Colonoscopy

     I’ve been to the Mountain!

     Like many journeys in life, my journey began before I knew it.  The first steps were into the pharmacy, unless you want to take the long view of things.  In the long view my journey probably began years ago when I began taking Synthroid or a generic substitute.

      I had called in a prescription refill, but when I went to the desk to get it, the pharmacist said, “We can’t refill it.”

       “But it says one refill by 4/14,” I said.  The pharmacist scrolled around on the computer.

      “No.  Before 10/13,” he said.

      “You sure?”

     “Yes.”

     “Now what do I do?”

      “We called the clinic.  They’ll let you have five pills, but they want to see you.”  I took my five pills and went home.

      Jill answered when I called the clinic.  Yes, she knew all about it.  Kyle wanted to see me, but first I needed lab work, a thyroid test.  “Come by the office and pick up the lab order.  Then we’ll make you an appointment with Kyle.”

      “But I’ve already made an appointment with the county nurse to do the blood draw Tuesday.”

     “Well, whatever.”  So I counted pills.  With the ones in my old folks pill container, you know the one, long rectangular with seven compartments with lids marked S, M, T, etc. with brail, too just in case you lose your glasses, and the emergency pills in two bottles in my shaving kit, and the five new ones, I can go for eight days.  That will be five days after the county nurse’s “blood draw.”  Two or three times a year they offer blood tests, a whole bunch for $70 or less depending on what you get.

     I’ve always kept an eye on my glucose just so diabetes can’t ambush me.  At my age you want a PSA too to ward off prostate cancer, and of course the thyroid one.  Then there was the calcium one.  Premature gray guys are susceptible to osteoporosis.  I took calcium for a few years.  I quit after the last blood draw and I wanted to see if it made any difference. (It didn’t.)

     I called Karla, the county health nurse.  (Karla and Jill are both former students of mine.)

      “Karla, how long will it take to get the results from the blood tests?”

     “Sometimes we have them by Thursday, but it takes a week to get the results out to everybody.  Why?”  So I explained my predicament.

     “I don’t want to get tested twice if I don’t have to.”

    “No need to.  I’ll call you when the results come in.”  So I went in Tuesday morning and got my blood drawn.  I hadn’t heard from Karla by Friday, so on Monday I called.  Karla wasn’t in, and her secretary said they didn’t have the results yet.  I had one pill left. 

    “Will you have her call me when she gets in?”  Karla didn’t call for a couple of hours, but when she did call, she said, “Your blood test results are in.  Do you want me to send them up to the clinic, or do you want to pick them up?”

     “Why don’t I just pick them up and take them up myself.  Then they can tell me what they want me to do.”  And I did.  Jill said she would show them to Kyle.

     Later that same afternoon, Jill called back.  “We’ve called your prescription in and you can pick it up anytime.”  No rush.  I still have one pill left.  “But Kyle still wants to see you.  When would you like to come in?”

      Now the journey is on for real.  The mountain which has been below the horizon is just about to peek above it.

      I’m new at this Medicare business.  I thought the yearly checkup was optional.  Well, not if you have to have a prescription renewed.  Much later I would see where I took a wrong turn in this maze of life.  I should have said Kyle is pretty busy so why don’t I just see Doc D?  Doc would have looked at the lab reports, asked about my home brewing and then would have said, “You feeling ok?  Well, you look OK.  We’ll just renew your prescription for another year.  I really think we should start a microbrewery.”  End of exam. 

        But no, I went to see Kyle.  His physical was cursory.  The nurse had taken my vitals and recorded them.  He looked at them, listened to me breathe and to my heart beat.  Then came the questions.

      Have any problems?  Still sexually active?  Depression?  Use alcohol?  How much?

     “A beer a day.”

     “Keeps the nagging wife away?”  You have to like Kyle.

     But then the IED along the side of the road, that which caught me totally off guard, blew up right in my face.  “When did you have your last colonoscopy?”

       “Er, ahem, um.  Never had one.”

     “Never!?  You’re how old? 66?  You need to have one.”  There followed the lecture, colon cancer 100% curable if found in time, if you wait for symptoms, too late, etc.

       “Look, one shitty day in exchange for knowing you don’t have colon cancer and you’re good to go for ten years.  Do it again when you’re 76.  Ten years after that, you’ll be 86 and by then who cares?”

      Yeah, yeah.  I was weakening.  How could I have any resolve?  I was completely ambushed, taken totally by surprise.  Then came the clincher.

       “Besides, when the doctor does your colonoscopy, he’ll check your prostate and I won’t have to do it today!”

       Isn’t it completely human to avoid immediate pain by putting it off to some indefinite future time, especially when you’ve been caught so sudden-like, without time to do any serious rationalizing?  I’m sure all of you would have said, “Oh, let’s just go ahead and check my prostate today and not worry about the colonoscopy.”  Yeah right.

     Anyway, do you see that mountain now?  Do you see how we humans stumbling along through this maze of life, tying to take the path of least resistance as Nature programs us to do, get trapped into climbing a mountain while all we wanted to do was to stay in the valley or on the plain?  Or keep your thyroid going.

      Or do you only see a mole hill magnified several million times through the lens of a paranoiac, an anal paranoiac at that?

    Well, one man’s mole hill is another man’s mountain.  On with the story.  The clinic called again, Lindsay, another former student.  “We have a procedure (procedure?) scheduled for you on January 16.”

     “I have a pretty busy day scheduled for the 16^th.”  Well, we did have a clinician coming in from Denver to work with the barbershop guys.  Couldn’t miss that could I?

     “How about the 23^rd?”

     Nothing on the calendar for the 23^rd.  Darn!  Now there is.

    “23^rd is ok.”  Amazing how easily a person of conscience can break the 8^th (if you’re Lutheran) commandment.  It was anything but ok.  But there it was.  The “indefinite” in “indefinite future” was gone.

     Lindsay called again on the 16^th (just to see if I really was busy?).  I need to make an appointment to see Kyle, then see her either before or after, and be sure my insurance information is up to date.  Life?  Or health?  I didn’t ask.

      This time Kyle had only one question.  “Are you going to chicken out on me?”  I’ll bet Kyle is a great fisherman.  Hook is set, 150 pound monofilament line, heavy duty reel.  He just as well have said,  “I dare you.” 

     Off to Lindsay, fill out the usual questions (ever had this, or that? Allergic to anything?), and get a packet of instructions with the blanks filled in.  Pick up the prescription at the pharmacy on Tuesday and follow the mixing instructions.  On Wednesday you will be on a liquid diet.  You can have coffee (no cream), tea, soft drinks and Jello, etc.

      Sure enough, Tuesday got here, though I was hoping it wouldn’t.  The pharmacy gave me this big plastic bag that weighed hardly anything at all.  The lady standing at the counter with me, a rather religious lady who used to be an aide who worked with visually impaired in my classes, says, when they handed me the bag, “Whoa!  Looks like a fun time for you!”

     “What?  The plastic bag didn’t fool you?  I just as well have gone to the liquor store if you already know what’s in the sack!” 

     “I know what’s in the bag!  Ha ha ha.”   So did everybody else, apparently.  Home and read the instructions.  In the bag is a one gallon (4 liter) plastic jug with some powder and crystals in it.  Fill it with water, shake it up until everything is dissolved, put in the refrigerator.  Easily done.

      Not too much time to worry about it Tuesday.  That night we went to see “Church Basement Ladies.”   Then it became Wednesday.  No solid food.  Liquid diet.  Follow the instructions on the jug.  Drink a tall glass (8 oz.) every ten minutes.

    Out to the walk-in refrigerator, also known as the garage.  Return with jug.  Pour out a tall glassful.  Flitting through my mind, the last scene of Socrates’ life, the one where his now-friend and jailer tearfully brings him the hemlock and gives him his instructions.  “Drink this down, then walk around until your legs feel heavy.”  It was a few minutes past eight.  Here’s to Socrates.                                    

    Ten minutes later I tried another dose of the sennaic hemlock.  My stomach wasn’t big enough for that second one.  The Lindsay papers said about every 45 minutes.  Well, that would take too long.  Just drink it as fast as you can.

      Soon, my time was taken up between going to the kitchen to refill my glass and to the bathroom.  A few minutes before noon, I drained the last bumper.  I handed the empty jug to the Goodwife on her way to the recycle center.  It was number 2 plastic.  Appropriate.

     If you don’t look back, it’s hard to tell how far you’ve come up the mountain.  In retrospect, by 2 p.m. when things slowed down considerably, I had scaled the steepest cliff.  I couldn’t know that then.  I still had another 12 hours of liquid-only diet and 10 to 12 hours of nothing at all to eat or drink.

     One can of fat-free chicken broth, one can of fat-free beef broth, one packet of dehydrated soup, about a quart of grapefruit juice was what I “ate.”  I couldn’t help but sympathize with all souls in the world who were involuntarily fasting, especially kids, as I crawled into bed Wednesday night.

     Then it was Thursday, summit day.  The alarm was set for 6:45.  I awoke at 6:30, crawled into the shower and waited for 7:30.  Take one step at a time and we’ll get through this.  A look at the thermometer as we stepped out the door, 5 degrees F.

     Lindsay is at the front desk at 7:45.  Here comes Jolene, another former student, to take me to my room.  “You have a roommate.  I think you’ll recognize him,” Jolene says.  There already in backless gown, IV in left arm, waiting was my 20 year colleague, football coach, AD, PE teacher Dan.

       “I didn’t think things could get much worse,” Dan greets me.

      “Yeah, we’ve really hit bottom.”

      Jolene hands me a rag and says, “Here’s your gown.  You can change in the bathroom and put your clothes in this closet.”

      I have to walk past Dan’s lounger to get to the bathroom.  “Close the door.  I don’t want to see this,” he says.

    “Not in the mood for a strip tease?”  After trying to tie the neck string of the gown with it on, I finally took it off, tied the string and put my head through the loop.

     “Get the ties figured out?” Jolene asks as I step out of the bathroom, juggling clothes and shoes in one hand, trying with the other hand to avoid giving Dan a BA.  “Oop, nope.  Missed this one,” as she gets behind me and ties the apron string I somehow missed.

     The nurse-anesthetist arrives just as Jolene is inserting the IV.  “We’ll try this mask on.  We’ll be giving you a little oxygen.”  Mask on, mask off.  The usual questions, any allergies, any problems with anesthesia, any questions?  No.  “See you in a little while.”

      “What are you having done?” I ask Dan through the curtain.

    “Both.”

     “Both?”

     “Upper and lower.”

    “Well, tell them to do the upper first.”

      “OK.  Why?”

      “You don’t want them cramming that thing down your throat after they’ve used it on the other end.”

      “They don’t use the same one,” Jolene says.  “The one they use on your stomach is smaller.”

       Eventually, the surgeon comes in, apologizes for being late, forgot to set his alarm, asks Dan what we’re looking for, assures him it won’t take long and he’ll know the results before he leaves.

      “And what are we doing for you, just a routine exam?”

       “Yes.”

     The Goodwife chips in, “Kyle is a good salesman. He’s keeping you busy.”

      “This will be easy.  You’ll know before you leave if I find anything.  I remember you.  I don’t remember many of the people I’ve operated on, but I remember you.”

      “Yes, you’ve dug a hole in me before.”  The truth is, he saved my life by referring me first to a urologist, and then to an infectious disease doctor who both helped me get rid of staff infection in mesh used to fix my hernia.

     “I was a bet between you and Dr. B.  He bet you he could cure me with antibiotics.  You didn’t think he could.  You lost, thank goodness.”

       “No problems with it any more?”

       “Not since it dried up.”

      “What has it been, five or six years?  Well if you ever do have any problems, I’d like to know.  You are a pretty rare case.  Well, see you in a little bit.”

       Somewhere during our conversation, they’ve hauled old Dan off.  I’m reminded of the scene in Animal Farm where they load old Boxer up in the knacker’s van and haul him off to the glue factory. 

     Now nothing to do but wait.  And wait.  I should have brought something to read.  Finally, the nurse wheels Dan back into the room.  He asks me, “You OK?”

     “Yeah, I’m fine.  How about you?”

      “I’m doing ok.  Hey, there’s a lot of our former students in that room.”

     “Having any pain?  Gas pains?”  the nurse asks Dan.

     “Yeah, gas pains,” Dan agrees.

     “Well, let it go.  The truth is, we can’t let you go until we know you can pass that gas.”

     “Maybe I should leave,” says the Goodwife.  As she’s leaving, the nurse laughs and says, “Where else can you fart and the women in the room will cheer instead of chewing you out.”

     “Do I need to come over and pull your finger?” I ask.

    “Do you have someone to take you home?” the nurse asks Dan.

     “Yeah.”

     “Who?”

     “My wife.”

     “What’s her name?”

     “Sally.”

     “Where is she?”

     “Home.”

    “I’ll call her.  What’s your phone number?”

      Then the wheelchair is in front of me.  “I’ve come for you,” the nurse says.

    “They’re coming to take me away, hey hey, They’re coming to take me away,” I quote.

    “Yup, I’m coming to take you away,” echoes the nurse. 

     “What do I do with my glasses?”

     “We’ll put them right here,” says the nurse and puts them on the table.  Down the hall we go past the nurse’s station.  I say “hi” to all my former students at the station.

     Cheryl greets me at the OR door.  “Just sit on this pad.  Now roll onto your side.”  She adjusts the pad and undoes the gown draw string, throws a blanket over me.  Around the table to my front side Cheryl asks, “What are we doing today?”

     What?  What are we doing?  Climbing a mountain?  “WE are doing a colonoscopy,” I say.  Then I think.  “Wait a minute!  What if I answer that question wrong, do I get kicked out of here?”

     Cheryl laughs, “Too late, you already answered correctly.”  The nurse-anesthetist comes in, puts a mask on me.

     “I’m going to give you a little oxygen to clear your head.”  Another violation of the 8^th commandment, but this one isn’t on my soul.  “How are you doing?”

      “I’m getting a little sleepy.”

      “That’s ok.”

      That’s it.  I’ve reached the mountain top.  A bit anti-climactic, don’t you think?

      The next thing I’m aware of is sitting back in the room in the same lounge chair.  “How’d I get my glasses on?”

      “We put them on you the first thing we got you back in the room.  Can you pass gas?”

     Action speaks louder than words, so I acted.  “That’s good,” the nurse says.  I’m little surprised that old Dan is still farting around on the other side of the curtain.  But then things aren’t all that clear yet.  The surgeon comes in to tell me I’m good.  As he’s telling Dan he’s good on the lower end but he couldn’t find anything to cause his stomach pains, I’m given my clothes and shepherded into the bathroom.  Somewhere in the jumble of events I chose a muffin and a glass of water for a snack, have to return to the bathroom because the gas-passing has gone a little beyond air. Then the muffin and water are gone and the Goodwife hands me my coat and we are making our way down the hall to the front door.  I don’t remember Dan leaving or if he was there when I left.

      Sally was there.  When she saw me she said too bad Joe wasn’t there.  The three of us retired together and were honored together by the school district.  It would be a reunion of sorts.

      Outside, it has warmed up to 9 degrees and that walk to the car sobers me up pretty fast.  Hey!  I walked out that door, didn’t have to be carried!  My backside is covered.  I can eat.  The sun is shining!  I can eat!

    Home we go.  The first thing I did after taking my coat off was throw the skillet on the burner, fry some bacon, an egg and have a banana ready for dessert.  Don’t forget the acidophilus.  The real end of this will be when things are back in working order. 

      But hey!  I’m down from the mountain!  It’s great to be back on the old flat plain.  Man is it good to be able to eat.

    I may go see Kyle again someday.  When my prescription runs out.