The First Colonoscopy adventure

by Graham Email

Via a combination of inertia, and a certain amount of blase conviction that bad medical stuff happens to The Other Guy, I had managed to get all the way to my 58th year without having my colon inspected in any way shape or form.
Now...I do have a pretty bullet-proof gastro-intestinal tract- it is decades since I had food poisoning, I never get physically sick and I have never had any sustained digestive tract issues. However, ageing and loss of immune system efficacy are realities. There is also the historical reality that Mary's father died of colon cancer at age 53; by the time he was diagnosed with the disease, it was too far advanced for him to be cured.
So, when I changed to a new PCP this Spring, one of his challenges (a bit smart-assish of him, I did think at the time) was "what is the chance of you having a colonoscopy this year", the unspoken implication being that I somehow lacked the cojones to agree to one. Upon sensing my general lack of excitement at the prospect, he effectively bounced me off Inertia First Base by writing a referral to a Dr Paul Hackett.
So, a couple of weeks later, I paid a courtesy visit to Dr Hackett, who, it turns out, is a motorbike racer when not inspecting and/or repairing human gastro-intestinal plumbing. So we talked about Silverstone racing circuit, and in between that subject, he showed me how I would be violated under controlled conditions to have my colon inspected in detail, with a camera endoscope setting off from my anus, going up across and down, all the way to the end of my small intestine. It still sounded a tad non-thrilling, but So Be It.
So, after two postponements, with Mary having had her colonoscopy weeks and weeks ago, I reached the Really Fun Part. This of course, entails the removal of used food from one's gastro-intestinal tract. Since nobody has yet invented or popularized a Colon Flusher (enemas being only useful for the last few inches or so), this happens from the top end, via the ingestion of substances that piss off the gastro-intestinal plumbing so much that it expels all liquids and solids contained therein.
The substance cocktail that I was prescribed goes by the odd-sounding name of Movi-Prep. This sounds like a starter dish at my local cinema multiplex...
Movi-Prep is a collection of substances (mostly sodium salts) that are mixed with water to create a drink that one ingests in two separate sittings, one 24 hours in advance, and the second 6 hours in advance. These salts annoy one's GI tract to the point where everything moves on out at a fair clip.
Movi-Prep is not a relaxing coffee-type drink, to be enjoyed on the sofa while stroking the cats. The manufacturers attempt to make it sort of palatable by adding a lemon flavoring and sweeteners (mostly aspartame) to it, but that merely makes it sickly sweet and cloying. The only way to drink this stuff is to chug it down. Sipping it is a bad idea. The other challenge is that each sitting of Movi Prep is 4 glasses full, to be taken at 15 minute intervals. After the second glass, drinking it down starts to become seriously tedious. Part of it is the taste and texture, part of it is that you get kind of full drinking the stuff down in an hour or less.
However, it does work, although in my case it took over an hour before (as I like to say) the contents began settling in transit, and great movements began occurring. Within a couple of hours, I rediscovered the joys of peeing from one's anus. And so this continued through the evening, as I regularly journeyed to the restroom.
The next morning, I started the process all over again, with the glasses full become steadily less appealing and more tedious. Once again, after an hour or so, I was once again cheerfully peeing from my anus, my GI tract now becoming seriously devoid of contents, which in turn triggered a series of rumblings that at times sounded like the sort of sounds heard from not-quite-dormant volcanoes in the Pacific Ring Of Fire.
The GI clinic then threw a curveball by calling me in early, presumably somebody had wimped out or added too much vodka to their Movi-Prep.
So we set off for the clinic, role reversal, Mary as my driver. The usual process then unfolded as I was asked to sign many forms all covered in Stuff The Lawyers Make Us Write. However, they must be losing their touch because not one form contained the infamous Main Street prescription drug All-Purpose-Get-Out-Of-Jail-Free Clause ("may cause vomiting, convulsions and death"). However, since there is more chance of a perforated colon (which at every least leads to the creation of an abdominal zip as a collection of medics open one up to repair it), I merely signed the documents, in the standard rote-ish way, and moved to the next step - the obligatory determination of whether I existed.
They ascertained the presence of respiration, a body temperature somewhat above room temperature, and compelling evidence of the circulation of a red substance through my body due to the presence of a pump in my upper torso. That, plus my general ability to move my body and blather in a foreign accent, led them to conclude that I was alive, and they could move to the next step.
The next step was the final Great Movement (there's always something left to expel with Movi-Prep) and then the donning of the hospital gown, which, complete with booties and hairnet, makes one feel like a shuffling old lady from working-class England. I duly shuffled over to my bed, whereupon the medical vultures descended upon me, invading my venous system to plug in the tubing down which they clearly planned to pour quantities of state-altering substances. A totally cheerful anesthesiologist introduced himself and assured me that Dr. Hackett thought highly of me. I wondered if he would still hold that thought while staring at the wonderful topology of my transverse colon...
In no time at all it seemed like I was hooked up to the anesthesiologist's chemical laboratory, wi-fi, the national grid, and possibly the local water and sewerage systems. If I was going to suffer any unusual event, it would be the most-monitored event of my life.
After some paperwork scribbling from the nurses, they swiftly accelerated me out of the prep area backwards into The Room. I could tell it was The Room, because of the presence of a large LCD television screen on the wall. Yes, this was the viewing room for the 2013 Graham Shevlin Slow-Motion Colon Tour. However, the view on the screen was that of a wall and some expensive-looking equipment; clearly the endoscope was not yet anywhere near my posterior.
I wondered whether they had a satellite uplink to beam this event up for posterity ("And now we are going live to Duncanville Texas via satellite link to see whether Graham Shevlin really is full of shit...Carol, can you tell us what this picture is showing?").
I was asked to position myself on my left side (which is just as well, since I do not snore on that side). The nurses carefully uncrossed my legs, thus ensuring that resistance would be futile, even when I was asleep. Clearly, they knew how to handle monitored and trussed human subjects at this clinic.
The anethesiologist, determining that I was merely a tad nervous (hah! imagine that!), injected me with a substance to slow my heart rate; I determined that I could slow my heart rate merely by breathing better, since being monitored to hell and back with tubes and wires and then repositioned on one's side does lead to breathing stress. Then the immensely cheerful Dr. Hackett appeared, greeting me from the opposite side of my body. From my prone position, I was unable to see whether he immediately went back to rubbing his own hands in glee...
At this point, they did something very cunning, because I then woke up, back in recovery, lying on my back. The bastards had knocked me out with no warning whatsoever, none of that "count to 10 Mr Shevlin" nonsense. (I always thought that charade was a betting pool for the nurses in theater. "OK, how many seconds will he count to before he blacks out? Guesses on this board please. Winner buys the drinks at the Spleen and Pancreas bar tonight...")
So that was that. Deprived of a longer nap, I lay there and tried to wake up properly...then the sneaky anesthesiologist re-appeared. He is one of those guys that you can imagine being happy and smiling even if you have been partially dismantled in a road accident and are about to undergo a squillion hours of surgery ("Hi there Mr. Shevlin, as you have probably noticed, you are kind of injured...I am not sure where we're going to re-attach these limbs but we'll do the best we can can...have fun, we certainly will...sign this consent form with your nose and we'll get cracking").
He then revealed that they had given me Propofol, which is a fine substance, but, as some of you may have read, was also the substance that appeared, when poorly administered, to have assisted in the untimely demise of Michael Jackson. However, it is quite clearly highly useful when used correctly. I felt like I had merely had a good nap. No odd feeling of being disoriented when I woke up, and I could remember stuff, unlike the last time I was knocked out, when I had no short-term memory for 25 minutes after waking up. That previous loss of memory was probably due to being adminstered Versed, which is known to cause amnesia.
The immeasurably cheerful Dr. Hackett then appeared to shake my hand again, and wave a sheaf of video stills in front of me, all of them showing images of what looked like a deranged variant of the London sewerage system, albeit with curved and artistically intricate pipework.
Time for the Polyp Score....Ladeez n'Gentlemen, the score for Mr. Shevlin is...
1.
Sampled to determine its severity. If good, no visit for 5 years. if not so good, visit in 2 years. Results in 2 weeks. Some diverticuloses also found. This is not uncommon. Apparently processed food is hard on the lower colon, hence the appearance of diverticulosis. The less diverticulosis there is, the less chance of one developing diverticulitis, which can be nasty.
And that, folks, was that. The procedure itself was a total non-event compared to the 24 preceding hours of glorious GI evacuation fun. I divested myself of my hospital scrubs, and marched out to go home and actually ingest some solid food.
I shall continue my motor racing conversation with Dr. Hackett in 2 weeks. We might also discuss polyps and diverticulosis along the way..one never knows.
UPDATE - I held a brief conversation about polyps with Dr. Hackett today. The polyp was hyperplastic with no chance of it becoming adenomatous (which is a precursor to developing cancer). Therefore...I do not need another colonoscopy for 5 years, unless I have any colon-related issues in the meantime. Mary was similarly clear, her polyps were also hyperplastic. The diverticuloses were minor, merely folds in the colon instead of full-blown pockets, and are expected if one is more than 50 years of age.
So, we then discussed MotoGP for a while...