Nobody other than a masochist says, “Oh joy, I’m going to have a colonoscopy today!”
So I’ve resisted having an endoscope snaked up my butt, even while sedated. I’d heard horror stories about people who suffered a lot of pain during a colonoscopy but were too zonked out to effectively communicate what was going on.
Then I learned about virtual (or CT) colonoscopy. It’s non-invasive (yes!) and doesn’t require sedation. Like most things medical there’s debate over whether conventional or virtual colonoscopy is better.
“CT colonoscopy with the use of a three-dimensional approach is an accurate screening method for the detection of colorectal neoplasia in asymptomatic average-risk adults and compares favorably with optical colonoscopy in terms of the detection of clinically relevant lesions.”
Good enough for me. My family doctor was willing to write a referral for this endoscopic alternative, and this morning my 58-year old body found itself poised to pass through the maw of Body View Diagnostic Scanning’s CT machine (they’re in Clackamas, Oregon right off I-205; phone 503-653-7226).
It took just half an hour to get both a heart scan and a virtual colonoscopy. The first was completely painless; the latter was a bit uncomfortable because of the carbon dioxide that gets pumped into the colon to inflate it.
But it still was a walk in the park compared to a regular colonoscopy. The preparation procedure isn’t as onerous and there’s no sedation recovery time. Nor any risk of complications, such as a bowel perforation.
The main drawback of a virtual colonoscopy is that suspicious polyps can’t be removed on the spot. However, Body View says that polyps are found in only 7-10% of patients, so I’ll take my chances (I get the results of the scan tomorrow).
It’s important to have a colonoscopy once you’re over 50. But many people don’t, because the procedure is intimidating. What helped to sell me on a virtual colonoscopy was the Boston Medical Center’s pitch to physicians.
It is one thing for doctors to recommend colon screening for their patients, it is another thing for doctors themselves (their spouses and/or parents) to have their own colons checked. Now that an accurate, quick, and safe test is available it is even less excusable to avoid or delay "clearing your colon." Colon screening by Virtual Colonoscopy , at least for a doctor and his family, should be as basic and instinctive as a mammogram for her and a PSA for him once a certain age is reached.Similarly, the Body View staff told me that they perform quite a few virtual colonoscopies on gastroenterologists. If it’s good enough for MD’s, it’s good enough for me. And Laurel, who has had one also.
Still, neither of us enjoyed the frequent trips to the bathroom during the bowel cleansing that starts the day before the procedure. After 5:30 pm, when you chug down some magnesium citrate, you don’t want to stray far from your new best friend: the toilet.
This has to be done with a regular colonoscopy also, though. And we liked Body View’s more lenient dining guidelines on the day before the exam. I got to have a normal breakfast, then a light low fat/fiber lunch (for me, banana and pasta with plain tomato sauce).
Dinner at 5 pm, such as it was, consisted of a nutritional drink. Then it was cold turkey (or, rather, tofu) for this vegetarian until 10:00 am the next morning, when I was able to eat some post exam snacks provided by Body View.
I’m not used to going without solid food for almost 24 hours. I did a lot of starving-children-in-Africa visualizing to keep things in perspective. It was hard to get to sleep on a nearly empty stomach. While I lay there, initially passing the awake time by feeling sorry for myself, I eventually realized that this is what lots of people in the world experience every night.
Overall, my virtual colonoscopy wasn’t as difficult as I expected. I got used to feeling hungry after a while. I felt almost normal (albeit several pounds lighter) driving up the freeway to Portland this morning.
The two-person staff at Body View greeted me with a smile. They’re pleasant, competent, egalitarian, and refreshingly informal. After the exam I got to view my heart and colonoscopy scans on computer screens and hear a general explanation of the procedures. Plus, get some initial heart scan results.
My cardiac calcium plaque score was 4. Pretty good, but not perfect. This means that my risk of coronary artery disease is very unlikely, less than 10 percent. The Body View guy said that I scored better than about 78% of men my age. I told him that was good news. But since most American men my age are out of shape, overweight, and eat unhealthily, I didn’t consider it great news.
I ended up with a $1,141.25 VISA receipt for my share of the two scans. It was that high because I hardly ever go to the doctor and still had $750 left to meet on my $1,000 Regence Blue Cross deductible.
But as my family doctor said when we discussed the pros and cons of getting these scans (mainly the heart scan; getting a colonoscopy is a no-brainer for anyone over 50), “It just depends on what you want to spend your money on.”
I told her that for eleven hundred bucks and change I could get a nice new computer. Or some other electronic toy. However, if I ended up with undiagnosed colon cancer or heart disease, I’d kick myself for not choosing the diagnostic tests instead.
Do yourself a favor. If you can afford it, or even if you feel that you can’t, get a colonoscopy after you pass the half century mark. With the virtual variety, you’ll hardly feel a thing.
Except a toilet seat, quite a few times, the day before. And some stomach rumblings when midnight snack time arrives and you can't even drink a glass of water. All in all, a small price to pay to markedly reduce the risk of dying from colon cancer.
Check out the Center for Virtual Colonoscopy at Boston Medical Center for more information about this procedure.