My fourth colonoscopy goes smoothly at Salem Gastro

First off, I just noticed the appealing slogan on the Salem Gastro web site: "What matters is what's inside." Nice mixture of philosophy and double entendre. 

The colonoscopy I had last month at the hands of Dr. Richard Brandes wasn't exactly appealing, but it went about as smoothly as possible.

This was my fourth colonoscopy.

Well, fifth, counting a virtual (CT) colonoscopy I had in 2006. In retrospect, that probably wasn't a great idea, since if a suspicious polyp had been found (maybe all polyps are suspicious), I would have needed to undergo a regular colonoscopy. But at the time it seemed like a good idea: simpler prep, no anesthesia.

Fortunately, I had a regular colonoscopy in 2009 after an occult blood test was positive, though a repeat test was negative. My family physician thought I should have a "real" colonoscopy, and it revealed a polyp that turned out to be benign.

Then I had another colonoscopy just two years later, in 2011, because the prep in 2009 wasn't ideal, and the doctor who performed the procedure said he couldn't see every part of my colon. Another wise decision, since another benign polyp was found in that location in 2011.

My first two regular colonoscopies were done at Gastroenterology Associates of Oregon in Tualatin, because I was turned off by what struck me as an overly lengthy prep period that Salem Gastro required at the time: no solid food for two days prior to the colonoscopy. Meaning, if your appointment was 9 am on Wednesday, you'd start the prep on Monday morning.

But in 2014 I was pleased to learn that Salem Gastro allowed a low volume prep solution, Suprep, that didn't require as much drinking on the night before my colonoscopy. And the no solid food time was a bit less, I believe. Again, three benign polyps were found.

As with my previous two colonoscopies, I enjoyed the propofol anesthesia -- which stimulated a quasi-spiritual 2011 blog post, "Finding enlightenment through a colonoscopy (and propofol)."

Five years passed before I was scheduled to have another colonoscopy in 2019.

Perhaps the longer period this time was because benign polyps were found the three previous colonoscopies. Regardless, my 2019 colonoscopy seemed to go the smoothest -- aside from some anxiety about possible snow being in the forecast, since I sure didn't want to go through the prep and then be stuck in our rural south Salem home because of thick snow or ice.

This time around I'd scheduled the procedure for early afternoon.

That meant I went without food for about four extra hours, compared to having an early morning colonoscopy, but I liked not having to get up early and head off to Salem Gastro at a time when retired me isn't used to fully functioning.

Interestingly, there were some differences between my 2014 colonoscopy at Salem Gastro and the 2019 procedure. Guess this shows the benefit of being an obsessive blogger. My posts function as sort of a diary. In 2014 I noted that it was nice to sit in a chair during the pre-colonoscopy preparation period. And I walked to the procedure room.

This time I reclined during the preparation period, and I was wheeled into the procedure room. But Dr. Brandes was still appealingly loose and joking around with the nurses, with rock music playing, as it was in 2014.

The nurse anesthetist told me before the colonoscopy that some changes had been made to the propofol. This time there was no counting backwards, or indeed any indication at all that I'd started getting the propofol. I was just out. Waking up, I didn't feel as blissful as the previous time. 

Meaning, no feeling that I'd been in a happy place, and now I had to deal with reality again. Instead, I had a vague recollection of what I thought at the time had been a dream. Now, though, I'm wondering if I was minimally aware during part or all of the procedure, and my "dream" was a vague memory. 

No big deal either way.

As I've noted before, it's unclear to me whether propofol truly renders you unconscious, or whether you forget what happened during the colonoscopy. I prefer the first option, so that's what I choose to believe, since it would bother me to consider that I endured pain during the procedure and simply didn't have a memory of it.

Dr. Brandes sent me a letter saying that the polyps removed this time (again!) were benign (again!), and I should have a repeat colonoscopy in five years. That seems a long ways off, but when 2024 rolls around, at least I'll have this blog post to refer to as a written memory of how smoothly my previous colonoscopy went.

The staff at Salem Gastro were wonderfully informal and pleasant. I had a great conversation with the nurse who handled my pre-colonoscopy preparation. However, I can't really recall when we talked about.

I like to think that's due to the propofol, rather than my age.

Comments

[tucson]

In 2010 I was having some blood on my turds. Finally, after spraying blood all over a public toilet I thought it best to see a specialist. Turned out I had a very large neoplasm (tumor) in my rectum. "One of the largest I have ever seen" said the surgeon. It turned out to be benign (if a giant tumor can be considered benign), but the surgeon was sure it would have become cancerous eventually and killed me.

Since then I have had several follow-up colonoscopies with no further issues. I resent waking up from the propophol. It's really a profound sleep but the nurses want you out of there asap, so there is no lingering in happy nappy time.

My wife had a colonoscopy last year that put her in the hospital for five days after emergency abdominal surgery to repair a perforation done by the gastroenterologist who performed the colonoscopy, and he wasn't even trying to remove a polyp. He just fucked up doing routine scoping. He wasn't a rookie. He had been performing 10 procedures a day for fifteen years with only one other similar incident. Maybe that was the problem and he needed a break.

There are risks in the procedure as in any medical procedure/surgery. I was surprised to find out that nationwide the perforation rate is about 5%. Most of those occur in the process of snipping a polyp.They keep that statistic on the down low. I still think it's worth the risk for most people because colon cancer is common and largely preventable/curable if found early.