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Your Colonoscopy

Posted 10/3/2007

Yes, yours.

If you’re under 50, you have my blessing to press the DELETE button and move on to your next message. Readers in their mid-40s might want to keep reading. Your time is coming.

First, I’m a major advocate of preventive colonoscopies. In experienced hands, they are safe and only mildly uncomfortable. Colonoscopies save lives, period. Until the flexible colonoscope was invented (it allows a view of the entire large intestine), colon cancer was a frequent and unpleasant cause of death.

Sadly, among the uninsured–including veterans, because the VA doesn’t cover preventive colonoscopies–people still die regularly of colon cancer. And unless it’s detected early, colon cancer that has spread, usually to the liver, is very difficult to treat.

Decide now to dedicate 24 hours of your life to your colonoscopy. There are variations to the colon cleansing routine, but here’s the approach my doc uses:

On Day 1, starting in the morning, you limit your eating to clear liquids–if you can see through it you may ingest it (water, tea, jello, broth). At about 4 PM, you start popping laxative pills called Visicol, with plenty of water. From 8 PM until midnight, you’ll be in awe as you ponder the amount of waste material you carry around each day. You go to bed and in the morning you greet the new day by taking more Visicol and water. At about 9 AM, your bowel contents ultimately emerge looking like clean water.

This is when your gastroenterologist wants to see you.

Head to the outpatient department of your hospital, where you’ll join a roomful of others who have whistle-clean colons like yours. You’ll be called in and lie down, and the nurse will start an IV line and administer a medicine called Versed, a painkiller that allows you to stay awake if you like. A tad more Versed and you’re asleep. I chose to stay awake and watch.

In the colonoscopy room, you lie on your side, watching the inside of your colon on a monitor. It’s quite a sight. Your doctor may point out the findings during the procedure itself and if any growths (polyps) are found, they’ll be removed through the colonoscope by lassoing and nipping them with a wire. Start to finish, the whole procedure averages about fifteen minutes.

You’ll be wheeled into a private area where you and other post-colonoscopy patients pass the air that the doctor pumped into your intestine to get a clear view. Fortunately, you’re sequestered behind curtains, so you’re alone and no one knows it’s you, but it’s quite a symphony.

After an hour or so, the IV is removed and you get dressed and head home. You’ll need a ride in order to be released, since you’ll still be mildly sedated and can’t drive safely. On the way home, you suddenly realize you haven’t eaten for 24 hours and you’re famished, so you stop at a restaurant and start to fill your intestines again.

Most gastroenterologists send you a follow-up report (with photos suitable for the front of your refrigerator, but alas, no refrigerator magnet).

There are many superb gastroenterologists in the Chicago area. I’ve been sending patients to Dr. William Markey (www.williammarkeymd.com) for more than 20 years. He’s on the staff at Rush, Illinois Masonic, and Lincoln Park hospitals.

As a bonus, there are good restaurants near each location.


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DIAGNOSE-IT-YOURSELF: COVID-19

Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

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