Notes on My Colon Cancer
charlieharrington.com
charlieharrington.com
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.
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.
I didn't particularly enjoy it, but it wasn't a problem.
I think people will have different tolerances to different protocols.
I will say though, after having the colonoscopy, my general bowel symptoms(never ending gas, mostly) improved dramatically. I'm thinking about doing a chemical cleanse every year just to keep things working fine.
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.
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.
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
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.
I must admit, the experience wasn't awful. It was like getting an intestinal reset. Getting completely cleared out from the fast and prep. I felt like a new man, and very well rested after the "twilight" sedation.
I only wish they could have given me a copy of the video of the procedure for my YouTube channel.
It was the 15th time that week he'd heard the "rectum, damn near killed them" joke and he didn't feel he needed another aspiring comedian on the operating table.
This is the primary purpose of the "sedative".
I had samples taken from the interior of my stomach via a machine that went down my throat. It was an intensely unpleasant experience; you're trying to vomit for most of the time the cable is there.
Anesthesia was not even recommended, but they really wanted me to take something that would inhibit memory formation. I asked if people who took the drug struggled or retched any less. "No." (I declined to take it.)
This is also how women were drugged for childbirth in the mid-20th century. No anesthesia, but memory inhibitors so they couldn't remember what had happened. That was eventually "discovered" by the press and became a huge scandal. I don't get how the approach persists elsewhere.
The concept of anesthesia is that you don't feel pain, not that you're unconscious. If you're unconscious, it's "general anesthesia"; if you're not, it's "local anesthesia".
Aside from potential lasting effects from trauma remembered or not, and so on, I always thought: It would still change the doctors.
Can you provide any additional information on this? I can't find anything online. Maybe I'm using the wrong search terms.
Jimi Hendrix remembered he was playing MUCH BETTER guitar when he was on acid.
Until he heard the recordings....
The rate of new colorectal cancer diagnoses has been increasing for those under 50 years old, despite the rate falling for the older population. I don't know if they've narrowed down a major cause. My pet theory is obesity.
The usual recommendation to start screening at 50 is for asymptomatic people with no increased risk. If you have symptoms, family history of colorectal cancer, or enough other risk factors[0], bring up screening with your doctor. As somebody else mentioned, you could do fecal occult blood tests (FOBT) or other non-invasive tests if you're worried about colonoscopies.
[0]https://www.cancer.org/cancer/colon-rectal-cancer/causes-ris...
(Fentanyl gets a bad rap because it's very dangerous as a street drug. In a healthcare setting it's a wonder drug, superior in almost every way to morphine.)
Once every few years they find a suspicious polyp and snip it of / cauterize the wound, all with just local numbing. Still nothing worse than stubbing a toe, and certainly not worth the risk of using sedatives.
I can understand if some people want sedatives, but anesthesia is pretty high risk like you were saying.
"Not a single shred of evidence to be found" -> "I didn't actually look but like telling people they're wrong lol"
If you want to come into a thread telling people that are already apprehensive about a procedure "please don't do X its dangerous!" when an _actual_ first google will give you a Mayo Clinic saying its perfectly fine, then you need to provide some fucking evidence.
Your evidence is unconvincing, but good job being condescending.
It gets worse the farther they go.
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.
Still, getting anesthesia for something like a colonoscopy or a root canal strikes me as a very disproportionate risk given the evidence.
Side note: I was never warned about a particular effect of propofol. They started pumping it in and told me to count down from 10. At about 5, I suddenly felt this horrible searing, burning pain in my IV-connected arm that I felt spreading throughout my body. Thinking something was terribly wrong, I opened my mouth to say I'm feeling awful pain, but by then I was already falling unconscious. So I only consciously felt the pain for a few seconds, feeling totally fine (besides grogginess) when I woke up, but it was panic-inducing and some of the worst pain I've felt.
Apparently it's pretty common for propofol. I think they might have told me I might feel a little discomfort, but they didn't mention the possibility of sudden, dramatic pain, for some reason. I could've grit my teeth through those seconds if I knew it was possibly going to happen, but I feared that I was having an unexpected severe allergic reaction or something, so I spent those few seconds absolutely terrified.
I’ve experienced the exact same pain you’re talking about but with IV antibiotics. No nurse or doctor could actually explain why it was happening to me, other than to say the IV had “gone bad.” Because I was in the hospital for so long, they eventually switched me to a PICC line. Absolutely zero pain with that.
My own experiences with propofol involved either the PICC line, or maybe some kind of arterial line or something (I was unconscious when I was first sedated during this incident).
[1] https://www.jaci-inpractice.org/article/S2213-2198(19)30762-...
A good, modern anaesthetist in a western hospital has access to an incredible array of information about their patient, ranging from their complete physiological state to the partial pressures of anaesthetic gasses going into, and out of, their lungs (and thus in their blood stream). This largely means that the horror stories of the past about people "waking up and being unable to move" -- the triad becoming unbalanced and muscle relaxation ± analgesia being (barely) adequate, but narcosis clearly not -- remain in the past.
I've probably waffled incoherently enough, but it's worth reiterating that anaesthesia is a _field of medicine_ in its own right. There are literally thousands of approaches, drug combinations, and "gotchas" to deal with, in all sorts of situations -- right the way from the straightforward and simple to patients with massive facial injuries where it is very difficult to know how to intubate them without causing further damage. Drug combinations are prescribed on the basis of the patient, the indication, and local rules and availability (including toxicity to the operator and cost -- many anaesthetic gasses are carcinogenic if you're exposed to them for a long period of time in trace amounts, which occasionally becomes an issue).
Re: the content of this article --- if you have blood in your stool, see your doctor. (S)he won't be embarrassed about shoving a finger up your arse, and the outcomes range from "eat more fruit", or "don't have anal sex for a little while" to lifesaving surgery.
If you're having a medical procedure and the physician mentions general anesthesia, always ask if IV sedation works as an alternative.
An acquaintance of mine with Down's syndrome, no less, couldn't do a gastroscopy to investigate a quality-of-life issue that was assumed to be benign, due to this. Boggles my mind, honestly.
General anesthesia might be over-used, but some healthcare systems go too far in the other direction too.
You can also go to other doctors in a socialized one, if their treatment (style) does not fit your cause.
Also, in my experience there's lots of choice in most socialized health care systems.
I had a gastroscopy in Austria, the Doctor asked me if I'd like a general anesthesia or rather a local, nerve blocker - mostly to avoid the gag reflex.
He said that it may not be as pleasant without the anesthesia, but I still opted for it and am really glad I did. While it really was not pleasant, I was up and going again in about half an hour.
It's just "how it's done". Just like the US has it's own unique methods that seem odd to Europe.
Don't it just turn on the chlorine tap on a neuron to open so that the voltage is now much lower and it will inhibit the signaling ???.
It is the natural mechanism of a neuron so I don't see what side effects there could be - it is like pulling a jumper wire from one pin to another pin on a board to get a voltage right.
Benzodiazepines are considerate anxiolytics whereas propofol would be considered moderate sedation. Neither of these require airway control (intubation) because people tend to keep breathing on their own and we really would much prefer that.
With general anesthesia, you cannot protect your airway whatsoever and will need some form of airway control via either endotracheal intubation or LMA.
The patient is aware, can breathe on their own, and can respond to basic commands, but is relaxed, with a much higher pain threshold, and has no memory of the event.
That sync with your experience, doc?
For the overwhelming majority of patients, you simply fall asleep, avoid discomfort, and then go on with your life. Weighing that against the risks of a traumatic or very painful wakeful experience is not trivial.
What I'm trying to argue is that "one step away from death" is a state we too-often in American medicine treat as hum-drum.
My experience is that GI doctors enjoy chatting during the procedure but specialist nurses (who often perform minor endoscopies) are usually not very communicative.
Colonoscopy was generally OK, and it's quite interesting to see both what your insides look like, and the radar image of the path the scope takes.
The prep the day before is the worst bit IMV
If you feel like you're relaxed enough to be calm when someone does something to you that your body will tell you is going to kill you, then it's not so bad. They sedate your throat to kill the gag reflex, but it doesn't work 100%.
The upside for me was that it was over so quickly, and I could go on with my day, was allowed to drive, etc.
I went for no sedation during a colonoscopy too, but after a while it got too painful and I asked for some
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!
I will note that general anaesthesia generates lots of extra billable hours (anaesthetist! extra nurse/assistant anaesthetists!), which might be why US hospitals are so keen on it and NHS hospitals are less so.
This may sound like a strange sentiment, but years ago I broke a bone on a weekend and they put my arm in a sling at the emergency room. I got to see a doctor on monday and he said - you have to move your arm. "Move it every day, otherwise you will lose your range of motion. Let pain be your guide".
Completely different advice than I expected (I expected to keep it immobilized as much as possible until fully healed)
So I wonder if I was knocked out - would they damage something while they're looking around without my hints?
There are risks to colonoscopy, primarily in older patients. You can get a perforated bowel.
Quite plausible that where sedation is warranted this reduces the risk. But that would depend upon whether the cause of this perforation is even amenable to patient/doctor feedback.
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.
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.
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.
[citation needed], especially because gut flora isn't something you necessarily want to reset.
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...
That sounds good.
> Waking up from the anesthesia
Hm, that's not something that would happen if they were easy and painless.
I experienced the same.
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.
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 wasn't knocked out but I might as well have been as I didn't feel any pain and kept kind of drifting off half to sleep. It was completely fine and I'd not worry at all about getting it done again.
I had the exact same feeling afterwards. The issue has disappeared since, and that was 2 years ago.
I don't like going under.
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.
https://www.gov.uk/government/publications/bowel-cancer-scre...
> Entonox pain relief should be available at all sites where bowel scope screening is provided, as the procedure will be performed without sedation, unless a decision was made and documented at a best interest meeting about the appropriateness of performing the test with reasonable adjustments.
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.
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.
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.
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.
Good luck - remember the recurrence rates are comparatively low once you get past a few years.
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.
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.
For this reason and a couple other IBS symptoms, I've gotten two colonoscopies, one capsule endoscopy, and one sigmoidoscopy in my day. And all have come back negative for anything whatsoever.
Again, if you've got symptoms, see a doctor. But if you're like me and freak out at everything and assume you're dying at the drop of a hat—it's likely not something awful.
Our local bowel cancer charity recommends these. If positive, get a colo(no)scopy. If negative, retest in another year or two. These are sent out to everyone over 50 IIRC. They're also recommended to anyone who is younger and possibly at risk.
This! If you have cases in your family, genetical disposition or not, get them as soon as possible. My doctor recommended at least 10 years before the earliest case in your family, which would put my kids at 18. Missing a cancer diagnosis early on is probaly the worst thing you will regret in your life.
His library [1] is also worth checking out!
Colon cancer runs rampant in my family. My dad was a stage 3 survivor (it's now been 12+ years), however his younger sister (my aunt) just died about 6 weeks ago after an 18 month battle. She was a former nurse, and had basically missed getting one of her regular colonoscopies. At that time, she was supposed to go every 5 years and I think she went 10 - too long for her age. She ended up with a blockage, which by that time meant things were realistically too late. She was only 64 and in otherwise excellent health. A second, younger aunt on that side suffers from diverticulitis and has had bowel surgery.
The cancer gene also runs on my moms side; an aunt there had both colon and breast but survived both. So, I'm pretty much screwed. As a result of those risk factors and various symptoms, I've personally had two colonoscopies (one just a month ago).
I'm close to 40, and I had a 2mm polyp removed. There's a high chance that such a polyp would have developed into colon cancer within a few years. I'm now on the 3-year plan for colonoscopy checks. The good news is, in general, colon cancer is one of the most successfully treated diseases if caught early enough. Gastroenterologists will tell you that there's no excuse to die of colon cancer if you get regularly checked.
What I would tell people is to get checked by age 40. If you have any symptoms don't hesitate to call a gastro and get in for a check. For most people, it is hemorrhoids or something else - but I've got a friend (39 years old) who was diagnosed with stage 4 colon cancer - the point is this thing is hitting people in their 30s, so it needs to be taken seriously if you're symptomatic.
On the topic of prep, it's not that bad. It's basically 24 hours of suckage because you're on liquid diet for a day, and taking the prep that evening (typically split-prep, some before bed, some in the middle of the night). Try to schedule your colonoscopy for the first thing in the morning so that you don't have to go more than a day without solid food.
(edit: spelling correction)
If the virtual kind saw a problem, it would be followed by the regular camera kind.
They were cheaper than a gastroentreologist. But for some reason they never caught on with doctors or insurance companies.
In the case of my MIL, the biopsy first came back as a fungus which we _now_ know was an impossibility.
Like so many other commenters, I had my scheduled colonoscopy and it was a walk in the part except drinking that horribly disgusting prep liquid. That was gross, but I've probably had worse in my young and very stupid years.
I didn't have insurance, so I just ignored it. Now I live in Taiwan where everyone has insurance but I STILL haven't done it. I'll make an appointment today.
Then Chadwick died, and I'm like, man, he got diagnosed with Stage 3 the same age I am now, and I'm in terrible shape compared to him.
I'm thinking I should probably get a colonoscopy next summer, after this wave of Covid dies down again. Wouldn't be surprised if I at least have some pre-cancerous polyps.
If you think of each day that goes by a 1% chance of getting cancer, that might work as a motivator. (I don't know if that's an accurate probability, but really I wouldn't risk it. I had a nasty bleeding tumor removed a few years back and it was no big deal because it was caught early and hadn't become cancerous yet. If I had waited a year things might have turned out a lot worse.)
As other already said, a colonoscopy isn't really bad. It deffenitly beats having cancer by an order of magnitude!
I recently lost a close friend to bowel cancer in his 30s. He'd been ignoring blood in his stools, and it was stage 4 before it got picked up.
Don't find excuses to put it off.
Like others, I encourage you to bring it up with your doc and ask about getting tested.
They did visually confirm inflamed external hemorrhoids a few years ago. I think they also took a stool sample and didn't find any blood in the stool itself, I believe (can't remember what else they tested in the stool), and when it happens it's usually after some significant walking (i.e. a long walk with the dogs), and it's bright red and not mixed in with the stool, so I've been inclined to agree with them.
I had blood almost 20 years ago back in college too, and it took forever for the situation to calm down because I had to walk so much to get from class to class every day (like a 15 minute walk between every class), so I was constantly irritating it. Back then I never got it checked out because I was too embarrassed, just tried to hide it as best as I could.
And when it was really bad a few years ago it was when we were living in a townhome with a dog and I had to go walk him for 15-20 minutes 4 times a day every day, so it was a similar issue to back in college. It's been pretty rare since then (I've only had it happen twice the past two years, and the most recent time it was after we returned from a 3 hour hike).
So I'm pretty sure it's more just the hemorrhoids. I do still want to get it checked, but Covid is more of a concern since I have some risk factors that could lead to a poor outcome. And I'm not even saying wait until Covid "goes away" or anything, just until next summer when it's likely to go down to a somewhat manageable level again (<5% positivity rate), at least in my state. Currently we're about double that.
EDIT: Also another commenter made me aware that you can order and get at-home Fecal Immunochemical Tests (which I'm pretty sure was what I got at the doctors several years ago) to help detect blood within the stool, so I went ahead and ordered one. If that comes back positive, I'll schedule a colonoscopy right away.
Er, actually after consulting with my doctor, since apparently insurance companies aren't required to cover it before the age of 50 and they can cost up to $4000. Maybe with a doctor recommendation insurance will cover it.
The Infection Survival Rate of COVID19 for those 20-49 is 99.98%, according to the CDC:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
0-19 years: 99.997%
20-49 years: 99.98%
50-69 years: 99.5%
70+ years: 94.6%
This gives a death rate of 20 out of 100,000 people for the 20-49 age group who get COVID19. And there is no guarantee you will contract COVID19.
I don't know what proportion of people with your symptoms have colon cancer, but I assume it's unfortunately much larger than 20 out of 100,000. The survival rate for colon cancer is highly dependent on how early it is diagnosed.
I really feel like I'm due an MOT on my body.
Does anyone have recommended reading for basic cancer knowledge? I'm 32, know nothing, no family history of cancer AFAIK, but I have a large family and I want to start preparing and getting information. Thanks in advance!
It introduces the fundamental features of all cancers. Every cancer ends up with pretty much all of these traits because of strong survivorship bias. Those that don't develop these traits die off.
For trials, there's also https://trialfinder.fightcrc.org/ - created by Dr. Tom Marsilje (a cancer researcher) - who had an inspiring journey both as a patient and researcher.
Nice explanation of how a robotic sigmoid resection is performed: https://youtu.be/LpzxfMRlBVk
Firefly perfusion assessment time-stamp: https://youtu.be/LpzxfMRlBVk?t=1527
Disclosure- Intuitive employee with no specific knowledge about this case.
The "sedation" is not really anesthesia, but rather a drug that messes with your short term memory (and makes you goofy). If you don't like the idea of somebody messing with your brain circuitry, ask not to be sedated.
Do get the anesthetic though.
As a cancer survivor, paranoia saves lives. If something seems out of order, go see a doc.
That's the giveaway, right there. Bright red blood on your toilet paper is usually just hemorrhoids. Uncomfortable but treatable and not life threatening.
Deep red or "muddy red" blood on your toilet paper means the blood came from deeper within your intestine, and it should always be checked out regardless of how young you are. If your doctor refuses to do so, get a new doctor.
The bottom line is that if you ever have ANY bleeding from your anus, or in your stool, visit your doctor immediately.
(15 year survivor of colorectal stage 3 cancer)
I agree with your advice: Any blood in your stool should be checked out. Don't let your doctor talk you out of it.
Doctors I've seen don't really care about anything beyond parents and siblings for family history. They wouldn't bother with grandparents' siblings, as referred to by OP.
Has this changed recently, or is it different for some conditions?
I had surgery where they removed around 30 cm of my colon and some lymph knots, one of which had cancerous cells. went on to get 6 months of easy, as compared other people I saw and met, chemo therapy. The worst part was, when roughly one month after the chemo finished I again had blood in the stool, a lot of it. At that point I was on a high, after all I just finished chemo and survived, right? Damn, that sucked, worse than the initial diagnosis, back then I almost expected it. Luckily, it wasn't cancer, but it took my months to recover from that scare. looking back, I'd say that was harder than everything before, also because people around me kind of got the hard time going through cancer. They didnt really get why the fact not having cancer was so much harder for me.
What I did learn from that is, that I'm less afraid of death than I am from the process of dying, if this makes sense. And that life is too short to care about certain things. It changed me, and then it did not, it is hard to describe. The things that really helped me was my son, aged 3 back then, having a wife that regularly kicked my ass when I needed it. Especially the one time I was cloe to give up (silly me, but it made sense back then). And having a good friend to talk to about stuff that wasn't for families ears.
One thing, so, that very very few people got was the stress and hardship cancer means for ones family. As a patient you can get, and are offered, all the support from your environment. Your family not so much. And man, was I an ass sometimes back then.
Luckily, I have no genetic preposition for cancer. Still, my kids will get colonscopies aged 16. better be safe than sorry, and a cancer diagnosis is nothing you want to miss. I undertand why people are afraid of the diagnosis, but this is nothing that can be ignored. The earlier cancer is caught, the easier the treatmen and the better the chances of survival. And sometimes, a couple of months can make all the difference.
So yes, get a colonoscopy early, as early as possible and do not wait. Coloniscopies are no big deal, the worst part being the prep and even that got better over the years. And even you find it intrusive and unpleasant, which some people do, it still beats surgery, chemo therapy and potential death.
Alas, I don't have a colon any more, but when I did, I wrote: https://www.jeffgeerling.com/blog/2017/colonoscopy-or-mount-...
If you have family history or symptoms you accelerate the schedule.
And if you are diagnosed with cancer - its basically a death sentence unless you have somewhere few hundred thousand dollars laying around, because the best operation surgeons can do in your country is cut out appendix like it is 1990s.
This system actually has advantages. From an outside perspective, it seems like Americans spend an awful lot of time in doctor's offices and obsessing over health issues (a strange way to spend one's life), when the end result will be the same.
Thanks for the best time I ever had reading about someone having had cancer and all the best to you.
Also, lots of microRNA tests coming down the pipe. Get them every year and catch cancer when it is stage 0.
Cue severe embarrassment when the nurses came around to to my bed to "administer" the colon cleansing procedure , believe nowadays they give you a laxative to drink the night before.
Got a mild sedative and it was not painful at all.
[1] - Turned out to be polyps, non-cancerous.
As for this comment:
What people miss is that these treatments are invented by out of work surgeons.
The technology was actually invented by a gastroenterologist at the University of Michigan in the 1950s based on pioneering research of Narinder Singh Kapany on fiber optics. Ignoring the fact that there are very few "out of work" general surgeons, most colonoscopies are not performed by general surgeons but by trained GI specialists assisted by technicians and specialized equipment.