Facing Your Enemas

Once upon a time, discussions of this sort would have creeped me out.  Now that I’ve matured, and learned the facts of life, it’s a lot easier to talk or write about these things – maybe too easy…

Despite dire warnings, the recommendations of doctors, loved ones and numerous celebrities, the very thought of it may be enough to bring the bravest and toughest among us to our knees.  The indignity of it, the invasion of privacy, the probing, the pictures…  Of course, I’m referring to a colonoscopy, which for many of us is a least-prized 50th birthday present.

At a small party my wife and I attended recently with a group of contemporaries, as conversations with folks our age tend to go, the discussion eventually got around to the subject of colonoscopies.  Almost everyone had been through at least one, but two people hadn’t had theirs yet.  One had scheduled an appointment, and it was coming up soon, so the taunts and teasing escalated as the night wore on.  The conversation was hilarious as several people recounted their close encounters and contemplated posting their pictures on FaceBook, or better yet, YouTube!  Only my wife and another couple knew that my colonoscopy a month earlier had uncovered early stage colorectal cancer.

For those who haven’t had “the procedure” yet, the prep is the worst part, but for most, it’s not so bad.  A handful of tablets or magic powder and a torrent of fluids the night before clears the way for the doctor to perform the exam while you’re in a blissful state of sleep.  If it’s any consolation, you can imagine that the doctor’s perspective is a lot different, and that you’re certainly on the better end of things.  If you’re employed, it’ll mean a day off, but you’ll need a chauffeur, which may make things a bit more challenging, and a bit less private.  But once the procedure is completed, you'll get over it and reward yourself by gorging and replenishing your system.

In my case, I had put the procedure off for several years, and finally ran out of excuses.  The doctor who performed the routine examination removed a small non-suspicious growth, and as a matter of routine, sent it to the pathology lab, where it was found to be cancerous.  Although surprised by the results, she felt that she had gotten it all with the initial excision.  This was substantiated with additional testing performed at a cancer center that she recommended.  While the doctors are confident, there’s no certainty that it’s gone.  However, all indications are good, and with (ugghh!) more frequent ‘oscopies, the doctors feel they can effectively monitor for recurrence.  I suggested that with training, since I spend so much time with my head up my butt, I could keep a close eye on it myself.  Ever the professionals, they felt that an expert (second) opinion would be more beneficial than just relying on my own point of view.

The reason that colonoscopies are such a good idea is that they are relatively simple to perform, very effective at detecting disease, and don’t require hospitalization.  Colorectal cancer is the third most prevalent, and the second most deadly form of cancer in the US.  In 2008, an estimated 150,000 new cases were diagnosed, and approximately 50,000 lives were lost to the disease.  Almost 1 person in 19 will be diagnosed with it in his or her lifetime.  If the procedure is performed in time, doctors can detect many colorectal cancers early, when the cure rate is very high.  If not caught soon enough, colorectal cancer is one of the more insidious forms of cancer, showing few, if any, symptoms.  If caught in mid- to late-stage, the prognosis is equivocal, and the road ahead is potentially painful and debilitating, and very expensive.

Take it from me - denial is an ineffective preventive or defensive strategy, and avoiding the unpleasantness of a colonoscopy and its prelude is not a wise course of action.  Some things are best dealt with head-on (pardon the metaphor), and the consequences of inaction or procrastination can be fatal.  And as I’ve learned, having your head up your butt doesn’t provide as good a view as a trained professional can get.  So, if you’ve been depriving some doctor the joy of examining your nether region, park your excuses and make the call.  It could just save your life – it surely saved mine.