Tuesday, July 7, 2009


This post is about a colonoscopy, so some portions may exceed your allowable gross-out factor. In fact, I loved teaching pathology at the college, so I might get a little out of control. Just be warned.

You like that brown font color? Heh.

I had my colonoscopy yesterday.

I posted a blurb about this a few days ago, but let me refresh your memory for some statistics: colorectal cancer is the third most common form of cancer and the second leading cause of cancer-related death in the Western world.

It killed my grandmother.
My mother has gotten part of her large intestine removed.
It doesn't like my family.

So, I started getting screened early. Typically, you start at 50, but, because of the family history, I got my first one at age 48, with 2 polyps snipped out then. Polyps themselves are usually benign, as mine were, but if left alone, they may turn cancerous later. And their presence predisposes you to developing nasty, angry ones later in life.

I CANNOT overstate the importance of regular screening.

On to the story.

First of all, there is no way I can write about this and be as entertaining as, say, Dave Barry. So, I'm going to let you read his account of the procedure. At least I think he wrote it. Sounds like him. My mom sent it to me in an e-mail.

The Colonoscopy Journal

I called my friend Andy, a gastroenterologist, to make an appointment for a colonoscopy.

A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis. Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner.

I nodded thoughtfully, but I didn't really hear anything he said, because my brain was shrieking, quote, 'HE'S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!'

I left Andy's office with some written instructions, and a prescription for a product called 'MoviPrep', which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America's enemies.

I spent the next several days productively sitting around being nervous. Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn't eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then, you fill it with lukewarm water... (For those unfamiliar with the metric system, a liter is about 32 gallons). Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes - and here I am being kind - like a mixture of goat spit and urinal cleanser, with just a hint of lemon.

The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, 'a loose, watery bowel movement may result.' This is kind of like saying that after you jump off your roof, you may experience contact with the ground.

MoviPrep is a nuclear laxative. I don't want to be too graphic, here, but: have you ever seen a space-shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom, spurting violently. You eliminate everything. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.

After an action-packed evening, I finally got to sleep.

The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, 'What if I spurt on Andy?' How do you apologize to a friend for something like that? Flowers would not be enough.

At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the heck the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.

Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep.

At first I was ticked off that I hadn't thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no choice but to burn your house.

When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand.

There was music playing in the room, and I realized that the song was 'Dancing Queen' by ABBA. I remarked to Andy that, of all the songs that could be playing during this particular procedure, 'Dancing Queen' had to be the least appropriate.

'You want me to turn it up?' said Andy, from somewhere behind me. 'Ha ha,' I said. And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.

I have no idea. Really. I slept through it. One moment, ABBA was yelling ' Dancing Queen, feel the beat of the tambourine', and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that It was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.

No doubt, when good ol' Dave thought about what was going to happen to him, he envisioned the feeling as something like this . . .


I knew that wasn't quite accurate. I've had one of these before, so I kind of knew what to expect. But time can ease the pain & dull the memory. Previous experience aside, in order to do this, you have to leave every single shred of your dignity at home. Even more so than for childbirth. At least with childbirth, everyone's careful & very public scrutiny of your naughty bits at least gets you a precious baby for your humiliation.

This? They aren't interested in anything so sentimental. All that careful scrutiny of your hind parts is purely for their fascinated interest in your bowels and what emanates from them. Nice.

If you've ever done this before, you know the worst part isn't the procedure itself. It's THE DAY BEFORE.

My mise en place for Sunday's eats:

I didn't drink the horrid stuff this time. Noooooo. This time, I was smart and asked for the horse pills.

Doc: Swallowing pills doesn't bother you?
Me: No, I love to swallow pills. Wait, that didn't sound right.

Truth is, I am an expert at swallowing pills. Wait, that didn't sound right. But my mother made sure we learned how to swallow pills at a young age, and I am very grateful for the lesson. We even used to have contests to see who could swallow the most vitamin C pills at once. Vitamin C is benign stuff. You can't OD on it, and any excess just gets pee'd out. So, given a choice between drinking foul liquids or taking a bunch of pills, I'll take the pills, thanks.

My food intake on Sunday consisted of 2 banana popsicles, a bunch of white grape juice with some strained limeade to kick it up, jello, and water. I decided not to have any of my homemade chicken broth after all. Just wasn't in the mood.

Then, at 5:00 pm, the horse pill regime started. Every 15 minutes, I take 4 pills with 8 oz of liquid for a total of 20 pills. Then, I wait . . . .


The anal sphincter is an amazing & incredibly strong structure. I have a newfound respect for it, as I did not leave any skid marks on my underwear all night. Although, that's not what would have happened anyway, if you know what I mean.

The sensation was like peeing out your butt. Seriously. Just relax that sphincter and Dave's geyser analogy isn't far off. It is a very odd sensation. There is no pushing or straining at all. Just the opening of the faucet. It's really very unsatisfying - you never feel 'empty'. In fact, when I mentioned this to BS, we had a lovely warm & fuzzy heart-to-heart conversation comparing that particular sensation to the male urine stream after 3 beers. I recall his boastful comparisons to fire hydrants and sandblasters, as well as games of aiming at things in the toilet. Ahhh, special moments between mother & son.

Anyhoooo, needless to say, I didn't get my 8 hours that night. The horse pill sequence was repeated in the wee hours of yesterday morning. Seriously, like Dave, since I had to go again when I got to the office, all I could think of was the hideous scenario of some residual Old Faithful being in there when they inserted the probe. ~s~h~u~d~d~e~r~

I even took my camera with me to document the whole thing, but my batteries died after 2 pictures. Sigh.

My blood pressure was equally lovely - 117/68

See the looooooong tube?

I did, however, ask for a little less anesthesia so I could watch on the monitor. The doc kind of smiled knowingly, and pretty quickly, I had a wee change of heart.

Me: Okay, it's really starting to hurt. Can I have some more stuff now?
Doc: Heh.
Me: Ahhh, that's....... better.......................

Then I woke up in recovery. See, here's the thing. They did what is referred to as a "flip" or "double-ender" on me, as they had to do an endoscopy (technically an esophagogastroduodenoscopy) to take a peek down my throat because of my reflux (for which I have been essentially taking Prilosec for the last 10 years). You can bet your sweet bippy I was asleep for that one. I had a polyp removed there 9 years ago.

I recovered at my mother's condo-on-the-beach, fully intending to gaze out at her view whilst lounging in the easy chair. What really happened was that I slept all afternoon (snoring, according to her) and woke up with a horrendous sore throat. BS came by after awhile to take me home after we all ate leftovers of sloppy joes & broccoli salad. Yum. And I got to bring home the rest of the sloppy joes. Thanks Mom!

The sore throat only got worse as the evening went on, and when I woke up this morning, I could barely swallow and it hurt to talk. It was deep in my throat, about the level of my collarbone, way beyond the reach of a soothing salt-water gargle. Drinking was agony, and eating anything was torture. I sounded like a frog, much to the amusement of anyone I spoke with today, and none of it eased until late in the afternoon, as I type this (4:37 pm).

The verdict?
Colonoscopy: 3 polyps (non-cancerous) removed and sent for biopsy.
Endoscopy: gastritis (biopsy sent), hiatal hernia (not a big deal), tight upper esophageal sphincter (which he dilated), and continued prescriptions for Prilosec, or it's generic equivalent.

My butt feels fine.

If you have never been screened before, don't put it off for fear or humiliation. You won't feel a thing. You won't notice anyone poking around your nether regions. You will be asleep. Hey, the docs & nurses get paid to do this, it's no big deal for them.

Many thanks to Dr. Jan Janson of Gastroenterology Ltd. in Virginia Beach. You are kind, skillful, and funny! You made it all very easy.

All in all, it was great fun.

edited to add: I scared my mother this evening when I spoke with her. "Are you sure this is Kathy?" She thought it was BS pretending to be me. And she heard me when the voice had improved. My co-workers heard me when it was at its worst. I've been told that next time I have to write 'singer' across my forehead so they'll use a smaller tube.


Sista G said...

Well - how full of vivid images in our minds and colorful metaphors!! Didn't one of our paternal grandparents have colorectal cancer, too? Maybe I'm mistaken...
I get my next 5 year C next August, due to the fam history. I'm gonna take horse pills, too - thanks for the idea. Yes, we were raised taking pills.

Kathy said...

Grampa was prostate cancer (that's why Daddy was so scared of his), and I thought Grama was heart.

BS had great fun describing the proud male pee rituals. The fruit doesn't fall far from the tree, eh?

Pills are definitely the way to go - 4 at a time with 8 oz of liquid. Do that every 15 min, 5x at night & 3x in the morning. I found that easier than drinking it all at once.

Gwendolyn said...

Kathy you are one hecka of an instructor...get your @#% back into the classroom...the world needs you.

Kathy said...

Awww Gwennie - you're biased.

Hairball said...

Seriously, like Dave, since I had to go again when I got to the office, all I could think of was the hideous scenario of some residual Old Faithful being in there when they inserted the probe. ~s~h~u~d~d~e~r~

I was thinking about what might happen if you got stuck in traffic on the way to the appointment.

Anonymous said...

Wow... you summed it all up exactly as I experienced it two years ago (I'm 49 now). Same reason: family history. I'm going back in tomorrow, and am drinking my broth as I type this.

I keep trying to get friends who've never had a C, and who are at or over 50 (some much over) to go. Like my wife says, "hey, it beats ending up with a colostomy bag!"

You're right - the prep is FAR worse than the procedure. That's the easy part. The best part though is going out to eat breakfast after about 36 hours of fasting. :-)

Great blog!