When I wrote last week, in a follow-up to my Sept. 8 Cologuard column, that the danger of follow-ups is there can be no end to them, I wasn't kidding. I thought I was done. I wanted to be done. And then I received this email from Timothy Hufman of Willowbrook. Tell me, what would YOU do? I really have no choice here:Dear Mr. Steinberg:
I have been reading your articles on Cologuard. I appreciate your mixture of humor and helpful information. Yesterday, you pointed out the pros and cons of using Cologuard as compared to getting a colonoscopy. One of the risks you mentioned with a colonoscopy was that its effectiveness depended greatly on the doctor who did the procedure. You pointed out that “Some doctors look harder than others. Some spend three minutes snooping around your colon. Others spend up to 14. The harder they look, the more they find.”
I have come up with a technique to insure that my doctor does a complete examination – I join him (or her) in the examination. In essence, I have had a colonoscopy without taking any anesthesia. This allowed me to remain awake and alert during the whole examination looking at the same monitor the doctor was watching as he traveled through my colon.
The experience was not painful as the colon has no nerve endings. “Meaningful discomfort” may be a more accurate description of the event. Most problematic was the initial insertion of the scope. All of a sudden, I got that “full” feeling similar to what one experiences seven hours after a huge meal when you are desperately looking for a bathroom. Thereafter, I was happily able to watch the show on the monitor from the comfort of my gurney with only mild cramping as air was blown into my intestine to inflate it for easy passage of the scope.
Significantly, the procedure does not include an examination of the colon while “going in.” Thus, the scope quickly moved up my intestine with a view on the monitor similar to a wild roller coaster ride through a dark tunnel with only one small headlight illuminating the way.
It was fascinating watching the scope make the hair-pin turns following my large intestine as it wound through my bowel cavity. Along the way, we came to one real sharp bend which the scope had a hard time maneuvering . As the doctor continued to struggle with getting the scope around the curve, I looked down at my abdomen, where the scope was stuck, to see my skin go up and down as if there was a finger in my bowel trying to push out.
Finally, the scope reached the ileocecal valve which separates the small from the large intestine. At that point, the doctor began the examination by slowly retracting the scope as the camera, with its miniature light, illuminated the portion of my intestine that we were just leaving. At one point in our journey, I saw a dark spot on the colon wall. I cried out, “Wait, wait, what was that we just passed?” The doctor sighed and dutifully retraced his steps up the intestine to the dark area of my concern. It turned out to be a bran flake or some other debris that had apparently clung to the intestine wall during the preparation period when I flushed out my system. Having satisfied my concern, the doctor continued the journey.
“Slow down” I said, when he began going too fast for me to carefully see the area we were passing through. Again, there was that sigh as he slowed down the retraction of the scope. Thereafter, aside from a few other pieces of partially digested food that we passed by, the rest of the trip was uneventful.
Finally, at the end of the inspection, just before removing the scope, the doctor bent the camera around so that I could look at my hemorrhoids as they appeared from the inside. I think the doctor took a little pleasure in seeing my look of horror at what I was observing.
With that, my journey was over. Although I was still cramping a little from all of the air still inflating my intestine, I was relaxed knowing that the examination of my colon had been thorough.