Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Thursday, May 15, 2014

Word of Mouth: Top to Bottom

I have started running again, just a little. I've been working on doing about 8 to 10 miles on my feet each day, some dog walking, and then running small amounts. I feel great when I run. I'm a little slow but my legs don't feel bad. Yesterday I did 5 miles and wanted to keep going but stopped myself. The plan is 20 miles this week, 40 next, and see how it goes from there.

I plan to run the Houska Houska on May 26, which is a fun 5K. That week I will also do my first speed session again. I'm not going to push hard, it will just be interesting to see where I am 3 or 4 weeks post-race. And as of the first week of June I'd like to be back into training for this fall. I can't wait to get going again!

So the rest of this post is my public service announcement. If you're squeamish and can't bring yourself to put your big boy or big girl panties on, then by all means, move on to another post. If you think it's TMI, then I'm calling you a wimp.

I'm a 50 year old athlete, I run ultras, I've been mostly healthy all my life. I hope to continue that way. Some things you just never know if they're going to happen, but to the extent that you can prevent some awful thing from happening, I think you should. My opinion on this, and you might not agree, is that you have a social responsibility to control health care costs in your own life for the benefit of society in general.

By avoiding preventive care, your chances of having a serious health condition that needs expensive and drawn-out treatment result in increased costs that are spread to everyone. That's not fair. I'm not saying that everything can be detected early, because it can't. And no test, no screening procedure is ever fool-proof and 100% accurate.

Yes there are many tumors that go undetected, some cancers that often can't be caught early like pancreatic and ovarian, and I can't even tell you the number of women who had a mammogram come out "normal" and then within a short period of time later, found a lump that was beyond stage I. But those are generally the exceptions.

And if you are diagnosed with cancer or some chronic disease, it is not your fault (almost never! the exception would be if you willfully and knowingly allowed it to progress and then decided to wait to obtain treatment) and you deserve the best care that is available to restore your health, regardless of where you fall on the socioeconomic ladder. Knowledge is power and I am just saying that you have a responsibility to your fellow citizens not to bury your head in the sand if you have the knowledge and are able to access preventive care.

Having seen and administered the treatment for many types of cancer, I can tell you almost without exception, you are much better off detecting a disease, especially cancer, early, because the outcome and treatment are so much more favorable.

Yesterday I had an appointment with a dermatologist to check out my skin and lips because at my checkup this spring my dentist thought I had some sun damage on my lower lip that should be looked at. The dermatologist thought things looked pretty good, and advised against freezing off the few small spots on my cheeks, nose, and upper lip that are little pre-cancers until later on in the year, when I'm not having so much sun exposure, because it would leave white scars right now.

There were a few little rough spots on the edge of my upper lip, again, not too concerning, these are tiny little precancer areas. And the area of my lower lip that the dentist was concerned about, the dermatologist felt that there was nothing concerning at all there.

So I took care of the top half as far as cancer surveillance. Went to the dermatologist, had my mammogram, and now the not as much fun part: I scheduled the Roto-Rooter for the last week of May.

As an oncology nurse, I have to set a good example for readers. So I'm writing about colonoscopies. This won't be the last post, either. This is the PRE-colonoscopy blogpost. There might be a during the prep blogpost if I can get away from the can long enough, and yes I promise you I will wash my hands before I come back to the computer, there will be no virtual spread of disease and E. coli by reading my blog...and I also promise you, there will most definitely be a post-colonoscopy blogpost even though I anticipate I will have no memory of the entire procedure.

My intention is not to post graphic pictures or gross you out. The appearance of my inferior-most orifice will remain a secret between me and the gastroenterologist. But as far as the details of the procedure, if you're freaked out by the "EW" factor, then it's time to re-condition yourself.

I didn't get to have the colonoscopy appointment as soon as I wanted to, but I got it a week later, and still in May, with the doctor I wanted, so I'm content with that.

I wanted to get it done before Memorial Day because I want to return to full training but one more week won't hurt anything. I'm a little concerned about getting the anesthetic out of my system. They use propofol (yes that's the Michael Jackson drug) and from what I can tell about the pharmacokinetics (how the drug works, moves through your body, and is eliminated) it looks like it will be a good 48 hours before it's cleared. Until that time is over I'm not taking any chances. Two years ago when Dennis had his colonoscopy he broke his foot the day after, by slipping off the stairs. I'm convinced it happened because he was still affected by the propofol.

It kind of freaks me out to have them putting propofol in my system. We used that all the time for sedation for patients on ventilators in ICU. It's pretty freaky stuff. It wears off quickly, and it's this thick milky-looking liquid. I don't want it in my body. That is more of an issue for me than the scope itself. But I also know I don't want to be aware of or remember what they're doing with the endoscope, so I'll compromise.

What are the biggest fears people have around getting a colonoscopy that keeps them from doing it?

1. Embarrassment: exposing your butt hole to other people. Seriously. Everybody has one. (Some more than others)

Believe me, I don't remember the faces or other parts of any of the patients I ever was present with during their scope, and there were a lot. Even less so with your doctor, they do these day in and day out, they are busy watching the video screen of the inside of your colon, not paying attention to any personalized markings on your body. You won't run into your gastroenterologist in the grocery store and they'll think...oh yeah that was the one with the hairy butthole...

Now if you have a tattoo on your right butt cheek that says "Scope Me" or has the doctor's name, well, maybe they would remember that...but the room is dark so they might not even see it.

As far as the outside parts go, seen one, seen 'em all. Some have hemorrhoids, some don't. Unless you tattoo your hemorrhoids, they won't remember. That's about it...

What if you pass gas during the procedure? You might, but it's more likely to do that afterwards. But you'll be in your little recovery area and everyone else is out of it with anesthesia too. They won't know where it's coming from. Sort of like farting in a crowded, loud room full of people. And during the procedure, there is noise in the room and they aren't very close to the offending part anyway, they are focused on moving the scope and the video screen. You won't know, and won't remember. Everyone farts, you, your dog, your grandmother. Even gastroenterologists fart.

2. Afraid of pain: It's highly unlikely that it will be painful unless you already have some sort of serious GI disorder, and in that case they would medicate you. You will be lightly sedated, and the doctor can even talk to you during the procedure. Afterwards you will not remember it. But you will be able to let the doctor know during the procedure if you're having any pain. They can give pain medication if necessary, but usually it is not needed.

3. Afraid they'll find "something": If they find a polyp, they will remove it during the procedure. You won't even know. They'll slip this little wire around it and cut it off, take it out and send it off to the pathologist. It's done. Most of the time the polyps are benign and if they are suspicious, the nice thing is that they are out of there. Unless they find a major tumor, they are not likely to have to do anything else.

Sometimes they find a polyp that upon examination by a pathologist, needs to be followed up on with a repeat colonoscopy in 5 years, instead of 10 years. But since they took it out already, at least you have the peace of mind knowing that you've stopped the growth of a potential cancer and set it back. That alone is better than not knowing there is something growing in there, and finding it when it's already spread.

Wouldn't you rather know that you had a precancerous polyp removed and out of your body? At least you'll know you can do something about it in the future. And you'll know that the colonoscopy procedure wasn't that bad. It's a lot easier than waiting until there's a huge tumor that has spread to your liver and you need chemotherapy and surgery and possibly living afterwards with a colostomy bag attached to your abdomen. Believe me, a quick colonoscopy that you won't even remember is much more favorable.

4. Fear of complications: Unless you are in poor health, have advanced cancer, or already have some kind of advanced GI tract disease, it is very unlikely that anything can go wrong in a healthy colon. The scopes don't have sharp edges, the little tools they use are retracted inside the endoscope, and they are watching the entire procedure on video the whole time.

The doc I chose is one I actually know, and have conversations with if I run into him somewhere in the hallway or in town, and I know his wife too. But I feel totally comfortable because I've worked with him doing the procedure before and I know he does a thorough job. He's got a nice personality and you feel at ease around him. I won't be freaked out after the procedure if I run into him in the grocery store.

So that's my public service announcement for the day. I admit that yes I do feel a little icky about it. It's not something I look forward to. But I also know that it's better to get it over with, so I'm looking forward to being done.

The important thing to remember, other than GET YOUR COLONOSCOPY is, make sure you choose a doctor whose name you haven't tattooed on your butt.

No comments: