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Ugly but very important

By Ken Yeager

I am sure many of you have seen this but just in case, allow me to post it as a reminder to get an appointment. It is important. During my time in the Foreign Service we (wife and I) were obliged to have a complete physical every time we changed postings. As we had served in some rather unhealthy places, it was nice to know that after some years in Africa we hadn’t picked up some bug that would come to haunt us later in life. Unfortunately, the full physical did not pick up on my wife’s CLL problem that was diagnosed during our time in Morocco (1997-1999), but so far she is winning that battle. Once we turned 50, this (below article) became a requirement and is something to repeat every 10 years or so afterward.

BYLINE: By Dave Barry, McClatchy Newspapers

OK. You turned 50. You know you’re supposed to get a colonoscopy. But you haven’t. Here are your reasons:

1. You’ve been busy.

2. You don’t have a history of cancer in your family.

3. You haven’t noticed any problems.

4. You don’t want a doctor to stick a tube 17,000 feet up your behind.

Let’s examine these reasons one at a time. No, wait, let’s not. Because you and I both know that the only real reason is No. 4. This is natural.

The idea of having another human, even a medical human, becoming deeply involved in what is technically known as your “behindular zone” gives you the creeping willies.

I know this because I am like you, except worse. I yield to nobody in the field of being a pathetic weenie medical coward. I become faint and nauseous during even very minor medical procedures, such as making an appointment by phone. It’s much worse when I come into physical contact with the medical profession. More than one doctor’s office has a dent in the floor caused by my forehead striking it seconds after I got a shot.

In 1997, when I turned 50, everybody told me I should get a colonoscopy.

I agreed that I definitely should, but not right away. By following this policy, I reached age 55 without having had a colonoscopy. Then I did something so pathetic and embarrassing that I am frankly ashamed to tell you about it.

What happened was, a giant 40-foot replica of a human colon came to Miami Beach. Really. It’s an educational exhibit called the Colossal Colon, and it was on a nationwide tour to promote awareness of colo- rectal cancer. The idea is, you crawl through the Colossal Colon, and you encounter various educational items in there, such as polyps, cancer and hemorrhoids the size of regulation volleyballs, and you go, “Whoa, I better find out if I contain any of these things,” and you get a colonoscopy.

If you are a professional humor writer, and there is a giant colon within a 200-mile radius, you are legally obligated to go see it. So I went to Miami Beach and crawled through the Colossal Colon. I wrote a column about it, making tasteless colon jokes. But I also urged everyone to get a colonoscopy. I even, when I emerged from the Colossal Colon, signed a pledge stating that I would get one.

But I didn’t get one. I was a fraud, a hypocrite, a liar. I was practically a member of Congress. Five more years passed. I turned 60, and I still hadn’t gotten a colonoscopy. Then, a couple of weeks ago, I got an e-mail from my brother Sam, who is 10 years younger than I am, but more mature. The e-mail was addressed to me and my middle brother, Phil. It said:

“Dear Brothers, “I went in for a routine colonoscopy and got the dreaded

diagnosis: cancer. We’re told it’s early and that there is a good prognosis that they can get it all out, so, fingers crossed, knock on wood, and all that. And of course they told me to tell my siblings to get screened. I imagine you both have.”

Um. Well. First I called Sam. He was hopeful, but scared. We talked for a while, and when we hung up, I called my friend Andy Sable, a gastroenterologist, to make an appointment for a colonoscopy. A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis. Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner. I nodded thoughtfully, but I didn’t really hear anything he said, because my brain was shrieking, quote, “HE’S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!”

I left Andy’s office with some written instructions, and a prescription for a product called “MoviPrep,” which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America’s enemies.

I spent the next several days productively sitting around being nervous.

Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn’t eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons.) Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes – and here I am being kind – like a mixture of goat spit and urinal cleanser, with just a hint of lemon.

The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, “a loose watery bowel movement may result.” This is kind of like saying that after you jump off your roof, you may experience contact with the ground.

MoviPrep is a nuclear laxative. I don’t want to be too graphic, here,

but: Have you ever seen a space shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom, spurting violently. You eliminate everything.

And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.

After an action-packed evening, I finally got to sleep. The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, “What if I spurt on Andy?” How do you apologize to a friend for something like that? Flowers would not be enough.

At the clinic I had to sign many forms acknowledging hat I understood and totally agreed with whatever the h*ell the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.

Then a nurse named Eddie put a little needle in a vein in my left hand.

Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep. At first I was ticked off that I hadn’t thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no choice but to burn your house.

When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand. There was music playing in the room, and I realized that the song was “Dancing Queen” by Abba. I remarked to Andy that, of all the songs that could be playing during this particular procedure, “Dancing Queen” has to be the least appropriate.

“You want me to turn it up?” said Andy, from somewhere behind me. “Ha ha,” I said. And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.

I have no idea. Really. I slept through it. One moment, Abba was shrieking “Dancing Queen! Feel the beat from the tambourine …” … and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that it was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.

But my point is this: In addition to being a pathetic medical weenie, I was a complete moron. For more than a decade I avoided getting a procedure that was, essentially, nothing. There was no pain and, except for the MoviPrep, no discomfort. I was risking my life for nothing.

If my brother Sam had been as stupid as I was – if, when he turned 50, he had ignored all the medical advice and avoided getting screened – he still would have had cancer. He just wouldn’t have known. And by the time he did know – by the time he felt symptoms – his situation would have been much, much more serious. But because he was a grown-up, the doctors caught the cancer early, and they operated and took it out. Sam is now recovering and eating what he describes as “really, really boring food.” His prognosis is good, and everybody is optimistic, fingers crossed, knock on wood, and all that.

Which brings us to you, Mr. or Mrs. or Miss or Ms.

Over-50-And-Hasn’t-Had-a-Colonoscopy. Here’s the deal: You either have colorectal cancer, or you don’t. If you do, a colonoscopy will enable doctors to find it and do something about it. And if you don’t have cancer, believe me, it’s very reassuring to know you don’t. There is no sane reason for you not to have it done.

I am so eager for you to do this that I am going to induce you with an Exclusive Limited Time Offer. If you, after reading this, get a colonoscopy, let me know by sending a self-addressed stamped envelope to Dave Barry Colonoscopy Inducement, The Miami Herald, 1 Herald Plaza, Miami, Fla. 33132.

I will send you back a certificate, signed by me and suitable for framing if you don’t mind framing a cheesy certificate, stating that you are a grown-up who got a colonoscopy.

Accompanying this certificate will be a square of limited-edition custom-printed toilet paper with an image of Miss Paris Hilton on it. You may frame this also, or use it in whatever other way you deem fit.

But even if you don’t want this inducement, please get a colonoscopy. If I can do it, you can do it. Don’t put it off. Just do it.

Be sure to stress that you want the non-Abba version.

4 comments to Ugly but very important

  • Suellen Oliver Campbell

    Thank you for the reminder, Ken. Most of have taken better care of our children and parents than we do ourselves.
    Dave Barry’s piece has always made me laugh. What a description of an non-entertaining procedure.
    Have a great weekend and upcoming week.

  • Kevin L. Wells

    Been there, done that, and it is no big deal.

    I even asked about the drugs, which, by the way, are also no big deal.

    I must be resistant. After they (allegedly) pushed the plunger on the drug load, I asked if there was a tape or DVD made, and no, damn-it, there was none.

    I kept a running dialog going. I asked the Nurse Anesthetist where she went to school (Baylor, a very good school). Next, I asked the physician why he used monochromatic light (It shows blood vessels more clearly)

    Actually, the whole image looks just like the scene in Aliens in which Ripley (Sigourney Weaver) goes down into the alien nest in search of the little girl. It is circular sectioned passage with fluids inexplicably dripping and oozing.

    Very untidy, but, in my case, nothing oozing or dripping that was out of place and certainly no aliens or alien tissue.

    After it was all over, I asked the physician if he has seen anything in there coating my colon “like spackle or paste” (the precise words used in one of those stupid colon cleansing formula ads on television) and I was free of that problem.

    They wheeled me back to the room for recovery. They heck with that, I was getting dressed, which seemed to upset them no end when they discovered that I had done so.

    I think they were expecting me to lie there drooling on the pillow until the drugs wore off.

    The only problem was on the way home. I blew the doors off with an Olympic class performance. My wife, not trusting me to be civilized, changed the plan to Chinese take-out and I finished my needful task while she was inside doing the ordering.

    Go ahead people, give your “Inner Jerk” free rein, have some fun!


  • Elizabeth Respess

    I had one when I turned 45, so I’m not chicken, but it is easy to put off. I am now 52 and recovering from breast cancer. I guess now would be a good time to make an appointment for the dreaded roto-rooter exam. Thanks for the reminder. Dave Barry has always been a favorite. Nothing like humor to get you through adversity.

  • Colon cancer test could save thousands in Britain
    From Associated Press
    April 28, 2010 4:23 PM EDT

    LONDON (AP) — A five-minute colon cancer test could reduce the number of deaths from the disease by about 40 percent, a new study says.

    British researchers followed more than 170,000 people for about 11 years. Of those, more than 40,000 had a “flexi-scope” test, an exam that removes polyps, small growths that could become cancerous.

    The test involves having a pen-sized tube inserted into the colon so doctors can identify and remove small polyps. Researchers used the test on people in their 50s. In the U.K., government-funded colon cancer screening doesn’t start until age 60.

    Researchers compared those results to more than 113,000 people who were not screened. They found the flexi-scope test reduced peoples’ chances of getting colon cancer by one third. It also cut their chances of dying by 43 percent. Researchers said the test needed to be done just once in a person’s lifetime.

    The results were published online Wednesday in the medical journal, Lancet. It was paid for by Britain’s Medical Research Council, National Health Service Research & Development, Cancer Research UK and KeyMed.

    Experts said the findings could make some authorities reconsider how they look for colon cancer. Worldwide, the disease causes 1 million cases and 600,000 deaths every year.

    In Britain, people aged 60 to 74 are tested every other year with a fecal blood test. In the U.S., colonoscopies — 20-minute scans of the entire colon that require sedation — are common, even though no trials have proved they work for cancer screening. Use of the flexi-scope test has plummeted in the U.S. because colonoscopies are perceived as being better.

    To find polyps or to detect cancer early, the American Cancer Society recommends several options for people over 50: a flexi-scope test, double-contrast barium enema or virtual colonoscopy every five years or a colonoscopy every 10 years.

    “It’s not for me to tell governments what to do,” said Dr. Wendy Atkin, a professor of surgery and cancer at Imperial College London, who led the research. “But this is a very big effect, with a very quick and a very cheap test.”

    Atkin said the test only needed to be done once because polyps that grow in the bowel appear before age 60 — so any potentially cancerous growths should be caught if the test is done on people in their fifties. But the test only works on the lower bowel, so other exams, like the fecal blood test, would still be necessary.

    Dr. David Ransohoff of the departments of medicine and epidemiology, University of North Carolina at Chapel Hill, North Carolina, said the Lancet findings might make doctors rethink whether the less-invasive flexi-scope test to scan the lower bowel, plus a highly sensitive fecal blood test to scan the upper bowel, could be better than a colonoscopy. Ransohoff was not linked to the study and wrote an accompanying commentary in the Lancet.

    Ransohoff said the finding the test only needed to be done once in a person’s lifetime was “striking” and further follow-up was necessary to see just how long this protective effect lasts.

    Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society, said the study results would not change their colon cancer screening guidelines.

    “We have long included (flexi-scope) tests as one of our preferred tests to prevent disease,” he said. “I would hope clinicians look at this information and recognize there is some value in this test.”

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