Colonoscopy Journal:

I called my friend Andy Sable, a gastroenterologist, to make an appointment for a colonoscopy.

A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis .

Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner.

I nodded thoughtfully, but I didn’t really hear anything he said, because my brain was shrieking, ‘HE’S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!’

I left Andy’s office with some written instructions, and a prescription for a product called ‘MoviPrep,’ which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America ‘s enemies.

I spent the next several days productively sitting around being nervous.

Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn’t eat any solid food that day; all I had was chicken broth, which is basicallywater, only with less flavor.

Then, in the evening, I took the MoviPrep. You mix two packets of powder together in a one-literplastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons). Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes – and here I am being kind – like a mixture of goat spit and urinal cleanser, with just a hint of lemon..

The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, ‘a loose, watery bowel movement may result.’

This is kind of like saying that after you jump off your roof, you may experience contact with the ground.

MoviPrep is a nuclear laxative. I don’t want to be too graphic here, but have you ever seen a space-shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom, spurting violently. You eliminate everything.. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.

After an action-packed evening, I finally got to sleep.

The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, ‘What if I spurt on Andy?’ How do you apologize to a friend for something like that? Flowers would not be enough.

At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the heck the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.

Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep.
At first I was ticked off that I hadn’t thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no choice but to burn your house.

When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point.

Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand.

There was music playing in the room, and I realized that the song was ‘Dancing Queen’ by ABBA. I remarked to Andy that, of all the songs that could be playing during this particular procedure, ‘Dancing Queen’ had to be the least appropriate.

‘You want me to turn it up?’ said Andy, from somewhere behind me.

‘Ha ha,’ I said. And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.

I have no idea. Really. I slept through it. One moment, ABBA was yelling ‘Dancing Queen, feel the beat of the tambourine,’ and the next moment, I was back in the other room, waking up in a very mellow mood.

Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that It was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.


On the subject of Colonoscopies . . .
Colonoscopies are no joke, but these comments during the exam were quite humorous. A physician claimed that the following are actual comments made by his patients (predominately male) while he was performing their colonoscopies:

1.. ‘Take it easy, Doc. You’re boldly going where no man has gone before!’

2. ‘Find Amelia Earhart yet?’

3. ‘Can you hear me NOW?’

4. ‘Are we there yet? Are we there yet? Are we there yet?’

5. ‘You know, in Arkansas , we’re now legally married.’

6. ‘Any sign of the trapped miners, Chief?’

7. ‘You put your left hand in, you take your left hand out . ..’

8. ‘Hey! Now I know how a Muppet feels!’

9. ‘If your hand doesn’t fit, you must quit!’

10… ‘Hey Doc, let me know if you find my dignity.’

11. ‘You used to be an executive at Enron, didn’t you?’

12. ‘God, now I know why I am not gay.’

And the VERY best one of all:
13. ‘Could you write a note for my wife saying that my head is not up there?’
 

I normally like to see all my patients beforehand so that full informed consent can be obtained. I can see my patients before hand at:

The Clinic Footscray (Wednesday) – Aug 17th and 24th
1st Floor, 91 Paisley Street, Footscray 3011 Tel: 9687 2271 Fax: 9689 6008

John Fawkner Private Hospital Consulting Rooms(Monday – Aug 22nd)
267 Moreland Road, Coburg 3058 Tel: 9385 2285

Caroline Springs Specialist Centre Suite 3-5, 224-226 Caroline Springs Blvd, Caroline Springs 3023 Tel: 8361 7655

Please bring along a referral from the general practitioner. (If you have seen me before, you would need a new referral if the last referral letter from your GP was more than 12 months old)

If it is not possible to come for a consult before hand or it is an urgent referral(ie acute bleeding from haemorrhoids) – please contact me directly through the rooms.

For more information about the procedures and the bowel preparation please see www.melbournesurgery.com

Advantage:

Minimally invasive – all one needs to do is swallow the capsule with the camera

Unlike traditional colonoscopy – no need for sedation, less risks – main risk with capsule endoscopy is if the capsule is not passed in the setting of a narrowing of the bowel(ie stricture, tumour)

Disadvantages:

Less sensitive – ie more likely to miss polyps — this is because views are random depending on how the capsule is positioned as it moves through the colon. Hence if one has symptoms or positive faecal occult blood test, it is better to do a colonoscopy.

Also in Australia, the cost of this is not covered by Medicare

http://www.youtube.com/watch?v=BBMsPNI6EZE

Causes include:

1. Bowel cancer – in particular a rectal cancer or cancer in the sigmoid colon

2. Polyps in the bowel – especially large ones in the rectum

3. Haemorroids – this is quite common but it is important to speak to your doctor about it and be examined throughly to exclude more serious cause

4. Inflammatory bowel disease eg proctitis, ulcerative colitis, Crohn’s disease

5. Anal fissure – usually there is a lot of pain when or after opening the bowels(but be warned : rectal cancer invading into the anal canal can also be painful)

6. Trauma to the perianal tissue

1 in 10 men

1 in 14 women

Medial age at diagnosis: 70 years old

Risks in next 5 years:

30 year old person – 1 in 7000(less than the risks from a colonoscopy of perforation and serious bleeding)

40 year old person – 1 in 1200

50 year old person – 1 in 300

60 year old person – 1 in 100

70 year old person – 1in 65

80 year old person – 1 in 50

The risk is also greater for people with a family history of bowel cancer

Lifestyle steps you can take include;

1. Having a healthy body weight(ie body mass index below 25)

2. Regular exercise 30-60minute a day

3. Limiting alcohol drinks to not more than 2 standard drinks a day for a man(and not more than one standard drinks a day for a woman)

4. Not smoking

Your diet should:

1. Have adequate fibre( 30G/day) – take lots of poorly soluble fibre(eg wheat bran), have at least 5 serves of vegetables a day, have at least 2 fruits a day

2. Take adequate calcium 1-1.2G/day (may need calcium supplements)

3. Restrict daily energy intake to <2500 calories/day for a man and <2000 calories/day for a woman

4. Be low in fat – <25% of total energy intake should be from fat. (eg avoid fried oily food like fish and chips, be aware too that even instant noodles have a lot of fat in them as they are sprayed or fried in fat in their preparation!!)

4. Be low in fat – <25% of total energy intake should be from fat. (eg avoid fried oily food like fish and chips, be aware too that even instant noodles have a lot of fat in them as they are sprayed or fried in fat in their preparation!!)
5. Take only moderate amount of red meat – best to be lean. Avoid food that is burn/charred. Reduce consumption of processed meat(eg salami, Chinese sausages, luncheon meat)

The general recommendation is for 30 grams of fibre a day.
An easy way to remember is to consider an apple as having 3 grams of fibre. Hence one needs 10 apple-equivalent of fibre to reach the target of 30grams of fibre a day.
Other simple easy ways  to remember the figures:2 Weetbix = 3 grams
Hence one needs about 10 grams of fibre with each main meal of the day to reach that target.
Often patients tell me that they already eat a lot of fibre. Here is an example of a typical diet that is relatively health but may not have all the 30G of fibre:1. Breakfast – cereals inc bran2. Morning tea – a piece of fruit3. Lunch – Sandwich with leafy vegetables in it and a piece of fruit4. Dinner – generous servings of vegetables/salad and another fruitThis might mean only about 20-22Grams of fibre for the day – still 8 grams short of the target!
If dietary intake is not adequate, then one can easily top up the balance with  fibre in the powdered form that one can mix with drinks. Eg psyllium husks such as Metamucil or Fybogel(you can mix the latter with one’s cooking)

I know this is long but it is VERY VERY funny especially for those of us who are members of the “Colonoscopy Club”. If you can recall Billy Connolly’s sound effects version you will laugh even more!

Subject: Fwd: Colonoscopy Journal -
ABOUT THE WRITER……
Dave Barry is a Pulitzer Prize-winning humour columnist for the Miami Herald.

Colonoscopy Journal:

I called my friend Andy Sable, a gastroenterologist, to make an appointment for a colonoscopy.

A few days later, in his office, Andy showed me a colour diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through   Minneapolis .

Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner.

I nodded thoughtfully, but I didn’t really hear anything he said, because my brain was shrieking, ‘HE’S GOING TO STICK A TUBE 17,000 FEET UP YOUR BEHIND!’

I left Andy’s office with some written instructions, and a prescription for a product called ‘MoviPrep,’ which comes in a box large enough to hold a microwave oven.  I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of   America  ’s enemies.

I spent the next several days productively sitting around being nervous.

Then, on the day before my colonoscopy, I began my preparation.  In accordance with my instructions, I didn’t eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavour.

Then, in the evening, I took the MoviPrep.  You mix two packets of powder together in a one-litre plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a litre is about 32 gallons). Then you have to drink the whole jug.  This takes about an hour, because MoviPrep tastes – and here I am being kind – like a mixture of goat spit and urinal cleanser, with just a hint of lemon..

The instructions for MoviPrep, clearly written by somebody with a great sense of humour, state that after you drink it, ‘a loose, watery bowel movement may result.’

This is kind of like saying that after you jump off your roof, you may experience contact with the ground.

MoviPrep is a nuclear laxative. I don’t want to be too graphic, here, but, have you ever seen a space-shuttle launch?  This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt.  You spend several hours pretty much confined to the bathroom, spurting violently.  You eliminate everything.  And then, when you figure you must be totally empty, you have to drink another litre of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.

After an action-packed evening, I finally got to sleep.

The next morning my wife drove me to the clinic. I was very nervous.  Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage.  I was thinking, ‘What if I spurt on Andy?’  How do you apologize to a friend for something like that? Flowers would not be enough.

At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the heck the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked..

Then a nurse named Eddie put a little needle in a vein in my left hand.  Ordinarily I would have fainted, but Eddie was very good, and I was already lying down.  Eddie also told me that some people put vodka in their MoviPrep.
At first I was ticked off that I hadn’t thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode.  You would have no choice but to burn your house.

When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anaesthetist.  I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere..  I was seriously nervous at this point.

Andy had me roll over on my left side, and the anaesthetist began hooking something up to the needle in my hand.

There was music playing in the room, and I realised that the song was ‘Dancing Queen’ by ABBA.  I remarked to Andy that, of all the songs that could be playing during this particular procedure, ‘Dancing Queen’ had to be the least appropriate.

‘You want me to turn it up?’ said Andy, from somewhere behind me.

‘Ha ha,’ I said.  And then it was time, the moment I had been dreading for more than a decade.  If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.

I have no idea.  Really.  I slept through it.  One moment, ABBA was yelling ‘Dancing Queen, feel the beat of the tambourine,’ and the next moment, I was back in the other room, waking up in a very mellow mood.

Andy was looking down at me and asking me how I felt.  I felt excellent.  I felt even more excellent when Andy told me that IT was all over, and that my colon had passed with flying colours. I have never been prouder of an internal organ.

On the subject of Colonoscopies…
Colonoscopies are no joke, but these comments during the exam were quite humorous…. A physician claimed that the following are actual comments made by his patients (predominately male) while he was performing their colonoscopies:

1. ‘Take it easy, Doc. You’re boldly going where no man has gone before!’

2. ‘Are we there yet? Are we there yet? Are we there yet?’

3. ‘You know, in   Arkansas , we’re now legally married.’

4. ‘Hey! Now I know how a Muppet feels!’

5. ‘Hey Doc, let me know if you find my dignity.’
6. ‘God, now I know why I am not gay.’

And the best one of all:
7.. ‘Could you write a note for my wife saying that my head is not up there?’