Fellow readers: Do not be afraid of a colonoscopy. Do not avoid it-- in fact, look forward to it. They are easy and painless. Waking up from the anesthesia I felt more relaxed than I ever have in my life. Also, the prep of clearing your system will reset your digestive system and you'll feel like a new person. I think the prep cleared out whatever it was that was causing us to investigate my digestive system in the first place.
The night before mine, I googled to see if I could find anything that would make me feel less anxious and uncomfortable and I couldn't. Well, fellow reader, I hope this comment and the article put you at rest when it comes to doing this important and necessary procedure.
Recommend anyone considering this to ask your doctor about using a sedative instead of general anesthesias.
As best I can tell general anesthesia for colonoscopy for low risk appears to be a cultural custom especially prevalent in the northeastern USA.
Anesthesia has many more possible side effects than sedatives and ought to be avoided unless needed (this applies to any unneeded treatment).
Plus if you’re awake you can actually watch the scope going, it’s cool! Not painful at all. Agree there is no reason to fear colonoscopy but there is also no reason to undergo general anesthesias for it either in most cases
I had a colonoscopy five years ago here in the UK without any anesthesia and it was perfectly fine. Walked into the theatre wearing a gown and a pair of shorts with a flap at the back, and hopped up onto the bed. Somewhat embarrassing with a half dozen nurses standing around various bits of kit and more monitors than NASA.
They asked me if I wanted to watch, then angled one of the monitors so I could see what they were doing. Laid on side, knees up and relax. Blimely is my bum really that hairy? Don't normally get to see if from that angle.
It feels weird and a little uncomfortable at times, but certainly not painful - even when they found a polyp and removed it with a remote lasso tool of some kind. This later turned out to be harmless.
As is normal for Brits, there was a lot of humour, with the women discussing the latest TV soap opera whilest doing their thing with the "dynorod" tool. As they pump in a gas of some kind to keep the bowl inflated while they work, they tell me it's okay to fart whenever I need. Boy, I think I've got a bad job sometimes. Whatever the nurse with the pointy end gets paid - it's not enough.
It's not exactly pleasant, but necessary and quite interesting to watch inside your own body (not as interesting as watching surgeons put stents into my heart, but that's another story).
Totally agree with Graeme, nothing to fear and massive win if they find things before it's too late. Don't hesitate!
We badly over-use general anesthesia. Next to antibiotics it might be the most over-used thing in medicine. When you scratch the surface of the neuroscience of general anesthesia you will never want to experience it in your life if you can help it. It's effectively a controlled coma, and though we can control it, we don't know the precise mechanism of action. (Like so many things with the central nervous system it was discovered by trial-and-error.)
If you're having a medical procedure and the physician mentions general anesthesia, always ask if IV sedation works as an alternative.
> Plus if you’re awake you can actually watch the scope going, it’s cool! Not painful at all.
For sure! My first colonoscopy I was sedated and enjoyed watching the screen. In fact, I remember I was making HILARIOUS jokes the entire time. I could not remember them afterwards though. My second colonoscopy my doctor sedated me again, but put me further under for reasons that remain a mystery.
Also, a year ago we buried my brother-in-law at age 53. He was diagnosed stage 4 at age 48. DO NOT DELAY your colonoscopy. I think 50 is too late to wait.
Second this. There is evidence that anesthesia causes brain damage. This shows up in the data most for babies and small children, and the elderly, where you can see it on IQ tests and chance of dementia. It's more pronounced with multiple surgeries. It may be that it's damaging everyone's brains, but it's just not as noticeable for adults. One study with twins showed about a 1.5 point IQ loss from a major surgery.
Of course, 1.5 IQ points is not likely to dramatically change the course of your life, but I would absolutely not get it if the procedure could be done under sedation.
I once had an endoscopy without any sedatives or anesthesia and that really sucked. The doc stuck a large tube down my throat and had me gagging for what felt like an eternity. After the procedure I needed a few minutes to wipe the tears that started forming from my eyes and gain some composure. This was done in Poland. If a colonoscopy is anything like that then not sure I'd want to be doing them regularly.
I've got it done without sedatives 10 years. It was quite a ride. They went only half way and I had enough. It was literally a gut-wrenching experience.
I have ulcerative colitis so have had many many colonoscopies. General anaesthetic is never used in UK but twilight sedation is normal. I refuse this as (after an unpleasant gastroscopy) I can't stand having tubes stuck up my orifices while I'm unable to fully intellectualise what's happening. They're usually happy to give a bit of fentanyl instead.
My experience is that GI doctors enjoy chatting during the procedure but specialist nurses (who often perform minor endoscopies) are usually not very communicative.
They regularly use Propofol which is not the same as general anesthesia. I've waken up (in pain) on Propofol. Pretty much impossible with a GA fluorinated gas. General Anesthesia is a very monitored situation as it's potentially very dangerous (you have to be put on a ventilator).
This is something I've been wondering for a while, perhaps someone here knows. I've had two colonoscopies, and my understanding was that what they used was a sedative, but I was definitely totally unconscious. What's the line between sedation and general anaesthesia?
100% agree. I've had several colonoscopies without anesthesia. This does not make me a badass (npi). It merely reflects that the fear of this procedure is completely out of proportion to the reality. It's a little bit uncomfortable in the same way that being gassy after a big meal is uncomfortable, but it's less painful than a flu shot.
Colonoscopies aren't quite general anesthesia in the US (generally, I'm sure there are exceptions). General anesthesia as being completely unresponsive to external stimuli and potentially needing supportive measures to make sure you maintain your airway.
What they tend to do is "conscious sedation". Basically load you up with a sedative and painkiller - midazolam and fentanyl as an example. You're not completely out of it, you can breath on your own and will show some response to stimuli. But you won't remember any of it due to the amnesia from the sedative.
Very good advice. It seems that it is difficult to ensure sufficient oxygen to the brain under anaesthesia, and the effects are more noticeable in older patients.
At my first, I was offered the option of minimal sedation, which I took. Then my doc offered to put up an extra monitor so I could take the tour, as it were. It was fascinating.
By now, I've had 9 colonoscopies. My brother had colon cancer, hence the maybe higher frequency than usual. They've all been either non-events or pretty interesting.
If you have any symptoms at all, get the procedure done. Immediately.
If in doubt, take it. better be safe than sorry, especailly since colon cancer usually takes time to became really bad and can be treated rather easily when caught early. Also agree that 50 is too late. Case in point, I had colon cancer when I was 28. Turned out well, but 6 months of chemo therapy is nothing I want to repeat, and I had the easy therapy.
I just had a colonoscopy a few weeks ago because of some minor bleeding. Ended up just being hemorrhoids and a small polyp. Definitely worth having the peace of mind.
The worst part or the prep was not sleeping much that night because I was up until 3am. Watching TV most of the night was relaxing, though. After the procedure I took it easy all day while the propofol effects wore off.
Don’t wait to have a colonoscopy. The prep isn’t that difficult!
I’ve got Crohn’s so I’ve had my share of colonoscopies, completely agree that the procedure is a breeze. And now that propofol is the standard it’s that much better, the older versed/morphine combo really hammered you. The prep is the worst bit and it’s better if you prep well for the prep; wet wipes, bidet, water bottle anything, some good reading material and a good even free from other disruptions (you’ll be disrupted enough...)
I had a colonoscopy almost two weeks ago (a 3-year follow-up on having a large not-quite-cancerous-yet polyp removed), and got in a lot of Factorio the night before.
So in a sense it wasn't that different than a regular night of staying up till four in the morning playing Factorio, except that I had to drink a gallon of stuff that tastes like diluted seawater. I had forgotten how gross that stuff is, but in the end that was the worst part.
Here in the UK you just get pain relief, and are generally conscious for the procedure - though gas and air is available if it is uncomfortable.
It caused me no pain at all, was quick and easy and I'm pleased I went ahead with it.
My father found he had bowel cancer from a routine fecal occult test they were sending to all men above 65 in my area. He took some convincing to do the test, but found he had cancer and was swiftly operated on. My older brother found he had it far younger, about 52 and his was far more advanced when it was discovered, and 5 years of treatment later it won't be something they can cure. So it is pure chance my father's was caught so early and was so successful.
After speaking to my gp they agreed to start my colonoscopy cycle at 40 - with one every 5 years until I hit 55 and then likely more frequently.
I was a little nervous but it was totally fine and I feel freed that it is one worry that is if not behind me, that is controlled.
Top tip is to follow the instructions of the laxatives well and eat nothing except a broth or miso soup, and it will be far easier on your gut.
By far the worst part is what they refer to as the “bowel prep” i.e. strong laxatives. A top tip is to coat the affected area with Vaseline before starting!
That and the sedation depends on whether you’re getting a “flexible sigmoidoscopy” or a full colonoscopy. The latter is the full 1.5-2 metre insertion to inspect all the way to where the small intestine starts, which typically involves sedation (though conscious). The former is usually preceded by a home enema rather than laxatives and done with pain relief only.
> Here in the UK you just get pain relief, and are generally conscious for the procedure - though gas and air is available if it is uncomfortable. It caused me no pain at all, was quick and easy and I'm pleased I went ahead with it.
Not necessarily, you can get the Good Stuff that knocks you out during the procedure in the UK (I have), but I'm not sure what the criteria are for getting it, if any.
Thanks for that comment. I once, out of nowhere, had a bad bout of panic attacks and subsequent health anxiety. Every symptom(which were themselves manifesting) led me to believe I was dying. Literally the only thing that helped was googling the symptom + "anxiety.". I felt like an idiot googling 'random pinching pain anxiety', but found all kinds of accounts. After reading hundreds of poor folks in my shoes describe everything I was going through, the symptom faded, and I felt peace. Really weird time for me for sure. But just know people reading random comments can really put minds at ease.
Cannot confirm; my girlfriend had a sigmoidoscopy (similar) and she experienced it as traumatizing and violating. I don't believe she got any anesthetics admitted; pretty sure it's not standard.
Please don't romanticize invasive diagnostics. If you want to advocate for the occasional bowel purge or using anesthetics to sleep have at it though. But also, general anesthesia should be avoided as much as possible, it's not a trivial matter.
In the UK it's uncommon to be anaesthetised for for endoscopies or colonoscopy. I've been offered either midazolam or gas & air for colonoscopies and pretty sure my last couple of endoscopies were done without anything.
The movicol prep stuff they give you isn't ideal either; you've got to drink a lot of odd tasting fluids that then give you basically explosive diorama which can be awful in itself. It also causes some people to explosively vomit as well (it's designed to make your body want to eject it asap) which really isn't fun when it's trying to escape both ends at once.
The actual procedure isn't amazing either. A camera down either end is uncomfortable at best ranging to extremely painful (short term) as they try and get round the corners in your bowel. There's also the potential it to go wrong in some nasty ways or for odd side effects, and at absolute best, you're still stuck on a table trying to make polite conversation with 2m of camera tube stuck up your bum.
Can confirm your refusal to confirm; none of it's a thrilling or trivial experience.
Yes, this, totally this. Even the bowel prep [was] easy and painless [for me -- added this edit]. It's a good excuse to just binge a show, too.
I think the traditional guidance has been to go for your first colonoscopy around age 50. My doc mentioned that they're recommending that move down to 45, because they're seeing more and more young people with issues. You should bring this up with you doc if you have any similar symptoms or if there's any family history of colon cancer.
Bullshit. I've got Crohn's, and have had more colonoscopies than I can count since age 13. About 75% of the time, I'm throwing up due to the prep. The prep is the WORST part.
It has gotten better over the years. If you go for one, do NOT let them give you the jug full of powder. I've had much better luck with prep-o-pik.
The other PITA is they generally won't let you go for the procedure by yourself, since you're under anesthetic and don't trust you to get home OK. That means you have to find a friend who is willing to wait 2+ hours for you.
They usually are, for most people. But for me the first time I did it was the most painful experience ever. So painful in fact that they had to abort it and book me for another time and that time I went under.
That was before my surgery and when my intestines were all over the place. That being said, after my surgery in which they corrected the placement of my intestines, it was painless. That time, the last time I did it, I chit chatted with the doctor and nurse and it was funnily a pretty relaxing experience since I'd gotten some mild drugs before because I was nervous it would hurt as it did the fist time.
Absolutely agree. I got one a few weeks back, the colonoscopy itself was painless, the prep is the worst part. They found some benign polyps, which were removed. Yes, people, if you have a history of colon cancer please talk to a gastroenterologist ( my dad was diagnosed with colon cancer in early Feb and I had to get it asap since it's hereditary)
Colon cancer is the most common type of cancer and recent guidelines have changed the age of getting a colonoscopy from 50 to 45.
In US, if I have no symptoms, can I just get it done as a preventive care? I doubt that wothout a referral. Has anyone done that? I m approaching 40 and wondering
Maybe? I think they're recommended for everyone at 50 years, but for anyone else I don't think they would normally recommend getting one unless you have some symptom or family history of cancer.
Getting a genetic test might be another option if cancer is what you're worried about. Not as accurate as a colonoscopy, though.
Colonoscopy is absolutely painless. However, in my case, when I woke up, they took forever to tell me the results (about 30 mins), so expected the worst. I'm an incredible patient person, but in this case I got up of bed and screamed to the nurses: "can you just tell me news now? I can handle it." I later realized they were just having a printer problem, and the doctor had left and they couldn't reach him to speak to me, but everything had come out ok. But I hope people are told the news immediately after they wake up (whether good or bad); some of us have been contemplating impending death since being referred for colonoscopy. They were the longest 30 mins of my life. I've never screamed at somebody, and I wonder whether the anesthesia had anything to do with it.
I would take 5 colonoscopies instead of gastroscopy any day... It really is not a big deal. I was a quite high but I managed to actually watched the camera feed during procedure. The only problem later on was that I had trouble of putting my clothes on and do anything that needed little effort for at least one hour, because of the wonderful drugs.
It isn't that common in america but most of the world does colonoscopies without anesthesia. Without complicating conditions there is little more than minor discomfort and without anesthesia are very quick and much less expensive. With a little searching you should be able to find a doctor who will do the procedure that way.
Interestingly, colonoscopies here in DK are mostly without anesthesia. I prepared by looking at mostly-American sites where some doctors said 90% of patients prefer full anesthesia, and the rest some other sedative drugs.
The procedure was 20 minutes, painless and slightly uncomfortable where the nurse had to push on my stomach to help the probe round the guts, that was like some brief constipation. You get to your appendix from the inside and physically realize how much the colon takes up in your body.
BTW, in Denmark, a 40+ yo patient with rectal bleeding that cannot be physically confirmed as hemorrhoids by the GP would likely be referred to the emergency cancer track, with I think, 2 weeks before all the tests have to be finished.
It's uncomfortable but not painful really. I've had a few as I have celiac disease. Let's say that you don't have to worry about choking like with a gastroscopy, which I "luckily" had booked for the same day as the colonoscopy. I've never been sedated or had any anesthesia for either, it's really only the air afterwards that's painful, but that's not worse than when your stomach is upset during a flu or something.
It isn’t. Considered better too do it under a milder sedative in most cases I think as there are fewer side effects.
I checked and general anesthesia seems to he a custom used in some regions of America. I’ve had 3 colonoscopies and been awake for each one. They aren’t painful in the slightest and you get to watch them on screen! Anyone who gets one should talk to their doctor about sedation options.
I don't think it's a matter of being painful necessarily (though it might be, depending on what they do), but rather most people just don't want to be awake for what is at best a socially awkward experience. I've had several, and I'm grateful to have been unconscious. (They had to wheel me back in once without sedation to take another look around a biopsy site to make sure I wasn't bleeding too much. It was kind of interesting, but not terribly pleasant.)
> They are easy and painless. Waking up from the anesthesia I felt more relaxed than I ever have in my life.
Alternatively, you can opt for no anesthesia/sedative, if like me your major concern is lingering after effects (and a fear of going under). I had a colonoscopy and an EGD in the same visit, really wasn’t a big deal. Also quite fun to see your insides on the monitor — gave me peace of mind to see perfectly uniform pink healthy flesh, as opposed to some of the craziness you can find on YouTube.
The prep juice tastes so nasty but you are right about feeling refreshed. After the colonoscopy I had intense cravings for a cheeseburger and milkshake, but let me tell you that was a mistake! It gave me the worst acid reflux. Keep in mind your insides are virgin again after the prep juice. It causes you to shed the lining of your stomach, I'll be smarter next time.
>Also, the prep of clearing your system will reset your digestive system and you'll feel like a new person. I think the prep cleared out whatever it was that was causing us to investigate my digestive system in the first place.
I had the exact same feeling afterwards. The issue has disappeared since, and that was 2 years ago.
As a data point: I met a service technician for colonoscopy equipment (in good spirits) and he said he wouldn't recommend one.
From my past experience, I'd recommend MRI over anything else (especially CT scans), though it's apparently not as useful in diagnosing bowel stuff as colonoscopies.
These are almost lateral approaches and very different from each other though, with MRI being more like a sonar scan and colonoscopies more like sending a submarine equipped with a camera into the depths.
Both can be very useful and helpful in aiding diagnosis with more data points.
Case in point, I have had an MRI (which showed nothing), several CT scans (which showed temporary blockage) and both methods have not really led to a conclusive diagnosis.
I have a family history of colon cancer, so get them done periodically. The procedure isn't terrible, but the prep is worse. Pretty sure I need seat belts for the toilet for that day. Otherwise... meh. Beats dying.
I second this - I've had about 10 colonoscopies/endoscopies in my life (due to a medical condition) and it went well each time, no pain as steve said. The prep is also an opportunity for cleansing of the digestive system.
I'm in the US, and have had one colonoscopy at age 33 (to rule out cancer, I had rectal bleeding). It was hemorrhoids, but will have another any month now because of family history of polyps and colon cancer. And I'll have one every 5 years even if I have zero symptoms.
For example in Germany you can get a colonoscopy paid by the health insurance without any specific reason every 5 years from the age of 50. You can always get one at any age for no reason if you simply pay yourself.
Most insurance policies won't cover a colonoscopy without symptoms or family history, and most gastroenterologists won't recommend one in that situation anyways.
Bracing for a passel of autointoxication links to bubble to the top of Hackernews, accompanied by anecdata of the form "I started giving myself coffee enemas and my chronic headache/gout/acne simply vanished".
Since "becoming an adult", I've lived in three cities in two countries, which means that've generally had no idea who my primary care doctor is or was, only that I'd need to find one to give me a referral to get this wart on my foot removed.
F?%k, this is way to relatable. Same as the author I'm an expat which hasn't had a GP check in 5 years, not counting getting a dermatologist procedures. I feel like this is an experience of a lot of expats. Those of us coming from small towns mostly had a GP from when we were 6 all the way until we left the town for good. It's difficult to get that relationship with someone else and I'm afraid that it might be a contributing factor to people getting less checked. Also, in my case all the family members went to him, so he kinda knew the family history. I still mourn for him, he would always greet me at the door of his office with something like "wtf, you again? why are you here?". He was an excellent diagnostician...
Same here. I feel odd hearing the commercials nudging me to "ask my doctor..." - I don't have a "my" doctor. I just go to the nearest network clinic, they have my details on the computer and whoever is attending that day looks at them.
Not only expats; I've moved a few times but hadn't bothered to change my GP for over 5 years because I never needed it (thankfully). The last time I needed it was because the skin on my hands was fucked (cold + dry air and a newfound habit of actually washing my hands; vaseline cream helped) and chronic neck pain (treatment didn't help, but changing my backpack apparently did?).
Anyway I bought a house a few years ago and I'm a bit more settled so I've moved to a local GP, and I hope to never need it.
Relatable to a lot of people in the military. Pretty much every visit is with a new person who doesn't know you, they just know the record they reviewed minutes before.
I’ve read that there are some emerging theories of a bacterial component of colon cancer, which I find interesting [1][2][3]. A friend, also in his 30s, recently was diagnosed with colon cancer and it seems like doctors are really noticing an increase in colon cancer among a younger population. It just seems so young to be dealing with it. Regardless, I’m glad the author is recovering and found it early enough!
My fiance was diagnosed in her 20s. Still relatively rare at that age, but the doctors noted there's significant increases in prevalence in young people.
Same here, I was 28. Started to wonder if that could be connected to Tchernobyl, I was in Kindergarten back then. Since t didn't change a thing for me, I never looked for studies around this, so.
Gut biome is IMO one of the most interesting (and gross) areas of medical science at the moment; this morning's news mentioned a 1 million research starting to investigate gut biome and diabetes.
I feel you on this. I found out I had kidney cancer after my appendix decided it was time to go. I only had 3% of my left kidney removed and that is it. No chemo or anything just sore for a few weeks.
And man do I have guilt and felt like a fake cancer survivor. My experience was so minimal compared to a lot of people. But I realized I am a cancer survivor because of all the mental anguish cancer puts on me. It’s nothing I can ever explain, it is just this super terrible feeling of not knowing. Is my cough metastasized cancer? Probably not but my mind sure loves to think so. Having to deal with my own mortality was a big thing. I wonder if dying of old age causes as much stress and anxiety as knowing you have cancer and could die.
Stage 3 thyroid cancer survivor here at a similar age to the author. I totally feel like a fake cancer survivor but it's definitely turned me into a hypochondriac. I had to get a colonoscopy recently due to my GI issues and some of the symptoms were similar to the ones for colon cancer. I've tried to move on after 2 surgeries, RAI, medication adjustment but mentally it's been tough. I have to get tested regularly to make sure there's no recurrence. The stress and anxiety have been extremely tough to deal with for someone who has been mentally tough all their life.
Fuck, that sucks. I hope you have someone to talk to, because that constant enxiety can wear you down. In my case it was a very good friend, close family had enough on their hands already to cope with.
Same here. TT at 32 last week. Also got a colonoscopy about 5 years ago for (unrelated?) GI issues. What are you looking at for screening going forward?
I'm hoping the median synthroid dose im on ends up working out, but I still have to wait for pathology and RAI.
Edit: if it makes you feel any better all the docs/surgeons ive talked to have expressed that if they had to choose a cancer to get, it'd be thyroid.
I would never have believed it, but cancer changes you. And I can totally relate to the experience, while I wnet through chemo, it was an easy one. Seeing all the others, successfully going through it felt kind of like cheating to me, e.g. I never lost my hair or a lot of weight. Other had to be brouht to the brink of death in order to survive.
One thing I realized was, that I was less afraid of death itself, but rather the process of dying which can be a rather lengthy and ugly thing. Worst thing to happen, eve wirse than the initial diagnosis, was the moment a couple of months after I inished chemo. Some hemorroids started to act up again, and it was a quite realistic scenario that the cancer was back. Damn, I was destroyed by that. The initial diagnosis didn#t realy surprise me, for some reason I kind of expected that after all the tests they did. The potential second one caught me completely off guard, it took me a couple of months to recover from that. looking back, I'd say that was the worst part of the whole thing.
> And man do I have guilt and felt like a fake cancer survivor.
Just a data point from an third-party observer with no reason to lie to you: your survivor guilt [0] is normal, but you've done nothing wrong and your experience with cancer is valid and I appreciate you talking about it. It's easy to fall for the trap of minimizing your problems after comparing yourself to other people, and it takes courage to be vulnerable and honest about the things that get you down sometimes.
> Is my cough metastasized cancer? Probably not but my mind sure loves to think so.
The same when an immediate family member has gone through or died of it.
Instead of being a survivor it’s more like a countdown due to the similar hereditary and environmental factors. Doctors will say “no, don’t worry about that”, the same people could be writing an entry in a scientific journal after your case finally appears.
God damn it! I get upset when reading this article! The doctor mentioned at the beginning of the article is obviously not doing his job! "Don't worry about it?!" "you don't need another physical exam!?"
Making assumptions without examination is incredibly unprofessional and carries with it potential critical consequences.
If you have an issue and bring it to your doctor and your doctor fails to follow up with an examination and makes assumptions, it is time to find another doctor.
Yep, I was in almost exactly that situation and the doctor said something along the lines of "it's almost always a hemorrhoid, but we'd better schedule you for a colonoscopy just to make sure" and sure enough there was a tumor that wasn't cancerous yet, but could very well have become so and killed me in a few years if nothing had been done.
(It runs in the family apparently; my grandmother on my mom's side was from a large family, with seven or eight siblings. They all died of colon cancer. She got it too, but since she went to the doctor with her symptoms instead of staying at home, they were able to remove part of her colon before it got really bad and she lived for many more years.)
Moral of the story: go to the doctor if you're bleeding from unexpected places.
Thank gd that caught in time in your case. I was beyond the not-yet-cancerous stage when I had the "better have good look now"colonoscopy. Still early enough to still be around, so!
Hemerroids are usually a very bright obviously blood-like red. I appreciate he wrote the above description with the benefit of a lot more knowledge than he had when he first saw a doctor, but they should've asked about the colour even if he didn't offer it, and that should've raised extra suspicion immediately.
This happened to someone I know recently. She was a little younger than OP and repeatedly told her doctor how she had symptoms which could potentially be colon cancer but she was repeatedly told not to worry as she was too young and it was probably just haemorrhoids.
This went on for about a year I believe. Things got worse and when test were done she found out she had stage 4 cancer and probably only had a few months to live.
If you have symptoms which could be cancer regardless of your age insist you have the right tests done to rule it out. Most cancer is very preventable in its early stages.
Yep this is exactly what happened to my dad. He had bloody stools, told no one but his 80-year old doctor who said “relax it’s just hemorrhoids” without verifying his claim. This went on for years until he was diagnosed with Stage IV and died five years later at 51. Just one colonoscopy even a year sooner may have saved his life.
I was diagnosed at age 41 with colorectal cancer. My GP had ignored my complaints about it a year earlier, and dismissed it (without a rectal exam) as "probably hemorrhoids." A year later, he thought better of it and sent me for a consult with a specialist who instantly spotted a 5cm mass in my rectum.
A year later, while doing a followup from my surgery, I mentioned how cavalier my GP was to the surgeon who saved my life. He said that many doctors don't really think of colon cancer for anyone under 50 unless there's a family history.
That was 15 years ago, and the medical community has generally understood that colorectal cancer can occur far earlier than previously expected.
Many doctors just aren't very good. I went to an allergy doctor about perfume allergy. They told me it was incurable and probably won't get better, just avoid perfume. I started doing my own research. I found a study result that showed that perfume allergy is psycho-somatic. Then I learned stress reduction techniques and used them to cure myself.
I have Crohn's disease and in 2015 had 5 ft of small intestine and half of the adjoining colon removed.
Unfortunately my insides were so fucked up that they had to properly open me up (i.e. not keyhole, more doorframe). Then I got sepsis after the operation and was in the high-dependency unit (US equivalent is ICU I think?) for a bit. That was fun. I was there for a few days, but remember about 2 hours of it. My family visited apparently, I had no idea, but I was talking to them, so I'm told.
I couldn't walk for weeks, other than staggering around (which they encourage you to do otherwise the scar tissue will heal too tight). The wound took about 3 months to properly close up, I had a nice deep hole in my abdomen for much of that, you get used to the gory stuff.
I'm generally better now though. Crohn's still dictates much of my daily life though, but you learn to live with it.
Similar situation here. I was traveling, which made it even worse - I literally collapsed at the airport out of fatigue, which turned out to be severe internal bleeding. Thankfully didn't get any further complications although if I had delayed, it would have definitely put me at risk for colon cancer.
It's actually funny that the doctors in my case actually detected polyps in my intestine when I was 18 (showed symptoms since I was young, but all the doctors in India just waved it off as stress - for a 14 year old!). But again, they just waved it off for a long time and gave me meds that suppressed the symptoms. It was only when I was on work travel that the wonderful folks at the Zurich university hospital pinpointed it. Got a second opinion, and indeed it was Crohn's. Indian doctors just kept discounting it because Asians have a lesser tendency to get it, but recent research shows that your diet factors more than where you're from.
My only advice to anyone in my position or similar would be to take full control of your health and try to get the best possible treatment, instead of trying to reinforce your biases. Had I not been able to get checked at a much better facility then, I might have been in a far worse position now.
Don't count on family to be of help as much either, unless it's a spouse. For what it's worth, around the same time as that incident, my grandfather passed away at a ripe old age of 94. He previously complained about stomach aches and toilet issues, often getting grumpy af, but family members just brushed it away as signs of old age (including my parents). In the end, when he was shifted to a proper hospital in India during his final hours (quite literally), the doctors surmised that it might have been stomach cancer all those years. But of course, by then it was too late to take a biopsy and he passed away with the next couple of hours. That advice about recording your family health issues in a notebook is spot on.
Thank you for writing this experience so wonderfully. I can really relate to this journey. Lost my brother to Colorectal cancer 2.5 years back, he was 27 at the time. What happened with Boseman happened with us 15 years earlier(Stage III transitioning to IV). We didn't have any family history of cancer. He was wild type for all kind of known mutations (KRAS, NRAS and BRAF) for the cancer. In simple terms, doctors didn't know what exactly caused his cancer.
I'm also at a good risk of getting it at some point probably. I'm 23 rn, last colonoscopy didn't show any polyps fortunately. Trying to maintain a healthy diet and lifestyle. Every cancer writeup is kinda scary for me.
At the time of diagnosis, my brother was going through stressful situations(his startup, personal life), not able to focus much on physical and mental health. I'd like to know if Chris thinks there was something else that triggered/fueled his cancer apart from genetics.
Glad to hear you are staying on top of your situation.
As far as triggering my cancer, I have no idea. And I don't think anyone is going to give me any more clarity than that. I don't think it's possible to do so. What they have told me is that more and more young people are getting colon cancer, and they aren't quite sure why.
Thanks for the response. Yeah, medical science is still so much limited when it comes to cancer. I did lot of research on Integrative cancer care post our experience and realized how positive changes to lifestyle impacts the mind and body. Now trying to help others going through similar challenges through self hosted support group sessions.
I've subscribed to your writings, looking forward to them. I'm also a Software Engineer professionally. :)
Not to discredit the potentially valid concerns of these articles but it's not quite accurate to say these aren't an improvement.
I'm a few weeks out from a robotic assisted surgery related to kidney cancer and the recovery time is significantly shorter in duration (6 weeks instead of 3-6 months) than the non robotic surgery. My understanding is that the DaVinci surgical robot also allowed them to be more precise with how much tissue they removed as well.
Hopefully the medical community can get a better sense of when it's appropriate to use such technology but it would be a mistake to dismiss the benefits because of misuse by some surgeons.
Readit News
The night before mine, I googled to see if I could find anything that would make me feel less anxious and uncomfortable and I couldn't. Well, fellow reader, I hope this comment and the article put you at rest when it comes to doing this important and necessary procedure.
As best I can tell general anesthesia for colonoscopy for low risk appears to be a cultural custom especially prevalent in the northeastern USA.
Anesthesia has many more possible side effects than sedatives and ought to be avoided unless needed (this applies to any unneeded treatment).
Plus if you’re awake you can actually watch the scope going, it’s cool! Not painful at all. Agree there is no reason to fear colonoscopy but there is also no reason to undergo general anesthesias for it either in most cases
They asked me if I wanted to watch, then angled one of the monitors so I could see what they were doing. Laid on side, knees up and relax. Blimely is my bum really that hairy? Don't normally get to see if from that angle.
It feels weird and a little uncomfortable at times, but certainly not painful - even when they found a polyp and removed it with a remote lasso tool of some kind. This later turned out to be harmless.
As is normal for Brits, there was a lot of humour, with the women discussing the latest TV soap opera whilest doing their thing with the "dynorod" tool. As they pump in a gas of some kind to keep the bowl inflated while they work, they tell me it's okay to fart whenever I need. Boy, I think I've got a bad job sometimes. Whatever the nurse with the pointy end gets paid - it's not enough.
It's not exactly pleasant, but necessary and quite interesting to watch inside your own body (not as interesting as watching surgeons put stents into my heart, but that's another story).
Totally agree with Graeme, nothing to fear and massive win if they find things before it's too late. Don't hesitate!
If you're having a medical procedure and the physician mentions general anesthesia, always ask if IV sedation works as an alternative.
For sure! My first colonoscopy I was sedated and enjoyed watching the screen. In fact, I remember I was making HILARIOUS jokes the entire time. I could not remember them afterwards though. My second colonoscopy my doctor sedated me again, but put me further under for reasons that remain a mystery.
Also, a year ago we buried my brother-in-law at age 53. He was diagnosed stage 4 at age 48. DO NOT DELAY your colonoscopy. I think 50 is too late to wait.
Of course, 1.5 IQ points is not likely to dramatically change the course of your life, but I would absolutely not get it if the procedure could be done under sedation.
My experience is that GI doctors enjoy chatting during the procedure but specialist nurses (who often perform minor endoscopies) are usually not very communicative.
What they tend to do is "conscious sedation". Basically load you up with a sedative and painkiller - midazolam and fentanyl as an example. You're not completely out of it, you can breath on your own and will show some response to stimuli. But you won't remember any of it due to the amnesia from the sedative.
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At my first, I was offered the option of minimal sedation, which I took. Then my doc offered to put up an extra monitor so I could take the tour, as it were. It was fascinating.
By now, I've had 9 colonoscopies. My brother had colon cancer, hence the maybe higher frequency than usual. They've all been either non-events or pretty interesting.
If you have any symptoms at all, get the procedure done. Immediately.
The worst part or the prep was not sleeping much that night because I was up until 3am. Watching TV most of the night was relaxing, though. After the procedure I took it easy all day while the propofol effects wore off.
Don’t wait to have a colonoscopy. The prep isn’t that difficult!
So in a sense it wasn't that different than a regular night of staying up till four in the morning playing Factorio, except that I had to drink a gallon of stuff that tastes like diluted seawater. I had forgotten how gross that stuff is, but in the end that was the worst part.
My father found he had bowel cancer from a routine fecal occult test they were sending to all men above 65 in my area. He took some convincing to do the test, but found he had cancer and was swiftly operated on. My older brother found he had it far younger, about 52 and his was far more advanced when it was discovered, and 5 years of treatment later it won't be something they can cure. So it is pure chance my father's was caught so early and was so successful.
After speaking to my gp they agreed to start my colonoscopy cycle at 40 - with one every 5 years until I hit 55 and then likely more frequently.
I was a little nervous but it was totally fine and I feel freed that it is one worry that is if not behind me, that is controlled.
Top tip is to follow the instructions of the laxatives well and eat nothing except a broth or miso soup, and it will be far easier on your gut.
That and the sedation depends on whether you’re getting a “flexible sigmoidoscopy” or a full colonoscopy. The latter is the full 1.5-2 metre insertion to inspect all the way to where the small intestine starts, which typically involves sedation (though conscious). The former is usually preceded by a home enema rather than laxatives and done with pain relief only.
Not necessarily, you can get the Good Stuff that knocks you out during the procedure in the UK (I have), but I'm not sure what the criteria are for getting it, if any.
Please don't romanticize invasive diagnostics. If you want to advocate for the occasional bowel purge or using anesthetics to sleep have at it though. But also, general anesthesia should be avoided as much as possible, it's not a trivial matter.
The movicol prep stuff they give you isn't ideal either; you've got to drink a lot of odd tasting fluids that then give you basically explosive diorama which can be awful in itself. It also causes some people to explosively vomit as well (it's designed to make your body want to eject it asap) which really isn't fun when it's trying to escape both ends at once.
The actual procedure isn't amazing either. A camera down either end is uncomfortable at best ranging to extremely painful (short term) as they try and get round the corners in your bowel. There's also the potential it to go wrong in some nasty ways or for odd side effects, and at absolute best, you're still stuck on a table trying to make polite conversation with 2m of camera tube stuck up your bum.
Can confirm your refusal to confirm; none of it's a thrilling or trivial experience.
I think the traditional guidance has been to go for your first colonoscopy around age 50. My doc mentioned that they're recommending that move down to 45, because they're seeing more and more young people with issues. You should bring this up with you doc if you have any similar symptoms or if there's any family history of colon cancer.
[edited]
Bullshit. I've got Crohn's, and have had more colonoscopies than I can count since age 13. About 75% of the time, I'm throwing up due to the prep. The prep is the WORST part.
It has gotten better over the years. If you go for one, do NOT let them give you the jug full of powder. I've had much better luck with prep-o-pik.
The other PITA is they generally won't let you go for the procedure by yourself, since you're under anesthetic and don't trust you to get home OK. That means you have to find a friend who is willing to wait 2+ hours for you.
They usually are, for most people. But for me the first time I did it was the most painful experience ever. So painful in fact that they had to abort it and book me for another time and that time I went under.
That was before my surgery and when my intestines were all over the place. That being said, after my surgery in which they corrected the placement of my intestines, it was painless. That time, the last time I did it, I chit chatted with the doctor and nurse and it was funnily a pretty relaxing experience since I'd gotten some mild drugs before because I was nervous it would hurt as it did the fist time.
I have done a colonoscopy 3 times.
Getting a genetic test might be another option if cancer is what you're worried about. Not as accurate as a colonoscopy, though.
The other option is stool sample testing for blood.
https://www.amazon.com/Second-Generation-Immunochemical-Colo...
The procedure was 20 minutes, painless and slightly uncomfortable where the nurse had to push on my stomach to help the probe round the guts, that was like some brief constipation. You get to your appendix from the inside and physically realize how much the colon takes up in your body.
BTW, in Denmark, a 40+ yo patient with rectal bleeding that cannot be physically confirmed as hemorrhoids by the GP would likely be referred to the emergency cancer track, with I think, 2 weeks before all the tests have to be finished.
I checked and general anesthesia seems to he a custom used in some regions of America. I’ve had 3 colonoscopies and been awake for each one. They aren’t painful in the slightest and you get to watch them on screen! Anyone who gets one should talk to their doctor about sedation options.
Alternatively, you can opt for no anesthesia/sedative, if like me your major concern is lingering after effects (and a fear of going under). I had a colonoscopy and an EGD in the same visit, really wasn’t a big deal. Also quite fun to see your insides on the monitor — gave me peace of mind to see perfectly uniform pink healthy flesh, as opposed to some of the craziness you can find on YouTube.
I had the exact same feeling afterwards. The issue has disappeared since, and that was 2 years ago.
From my past experience, I'd recommend MRI over anything else (especially CT scans), though it's apparently not as useful in diagnosing bowel stuff as colonoscopies.
Both can be very useful and helpful in aiding diagnosis with more data points.
Case in point, I have had an MRI (which showed nothing), several CT scans (which showed temporary blockage) and both methods have not really led to a conclusive diagnosis.
For example in Germany you can get a colonoscopy paid by the health insurance without any specific reason every 5 years from the age of 50. You can always get one at any age for no reason if you simply pay yourself.
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[citation needed], especially because gut flora isn't something you necessarily want to reset.
I experienced the same.
That sounds good.
> Waking up from the anesthesia
Hm, that's not something that would happen if they were easy and painless.
I don't like going under.
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F?%k, this is way to relatable. Same as the author I'm an expat which hasn't had a GP check in 5 years, not counting getting a dermatologist procedures. I feel like this is an experience of a lot of expats. Those of us coming from small towns mostly had a GP from when we were 6 all the way until we left the town for good. It's difficult to get that relationship with someone else and I'm afraid that it might be a contributing factor to people getting less checked. Also, in my case all the family members went to him, so he kinda knew the family history. I still mourn for him, he would always greet me at the door of his office with something like "wtf, you again? why are you here?". He was an excellent diagnostician...
Anyway I bought a house a few years ago and I'm a bit more settled so I've moved to a local GP, and I hope to never need it.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625019/
[2] https://www.hindawi.com/journals/jo/2019/5636272/
[3] https://www.healio.com/news/hematology-oncology/20200127/gut...
And man do I have guilt and felt like a fake cancer survivor. My experience was so minimal compared to a lot of people. But I realized I am a cancer survivor because of all the mental anguish cancer puts on me. It’s nothing I can ever explain, it is just this super terrible feeling of not knowing. Is my cough metastasized cancer? Probably not but my mind sure loves to think so. Having to deal with my own mortality was a big thing. I wonder if dying of old age causes as much stress and anxiety as knowing you have cancer and could die.
I'm hoping the median synthroid dose im on ends up working out, but I still have to wait for pathology and RAI.
Edit: if it makes you feel any better all the docs/surgeons ive talked to have expressed that if they had to choose a cancer to get, it'd be thyroid.
Stay healthy.
One thing I realized was, that I was less afraid of death itself, but rather the process of dying which can be a rather lengthy and ugly thing. Worst thing to happen, eve wirse than the initial diagnosis, was the moment a couple of months after I inished chemo. Some hemorroids started to act up again, and it was a quite realistic scenario that the cancer was back. Damn, I was destroyed by that. The initial diagnosis didn#t realy surprise me, for some reason I kind of expected that after all the tests they did. The potential second one caught me completely off guard, it took me a couple of months to recover from that. looking back, I'd say that was the worst part of the whole thing.
Good luck - remember the recurrence rates are comparatively low once you get past a few years.
Just a data point from an third-party observer with no reason to lie to you: your survivor guilt [0] is normal, but you've done nothing wrong and your experience with cancer is valid and I appreciate you talking about it. It's easy to fall for the trap of minimizing your problems after comparing yourself to other people, and it takes courage to be vulnerable and honest about the things that get you down sometimes.
TL;DR: Thanks for your comment.
[0]: https://en.m.wikipedia.org/wiki/Survivor_guilt
The same when an immediate family member has gone through or died of it.
Instead of being a survivor it’s more like a countdown due to the similar hereditary and environmental factors. Doctors will say “no, don’t worry about that”, the same people could be writing an entry in a scientific journal after your case finally appears.
“Hereditary and Environmental links in X cancer”
Making assumptions without examination is incredibly unprofessional and carries with it potential critical consequences.
If you have an issue and bring it to your doctor and your doctor fails to follow up with an examination and makes assumptions, it is time to find another doctor.
(It runs in the family apparently; my grandmother on my mom's side was from a large family, with seven or eight siblings. They all died of colon cancer. She got it too, but since she went to the doctor with her symptoms instead of staying at home, they were able to remove part of her colon before it got really bad and she lived for many more years.)
Moral of the story: go to the doctor if you're bleeding from unexpected places.
> Not bright red, more like muddy-red. Poopy-red.
Hemerroids are usually a very bright obviously blood-like red. I appreciate he wrote the above description with the benefit of a lot more knowledge than he had when he first saw a doctor, but they should've asked about the colour even if he didn't offer it, and that should've raised extra suspicion immediately.
This went on for about a year I believe. Things got worse and when test were done she found out she had stage 4 cancer and probably only had a few months to live.
If you have symptoms which could be cancer regardless of your age insist you have the right tests done to rule it out. Most cancer is very preventable in its early stages.
A year later, while doing a followup from my surgery, I mentioned how cavalier my GP was to the surgeon who saved my life. He said that many doctors don't really think of colon cancer for anyone under 50 unless there's a family history.
That was 15 years ago, and the medical community has generally understood that colorectal cancer can occur far earlier than previously expected.
I have Crohn's disease and in 2015 had 5 ft of small intestine and half of the adjoining colon removed.
Unfortunately my insides were so fucked up that they had to properly open me up (i.e. not keyhole, more doorframe). Then I got sepsis after the operation and was in the high-dependency unit (US equivalent is ICU I think?) for a bit. That was fun. I was there for a few days, but remember about 2 hours of it. My family visited apparently, I had no idea, but I was talking to them, so I'm told.
I couldn't walk for weeks, other than staggering around (which they encourage you to do otherwise the scar tissue will heal too tight). The wound took about 3 months to properly close up, I had a nice deep hole in my abdomen for much of that, you get used to the gory stuff.
I'm generally better now though. Crohn's still dictates much of my daily life though, but you learn to live with it.
It's actually funny that the doctors in my case actually detected polyps in my intestine when I was 18 (showed symptoms since I was young, but all the doctors in India just waved it off as stress - for a 14 year old!). But again, they just waved it off for a long time and gave me meds that suppressed the symptoms. It was only when I was on work travel that the wonderful folks at the Zurich university hospital pinpointed it. Got a second opinion, and indeed it was Crohn's. Indian doctors just kept discounting it because Asians have a lesser tendency to get it, but recent research shows that your diet factors more than where you're from.
My only advice to anyone in my position or similar would be to take full control of your health and try to get the best possible treatment, instead of trying to reinforce your biases. Had I not been able to get checked at a much better facility then, I might have been in a far worse position now.
Don't count on family to be of help as much either, unless it's a spouse. For what it's worth, around the same time as that incident, my grandfather passed away at a ripe old age of 94. He previously complained about stomach aches and toilet issues, often getting grumpy af, but family members just brushed it away as signs of old age (including my parents). In the end, when he was shifted to a proper hospital in India during his final hours (quite literally), the doctors surmised that it might have been stomach cancer all those years. But of course, by then it was too late to take a biopsy and he passed away with the next couple of hours. That advice about recording your family health issues in a notebook is spot on.
I'm also at a good risk of getting it at some point probably. I'm 23 rn, last colonoscopy didn't show any polyps fortunately. Trying to maintain a healthy diet and lifestyle. Every cancer writeup is kinda scary for me.
At the time of diagnosis, my brother was going through stressful situations(his startup, personal life), not able to focus much on physical and mental health. I'd like to know if Chris thinks there was something else that triggered/fueled his cancer apart from genetics.
Glad to hear you are staying on top of your situation.
As far as triggering my cancer, I have no idea. And I don't think anyone is going to give me any more clarity than that. I don't think it's possible to do so. What they have told me is that more and more young people are getting colon cancer, and they aren't quite sure why.
I've subscribed to your writings, looking forward to them. I'm also a Software Engineer professionally. :)
High-tech surgical robots aren’t an improvement over traditional operations. [1] For some patients, the robots may be worse. [2] and [3].
[1] https://www.nytimes.com/2019/03/11/health/robotic-surgery-ca...
[2] https://well.blogs.nytimes.com/2013/09/09/new-concerns-on-ro...
[3] https://www.nytimes.com/2013/03/26/health/salesmen-in-the-su...
I'm a few weeks out from a robotic assisted surgery related to kidney cancer and the recovery time is significantly shorter in duration (6 weeks instead of 3-6 months) than the non robotic surgery. My understanding is that the DaVinci surgical robot also allowed them to be more precise with how much tissue they removed as well.
Hopefully the medical community can get a better sense of when it's appropriate to use such technology but it would be a mistake to dismiss the benefits because of misuse by some surgeons.