We’re Talking Up the Butt Here

This post is about colonoscopies. I can promise you two things. There are no 1) medical pictures, nor 2) graphic descriptions of the procedure or the preparation.

The cheaply provocative title of this post is derived from a line spoken by Sarah Jessica Parker in her role as the inimitable Carrie Bradshaw in the HBO series Sex and the City. Discussing a much different invasion with friends in the back of a taxi, Ms. Bradshaw responds to the driver’s no-smoking reminder by saying, “We’re talking up the butt here, sir; I think a cigarette is in order!”

Oh, gimme a break. I needed a thumbnail.

Oh, gimme a break. I needed a thumbnail.

And so it is. But when I get my second colonoscopy tomorrow, I’ll be trying to prevent cancer. So a cigarette is out. And despite the arduous purgative preparation and the things that are done to me while I’m asleep, I’m glad I’m having this procedure. You should too. That’s the last preachy thing I’ll say. Here are the data:

  • Colonoscopies and other forms of colorectal cancer screenings are a rite of passage for the over-50 set. That’s because 90 percent of all new cases of colorectal cancer occur in people over 50, according to the Colon Cancer Alliance, a fundraising and education organization.
  • Colon cancer is the second-leading cause of cancer-related deaths in the United States.
  • The five-year survival rate (that is, the percentage of patients who survive at least five years after diagnosis; many survive more) if the cancer is caught at a “local” stage — not having spread beyond the colon or rectum — is 90 percent. If the cancer spreads to other tissues, the survival rate drops to about 69 percent.
  • There are more than a million colorectal cancer survivors alive in the United States today.

Moral of the story: get screened. You’ve heard all the arguments about doing it for the ones you love. You love yourself too, right? Just do it.

I almost didn’t. A colleague’s wife, who happens to be a nurse, actually reminded me on Facebook when I turned 50 that I had better get on with scheduling my appointment. I still remember how I responded: ” Aw! Hell! Dammit! Really! Crap! Dang! [pause] O.K.”

I’ll spare you the clinical details, but suffice to say, it went fine. Sorta. The gastroenterologist nicked off a polyp not too far in, then had to scrape off another one much further up the line. (The differing shapes of the polyps required different methods. Pathology showed both to be benign.) But when they do that, there might be a cell or two left. So I’m back a year later for another look. If this one is clear, I’m good for 10 years. I have no family history or other contributing factors, so I’m not worried.

One way or another, I’ll know, and if there’s a need for treatment, we can get started.

A word about the preparation. In my parents’ generation, there was a lot of chalky, unpleasant liquid to get down, and it was aggressive stuff. The colon is long, about five feet of muscle. Food and waste work through it in stages; it takes time. It’s necessary for the system to be clean along its entire length for the doctor to get a thorough look. So, gotta purge. And since you can’t eat solid food during this time, the purge has to be pretty quick, compressed into the 36 hours or so before the procedure.

Sounds heavy? It is, but the manner of accomplishing it is significantly easier than it used to be. A combination of over-the-counter stool softeners and  laxatives in pill and liquid form do the job. The real problem is being trapped at home for a day. But I’ll get a lot of work done, all within 30 feet of a bathroom. Discomfort? I have some abdominal cramping as I write this, but it’s nothing serious. I eat a fairly high-fiber diet; that may be the cause. It’ll be over soon.

In any event, the day and a half of preparation is infinitely better than the heartache of a cancer diagnosis, especially one you realize you could have caught early. And the procedure itself? A breeze. You’ll be under a general anesthetic the whole time, and when you wake up, you’ll feel pretty blissed out. As long as you don’t have an undue reaction to the anesthesia, you’ll be able to have a welcome meal pretty soon after.

I said I wouldn’t get preachy. So imagine we’re just old friends talking. If you’re 50 or older — or earlier if you have family history or other contributing factors — do this. Dance at your child’s wedding. Hold your grandchild. Take your husband’s or wife’s hand — over and over again. You have appointments 20, 25, 30 years from now.

Be there.

For more information on colorectal cancers, screening, risk factors, and treatment, click here to link to an excellent pdf from The American Cancer Society.

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One thought on “We’re Talking Up the Butt Here

  1. George Beatty says:

    I got my first procedure at 72. They found a growth the size of a baseball.It was benign. Still required a lower anterior resection to remove. I shudder to think of the consequences had I continued to avoid the procedure.

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