Gut Check

Photo shows a pile of brown ovoid pellets of deer poop, also called scat.
I’d rather look at deer poop than the results of my colonoscopy prep.

No one needs to read another cancer story, so I’ll give you one that’s about dodging that particular bullet. And how you can too. Absolutely no one wants to read about prepping for a colonoscopy, so I’ll save the graphic details for my notes for the next one, because there will be a next one. That’s both good and bad news.

Since my dad died of colon cancer, I’ve been on the “five-year plan,” for screenings. The CDC advises normal people to get screened every ten years (frequency varies depending on the kind of screening; I’ll stick to colonoscopies since that’s what I get) between the ages of 45 and 75. A family history calls for one every five years. I started out fine. Had the second one five years after the first. Then, being the procrastinator I am, I let the next slip to seven years. But it was also clean. The most recent screening should have happened in 2020, but you know what delayed all sorts of health care that year and the next—other than Covid care.

So it has been another seven years. They pick these numbers—ten and five—because colon cancer starts as polyps that take about ten years to turn cancerous. I’ve had three clean scans, so I asked the doctor if this one was clean might I go to ten years? She said we’d discuss after the scan.

No need to discuss.

In my groggy state upon awakening, the nurse said a polyp had been removed, 13 mm, which to me seemed large (it is). Ugh. I had to wait ten days for the pathology report, trying not to think about what it could say. The doctor’s notes had said it looked benign, so I clung to that.

The report arrived. “Adenomatous,” precancerous but not cancer.

Not cancer.

Whew!

“Your next colonoscopy for surveillance should be in 3 years.”

Bummer. But it could have been worse. Some guidelines call for every year.

Among the lifestyle risk factors for colon cancer (again, per the CDC) are lack of regular physical activity (I am very active; best physical health of my life), a diet low in fruit and vegetables (my wife makes sure I get plenty of fruits and veggies), a low-fiber and high-fat diet, or a diet high in processed meats (I never eat processed meats, and see previous for the fruits and veggies), overweight and obesity (well, I’ve got a few more pounds than I’d like, but nothing any doc has told me to lose), alcohol consumption (a rare drink; mostly a growler of hard cider over the summer), and tobacco use (never smoked; only second-hand from my parents). Oh, and age. Risk increases with age. Nothing I can do about that. So there’s little I can do to decrease my odds through lifestyle changes.

I’m left with being diligent about screening.

Anyone who has had a colonoscopy knows it’s not the hose up your butt that’s difficult (that happens during a nice sleep), but cleaning out the colon the night before. You drink this noxious fluid that causes everything to evacuate your bowel. I had noticed the pre-prep instructions were different from the last time I went through this, with fewer days needed on a low-fiber diet. I didn’t quite trust that since it could have been changed to accommodate the average American’s already low-fiber diet. Mine, I came to realize, is very high on the fiber. So I cut back gradually a few days early.

I was prescribed PEG-3350, polyethylene glycol, which to me is antifreeze (but there must be some difference, right?). It’s the generic for GoLYTELY, for those in the know. If you haven’t had a colonoscopy in the last seven years, be warned that the formula may have changed—that’s what the nurse suggested when I asked why the diet prep was different. For whatever reason, this time was much different from the past, and I was not properly prepared. I’ll just leave it at that. I’ll only say that ahead of time, bring everything you will need into the bathroom with you because you are not leaving that room for at least two hours after drinking half of the potion (which itself happens over two hours). Then you have to do it again for the remainder several hours later. Granted, people may differ, but this was my experience.

When the nurse the next day asked which prep I took, he responded, “Oh, the explosive diarrhea one.” Gee, thanks for that too-late warning. Hands down, it is a terrible, horrible, no good, very bad experience. In the midst of it I swore I was never going through this again, cancer be damned.

Funny how an adenomatous polyp can change one’s perspective.

It’s easy to become cavalier as one ages and remains healthy. I’ve gotten this far, surely I’m home free! But the insidious truth is that while I think nothing has changed, my body is aging. Entropy is having its way whether I like it or not. So I can’t be lulled into thinking good health will last all on its own. It won’t.

We are designed to fail in the end, no matter how hard we try. Which is why I urge you, if you are in that age range or have other risk factors, to get screened. The prep may be horrible, but I don’t want to think about the treatment for colon cancer, or what it would put my loved ones through.

Get screened. Then enjoy sharing your horrible experience on a blog like this. And hope that it’s about dodging that bullet and not taking a hit.

With this reality check, I will watch my cholesterol and get my mammograms and submit to more colon screenings. Not only will I go through this again, I’ll willingly do it in three years instead of five, or seven, or ten. I’ll just remember to schedule for the summer so I can have windows open.


Resources

Go ahead and Google colon cancer and check out other risk factors beyond lifestyle, since there are some that I didn’t go into because they weren’t relevant to me. Just be sure to look at sites you trust. I’ll let you decide that. For me, it was major medical sites. And my doctor. Listen to your doctor!

Or start at the CDC.

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