Dread the Colonoscopy and Do It Anyway

The procedure is surprisingly bearable but the payoff is extreme in averting colorectal cancer. If you’re over 50, you need to do this, yes, need.

By: Al Valente

O.K. now that you’re 50 years or perhaps older, it’s time to have a procedure that nobody like to have…the dreaded colonoscopy. It involves swallowing your pride and allowing strangers to peer into your most private body part. But the procedure has actually become more humane in the last decade… and it most definitely can save your life.

News Anchor, Katie Couric lost her husband, Jay Monahan, to colorectal cancer in 1998. In her efforts to create public awareness about the disease she actually underwent a colonoscopy live on national TV. As Ms. Couric says, “A colonoscopy may not be on the top of your to-do list, but it is a lot more fun than being diagnosed with cancer”.

Unfortunately, colorectal cancer is a stealthy and insidious disease, when it advances, oftentimes totally unknown to the patient, it can be a hard battle to fight. Contrastly, if potential problem areas are detected and treated early, colorectal cancer risk can be virtually eliminated. So, dread it and do it anyway.

Advances in the procedure continue to move forward. As little as 15 years ago, one had to consume a gallon of horrible tasting fluid that tasted like sea water to cleanse the bowel, a tortuous task that could that could feel at home at Abu Ghraib . Today, with so many boomers having the procedure performed, colonoscopies and its precursor cleansing are far more humane and your dignity is far more preserved.

The Incredible Feeling of Emotional Relief When It’s Finally Done

When it comes to your health, ignorance is definitely not bliss. A time bomb can be ticking away in your bowel; it’s best to know if there is and to have the bomb diffused.

Conversely, what you absolutely do not know for certain, can be cause for needless worry. We often hear about the prevalence of colorectal cancer and its morbidity rate and secretly worry we may have it. But, we tend to play ostrich, and merely hope that we don’t have it.

A colonoscopy will unequivocally yield that answer within a week should a biopsy be taken.

When you get that clean bill of health, you have an incredible feeling of relief. It’s similar to the feeling you get when you have all those moles on your body, and you know you did too much sunbathing as a teenager, and suddenly your dermatologist tells you they’re all benign.

The really great news is that the early stage polyps are slow to turn malignant, sometimes they take as long as 10 years. So, when you get that clean bill of health from your doctor, you usually have a 10 year pass before your next procedure.

Colorectal Cancer – It’s Serious

Colorectal cancer is not to be taken lightly. It does not discriminate, except perhaps for age. It affects both men and women of all races. It is most prevalent in people over 50 years of age, which is why screenings should commence at that age.

According to the CDC, it is the second leading cancer killer in the U.S. In 2005, 37% of patients diagnosed with colorectal cancer died from it.

But the good news is, if treated early, it can be virtually eliminated before it occurs by removing polyps which could potentially turn cancerous.

Economics of Colonoscopies

Colonoscopies are not cheap. They are generally performed in a hospital. Even though it’s done on an outpatient basis, there is a prep nurse, a doctor that performs the procedure, the staff of nurses assisting her or him, and all those computers and probes.

If you had to pay for the whole thing yourself it could run between $2,000 and $3,000 depending on the medical clinic and location. That’s a tough expense to cough up for a test that most likely will come up negative.

If you do have health insurance, the co-pay can range anywhere from $200 to $500 depending upon your insurer. Again, most likely you’ll get a clean bill of health and you can spread that $500 over 10 years until your next procedure. That’s only $50 a year for a lot of peace of mind.

Alternative Routines

You can discuss other alternative testing procedures with your doctor. The costs will vary. Although a colonoscopy is most favored since they are both diagnosing and removing potentially hazardous polyps. Ff some of these other tests are performed, a colonoscopy may also have to be performed anyway. Here are some alternative measures:

Sigmoid Screening

Think of this a colonoscopy in miniature. A scope is still inserted but only views the lower 1/3 of the colon where generally most problems occur. This is still invasive but scaled down version.

X-Ray

In this procedure, a barium enema is performed and X-rays are taken. The doctor can view the health of your colon from the outside. Polyps and other problem areas can be identified. But, obviously if polyps are found another invasive procedure needs to be performed to remove them.

Cat Scan

This a virtual colonoscopy where 3-D imagery gives your doctor a picture of what’s happening on the inside. Similar to the X-ray, if you’re clean, you’re done, if not, another procedure needs to be performed.

DNA test

Exact Sciences, a Madison Wisconsin company, has developed a non-invasive laboratory-developed stool-based DNA testing service for the detection of colorectal cancer in the average-risk population. The big plus is that it is non-invasive, the downside is that there is no removal of polyps should they be found.

The Day of your Colonoscopy, What You Can Expect

Since a colonoscopy is a visual examination the large intestine which is usually busy doing its job and processing waste, the waste has to be totally removed. A colonoscopy thus requires a clean colon, one that’s totally devoid of stool.

The first thing that has to happen is your food intake is stopped, usually about 36 hours before your procedure.

The Last Supper

Typically, you will have your last supper, your last intake of solid food, the night before your all day fast and cleansing. Obviously, the less food in your system, the less has to be expelled.

Will you be irritable? Maybe, but, you are allowed certain clear liquids.

Many patients find that chicken bullion and ginger ale helps to keep you functioning the first 2/3’s of your fasting day until the cleansing treatment begins. You won’t feel like running a marathon, but you can be surprisingly functional.

It’s often a good time to reflect on how fortunate we are to live in a period and a country of abundant food (too much so given our level of obesity).

You’ll Sleep Through the Whole Experience

The actual colonoscopy procedure is a cake walk because you’re going to sleep through the whole thing. The day of fasting an cleansing that takes place the day before is the hard part.

You’ll have to strip down and put on a Johnny, a nurse will prep you and insert an IV along with a blood pressure cuff and pulse reader.

Then you just lie back and wait to get wheeled off to the procedure room.

For your part, sometime shortly after arriving at the procedure room the nurse will inject a sedative into your IV, and puff, you’re fast asleep. In rare instances, in cases of allergies or other reactions, an anesthesiologist may be on hand to administer special sedatives. And before you know it, you’ll wake up in the recovery room not believing it could be over.

The colonoscope has a tiny camera on the end that will transmit images to a computer screen. Your doctor will actually use a computer screen with the images she or he is looking at. Image of problem areas can be printed off for future reference. They will document any polyps that had to be removed, etc.

While the doctor is in there, he or she will remove any polyps found. The end of the colonoscope has a sort of loop that they can place around the polyp and snip it off and cauterize it to prevent bleeding.

You’re Done

That’s it. You will wake up, and you’ll be good to go for another 10 years. Your doctor may even give you photo prints of your insides, kind of like a star on the forehead.

So, what are you waiting for, discuss having the procedure done with your doctor today.

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