The colon monologues: How I learned to love my insides

The proper placement of the two-dot punctuation sign known as the colon causes no end of perplexity, but the consequences of misplacing it are usually not fatal. Not so the consequences of ignoring the part of the body with the same name.

My mother died of colon cancer at the age of 56. That puts my brother and me at higher risk for this form of cancer, which is the third most common type for both men and women (when each sex is considered separately) in the United States. Studies have also shown that its incidence is on the rise in many countries.

But it is also one of the most preventable cancers. Smoking, obesity and lack of exercise are among the risk factors, but a relatively simple procedure can prevent the disease in the majority of cases simply by, literally, nipping it in the bud.

I had a colonoscopy last Friday. I it was my fourth or fifth. In the procedure, usually performed under some form of anesthesia, the gastroenterologist takes a guided tour of your intestines, stopping to examine anything that looks suspicious. What arouses suspicion? Polyps: small growths that can be the precursors of colon cancer. The doctor snares and removes each polyp and sends it to a pathology lab.

So that the doctor can see the intestines clearly, they must be whistle clean. This means one has to prep by taking strong laxatives. The first time I had a colonoscopy, I had to swallow two gallons of vile-tasting liquid that made me gag with every sip. Now the system has been refined. This time I took two tiny pills, and then two additional installments, each consisting of one cup of a fruit-flavored solution plus six glasses of water.

I also canceled all appointments for 24 hours, because I knew I would be making frequent trips to the toilet before the procedure and that I would be groggy afterwards.

Today it is also possible to have a virtual colonoscopy, which is noninvasive. But the prep is the same, and if anything suspicious is found, a regular colonoscopy is necessary to remove it.

In a previous colonoscopy, my doctor found and removed three polyps. This time he found and removed two.

It’s not fun and it’s not something people like to discuss. But each of those five polyps, left to its own devices, could have turned into a killer.

That’s why I consider a colonoscopy an investment in life.

Text copyright 2012 by Esther Hecht. No part of the text may be used without written permission of the author.



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11 Responses to “The colon monologues: How I learned to love my insides”

  1. laser Says:

    Well stated. You did not tell us what the pathology lab reported about any of your polyps. Of the several colonoscopies that I have had, the two before the last were not conclusive because — despite my follwoing all the instructions, the intestine was not clean down to the end. (And this included special instructions after the first unsuccessful one). The last procedure, which was clean, found no polyps, but a previous one found one benign polyp.

    From what I read, there is no agreement as to how often one must perform a colonoscopy, whether or not one has had polyps in the past.

    My late father’s doctor was surprised when colon cancer was found, because he had done a clean occult blood test not long before. Therefore, it is clear that the occult blood test gives false negatives, which could be fatal. (In my father’s case, his operation was successful, by the way.)

    Please keep us up to date on the lab test results.

    • estherhecht Says:

      Thanks for your comments and concern. The previous polyps were benign. I assume that the current ones are too, but will have results only in three weeks. After the last colonoscopy, in which no polyps were found, the doctor told me to repeat the test in five years’ time, which is what I did.
      I read recently that the occult blood test is quite unreliable.

  2. An tea capitalist Says:

    When you live in a country with free healthcare its definitely a good investment to go see your doctor when you are sick. When you live in the only country in the OECD with no public healthcare, and where health services are the second most expensive in the world (after east timor) but also the rated as the worst level of healthcare in the OECD (by the WHO), all this talk about preventative procedures is theoretical as best. That is unless you make lots of money, and are not one of the almost 50 million americans who do not have any form of health insurance, or not someone like me, who must buy health insurance for our family privately due to state laws, but cannot afford to pay the out of pocket cost of seeing a doctor.

    • estherhecht Says:

      Thank you for your comment. I do not live in a country with free health care. in Israel we pay for our health care, but I admit that we pay considerably less, relative to our income, than people must pay in the United States. If I lived in the United States, when elections came around I would not vote for “none of the above.” I would vote for the candidate who pushed for a better and more universal health care system.

      • An tea capitalist Says:

        If as you say “I would vote for the candidate who pushed for a better and more universal health care system”, it is most likely you will find that you have to not vote for either of the ONLY two options, which are pretty much the same, if not identical. The words “universal” and “care” put in the same sentence constitute something that is inherently un-american.

  3. Judy Labensohn Says:

    I found the prepping for the virtual colonoscopy so distressing that I vowed not to do it next decade. Also the insensitivity of the technicians and “supportive” staff was astonishing. Maybe I’ll forget all that by 2021 and do it anyway, even though the best prevention for everything, it seems, is eating veggies, fruit, whole grains and exercising.

    • laser Says:

      I understand that the preparation for both active and virtual colonoscopies is the same. There are different preparations and different regimes for each, and the one to be used depends on the preferences of the physician. Perhaps Judy’s objection is to the particular preparation and not to the procedure. If one has had several colonoscopies of any sort and has found one preparation preferable, the thing to do is to ask the physician if it is possible to use the preparation that the patient prefers. If not, there are other physicians from whom to choose.

    • estherhecht Says:

      Sorry to hear that, Judy. The preventive measures are all fine in themselves, but perhaps not sufficient. I don’t know why you chose to do a virtual rather than a regular colonoscopy, but if you ever decide to do a regular colonoscopy, I’d recommend the doctor I went to.

  4. Tamara Says:

    I’m writing this a few weeks after you wrote this, Esther, because I was in the USA along with David visiting a close friend of mine who I have known since early childhood who is most likely terminally ill with Stage 4 cancer with inoperable tumors.

    So reading your comments was all the more meaningful.

    Moreover, like you a member of my nuclear family died of colon cancer. In my case it was my brother who died about 20 years ago at the age of 46.

    So I too have colonscopies regularly, as does my other brother. I agree with you that they are worth the effort, and I am so pleased that we are able to keep abreast of possible problems with such an examination.

    I also had a polyp removed a while back. Last time, however, I was fine. Likewise, my brother has had polyps removed. And now I have read about yourself.

    I applaud you bringing up this somewhat delicate discussion, and here’s another thumbs up to this important medical examination.

    • estherhecht Says:

      Thanks very much for your comments, , Tamara. I’m sorry about your friend. I wish you and your family continued good health.

      • Tamara Says:

        My pleasure, Esther.

        I appreciate your comment about my friend, that’s kind of you.

        Traveling to See her was one of the most emotionally difficult things that I have ever done (and most particularly, parting with her when we were there for the last time).

        On the other hand, it was one of those situations when ‘a lot of love’ was coursing amongst all of us, as David put it. There is nothing quite like a very serious illness for getting one’s perspective in life in order, true?

        Very sadly as well, it appears highly likely that her case was terribly mishandled by her doctor with a previous condition that she had. I am adding this here as further reason for us all to make sure that we look after our own health since doctors are busy and human and can make deadly mistakes too.

        Many thanks as well for your good wishes for my and my family’s health – and ditto back to you, of course…

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