MY COLONOSCOPY EXPERIENCES —PART 1
Colon cancer is one of the leading causes of death in the United States. Every year more than 50,000 people die from colon cancer. The sad part is that colon cancer is easy to cure—but only if it is caught in the early stages. And colon cancer is easy to detect—but only if you are willing to undergo the proper screening. The best screening for colon cancer is a colonoscopy.
The problem is that too many people would rather risk colon cancer than get the necessary screening to detect it. I know, because I used to be one of those people. When my doctor first suggested that I have a colonoscopy I said, “Absolutely not!” But then she explained why it was in my best interest to have the test—the benefits of having it, and the risks of not having it. My original answer of “Absolutely not” eventually changed to “Maybe—Let me think about it”, and finally to “Sure—Let’s do it.”
This article tells the true story of my colonoscopy exams. The first one that I received in 1997, the second one that I received in 2002, the third one that I received in 2007, the fourth one that I received in 2009, the fifth one that I also received in 2009, and the sixth one that I received in 2013. Two colonoscopies in the same year? You’ll have to read the article to understand why that happened.
Why am I writing this article? To improve my typing skills. Just kidding! My hope is that this article will cause some people to be screened for colon cancer who would otherwise not have done so. If I can accomplish this for even one person, it means that I may have saved a life. And that’s as close as I’ll ever come to doing something heroic.
While I was trying to decide whether or not to have the test, I heard some real horror stories about colonoscopies. They simply weren’t true. The actual test was much easier than I ever imagined possible. And I’m not a brave person. If I can do it, anybody can do it.
My first colonoscopy convinced me that the test is nothing to be afraid of. My second, third, fourth, fifth and sixth colonoscopies reaffirmed this. My third and sixth colonoscopies probably saved my life. And my fourth colonoscopy probably also saved my life—but not the way you may have expected.
So do yourself a favor. If your doctor recommends that you have a colonoscopy, say yes. If your doctor doesn’t bring up the subject, you bring it up first. Ask your doctor what type of colon cancer screening you should have. And suppose your doctor already recommended a colonoscopy, and you said “no way”? Then do what I did. Call your doctor and ask if it would be OK to change your mind and correct a mistake that you made.
For reasons of privacy and confidentiality, I have chosen not to mention my name in this article. But I will tell you a little about myself. I’m a 63 -year-old man who lives in St. Louis,Missouri. I try to keep myself in good health. I get annual physical exams, don’t smoke, don’t drink alcohol, exercise regularly, and eat a sensible diet. My physical exams have always produced good results.
ABOUT MY DOCTOR
I’ve been going to the same doctor since 1983—Anna Niesen MD. Dr. Niesen’s specialties are Internal Medicine and Gastroenterology. However, it wasn’t until 1997 when I first had the opportunity to make use of Dr. Niesen’s skills in Gastroenterology. On a scale of 1 to 10, I would rate Dr. Niesen at a 12. She is an excellent doctor who really cares about her patients.
WHY I DECIDED TO WRITE THIS ARTICLE
Shortly after I had my first colonoscopy in 1997, I happened to mention to Dr. Niesen the fact that all of the articles on what to expect from a colonoscopy were written by medical professionals. I said that it would be nice if a layperson could write an article telling what to expect before, during, and after a colonoscopy. Dr. Niesen said, “Why does someone else have to do it? Since it is your idea why can’t you do it?”
So I did. I wrote an article about my colonoscopy experience. I later updated the article in 2002 to include my second colonoscopy, in 2007 to include my third colonoscopy, and in 2009 to include both my fourth and fifth colonoscopies.
Over the years I’ve given copies of the article to health care professionals who deal with patients who may get this test, as well as lay people who are considering having or already have decided to have the test, and want to know what to expect.
MY FIRST COLONOSCOPY
It all began on March 21, 1997. That day I visited Dr. Niesen for my annual physical exam. Afterwards, she wrote me an order for the annual blood tests that I have done in a nearby lab. She then said, “Everything looks fine, as usual. However, there is one thing in your family background that has me concerned. Your grandmother had colon cancer. With a family history of colon cancer, we have to be more aggressive in screening for that disease than if the family history didn’t exist.” I knew where this conversation was going, and I didn’t like it. She was going to suggest that I have a proctoscopic exam. This consists of inserting a flexible lighted tube into the rectum and lower colon to search for colon cancer. I had never had a proctoscopic exam, but I’ve known people who had. They described the procedure as very uncomfortable.
When Dr. Niesen told me what she actually had in mind, I suddenly wished that she had suggested a proctoscopic exam. What she had in mind was a colonoscopy. A colonoscopy is similar to a proctoscopic exam, except that the scope goes much deeper—the entire length of the colon. People I knew who had this test described it as a really horrible procedure.
I already disliked the idea, and I started to like it even less when Dr. Niesen gave me a handout of the procedures to be followed the day before and the morning of the exam. The day before the test I was to eat (or should I say drink) only a clear liquid diet. The afternoon before the test I would drink a gallon of a powerful laxative called Colyte, which would keep me running to the bathroom for 4 or 5 hours. The morning of the exam I would take a plain water enema before reporting to the hospital. At the hospital, I would be hooked up to an IV (Intravenous line), before the colonoscopy began.
I didn’t want to go on a clear liquid diet for a whole day. I’d probably be starved. Nor did I want to drink a gallon of a powerful laxative. I’d never before taken so much as a teaspoon of a mild laxative. Equally bad was having to take an enema. The last time that I had an enema was in the hospital at the age of 9. It was a painful procedure that I didn’t want to repeat. Finally, I didn’t want to be hooked up to an IV. I’d never had an IV, but I’ve been at the bedside of hospital patients who had them inserted. The looks on their faces told me that they were in pain. I told Dr. Niesen that I didn’t want to have this test, but she reminded me of the importance of being properly screened for colon cancer.
Over the weekend I visited a medical school library, and read some medical journal articles on colonoscopies. What I read only served to convince me that I really didn’t want to have this test. I decided that the best way to handle the situation was to get the blood tests that Dr. Niesen ordered, and just “forget” about the colonoscopy. With all of the patients that Dr. Niesen had, she’d never know if one of her patients forgot to have one test that she ordered.
Because I had been busy at work, it was late May before I got around to going in for the blood tests. On June 13 (it was a Friday 13), I got a call from Sandy, one of the nurses in Dr. Niesen’s office. She said that the blood tests were all normal. Just when I thought that the conversation was over Sandy asked, “So when are you going to schedule an appointment for the colonoscopy that Dr. Niesen ordered for you?” I told Sandy that I had heard and read enough bad things about colonoscopies that I would just as soon not have the test.Sandyreplied, “I think that you’re exaggerating a bit. The preparation for the exam can be kind of rough, but the test itself is no big deal. Besides, with a family history of colon cancer it’s important that you be properly screened for that disease. And when it comes to screening for colon cancer, nothing can compare to a colonoscopy. Before you flat out refuse the test I wish that you would at least give the matter some serious consideration.”
Over the weekend I gave the matter a lot of consideration, and suddenly felt rather ashamed of myself. For over two months I had been making excuses why I shouldn’t have the test, rather than just setting up an appointment and getting it over with. I didn’t think that I had inherited colon cancer from my grandmother. But I suddenly realized that it was possible. I decided that first thing Monday Morning I was going to call Dr. Niesen’s office and ask Sandy to set me an appointment for a colonoscopy.
When I called Dr. Niesen’s office on Monday, I learned that Sandy was on vacation for the week. So I asked John (the office manager) to set me an appointment for a colonoscopy. John told me to report to the Endoscopy Unit of St. Mary’s Hospital on Saturday, July 12, at 8:00 a.m. He then reiterated the instructions which were on the handout that I got from Dr. Niesen. One good thing came out of this discussion. The handout that I got from Dr. Niesen said to take a plain water enema the morning of the exam. John said that if I drank the entire gallon of Colyte I could skip the enema. At least this would be one indignity that I wouldn’t have to suffer.
During the next few weeks I found myself mentally going back and forth as to whether or not I was doing the right thing by having this test. Some days I would be convinced that I was doing the right thing. Other days I would begin to have serious doubts. On Tuesday, July 8—four days before the scheduled exam—I was telling a friend about the upcoming test. She said, “You’re making a big mistake. My father had that test several months ago. He said that it was very uncomfortable. Plus the fact that he was sick for several days afterwards.” I told my friend how Sandy had said that the test was no big deal, plus the fact thatSandyhadn’t said one word about getting sick afterwards. My friend replied, “Of course not. They won’t tell you that because they want you to have the test.”
Now I was really confused. Should I go through with the test or just forget about it. The following morning I called Dr. Niesen’s office and expressed my concerns to Sandy. I asked, “How can any test that’s so invasive not be painful?”Sandyreplied, “Because you’ll be under conscious sedation. You’ll barely know what is happening.” At the time I assumed that I was only being given conscious sedation because I had expressed fear about the test. I later learned that Dr. Niesen, along with most other doctors, always use conscious sedation during colonoscopies. The only exception is if the patient specifically asks not to be sedated. In that case, the doctors will go out of their way to convince the patient to change their mind.
I then told Sandy what my friend said about being sick afterwards. She responded, “ I suppose that could happen if the test isn’t given properly. But Dr. Niesen has been giving this test for over 20 years, and knows how to do it very gently. And Dr. Niesen won’t be giving the test alone. She will have a Registered Nurse assisting her. The nurses at St. Mary’s Endoscopy Unit are the most competent, compassionate, health care workers that I have ever met.” That was the turning point. At that moment I decided that I was going through with the test, and this time there would be no more second-guessing. Forget what my friends said, and forget what the medical journals said. I was going to listen to Dr. Niesen.
I suddenly realized that I had two important decisions to make. The first decision was where to go when it came time to drink the Colyte. I don’t live alone, and I frequently have visitors drop by unannounced. Once I started drinking the Colyte, I’d be running to the bathroom for 4 or 5 hours, and I didn’t want to do this with other people around. I called the Cheshire Inn, and reserved a room for Friday and Saturday. The Cheshire Inn is located about two blocks from St. Mary’s Hospital, so I could easily walk to and from the hospital on Saturday Morning.
The second decision that I had to make was whether or not to have an enema the morning of the test. The handout that I got from Dr. Niesen said to take an enema the morning of the exam. John said that if I drank the entire gallon of Colyte I could skip the enema. But suppose I couldn’t finish the Colyte? In that case, having the enema could mean the difference between successfully completing the test, or having to go through it a second time. Under the circumstances, I decided to go ahead and have the enema.
I didn’t want to try to give an enema to myself, for fear of causing an injury. So I decided to hire a private duty nurse. I opened the Yellow Pages, and selected Delmar Gardens Home Health Care. The reason why I selected them was because I knew that they were related to Delmar Gardens Nursing Home. I had an aunt and uncle who had spent time in Delmar Gardens Nursing Home, and I was very impressed with the excellent care that they both received. When I called Delmar Gardens Home Health Care, I was transferred to Theresa Jones, the patient coordinator. I asked Ms. Jones if she could send a nurse to the Cheshire Inn on Saturday Morning at 6:30 a.m. to give me a cleansing enema. Ms. Jones said that finding somebody to work at this odd hour on such short notice would be difficult. Nevertheless, she promised to do everything possible to find somebody. She suggested that I call back on Friday to see if her efforts had been successful.
I took off work the day before the exam.—Friday, July 11. I went to the grocery store and purchased my clear liquid diet for the day — this consisted of apple juice, white grape juice, and lime flavored carbonated water. I then purchased the Colyte from St. Mary’s Pharmacy. After checking into the hotel I called Delmar Gardens Home Health Care to see if Theresa Jones had found a nurse to give me the enema. Ms. Jones said that she had been unable to find a nurse’s aide or a licensed practical nurse to work at the requested time. She did find a registered nurse, but warned me that the price would be much higher. The price that she quoted me sounded reasonable. (It was less than I was expecting to pay.) So I told her to go ahead.
I started drinking the Colyte at 3:30 in the afternoon. The next few hours were kind of rough, having to make repeated trips to the bathroom. However, the procedure wasn’t as bad as I had feared. I didn’t experience any of the nausea, dizziness, or cramps that the medical books said occasionally resulted from drinking Colyte.
Later that evening I got a telephone call from Linda, the Registered Nurse who would be giving me the pre-exam enema the following morning. She explained how the procedure would work. She said that enemas can be uncomfortable, and that I’d probably experience a lot of cramping. Despite this caveat, she seemed like a really nice person, and promised to do everything possible to minimize the discomfort.
I awoke at 5:00 on Saturday Morning, and didn’t even try to go back to sleep. Linda arrived at 6:30 as promised. She had me fill out some forms, took my vital signs, then said, “I’d like for you to undress below the waist and lie on the bed on your left side.” As I lay on the bed I wondered which would be worse, the discomfort or the embarrassment of the procedure.
Linda returned several minutes later, carrying a disposable plastic enema bucket filled with 1 ½ liters of warm water. Linda ran the water in very slowly, giving me progress reports—how much I had taken, and how much I still had to go. I took the entire solution with only minimal discomfort. She then asked me to hold the water in for 10 minutes. After about 5 minutes the cramps started to get pretty bad, so I was able to talk Linda into letting me go to the bathroom after 7 minutes.
I then got dressed and walked the two blocks to St. Mary’s Hospital. As I was checking in at the Registration Desk I suddenly began to get nervous. Up until now this test was just something to deal with in the future. Suddenly the future was here. I was instructed to undress and put on a hospital gown. I was then introduced to the three Registered Nurses who would be working with me that morning—Judy, Kathy, and Carol. Judy and Kathy would start the IV, while Carol would assist Dr. Niesen during the colonoscopy. I told the nurses how Sandy had spoken very highly of them. I then mentioned that I had never had an IV or a colonoscopy, and admitted that I was rather nervous about both procedures. The nurses assured me that they would do everything they could to make both procedures as easy as possible.
Judy and Kathy had me lie on a bed where an IV Bag was set up. While Judy inserted the IV Needle into my right arm, Kathy held my left hand and gave me an encouraging smile. I felt a brief stick, and that was the extent of the discomfort. The metal needle was replaced with a plastic shunt. This meant no lingering pain, and none of the black and blue marks that sometimes result from IV insertions. I even had full range of motion of my hand and arm. Judy explained that the IV Bag contained a saline solution, which would be replaced with medication once the colonoscopy began.
As I waited for the test to begin I engaged some of the other patients in conversation. In a way, I was luckier than they were. When their test was over they would be returning to their hospital room. When my test was over, I would be returning to the hotel. At 9:30 Carol said that it was time to begin the colonoscopy, and introduced me to a man named Dr. Lee. I looked suspiciously at Dr. Lee and said, “I thought that Dr. Niesen was supposed to be performing this test.” He said, “She is. I’m an Intern who will be assisting her. If that’s OK with you.” I replied that would be fine.
I was wheeled into a semi-dark room where Dr. Niesen was waiting. In the middle of the room I noticed a TV Screen or computer monitor—I wasn’t sure which. Off to the side I glimpsed an object that I suspected was the colonoscope. I decided not to look at it, for fear that if I saw the size I would change my mind. I asked Dr. Niesen if she thought that I would ever go through with this test. She said, “No, I really didn’t. But I’m glad that you decided to do so. Now I’d like you to roll over onto your left side.” I rolled over and noticed that I was quite scared. The test was about to begin. Dr. Niesen said, “Carol is going to add some sedatives to your IV. When you wake up, it will all be over.”
That was the last thing that I remember before waking up in the Recovery Room. Kathy was standing at my bedside and told me that the test was over. I was kind of sleepy from the sedatives, but otherwise felt fine. There was no pain or discomfort. And I didn’t feel sick. I asked Kathy how the test results looked. She said, “Why don’t you ask Dr. Niesen.” That’s when I noticed that Dr. Niesen was in the room. She gave me a thumbs up and said that everything looked fine. There was no indication of cancer or any other abnormalities. The dreaded IV and colonoscopy proved to be no big deal. Plus I had the peace of mind of knowing that I didn’t have colon cancer. Not to mention the fact that I got to meet several really nice people that morning.
About 20 minutes later I felt well enough to walk back to the hotel, but the Nursing Staff insisted that I not do so. The called a taxicab so that I wouldn’t have to exert myself. (Back in 1997 it was acceptable for colonoscopy patients to leave the hospital in a taxicab. Today they are not allowed to leave in a taxicab or other public transportation. Not sure why this changed.)
When I got back to the hotel I noticed that I was very hungry. It had been almost 48 hours since I had eaten any solid food. I made up for it by having a nice prime rib dinner at the hotel’s restaurant.
I decided to spend the night at the hotel. I was still kind of tired from the sedatives, and didn’t want to risk driving home. Plus I thought that it would be a good idea to be close to the hospital, in case something went wrong. As it turned out, however, nothing went wrong. I felt fine when I woke up on Sunday Morning. There was no indication that I had just gone through such an invasive procedure. I alternately ran and walked six miles throughForest Park, ate breakfast, checked out of the hotel, and drove home.
That would be the end of the story about my first colonoscopy, were it not for an incident that took place several months later. I had gone out to eat after bowling one night with some friends. One of the ladies in the group mentioned how her father had died of colon cancer. She described how the last few months of her father’s life were pure torture. She said the doctors told her that if her father had gotten a colonoscopy while the disease was still in the early stages, it could have been easily cured. At that moment I realized two things: (1) I had done the right thing by having the colonoscopy; (2) If I hadn’t gotten the colonoscopy, I would be calling Dr. Niesen the following morning, asking her to set me up an appointment for one as soon as possible.
MY SECOND COLONOSCOPY
We now fast forward almost 5 years to April 11, 2002. That afternoon I visited Dr. Niesen for my annual physical exam. I realized going in there was a chance that Dr. Niesen might order another colonoscopy for me. When I had my last colonoscopy in 1997, Dr. Niesen said that I would probably be repeating this test every 5 years. If you add 5 plus 1997—-well, you can do the arithmetic.
During the physical exam Dr. Niesen didn’t mention one word about me having another colonoscopy. And I certainly wasn’t going to bring up the subject. When the exam was finished she said, “Everything looks fine. Get dressed, and I’ll meet you out front.” It looked like I had just gotten another year’s reprieve on the colonoscopy.
At the front desk Dr. Niesen said to her nurse named Bonnie, “Give him a slip for the same blood tests that he had last year. And also set him up for a colonoscopy exam.” I said, “Wait a minute. I thought you had forgotten about that. You didn’t say one word about a colonoscopy during the physical exam.” Dr. Niesen said, “That’s because I didn’t want to give you an opportunity to argue about it.” I said, “That was last time. I’m not going to argue this time. All I will ask is that we do the exam on a Saturday. That way I will only have to take off work for one day—Friday for the prep. If we do the exam during the week, then I will have to take off work two days—One day for the prep, and one day for the test.” Dr. Niesen said that would be fine. She frequently performed colonoscopy exams on Saturday. Bonnie set me an appointment for Saturday, June 1. She told me to report to the Endoscopy Unit of St. Mary’s Hospital at 8:00 a.m. She said that the actual colonoscopy would probably begin around 9:30. She gave me a handout of the pre-exam procedures. It looked similar to what I was given last time.
Once again, I reserved a room at the Cheshire Inn for Friday and Saturday of the “exam weekend”. On Friday I could drink the Colyte without having anyone else present. On Saturday I would have an easy walk to the hospital, and a short taxicab ride back after the test. This time there was no second-guessing as to whether or not I should go through with the test. I knew that I was doing the right thing by having the test.
On Saturday, May 4, I attended a health fair. One of the many booths at the fair covered the subject of colon cancer. Several Registered Nurses were running the booth, and handing out literature about colonoscopies. One of the visitors at the booth said, “Forget it. I would never let someone give me a test like that.” I walked up to the man and said, “That’s what I used to think, also. But in 1997 my doctor convinced me to have the test. It was really no big deal. The test came out normal, which gave me a great peace of mind. And if the results had come back with a problem, at least I would have had a better chance for an early cure.” The man asked me to tell him honestly whether or not I would be willing to repeat the test. I said, “I certainly would. I’m having my next colonoscopy exactly 4 weeks from today.” After the man left, the nurses at the booth thanked me for my testimonial.
A few weeks later I was on The Internet, when I decided to see what kind of information was available on the subject of colonoscopies. I found an article written by a Doctor in Texas. He said something that I already knew—The worst part of a colonoscopy isn’t the test itself. It’s drinking the prep liquid. (Such as Colyte.) Then he said something that I didn’t know. He said that you could get by drinking a lesser amount of Colyte by having a colonic irrigation a few hours before you start drinking the Colyte. The Doctor also said that a colonic irrigation would help to reduce some of the negative side effects of Colyte. What exactly is a colonic irrigation? The article described it as sort of a deluxe enema. No thanks! That’s not for me. It’s bad enough that I have to take an enema on the morning of the test. I’ll just deal with the Colyte the day before.
But then I read the next paragraph and started to have some second thoughts. The article explained that a colonic irrigation had two advantages over an enema. First, a single colonic irrigation will clean you out better than multiple enemas. Second, while enemas can be quite uncomfortable, colonic irrigations produce almost no discomfort. OK, I was starting to get interested. I found a therapist named Cindy, who performed colonic irrigations. I called her, and she set me an appointment for Friday, May 31 (the day before the colonoscopy) at 10:00 a.m.
One week before the exam—Saturday May 25—I attended the funeral of a good friend who died of cancer at the age of 58. It wasn’t colon cancer. Rather, it was lung cancer. Between the fact that he was a heavy smoker, plus the fact that he had resisted going to the doctor until the symptoms got very bad, the cancer was not caught until it was in the late stages. As I drove out of the cemetery after the funeral, it served as a reminder to me how important it is to live a healthful lifestyle, and get proper screenings for cancer and other diseases.
I took off work on Friday May 31—the day before the colonoscopy. At 10:00 a.m. I had my colonic irrigation appointment. The colonic irrigation was surprisingly easy to take. I lay on a table on my back while Cindy pumped water in and out of my colon for about 45 minutes. While I took several gallons of water during the 45 minutes, only a small amount of water was in me at any one time. The only discomfort I felt was right at the end. Cindy said, “This is going to be your last fill. So this time I would like you to take as much water as you can. When you reach your limit let me know and I will remove it.” Afterwards, Cindy wished me luck on tomorrow’s test. She told me to call her and let her know how the test results turned out.
I purchased the Colyte from Walgreens. Then I went to the grocery store and purchased my “clear liquid diet” for the day. This consisted of apple juice, white grape juice, lime flavored carbonated water, and pear juice. I got the idea for pear juice from an Internet Site. This said that drinking pear juice could help to prevent and/or cure stomach cramps. Since one of the potential side effects of drinking Colyte is stomach cramps, I thought this might be a good idea.
It was around 3:00 when I noticed a side effect of a clear liquid diet that nobody had told me about. I seemed fine on the liquid diet as long as I didn’t exert myself. But as I began to climb a small flight of stairs I suddenly found this to be a real struggle. I wasn’t sure if I was going to make it to the top. Only 4 days earlier, I had successfully completed a 6-mile run, which included several steep uphill stretches. So it’s not like I was out of shape. I have to assume that the clear liquid diet either didn’t provide enough calories or enough nutrients to give me the energy that I needed. I would have liked to blame this on the Colyte. But I hadn’t started to drink the Colyte yet.
I started to drink the Colyte at 4:00. Thanks to the colonic irrigation, I was able to get by with only drinking about half of the bottle of Colyte. And I had no side effects. At least no unexpected side effects. I did find myself getting up quite a few times at night to run into the bathroom. That plus the fact that I was kind of nervous about the upcoming test made for rather limited sleep on Friday Night.
The final thing that had to be done to prepare for the colonoscopy was to take an enema on Saturday Morning before reporting to the hospital. I set up the plans for this about two weeks before the colonoscopy. I could have probably given the enema to myself. But I was concerned that I might do something wrong, and cause an injury. When I had my last colonoscopy, I contacted Delmar Gardens Home Health Care, who sent out a Nurse named Linda. She performed the procedure with very little discomfort. I was considering calling Delmar Gardens and asking if they could send out Linda again. But there were two problems with this. First, I didn’t know Linda’s last name. Second, I had no idea if Linda was still working for Delmar Gardens. This was, after all, 5 years later.
That’s when I came up with another idea. Last Summer (July 2001) I met a Registered Nurse named Margaret at a holistic health seminar. Margaret mentioned that she worked as a Private Duty Nurse. She gave me some of her business cards, and asked if I would give them out to anyone who might need her services. I rummaged through my desk until I found one of her cards. I gave her a call, and explained the situation. Margaret said, “Sure, I’d be happy to do that for you. I’ve been giving enemas for over 35 years. When I was in nursing school back in the 1960’s, Registered Nurses got a lot of training in how to give enemas. Not like today, when most nursing schools don’t even teach that procedure.” I said, “Margaret, as far as I’m concerned the entire procedure could disappear. But right now it’s one of those necessary evils that I need to get through the test.” Margaret replied, “OK, I’ll get off of my soapbox. I’ll drop by your hotel room between 6:30 and 7:00 on Saturday Morning, June 1.
Margaret arrived on Saturday Morning around 7:00. A man who she introduced as Jerry accompanied her. She said, “I’m going to let Jerry give you the enema. He’s studying to be a CNA, and I thought that this would be good practice for him.” I said, “Wait a minute, Margaret. I hired you—A person with over 35 years experience. Not a student who is looking for someone to practice on.” Margaret said, “I just figured that because of the part of the anatomy involved, you would prefer to have this procedure done by a man.” I said, “It’s not a question of a man versus a woman. It’s a question of who is the most qualified person. That’s you.” Margaret said, “OK, I’ll give you the enema.” She opened her handbag and pulled out a 2-liter disposable plastic enema bag.
Margaret told me to undress and had me lie on the bed in something that seemed like a cross between my left side and my stomach. She called it the left Sims position. As I was receiving the enema I started to get cramps. I said, “I hope that we are almost finished, because I’m starting to get full.” Margaret said, “You’ve only taken about half of it. Try doing some deep breathing through your mouth. That should help reduce the cramps.” That reduced the cramps enough so that I was able to take all of the water. But I could only hold it for a few minutes.
As I was getting dressed I began to feel guilty about my behavior a few minutes earlier. I shouldn’t have jumped on Margaret and insulted Jerry. I’m usually a nicer person than this. Maybe I was on edge because I was nervous about the test.
A few minutes later I began to feel even guiltier about my behavior, when I realized what a nice person Jerry was. He asked me how I planned to get back from the hospital. I stated that I would probably take a taxicab. He said, “You’re not going to take a taxicab. The driver will let you off at the door, and leave you to fend for yourself to get to your room. I’ll drive you back.” I said, “I can’t ask you to do that, Jerry. It could be hours before I’m ready to leave the hospital.” Jerry wrote something on a piece of paper, which he handed to me. He said, “Hold onto this. It’s my cell phone number. Here’s what we will do. Margaret and I will drive you to the hospital. I will walk into the Endoscopy Unit with you, to see where it is. Then I will drive Margaret home, and find something to do for a few hours. When it’s time for you to leave, either call my cell phone number, or else have one of the Hospital Staff do it.” I offered to pay them extra for this added service, but Margaret and Jerry both refused to take any additional money.
At the Registration Desk I filled out some forms, then was turned over to a Registered Nurse named Theresa. She took my blood pressure, and asked me some questions about my medical history. My blood pressure was quite a bit higher than it normally is. But Theresa assured me that this was not unusual for patients who were waiting to have this sort of procedure. She told me to undress, put on a hospital gown, and come out to the Holding/Recovery Area.
The hospital gown was one of the new fangled models with all sorts of clamps that I couldn’t seem to figure out. I must have looked pretty ridiculous, because when I walked into the Holding/Recovery Room, several of the nurses started laughing. A nurse named Laurie said, “Here, let me help you with that gown.” She made some major corrections to the way that I had it put on. She then said, “I’m sorry that I laughed at you.” I said, “No problem. If you’re laughing, I’m laughing. And if I’m laughing, it means that I’ll be less nervous.”
Looking around the Holding/Recovery Room I saw Ellen—one of the nurses from Dr. Niesen’s Office—tending to a patient. I said, “Good morning, Ellen. It’s nice to see a familiar face.” She said, “In a few hours we will all be familiar faces to you.” I understood what Ellen meant. From my last visit in 1997, I realized that when you come to St. Mary’s Endoscopy Unit you are more than just a patient. You are a patient and a friend. I said, “Ellen, do you think there is any chance that I might get a reprieve?Maybe Dr. Niesen forgot that we had this test scheduled?” Ellen said, “I don’t think that is going to happen. Look behind you.” I turned around and saw Dr. Niesen in a glass-enclosed room. She smiled and waved at me.
Ellen said, “I’m going to go ahead and start your IV. Come over here and lie on the bed. When I was lying on the bed I looked up at the IV bag and the needle, and suddenly began to get scared. I’m not sure why this happened. The last IV that I had—right in this same room—proved to be a very easy procedure. But who can explain human emotions? I needed to buy myself some time, so I said, “Wait a minute, Ellen. Last time they used two nurses for this procedure. One nurse held my hand, while the other nurse inserted the IV needle.” Ellen must have figured what was happening. She squeezed my hand, made eye contact with me, and asked, “Will you be OK with me starting the IV now? Or do you need a few minutes to compose yourself?” The fear went away as suddenly as it had come. I said, “You can go ahead and start it now. But thanks for giving me that option.” I felt a brief stick when Ellen inserted the needle. The discomfort lasted for maybe 2 or 3 seconds. Ellen said, “Now don’t go anywhere.”
Around 9:20 a Registered Nurse walked up to my bed, and introduced herself as Donna. She said, “We’re going into the Endoscopy Room now. I’ll be assisting Dr. Niesen during the colonoscopy.” I said, “Donna, what are the chances of convincing you to lose me before we get to the Endoscopy Room?” She answered, “Somewhere between slim and none.” Despite my jokes in this area, I really didn’t want the test to be cancelled or postponed. I didn’t want the test to be cancelled, because I knew that it was something that I needed to have done. And I didn’t want it postponed, because that would mean having to go through the prep a second time. As Donna wheeled me out of the room, Laurie and Ellen wished me good luck with the test, and promised to be waiting for me when I returned.
Donna wheeled me into the Endoscopy Room. She pointed out the monitor, and asked if I would like to see the colonoscope. I said, “No Donna. I really don’t think that would be a good idea. I’m afraid that if I see the size of that thing, I may just change my mind.” Dr. Niesen walked in at that moment and said, “We certainly don’t want that to happen.” I said, “Dr. Niesen, I want you to know that you are a very persuasive person. You are one of the few people who could actually convince me to have this test.” She said, “There was no convincing involved. I just told you that you were going to do it.”
Dr. Niesen said, “We’ve started the sedatives, so you should start feeling sleepy fairly soon. Go ahead and roll over onto you left side.” For the next few minutes Dr. Niesen, Donna, and I made small talk. I recall Donna telling me about the husband and wife who came in together for a colonoscopy. Each of them asked to have the procedure done without any sedatives. I assured Donna and Dr. Niesen that I would never be that brave. I was starting to feel sleepy, and just hoped that the sedatives would take hold before the colonoscope was inserted—or at least before it got too high. As it turned out, I never did feel the insertion of the scope.
When I woke up in the Holding/Recovery Area, the wall clock showed a few minutes after 11:00. The entire procedure had taken approximately 1-½ hours. I wasn’t sure how much of this time was the actual exam, and how much of the time was sleeping off the sedatives. Donna, Ellen, and Laurie came over and asked me how I felt. I replied, “Not very well. I’ve got a stomachache.” Donna said, “That’s not too surprising, considering that you just had the scope through your entire colon. The stomachache will go away in about an hour.” I said, “Donna, there’s no way that this is going to be gone in an hour.” But Donna was correct. In fact, her estimate was on the high side. The stomachache was actually gone in about 30 minutes. To help me wake up I was instructed to walk around the room, while a man named George held onto me for support.
When I walked out into the front, Jerry was waiting for me. I’m not sure if he just came back to wait, or if one of the Hospital Staff had called him. He shook hands with me, asked me how everything went, and then took me back to my hotel room. In the room he asked if I would like him to get me something to eat. I said, “That would be great. After having only a clear liquid diet yesterday, and nothing to eat today, I’m starved. How about walking down the street to Carl’s Deli and bringing me back a corned beef sandwich and some cole slaw. And buy yourself something also.” Jerry asked if I wanted anything to drink. I said, “No thanks. I’ll just finish up the bottles of juice from yesterday.” When Jerry returned with the food he said, “I’m going to take off now. But if you need anything, feel free to call me.”
After eating lunch I noticed that I was feeling very tired. I got in bed and slept for several hours. I was awaken by the ringing of the telephone around 5:00 in the afternoon. It was Margaret calling to see how I was doing. She asked how the test results had come out. I said, “You know what? In all the excitement I forgot to ask. That should have been my first question when I woke up.” She said, “I wouldn’t worry about it. If there was a problem I’m sure that your doctor would have told you.”
For supper I went downstairs to the hotel’s restaurant and ordered their specialty—prime rib. I realize that prime rib isn’t exactly a healthy food—especially several hours after a colonoscopy. But I figured that I had earned it. I spent the night at the hotel. I was paying for the room for the night anyway. Plus I really felt too tired to try to drive home. I just hoped that I would feel OK when I woke up in the morning.
I felt fine when I woke up on Sunday Morning. If I hadn’t known better, I would have never believed that I had gotten such an invasive procedure less than 24 hours earlier. The last time that I got a colonoscopy, I went out on Sunday Morning and alternately ran and walked 6 miles through Forest Park. This time I didn’t bring along my running shoes. So I settled for walking the 6-mile course through Forest Park. I promised myself that before the summer was over, I would come back and run the entire 6 miles. I then ate breakfast, checked out of the hotel and drove home.
When I got home one of the first things that I did was to go to the kitchen table and write two letters. One letter was to Dr. Niesen. The other letter was to the Staff at St. Mary’s Endoscopy Unit. I offered my thanks for them doing so much to help get me through yesterday’s colonoscopy. I wonder how often doctors and nurses get letters from patients who thank them for performing a colonoscopy! Getting a colonoscopy will never be on my list of favorite things to do. But Dr. Niesen and the Staff at St. Mary’s Endoscopy Unit sure made it a lot easier than I would have ever guessed was possible.
On Monday I began to think about what Margaret had said to me on the telephone—“I wouldn’t worry about it. If there was a problem I’m sure that your doctor would have told you.” Maybe Margaret was right. But suppose she was wrong? Suppose there was a problem that Dr. Niesen didn’t want to discuss while I was still partially under the effects of the sedation? I suddenly began to worry, and it got worse as the day went on. Every time that the telephone rang I had two opposite feelings. I wanted it to be Dr. Niesen, so that she could tell me that everything was OK. But at the same time I didn’t want it to be Dr. Niesen, for fear that she might tell me there was a problem.
When Dr. Niesen did call I quickly asked, “So what’s the verdict? Good news or bad news?” Dr. Niesen said, “Very good news. Everything looks just fine. No cancer, no polyps, nothing that would indicate a problem.” The relief that flooded through me at that moment was great. I couldn’t have been happier if I had just been told that I won the million-dollar lottery. (Well, I might be exaggerating a little to make that comparison. But I was very happy.)
On the morning of August 10, 2002, I returned toForest Park, and fulfilled the promise that I made to myself on June 2. The one whereby I promised to run the entire 6-mile course before the end of the summer. Afterwards, I ate breakfast in the cafeteria of St. Mary’s Hospital, since it was right around the corner from where my run ended. In case you’re wondering, no I didn’t stop by the Endoscopy Unit to visit. The Staff at St. Mary’s Endoscopy Unit are wonderful people. But a hospital Endoscopy unit isn’t exactly the sort of place that I want to visit without my doctor’s orders.
BETWEEN MY SECOND AND THIRD COLONOSCOPIES
Since the time of my second colonoscopy I would occasionally pull up medical websites on the Internet, just to satisfy my curiosity as to whether anything had changed in this field. Nothing had taken the place of a colonoscopy as the gold standard for detecting colon cancer.
One thing that I did learn from an Internet site was TV Newsperson Katie Couric’s crusade to have more people get tested for colon cancer. This came from a personal tragedy that she suffered. Her husband died of colon cancer at the age of 42, despite the fact that he had none of the risk factors normally associated with colon cancer.
In an attempt to get the word out, in March 2000 Katie Couric had a colonoscopy that was broadcast on live television. Shortly afterwards, the number of people who requested colonoscopies from their doctors dramatically increased. The medical community called this “The Couric Effect”. For some reason I had not heard about any of this at the time that it happened. Rather, I read about it on the Internet three years later.
I did purchase a CD on the subject of colon cancer screening from Katie Couric’s foundation. (I believe it is called NCCRA.) It is hard to watch that CD and not walk away with the realization that a colonoscopy is an important life saving procedure.
After watching the CD I offered it to a friend who was about my age. When he returned the CD he told me something that I hadn’t known. He said, “You don’t have to sell me on the importance of colon cancer screening. I was diagnosed with colon cancer back in 1983 when I was living in Chicago. I was barely 30 years old at the time. Luckily, it was caught early, and I have remained cancer free ever since. And just to show you what a small world it is, remember the last doctor who Katie Couric interviewed on the CD? That was the same colon-rectal surgeon who diagnosed my colon cancer, and operated on me.”
NOTE: Subsequent colonoscopy exams will be documented in Part 2, Part 3 and Part 4 of this article. This article is being broken down into four parts because of the length of the article.