Colons “R” Us

Colons ‘R’ Us

By

Leo de Natale

January,  2020.  Two months before The Plague appeared and turned the world upside down.  Little did we know how health care would rapidly change.   I was  dreading an upcoming medical appointment.  It was the last time I underwent a medical procedure where there were no masks, social distancing or a shortage of hand disinfectant.   My appointment was for the ultimate adults only experience.

Anyone over age 50 knows the fear and loathing of “the colonoscopy”, one of the most unpleasant and humiliating experience one can endure. It is drilled into us that colonoscopies – the term evokes images of disgusting insects – are a necessary evil. Statistics show that many individuals failing to subject themselves to the procedure do so at their own risk. Colon cancer is a disease that can be avoided if pre-cancerous polyps – I always think of sea anemones – are detected and removed in a timely fashion. Just ask the late Speaker of the U.S. House Thomas “Tip” ‘Neill. Never had a colonoscopy and died of colon cancer. It was discovered after Tip’s last Thanksgiving dinner. Many persons of lesser fame have stories of family members/loved ones who experience a similar fate.

As they say, it’s always the “prepping” that’s the worst part. It includes a steady dose of embarrassment and discomfort. For the three days prior to the procedure, diet is restricted. No heavy meals, no roughage, no coffee, no booze. The day before you become an ascetic. Clear liquid diet consisting of chicken bullion, Jello (no red colors, please, can be misinterpreted as blood.), apple juice and other benign drinks.

This all culminates in an intestinal Armageddon.  The Gastroenterologist (GI) supplies you with very specific instructions to imbibe a liquid laxative and water.  Swallowing this glop is nearly nauseating.  It tastes like paint thinner laced with sugar.  This act is followed by two 16 ounces of water within one hour after ingesting the devil’s brew.

 No less than 15-20 minutes later, Boom!, Vesuvius erupts and you’re sent running to the toilet.  Your bowels explode with a massive evacuation.  I’m not being scatological but it’s bad.  In ten minute intervals there are more bathroom visits, each producing more liquids than solids. It eventually becomes anal urination.  The anus starts feeling as if some sadist is torturing you with a belt sander.  Very, very sore. This pattern lasts for about two hours and then there is calm.

My procedure was early morning, 7 am. I was the first “customer” of the day and had to arrive by 6:15 am. That’s good and bad because the final “cleansing” liquid is taken twice within seven hours. In my case I took my first dose at 5 pm the previous day. That meant my second slug was 2 am. My wife and German Shepherd Dog Kaiser slept well. I didn’t. I endured one final volcanic eruption. A miserable experience. I was awake at 5 am. My GI tract appeared to be behaving itself. I showered, thoroughly cleansing “down there”, shaved and brushed my teeth. I was ready.

The trip to the freestanding GI speciality clinic—I refer to it as “Colons ‘R’ Us”—because nearly all the procedures are colonoscopies. Business is usually brisk there with a parking lot full of zoned-out patients. From my home, the commute takes 20-30 minutes. Patients undergoing the “black snake procedure” – that’s the term used by GI guys – must be driven home due to the anesthesia. My wife and I decided that, given the increasingly high traffic volume at any hour(this was before the pandemic), we’d leave a time cushion.

My wife has poor night vision so I drove to the clinic.  Kaiser came along and rode shotgun.   Regarding time projection, I was wrong.  Traffic was light and we arrived at 5:45.  We waited 15 minutes.  The front door was opened and I kissed Kathy goodbye, gave Kaiser a head pat and alighted from the car.

I love how these medical folks say “You must arrive by 6:15!”  In other words, they demand punctuality but then you cool your heels for nearly 45 minutes.  There are always delays.

I plodded into the clinic. I felt and probably resembled Jack Nicholson in One Flew Over the Cuckoo’s Nest after he was lobotomized. I was the first to arrive. I’ve always regarded trips to speciality clinics as medical deli counters. Instead of cured meats or cheese, you’re ordering up a trip to la-la land. I pulled the ticket #1. A portly receptionist with ugly hands checked me in and gave me the paperwork. The forms state I’m undergoing an elective procedure and if they screw up, they can’t be held responsible. Perforated colons are always a risk. The form is a CYA release.

The nursing personnel arrived in dribs and drabs while I was waiting. Finally, a nurse calls my name and I shuffle into a room containing numerous gurneys divided by hospital curtains. She tells me to strip naked except from my socks. I don the usual attire, a johnny gown, and await further instructions. She enters and takes the vital signs: blood pressure, oxygenation and temperature. She then inserts a catheter into my right forearm vein. That’s where the happy juice will be injected. She never introduces herself by name. Her fingernails are white acrylic that need to be redone. She is pleasant but not warm and fuzzy. She, like the rest of us poor bastards undergoing the procedures, appears semi-comatose. Is there some place you’d rather be?

The next character I see is an elderly intake MD who speaks with a Middle Eastern accent.  He is paunchy, quite nearsighted and has the oddest  cover-up-my-balding head hairdo.  The hair atop his skull is thinning. He has swirled it around and doused it with enough Aqua Net hair spray to survive a wind tunnel.  He asks me about my health history while asking me, “Do you speak Italiano?”.  A little I respond, but mostly curse words.

 I use some medical jargon and he presumes I’m in the health care field.  Optometrist, I respond.  Ah, he says and leaves it at that.  Optometrists are still perceived as the untermenchen of doctors.   No further medical talk.   He is a courteous man and when finished, he and his paunch disappear en route to another suffering victim awaiting the same procedure.

Sometime after 7 am, I am wheeled into the procedure room.  My longtime gastroenterologist, Leon Minjue,  arrives along with the nurse anesthetist.  We briefly chat and then I am told to roll over to my left hip.

 At this point I’m mooning the world and that’s the last thing I remember until a voice says, “Time to wake up, Leo!”.  I’ve always been amazed at the rapidity of sedation.  In the blink of an eye you are out, gonzo.  Blissful yet insidious.

I remain  in the recovery room.  The nurse asks me if I want something to drink.  Apple juice, please.  I’m conscious, but still in a mild fog.   Leon  quickly arrives and tells me everything went well.  He did, however, detect two polyps, a biggy at 14 mm,potentially pre-cancerous, and a smaller one at 5mm.  He excised both and sent them for histological analysis, a standard procedure.  I later learn both tissue samples were benign. To paraphrase John Turturro’s character Quintana in The Big Lebowski , you don’t fuck with the Jesus or colon polyps. 

Leon discusses his findings but the sedative is still clouding my brain.  I may have forgotten some of his conversation but I do remember the polyps.  What amazes me is the  advanced sophistication  in medical equipment. 

He hands me a computer generated report complete with photographs of my colon including an up close and personal view of the dreaded polyps.  Jesting, I ask Leon if these are suitable for framing.   

 Unamused, Leon tells me I’ll need to repeat the next colonoscopy in five years.  My attitude is I don’t know where the trajectory of my health and life will travel.  My late father once told me “When you go, go out as a champ”.  When a person  reaches his or her  60’s and 70’s,  mortality steps to the forefront.  We all have friends and relatives who die early.  A 29-year-old has difficulty when he hears someone say “He was 61 and died from a heart attack.  So young”.   Really? Like, if you’re over 30, that is old, dude.

What youths eventually learn is aging accelerates at warp speed. The 30’s, 40’s and 50’s whiz by and, suddenly, you’re collecting social security and complaining about gall bladder attacks or undergoing a total knee replacement. I know. Been there, done that. As the famous Serenity Prayer says, “Living one day at a time, enjoying one moment at a time.” Those words are true and the best mantra ever uttered. The pandemic has made the prayer very relevant.