Umm, And I'll Have The Colonoscopy, Please (Part I)
If you're anything like me, colonoscopy ranks on the squirm scale well above leeches and root canals, somewhere up near death by evisceration.
A colonoscopy, in case you don't know, is a medical procedure that involves shoving five feet of cable up your ass to check out your colon. On the business end of the cable is an ass-doctor's version of a Swiss Army knife, designed for a search-and-destroy mission. It includes a light and video camera; and through its interior can be fed all sorts of additional things -- blasts of air, a wire snare, a flame thrower (for electrocautery, or so they say). Take note, Mattel: this would make a great kids' toy.
You can find thousands of descriptions of the equipment and procedure on the web, complete with diagrams and videos. My favorite is Dr. Fusco's Colonscopy on GIheatlth.com. Dr. Fusco, an ass doctor himself, has posted the account and homey photos of his own colonoscopy. The photo to the right shows him adhering to the night-before dietary regime: "So, while everyone
These pictures come from Dr. Fusco's site. I'm not Dr. Fusco, but I endured pretty much the same thing.
else was enjoying roast beef and chicken, I had a nice big bowl of lemon Jello."
Like Dr. Fusco's account, nearly all of the descriptions on the web are varnished diddies designed to set the mind at ease: "The flexible colonoscope is a remarkable piece of equipment." "The thin, well-lubricated colonoscope is gently inserted..." "Many people report that they remember very little of the examination." Apparently, for some people a colonoscopy isn't a big deal: "As expected, the test was a breeze." One can also find those lucky few who enjoy the sensation of large objects shoved up their asses, those people who probably request a colonoscopy, sans anesthesia, as soon as they turn fifty -- the age at which doctors want to start aggressively searching for tell-tails of colon cancer.
I'm writing this account for people on the other extreme -- for those so fearful of anal penetration that they avoid walking backwards. I underwent my first colonoscopy a year ago. In recounting my experience, I have no reason to reassure you. Indeed, given that I am an aspiring PoopReporter, you can expect me to play up the unpleasantry.
To understand the decisions I made leading up to the exam, you should know my body's general admission policy. If you're a physician and you need to get into my body, you go right ahead and cut yourself a new hole just as big as you please. But listen up: all existing holes are OFF LIMITS. If you didn't know, these holes have dedicated purposes -- and most were designed exclusively for one-way traffic. This isn't really my rule, per se. It's a policy made and aggressively enforced by guard dogs stationed at each of my holes -- dogs who take no orders from me. If I tell them "Heel," they say, "Fuck off."
Swabbing my throat sends the tonsil dogs into frenzies. Just thinking the word "catheter" will cause the pee-tube dogs to throw themselves violently against the fence. But the nastiest of these are the junkyard dogs chained to my anus.
The first doctor to give me The Finger told me that I'd feel a little "pressure," and perhaps mild "discomfort." I get real nervous whenever a medical professional tells me I may experience discomfort. Discomfort is what I experience flying coast-to-coast on Delta Airlines, shoehorned into seats designed for squirrels. While I don't particularly look forward to boarding the plane, I don't sit sweating bullets in the terminal beforehand. When a doctor jams a finger up my ass, I'm instantly up on my toes, I'm exuding eerie guttural sounds, I'm shouting SHIT and FUCK like I have Tourette's. Does that sound to you like someone experiencing a little pressure or mild discomfort? Those are reliable indicators of penetrating, zig-zaggy, lightning-bolt, tooth-gnashing pain.
My dog-bite response to anal penetration startled the first two doctors who insisted on forcing their way in. So now I warn the doctor, as he moves towards me with the glove, that my body is going to stage a vigorous protest. I'm sorry, I tell him, there is nothing I can do about it. The last doctor thanked me afterwards for alerting him. His wide-open eyes told me that he'd never seen a display quite like it.
Knowing this about me, you can guess what I thought of the idea of a colonoscopy -- having my ass reamed for thirty minutes by a plumber's snake. I'd been putting it off for a few years, hoping for a technological breakthrough. What prompted me to suddenly submit was the diagnosis of colon cancer in the young wife of a colleague. Hearing the details of her surgery and its aftermath convinced me that I never wanted that particular disease. I'd prefer to die of something else. Electrocution, for example.
But before visiting my regular doctor, I did my homework. I learned that there are two procedures for checking the colon. In the colonoscopy, which we've been talking about, the ass doctor examines the full length of your colon. But a more conservative option is the sigmoidoscopy, which involves checking out only the lower third. (Why they don't call it "Colonoscopy Lite," I don't know.) Knowing my dogs as you now do, you might predict that I'd fervently petition for the sigmoidoscopy. You'd be wrong. I was prepared to say or do whatever I needed to get signed up for the Full Monty. Here's why:
- With the sigmoidoscopy, the standard routine provides little or no anesthesia. With the colonoscopy, they'll knock you right over the head if you want.
Why would anyone choose the sigmoidoscopy? First, it's usually not you choosing it, but rather your health insurer, via your doctor. And they take the shorter route because it costs them less. But there is another reason you might opt for the sigmoidocopy: with it, the chances of the doctor accidentally jamming the cable right through the wall of your colon drop to 1 in 10,000, from 1 in 5,000. (If they do perforate your colon, they rush you to the emergency room where they treat you the same as if you'd been shot in the gut.) I think I'd rather die of a gunshot wound than survive colon cancer, so I didn't put much concern on the perforation risk.
My doctor was pretty quick to recommend the colonoscopy -- perhaps because he was well acquainted with my anus dogs. Had he not been so inclined, I was prepared to lie and complain of an innocent-sounding symptom that I learned would guarantee me the colonoscopy. (The high ethical standards of PoopReport preclude me from revealing that here. Sorry.)
I scheduled the procedure first thing on a Monday morning. Those who make their living doing this procedure do so by running an ass-embly line. And just as I don't want to buy a car assembled on a Friday, I don't want some bleary-eyed ass doctor operating the corkscrew.
Plus, I hate sitting on a toilet seat still warm from the guy before. So I wanted the corkscrew itself to have enjoyed some time off before it cuddled up to me.
You will hear most colonoscopy survivors say that the worst part is the preparation -- removing all shit from your colon, getting it squeaky clean. This process begins two days before the exam, when you have to forgo certain foods (uncooked fruits, beets, and so on). But on colonoscopy eve, in place of solid foods, you take a laxative.
One has a couple of options in terms of potable poisons to do the job;
Dr. Fusco and his gallon of laxative. Bottom's up!
and I have no idea how a particular clinic decides which to prescribe. But based on my informal surveys, I'm pretty sure which one you want: the Fleet phospho-soda (consisting of two six-ounce doses). To avoid is the ONE GALLON of polyethylene glycol, aka GoLYTELY, NuLYTELY, CoLyte -- the people who named these products were obviously pranksters, because everyone I talked to who managed to drink the whole gallon described it as a gag-fest, likening it to snot syrup and warm spit.
I scored the Fleet phospho-soda. While it made me wince, there wasn't much of it, so I could rush it down before the tonsil dogs were fully awake. After swallowing the dam buster, one then drinks a reservoir of water. I was now a disaster waiting to happen -- a ticking shit bomb.
My first few explosions a couple hours later were similar to standard diarrhea. Not a pretty sight. But by the early morning, I was blasting out drinking water. If Disneyland had a theme ride based on shitting -- Diarrhea of the Caribbean, say -- this would be it: all the comic cheek-flapping noises and pit-of-the-stomach thrills of explosive diarrhea -- even to the point of getting just a little wet -- but without the acidic bite and gruesome odors. If an enema didn't require inserting a nozzle up my ass, this experience would have won a steady customer.
Part II: Touching the void.
|Here we see Dr. Fusco pre-op and post-op. Can you guess which is which?|