Relax. No, I don’t have cancer, but it runs in my family. I’ve lost both a grandmother, and an uncle, to it. Because of this, despite not yet being fifty, I’m supposed to get an annual colonoscopy.
I’ve yet to have one.
The reason for this is simple, stupid, but nevertheless true: I’ve had a flexible sigmoidoscopy. What’s that, you ask?
A sigmoidoscopy is colonoscopy’s younger sibling (or maybe its second cousin, twice removed). All of the prep work is the same; meaning no food beginning 12-24 hours prior, stool softeners, and that lovely Cascara, which is like drinking chalk-flavored Gatorade.
In case you missed that, one’s mission–whether one accepts it, or not–is to self-induce diarrhea in advanced of undergoing the procedure. On purpose.
People died of diarrhea during the Civil War!
In any case, while the preparations are similar, there is one crucial difference between the flex sig and a full colonoscopy; namely, that a colonoscopy is done under general anesthesia, whereas the sigmoidoscopy is done fully awake.
Yes, you read that right: it’s done entirely conscious. And while both are out patient procedures, the former is usually done in a hospital, while the latter can be done in one’s doctor’s office.
If my understanding is correct, the prevailing medical thought is that because the flexible sigmoidoscopy doesn’t go as far into the colon, it’s less a pain in the butt, and can consequently be done awake.
Let that sink in.
One reports to one’s doctor’s office, after having quite literally crapped one’s guts out, to lie prone upon a table, in a too-cold room, with nothing but a paper gown on to ward off the chill. The doctor enters, with a nurse, because like the boy and girl scouts this requires two-deep leadership (it wouldn’t do to have anything untoward occur). And then, without so much as a by-your-leave (or even dinner), lube is lugubriously applied to a region reserved as an exit only zone. After that, a long tube, at a snail’s pace, is inserted. All the while, the nurse is encouraging relaxation; “just breathe,” she says.
Relaxation is about the farthest thing from one’s mind at that point. It’s more like grin and bear it–or grimace and bear it. One of the two. The best that can happen is an uneasy peace; it’s not going to last forever, or one will die right there of embarrassment.
There is after all a long, dark tube right up there in the Hershey Highway.
But the worst is yet to come:
Air, like helium into party balloons, is pumped up in there so that the doctor may better appreciate the structures of the lower bowel. Only it’s no party; it’s quite literally a pain in the butt. And beyond.
As a patient, whether one can, or cannot, see the monitor upon which the Colon Cam is displayed, one’s doctor will typically begin a descriptive video service. (Nowhere did this item ever even begin to appear on my bucket list: have your sigmoid colon described in vivid detail by your doctor). “That’s a hemorrhoid! There’s another one! Good! Don’t see any polyps! Oh, look! A piece of poo!”
If one felt embarrassed before, that right there would be where the bottom fell out of the nadir of embarrassment. Oh, to melt through the table, into the floor, and be no more! Curse this too, too solid flesh!
Then at last it’s over, one is handed tissues to wipe off the thick, viscous jelly from one’s nethers; the doctor and nurse exuent omnes, and one is left to contemplate the series of events leading to this tube time and place.
Wiping, washing, and dressing complete, one is free to leave; breathing a sigh (or several) of relief, thinking the worst is behind you.
Oh, how wrong that is!
The air pumped up in there, no longer having a tube occluding its exit route, discovers the point of least resistance–namely, one’s anus. If the blow-by-blow of the colon highway was the bottom dropping out of the nadir of the experience this is somehow even lower.
It’s not just a little gas; it’s like the inevitable results of a weeklong refried bean binge, the Vesuvius of anal expulsions (think pyroclastic flow–all hot ash and gas, no lava), and the Manhattan Project all rolled into one. In other words, “I am become death, the destroyer of worlds.” Yet other than death there is no escaping these noxious emissions.
And that, ladies and gentlemen of the jury, is why I have yet to have a full colonoscopy. The defense rests. I place myself upon the mercy of the court.
Have you had a colonoscopy/sigmoidoscopy? How did it go?
Also published on Medium.