Streetcar: An Ounce of Prevention

Be PREP-ared

Several years ago, when a physician first recommend that I have a colonoscopy as a precautionary measure, I was unfamiliar with the procedure. He explained that a microscopic TV-type camera that was attached to a tube would be gently pushed through my…

“Through my what!”

And that was just the beginning. As the device (an Olympus scope) winds its way through a colon, doctors watch a monitor for signs of devious polyps that could be dangerous if not removed. When polyps are found, tiny loops perform a process called “a cold swipe” that cuts them off. They are then positioned for a color picture to be examined by a pathologist. Polyps are ugly little flesh blob critters that best serve humanity by being removed. They are the fear of every medical checkup when the doctor examines the chart and reminds the patient about the dreaded colonoscopy.

Eventually the day came when I could not delay the procedure anymore. Excuses were running out. On paper “colonoscopy” is a terrible sounding treatment, but as the doctor and many others would advise, the problem is not with the procedure “but the prep.”

Yes, the prep. According to detailed instructions we the patients were not to eat any solids for roughly a day and a half before the procedure. That eliminated almost all that tastes good, including anything that is red. Allowable though is Jell-O. Not any flavor Jell-O but particularly the lighter colors, such as lemon or lime. Jell-O is a food from the past that if you ask anyone, they will likely say, “I haven’t had that in 20 years.” (Which is the same thing they say about the last time they played Monopoly.) Two decades ago, there might have been a serving of canned fruit cocktail stirred into the gelatin, but for the “prep” we are reduced to life’s rough side—including, unadorned Jell-O. My theory is that the entire Jell-O industry is supported by colonoscopies. The red-colored alternatives are just for post-operative variation.

Chicken broth is also permissible. I bought two cans but never opened either. They await another day and another feast. Also, in the prep list are pills and liquids designed to clean out your innards, and water—lots of water. I went from late Sunday afternoon to late Tuesday afternoon without having anything solid. A brownie broke the fast, but to its credit, someone explained, Jell-O helped. It has the virtue of being filling. At this stage, all virtues are welcomed.

(Writer’s note: This is the paragraph where I was going to explain in detail the actual procedure; including the memories, fears, sounds and pains. For convenience I have broken this explanation into two parts

Part 1. Having been wheeled into the operating room an Ochsner anes- thesiologist explained that she was about to inject me with a sedative.

Part 2. A nurse gently urged me to wake up. “Where am I?” I asked. “The recovery room,” she answered. “Have I had the colonoscopy?” “Yes,” she answered.)

I remembered nothing. No wonder the prep is said to be worse than the procedure because there is no memory of the latter. From reading a doctor’s post-operative description, at one point my body position had to be changed and “manual pressure” was used. He added that I responded well. No memory, no pain.

You won’t find this in any medical guidebook, but to me, the final step took place about an hour and a half later when we stepped into Mandina’s for an early but long anticipated supper. As we entered, we saw a couple we knew among the diners. This is not a subject I would usually bring up but in the swagger of the moment I told them I had just come from getting a colonoscopy. The male of the two was not impressed. “How many have you had?” he asked. I told him that was my first one. He told me he had had five.

Later that week I saw a woman acquaintance and the topic came up again. It turns out that on the same day, at practically the same hour, she also had gone through the same procedure, but at a different place. It was her sixth time.

My sense of bravado gradually deflated. Later that day a relative told me that she too had undergone treatment – five times.

Here I should mention that colonoscopies are a serious business and I urge those among the reluctant, like I was, to get it—besides, “it is not the procedure but the prep.” Time from insertion to withdrawal of the scope was 23 minutes.

And remember, we all need to do our part to support the Jell-O industry.

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