Sunday, May 07, 2006

High-Fiving Where the Sun Don' t Shine

All three colonoscopies didn't hurt. In fact, the only thing I remember of them was the sweet dream a little versed and dilaudid can induce. The first could actually be my first anatomy class. Some previous girlfriends would beg to differ!

I was 17 years old and after years of digestive problems I finally earned a trip to where ‘the sun don’t shine’. They tried to knock me out but didn't quite get it right. Seeing the inside of my own body was, I thought, 'so cool'!

Recently, I saw a commercial on television featuring patients exiting the colonoscopy suite high fiving everyone outside. I'm not sure it quite captures the mood of relief after the experience but kudos for the public awareness campaign. I'd rather spread the word about a possible life saving colonoscopy than about the HPV test no one really needs, or the Viagra. Personally I think they should follow every Cialis commercial with one for genital herpes. But I digress.

Colon cancer is the second most common cancer in both men and women and is responsibly for nearly fifty thousand deaths per year. This year alone, 150,000 people will be diagnosed with this disease.

Although there is no study proving that colonoscopies prevent colon cancer there is a lot of indirect evidence to support this hypothesis. Early carcinomas have been found in adenomas and the distribution of the two in the colon is very similar. Guaiac stool cards have been found to decrease the rate of colon cancer, presumably because they lead to a colonoscopy.

I understand the recent popularity of virtual colonoscopy, however, from this perspective I can say it's "virtually" useless, for anything other than making the radiologists richer. The preparation for the procedure is exactly the same and at least during a colonoscopy the patient receives sedation. Furthermore, during a colonoscopy, if something is found it can be resected immediately. If a cancer or polyp is found on a virtual colonoscopy the patient will need a real colonoscopy to boot. Bottom line, from the perspective of a three time veteran of colonoscopy the prep is by far the worst part of it and it's not any more comfortable for a virtual colonoscopy.

And this is the most important reason for getting your colonoscopy. There are only a handful of cancers for which prevention is effective, the rest are either screened for (to identify those who already have the disease) or not even screened for (no effective test). A colonoscopy can not only screen but at times can actually be curative.

It seems a complete waste when a father or a grandmother dies from a CANCER that could have been cured in a matter of minutes years earlier.

So get past your homophobia and get a colonoscopy if you need one. It rarely hurts, I promise.

And take my word for it; a little Versed is a lot of fun!

90 Comments:

Anonymous Catherine said...

Because of undiagnosed internal bleeding, I was scheduled for both a colonoscopy and an endoscopy on the same day. I agree with you heartily when you say the prep was worse than the procedures. Whoever developed Golytely must have graduated from the Marquis de Sade school of medicine!

I had the colonoscopy first. Though Versed had been administered, it hadn't fully kicked in and I was aware of the procedure. As with you, I thought it was cool to watch my own Fantastic Voyage thru my colon. At one point, the doctor asked the group a question, "What in the world is that?" I looked at the monitor and had to laugh. It was a caraway seed from the rye bread I'd eaten the day before. (Take that, Golytely, we're even!)

About at that point, the Versed took over and I remember nothing more of the colonoscopy and absolutely nothing of the endoscopy.

Diagnosis: Several benign polyps removed and the discovery of a paraesophogeal hernia and bleeding ulcer.

Because of the discovery of the polyps, I'm scheduled for my next colonoscopy in five years. As you said, the procedure isn't anything to avoid out of fear or embarassment. The Versed will take care of that. I think that our awareness is probably on the rare side.

9:04 AM  
Anonymous Anonymous said...

I absolutely agree that everyone over 50 should have one and those of us under 50 with a positive Guaiac certainly need them.

Just a note here, I had my endoscopies (six to date) and my one colonoscopy all without any sedation but 50mg Demerol IM. And it wasn't bad. Watching the monitor, practicing deep breathing and not having to deal with the whole IV sedation possible side-effects made it work fine for me. Truly, I'd rather have a colonoscopy than my last pap smear.

Point is, I think the prep is a hassle (I used Visicol tablets) and probably will have another because in the grand scheme of things, it is so important.

It's worth it, with sedation or without.

6:43 PM  
Anonymous Kim said...

Ah....just the idea of versed is enough to get me to the colonoscopy in time....
I'm a year and a a half away from fifty, so......my time is coming!

2:28 AM  
Anonymous Anonymous said...

I've had two..and both were torture. Not enough of any drug to keep from writhing in pain. Point me to a doctor that actually believes that these things hurt and will provide decent meds and I'll get the third one I need.
Until then, no..no..and HELL no.

7:02 AM  
Blogger Nurse Practitioners Save Lives said...

Versed is a wonder drug! I had a colonoscopy and didn't feel a thing. I agree that the prep is the worst part! Speak to the anesthesiologist prior and make sure that they are aware that you want a great trip! How about a link doc??

7:28 AM  
Blogger Elisson said...

Versed and colonoscopies...perfect together.

As I was recovering from my procedure a few years ago, I asked, in my Versed-induced haze, whether I was leaving a vapor trail. So say the nurses: I have absolutely no recollection of it...

9:02 AM  
Blogger Peg said...

I agree the prep is the worst part...I guess there are pills for it, but from what I understand the gallon of yuck they have you drink still works the best. I remember nothing of the procedure except when they took my benign pollup out I remember yelling OUCH! They pushed more happy medicine and back to slumber I went...never saw a thing. The best news was getting the results of the biopsy that said not only was it not cancerous it was also the kind that doesn't turn into cancer and I now have a 10 year "warranty" on my colon :) I was only 42 when I had it done because of unexplained abdominal pain. It really is nothing to be afraid of and I wouldnt put off doing it if your age calls for it or you have symptoms that require it earlier.

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Blogger Internal Medicine Doctor said...

catherine: golytely is evil personified!

nurse practitioner: I spoke to the anesthesiologist and made myself QUITE CLEAR!

Ellison: I will post the top ten things people said during a colonoscopy sometime. it's hilarious!

Peg: "happy meidicine"...I never heard anyone call it that although I would say it's right on

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Blogger IML said...

A timely article. My husband went to get his hemorrhoid removed this morning.He was encouraged to go for a colonscopy as all adults over the age of 40 are encouraged to do so. I am glad he did. Only discomfort, he had to drink 2 liter of a mixture to flush the system the night before.

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Blogger Dr. Charles said...

great reminder, thanks man.

10:55 AM  
Blogger Carol said...

Two thumbs up for my favorite "V" words:

Versed and Valium.

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Anonymous Anonymous said...

Would it help to realize that for about half of us, anxiety has nothing to do with homophobia...

Maybe heterophobia, fear of sexual assault, rape... but not homophobia.

8:56 AM  
Anonymous Anonymous said...

It's not the test itself, most thinking people understand that what your're asleep for doesn't hurt. It's the prep for the test and that has nothing to do with homophobia. It has to do with the fact that I don't necessarily enjoy sitting on the toilet wrapped in a blanket and drinking go-lytely for several hours then going into a test that for some reason I've associated in my head with gulloting shrimp. I've had it done this year and I don't have to go back for 5 more, yeay!!!

5:20 PM  
Anonymous Anonymous said...

A good friend was recently talked by another friend into going for her first post-50 colonoscopy, which her PCP had neither mentioned nor (once asked) particularly encouraged (why? his referral rate was too high?) -- primary cancer was found, surgery followed, so far so good. DO IT. The Versed is worth it and oh yes the peace of mind.

9:30 AM  
Anonymous Anonymous said...

One year after my first colonoscopy and almost a year with a therepist trying to stop the panic attacks and terror attacks caused by having a severe reaction to the Versed and Demerol. The prep is the easy part. If I had known this is what those drugs did to you I would never had agreed to the test. I had a good life before and hope to someday get it back.

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Blogger ditzydoctor said...

eeks i'm scheduled for my first ever endoscopy (OGD) sometime soon to check out my recurring achalasia, and i'm quite terrified after watching my tutors perform them. it looks brutal! but reading your post on colonoscopy sure makes me feel alot better, so thanks! =D

7:23 AM  
Anonymous Anonymous said...

Everytime I turn around, one more person is after me to "just go and get it over with"!

Ok, ok, I will!

Thank you, just another patient..

9:17 PM  
Anonymous Anonymous said...

sorry-colonoscopy with the date-rape drug Versed is a painful, horrible experience..it;s given for amnesia-they want you to forget the abuse that you undergo by uncaring and sloppy dosctor's...........sorry, it's the truth

4:54 PM  
Anonymous Anonymous said...

just an additional comment by a nurse-if you have to have a colonoscopy-you don't want the drug Versed (midazolam)....it's patient-abuse; plain and simple....lot's of people are hurt by this awful drug...."you won't remeber a thing".....welcome to the group of patients who are haunted by the colonoscopy "experience".....with this horrible amnesia drug....just remember..it doesn't work in a lot of people and you will regret it............

4:59 PM  
Anonymous Anonymous said...

from the anesthesia world- we like you to have Versed (midazolam) so you are immobile and can't complain...no matter what is done yo you, you probably won't remember the terrible experience until after you get home; by then nobody cares............

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Anonymous Anonymous said...

Hi,

I have another colonoscopy this thursday. This will be my 5th one. I have to get one every year due to a rare gene that was discovered in our family that leds to colon cancer. I seen my two brothers (age 21 and 27) pass away from this horrible diease which could have been prevented by a simple colonoscopy. Please get it done. I take a product called fleet for prep. It's a 45 ml bottle (couple of ounces). I take one in the morning the day before with grapefruit juice and one in the evening. It does the trick. I tried everything else on the market and it's the only one I can take. My only complaint during the test is the cramping pains, is there something I can do about this?

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Anonymous colon cleansing diet said...

I had a colonoscopy when I was 39 (I'm now 49). It was recommended because I had blood in my stool.

The colonoscopy is a breeze and they found three very large polyps (not cancerous). The doctor was very surprised at how big they were and said if I had waited much longer it wold defenitly be cancerous. A folow up colonoscopy 2 years later found everything normal, go back for another one in 2 years.

I guess I'm lucky that a simple hemroid made me get my first colonoscopy at an early age and I would suggest anyone with a family history of colon cancer to get checked out early, it really is not that bad.

5:29 PM  
Anonymous Anonymous said...

"Ellison: I will post the top ten things people said during a colonoscopy sometime. it's hilarious!"

One more reason NOT to get a colonoscopy - the destruction of yoru dignity by health care workers.

Here's the truth about colonoscopies:
1) There is no research to support a reduction in colon cancer deaths because of the use of this procedure.

2) The risk of getting a perforated colon from this procedure (two in one thousand) is actually higher than your risk of getting colon cancer.

3) There are risks associated with anesthesia, including early dementia, etc.

4) A polyp can become malignant in less than 90 days so the advice to get a colonoscopy after age 50 and one every five years is useless. You could have this done in January, be told you are clean, and then develop malignant cancer by Spring.

Only bother with this test if you have a family history of cancer. The risks are too high to confer any benefit on anyone else.

9:53 AM  
Anonymous Anonymous said...

The risk of long-term memory loss due to Versed or similar drugs is just too great.get the exam with nothing or with painkiller only; but you have to search for a doc to do this. Unsedated, they have to go slow and careful; if you are a sedated, zombified and amnesic patient, they go fast and do a really dangerous, crummy exam.

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