My Father had colon cancer, my grandfather had colon cancer, my great-grandfather had colon cancer (are you seeing a pattern here yet?), so if you have a family history like this then please keep reading.
Now here is the challenge, colorectal cancer can be present for several years before symptoms develop, and by the time they do you often do nothing and put it all down to other factors for a few more years, and by then it is too late because it has gone too far.
So what are the symptoms? Well they include fatigue, weakness, shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating, all of which can also be symptoms of other things, for example conditions such as irritable bowel syndrome (spastic colon), ulcerative colitis, Crohn’s disease, diverticulosis, and peptic ulcer disease, so if you have for example IBS, then you might assume that is what is happening.
So what can you do?
You can do what I had done yesterday – have a colonoscopy.
So I’m going to spend a bit of time talking about what happened, and if in doing so, I inspire just one other person who has a family history like mine to think, “Hey you know what, I better have a chat to my Doctor about doing this“, then I will have achieved my goal.
Being a UK resident, the UK’s NHS (National Health Service) is a zero cost option (sorry US folks), but there is also the possibility of having things done privately via health insurance. In my case, the NHS is the way to go, so having been plugged into the system for this several years ago, the NHS reached out and contacted me (yea, the system works), and invited me to have a Colonoscopy.
In response to the letter they ask you to first visit your local surgery (with a form they send) requesting a blood sample, so you make an appointment with the nurse, pop around with the form and have that all sorted, all nice and simple.
Once done, you then contact the number on the letter and make an appointment directly with the GI unit. For me that is a bit of a hike, they are 20 miles away, but then you really do want to be in with the folks who do this each and every day and specialise in this.
The plan is that they have a long flexible telescopic tube and so it is about here you might be thinking, “Well you can take that and shove it up your …“. If so, then you’ve got it, because that is literally what happens. Next thought might be “Oh sh*t“, and to that I would add that you really do want to avoid that.
OK, relax, it is not that bad, let me explain.
They send you a preparation pack, that consists of a couple of pages of guidance, along with 10 senna tables and two packs of Citramag, which can all be basically summed up like this – you need to get cleaned out so that they can get a good clear view with no (ahem) “obstructions” in the way.
Here is how it works – 2 days prior you are on a low fibre diet, then the day before it is a light lunch, no dinner, and plenty of fluids. Then at 4pm you pop the senna tablets (yes all 10 in one go), 5pm you take the first pack of Citramag, and at 7pm you take the second.
Side Note: The Citramag is not too bad, you add the pack to 200ml of hot water (that is about 1 cup) in a big jug … slowly … because it will initially fizz like crazy. For the first one, I dumped the entire packet in and it went nuts, luckily in a jug, so I saved most of it. If it had been a cup, I would have lost most of it. Once it has cooled down you soon find that it tastes OK, not too bad at all.
As for the restricted diet, what did I do? Well I went for a slight variation and simply stopped eating anything from Wednesday, but kept up my fluid intake. That was perhaps a bit of overkill on my part, and yes, I was hungry by Friday. One other important observation, when you get to the part where they recommend that you be close to the loo when you start taking the tablets, be warned – they mean it, that stuff is a super laxative.
You can perhaps conjure up visions of me in the smallest reading room in the house at 2am dripping with sweat, enduring stomach cramps, and wondering if this was all a big mistake, but I later discovered that I got it right, the doctor noted that my bowel prep had been good.
On the Day
It is a day visit, no overnight stay, but you do need to be prepared to be taken home, you can’t drive after it because they give you a sedative and driving with that in your system is something you really really do not want to do, no matter how good you feel afterwards.
So you arrive at the hospital and proceed to play dungeons and dragons as you traverse their labyrinth and struggle to locate the GI unit. I’m not kidding …
Upon arrival at the main entrance [unmanned, it was 7am] , go past reception towards the pharmacy, turn left, follow the pink signs, turn right at ward 4, then follow the corridor, [avoiding the trolls], than at the kink in the corridor, take a sharp left [quietly so as not to awaken the dragon], then follow the signs for ward 14, and just before you get there, take another sharp right to the double doors of the GI unit, recite the magic password, and enter.
You check in and then you wait. You will be doing a lot of waiting, so bring a book (or two), you can only read the posters on the walls a limited number of times, all telling you how clean the unit is, what their cleaning rota is, and that Agnes did a really great job cleaning it all and got an award. They also had a notice up bolding proclaiming that the percentage of complaints was 100% … 100% … oh wait, that reads “compliments”, not “complaints”. (They might wish to think about re-wording that)
When your name gets called, you go into a room where a nice nurse will automatically reply, “I’m from Poland”, in response to the inevitable “I was wondering …”, so yes, apparently everybody notices her accent and asks that. She takes your blood pressure, goes through some health questions (are you still breathing?, what is the date today?, etc…). Then takes you into the unit and explains what will be happening next.
Key question you will be asked: Do you want sedation? … it’s optional. If this is your first time, or you really don’t want to know and are nervous about it all, then go for a “Yes”.
Time to get ready
OK, so given what they are about to do, you might indeed be wondering what happens next. Well, you get presented with one of those hospital gowns that open at the back, and a special pair of paper underpants with a rather ominous flap that opens at the back – hint you wear all this and nothing else, except perhaps your socks and a smile once the Pethidine kicks in.
As I mentioned before, having a sedative is optional, and even having the sedative does not put you to sleep. Interesting side effect of the sedative is that you will most probably not remember, but you will have been awake and woozy.
You lie on your left side, and get hooked up to various monitors, (blood pressure, pulse) and a device is placed in front of your stomach (think of it as radar so the doctor can see how things progress) … and since I was off into the land of Pethidine I don’t remember anything after that.
Interesting observation … I was awake, the sedative wipes your memory of being half-awake (Yes, I know, I already mentioned that, I simply forgot that I did)
It is designed to be like this because increased degrees of sedation bring more risk and a slower recovery time afterwards.
So once you are back in the main ward, they offer you something to eat and drink and then once you have recovered, and are up (in about an hour, the procedure itself was roughly 10 minutes), you are back out to the waiting area (back to your book again or the posters on the wall telling you how clean everything is), to wait to be briefed on the results.
So basically it was generally good news, they only needed to remove one polyp, and that is now off for a biopsy (I’ll hear about that in three weeks), but apart from that, it was an all clear for now and I’ll be back again in three years.
What About You
If you have a family history similar to mine, doing nothing is really not an option. If you can catch it all early, then colorectal cancer is very treatable. If instead you do nothing and wait for the symptoms then you will be a lot further down the road and treatment will be far more challenging.
Be wise and take action.