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My Colonoscopy

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As I write this, I am just back from my colonoscopy, more or less. All went well, but I am still shrugging off the lingering tendrils of my sedation. So let's chalk up any grammatical snafus to that, shall we?

I had, of late, had some GI symptoms. But those were mostly coincidental and likely due to extensive travel and the havoc changing time zones wreaks on circadian rhythms.

Mostly, it was just time to have this done. I turned 50 last month, and the U.S. Preventive Services Task Force recommends screening for colon cancer starting at age 50. I am a preventive medicine specialist, committed to practicing what I preach, and now 50 years old -- so the math here was pretty simple.

As noted, all went well. This was partly thanks to my outstanding gastroenterologist, Dr. Harry Schwartz, affiliated with Griffin Hospital in Derby, Conn. A good share of credit also goes to the staff of the GI suite at Griffin, where the care could not have been more professional, efficient, compassionate, or... patient-centered. This is to be expected, perhaps, at the global headquarters of the Planetree Alliance for Patient-Centered Care. But expectations are not always met. These were, and then some.

I note in passing that as long as you don't have to do it all the time, being a patient occasionally at a place like Griffin is, oddly, rather a treat. When else are we truly at the center of devoted attention and solicitous concern? Perhaps having a massage or going to a spa is along these lines. But I don't tend to do those, so for me this is quite novel. And really rather nice. Not to mention that the sedative, propofol, provides for one helluva nap.

In fact, the procedure was very easy to tolerate, for those who may have anxiety on that front. Admittedly, the prep is not fun. But as for the colonoscopy itself, I got my sedative and woke up to find it already over while wondering when it was going to start. To some extent, this is thanks to Dr. Schwartz. All gastroenterologists pump air into the colon during the procedure to expand the bowel wall and allow for a clear view. Not all repeat their steps to suction that air back out -- rather than leaving that work to you, courtesy of the time-honored method. Suctioning that air out pretty much eliminates post-procedure bloating and discomfort, and all that goes with it, and I thank Dr. Schwartz for such meticulous care. Since it can be done, be sure to ask for the same when your turn comes.

Things went well, also, because I brought a pretty good GI tract along with me. I take the best care of it I can, by taking the best possible care of my whole self. I eat optimally, exercise vigorously every day, have never smoked, drink moderately, try hard to get enough sleep, do what I need to do to dissipate my stress, and have lots of love in my life. That's a good recipe for health from head to toe, and mouth to... well, you know.

But, even so, I had a polyp. I have uploaded the images of the polyp being located, snared, and removed -- as seen through Dr. Schwartz' colonoscope.

I am awaiting the pathology report, but by appearance this is a simple adenoma. Such polyps are very common. Neglected for many years, they can evolve into cancer. But unless neglected for years, they are a long way from doing so.

My good friend, Mehmet Oz, famously had similar results from his screening colonoscopy. His on-air coverage of it suggested it rocked his world a bit, and my brief private discussion with him about it did not suggest anything different. He, too, takes excellent care of himself -- and so the polyp was a shock.

I see it a bit differently. For one thing, at 50, I certainly don't have baby-soft skin. I've been wearing this skin in all kinds of weather for five decades, and there are indications of that wear and tear. A dark spot here, a rough patch there, a skin tag... well, you don't need to know. Let's just accept that skin succumbs gradually to age and cumulative abuses, even if cared for well. My wife loves me anyway.

We are, in essence, a tunnel. Our skin is the outer surface. The lining of our GI tract is our inner surface. So it, too, is exposed to wear and tear -- just from within rather than without. But it's the same difference.

So, my attitude is: My guts have put up with everything run through them for five decades. They are no less entitled to sprout a polyp than my skin is to sprout a mole. Stuff happens.

So I am not surprised or upset by the finding. Quite the contrary -- this is exactly why screening colonoscopy is strongly recommended in the first place. Polyps are common by around age 50. Find and remove polyps at age 50, and the potential for them coming to attention as a cancer years later is eliminated. This is preventive medicine working exactly as it should. I'm glad to be a beneficiary of it.

As for the effects of my healthy living: Across a truly great surface area, my innards were (I am told) in great shape. No other lesions, no other polyps, no diverticula. That one isolated, and almost certainly benign, polyp is the toll of 50 years; all those acres of healthy bowel are the dividend of healthy living.

And so, my conclusions: Take good care of yourself, and you will be taking good care of your GI tract. Take good care of your GI tract, and it will very probably take good care of you. But it is working hard every day, and may well suffer effects of wear and tear as a result, much like your skin. Get a colonoscopy at the recommended time and intervals and let a competent gastroenterologist turn any consequences of such wear and tear from tomorrow's potential heartache into today's inconsequential pathology specimen.

With that, I must leave you, because my wife just put a wonderful dinner on the table. I have a fast to break: 16 hours of bowel prep and 36 hours or so of clear liquids. We have good news to celebrate. And I have a fundamentally-healthy, punctually-screened, and now polyp-free GI tract -- and I'm not afraid to use it!

-fin

Dr. David L. Katz; www.davidkatzmd.com

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