Several years ago, I had my first screening colonoscopy as recommended by the American Cancer Society. I had no symptoms, my 3 day stool Hemoccult card test was normal showing no hidden blood, and I have no family history of colon cancer or polyps. My partner, Dr. Ernest Stanley (Yes, we "scope" each other in our spare time.), performed my exam at Three Rivers Endoscopy Center. As expected, the test was a breeze. Thanks to "conscious sedation", I didn't feel a thing. When I awoke, I was surprised to learn that he found two colon polyps on the right side of my colon, about four feet inside. (The average colon is about five to six feet in length.) Dr. Stanley removed them during the colonoscopy exam with a wire snare and sent the polyps for a biopsy. They came back showing adenomatous, or pre-cancerous, cells. Fortunately, they were discovered and removed before any cancer cells had a chance to develop. Dr. Stanley also found that I had some changes of diverticulosis in my left colon, but no inflammation, or diverticulitis. That screening colonoscopy probably saved my life...
Recently, I had a followup colonoscopy examination to reevaluate my colon. I thought I would share my experience with some of our patients. It's not something you would want to do every day, but the whole process is really a lot simpler than most people think.
No Solid Food
Careful preparation is necessary for a successful examination. Most patients agree that the preparation for a colonoscopy is worse than the test itself. It is just one of those things you have to do. To prepare, you must empty your colon of all waste matter. This means a period of fasting followed by a laxative purge. I was not allowed to eat any solid food the day before my exam - just clear fluids, popsicles, and Jello. I forgot that my family was going to my mother's for Sunday brunch that day, but didn't want to cancel. So, while everyone else was enjoying roast beef and chicken, I had a nice big bowl of lemon Jello. Here I am at my mother's dinner table enjoying my Jello appetizer, Jello entree and Jello dessert. The rest of the day I drank chicken broth and hot tea. Amazingly, I was not that hungry. |
Laxative Purge
Once I returned home from my mother's, I began my laxative purge using the orange flavored NuLytely solution. I drank all 16 glasses over the course of 3 hours. It wasn't too bad, especially once it started coming out as fast as it was going in. I found there is not much free time to watch TV during the purge. You have to be fully committed to the bathroom. Fortunately, I had the foresight to buy a new medical mystery paperback which helped pass the time. A lot of my patients rent a video which they can pause during their bathroom time. For the remainder of the evening, I drank hot tea and enjoyed my book. I went to bed early and got a good night's sleep for my test the next morning. |
Before the Procedure
Here I am in the pre-operative holding area awaiting my examination. I arrived 30 minutes before my test to allow time for registration and preparation. Since the test requires sedation, I was not able to drive home. My wife, Jean, was nice enough to come with me and wait during the exam and recovery period. Here I have changed into a patient gown. The nurse has taken my vital signs and recorded my allergies, medications, and pertinent medicial history. She then started an IV line in my arm which will be used to give me intravenous medication before the examination. While waiting, I planned my menu for the rest of the day. |
During My Procedure
Here I am in the endoscopy room sleeping peacefully during my colonoscopy. The comfortable mattress and prewarmed blankets helped me to relax and the intravenous medication (called "conscious sedation") put me into a light comfortable sleep. The sedation is very safe, but it is always best to monitor patients vital signs when sedated. Here the GI technicians have hooked me up to an EKG monitor to follow my heart rhythm. An automatic blood pressure machine also checked my blood pressure every 5 minutes during the exam. All patients are routinely given supplemental oxygen during the procedure. To monitor this, a noninvasive Pulse Oximeter probe was placed over my index finger. This measured the oxygen in my blood during the exam. All of these wires and gadgets alarm some patients, but they are just there for safety's sake. Dr. Stanley did a great job and the test was a breeze. It only took about 20 minutes and I felt nothing. Like most of my patients, I awoke and asked when we were going to begin. It is really a strange feeling to have missed the whole event, but that is best. |
Recovery Room
After my examination, my stretcher was wheeled into the recovery room where I slept for a short while. Here I am just awakening after my test looking a little loopy. Dr. Stanley came into the recovery room and explained the results to me and my wife. I was pleased to learn that there was no cancer and I did not have any more polyps this time. It was good news. My diverticulosis is a little worse, but that is mostly a result of aging. I don't have much control over that. At least there is no sign of diverticulitis, or inflammation. After a small snack and some orange juice I was awake enough for my wife to drive me home. Once home, my wife treated me to a nice breakfast of steak and eggs. Then I slept for several hours and awoke very refreshed and glad that my test went so well and the news was good. It makes you feel very positive when you make the effort to protect your health. I believe in preventative maintenance. It works for my car. Now, as I get older, it works for me, too. |
Inside Dr. Fusco's Colon
Here you can see the photos that Dr. Stanley took of my colon during my colonoscopy. Just click on the picture of the colon. Notice how well the laxative preparation cleans all the waste out of the colon, so that the doctor can see clearly. Sometimes called the large intestine because of its wider diameter, the colon is actually much shorter than the small intestine, only about 5 feet long. The colon begins in the cecum located in the lower right portion of your abdominal cavity. Your appendix is connected to the cecum, and that is why appendicitis causes pain in the right lower side of the abdomen. At the junction of the small intestine and the cecum there is a valve, called the ileocecal valve, that prevents material from the cecum from moving backward into the ileum. Your cecum continues as the ascending colon upward along your right side. Just under the liver it makes a sharp turn. The colon continues across the upper abdomen as the transverse colon, only to make another sharp downturn. The colon continues straight down your left side as the descending colon and then into an S-shaped segment called the sigmoid colon. This is the area where most "pockets" of diverticulosis form. The sigmoid colon connects to the last six inches called the rectum. The rectum continues directly into the short anal canal which terminates with the anal sphincter. The anal sphincter is a valve that must remain closed to prevent stool incontinence and open properly to permit a bowel movement. Some observers have referred to the anal sphincter muscle as the social muscle, because it is able to prevent accidental bowel movements and to distinguish between passing gas as opposed to solids and liquids. |