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Tuesday, October 27. 2009
Just For Old People II
Getting old ain’t for weaklings. Truly. As we get older everything we do gets harder, especially if it’s physical or requires us to remember stuff. If that isn’t bad enough, medical experts tell us we are more prone to certain health issues and we need to take tests and have procedures for early detection and possible cure of said health issues.Many of these tests and procedures often require us to surrender a certain amount of dignity as the doctor — and his or her medical staff — probe and examine your most intimate physiological details. They are all professional of course. It’s all pretty clinical; they don their surgical gowns and hats — latex gloves — get their equipment ready, and after what seems like an eternity laying there on the gurney the medical people begin their procedures.
And then you realize you’ve spent the last week or so worrying about nuthin’. It wasn’t that bad. The worst part of it all is the preparation to get ready for the procedure.
But let me back up here for a moment. You don’t wake up one day and say to yourself, “I’m gonna have an invasive medical procedure tomorrow, I better get ready!”
No, the obsessive worry begins long before you ever arrive at the doctor’s door, with dignity in hand and fear in your eyes.
My worrisome procedure was a sigmoidoscopy, which isn’t quite a colonoscopy, but still requires a doctor to insert a tube with a camera in your butt. It’s named for the part of the colon where the insertion of the flexible tube stops in the examination.
Now, years ago, after hitting my 40th birthday, a doctor at the time suggested I would begin the every five-year probes, the colonoscopies, soon, before my 45th birthday. At that visit he donned some latex gloves, told me to drop my drawers and bend over the examination table. Maybe it’s no coincidence that shortly thereafter I had my first heart attack.
Since then, my primary care providers have been inserting their fingers in my sphincter at least once a year. Since my 45th birthday it’s felt like I’ve dodged a bullet since none of these medical professionals ever said the dreaded words, “We’re going to schedule you for a colonoscopy.”
It’s bad enough having a stranger stick a finger up your butt, but the thought of other strangers sticking fingers and cold surgical steel into your colon, well, that’s just damn scary.
Now, before anyone thinks I’m a bit of a prude, I’ve had several lovers who have happily obliged — or in one case, surprised — me with … well, it was all in the passion of the moment. Except for the hooker in Vegas. That one I had to pay for.So anyway, a few months ago I was seeing my V.A. primary care provider, a nurse practitioner, for my usual yearly check-up. She of course checked on my cardiac issues, the scars on my chest and of course, probed my butt with her finger. She’s so damn professional it takes all the sexual excitement out of it.
Then she said I would be doing the poop smears — stool samples they call them — in preparation for the dreaded test. What you have to do, for three days in a row, is collect a small bit of your stool, smear it on a card and in my case mail it off to a lab.
Thankfully I was diagnosed with pneumonia shortly after so the stool samples had to wait until the therapy for the pneumonia was completed. But eventually, I was collecting samples, smearing them on those cards and sending them off to the V.A. lab.
The medical staff of the Veterans Administration Medical Center in La Jolla work pretty fast. The bureaucracy, that’s a whole different subject, far lengthier than any mere tangent could address. Within about ten days I had the dreaded letter in hand requesting that I call the V.A. and schedule the appointment within seven days of receipt. So I did.
Monday, October 26 was the scheduled date of the procedure. Here’s where the suffering and indignity come in. After scheduling the appointment I received yet another letter instructing me to buy certain items at my local pharmacy: Magnesium Citrate and a home enema kit. Oh jeez. Without a fuckin’ clue of where to look for these items, I had to ask a nice young sales associate. He took me to the aisle, showed me where it all was — and I was grateful it was a man showing me — and then an older woman walked up and had to add her two cents worth. Horrifying.
Once through the checkout line, and of course there were two people in front of my so everyone around could examine my purchases while we waited, it was on the way home for me! My buddy John driving!
John has already enjoyed this procedure and he smiled with glee knowing I would soon be joining the club! After a final breakfast on Sunday Morning — two eggs with corn beef hash at Mimi’s — the regimen of preparation began. This is the tough part: no eating at all until after the procedure, which at that time was still 26 hours away. Jeez! Couldn’t consume anything but clear liquids, which meant no Diet Coke! You gotta be shittin’ me! Well, that was to come later that evening after the Magnesium Citrate was ingested.
This was the toughest part. By 5 p.m. I was starving. My two 12-packs of Diet Coke looked at me sadly, none to be consumed that day. At 7:30 it was time to drink the Magnesium Citrate, grateful I had unknowingly picked the lemon-flavored version. I slobbered all 10 ounces down my throat. No effect.
So, with Sunday Night Football on I tried to sleep until, just after the game ended, the rumbling began. Off to the toilet and voila! The Magnesium Citrate was doing its thing! And it continued working well into the wee hours of the morning. Catching a little sleep I woke up, knowing the home enema kit was waiting patiently on the bathroom sink. DAMMIT!
For a couple hours I putzed around on the computer, sent a few text messages, caught up on all the political TV I’ve been missing since getting a job, all the while the ordeal with the enema kit swirling around the darker crevices of my brain.
At 9:30 a.m., just three hours before I had to appear at the hospital, I went and did the deed. There isn’t much fluid in the little bottle, about 10 ounces, but they tell you on the kit not to worry if you don’t use it all. I pumped about half of it in and it took forever—it seemed. And sure enough, within two minutes it all came rushing out again. Remember the scene from The Right Stuff when the astronauts are rushing to the nearest men’s room to evacuate their bowels? It really does get that urgent. Thankfully, my toilet was a mere foot away.That little part of the process wasn’t even that bad. Hell, I’d do it again just for fun! Clean out the old system from time-to-time, Frank Zappa’s “Illinois Enema Bandit” playing on the iPod! What the Hell, have a little fun with it!
So finally, my friend Ilona picked me up — I wasn’t ready when she arrived, the only part of this for which I feel any shame — and off we went to the V.A. hospital in La Jolla. I waited for 40 minutes in the waiting room, obsessing about it all, wondering what was going to happen.
Into the examination room I went, led by the doctor who would do the procedure. Once there we sat down and he explained everything about it, including why it’s so important for us to have these procedures; find any early indications of colon cancer so we can remove the offending polyps.
After that the technician put a surgical gown on me and told me to remove my shorts. I’m so glad there weren’t any skid marks in my Hanes. Now that would have been embarrassing. After laying on a gurney for about ten minutes the doctor and his technician began their procedure. The doctor wanted me to watch everything on the monitor. NO WAY! I’m no fan of House! I don’t like all that fake blood and guts on TV, why would I want to watch the real thing, even if it’s my own colon?
Nonetheless, the doctor was pointing out the ridges that are muscles, the healthy tissue that makes up the colon — the little bits of “waste” that resisted all the laxatives — and a divicular-something that wasn’t a problem but could lead to problems. Well, okay, it was fascinating and educational, but I’m still not watching House.
The toughest part was that to do the procedure the doctor pumps gas in your colon to open it up a bit so we can see it. He likened it to blowing up a balloon. It causes cramps, which can be somewhat painful, but other than that, there really is no discomfort. Just to be sure, they use a lubricant, we can assume K•Y (I’ve seen it in their offices), to insert the flexible tube into your butt.
All in all, the procedure took just less than ten minutes. Afterwards I needed to hit the restroom to expel all the gas in my system, the noise echoing all over that cavernous V.A. restroom, but other than that, there weren’t any after effects. Ilona obliged me and stopped at a drive-thru Subway where I got a foot-long Spicy Italian. Once home I broke out the potato chips and popped open a Diet Coke and feasted!
I actually drank three Diet Cokes in quick succession.
The point of this excessively long essay on my sigmoidoscopy is that everyone, once you get to a certain age, ought not avoid it. There really isn’t anything truly undignified about any of it — other than asking where to find the Magnesium Citrate and enema kits in the pharmacy — but even that passes because, really, do you actually think a week later the store employees will remember you bought those items?My favorite musician/composer of all time, Frank Zappa, died at the age of 53 from colon cancer, the sad reality being that had it been detected earlier he would probably have lived a longer life. He would be celebrating his 69th birthday December 21st. That’s why I’m writing this. Don’t be worried about it, or, if you are, get it done. There’s really nothing to it and the benefits far outweigh whatever you think the embarrassment and indignity entail.
Next time though, I hope I get a hot young woman doctor or technician doing the procedure. That would make it much more enjoyable!
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