Epilogue: I Scope with Dope

Eighteen years later, we arrived right on time for my fourth colonoscopy yesterday morning, but Dr. H was running, excuse the pun, a little behind. Heidi was allowed to wait with me right up until the time they wheeled me back, and the staff at the GI Unit could not have been any nicer. Without exception, though, they all seemed a little shocked about my intention to go through without any sedative.

"I don't want to influence you," one nurse said, "but these are reallllly good drugs. You're asleep in literally 10 seconds and awake 10 minutes after they're done."

"But what about side effects?" I asked.

She shrugged. "Most people tell me it's like the most refreshing nap ever."

Everyone was like that-- super respectful of my wishes, but very clear that the anesthesia they use today was excellent.

I had never been put under for anything, and I couldn't imagine it, but the last colonoscopy I'd had was a little ouchy at the end. I endured the cramps through gritted teeth, virtuous in the knowledge that I would be dressed and ready to go in a few minutes.

"But Trace," my sister once told me, "if you take the drugs, you don't care if you can't leave right away."

"Well," I told my nurse as he started the IV, "I guess I should have something to compare. I've decided I'll go with the anesthesia."

He nodded. "It makes it easier for the doctor," he said, "if he doesn't have to worry about hurting you."

Just then the anesthesia nurse came in. "You might feel a little burn at the site," she said, "but you'll be asleep in 10 seconds."

I didn't believe it. I watched as she pushed the white fluid from her syringe into the line. (We fondly call it 'milk of amnesia' the other nurse had told me.) I closed my eyes; there was no heat, just a little roaring in my ears and then stars in the dark.

The next thing I heard was, "Everything went great!" and they were wheeling me to a recovery cubicle. And 20 minutes later? I was dressed and on my way, feeling like I'd had the best nap ever.

Now that is a good drug!

Procedure: Part IV

What is phosphos soda, anyway? The night before my procedure I drank four shots of the bitter, salty stuff, at twenty-minute intervals, followed by 32-ounce water chasers. As bad as it was, the taste was not the worst of it. It wasn’t long before any remaining liquid from the past two days was decisively evacuated, and I wished that I’d stayed away from that spicy broth.

Now, watching on TV, I saw just how clean and empty my bowels were. Rippling with peristalsis, the walls of my colon glowed yellow, a fine network of greenish-blue veins visible below the surface. Dr. H narrated our progress as we went, stopping a few minutes in to pinch a little polyp with the forceps. He would send it to the lab for biopsy, but even if it was pre-cancerous, he assured me that it was of no concern. As the serrated teeth of the little alligator-like instrument chewed away at the tiny bump, it bled, bright red washing down the sides of the tunnel, but I couldn’t feel it; there are no nerves inside our intestines. We moved on, and in a moment reached a tight turn. “I’m going to blow some air here to straighten it out,” he told me, “you might feel a little pressure.”

Inflating your intestines turns out to be rather painful, which is why they invented beano and gas-x. I ground my teeth, willing my recalcitrant gut to unbend and let the colonoscopy continue. Finally it opened up like a lazy windsock in a light breeze, and the cramping disappeared. After that, it was a straight shot all the way to my appendix, which resembled Pinocchio’s nose. That was the end of the line, and, with the exception of that one little polyp, there was nothing. The trip out was much quicker, and a lot like watching a tape of what I’d just seen in rewind. One last quick view of my bare butt, and it was all over. “You did great,” Dr. H told me. “See you in three years.”

Back in my recovery cubicle, I got dressed. Yet another nurse was startled that I was all ready to go when she came in to check on me. Before I was discharged, she gave me a run down of what I might expect over the course of the day, “But don’t worry,” she assured me, “it’s fresh air.”

Procedure: Part III

Finally, after a few questions and a rectal exam, my GP wrote a referral for a gastroenterologist and ordered some blood work. She said everything seemed normal to her, but you couldn’t take any chances with my family history. The gastro guy, Dr. H., was highly recommended, though; “He’s very gentle.” When I saw him ten days later, he told me that the results of all my labs were normal, but a colonoscopy was indicated, anyway. It would be another two-and-a-half weeks before he could fit me in.

A week before I was finally going to get scoped and find out once and for all whether there was anything to worry about, the dark red color appeared again. I examined it closely. It looked suspiciously like the beets I had eaten for dinner the evening before. When I was growing up, my mother never served us beets; I don’t think she likes them. A month or so ago, I’d been to dinner at a friend’s home, and he had served a delicious salad with roasted beets, haricots vertes, and goat cheese. It was so tasty, in fact, that I had made the salad myself, just last night. Hmmm, I wondered. How thoroughly do we digest beets anyway?

In my mind, the mystery was solved, but the colonoscopy was still on the calendar. Two days before it, the preparation began, a clear liquid diet. How bad can that be? I thought. There are many clear liquids, and I was totally up for the challenge. For example, I strained Thai hot and sour soup as a much more flavorful alternative to plain chicken broth, and wine is definitely clear, but after a couple of meals, I found out that the main problem with clear liquids is that they are not satisfying. I wanted solid food. Forty-eight hours on a liquid diet would have been bad enough, but the clear liquids are really only to ease the second part of the preparation: the cleanse.

Procedure: Part II

The next day I made an appointment with my general practitioner. The earliest she could see me was a couple of weeks away. This was in the days before google even existed, much less had become a verb. I used my dial-up service to conduct some internet research. It was limited, but all I read pointed to the same thing. In the absence of trauma, the most likely explanation was some stage of colon cancer. I was not surprised. My father had died of that disease ten years before; I knew I was at risk.

As the days passed, I studied the toilet every time I had a bowel movement, and I was relieved to see no tint to the water. I hoped it was a false alarm, but I knew that the amount of blood I had seen was a possible indicator that anything wrong could be quite advanced.

Confronted by my own mortality, it was hard not to be a little morbid sometimes. Songs on the radio seemed like excellent choices for a memorial service, especially I Will Remember You by Sarah MacLachlan and I Believe I Can Fly by R. Kelly. “And she planned it herself?” my mourners would marvel. “Wow, I just couldn’t have done it.” It was hard not to be optimistic, too, to be sure it was nothing, mostly because something like that couldn’t happen to me, and plus, I was only 35.

The two weeks crawled by. I stayed busy doing crossword puzzles. I couldn’t get enough of them; there was something soothing about challenges with definite answers. I had decided not to tell my family, because I didn’t want them to worry. I didn’t mention it at work; it seemed a little too personal, and D and I didn’t really talk about it either, although later, she told me that she wrote a long list of all the things that she wouldn’t miss about me.

I’m sure that list came in handy a few months later when we broke up.

Procedure: Part I

In honor of my upcoming "procedure" I present the following never-before-published piece about my first colonoscopy. It was written in 2008, although the procedure itself took place in 1997.

The dark pink asterisk of my own a**hole rushed toward me on the monitor, and before I had time to consider what would happen next, it did, and the screen was filled with the slick and shiny tunnel of my colon. A camera, a light, suction, and forceps? All in there? I lay on my left side, loosely covered with a pink blanket, my hospital gown open in the back for obvious reasons, an IV in my right arm. “How are you, Hon?” a nurse asked me. She was concerned because I had refused the sedative for this procedure. At first I’d said no because I didn’t want the IV, but they made me have it anyway, so that they could push the drugs if I needed them.

“You have to lie very still, and there may be some discomfort,” a different nurse had told me earlier. “We’ll want to be ready if you experience too much pain.” She snapped the tourniquet, wrapped it around my arm, and tore into the sterile packaging on the stainless steel tray. I looked the other way, cringed when she said, “A little stick here,” and turned back in time to see two latex fingers pressing on a bloody gauze pad. Some surgical tape and she was finished.

“What’s the recovery time?” I asked. “How long until I can leave?”

“That depends. With the sedative, we’ll keep you a few hours until you’re alert; without it, you can leave right away.”

That settled it for me, no drugs. The preparation for this procedure had started two days earlier, and had been unpleasant enough, but the real journey had begun six weeks ago, with a routine trip to the bathroom. Turning to flush, I was startled by a distinct crimson cast to the water at the bottom of the pot. It looked like blood—a lot of blood. I felt fine though; there was no pain, no other symptoms. I hesitated before I flushed, unsure of what to do. Wait and see? Call 911? Get a second opinion?

“D!” I called. “You gotta look at something gross.”

Writing to Go

My writing group decided to try our hands at travel writing this time. Here's mine:

One of Chris Van Allsburg’s latest books is called Queen of the Falls. It tells the true story of Annie Edson Taylor, the first person to go over Niagara Falls in a barrel and survive. The year was 1901, and Taylor was a 62-year-old widow who figured she had nothing to lose and financial security to gain by taking this daring plunge. She poses unsmiling in the photographs of the time, standing grimly next to her custom-built barrel. In one, a tiny ginger and white cat perches on the huge cask beside her; she had sent him over the falls before her to see if he would survive. When Annie’s turn came, on October 24, her 63rd birthday, she slid into the barrel, which was fitted with a mattress, and had a friend screw the lid down and pump out most of the air to create a vacuum seal. Then it was over the side of the row boat and into the roiling waters of the Niagara River. In less than 20 minutes she was swept over the Horseshoe Falls and into history.

It was hard not to think of that story as I stood at the edge of that same precipice on a rainy day in late June. I had been to Niagara Falls many times before but this was the first time for my mother, sister, brother-in-law, nephew, and niece. We had chosen to start our visit on the Canadian side. Many people claim it superior to its American counterpart, but I do not share that opinion. If anything, that vantage offers a better view of the American Falls along with the Horseshoe cataract that both nations share, but from either side of the river you can get close enough to feel the roar of the water in your chest as it blasts toward the brink at 25 miles per hour and then plunges into the gorge at 2 ½ times that speed.

On this day, our wait on the Rainbow Bridge to pass through immigration and customs was a little less than 30 minutes, and my brother-in-law took advantage of the time to shoot several photos from the pedestrian walkway overlooking the falls. “It feels like a different country already,” my mother noted as we turned onto Niagara Parkway. I knew what she meant. The squat, mid-20th century architecture of the NY side had been replaced by a lighter, more international style of building, including several sky-scrapers. The parkway along the river is broad, and framed by wide sidewalks with green grass and curved flower beds beyond. It is more like a riverside promenade than the sprawling park with its meandering pathways and shade trees on the US side.

We found convenient parking in a lot just across from the visitors’ center and joined the throngs of other tourists heading for Niagara Falls. The rain held off, but the mist from the falls seemed to rise right into the low clouds above us, and the water was emerald green in the filtered light of the overcast day. We started our walk just upriver from the top of the falls, and traveled with the current until we reached an overlook directly above the edge. There the water poured over with such momentum that although the sharp rim was visible, it was submerged by at least three feet, and it was hard to believe that this was not even the fullest force of the falls. Since 1895, water has been diverted from the river to provide power to much of western New York and Ontario. These days, anywhere from 60-75% of the water flowing toward the falls is channeled underground to one of five hydroelectric power plants nearby.

Across the way, the yellow slickers of all those folks visiting the Cave of the Winds bobbed on the redwood decks at the foot of Bridal Veil Falls. Below us, at the foot of the falls, The Maid of the Mist intrepidly motored her way into the flume, her blue-coated patrons crowded on the bow eager to snap that perfect, postcard-worthy shot.

We heard many different languages from our fellow visitors, adding to the international vibe, and as we ambled along we found ourselves engaged in a good-natured ballet of selfies. One person would step out from the railing as another glided in; people would bow and spin to avoid photo bombing: all of us wanted a picture that conveyed the illusion that we were alone there, and yet? It wouldn’t have been the same without the rest of us.

Unabridged

I was organizing the apps on my phone this morning when I found one I had forgotten I had. Trailers provides instant access to hundreds of movie previews for upcoming films. Of course I took a look at what was trending, and I amused myself for perhaps 10 minutes watching a bunch of trailers.

Tonight at dinner I confessed that guilty pleasure to Heidi and Josh, describing the trailers I had seen in detail, and we spent a lively 20 minutes discussing them.

It reminded me of when I was a kid and I had the reputation of being quite the opposite of Reader's Digest: instead of condensing to recap a movie or TV show, my version would often take waaaaay longer than the original.

What can I say? If a picture is worth a thousand words, well, then, you do the math. I only wanted to be thorough and to do justice to art that had moved me. Well, that, and I did have a bit of a sequencing problem. I was famous for pausing several times through any summary. "But, wait, before that... " and back I would go to that relevant bit of information I had forgotten to share. 

As an educator today, I know that what I was doing back then was using all the tools of comprehension and processing-- summarizing, analyzing, connecting, evaluating, and questioning.

I'm sure that didn't make me any less aggravating to my audience, though.