<p>I am a medical professional and a medical conservative.
I love to bring subjects like that into discussion.</p>
<p>[Should</a> the colonoscopy be the ‘gold standard’? | Marketplace From American Public Media](<a href=“http://marketplace.publicradio.org/display/web/2010/08/18/pm-should-the-colonoscopy-be-the-gold-standard/]Should”>http://marketplace.publicradio.org/display/web/2010/08/18/pm-should-the-colonoscopy-be-the-gold-standard/)</p>
<p>A better question to ask is whether or not you have had any colorectal cancer screening test, if you are 50 or older. Any test is better than none.</p>
<p>The colonoscopy is so appealing (yes, I said appealing) because it involves 1.5-2 days of inconvenience, and if there are no significant findings, you are off the hook for colon screening for another 10 years. And, as a gastroenterologist colleague has said in comparing flexible sigmoidoscopy to colonoscopy, “would a woman want only one breast screened during a mammogram?”</p>
<p>But, it is difficult to argue with data. And it may be difficult to deny people their colonoscopy much like it is difficult to deny women their annual mammogram in their 40’s, based on the report issued last fall.</p>
<p>I have to have a colonoscopy every 5 years, not every 10, because they found a polyp at a previous colonoscopy.</p>
<p>This bothers me not at all, except for the inconvenience of having to impose on someone to give me a ride. </p>
<p>If I were told to have a sigmoidoscopy instead, I wouldn’t do it. I had one once. It was more painful than childbirth. No power on earth could get me to have that test again under any circumstances.</p>
<p>I had a colonoscopy when I turned 50. It wasn’t fun, but it really wasn’t that bad. The prep was inconvenient (I found it difficult to drink all that stuff), but the procedure itself was nothing. I had an upper GI scope at the same time–my only request was that they not use the same instrument for both procedures.</p>
<p>There are letters in the NYTimes today about this topic: <a href=“http://www.nytimes.com/2010/08/25/opinion/l25colon.html?_r=1&ref=letters[/url]”>http://www.nytimes.com/2010/08/25/opinion/l25colon.html?_r=1&ref=letters</a></p>
<p>
</p>
<p>Heh. I just had my first one a couple of months ago. Other than feeling a bit nauseous from all that lemon-lime Gatorade, it wasn’t bad at all. And like you, I thought the procedure itself was nothing - the place where I had it done was both very professional and very friendly.</p>
<p>@Hunt - lol.</p>
<p>I had my colonoscopy last Dec. Got it in before the new year since my deductible had already been met ($350). I had it on a Monday so I only needed to take one day off work, though my employer is very generous with sick days. I did need to take 1/2 day off for the consultation which was required by my health care provider. For me, the financial cost was $0 so why not?</p>
<p>Back to the link - very interesting study. Some good points made all around. When evaluating articles such as this folks often err in several ways - first they think “personally” and not as the population as a whole. Second, the mindset seems to be - if it does more, costs more and requires more skill and support then it must be better.</p>
<p>Folks should note this carefully:
Colonoscopy is three to four times more expensive than the simpler sigmoidoscopy test. And the risk of complication is seven times higher</p>
<p>There is a significant portion of the population for which the flex sig may be a good option. They can’t take time off work, the test is too expensive etc. In the 90’s my (then) husband had a flex sig around age 50. His family physician performed it. There was no prep. He just needed to show up and it took less than a half a day. He was back at work before noon.
For those folks, this study is good news indeed.</p>
<p>I am due for one. I had one in my early forties due to a symptom that turned out to be benign, but I have to admit I’m kind of dreading it. I was the one in a thousand who reacted to the salt solution like it was poison. I was very, very ill throughout the night – intense head pain, body hurt intensely, felt awful – like the worst flu. By the time I arrived for the procedure, my blood pressure was dangerously low and I was barely coherent – they had to pump me up with fluids before they could do anything. Then they were afraid to overmedicate me, so I woke up in the middle to the worst pain I’d ever felt and tried to move, which is dangerous. When my girlfriend picked me up, she took one look at me and insisted on seeing the doctor before she would take me home. She said to him, “Is she supposed to look like that?” because I was so pale, etc. (Everyone should have a friend like that.) So the small salt solution is out. I’m concerned that I can’t drink a gallon of the other stuff. I hear there is are pills you can take. Has anyone done that? I do want to emphasize, however, that I was the huge exception to the rule – everyone I know who has had a colonoscopy has had an uneventful experience, even if the cleansing was unpleasant.</p>
<p>For those of you that don’t want to drink the nasty prep… they do make pills that do the same thing:</p>
<p>
</p>
<p>Keep in mind that colon cancer is a silent deadly killer- and that once you are showing symptoms of the disease (bloody stool) it may be too late. </p>
<p>This is one of those things that need to be done. </p>
<p>…says chuckle getting off her soap box… :o</p>
<p>Apparently if you take the pills you still have to drink a ton of clear liquid… I guess to help the pills work.</p>
<p>For those that opt for the flex sig procedure- if you happen to have polyps in the intestine that doesn’t get scoped, you are at risk for colon cancer. Just because one part of your colon shows no signs, it doesn’t mean the rest of your colon is clear. All it takes is one polyp to turn cancerous.</p>
<p>sorry… this is a touchy point for me. Getting a flex sig doesn’t mean everything is good. It means the parts that were scoped are OK, not the rest. The colonoscopy is the only way to know for sure.</p>
<p>not to take away from the seriousness of this discussion (and thanks, kelowna, for bringing up an important subject), but can’t resist posting a link (full column below):</p>
<p>[Dave</a> Barry: A journey into my colon – and yours - Dave Barry - MiamiHerald.com](<a href=“http://www.miamiherald.com/2009/02/11/427603/dave-barry-a-journey-into-my-colon.html]Dave”>http://www.miamiherald.com/2009/02/11/427603/dave-barry-a-journey-into-my-colon.html)</p>
<p>Dave Barry: A journey into my colon – and yours</p>
<p>(This Dave Barry column was originally published Feb. 22, 2008.)</p>
<p>OK. You turned 50. You know you’re supposed to get a colonoscopy. But you haven’t. Here are your reasons:</p>
<ol>
<li><p>You’ve been busy.</p></li>
<li><p>You don’t have a history of cancer in your family.</p></li>
<li><p>You haven’t noticed any problems.</p></li>
<li><p>You don’t want a doctor to stick a tube 17,000 feet up your butt.</p></li>
</ol>
<p>Let’s examine these reasons one at a time. No, wait, let’s not. Because you and I both know that the only real reason is No. 4. This is natural. The idea of having another human, even a medical human, becoming deeply involved in what is technically known as your ‘‘behindular zone’’ gives you the creeping willies.</p>
<p>I know this because I am like you, except worse. I yield to nobody in the field of being a pathetic weenie medical coward. I become faint and nauseous during even very minor medical procedures, such as making an appointment by phone. It’s much worse when I come into physical contact with the medical profession. More than one doctor’s office has a dent in the floor caused by my forehead striking it seconds after I got a shot.</p>
<p>In 1997, when I turned 50, everybody told me I should get a colonoscopy. I agreed that I definitely should, but not right away. By following this policy, I reached age 55 without having had a colonoscopy. Then I did something so pathetic and embarrassing that I am frankly ashamed to tell you about it.</p>
<p>What happened was, a giant 40-foot replica of a human colon came to Miami Beach. Really. It’s an educational exhibit called the Colossal Colon, and it was on a nationwide tour to promote awareness of colo-rectal cancer. The idea is, you crawl through the Colossal Colon, and you encounter various educational items in there, such as polyps, cancer and hemorrhoids the size of regulation volleyballs, and you go, ‘‘Whoa, I better find out if I contain any of these things,’’ and you get a colonoscopy.</p>
<p>If you are as a professional humor writer, and there is a giant colon within a 200-mile radius, you are legally obligated to go see it. So I went to Miami Beach and crawled through the Colossal Colon. I wrote a column about it, making tasteless colon jokes. But I also urged everyone to get a colonoscopy. I even, when I emerged from the Colossal Colon, signed a pledge stating that I would get one.</p>
<p>But I didn’t get one. I was a fraud, a hypocrite, a liar. I was practically a member of Congress.</p>
<p>Five more years passed. I turned 60, and I still hadn’t gotten a colonoscopy. Then, a couple of weeks ago, I got an e-mail from my brother Sam, who is 10 years younger than I am, but more mature. The email was addressed to me and my middle brother, Phil. It said:</p>
<p>``Dear Brothers,
``I went in for a routine colonoscopy and got the dreaded diagnosis: cancer. We're told it's early and that there is a good prognosis that they can get it all out, so, fingers crossed, knock on wood, and all that. And of course they told me to tell my siblings to get screened. I imagine you both have.''
Um. Well.
First I called Sam. He was hopeful, but scared. We talked for a while, and when we hung up, I called my friend Andy Sable, a gastroenterologist, to make an appointment for a colonoscopy. A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis. Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner. I nodded thoughtfully, but I didn't really hear anything he said, because my brain was shrieking, quote, ``HE'S GOING TO STICK A TUBE 17,000 FEET UP YOUR BUTT!''
I left Andy's office with some written instructions, and a prescription for a product called ''MoviPrep,'' which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America's enemies.
I spent the next several days productively sitting around being nervous. Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn't eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons.) Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes -- and here I am being kind -- like a mixture of goat spit and urinal cleanser, with just a hint of lemon.
The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, ''a loose watery bowel movement may result.'' This is kind of like saying that after you jump off your roof, you may experience contact with the ground.
MoviPrep is a nuclear laxative. I don't want to be too graphic, here, but: Have you ever seen a space shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom, spurting violently. You eliminate everything. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.
After an action-packed evening, I finally got to sleep. The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, ''What if I spurt on Andy?'' How do you apologize to a friend for something like that? Flowers would not be enough.
At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the hell the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.
Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep. At first I was ticked off that I hadn't thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no choice but to burn your house.
When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand. There was music playing in the room, and I realized that the song was Dancing Queen by Abba. I remarked to Andy that, of all the songs that could be playing during this particular procedure, Dancing Queen has to be the least appropriate.
''You want me to turn it up?'' said Andy, from somewhere behind me.
''Ha ha,'' I said.
And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.
I have no idea. Really. I slept through it. One moment, Abba was shrieking ``Dancing Queen! Feel the beat from the tambourine . . .''</p>
<p>. . . and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that it was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.</p>
<p>But my point is this: In addition to being a pathetic medical weenie, I was a complete moron. For more than a decade I avoided getting a procedure that was, essentially, nothing. There was no pain and, except for the MoviPrep, no discomfort. I was risking my life for nothing.</p>
<p>If my brother Sam had been as stupid as I was – if, when he turned 50, he had ignored all the medical advice and avoided getting screened – he still would have had cancer. He just wouldn’t have known. And by the time he did know – by the time he felt symptoms – his situation would have been much, much more serious. But because he was a grown-up, the doctors caught the cancer early, and they operated and took it out. Sam is now recovering and eating what he describes as ‘‘really, really boring food.’’ His prognosis is good, and everybody is optimistic, fingers crossed, knock on wood, and all that.</p>
<p>Which brings us to you, Mr. or Mrs. or Miss or Ms. Over-50-And-Hasn’t-Had-a-Colonoscopy. Here’s the deal: You either have colo-rectal cancer, or you don’t. If you do, a colonoscopy will enable doctors to find it and do something about it. And if you don’t have cancer, believe me, it’s very reassuring to know you don’t. There is no sane reason for you not to have it done.</p>
<p>I am so eager for you to do this that I am going to induce you with an Exclusive Limited Time Offer. If you, after reading this, get a colonoscopy, let me know by sending a self-addressed stamped envelope to Dave Barry Colonoscopy Inducement, The Miami Herald, 1 Herald Plaza, Miami, FL 33132. I will send you back a certificate, signed by me and suitable for framing if you don’t mind framing a cheesy certificate, stating that you are a grown-up who got a colonoscopy. Accompanying this certificate will be a square of limited-edition custom-printed toilet paper with an image of Miss Paris Hilton on it. You may frame this also, or use it in whatever other way you deem fit.</p>
<p>But even if you don’t want this inducement, please get a colonoscopy. If I can do it, you can do it. Don’t put it off. Just do it.</p>
<p>Be sure to stress that you want the non-Abba version.</p>
<p>Read more: [Dave</a> Barry: A journey into my colon – and yours - 02/11/2009 | MiamiHerald.com](<a href=“http://www.miamiherald.com/2009/02/11/v-print/427603/dave-barry-a-journey-into-my-colon.html#ixzz0xcp5JbaC]Dave”>http://www.miamiherald.com/2009/02/11/v-print/427603/dave-barry-a-journey-into-my-colon.html#ixzz0xcp5JbaC)</p>
<p>Impossible to top Dave Barry but I just wanted to add something referring back to what Marian said in post #3. </p>
<p>I had my first colonoscopy at age 52 and was very surprised when the doctor found a very significant polyp. Fortunately it was still benign. My overwhelming feeling was huge relief and a firm conviction that I had just saved my life. I was told to come in 6 mos. later for a sigmoidoscopy which would reach the spot where the polyp was removed. </p>
<p>The sigmoidoscopy wasn’t fun and it was definitely bizarre but it wasn’t agonizing for me. It felt like I had an eel or something moving through my guts. My doctor was pretty gentle so that may have been the difference. He found the spot he was looking for (he told me he’d tattooed it!) and the polyp had not returned. Even so, I’m due back for another colonoscopy at the 1 year mark. </p>
<p>One of the ways I talked myself into the original colonoscopy was by focusing on the 10 years I’d be able to wait before having another. So it’s ironic that I’m now stuck having one every year. But I am so, so glad I did it. Please don’t let anything about either procedure put you off from doing it. It just isn’t a big deal compared to colon cancer.</p>
<p>Since many of my friends are my age, plus or minus a year or two, there was a couple of years when all we seemed to talk about was our colonoscopies. My favorite was my high-powered NYC friend who bragged about his doctor, who had the “fastest scope in the East,” – he went in for his colonoscopy in the morning and was at his desk at work before noon.</p>
<p>I hate stuff like this and put it off until I was 55–it was so easy that I felt dumb for not going sooner. I opted not to be aware of what was going on and was mostly asleep through the entire procedure. My H wanted to watch his procedure and he wasn’t as heavily sedated, and I guess he was able to watch a screen and see what was happening. That makes me shrudder just thinking about it. H had several polyps, which the doc removed immediately; he has to do a follow-up in 5 years as a result. H had his procedure in July. I picked him up from the hospital and drove him to a business meeting. The directions that he received from his doc said that one should not drive for 24 hours after the colonoscopy. He took it seriously, so I was his driver that day. My doc didn’t give the same warning–I had to have someone take me home, but nothing about foregoing driving for the rest of the day. As I recall, I felt fine.</p>
<p>
Yes!
However… how does on account for this:
???</p>
<p>Assuming there are good studies showing this is true - we need to investigate why it’s true.<br>
IF it is true then should ‘we’, society, be subjecting millions of people to colonoscopies and all of their risks, yes there are risks, (and pay the expense) when a very simple flex sig would do?
Maybe - from a public health standpoint - giving the risk and expense - the flex sig should be the standard and the colonoscopy reserved for individuals with certain risk factors/symptoms.</p>
<p>No plans…</p>
<p>I have a family history of colon cancer (one case was NOT picked up by a sigmoidoscopy, BTW), which I would not wish on my worst enemy, so, yeah, I go in for a colonoscopy every five years. Pretty uneventful so far, and at least I’m off the hook for doing everything for others for two days. (Maybe that says something pathetic about my relationship with my family?)</p>
<p>Still haven’t done this…there has to be a better way than missing two days of work for the “victim” and one day of work for the driver. What if you were able to start a prep at 6am and have someone take you for the procedure after their work day? Then you could return home late evening and be ready to go the next morning.</p>
<p>I had my first at age 50 and had a couple of benign polyps. My gastroenterologist recommended that I have one every two years and I’ve followed his advice. Have also had an upper GI endoscopy twice, which I found unpleasant, at the same time as the colonoscopy, but my doc gave me a bit more sedation the second time and it was fine.</p>
<p>I don’t know anyone my age who hasn’t had a colonoscopy, but part of that could be that with universal healthcare, no one has to consider the cost here.</p>
<p>I hated drinking that stuff. As to the actual procedure; they knocked me out, no problem. I’ll need one in a few years because of what they found.</p>
<p>ksm, you couldn’t do your prep during the workday because you are running – yes, running! – to the bathroom on a moment’s notice when the stuff kicks in.</p>