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About the cover

  D e s e r t   E x p o s u r e  September 2010


The Inside Story

That dreaded colonoscopy (and the even-more-dreaded day before) — what's it actually like?

By David A. Fryxell

This is not going to be one of those Katie Couric or Harry Smith colonoscopy stories. You probably recall how the former "Today Show" co-host and the co-host of CBS' "The Early Show" both allowed their colonoscopies to be televised in order to promote this important but squeamishness-inducing cancer-screening procedure. (Couric now also works for CBS — which, despite appearances, does not stand for the "Colonoscopy Broadcasting System." Though it would not surprise me if there were a Colonoscopy Channel somewhere on cable by now, between the Golf Channel and the Skydiving Network.)

For starters, this is the much more demure world of print; you will not see so much as a grainy black-and-white photo of me in a hospital gown. Then there's the fact that neither Katie nor Harry likely had so much trouble scheduling the procedure. (Although, as you'll see, the early-morning theme of both the "Today Show" and "The Early Show" does indeed continue in my own first-person journalistic saga.)

I was all set to do the right thing (albeit a bit late — you're supposed to get this test right when you turn 50) back in March, before my wife's turn on the table. I'd visited my doctor and gotten the referral to a local surgeon. I went for the pre-procedure exam at the surgeon's office, which mostly consisted of filling out a lot of forms following by a brief prodding and probing of my abdomen. My colonoscopy was scheduled and I filled my prescription for the "prep" goop that leaves your insides squeaky clean. I'd sworn off aspirin and ibuprofen and ratcheted down my diet. I'd cut out corn, nuts and seeds for three days prior to the procedure. The Nu-lytely prep powder was mixed with a frighteningly large amount of water and set in the fridge the night before (a tip from the pre-op nurse to help make it more tolerable for guzzling).

At eight o'clock on the morning before my colonoscopy, I was lollygagging a bit in the bathroom, trying to postpone the inevitable, when the phone rang. I was literally a walk down the hallway away from downing my first glass of Nu-lytely and launching into a long day in the bathroom when my wife hollered to say my procedure had been postponed. The doctor was sick — his hands were shaking, never a good thing in someone whose job it is to probe your insides — and I'd been given a last-minute reprieve.

I felt like one of those death-row prisoners who get a call from the governor after they've already been strapped into the electric chair.

After a few months, however, I was just ready to get the dang thing over with.

Because of a long-planned and non-refundable vacation (which I'd carefully scheduled after the original colonoscopy date), I couldn't reschedule until mid-June. (The original procedure had been smartly, I thought, planned for soon after my birthday; this would be just before our anniversary, so as not to interfere with any celebratory dining plans.) In the meantime, despite my best intentions to be a pioneer, my wife had her own colonoscopy; her experience went a long way toward alleviating my worst fears about what was in store.

The other thing I learned — almost the hard way — is that of the two days my surgeon does hospital procedures, Monday and Thursday, it's smarter to go for Mondays. They don't call you with the time you actually need to show up at the hospital until about noon the day before — or, for Monday procedures, on the preceding Friday. For Thursday appointments, that means The Call comes when you're well into the dreaded "prep" and there's no turning back.

When The Call came for my Monday procedure in mid-June, however, it was on Friday — when that gigantic jug of Nu-lytely and my day on the throne were still a day and a half away. So when the hospital told me I should show up at 2:10 — in the afternoon — for a procedure that would start (supposedly — you know how medical schedules slide) about 3:10 p.m., I had time to balk. That would mean no food all day Sunday, just liquids and Nu-lytely, and nothing at all — not even water — from midnight until mid-afternoon on Monday.

Nope, sorry, not happening.

The wonderfully understanding nurse at the surgeon's office agreed — since this was, after all, merely a screening procedure, not an emergency — to reschedule me for July. This time (since we'd arrived at this point originally due to the surgeon's illness), they'd let the hospital know that the surgeon wanted me scheduled as early in the day as possible. (Emergencies and diabetics who can't handle fasting very long get first dibs.) Great.

Then my father-in-law passed away at the end of June and all the carefully planned schedules in our lives went out the window. Although I figured I'd be back in time for my July date with the doctor, there was no telling when my wife could return. And I needed a post-anesthesia ride from the hospital, not to mention the moral support. So I called again and rescheduled again for mid-August. (Keep in mind that I also have to plan these things around Desert Exposure's monthly schedule. Tough to deliver bundles of papers, for example, while interrupting every 10 minutes to run in search of a men's room.)

The Call from the hospital came about 11 a.m. on the Friday before (I was still sticking with Mondays, just in case). Never before have I been so glad to be told I had to be somewhere at 6:30 in the morning.

So why go through all of this, anyway? According to a study by Dr. Thomas D. Sequist of Brigham and Women's Hospital in Boston, and colleagues, published earlier this year in the Archives of Internal Medicine, "Colorectal cancer is the secondary leading cause of cancer mortality [death] in the United States. Screening programs involving fecal occult blood testing, flexible sigmoidoscopy and colonoscopy lower the incidence of colorectal cancer by removing precancerous adenomas, detect cancers at more curable early stages and reduce colorectal cancer mortality." Although national guidelines suggest that average-risk adults age 50 and older should be screened for colorectal cancer, only 60% actually report up-to-date testing.

According to the American Cancer Society ((www.cancer.org), "Regular screening can often find colorectal cancer early, when it is most likely to be curable. In many cases, screening can also prevent colorectal cancer altogether. This is because some polyps, or growths, can be found and removed before they have the chance to turn into cancer."

I'd read a lot about the new "virtual" colonoscopy option, which sounds great at first: Who wouldn't want to just go through this "virtually" (I envisioned one of those Wii games) instead of, well, you know? Unfortunately, I learned, you still have to "prep" for a virtual colonoscopy — and it's the prep that everyone says is the worst part. With light anesthesia, you're barely supposed to be aware that the actual procedure is happening.

Worse, because a virtual colonoscopy can't remove any polyps that might be discovered, if the surgeon does find anything, you have to go through the whole rigmarole again — non-virtually this time, if you get my drift.

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