Wednesday, February 18, 2015

The Colonoscopy

Wednesday, February 18, 2015

Colonoscopy, we've all heard of it, but who really thinks about getting one? Seriously, the thought of being probed in ways you would never consider is enough to put it off or dismiss it entirely. But the reality is, the colonoscopy is the first line of detection for colon cancer, and the key to beating colon cancer is early detection. 

I'll try to save you a boring lecture but I think everyone should know some basic statistics of colorectal cancer, warning signs or symptoms, and what a colonoscopy involves. I'll also share my personal experience and results, as well as provide links to images of my colonoscopy, for the visual learners!

Basic Statistics
According to the American Cancer Society, colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the US, with about 141,210 new cases and 49,380 deaths (expected in 2011). About 72% of cases arise in the colon
and about 28% in the rectum.  Anyone can get colorectal cancer and the incidence and death rates increase with age, 35% to 40% higher in men than in women, and highest in African American men and women.  

Signs and Symptoms of Colorectal Cancer
Early colorectal cancer has no symptoms, which is why screening is important. However, if you have any of the following warning signs or symptoms you should see your doctor:
  • Bleeding from the rectum
  • Blood in the stool or in the toilet after having a bowel movement
  • Dark- or black-colored stools
  • A change in the shape of the stool
  • Cramping pain in the lower stomach
  • A feeling of discomfort or an urge to have a bowel movement when there is no need to have one
  • New onset of constipation or diarrhea that lasts for more than a few days
  • Unintentional weight loss
More information on colorectal cancer facts and figures from the American Cancer Society can be found at

According to the Centers for Disease Control and Prevention, colorectal screening beginning at the age of 50 is key to prevention. Those at higher risk should be screened even earlier, for example those with a family history should begin at age 40. Higher risk factors for colorectal cancer include the following:
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease
  • A strong family history of colorectal cancer of polyps
  • A known family history of a hereditary colorectal cancer syndrome such as familial
  • Adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)

I would add that another dimension of prevention would be eating an organic diet, free of chemicals and genetically modified organisms (GMOs) and the use of toxin free home and body care products. Of course, properly addressing stress and eliminating or greatly limiting exposure to toxic environments found in some occupations and quite honestly many homes are very important as well. However, all said, I believe the genetic component is even stronger than some of the current research suggesting our ability to "turn off and turn on" genetic expression via diet, lifestyle, environment, etc. This is known as epigenetics, which could be an entirely different post.

My Personal Colonoscopy Experience
You may have heard that the hardest part of a colonoscopy is actually the prep. It's true! I'm not sure if all gastroenterologist use the same prep, but mine was called GaviLyte - N. It's an oral solution of Polyethylene Glycol 3350 (PEG-3350), Sodium Chloride, Sodium Bicarbonate and Potassium Chloride. Essentially it's a potent laxative formulated to clean you out quickly. It comes with a lemon flavor back, however I didn't use it because it contains Maltodextrin, which contains gluten and I've had a gluten intolerance. It also contains an artificial sweetener, which I don't use. I used naturally lemon flavored stevia drops instead. Now, I'll also state here that I typically try to avoid Polyethylene Glycol in any drink, food, and even supplements, because I've found data indicating it has toxic properties and I'll leave it at that.

So, my instructions were to fast the entire day leading up to and morning of the procedure, and to drink eight 8 oz. glasses of the solution at noon, with 10 minutes in between each drink, and another eight 8 oz. glasses at 6 PM. You're probably wondering what it taste like, right? Well, to be honest, by the smell of it, I didn't want to taste it, so I chugged it as quickly as I could. I will say leaves a bit of a salty aftertaste and a taste of plastic from the container the solution is stored in...yes, you taste plastic, which is leached into the solution from the about toxic!

Now, what I'm about to tell you is not typical of the prep experienced by most least that's what I'm told!  So, I'm moving along, chugging this crap every 10 minutes, and immediately following my 5th glass at noon, my stomach was bloated and hurting so bad I was on my hands and knees in intense pain. My wife checked the warning label attached to the bottle of solution and it indicated that if any discomfort occurs, to reduce the amount per serving and/or increase the time between each dose. Additionally it indicated that a bowel movement should occur within an hour of drinking what I'm assuming as the recommended dose of eight 8 oz. glasses. 

Two and a half hours pass and the pain was not going away and I was now throwing up. My wife called the doctors office to tell them what was going on their advice was to not drink anymore until I have bowel kidding! Believe me, at this point, you couldn't force me to drink anymore! They suggested waiting an hour and she told them it's been 2 1/2 hours and asked if this pain and vomitting was normal. They said that my blood sugar may have been low from fasting and further suggested eating something with calories, in which jello, freeze pops, broth, and some juices are permitted. I told them that this was not possible...I couldn't even think about putting anything else into my stomach because I was in so much pain. At this point because I was in so much pain, vomitting, and had't had a bowel movement they recommended that I go immediately to the emergency room. Essentially, I'm now conflicted because I literally feel like I'm dying, but I seriously don't want to go to the ER. So, I decided to tough it out another hour or so and reassess the situation then. Close to 4 1/2 hours later the flood gates finally opened and bowel movements started flowing! Now, let me remind you that a bowel movement is suppose to occur after one hour of the drinks...not 4 1/2 hours! 

Alright, so the river's flowing and man, what a relief from the was like winning the lottery! Well, not quite, but at least I knew I wasn't dying! You're probably wondering why it took so long to have a bowel movement, since typically one occurs within an hour. Let's just say that things were seriously backed up and you'll find out more below when I talk about the findings...Hey, and if you're more of the visual learner, I'm even going to provide you with links to view my colonoscopy pictures.

Okay, so let's get to the actual colonoscopy. What does it involve? Basically a nurse places a catheter in your arm so they can administer a sedative. I was in a small room, gowned up, lying comfortably, waiting to be taken into the procedure room. I shouldn't say lying comfortably, because to be honest, I was nervous and a little scared because I had never been sedated and/or had anything remotely medically invasive performed. I don't want to scare you too much, because a colonoscopy is really not that invasive, I've just personally have never needed much in the form of medical intervention or procedures, and beyond a pill for pain here and there, I've never really used pharmaceuticals. So, my nervousness and fear was that I would have some type of bad reaction to the sedative. So, I'm thinking in my head, what if I never wake up?!

Truth be told, it was really easy. Once you're in the procedure room and positioned on your left side, the sedative is administered and within seconds it's lights out, nighty night! While you're resting peacefully, the doctor inserts a flexible tube with a little camera, called a colonoscope, through your rectum and into your colon. If anything is found, the doctor may take a small piece of tissue, known as a biopsy, or remove a polyp with tiny instruments inserted through the scope. Any test specimens taken are sent to a pathologist for inspection. The entire procedure only takes 20-30 minutes. You don't feel a thing or remember anything about the procedure. The sedative drug is short acting and you're basically awake right at the end or shortly after the procedure.

My Results
This has been a much longer post than what I was expecting, so I'll get right to the point with respect to my results. The colonoscopy revealed a large mass, believed to be cancer, almost entirely blocking and closing off my Transverse colon, which runs horizontally across your midsection. The size of the mass prohibited the doctor from completing the colonoscopy. The normal lumen (canal in which food or at this point fecal matter is transported and eventually evacuated via bowel movement) is typically between 3 cm to 6 cm. In my case, the lumen measures less than 1 cm, almost entirely blocking or closing off the colon. This makes eating food considerably difficult and painful as the matter cannot make it's way through the colon normally.

I told myself that this blog would be no holds barred, no sugar coating, and be a real account of my journey. So with that being said, I've provided a link below to the image of the mass in my transverse colon. This is what one form of colon cancer looks like. You can see, as I described above, the mass almost entirely closes off the lumen or canal. 

Medical Disclaimer: The links below contains personal medical information and or images for or of Michael Bauman. It is being shared for the purpose of educating others. Any unauthorized use or reproduction of this content and or images therein is strictly prohibited. Warning: Some may deem the images to be graphic in nature. Viewer discretion advised.

Image 1
Image 2
Image 3
Image 4
Image 5

Next Step(s)
The next steps include blood work and a CT scan to determine if cancer has spread. That was performed this morning. My next post will walk you through the CT scan and hopefully include results of both the CT and blood tests.

Take Home Points
While it is true that the prep the day prior to a colonoscopy is the hardest part, the actual procedure is quite simple, not painful, and way less invasive than you think. Remember, catching colorectal cancer early is key, and the colonoscopy is the first line of detection. If you experience any of the signs and symptoms in my post and/or have a strong family history, don't dismiss or put off a colonoscopy. Talk to your doctor. You can't beat what you can't see and don't know.


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