Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States.
Numerous studies have shown 33 percent to almost 50 percent of men and women eligible for colonoscopy screenings do not follow through with the procedure, which means potentially millions of people are losing the opportunity to treat colon cancer, should they have it.
Colon cancer is easier to treat and less problematic and deadly when it is caught early.
I mention all of this because I crossed the 50-year threshold two years ago. I’m not good about going to the doctor for most things, but now, when I do go, I get the list of things I need to grow up and address. First on the list was a colonoscopy.
I shifted in my chair when the doctor told me I would soon receive a call to schedule the screening. Later, when my wife asked about my doctor’s appointment, I told her I have to get a colonoscopy, and began to register a complaint. I stopped myself, bearing in mind that women go through other invasive screenings, and often at greater intervals.
When the digestive health clinic called to schedule the procedure, I was weirdly uncomfortable talking with the receptionist about it. She was just throwing around the word ‘colonoscopy,’ and I was saying it in verbal italics.
It was scheduled eight weeks out, and I immediately stopped thinking about it. Seven weeks later, I got the reminder call.
“I thought my colonoscopy is next month,” I said. I can only imagine how often the person making the reminder calls is then given excuses and asked about rescheduling. It crossed my mind to push back the appointment. But then I thought about my sister who, years ago, was surprised by a positive cancer diagnosis. The thought of chickening out knowing about the years of what she went through didn’t sit well.
I confirmed my appointment and was told I would receive a list of instructions to prepare for the colonoscopy. She spoke quickly and cheerfully, and I heard almost none of it.
“Could you repeat everything after ‘Hello, is this Dale Edwards?’” I asked. She laughed and said the instructions would be sent by email and I could call if I had questions.
“The prep day is the hardest part,” she said. “You won’t even notice the colonoscopy.” I didn’t buy that.
Best I could tell, the purpose of ‘prep day’ is to clear your intestines by liquifying everything in them. You start with being limited to only clear liquids from when you wake up the day before the colonoscopy, to three hours before the actual screening, when you’re not allowed to put anything in your mouth.
You can eat Jell-O, so long as it’s not red Jell-O. You can “eat” broth.
Laxatives play a big part in prep day. It’s advised that you stay near a bathroom, which is…solid advice. A day’s worth of Miralax (or a generic version) will be mixed with 64 ounces of Gatorade (but not the red kind).
You don’t have to drink the Gatorade/Miralax cocktail quickly. I consumed the first 32 ounces too fast and nearly threw it up. Once I slowed down, I was able to grind it out. Steven Petrow, a friend and fellow journalist who knew I was going through this, texted me about how I was feeling. “I may never again drink Gatorade,” I responded.
By the evening before my colonoscopy, the laxatives were working as advertised. I can’t deny I felt miserable. It wasn’t a feeling I could sleep off, as I was up regularly.
In the morning, I still wasn’t feeling great, but I was now, at least, looking forward to getting this over with. Four hours before my appointment, I had to drink a bottle of magnesium citrate, which is, yes, a laxative.
Magnesium citrate is clear, and it comes in a lemon flavor, which is what I bought. There’s no smell. It was like drinking fresh lemon juice and a bag of sugar. I couldn’t drink it too fast, because after each drink, I would pound my fist on the counter until I got my face under control.
My daughter drove me to the digestive health clinic. It is very important you have someone drive you. You will not be allowed to drive yourself home.
I checked in and the nurse went through the four pages of health history questions and checked my vitals. I’m pretty healthy, so we breezed through those. I put on the gown that was engineered to never fully close in the back, and laid on the bed and waited to be wheeled into the colonoscopy room. I also got an IV.
The anesthesiologist introduced himself and we ran through the same list of medical history questions. He told me about propofol, which is the drug I would be given just before the colonoscopy. He asked if I had trouble walking, had blurred vision, or headaches. I answered ‘no’ to all.
“Can you walk backward down two flights of stairs?” he asked.
I didn’t know what to say. My balance isn’t great, and I’m pretty sure I couldn’t walk backward down even one flight of stairs without falling. Does this mean the colonoscopy is off? “I don’t think I can do that,” I said.
“I’m just kidding,” he laughed. “I said that to loosen you up.” I told him I’d been plenty loosened up already, thank you.
Once wheeled into the screening room, I was told to roll on my side. The assistants kept me covered and asked if I was warm enough. The doctor who would be doing the colonoscopy introduced himself and talked me through the procedure. He said the whole thing would last about 30 minutes. The anesthesiologist told me he was starting the propofol, and within about five seconds the room started to spin a little. I might have dreamed it, but I think we briefly talked about Tim Burton movies.
I am not exaggerating: The next thing I heard was the nurse saying, “You’re all done. Great job.” I have zero memory of the procedure. I was given a soft drink, took a few minutes to shake off some of my grogginess, and then got dressed.
The doctor came back by to tell me everything looked great and that I wouldn’t have to have another screening for “at least 10 years.” He then gave me photos of my colon, and I might have said something about Instagram, but it might have been the propofol still hanging on.
My daughter took me home, and I ate solid food. The doctor said I could have whatever I felt like eating, but I thought I should start slow. I ate toast with butter.
Here are things to consider about colonoscopies:
• When your doctor recommends the screening, ask questions. One of the first things they will probably tell you is you will have no memory of it. I wasted hours worried over what it was going to feel like and how uncomfortable I was going to be. It was like a blink of an eye;
• You can do the at-home fecal test kit, but it’s not as thorough. And if the test shows any kind of irregularity, you’ll have to do the colonoscopy screening anyway;
• ‘Prep day’ is the hardest part. There are few positives unless you’re wanting to drop a couple of pounds;
• Following through with all of the preparation steps is extremely important. A completely clear system enables the colonoscopy camera to get the best view of the colon. It’s a slog, but it’s worth it;
• Even after the colonoscopy is done, those laxatives you’ve been taking are still going to be doing their thing. Take it easy, and stay close to a bathroom;
• The propofol can leave you loopy. My wife told my daughter to “record anything dad says,” thinking she might have something to later hold over me. I knew enough to keep my mouth shut;
• When the doctor gives you the “all clear,” it’s a fantastic feeling. If the screening does find something, your health care providers will be able to create a plan to address your situation. Having a plan of action is liberating, but it can’t be created until you follow through with the screening;
• You can do this.