Poop, poop, shit, crap, whatever you want to call it, this is not really a polite dinner table conversation topic. So if you're at a polite dinner table, bookmark this and come back to it later. For example, if you're on a flight to Orlando, keep reading. I'm writing this on a flight to Orlando. I feel like this topic is somewhat appropriate, but I digress.
This is about colon cancer screening.
It all started late last year. I turned 50 and suddenly found myself on a government watch list for testing of various parts of my aging body. I wrote about breast cancer testing a few months ago. Next up was colon cancer testing. I'm writing about this because I know people my age are putting this off. I get it. These types of tests really scare people. So I'm writing about my experience and hoping it will inspire others to stop avoiding them.
Let me tell you about the people who run it. Australian colorectal cancer screening programmeThey're stalkers. First they send you a letter. The letter is friendly, a little warning (tails up?), and then you better be careful of the next one: a colon cancer test kit to be administered in the privacy of your own bathroom. Sure enough, the letter arrived a few weeks later, right in the middle of party season and when we were planning our trip to Italy.
The kit sat on my desk for months, something I had been meaning to do, but with travel, work, life, and absolutely no motivation to actually take a stool sample, the kit kept teasing me every time I sat down at my desk. Meanwhile, I was getting reminders from my gut screening program. Eventually, I calmed down and stopped procrastinating.
It was all very easy: you place the swab on the stool (on a piece of biodegradable paper that you can flush down the toilet), place the entire swab in a small container of liquid and close the lid tightly, place the sample in a Ziploc bag and place it in a padded envelope. Probably the most tedious part of this method is that you have to send two samples for each of your two bathroom visits, which means you have to keep the samples in the fridge until your next trip to the bathroom. (Because I'm a germaphobe, I wrapped the padded envelope in three Ziploc bags and stuffed them in a brown paper bag. Totally unnecessary.)
The day after my second swab, I mailed my sample back and was given a massage as a reward (lol) for following the rules.
About two weeks later, my Stalker I received another letter from my friend from the screening program. There was blood in my sample and I needed to see my GP ASAP. That same day, I received texts and emails from my GP urging me to see them now, today. Of course, this meant the worst, so I panicked. The screening program letter said that in most cases there was nothing to worry about, but I still should see my GP.
Australia has a great public healthcare system, but I choose to go private because I can see a gastroenterologist referred by my GP and get an appointment within a week. This option means I have to pay out of pocket, so I want to check my privileges here. I don't know how long it takes to get seen at a public healthcare provider. (I had all my breast cancer screenings at a public healthcare provider and they were very quick. It may have been the same for my colon cancer screening, but I don't know about that.)
The GI doctor was great. He apologized for being exactly 7 minutes late. As a diabetic, I laughed and told him that, from my experience of spending hours in doctor's waiting rooms, he was actually too early. Although he only looked about 17, it was immediately clear that this doctor knew what he was doing, and he knew me well from the report he had in front of him.
This was a perfectly conducted appointment. Smart questions about diabetes, very clear explanations of what was going to happen, and he did everything he could to ease my anxiety. I reiterated with my primary care physician what was written in the screening letter. In most cases, a positive result is nothing to worry about. But any blood in the sample will definitely require a follow-up, and that means a colonoscopy. He scheduled me for a colonoscopy in 3 weeks. I had my test on Monday.
It's hard to feel positive about needing a colonoscopy, but I tried. I told myself I'd take a good nap on Monday and pretend I was a trashy influencer doing a trashy detox. After spending 24 hours prepping for my colonoscopy, I reassured myself that I wasn't a trashy influencer and that my trashy detox was, well, trashy.
For those of you who have never had a colonoscopy or don't know how to prepare for one, here's how it works: A week before the test, I was asked to stop eating nuts, seeds, beans, and red meat and to stick to a low-fiber diet. Two days before, my food choices were further restricted to white bread, eggs, peeled chicken, and fish. The morning before, I had no solid foods after a breakfast of white bread. I did, however, eat lots of clear liquids: tea and coffee (no milk), lemonade, apple juice, and jelly (no red or purple). My mom, being an Italian mom, made me clear, nutritious chicken broth by straining it over and over again, which got me through the time I couldn't eat.
I started taking the medication at 4pm the day before my surgery. I mixed the first packet into a glass of water and drank it over about 10 minutes. It tasted like a carbonated orange drink. I put on some elastic-waisted pants (I was warned not to mess with the belt or buttons) and sat down to watch Grand Designs and waited. “You'll have severe diarrhea.” The information leaflet said: Of course, Sherlock. (But obviously, there are lots of lies in that.) The solution started to work after about 45 minutes.
At 8pm I mixed the second packet into a litre of water and drank it over the course of an hour. I had to rush to the toilet as everything was flushed from my body, which took about 6 hours in total. It was unpleasant, but that's exactly how it was supposed to be.
By 10pm I felt like I could get to bed without multiple trips to the bathroom and slept soundly until my alarm went off the next morning at 7am. I made and swallowed my last prep bag (same as the first one), and fasted from 8am until my procedure at 1pm.
During that time, my diabetes was completely under control. I raised my AID blood glucose target from 5.0mmol/l to 7.5mmol/l and temporarily reduced my basal insulin a little. My blood glucose remained stable. There were a few times when I saw a downward trending arrow, but it was cured by a few sips of clear lemonade.
We headed down to the hospital on Monday midday. It was a very positive experience from start to finish with great encounters with all the admitting staff and medical professionals. I even laughed at the surprised reaction of the anesthesiologist when I handed him the iPhone and instructions. “Swipe right to see your blood glucose level.”
I walked into the procedure room, climbed onto the table, chatted with a thousand cast members, and woke up in a recovery room. The gastroenterologist came in to let me know everything went well. I loved that he didn't hide the lead. “Renza, you don't have cancer. Everything is fine. You did have one polyp, but we removed it and sent it for pathology. I'll call you in two weeks. You'll need to come in for another colonoscopy in three years.” He complimented me on how diligently I followed the preparation instructions – apparently I can follow along with intent!
The anesthesiologist also came in, still a little thrilled with my skill, and remarked that my blood sugar had remained stable throughout the procedure. Diabetes was never a big concern for me, but I thanked the very smart people at Open-Source AID, as I do every day, for making things just a little easier for me.
That's the story of my colon cancer screening and subsequent colonoscopy. I really didn't want to have it, but I'm glad I did. How lucky we are to have these screening programs. It's the same equation as screening for diabetes-related complications: early detection, early treatment, best outcome. Plus, you get peace of mind knowing that now you have nothing to worry about. Isn't that just a good thing?
That's it!