Yesterday morning, a woman put a five-foot hose up my ass.
Actually, it was two women.
With a third looking on.
I make the joke now because, yesterday, I got the feeling that you’re not supposed to make jokes at the colonoscopy clinic. And if you did, the likelihood that it would be the first time they’d heard it would be very low. So I played it straight. If they were going to ignore the fact that butts are innately funny, I would, too.
And, actually, there was nothing funny about it. In the end – ok, sorry, that was cheap – it was actually a wondrous experience. I came out of it elated, like I had participated in something kind of special.
And, I guess, if the purpose of the undertaking is to save your life and spare you the agony of a horrific cancer, well, it actually is kind of special.
Though it doesn’t start out that way.
Before they can put the scope in, you’ve got to get the poop out.
That’s called “preparation,” and the unpleasantness of the preparation for my first colonoscopy is why I put off my second colonoscopy for an extra five years. Back then, they made me drink a gallon of something that tasted like salt water. Each swallow made me gag and wretch. I really hated it. And, like I said, it almost put me out of the colonoscopy business.
But I eat a traditional American diet. Yes, lots of plants and fiber, but also lots of red meat. And some of that meat I like grilled or smoked, and I like hotdogs and sausages. And I know what that can do to one’s potential for colon cancer. And I know that my kids need a father and my family needs a paycheck for some several years to come.
So I scheduled my second colonoscopy, and was relieved that it wouldn’t come for some several months.
But yesterday was that eventual day. And, like most things we dread, my fears and anxiety turned out to be baseless.
Thankfully, “preparation” is very different these days.
At noon of the day before the procedure, I took two little laxative pills. At 6 that night, I drank a bottle of Gatorade with several ounces of a laxative powder dissolved in it. I noticed a difference in the taste and smell, but it was not offensive or bothersome. I drank another bottle at 4:30 yesterday morning.
That was it. No gagging. No wretching. No problem. What a relief.
The laxatives did their job. They also made me feel a little ill, maybe even loopy, and it was unpleasant, but only mildly so.
But let’s get to the hose up the ass.
For my first colonoscopy, 10 years ago, they sedated me. They put you to sleep. You really aren’t there for any of it. I had heard, though, that you could ask not to be sedated. And this time I wanted to try that. I needed to work yesterday afternoon, and be clear headed for it, and I thought that if it was possible to avoid putting unnecessary drugs into my body, I’d like to.
The nurses at the clinic said that was ok, and gave me some tips, trying to describe what it would be like and assuring me that if it became unbearable the sedation could be administered immediately. The doctor, at the bedside, asked me why I didn’t want to be sedated, but I got the sense she asked more for me to hear the answer than for her to hear the answer.
So there I was, laying on my left side in one of those backless gowns, my right knee raised and moved forward. I could see two monitors, one with my vital signs on a continuous feed – resting heartrate in the mid-50s – and the other which was soon to be filled with a livestream of my innards.
Then she put it in.
It was, obviously, an unusual sensation. But it was not painful or innately unpleasant.
How a colonoscopy works is, they feed this long scope into your colon, up one side of your abdomen, across your belly below your ribs, and then down the other side of your abdomen to where the small and large intestines meet, about where your appendix is. The actual search for polyps is done on the way out, not the way in.
The inside of your colon doesn’t have any sensory nerves. It can’t feel, and consequently it can’t feel pain. But outside your colon, there are nerves that feel stretching or distention. You’ve felt that when you’ve had gas pains or the sensation that you need to take a crap.
On the way in, I felt very little. When the probe had to make its two turns, there was a sensation that was mildly unpleasant, but not quite what you’d call pain. The nurses had warned me about this and said that if I took a deep breath – pushed my diaphragm down – it would help. I did, and it did.
At the end of the large intestine, the doctor pointed out the opening of the appendix into the colon. I was glad she did. The screen was fascinating. I knew this wasn’t a guided tour, and that the doctors had better things to do than answer my biology-class questions, so I kept my mouth mostly shut, and kept the “What’s that?” questions to a minimum.
After the appendix, she pushed into the small intestine, to inspect a portion of it.
That was a different, and more unpleasant sensation.
But it was also amazing.
The lining of the small intestine is covered with short, hair-like villi, which increase the surface area and allow for the absorption of nutrients from food. I expressed my wonder, and the doctor said it was “beautiful,” and she was right.
It was beautiful. And sacred. One of those edge-of-the-Grand-Canyon sensations of awe.
At the divine design of the human body. And at the convergence of excellences that made that moment possible. This doctor who had spent 13 years after high school to acquire her education and skill, the engineering and manufacturing that created this device which could explore and treat the inside of my body. The administration and operation of a medical business that could equip and staff a clinic and treat a flood of patients.
All so you and I don’t have to die of colon cancer.
It really was amazing.
But let’s get back to why we’re here – looking for polyps.
To find these, on the slow trip back out of your gut, the device inflates your colon, so that its entire inside wall can be seen. You feel that. It’s a continuous and moving gas cramp. If there is an unpleasant part of the procedure, this is it.
But you find yourself, with the others, scouring the screen looking for polyps. There were three of them. I saw two of them just as the others mentioned them, and one a moment before.
Those come out.
One was removed with a little wire lasso that a probe looped over the top of it. Once secured, the wire was retracted and the polyp was cut off. You can see the laceration of the interior colon wall, and a little bit of blood or raw tissue, but there is no sensation. The other two were cut off with a circular clamp that, once the doctor manipulated it onto the polyp, withdrew into its sheath, taking the polyp with it.
They go off to be biopsied, and the doctor said they looked benign, but two of them were of the type that could have eventually gone cancerous.
Which leaves me kind of thinking they might have saved my life yesterday.
The colonoscopy ends with the device doing a u-turn in your rectum – interesting – in order to get a picture of the inside of your butt hole. Apparently, the inside of my butt hole is in fine working order.
And, apparently, I’m good for another five years.
Ten minutes later I was dressed and out the door and off to work for the afternoon.
And I was grateful for the experience. Two ticking time bombs were gone, my mind was eased, I had been impressed by the excellence of medical practitioners and technology, and I had been witness to the miracle of creation.
All in all, that’s not a bad day.
Plus, I got to make a joke about a woman putting a five-foot hose up my ass.