Let me tell you about my day today. I got up at 4:30am. I piled myself and Mr. RenaRF into the car and drove an hour to Warren County Memorial Hospital in Front Royal, VA. We had to be there by 6:45am. Mr. RenaRF was scheduled for his first colonoscopy.
Over the fold, I'll give you some graphic details about the day before and day of as well as some background on how and why he came to schedule it without any nagging whatsoever in the first place. Take a deep breath and follow me.
Most of you know that Mr. RenaRF and I are musicians. Because of this, we have many musician friends. Because music as a full-time pursuit makes it difficult to pay the bills, our musician friends (like us) all have day jobs. One of our friends is a Physician's Assistant (PA) for a colorectal doc. In this role, he spends a lot of his time assisting with colonoscopies. Just to speed this along, the friend had one of his friends develop colon cancer and die from it. This struck our friend hard, and he started on his campaign to ensure that his friends over a certain age get screened for colon cancer.
One of those friends was Mr. RenaRF. Having turned 50 a few months ago, he wasn't rushing out to schedule his colonoscopy. He has no family history that would warrant concern. Yet our friend essentially badgered him until he came in to the doctor's for a consultation. The doctor opened by telling Mr. RenaRF this:
"NO ONE has to die from colon cancer. No one."
It was delivered in such a way, with such conviction, that Mr. RenaRF instantly took the guy seriously and listened to what he had to say. He counseled Mr. RenaRF on colon cancer, it's slow-moving nature, and the imperative of early detection as well as intervention with things that might become colon cancer down the road. He explained that the procedure itself was nothing, that he (Mr. RenaRF!) would be sedated and not even know it was happening. Before leaving the hospital, Mr. RenaRF scheduled his colonoscopy for two weeks later.
Preparing for the colonoscopy starts the day before the procedure itself. Although they tell you not to eat solid food on that day, the doctor told Mr. RenaRF that he could have breakfast which, being a foodie, he did. You don't have to fast the rest of the day - you can have broths and bouillons, jello, and popsicles. The ONLY caveat is that NOTHING you eat can have red food coloring in it. Apparently this makes your colon look like some kind of 1970s-era Saturday Night Fever disco and interferes with the process.
The doctor prescribed to Mr. RenaRF two things in preparation for the colonoscopy. At about 2pm the day before the procedure, he had to take four pills. What these were were prescription strength laxatives. It took about 45 minutes to work and did cause about 20 minutes of cramping before he was off to the powder room. That first post-pill powder room visit is a signal to start drinking the fluid. What that was was essentially either a litre or a half-gallon container with about 1/2" of powdered stuff in the bottom. The doctor told him to mix it with Crystal Light (lemonade - remember - no red food coloring!!) and then follow the instructions. The instructions were to drink one 8oz. glass every ten minutes.
Now - where I come into this preparatory process is twofold: I was the food police early on in the day (making sure he didn't eat too late and didn't eat after breakfast) and the administrator of the drink at ten minute intervals. I know the cramping was uncomfortable for Mr. RenaRF, though he said it was only about 20 minutes of discomfort that was not pain. The stuff he had to drink was probably the most problematic. I looked it up on drugs.com (the total treatment, pills plus liquid, is called HalfLytely if you're interested) and saw that about 50% of people who use it experience some level of nausea, and Mr. RenaRF was no different. It passed, however, and so did a lot of other stuff, if you get my drift. The idea of the pre-colonoscopy treatment is, of course, to get you all squeaky clean and shiny so the doctor see your actual colon.
With all of that completed, we called it a night and, as mentioned in the intro, rose bright and early to get to the hospital. We went much further in terms of distance than most people would go, but we did so because of our connection to our musician friend. We arrived there about 10 minutes before the time listed on the informatin sheet he had been given and they settled him into a room.
The first thing is that everything has to come off and be placed in a personal belongings bag. I helped him into a hospital gown and tied the back, and they gave him these socks with grips on the sole part and told him he had to wear a surgical cap. With that, he laid down on the bed/gurney in the room and chatted with me and others as they took his blood pressure, ran an IV, and hooked him up to a heart monitor (the kind that clips on your finger).
His procedure was scheduled for 8:15am. At 8:00, they came and wheeled him out to the "day surgery" area, a place I could not follow. They told me that he would be given a "twilight" anesthesia once there. This isn't the kind that causes you to be semi-aware, but it's not the kind they put you under when you're being operated on, either. At any rate, I was assured that he'd be out during the actual process.
It tuns out they took him just a tad early - 8:10am - for the procedure. At 8:35am, the phone rang in the room. The nurses had told me that the doctor would call once the procedure was complete to give me the results (for obvious reasons, the actual patient, although told after the procedure, is too groggy and out of it to retain the information). The phone call was, of course, the doctor. The procedure had gone smoothly. Mr. RenaRF apparently snored through the whole thing. They had found four polyps that they actually removed by cutting them, and another 8-10 that they cauterized. This was a relatively high count, but the doctor assured me that there was nothing remotely concerning about the actual polyps. He wanted Mr. RenaRF back in three years and if everything was clear that time through, he wouldn't want to see him again for another five years. He told me that they'd bring him back to the room after about 10 minutes. I thanked him and hung up.
When they wheeled him in he was out of it. The nurse explained that everyone reacted differently - some people came out of the anesthesia relatively quickly, and others took up to two hours. The goal was for Mr. RenaRF to independently keep his eyes open for five solid minutes before they let him go home. Let me tell you - he was closer to two hours than twenty minutes. :-) He would wake up and crack one eye and look at me, confused. He would get his bearings and hold up the finger with the heart monitor on it and attempt to take it off. He would then attempt to poke at the little oxygen nozzle thingys in his nostrils. After dissuading him from pulling either off/out, he would ask "what did the Dr. say?". He would slur/mumble this, but I knew what he wanted to know, so I would tell him. He would fall back to sleep for another 15 minutes and then repeat the whole process (finger; nose; question; sleep). When a nurse would come in to check him, he would open his eyes and say "Let's go - I'm ready to roll" and then fall back asleep. You get the picture - he was out of it. The only thing he was doing consistently (and loudly and frequently) was, well, FARTING.
About 90 minutes after they returned him, however, he perked up. He talked to me and to our musician friend. He asked, lucid this time, about what the doctor said. He stayed awake. I asked him how he felt, physically. He remembered nothing - he was out the whole time. He had no pain. He was kind of hungry. They counseled him, as part of the discharging process, to avoid fried/greasy foods, raw vegetables and red meat for today. They wanted him to take it easy for the remainder of the day as well. They said that he might feel a bit dizzy or light-headed if he suddenly shifted position. Stuff like that.
It's now 3pm EST, and he's been out of the procedure for 6+ hours and home for 3 hours. He is not groggy. He has no pain. He's eating salmon. And he's calling every friend he has and is paying HIS friend's favor forward, working to get his friends of a certain age to save their own lives by going for a colonoscopy.
One big bonus for us is great health insurance. I work for a huge company and my benefits are excellent. It will cost us something, but I don't know how much yet. There is little information on the web about resources for those who are uninsured but who should get screened either because they have a family history of colon cancer or because they're 50+ and it's just time. Some of the message boards out there recommend that you go for a consultation and explain to your doctor that you have limited ability to pay and no and/or poor insurance. There are many messages out there about doctors being willing to work with patients so they can receive a potentially life-saving screening.
In researching my last diary, I also saw where Planned Parenthood will give colonoscopy referrals. I am furthermore hopeful that others will add to the list of colonoscopy resources so that I can append the diary.
I don't have to have one yet. But I'm telling you - and I'm totally squeamish - after seeing Mr. RenaRF go through his yesterday and today, I'm not afraid and I'll go when it's my turn. Please - save your own life. Get screened as soon as possible.
Update [2007-5-14 15:48:24 by RenaRF]: Mr. RenaRF has read the diary and has fully encouraged me to update the diary with a link to his email. He says to please write him if you're afraid or if you have questions. Just reference Daily Kos so he's not confused ;-)