Monday, August 25, 2014

Just Get Your Colonoscopy!

That's right. I'm going there. I admit it, when I turned fifty and the doctor started recommending a colonoscopy, I put it off. I didn't want to do the prep and I didn't want the long tube snaking through my guts. I just kept putting it off until I was fifty-two and my mother mentioned that her mother died of colon cancer. This was news to me. My mother always said that my grandmother died of heart disease. I checked with my sisters. Yup, that's the story they got-heart disease. But my mother had gone for a colonoscopy, and they found some precancerous polyps, and she suddenly remembered that her mother had died of colon cancer. Go figure.

Well, whether or not my mother is an unreliable narrator, I decided it was time to bite the bullet and get the procedure done, so I went for a consultation. The doctor assured me that he had done hundreds of colonoscopies, that it was quick and painless, that they would sedate me and I wouldn't even remember what happened, and he'd be glad to fit me in that very week. Lucky me!

I still wasn't very enthusiastic, but I went down to the drugstore and got a gallon container with some powder. The pharmacist explained it all very carefully. I was to mix the powder with a gallon of water and drink three fourths of it the day before the procedure, and the remaining fourth four hours before the procedure. He also warned me that if I didn't follow the directions faithfully, the doctor wouldn't be able to see anything and I'd have to come back and get another gallon container.

My test was scheduled for 8:30am Friday morning. I ate as I pleased up until 6:00pm Wednesday evening, then I didn't eat at all on Thursday. I drank a lot of clear tea, and at 5:00pm, I mixed up the powder and started drinking. It wasn't as bad as I thought it would be-it tasted like lemon flavored Gatorade. True, I hate Gatorade a lot, and I don't like to drink large amounts of liquid at any time, but I managed to drink the amount I was supposed to get down.

I was afraid it would make me feel sick, but it didn't. It did cause diarrhea, so much so that I basically sat in the bathroom until it stopped, but it wasn't the painful cramping kind that you get when you're sick. It just caused everything to run out. I wasn't looking forward to doing it all again at 4:30am (remember, my test was for 8:30am and I was supposed to finish the liquid off four hours before the test) but since I had already started, I might as well do a good job of it. As it happened, I did have some cramps, not too bad but enough to make me want to get up at 4:00 and start drinking again. The nurse explained later that the cramps were from the bowel continuing to try to work with nothing to work on.

The great advantage of having a colonoscopy is that they take you promptly at your appointment time. Your gut is all cleaned out, and even without food, normal metabolism will continue to clean waste out of your cells, so they're not going to dilly dally. I was taken right in for the test, and I must say, it was the easiest part of the whole procedure. They sedated me, and I woke up in the recovery room. It's a bit disconcerting to think I was awake and I don't remember the actual test, but considering what they were doing, I don't mind. I felt a little sick all day from the sedation, and it took a little while for my bowels to get back up to speed. I take probiotics, and that was helpful-after all, when you clean out your colon, you're also cleaning out all the helpful bacteria that live in your colon, so you want to replace them as fast as possible.

Bottom line-of course the pun is intended! They found one precancerous polyp and removed it. The doctor recommends another colonoscopy ten years from now. I think I can handle it. So why did I want to write about something so personal?

For one thing, the doctor told me some pretty disturbing statistics. Colon cancer is the third leading cause of cancer-related deaths in the United States. The American Cancer Society estimates there were 96,830 new cases of colon cancer and 40,000 new cases of rectal cancer in 2014. The death rate has been dropping for more than twenty years, thanks to screening, which finds polyps and removes them before they can develop into cancer. It also finds colon cancer in the early stages, when it's much easier to cure. And yet, only half of the people who should get screened, do get screened. I get that. Like I said, I put it off for two years. The prep is time-consuming and unpleasant. I wouldn't put it higher than unpleasant, but some people just don't want to do anything unpleasant. Colon cancer is a lot more unpleasant than a colonoscopy, but nobody ever thinks they're going to get cancer, so screening gets put off. It doesn't help that there are a number of people out there who put out misinformation about colonoscopies and encourage not getting them.

Are there risks to a colonoscopy? Of course there are. There are risks with any medical procedure. The bowel can be punctured, the site where a polyp was removed can start to bleed and require surgery, you can have a bad reaction to the sedation. You can also get into a fatal car accident driving to the doctor to get the test. The benefits far outweigh the risks. What's a day or two of minor misery compared to the peace of mind of knowing that you are cancer free? Or that something was found and fixed before it could ruin and possibly end your life?

Here are the risk factors for colon cancer. If you have one or more, and your doctor recommends getting a colonoscopy, get it done. It's a cliche but it's true. The life you save could be your own.
Older age. The great majority of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.
African-American race. African-Americans have a greater risk of colon cancer than do people of other races.
A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.
Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.
Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.
Family history of colon cancer and colon polyps. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.
Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat.
A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.
Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.
Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.
Smoking. People who smoke cigarettes may have an increased risk of colon cancer.
Alcohol. Heavy use of alcohol may increase your risk of colon cancer.
Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.