A while back, Chief Billy Goldfeder wrote a little story in The Secret List urging everyone over 50 to schedule a colonoscopy. He didn’t need to convince me; after my father died of cancer in 2005, I went to the doctor and scheduled a complete physical examination. Doc suggested that I have a colonoscopy, so I resigned myself to the medical profession for the procedure.

I don’t recall that Chief Billy went into details about his experience, so I thought I would share mine for all of you 50+ year-olds out there who are still sitting on the fence. Perhaps it will get a few of you moving, so to speak.

First, a definition: A colonoscopy allows a doctor to look inside the entire large intestine, or colon. Never mind how they do it - you won’t remember anything anyways, but more on this later. The procedure enables the physician to see things such as inflamed tissue, abnormal growths, and ulcers. It is most often used to look for early signs of cancer in the colon and rectum.

Most often the doctor will find polyps, or little growths on the inside of the bowel. It turns out that just about everyone has them. The polyps are painlessly removed during the procedure and sent to a lab for biopsy. What they look for is the type of cells that make up the growth, and classify them as either adenomatous or hyperplastic. The adenomas are the ones to keep an eye on, for they may become cancerous over time.

If your doctor finds the hyperplastic type, you will be put on a 5 to 10 year schedule for follow-up procedures. If you are like me, with the adenomatous type of polyp, the schedule is a ‘scope every three years.

The colonoscopy experience is comprised of a few relatively simple steps.

1. Make the decision. You won’t get any closer to having a colonoscopy until you work this step to completion. At what age should you consider doing it? Good question; the answer is generally 50 years of age for both men AND women. Now, you can pretend or assume everything is OK down there, or worry about it at night. Or, you can schedule one and find out for sure that everything is hunky-dory.

Talk to your primary care physician about it; he or she will recommend a gastroenterologist who will perform the procedure (or “look in” as my doctor calls it.) The doctor’s office will probably even help you with the next step, which is

2. Schedule it. I walked out of my doctor’s office with two dates set up – one for the interview and the other for the procedure. You may have to make the call yourself, but since you have made the decision – get ‘er done.

3. The interview. Prior to the procedure, the GI specialist will obtain a detailed medical history from you including family history, medications, allergies, etc. You may be given the option to watch a video explaining the procedure, risks, side effects, and such things in great detail. You will be given a prescription for a special beverage that will help you “prepare yourself” for the Big Day. They will also give you a detailed set of instructions as to what to eat, what not to eat, when to stop eating, when to start the special stuff, when and where to report on the Big Day, etc.

4. Preparation. As I said, you will be given instructions to follow on prep day, which is the day before the procedure. Example: a light breakfast at 8 AM; take your normal morning (prescribed) medications; clear fluids only, no red or orange beverages that stain the colon, etc. At noon, start drinking the solution that will make your insides “move right along”. The first time I had a procedure, I had to drink Fleet phospho-soda which, when mixed with 8 ounces of water, is without question the most God-awful stuff I will ever ingest.

Today the mixture is called Nu-Litely (I call it Go-lightly) which comes in the form of a gallon size plastic jug with a white substance in the bottom that dissolves when you mix it with water. You fill the jug, shake it and then drink a glass of it every 20 minutes until gone. I would add “or until you puke or can’t drink anymore” to the directions, but that’s just me.

Which reminds me: you need to be home for this, off duty, with a bathroom close at hand. A firm understanding with the other occupants of your residence would not be amiss. From about 2 o’clock on you will begin to NEED that bathroom, without a whole lot of warning. This will persist for some time until you are, uh, well cleaned out. Seatbelt use is optional.

5. The Easy Part. The next morning, you will probably not be very hungry, perhaps because of worries and jitters about Things Yet To Happen. Relax; you are past the hard part. Just make sure you get to the clinic on time with another person who will drive you home after the procedure is done. During the interview they will have warned you repeatedly about this: no driver, no procedure. You will have prepared in vain. This is an absolutely inviolable part of the whole process; you’ll see why shortly.

You’ll go to the outpatient clinic where they’ll make sure you are, in fact, you - by asking name, date of birth, number of black cats and such things a bazillion times. You will be given one of those open-backed hospital gowns to put on; your clothes can be put in a locker in the little cubicle you have been assigned. The friendly nurses will start an intravenous line through which the happy stuff will be administered. Your GI specialist will come in and say hi, and inject some happy stuff into the IV line… thud. You’re asleep.

(I awoke in the middle of my first procedure - they were simultaneously pushing and pulling on me. "What are you doing?" "We're trying to get the probe turned around the bend." I saw an image on a monitor. "Oh, cool..." thud. Sleep.)

Next thing you will know, someone will be talking to you to make sure you’re coming out of the sedative OK. Next, someone will be telling you to get dressed. Next, someone will ask you to get into a wheelchair for transport to the waiting car. Next, you will open your eyes when the driver slams the car door. You will next open your eyes when the car door slams again at home.

You will remember these isolated incidents very clearly, for you will NOT remember anything that happens between them. You will ask the same questions over and over again, for you will neither remember asking the questions or the answers given. The doctor will have come out and explained what was found to your driver, since you won't remember any of it. As I recall, my loving wife informed me I asked about what the doctor said no less than fifteen times before my mind cleared; I recall asking only twice, but not the answers given.

You will also be at peace, partly because of the drugs but also partly because you are now a veteran – you have Done It. You are now free to enjoy whatever foods you have been craving for the past 24 hours. Eat, drink, and be merry… and sleep.


As a footnote, I have my next procedure scheduled for January 2, which is probably the reason I’ve written this blog. Of course, this means that I will be “prepping” on January 1, and watching helplessly (and sipping my Go-lightly) as my family enjoys a great New Years Day repast. But it’s a small price to pay for peace of mind.