Wednesday, October 1, 2014

Colonoscopy and Upper GI

By Rob Watson

I am writing this for the benefit of my nieces and nephews who share my family history, and for those who might need one of these, or are just curious. In the interests of full disclosure, you should know there is no part of this experience that is in any way pleasant, uplifting, or enlightening. But, as they say about getting old, it sure beats the alternative.

I am currently two hours into recovering from my most recent Colonoscopy and a new experience, an upper GI... something. I have a family history of colon polyps. I have experienced a few sorts of inspections down there from about the age of 14. Nothing was found in the early years. I had a sigmoidoscopy about 1991 but cannot remember any results. I began colonoscopies in 1994, with one every 3 years or so sense. They have produced both benign and precancerous polyps in every inspection, always several, sometimes many, until today.

The process begins with an initial appointment with a Gastroenterologist. Here you should experience some parts of a physical examination and extensive questioning about your health history and current health. This is mostly done by trained healthcare professionals (THP). When these have been covered, the doctor reviews them, then comes to meet you and review all that has gone before. A date is set for your 'procedure'. You are also given a set of instructions for you to prep yourself for that procedure.

Those instructions include no solid food for 24 hours before the procedure. In fact no murky liquids either, only clear liquids, with nothing red or purple. Jello is OK. For some reason, and in contrast to normal fasting, I do not recall feeling hungry during this time. In the late afternoon or evening, you will be given something to drink, which can, regardless of the choices, only be characterized as awful. If you are lucky, it will not be terrible. My current experience included stuff that was so sickly sweet it threatened to come back the way it went in, instead of going out the other end. Your last instruction will be nothing, food or drink, after midnight, not even water.

This material is designed to clean you out, literally flush all contents from mouth to anus. With numerous visits to the toilet, you will quickly begin to expel solids, the soft materials, and so forth until nearly clear liquids are produced. I was allowed to watch my first colonoscopy. My colon was as clean as the pictures on the doctors walls.

On arrival at the medical center you will be greeted by pleasant helpful people. My former Gastroenterologist was a bit of a sour puss but he was the exception. You need to get use to being asked why you are there. (I will mark the times with *)It seems to be a test of your mental acuity rather than some need to know on their part. In today's experience I was checked in without delay* and given one of those call devices you get at a busy restaurant. No nurse hollering your name from the door. I went in to have my records checked and reviewed*. After a short wait was called to be preped for the procedure*.

*First you are connected to a heart monitoring machine to take heart rate, blood pressure, and blood oxygen level. You are given privacy to remove all your clothes and jewelry and don one of those hospital gowns that gap open in the rear. I was given a soft and pre-warmed blanket with which to cover on a nice soft bed. (In contrast, old sour puss had me lie down on an ice cold stainless steel table. No blanket.) *An IV is established in your hand and secured with tape. *The anesthesiologist meets me and asks if I have a family history of problems with any anesthesia and asks if I have any questions for him. *A HCP comes in, calls up my history on a computer and reviews all the entries with me. Wife is brought to the room to keep me company until the surgical room is ready. After a short wait,* a HCP appears, gives Wife instruction on where to meet me in the recovery room and rolls me to the operating room. *Here, a number of HCP get busy connecting me to monitoring machines and an oxygen-through-the-nose plastic tube. The anesthesiologist appears and tells me to keep my eyes open. (others may ask you to count backwards)

After what seems like an pleasant nap, I wake up in another room with Wife beside me. In referencing past experiences, here is what I/you have missed: The doctor inserts a long black flexible device into your anus. The head of which contains a gas tube for inflating your intestine, a wire loop for capturing and removing polyps, a light, and a video camera so everyone in the room can see what is happening. The head with the camera seems to be able to swivel. It is slowly pushed inside your large intestine, looking from side to side, looking for small white spots on the intestine wall. When one is found, the wire loop reaches out and plucks it from its place. (By some means it is transported to the outside where a technician examines it for cancer, usually a few hours later in time.) At this time, one can also see the small pockets in the intestine wall called diverticulitis (losis?). When the end of the large intestine is reached, the tube is removed and one begins to expel gas at a prodigious rate, which continues for a few hours afterwards.

Here is the cautionary note. Everyone hears the Horror stories about perforated colons/bowels. One happened at the clinic where old sour puss worked, but no one ever said who did it (6 doctors worked there). This caused me a fair amount of concern when I went for my last one there. YOU are your best defense against a bad outcome. Pain, serious pain, is one of the symptoms. (old time gunfighters said shoot for the gut because the pain will paralyze your opponent) The other is copious blood from the anus.(SMALL AMOUNTS OF BLOOD WILL APPEAR IF POLYPS ARE REMOVED) You must not delay if you have these symptoms. The lady in that town died from blood loss after 6 hours.

The discomfort is not over, even now, 6 hour after the procedure. What ever they gave me has dried out my mouth and I cannot eat anything... nor am I hungry. I love french bread it tasted awful. I asked Wife to stop for my favorite candy bar. It tastes great but it sticks in the mouth like very dry peanut butter. I quit eating after two mouth fulls. The remains sits on the desk beside me now. Sherbert and sprite was OK.

On a final note, after several experiences at nearly a dozen facilities over the years, I really liked the people, the process, and the outcome at The Central Louisiana Surgical Hospital, today. ( all the necessary unpleasantness aside). My results: for the first time, no polyps found!

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