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You try writing a column about colonoscopy and colon cancer prevention without using the word I uttered to my doctor when he told me that my routine colonoscopy had snagged a malignant polyp. Hey, it happens. Now that I'm months past three colon preps in six weeks and a colon resection to boot, I'm actually grateful it happened, because without that colonoscopy a week before my 51st birthday, and all the *%&$ that came after, I'd be walking around with colon cancer.
Colorectal cancer and its prevention are serious subjects too many people are silly about. There's definitely an ewww factor. Most of us, with the exception of young boys and male filmmakers, would rather not discuss what goes on in and around our colons and rectums. But our indoor plumbing is an ingenious way of taking out the trash, all in the comfort of the bathrooms we gussy up to make us forget what we're there to do. A screening colonoscopy is a procedure that detects and removes colorectal polyps, most of which are benign, but some of which can become cancerous. Yet when it's time — age 50 for most people without a family history or other risk factors — to make what generally is the once-a-decade appointment, 40 percent of people don't make the call, according to the Centers for Disease Control and Prevention.
I had no symptoms and didn't have any risk factors, but I had three polyps, one malignant, removed painlessly during my first routine colonoscopy last fall. Originally the plan was to do a repeat colonoscopy in a year. But when pathologists couldn't be sure that cancer hadn't spread into the colon wall and to nearby lymph nodes, the plan changed to, "Come in tomorrow for another colonoscopy so we can tattoo your insides before we take out the offending piece of colon." With a 15 percent chance that cancer cells had spread to lymph nodes, I took them up on the colectomy, an operation during which my surgeon removed 5 inches of my colon and hooked its ends back together. I healed well, and no further malignant cells were found, so I'm happy to put what ended up as merely a Stage 0 episode behind me.
And I'll almost happily submit to the many colonoscopies ahead of me.
Though there's no avoiding the necessity of clearing out one's colon so that the endoscopist can see what needs seeing, there are a variety of ways to do the prep. I had a tough time with my first experience. I gagged down half of the vile, standard GoLYTELY prep most docs prescribe, but I had no results. When my stomach did empty, it came out the wrong end. By 8 p.m., I threw up most of what I'd forced down. The doctor who was on call told me to drink a bottle of magnesium citrate (the Drano of laxatives) to get things going in the right direction. By 10 p.m., I had puked again, still with none of the expected results, but as soon as I decided to go to bed, all stool broke loose. Determined not to have wasted all the intestinal activity, I stayed up drinking more mag citrate to insure emptiness and exhaustion. For the second and third colon preps (not surprisingly, they're needed before colon surgery, too), I switched to a recipe that diluted MiraLAX with Gatorade and had a mag citrate chaser, which I tolerated well enough.
Since I was honest about the prep, you can trust me about the colonoscopy itself. One minute I was lying on a bed in a hospital gown with an IV in my hand, chatting merrily with medical folks about Richmond restaurants, and the next thing I remember is waking up in the recovery area ready to eat a cracker. Not one whit of discomfort or, almost as important, recollection. I've had more unpleasantness at the dentist.
Now that I've embarrassed myself, let me emphasize colon cancer's advantages over most other cancers. It's preventable, treatable and curable — when caught early enough — which is why a colonoscopy is so crucial. Then there's the bonus post-colonoscopy binge-eating of whatever you deserve after your all-liquid diet. Plus the topic gives you — or at least me — carte blanche to talk a blue streak. If I start a cancer fundraiser, I'll call it Cussing Out Cancer. So please schedule your !&*%@ colonoscopy today.