MERRY OSCOPY AND A HAPPY NEW COLON
By Andy Weddington
Friday, 18 December 2009
It's been one of those years. Our household is one year beyond winning a cancer battle. A high school classmate died of colon cancer a few months ago. An uncle died early Thursday morning--yes, yesterday--losing a tough fight with cancer. He kept his sense of humor to the end; ever smiling--maybe he knew something everyone else did not. Rest in peace, Jerry. And, thanks to Facebook, I've learned more than a handful of classmates from high school and college, and comrades in the Corps, have fought and beat cancer. The most recent, a dear friend from college I heard from last weekend, from out-of-the-blue, who I learned is a seven year breast cancer survivor. I was happy to hear from you "Maddy."
During the past year I've written several Commentaries addressing cancer. Not an especially easy topic to write about but a damn important one.
Life is not for wimps--cancer is proof. If you've been close to the disease you know the hell of it. If you've not been so close to experience your stomach turned inside out, upside down, tied in knots, and then iced with a cinch and wrench then consider yourself fortunate--at least for now. Odds are your day will come.
Until last year cancer was something that happened to others and usually to strangers. During the past few years a few acquaintances have been diagnosed but the disease still seemed distant. After my wife's diagnosis cancer is not distant anymore; it's personal. I get it and well know the stomach "disorder" described above.
After each Commentary about cancer I've received a handful of emails--usually from strangers passing along their personal ordeals battling cancer, stories about their family and friends; sometimes winning/sometimes losing, thanking me for taking time to write about the monster, and reminding me it's important to undergo age-recommended screening and asking if I have done so.
I appreciate the notes. And concern for my well-being. Believe me, neither an idiot nor gambler, I know all about the importance of screening and am on top of it. In fact, today I am going to reinforce that "the dreaded recommended screening once reaching the half-century benchmark" is no big deal.
Here's the tale...
The stories I've heard through the years about being scoped were funny. Funny solely because it had been someone else going through the rather embarrassing, invasive procedure. And the story tellers always added drama and humor--surely exaggerating the experience. Now it was my turn--a necessary part of life had finally arrived and it did not seem so funny--first, that I was that old and second, that I was going to be probed and inspected the entire twisting and turning length of Mother Nature's beautifully designed one-way 'exit only' route.
With a straight face, and what I believed to be a logical and impenetrable argument during my annual physical last year, I explained to the doctor why the timing was not good for me to undergo "the procedure." There was much on my mind and shoulders with my wife's less than week old diagnosis. I had no time. Nor was I in the mood for any more challenging news--should there be any.
The doctor listened attentively, nodded in agreement, and threw in an occasional "uh huh" for good measure. Reading her facial expressions and body language she was clearly coming around to my way of thinking. It was evident she was dazzled by my brilliance, flawless logic, and calm, mesmerizing delivery of every word. And, what relief I felt that my "sales pitch" was working. I was only moments away from hearing her say, "Absolutely, no need for you to be scoped. You look great. In fact let's wait five more years."
When I finally finished my rehearsed spiel, without so much as a moment of hesitation or batting an eye, she--a young Navy officer, at least fifteen years my junior matter-of-factly said, "Sir, I understand your current circumstances and concerns. Tough times and I sympathize. I can't truly imagine what you are feeling. But, this procedure is important. I don't know how this got by me last year but we need to go ahead and get it done--you are a year past the age we recommend beginning to screen. Let's proceed and make sure everything is okay. I will take care of scheduling your appointment with the surgeon."
In the other words that were not spoken due to military protocol, "Nice try, colonel. Do I look stupid? I am not buying any of your crap. You are going to get scoped and that's that. Got it?"
She was right.
I next met with the surgeon--he, too, a young Navy officer, was not any older than my primary care doctor. I believe he was a few years younger. It didn't look like he had to shave yet. He carefully reviewed my health record, asked some questions about family history, wanted to know about current fitness (it was painful to admit I could no longer run a sub 18 minute 3 mile run), and then nonchalantly explained the procedure from prep to recovery. He used an illustration or two--sketching on paper--to complement his layman's explanation. I didn't bother mentioning I could draw better than him. No point offending him considering what he was going to be doing to me in a week.
He came across as confident and competent, said he had done many of these, and the likelihood of something going wrong was practically non-existent while rattling off a few relevant statistics to ease my mind. I wanted to know anyway--learning a long time ago there is no such thing as a routine or risk-free medical procedure. And, I have always had the innate feeling that I would be the statistic representing "practically non-existent." Since I don't care for surprises, I asked my questions and the doctor answered. I was satisfied.
He said he does the procedure on Wednesdays. My interpretation: lines 'em up in the bullpen and typically does six or seven. Pretty much per Henry Ford's wonderful invention--the assembly line. Funny, in his eyes he probably felt like he was scoping Model T's. He said they'd first give me something to help relax and then use conscious sedation--won't remember a thing--the anesthesia wears off quickly and I'd be going home within a couple of hours; if not sooner. He continued and asked if I had any more questions. I did not. He handed me a page of instructions and told me to drop by the pharmacy before leaving the hospital to pick up the prep and said he'd see me in a week.
On the drive home through the desert it struck me the surgeon, at least when performing colonoscopies, is a spelunker of sorts--entering dark places with a little light and exploring twists and turns and crevices. And using tools, if necessary, to clip away (and mend) tissue along the route that does not belong. All done while weaving his way while watching a video monitor not having to worry about becoming bodily trapped in a tight space. Modern medicine is a marvel. Colonoscopies--so easy a caveman can do it. Sorry.
As an aside, my Dad recently told one of my brothers and me that during his procedure the surgeon actually had to summon for an extension to his equipment in order to reach the entire length of his organ. Dad thought it was hilarious. We laughed, too. Then realized it explained an awful lot from our youth--and in more ways than one.
Ah, finally, prep day arrived. The prescribed cleansing elixir was unflavored Golytely (flavors are for wimps)--a powder concoction at the bottom of a gallon-size, semi-opaque jug; just add water. I prepared it the night before and refrigerated per instructions--supposedly cold makes the taste more palatable.
I poured the first glass and drank it. Hmmm. Not bad. Think I'll have another. After the third glass it occurred to me that when I was a lieutenant there were times on liberty that I had voluntarily paid for and drank worse tasting stuff. And, did that more than once. The last time while celebrating with an Australian rugby team in a bar on Hilton Head. That was twenty-six years ago. Never again since.
Anyway, I was thinking this Golytely is not half bad--too bad it requires a prescription. And about that time the business of the Golytely worked as advertised--I felt like a mad scientist's chemistry lab--things were gurgling, bubbling, and moving. It was time to sit. And sit. And sit. If you subliminally read an "h" into the "s" word in the three previous sentences don't feel bad. I did too when proof-reading. Funny. And ironic.
Then I drank more. And sat more. Within about four hours the drinking and sitting was over. Turns out Golytely is the medicinal equivalent of Super Draino. Even better. Completely clears even the most stubborn clogs. Clean as a whistle. Now I just had to wait for morning and my turn in the chute for the OR.
The next morning, having not eaten in 24 hours, I reported to surgery. As you have probably already figured out, my procedure was done at a Naval hospital. The Corpsmen ever professional and efficient--as always. The anesthesiologist dropped by for a visit and, like the doctor a week earlier, reviewed the procedure. He gave me something to relax. I signed a form or two--I can't remember if that was before or after the relaxant. Surely it was before. I vaguely remember telling a joke or two to those tending to me. I don't even know that the jokes made any sense. They likely did not and the attendants were laughing at me--not with me.
Soon thereafter I remember being wheeled into the OR and eased from the gurney to a cold table and told to rest on my left side. Two or three--maybe more--medical staff were in the OR but I could not see any of them. The anesthesiologist was just out of sight, tending to my left arm, and talking to me--I've no idea about what. He could have been asking for bank account numbers, passwords, and pin numbers for all I know. The last words I remember him saying, "Here comes the doctor, time to get started (I felt a hand on my hip), good..." and it was lights out.
Next thing I remember is leaving the OR on the gurney and hearing the doctor say the procedure was routine and all looked good. Unlike my Dad, an extension for the snaking equipment was not required. The doctor said he'd see me in Recovery shortly. There were still a couple of "caves" to explore (patients in the bullpen).
In Recovery the doctor told me I was good for 10 years unless something unexpected popped up. Great news. He handed me a color photo of the inside of my colon along with a post-procedure note I asked he write for my wife: "Mrs. Weddington, your husband passed with flying colors and I can confirm his head is not up there." I considered posting the photo to accompany this Commentary but if you've seen one healthy colon you've seen them all. I don't think my wife kept the doctor's note. She didn't believe it and asked for a second opinion--from a female surgeon. Sorry, maybe in 10 years.
After meeting the Recovery Room discharge requirements (those who have been there know what I am talking about) blowing out air, I dressed and my wife drove me home. Within 48 hours of the procedure life was back to normal.
For the record, It would make no difference if the procedure were an annual requirement, I'd do it. It's no big deal. The experience confirmed there was no basis for apprehension or fear. Piece of cake.
A couple of weeks back I was in Texas and visiting with an acquaintance I'd not seen in nearly ten years. She told me since our last visit she beat colon cancer. Her story: She was in her early 60s at the time and was changing doctors. Her old doctor never pressed for a colonoscopy. Fine by her. Her new doctor, when learning she had never been scoped (well over a decade past due), insisted on it as soon as possible. Feeling fine (in the early stage(s) there may be no symptoms) she pushed back but the doctor persisted--he knew it was important and wanted to ensure a clean bill of health. She wisely went ahead with the procedure. Good thing she did--Stage 2. She's a six year survivor.
Colon cancer is a killer--it's the second most common cause of death in the United States. And, it's one typically thought of as a male disease. Wrong. Women are just as prone, if not more so, to colon cancer. Fact: only lung and breast cancer kill more women. Elizabeth Montgomery aka: Samantha Stephens (TV program "Bewitched") died in 1995 at age 62 from the disease--two months after diagnosis. She had ignored warning signs something was not quite right. Sharon Osbourne (Ozzy's other half) is a survivor. The bottom line (no pun intended): not undergoing a colonoscopy for fear of risks or diagnosis of cancer is irrational. It's insane.
Preventive medicine simply makes good sense. If you are 50 or older and have not had a colonoscopy then give yourself a Christmas present (they make great stocking stuffers, too) and schedule one--today. Or, make a New Year's resolution to get one scheduled as soon as possible. Early detection of colon cancer has proven to save lives. It's not only treatable--it's curable. If a family history of cancer, start at age 40--or sooner--and schedule one every five years; or so say the medical folks.
Believe me, the procedure is no big deal. Life is worth a couple of days of inconvenience and minimal risk. Don't be a wimp. No, I will not share the "sales pitch" I gave to my doctor. As eloquent as it was it did not work. For all the time I spent on crafting it I may as well have been polishing a fresh cow pie. And, don't listen to the exaggerated stories of others--the tellers are full of it; literally.
Okay, enough cancer.
"Merry Christmas and a Happy New Year!" And, "Happy Hanukkah, Kwanzaa, and Festivus, too. Oh, and Feliz Navidad. If I've overlooked or offended anyone...by my Season's Greetings or the recommendation to get scoped...well, I don't give a sit! Get over it. Tolerance is the two-way street of civility. Say, 'Thank You' and move on."
In the end, a scoped colon is a happy colon. Therefore, "Merry Oscopy and a Happy New Colon!" If you're angry or unhappy, go "elf yourself"--here's the link: http://www.elfyourself.com/. A smile guaranteed.
Now some 18 months post-scope and looking out for the health and welfare of our country, I suggest our president's personal physician prescribe Golytely for immediate use. Though Mr. Obama is a few years shy of meeting recommended age guidelines for initial scoping, the recent self-award of B+ for performance during his first year in office indicates the need for at least the prep portion of the procedure.
In our democracy--and it is still a democracy--the public, through polls, is the grading authority. At present, the president's approval numbers are in the low 40s (100 point scale). That is nowhere near a B+--even on a generous curve.
The sign prominently displayed behind the desk of a demanding but fair battalion commander whom I once served under: "Do Not Confuse Effort With Results." Enough said.