MY COLONOSCOPY EXPERIENCES — PART 2
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.
This article will begin where “My Colonoscopy Experiences — Part 1” left off. The reason for breaking up this article into parts is because Facebook Notes can only hold so many characters.
MY THIRD COLONOSCOPY:
Once again we go forward approximately 5 years to April 20, 2007. That afternoon I visited Dr. Niesen for my annual physical exam. Based on my past schedule of colonoscopy exams, I expected that I would get another one this year. After going through it two previous times it was no longer a big deal.
During the physical exam neither Dr. Niesen nor I mentioned a colonoscopy. However, I realized that it probably would not be mentioned until I was getting ready to leave, and received the written orders for the blood tests.
At the front desk Dr. Niesen’s nurse named Krista wrote me an order for the annual blood tests. She then asked me what day and time would be best for me to have a colonoscopy. I asked, “Are we talking hypothetically or actually”. That question was unnecessary, as I already knew the answer. Krista said that we were talking for real. I said that Saturday mornings would work best for me. Krista set me an appointment for Saturday, June 9, 2007. She told me to report to the Endoscopy Unit of St Mary’s Hospital at 7:00 in the morning. She said that the colonoscopy would begin around 8:30. That would be one hour earlier than we started last time.
Krista then handed me the instructions for the pre-exam prep. (I will hereinafter refer to this as the “new preparation” method, as opposed to the pre-exam prep used during my last two colonoscopies, which I will refer to as the “old preparation” method.)
The new preparation method was somewhat similar, although not identical, to the old preparation method. The clear liquid diet restriction to be followed the day before the exam, and nothing to be eaten the morning of the exam, was the same for both preparation methods. However, the old preparation method involved drinking a gallon of Colyte the afternoon before the exam. The new preparation method involved taking four laxative pills the afternoon before the exam, which would be followed by drinking a half-gallon (two quarts) of Colyte. Using the new preparation method it was no longer necessary to have an enema on the morning of the exam.
As with the last two exams, I made a room reservation at the Cheshire Inn for Friday and Saturday of the exam weekend. The proximity of the hotel to the hospital and the privacy that I would get from the hotel room would work out well. I still wasn’t sure how I was going to get back to the hotel on Saturday after the colonoscopy, but I had time to figure that one out.
I checked out the new preparation method on the Internet, and determined that the possible side effects were similar to those of the old preparation method. If anything, the new method took longer to work than the old method.
Prior to my second colonoscopy I had found an article on the Internet which said that having a colonic irrigation before you start to drink the Colyte can reduce the amount of Colyte that you have to drink, plus reduce some of the negative side effects of drinking the Colyte. Would having a colonic irrigation first provide the same benefits when using the new preparation method? I decided to research that question on the Internet.
I could not find anything on the Internet that discussed whether having a colonic irrigation first would allow you to take fewer laxative tablets or drink less of the Colyte with the new preparation method. Nor could I find the article from the doctor in Texas that I had read last time on the subject. You know how Internet sites come and go. However, I did find several articles which said that having a colonic irrigation first would help to reduce the possible side effects of the “new preparation” method.
The lady who gave me the colonic irrigation last time (Cindy) was still in business. In fact, her business had significantly grown during the last five years. She now had several therapists working for her, plus the fact that she was now providing a variety of holistic health services.
On the evening of May 2, I attended a seminar at Cindy’s business on the subject of nutrition. This was given by two graduate students from Saint Louis University, who were majoring in nutrition. After the lecture I asked Cindy if it would be possible to schedule an appointment for a colonic irrigation for Friday, June 8—the day before the colonoscopy. She said that would be no problem. She wasn’t sure who would be performing the procedure that day, but she marked me down for a 10:00 a.m. appointment.
As it got closer to the day of the exam I began looking for people who might be able to drive me back to the hotel after the colonoscopy. I called a lady named Helene, who I have known for almost 10 years from dancing. Although not employed in the medical field, Helene did attend medical school for a few years before dropping out for financial reasons. And in recent years she has developed an interest in holistic health.
Several years ago I had driven Helene to and from the hospital when she had some outpatient surgery. So perhaps this would be her opportunity to return the favor. When I called Helene she said that regrettably she could not pick me up from the hospital on June 9, as she was scheduled to work that day. She did say that if I came by her house on the evening of Thursday June 7, she would help me get started with the prep.
I asked Helene exactly what she had in mind, since the prep was not supposed to begin until Friday June 8. She said that she would give me a glycerin suppository, and follow it with an enema. I said, “That is not going to happen. This time the prep does not require an enema.” Helene said, “The pills and the liquids will be easier to take if you are cleaned out first.” I reminded her that I would be cleaned out first, because of Friday Morning’s colonic irrigation. Helene said, “That’s on Friday, the day of the main prep. The colonic irrigation will be easier to take if you first get cleaned out on Thursday.” I remarked that it sounded like the person who swallowed the spider to catch the fly. She said, “You don’t have to get sarcastic about it.”
Helene then said, “It doesn’t matter to me one way or the other. I’m doing this for you. Both of my parents had a colonoscopy last year. I performed this procedure on both of them the day before they began their prep, and they both said that it made the main part of the prep go much easier. Besides, hasn’t my advice to you in the past always been reliable? Remember the time in 1998 when you got that bad case of food poisoning from the bowling banquet that you attended? You tried several over the counter medicines that proved worthless. Then I suggested that you purchase some ginger powder and take a couple of teaspoons of it. That solved the problem like some miracle drug.”
Well, that was true. In fact, since that time I always keep ginger powder in the house for those rare times when I get nausea. I told Helene that I would think about it. She said, “Don’t take too long. If you’re not coming over I would like to know, so that I can make other plans for that evening.”
On May 30 I called Helene to tell her that I would come over on the evening of June 7, and allow her to give me her prep. I’d trust her on this one.
On Thursday afternoon (June 7), I found a way to get back to the hotel from the hospital after the colonoscopy on Saturday. I found a company close to Saint Mary’s Hospital that provided transportation to and from doctor’s offices and hospitals. They set me an appointment for Saturday morning, and said that I should give them a call when I was ready to leave the hospital.
On Thursday afternoon I ate a big supper at Dennys, realizing it would be the last solid food that I would have until Saturday after the test. Sort of like a condemned man’s last meal? No, I shouldn’t make that comparison. This test was being done to protect my life.
That evening I went to Helene’s house, hoping that I was doing the right thing. She greeted me at the front door and asked if I would like to have the grand tour of her new house. I said, “Right now I’m not in the mood for any pleasantries. What I would like to do is just to get this thing over with. Do whatever needs to be done, and then you and I will call it a day.”
Helene began by inserting a glycerin suppository, then immediately followed it with an enema using some sort of contraption that I couldn’t quite identify. When I started to feel cramps I said, “It’s over. Let’s stop right now.” Instead Helene began to massage my abdomen. I asked, “What are you doing? Nobody has ever done this to me during an enema before.” She replied, “They should have. This will accomplish several things, not the least of which will be to take your mind off of the cramps.” I was about to say “what nonsense!”, when I realized that she was correct. Maybe it was all in my mind, but from that point forward I had no more cramps or discomfort. When it was over and I had gotten dressed I said, “Thanks, I guess. Now let’s have that grand tour of your new house that you mentioned earlier.”
I took off work on Friday, June 8—the day before the colonoscopy. I purchased the prep kit containing the laxative pills and the Colyte from Walgreens, then went to the grocery store and purchased my clear liquid diet for the day. This consisted of several bottles of a variety of juices. By 9:00 a.m. I was already beginning to get hungry. How could I possibly last until Saturday after the test?
At 10:00 I arrived for my colonic irrigation appointment. The colonic irrigation was given by Maya, one of the graduate students who had given the class on nutrition that I attended on May 2. The colonic irrigation went very smoothly. I had no discomfort at all. As I was getting ready to leave Maya wished me good luck on the test.
I was just walking out the door when I turned back and said, “One more question, since you are very knowledgeable on the subject of nutrition. Is there anything that I can drink to keep me from being starved by this clear liquid diet?” Maya said, “Actually there is. Take a drive up to Trader Joe’s Health Food Store, and buy some Ginger Beer. Don’t let the word “beer” fool you. There is no alcohol in it. What it consists of is pineapple juice, lemon juice, limejuice, and ginger. Every one of these ingredients are good to make your stomach feel better if you get hungry from the clear liquid diet, or if you get nausea or cramps from the laxative pills or the liquid prep.” Sounds like Maya and Helene both agreed on the value of ginger for stomach problems.
I took Maya’s advice, and purchased some bottles of the Ginger Beer (which as we now realize is not beer at all) from Trader Joe’s, and drank one of the bottles before I even left the parking lot. After finishing the bottle I did notice that I did not feel nearly as hungry as I had before drinking it.
After checking into the hotel I began to use the prep kit. I took the four laxative tablets, and then began drinking the Colyte about an hour later. I got no unexpected bad side effects; unless you count the fact that I constantly had to get up during the night to run to the bathroom.
During the time that I was doing the prep (this was around 5:40 in the afternoon) I switched on the hotel’s television set without bothering to see what channel it was set on. Who do you think was on the screen doing the news? Katie Couric. That gave me a little more courage to go through with this. If Katie Couric can have a colonoscopy performed on live television while the entire nation watched, I could certainly go through with a colonoscopy given in private. In fact, any person who would have their colonoscopy broadcast on live television to save the lives of countless strangers has to be a wonderful person.
I had no trouble waking up at 5:00 on Saturday morning, since I was up half the night anyway. I got dressed and turned on the television, hoping to kill some time before I went to the hospital. I was getting nervous just sitting in the room trying to watch TV programs, waiting for the time to pass. So I turned off the TV, left the hotel, and went for a walk around the neighborhood. I walked into the Endoscopy Unit around 6:30, which was 30 minutes before the time that I was supposed to get there.
In the Endoscopy waiting room there were two other people. One was a lady waiting to undergo an endoscopic procedure, and the other person was her mother, who would be driving her home. We introduced ourselves, but for privacy reasons I won’t mention their names. They were both very interesting people, and talking to them helped the time pass, and took my mind off what I would soon be going through.
A few minutes after the daughter was called in, a Registered Nurse with a cheerful smile on her face named Joan called my name and asked me if I was ready to come in. I said, “I guess so. If I try to run away I’m sure that you will be able to catch me.” She smiled and said, “It won’t be that bad.” (An interesting side note here. I later found out that Joan most definitely would have been able to catch me if I had tried to run away. She is a marathon runner.)
Joan took me into the Holding / Recovery area and introduced me to some of the nurses who were working that morning. Two of those nurses—Ellen and Laurie—I remembered from my visit in 2002. Ellen had started the IV on me during that visit, and Laurie was the one who helped me put the hospital gown together. Other nurses who were introduced to me were Jo, Judy, and Maurie. (Judy was not the same Judy who I met during my 1997 colonoscopy.) I said, “If you cater to cowards we will get along very well.” They smiled and assured me that was the case.
I was instructed to get undressed in a curtained off room, put on a hospital gown, and lay on a bed where an IV bag had been set up. This time the hospital gown had no clamps. Just a simple slip on gown. Before closing the curtains to get undressed I noticed that the lady who I had met in the reception area earlier was lying on a bed hooked up to an IV. I gave her a thumbs up, and wished her good luck with her procedure. She said, “Thanks. Same here.”
I put on the hospital gown and lied down on the bed, trying not to look at the attached IV. Several minutes later Judy and Jo came in the room and said that they would start the IV. First, they covered me with a very warm blanket, which was well appreciated. As I watched Judy wrap a blood pressure cuff around my left arm, Jo said, “I’m inserting the needle in your right arm. You’ll just feel a brief stick.” She was right. I did feel a brief stick. But it was no big deal. Jo and Judy told me to just lie still until it was time to go into the Endoscopy Room.
It was around 8:30 or so when Maurie entered my room. She said that it was time to go into the Endoscopy Room, and that she would be assisting Dr. Niesen during the colonoscopy. She wheeled me into the Endoscopy Room and pointed out the various pieces of equipment. This time I even worked up the courage to look at the colonoscope.
Maurie was a very interesting person to talk to. As we talked about our jobs, hobbies, and various other aspects of our lives I almost forgot why I was there. Dr. Niesen walked in the room and greeted me cheerfully. I said, “Do you find it hard to believe that this is my third colonoscopy? Or how about the fact that on March 21, 1997, I told you that I would never have a colonoscopy?” She said, “You’ve come a long ways in that regards. You’re a smart person who realizes the importance of early screening.” With some renewed courage I looked at both Dr. Niesen and Maurie and said, “I’m not looking forward to this test. But since I’m having it, I can’t think of two people who I would rather have with me performing the test.” Dr. Niesen said, “Go ahead and roll over on your left side, and we will get started.” I rolled over, and that was the last thing that I remembered.
I woke up in the Holding / Recovery area, and noticed that the IV needle was now removed. I was sleepy and a little lightheaded from the sedatives, but otherwise I felt fine.
Quite a few of the nurses were in the room and walked over by my bedside. I said, “This is a nice way to wake up, in the company of all these beautiful women.” The nurses gave each other a little smile. Maurie asked, “So which one of us would you say is the most beautiful?” I was afraid that question was going to get me into trouble! I said, “Well actually —- you are all very beautiful.” Another nurse said, “We know that. But which one of us is the most beautiful?” I looked up at the ceiling, hoping that I may get some Divine inspiration. But it didn’t come. How do I get myself into these situations? I asked, “Can’t I just say that you are all equally beautiful?” Maurie laughed and said, “Of course you can. We’re just having some fun with you.” I said, “Oh sure, I knew that.” It was nice to share a joke with them.
Joan asked me if I wanted something to drink. I said, “You bet I do. As hungry as I am, I’ll take anything that I can get.” She brought me several cups of grape juice with ice.
Dr. Niesen walked in and asked me how I was doing. I said that I was feeling fine, but right now I wanted to know how the test results looked. She said, “Everything looked fine, except for one thing. I did find and remove one polyp.” I hadn’t been expecting that.
It’s a good thing that Dr. Niesen had insisted that I have a colonoscopy every five years. I asked if the polyp was malignant or benign. She said, “I have no way of knowing at this time. I’m sending it off to the Pathology Lab to have it tested. I expect that I will have an answer by Tuesday. Call my office, and I’ll let you know the outcome. Be aware that the majority of polyps are not cancerous. However, we have no reliable way of knowing which ones will ultimately turn into cancer. That is why it is important that all polyps found be removed. In the meantime, I am going to give you some literature on polyps. It also includes some good information on how to prevent new polyps from forming. One of the most important things you can do on an ongoing basis to prevent polyps is to eat a high fiber diet.”
About 15 minutes later I asked if one of the nurses could call for my ride to come. A man from the medical transport company showed up a short time later, and took me back to the hotel. I waited about an hour, and then took a stroll across street to Carl’s Deli to get myself a corned beef sandwich and some coleslaw. It was sure great to have some solid food to eat.
When I got back to the hotel after eating lunch, the reality of the situation hit me like a ton of bricks. I had a polyp, and I wouldn’t know for sure until Tuesday whether or not it was cancerous. Was this something that I had inherited from my grandmother? Or was there some other reason why this polyp had formed despite my overall healthy lifestyle?
There were certainly times in the past when I thought that Dr. Niesen was being overly cautious by putting me on a five-year schedule of colonoscopy exams. I wondered why we couldn’t just do this test every ten years. I suddenly realized that Dr. Niesen was absolutely correct to have set me up for this test every five years. If this polyp were cancerous I certainly wouldn’t have wanted it to remain undetected for another five years. And even if it proved to not be cancerous, if it hadn’t been detected now that would have given it time to later become cancerous.
I pulled out some notebook paper and wrote 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 today’s colonoscopy. Dr. Niesen and the fine staff at St. Mary’s Endoscopy Unit had (for the third time) made this into a very easy procedure.
Afterwards I got in bed and took a nap for about two hours. I guess that the lack of sleep yesterday, combined with the sedatives this morning, played a role in my being tired. For supper I had planned to go to the hotel’s restaurant to have some of their great prime rib. However, when I got to the restaurant I discovered that they were closed for a while for renovations. So I settled for a barbecue chicken sandwich at a nearby restaurant.
I spent the night at the hotel. By the time 8:00 rolled around I was surprised to see that I was no longer tired. Nevertheless, I didn’t want to risk trying to drive home. The sedatives may have still been affecting me more than I realized. Plus I was paying for the room for the night anyway.
I felt fine when I woke up on Sunday morning. There was nothing to suggest that I had been through such an invasive procedure less than 24 hours earlier. I was tempted to take a stroll through Forest Park, as I had done on the Sunday following my last colonoscopy. But I decided to put that off to some time in the future. Right now I had something else that I really needed to do. I had a lot of work waiting for me at the office, since I had taken off all day Friday. When I scheduled this colonoscopy six weeks earlier, I hadn’t realized what a busy week this would be at work. So I drove into the office, knocked out a few hours of work, then drove home. All I could do now was wait for the news on Tuesday as to whether or not the polyp was cancerous, and hope for the best.
During most of Monday I was almost a basket case, as I anxiously waited for the news that was scheduled to come on Tuesday. Was the polyp cancerous? If so, had the cancer spread anywhere? I realized that in all probability the polyp was not cancerous. But right now I wasn’t interested in dealing with probabilities. I wanted to know for certain. This may seem like a rather strange statement coming from a person who always seems to be quoting statistics. I guess when my life hangs in the balance I look at the world through different standards.
On Tuesday morning at work I spent several hours on a conference call, and it was obvious to everyone on the call that my mind was somewhere else than the subject at hand. Although I didn’t explain to any of them why I was having a difficult time answering simple questions that I usually rattle off without a second thought. I couldn’t take my mind off of the polyp.
On Tuesday afternoon I got a telephone call from one of the nurses in Dr. Niesen’s office. She said that the report on the polyp had come in from the Pathology Lab. She said that after Dr. Niesen finished seeing her patients for the day she would begin making telephone calls, probably after 6:00. I said that I was going to stay late at the office to catch up on some work, and asked if Dr. Niesen could call me there.
That evening I got a telephone call at work from Dr. Niesen. She asked, “So how are you doing?” I replied, “I’m doing fine. No, I’m really not doing fine. Actually, I’m scared to death concerning what you are about to tell me.” Dr. Niesen said, “Well, I have good news for you. I removed the polyp on Saturday, so it won’t cause you any problems. And the Pathology Report says it is not cancerous. So it didn’t leave any cancer in your body.” I can’t begin to describe the elation that came at that moment from knowing that I could continue to live a normal life. Who would ever think that being normal could be so wonderful?
I said, “So it sounds like the whole thing was a false alarm.” Dr. Niesen said, “Not so fast. I said that the polyp had not turned to cancer yet. The polyp was a tubular adenoma. This type frequently does turn into cancer. So if I hadn’t removed it, there is an excellent chance that you eventually would have gotten colon cancer.” That reality sent a cold chill down my spine.
This points out a difference between a colonoscopy and most medical screening procedures. While most medical screening procedures only detect diseases, a colonoscopy can prevent and even cure colon cancer. It can prevent colon cancer by removing polyps before they become cancerous. And in certain instances it can cure colon cancer when the doctor removes a cancerous polyp where the cancer has not spread outside of the polyp.
I asked how this could have happened when I maintained a healthy lifestyle. Dr. Niesen said, “My best guess is that it was the result of your family history of colon cancer. Had you not followed a healthy lifestyle you may have gotten that polyp at a younger age. Then again, some people get colon cancer despite no family history and despite a healthy lifestyle.” (That got me to thinking about Katie Couric’s husband.)
Dr. Niesen said, “The polyp was found in the uppermost part of your colon, near the liver.” The significance of this was obvious, but I had to ask to be sure. I said, “Are you saying that if we had done any screening procedure except a colonoscopy the polyp would have been missed?” Dr. Niesen said, “That is exactly what I am saying. If we had used any other screening test you and I would never know about the polyp. We would be thinking that everything was fine, not realizing that you were carrying around a time bomb capable of turning into cancer.”
I asked Dr. Niesen what I could do in the future. She said, “Keep following your healthy lifestyle. And try to increase the fiber in your diet. You’ll get some ideas for that from the booklet that I gave you on Saturday. While this can’t guarantee that you will never get another polyp, it will certainly reduce the odds. Not to mention the fact that a high fiber diet should help to keep your cholesterol numbers in check.”
Dr. Niesen said, “Now for one final piece of bad news. Because of this we can no longer wait five years between colonoscopy exams. We will need to do them on a more frequent basis.” I said, “Dr. Niesen, that is no problem at all. I will happily get a colonoscopy every year, even without sedation, if that is what I need to do for proper screening.” (OK, I didn’t really mean the part about “without sedation”. Although I did say it.) Dr. Niesen said, “Don’t worry. I would never ask anyone to undergo a colonoscopy without sedation. And we won’t have to do it every year. Maybe every two or three years. We’ll talk about it at next year’s physical exam.”
After the telephone conversation was ended, I decided to wrap things up for the evening. There would be plenty of time tomorrow to finish up what I had on my desk at work. As I was walking across the parking lot to my car, my mind began to fill with a bunch of “what ifs”. What if Dr. Niesen had never suggested (must less insisted) that I have a colonoscopy exam? What if my first response in 1997 of “I will never have a colonoscopy exam” had been my last word on the subject? What if my first or second colonoscopy exams had been a bad experience, and I had decided to never repeat the procedure? Things could have turned out much differently than they actually did. I considered myself lucky to have such a fine doctor.
On Wednesday morning I walked into my manager’s office and said, “How are you doing, Craig?” He said, “I’m doing fine. You’re the one who I am concerned about. These past two days you’ve been acting like some sort of a zombie. Was there something that you wanted to talk to me about?” I said, “No. I had a personal problem the last few days. But I got it taken care of last night.” He said, “So I guess there is no reason why today your mind won’t be on your work?” I said, “None that I can think of.”
ONE YEAR LATER
Saturday, July 12, 2008, was exactly 11 years to the day after my first colonoscopy. On that day I found myself back at the Cheshire Inn—this time as a visitor. And I also found myself back at St. Mary’s Hospital—as a visitor to the cafeteria. OK, I guess an explanation is in order.
A friend of mine named Cat was visiting Saint Louis that weekend. Of all the places to stay, she picked the Cheshire Inn. She liked the fact that it was right across street Park. I met her at the Cheshire Inn on Saturday morning, with the intention of us eating breakfast together, then going for a walk through Forest Park.
When I arrived at the hotel, Cat suggested that we eat breakfast at Parkmoor. I said, “You really have been away from Saint Louis for a long time. Parkmoor closed up in 1999. That will be 9 years this October. If you want to go some place close, we can go to the cafeteria in St. Mary’s Hospital. As hospital cafeteria food goes, theirs is better than most of them.”
When we finished eating breakfast, we were walking toward the east end of the building. As we walked past the entrance to the Endoscopy Unit, several staff members walked out. At least two of the ladies looked familiar. I was tempted to introduce myself, and ask if they remembered me. But I decided against this. They probably had a long day ahead of them, and were just out for a short break. It wouldn’t be fair to cut into their break to play 20 questions. So I just said hello, and wished them a nice day. They returned the greeting.
As we were walking through Forest Park Cat asked, “Did you know those ladies?” I said, “Maybe. Two of them looked familiar. I may have met them during one or more of my colonoscopies. Speaking of which, have you ever had a colonoscopy? I know that you’re turning 50 in December.” Cat said, “No, I’ve never had one. And I really don’t want one. But since I’m a former nurse, I know that it is an important test. So I’m sure that I will have a colonoscopy sometime next year.” I’ll have to remember to send her a copy of my article.
MY FOURTH COLONOSCOPY MAY HAVE SAVED MY LIFE
My fourth colonoscopy may have saved my life. But not for the reason that you may be thinking. Read on, and I will explain how.
We now jump forward to May 1, 2009. That afternoon I visited Dr. Niesen for my annual physical exam. I realized there was a chance that I would be getting another colonoscopy this year. When the polyp was found after my third colonoscopy in 2007, Dr. Niesen said that I would now be getting this test every 2 to 3 years, rather than every 5 years as was previously done. However, I was hoping that “every 2 to 3 years” would actually mean every 3 years, so that I wouldn’t have to go through this test until next year.
During the physical exam, neither Dr. Niesen nor I brought up the subject of a colonoscopy. However, I realized that I probably wouldn’t know for sure until it was time to leave.
When I was checking out, John said, “Looks like you will be getting the same blood tests that you get every year. The good news is that you don’t need a colonoscopy, since you just had one of those two years ago.” I said, “Actually, it has only been 692 days.” Right then Dr. Niesen walked out of her office and said, “Wait a minute. He does need a colonoscopy this year. Since I found the polyp in 2007, he is now on a two-year schedule for colonoscopy exams.” John raised his hands in surrender and said, “What can I tell you? I guess I’m overruled on this one.”
John asked me if I wanted to set up an appointment for a colonoscopy now, or if I wanted to give him a call next week and set something up. I was tempted to say that I would call him next week, and then “forget” to make the call. But I quickly decided that this would be a bad idea. Putting off medical tests until “later” was something that my mother did, and that is probably why she passed away back in October. By the time she finally did agree to have the medical tests recommended by her doctor, her condition was beyond the point of being curable.
So I told John we could set something up right now. He set me an appointment for Saturday, June 20. He told me to report to the Endoscopy Unit of St. Mary’s Hospital at 8:00 a.m. and said that the actual colonoscopy would begin around 9:30. He then gave me a handout of the pre-exam procedures to be followed. It looked like we were going back to the old preparation method — Drinking a gallon of Colyte. The only thing that had changed from the original version of the old preparation method was that an enema was no longer required as part of the prep. That was fine with me. Also, this time I would not have to spend $30 or $40 to purchase the Colyte from Walgreens. John gave me a bottle of the prep to take home. Now I just had to put it someplace where no visitors to my house would see it, yet someplace that I would remember.
The following day (Saturday, May 2) I bowled in a tournament where the proceeds went for colon cancer research. The event was sponsored by a lady named Sophia who works as a licensed practical nurse. The way that Sophia got into this was that her father died of colon cancer in 2007. So she is trying to get out the word that this disease is curable if it is caught in the early stages. At the event several people tried to give me literature on colon cancer screening. I’m not sure if they believed me when I said that just yesterday I scheduled an appointment for my next colonoscopy exam.
The day after that (Sunday, May 3) my friend Cat once again visited Saint Louis from out of state. Only this time she didn’t stay at the Cheshire Inn. Instead she stayed at a hotel near the Airport. She said, “I really appreciated you sending me your accounts of your colonoscopy exams. I’m going to be having the test myself later this year, so I can use that as a guide of what to expect.” I said, “It’s interesting that you mentioned that. I just found out on Friday that I’m going to be having the test again on June 20. So you may be getting an updated version of that article in a few more months.”
Once again I made a room reservation at the Cheshire Inn for Friday and Saturday of the exam weekend. This worked well in the past, so I figured that I may as well stay with it.
I also decided to have a colonic irrigation the day before the colonoscopy. With the old preparation method this does seem to reduce the amount of Colyte that you have to drink. Not to mention the fact that it can help to reduce some of the negative side effects of drinking Colyte. I called Cindy (the owner of the business where I had the colonic irrigations before my second and third colonoscopies) and explained the situation. She set me an appointment for 9:30 in the morning on Friday, June 19 — the day before the colonoscopy. She said that the procedure would probably be performed by a therapist named Karen.
My next step was to find a way to get back to the hotel from the hospital after the test. That proved to be easy this time. Last year my mother found a home health agency called Mid America Home Health Care. On several occasions my mother got visits from a Registered Nurse named Tonya, and two Nurses Aides named Harriett and Keondra. After my mother passed away, Harriett continued to provide services for me. I asked Harriett if she would be willing to drive me to and from the hospital on the day of the colonoscopy. She said that she would be happy to do this for me.
On May 30, I attended a birthday party for Helene. She helped me with the prep before my third colonoscopy. At the birthday party somehow the subject of cancer screening came up, and Helene asked me when I was getting my next colonoscopy. I said, “Sometime in 2012. I have the test every five years.” Helene said, “Why don’t I believe that answer?” I said, “I don’t know. Why don’t you believe it?” Helene said, “You were on 5 year recalls before the last test, when your doctor found a polyp. I can’t believe that your doctor wouldn’t have shortened the recall time after that.” I guess that I can’t put anything past her. I said, “OK, I’m now getting the test every two years. My next colonoscopy is scheduled for Saturday, June 20.”
Helene asked me what the prep schedule was this time. After I explained it, she said, “On Friday and Saturday you will follow your doctor’s schedule. On Monday through Thursday you will follow my schedule, as long as it doesn’t conflict with any instructions from your doctor. The reason why the prep is so difficult to go through is because you are trying to clean yourself out in one day. I’m going to have it so that you will clean yourself out over five days. By the time that you are ready to start drinking the Colyte you will be cleaned out well enough that this part should go very easy.”
Helene said, “On Monday through Thursday make sure that you drink a lot of water, and eat a high fiber diet. Vegetables are very important. Eat lots of carrots, celery, broccoli, cauliflower, lettuce, and cabbage. Try making yourself a salad with these vegetables, and use Olive Oil as your dressing. Also eat some pineapple and papaya on those days. The digestive enzymes in those fruits will be beneficial for this process. On Wednesday Evening I want you to come to my house, and we will do one more thing that should help the process along.” I decided not to ask, although I was fairly certain what this would be from last time.
On June 8, I decided to get a head start on Helene’s diet suggestion. She wasn’t asking me to eat less, or to take any questionable supplements. She was only asking me to eat a diet that was higher in fruits and vegetables, drink more water, and replace salad dressing containing fat with pure Olive Oil. I was surprised that by the end of the week I felt like I had more energy and endurance. Maybe I would stay with this diet after the test was over.
On Saturday, June 13—exactly one week before my colonoscopy—I walked in the Koman Race For The Cure, which raised money for breast cancer research. Although this was a different type of cancer than colon cancer, there were two messages that came through loud and clear during the walk: (1) Living a healthy lifestyle will reduce a person’s risk of getting cancer in the first place; (2) If a person does get cancer, the sooner it is diagnosed the better chances for survival. This reinforced my realization that I was doing the right thing by having the colonoscopy
When Dr. Niesen found the polyp in 2007, I stated that I would do whatever is necessary to get properly screened for colon cancer in the future. Dr. Niesen is an excellent doctor. Every one of the staff members who I had contact with at Saint Mary’s Endoscopy Unit were excellent. So why on the evening of Monday, June 15 (just 5 days before the colonoscopy) did I suddenly start to get nervous about this test while I was at the bowling alley? I wouldn’t seriously consider doing something stupid like trying to cancel the test. Would I?
I needed to get out of this mindset right now. When I got home from the bowling alley I got into my E-mail account and sent E-mails to three people asking them to tell me that (1) I was doing the right thing and; (2) I would do just fine with the test. One of those people was a Licensed Practical Nurse named Sophia, who I mentioned earlier in this article. Her father died of colon cancer in 2007. The second person was a Registered Nurse named Jo Ann, who works at a cancer center. The third person was a 34 year old lady who was diagnosed with colon cancer at the age of 27. She is now cancer free, and runs a not for profit organization that helps people who have been diagnosed with this disease. All three of these people responded to my E-mail in a positive way, giving me encouragement.
On Wednesday evening I arrived at Helene’s house, hoping that I would not regret this visit. Helene and Angie greeted me at the door. Angie was a friend of Helene’s who I had met a few weeks earlier at Helene’s birthday party. Angie worked as a reflexologist on the side. Helene asked me how her diet suggestion was working. I said, “I feel like I have a lot more energy with this diet. Whether it will help me when it comes time to do the prep on Friday, I guess the jury is still out on that one.”
Helene said, “Angie and I are going to give you two enemas to help with the cleaning out process.” Based on my visit to Helene before my last colonoscopy I kind of figured that may be the case, although I was hoping that would not be what she had in mind. I said, “Before we start we need to set some ground rules. If I say stop, then you stop. No questions. No arguments. No negotiations. Stop means stop.” Helene said, “That is understood. But I don’t think you will have any problems. Remember last time when you started to get cramps, I massaged your abdomen, and that really helped? Well this time I will start the abdominal massage right away, so the discomfort will never start. While this is happening, Angie will be doing reflexology on your hands and feet, paying particular attention to the areas which affect the intestines. Those two procedures together will insure that you feel very little in the way of cramps.
Helene and Angie had me lying on a massage table, and brought in something that looked like a glorified hot water bottle. I was expecting the worst, but thanks to the abdominal massage and the reflexology, there was very little discomfort during the enema. Other than a little momentary discomfort in my hands and feet, when Angie pressed a little too hard on the reflex points. Helene said, “I’ll bet that if Angie and I were with you during the colonoscopy and performed our abdominal massage and reflexology, you would be able to go through the procedure without any sedation.” I said, “You will never be able to prove it or disprove it by me, because I would never even think to try that”.
On Thursday I walked into the office of my co-worker Bridgit. I said, “Can I ask you to give me a pep talk about something?” She said, “Isn’t this a role reversal? Aren’t you the one who usually gives me a pep talk?” I said, “Not always. You’ve given me a few good pep talks when I really needed them. Let me explain what is going on.”
After explaining the situation to Bridgit she said, “OK, let’s look at it this way. Three things. First, you are 59 years old. Second, you have a family history of colon cancer. Third, your doctor found a polyp during your last colonoscopy. There is no way that you should not have this colonoscopy. Finally, you admit that your doctor and the staff at Saint Mary’s Endoscopy Unit are really great at their jobs. So stop being nervous and you will do just fine.” That’s what I wanted to hear.
On Thursday evening I ate a large turkey dinner at Deluxe Diner, knowing this would be the last solid food that I would eat before the test was over on Saturday. Later that evening my dentist, Dr. Pagano, took me and some of his other patients to the circus. That was a good opportunity for me not to think about Saturday’s exam.
I took off work on Friday, June 19—the day before the colonoscopy. I went to the grocery store and purchased my clear liquid diet for the day. This consisted of apple juice, banana juice, and pear juice. I then went to the health food store and purchased some ginger flavored carbonated water, and some Ginger Beer. (Which as I discussed earlier contains no alcohol, despite the word “beer”.)
I had my colonic irrigation appointment at 9:30. The procedure was performed by a therapist named Karen. The procedure went very smoothly, as I felt no discomfort at all. Plus Karen was a very interesting person to talk to. So that may have helped to take my mind off of what was going on. Afterwards Karen wished me good luck with the test.
After checking into the hotel I started drinking the liquid prep. I had assumed that it was Colyte, but when I opened the box I realized that it was some other brand of liquid prep. And unlike Colyte, which required drinking a gallon, this brand only required drinking two quarts (one half gallon). I didn’t care much for the taste, which was sort of a cross between Kool Aid and salt water. I didn’t have any unexpected negative side effects, other than some very brief mild stomach cramps, plus spending most of the night running into the bathroom.
I awoke at 5:00 in the morning on Saturday, and killed a few hours watching television. Harriett picked me up at 7:00 and drove me to the hospital. I filled out some forms and was given a brief interview of my medical history etc. When I was in the waiting room I said, “Harriett, if I decide to get up and walk out of here, you won’t let me do that, will you?” Harriett asked, “Why would you try to walk out of here?” I said, “You know, like if I get nervous or something.” Harriett replied, “Don’t be getting nervous. You admit that you’ve had the test before and didn’t have any problems.”
Around 7:40 a Registered Nurse , asked me to come inside. As I followed Sharon inside, Harriett wished me good luck with the test.Sharontook me to a curtained off area, where there was a table with some IV equipment attached. She told me to get undressed, put on a hospital gown, and lie down on the table.
A few minutes later Sharon came in with another Registered Nurse who she introduced as Mary. She said, “I will start your IV, and Mary will assist Dr. Niesen during the colonoscopy.” I said, “Sharon, I’m starting to get scared. I’ve been nervous about this test all week long, although I can’t figure out why.”Sharonsaid, “We don’t want you to be nervous. Take some deep breaths, think happy thoughts, and just loosen up.”
I felt a brief stick when Sharon inserted the needle. That was no big deal, but when I was hooked up to the monitor it showed that my heart rate was way too fast. I knew that it was probably caused by the fact that I was nervous, but how could I calm down when I heard the machine making this loud beeping noise, to remind me that my heart was beating too fast? Do you see the Catch 22 situation that I was in?
Around 9:30 Mary came in and said that it was time to go into the Endoscopy Room to begin the colonoscopy. She wheeled me into the Endoscopy Room, where I saw the monitor and the colonoscope. Dr. Niesen entered the room a few minutes later. She asked, “What is going on with your heart rate?” I said, “I’m scared. I’ve been nervous about this test all week, and there is no good reason for it. I’ve had the test three times and every one has been a very easy procedure. You’re a great doctor. The staff here is excellent. Intellectually there is no good reason for me to be nervous. But today my emotions seem to be overriding my intellect.” Dr. Niesen said, “When I start the sedatives hopefully your heart rate will drop. If that doesn’t happen I won’t be able to do the test. Roll over onto your left side, and let’s see what we can do.” I rolled over, and that was the last thing that I remembered.
When I woke up Dr. Niesen was standing at my bedside. I asked how the test results looked. She said, “I was not able to finish the test. I got about one third of the way through, and had to stop because your heart rate would not come down. I’m taking you into the Emergency Room.” I said, “Forget that. Just let me get dressed and I’ll go on home.” Dr. Niesen said, “That is not an option. I’m your doctor, and I am your friend, and I will not allow you to endanger yourself like that.” I said, “You’re right. Take me to the Emergency Room.”
Dr. Niesen took me into the Emergency Room, where a group of doctors and nurses immediately began working on me. They gave me some medication through an IV which they said would help to reduce my heart rate, hooked me up to some sort of a machine, and drew some blood from me. It wasn’t long before my heart rate dropped to normal. They told me that one of their top cardiologists, Dr. Lisa Reis, was being assigned to my case, and that she would be in to see me in a few minutes.
Several minutes later Dr. Reis came in and introduced herself. I said, “What is going on here? I came in for a colonoscopy, and suddenly I’m in the Emergency Room with a heart problem.” Dr. Reis said, “The colonoscopy did not cause the heart problem. I understand that over the years you have had EKG’s, stress tests, and echocardiograms, that have all come back with normal results. These are good tests, but they are not foolproof. The fact that this happened merely because you were nervous about a test means that there was a heart problem that had never been diagnosed. That being the case, don’t you think it was good that we found it out now when you were in the hospital, rather than having it surface when you were someplace where no medical help would be available?” I had to admit that she was correct on this point. Having the colonoscopy that morning may have saved me from a future heart attack.
A Registered Nurse walked up to my bed and said, “I am the Head Nurse on the Third Floor Cardiology Step Down Unit. Just as soon as a bed is available we will be taking you up there.” I said, “You mean for a few hours of tests?” The nurse said, “No. I mean you will be staying here overnight.” I said, “No, I am not staying in the hospital overnight.” The nurse said, “Yes you are.” By this time Harriett had been allowed in the Emergency Room, and she was standing at my bedside. She looked at me and said, “You need to listen to what the doctors and nurses are telling you. They are only interested in what is best for you.”
I said, “OK, I am willing to stay one night. But tomorrow I am leaving no matter what. I need to be back at work on Monday.” The nurse said, “You will stay here as many days as are necessary, until either Dr. Niesen or Dr. Reis decide it is safe for you to leave.” My response to that statement was not fit to be printed. But the nurse wasn’t about to be deterred. She said, “If you really want to leave we can’t stop you. It is your right to leave any time you want. But that right isn’t going to do you much good if you are lying on the floor dead from a heart attack.” I glanced over at Harriett, whose nod of the head suggested that I would do well to follow this advice. I said to the nurse, “You just won this argument. I’ll go upstairs with you, I’ll stay as long as is necessary, and I won’t cause any more trouble. And thank you for having the courage to insist that I do the right thing, rather than the easy thing.”
When I arrived on the Third Floor, I was once again hooked up to an IV, had some more blood drawn, given an EKG, and had a portable machine hooked up to my chest which would give a constant read out of my heart activity.
I’ve always had a great deal of respect for people who work in the health care field. And my stay in the hospital only increased that respect. This is a job which requires a great deal of technical knowledge, people skills, time management, ability to deal with difficult patients (like myself!), and the ability to correctly make split second decisions which may not be reversible.
Later that afternoon Dr. Niesen and Dr. Reis came into my room. There is a certain feeling of security with having two very fine doctors working together on your case. They explained that I had atrial fluttering. Left untreated this can cause some serious problems. However, if I take the medicine that they would be giving me when I leave, and follow their guidelines, I should be just fine. They listened to my heart, and mentioned that the last round of tests performed earlier that day all came back normal. I said, “So tell me this. With this condition will I be able to play the violin?” Dr. Reis said, “Of course you will.” I said, “That’s great. I’ve never been able to play the violin before.” Dr. Niesen laughed and said, “Listen to the comedian here. He must be feeling better if he is telling those kinds of jokes.”
I did stay in the hospital overnight. More tests and more blood drawings. I don’t like needles, but the staff was so good at drawing blood that I hardly felt a thing. It did get rather boring being confined to bed with nothing to do but watch TV and stare at the four walls. But I wasn’t going to complain. It was a small price to pay to get better. I was happy to hear that all of the subsequent tests came back normal.
On Sunday Morning Dr. Niesen came to see me. She gave me a printout of what I needed to do when I left the hospital, along with a prescription for the medicine that I would be taking. She also told me to call both her office and Dr. Reis’s office to schedule follow up visits.
I said, “Dr. Niesen, I want to ask you a favor. Understand that this is a great hospital. The staff is wonderful, and they have about the best hospital food that I’ve ever tasted. They could teach the restaurants a thing or two. But I would really appreciate it if you could see your way to letting me go home today.” I gave her a look which I hoped would say, “Work with me on this.” Dr. Niesen appeared to be giving it some thought then said, “Well what are you waiting for? Get dressed and get out of here. I’ll write a discharge order and turn it into the nurse’s station.” I said, “Thanks! You’re the best! Oh, and if you could have somebody come in and remove my IV. I’m afraid that if I try to do it I may bleed to death.” As Dr. Niesen was walking out of my room I said, “One more thing. Do you think that we can postpone the colonoscopy until next year?” Dr. Niesen said, “No. We will be doing the test again later this summer.” I said, “OK, I can live with that. And I promise you that next time I will be a braver person about the test.”
After my IV was removed I got dressed and made my rounds (not to be confused with a doctor’s rounds) telling the staff members goodbye, thanking them for everything that they did for me and wishing them the best of luck.
I then walked to the front desk to see Michelle. She said, “I guess that you are all ready to leave.” I said, “Not quite. There is one more thing that I need to do.” Michelle said, “I can’t imagine what that would be. It looks to me like everything is in order.” I looked directly at Michelle and said, “I want to apologize for the way that I talked to you yesterday. I had no right whatsoever to say the things that I said to you.” Michelle laughed and said, “Don’t worry about it. When people are sick they often say things that they don’t really mean. I’ve already forgotten about it.” I said, “Yeah, but I haven’t forgotten about it. You and every other staff person on this floor are very fine people. Now you’d better get me out of here before I start to cry.”
I found it somewhat ironic that I was standing on a cardiology floor where I had just received a host of heart related tests, and was wearing a shirt which said, “Law Enforcement Run.” Hardly the type of shirt you would expect to see a cardiology patient wearing. As it happened, I didn’t actually run in that event. I got the shirt from a former co-worker whose husband worked for the Missouri State Highway Patrol. However, less than four weeks earlier I did successfully complete a 6 mile run. How did I go from there to here in such a short amount of time? Then again, there have been Marathon Runners who have died from heart attacks. So I guess it happens.
On my way home I stopped off at Walgreens to get my prescription filled for the heart medicine. When I arrived home and walked into the house, I found it hard to believe that so much had happened in just a little over 24 hours. I resolved to follow Dr. Niesen’s and Dr. Reis’s instructions to the letter, so that I would have no more problems. They are both great doctors, and I was lucky to be their patient.
That evening I got on the computer and found an E-mail from Bridgit at work. It was sent on Friday Evening. It said, “As we discussed at work yesterday, don’t be nervous about the colonoscopy on Saturday. You will do just fine.” I wasn’t looking forward to facing Bridgit on Monday, and telling her what actually happened. The reality is that I wasn’t convinced that at least some of the rapid heartbeat on Saturday Morning wasn’t caused by my fear of the test. And if that was the case, then I should be ashamed of myself.
On the evening of Tuesday, June 23, I wrote a number of letters. These letters were sent to Dr. Niesen, Dr. Reis, the Endoscopy Staff, the staff of the Third Floor where I was a patient, and the Emergency Room Staff. Each letter offered my thanks for everything that they did for me. I also wrote a letter to the President of Saint Mary’s Hospital (William Jennings), telling him about my positive experiences in the hospital.
So I guess that before the summer is over I will be updating this article to also talk about my fifth colonoscopy.
NOTE: To be continued in Part 3