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The Ins and Outs of Your First Colonoscopy

Everyone should have a screening colonoscopy by age 50. A colonoscopy is a standard medical procedure wherein a fiber-optic scope is inserted into the rectum to search for colon cancer. Colon cancer is typically a fairly slow-growing malady. It usually starts as a polyp, sort of a little berry that hangs out into the lumen of the colon. 

Find that with a colonoscope, snatch it off, and you will live a long, fruitful life. However, let that rascal percolate long enough, and it can grow through the wall of the colon and metastasize. From there, it will foment no end of mischief.

Will Dabbs MD gets his first colonoscopy.
(Photo by Will Dabbs MD)

My First Colonoscopy

I’m a doctor. I fuss at somebody about this at work every single day. It’s a necessary part of the aging process, I explain patiently. It’s just not that big a deal, I opine. You’re overthinking it. Stop being such a pansy. Then it happened to me.

I actually performed quite a few colonoscopies in medical training. In fact, a particularly memorable colonoscopy was the only procedure I had to leave while in med school. It wasn’t that the exercise was unduly gruesome, though, by its nature, it was. I just couldn’t stop laughing.

Now, there’s certainly nothing intrinsically funny about a colonoscopy. The procedure in question took place at the VA hospital. The patient seemed old enough to have served during the Spanish-American War. He did fine, but the sounds he made were undeniably hilarious. 

The man was under conscious sedation. That means that he’s sort of awake, but not really. In that state, every time the scope moved, he made a sound like you inadvertently stepped on a hamster. I excused myself for a moment to regain my composure and then returned. No one was the wiser, particularly not Hamster Man.

Setting the Stage

Drawn from my standard work spiel on the subject, the procedure is a horrible, miserable, ghastly, unnatural experience, but the medicine they give you means you don’t know you’re there. You don’t remember it when it’s over. I’m usually intentionally vague on the details. I make everything sound easy peasy. 

Regardless, I was 52—two years past due—when I finally got off my butt (an intentionally awkward metaphor) and got set up for mine. Here’s my experience. Your mileage may vary.

A colonoscopy is a tool used primarily by medical practitioners.
(Photo by iStock)

Proctological Herpetology

A colonoscope is five-and-a-half feet long and looks like a black mamba. It is articulated a bit like a real snake and includes a fiber-optic camera at the tip. It also sports the most unsettling sharpened electrical device for retrieving biopsy samples. 

The plan is to put you to sleep and then ram that thing—this enormous writhing snake-like thing—all the way up your butt. While there, it has the option of biting off chunks of your entrails and electrocuting you from within to stop the subsequent bleeding. It doesn’t matter how woke, broad-minded or perverted you are, nobody should be down with that.

Most normal people hate snakes on principle. I know I certainly do. It’s a primal thing. The mental image of a gigantic snake diving into your rectum is typically the purview of mental patients and LSD devotees. And this was about to happen to me for real. 

I briefly considered whether I would do this locally, where everyone knows me, or invest in some Groucho Marx nose glasses and schedule it incognito in a neighboring town. I ultimately chose familiarity simply for convenience. If something went horribly awry, it would be a shorter trek to the cemetery.

The Required Medication

The entire sordid odyssey begins at the pharmacy. The medication comes in several flavors. The cheap stuff is a liquid. Trade names include such snazzy monikers as Osmoprep, Suprep, PLENVU, MiraLAX, CLENPIQ, GoLYTELY and MoviPrep. 

GoLYTELY and MoviPrep are my two faves, though the names are intentionally misleading. Trust me, there’s nothing “Light” about GoLYTELY. If MoviPrep was a movie, it certainly wouldn’t be the sort of film you’d watch in mixed company over popcorn and a Coke. With the benefit of hindsight, were I called upon to name this diabolical elixir myself, I’d choose something like Satan’s Rocket Fuel, LuciferDROOL, or Butt Plutonium.

I read the instructions carefully. It all seemed simple enough. I had prescribed stuff like this to scads of people. However, it now occurred to me that I had never technically been around to see what it actually did to folks. Cue the ominous music.

On the fateful evening, my wife wisely made an excuse to be someplace else. They say one of man’s primal fears is dying alone. After what came next, I’m not convinced that’s necessarily true. What follows is the best-enjoyed solo.

Better Out then In

At the appointed time, I measured out the vile stuff and knocked it back. It tasted vaguely like seawater. I’ve had worse. That boiled rabbit I ate in survival school in the Army set an awfully low bar. Much to my relief, nothing happened. I munched a spot of Jell-O, swilled a little Gatorade, and settled in behind some vapid military fiction to pass the time.

Like the coming of a violent storm, something about the environment viscerally cues you that peril is approaching. When disaster struck, it came shockingly quickly. I made it to the bathroom, but only just. 

I’ll spare you the gory details, save that I actually briefly considered outfitting my toilet with stirrups and an ejection seat. Elton John’s classic 1972 ballad Rocket Man took on a new, horrible connotation. My nether regions could have expeditiously extinguished a flaming jumbo jet. Half an hour later, I relieved myself of almost everything I had eaten since fifth grade. And we were just getting started.

This particular diabolical concoction was divided into two boluses. The first was unpleasant but manageable. That was consumed in the late afternoon the day before the procedure. The second was tougher to swallow than a politician’s promises. You choke that down the morning of the big event. By the time the MoviPrep had done its evil work, I was exhausted, grouchy, and at least 10 pounds lighter. This was a heck of a way to lose weight.

Time for the Procedure

Early the following morning, I dutifully reported to the GI lab. They run that place like an assembly line. Sitting pensively in the waiting room with the rest of the condemned was a surreal experience. Even fat people look skinny under those circumstances.

What exactly are you expected to chat about to pass the time? “So, how’d your evening go?” seems unduly awkward. Considering we had all recently endured a medically-induced traumatic butt tsunami, we mostly just stared straight ahead and quietly bemoaned our sordid state. 

When they finally called my name, I walked the gauntlet of sympathetic visages. Though no one spoke, their collective eyes communicated, “Be strong, brother. Don’t tell them anything.” I tried and failed to adopt an attitude of quiet defiance.

There's nothing funny about cancer screenings.
(Photo by iStock)

A Familiar Setting

I refer patients to these guys, so they were admittedly extra nice to me. When the time came to get naked, they brought me a blanket straight out of some kind of warmer and put me behind a flimsy sliding curtain. That blanket would have been nigh heavenly had I not been about to get naked as a newborn in the presence of a whole pile of women I didn’t know.

It’s quite literally impossible to look cool while getting naked in anticipation of a pending colonoscopy. On the other side of a single flimsy sheet of translucent cotton, the GI clinic women—some of whom were both young and cute—chattered about their social lives, dogs, and what they had done the previous evening. Meanwhile, I was depositing my clothing in a handy plastic bag and donning a gown that seemed more like a shower curtain for midgets than a genuine human garment.

In short order, they rolled me back into the torture chamber, all the while being attentive to my every need. However, I was different from most of their standard customers. I had, myself, done this to other people before. I wasn’t buying their lies.

I knew that the moment I fell asleep, they would discard that comfy blanket, splay me out like a pithed toad, and violate me like some kind of Inquisitor. Dying hamster sounds bounced back and forth inside my head. I simply asked that they refrain from taking any Facebook pictures and go ahead and get it over with. The CRNA asked me to count backward from 100. I think I made it to 99.

Go to the Light

I don’t sleep very well. Never have. That was a marketable asset back when I was a soldier. It is a profound liability nowadays. However, I think that was the best sleep I’ve had in a decade. I woke up in short order, and my precious bride took me out to breakfast. I wasn’t sore or otherwise any worse for the wear.

The GI sadist (who is also a friend) found no polyps, so I was good for a decade. Discovering bad stuff earns you a shorter interval. In the final analysis, there really wasn’t anything to it. The MoviPrep the night before was a quasi-religious experience, but the procedure itself was a big fat nothing burger. When you turn 50, just suck it up and get it done. However, be forewarned that I do get a mild case of PTSD nowadays whenever I’m in the presence of Jell-O.

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