Wednesday, March 27, 2013

Colonoscopy - Not Always Routine

Last Thursday I went in for a routine Colonoscopy. For those lucky enough to be unfamiliar with the term, a colonoscopy is a procedure whereby a fiber optic cable is inserted into your intestines via your anus; which is a tricky procedure at best; requiring well trained hands and eyes on the part of the doctor who performs the procedure. The only thing missing from the equation is an allowance which must be made for the doctor’s hearing, which may not always be on a par with his skill in the hands and eyes department.

To be fair, I am a difficult case. I am afflicted with a defective gene called HLA-B27, and as a result of this I have several medical conditions which turn the standard procedure of performing a colonoscopy into a tricky affair. With the patient needing to be “prepped” for the procedure by the means of a very potent chemical which makes Ex-Lax sound like a Hershey’s Kiss, the preparation can leave the patient devoid of any of their daily medications, and even open to dehydration. Such is the case with me.

Because of my medical problems I have always felt it incumbent upon myself to make these concerns and needs known well in advance; just as I did with this “procedure”. I even wrote my concerns in large block letters on each of the myriad of forms I was required to fill out prior to the event. So, in essence, everyone concerned with the performance of my colonoscopy had a veritable road map, if you will, of my medical problems, as well as any concerns I had about the course of my treatment, which was scheduled to last 3 hours, start to finish. Those concerns included extreme pain, dehydration, and the possibility of perforating my colon, which is one of the things that killed my mother.

7 hours and 45 minutes after entering the facility where my colonoscopy was being performed, I was released with my blood pressure 50% higher than normal; dehydrated; and with a bruised colon. During the procedure the doctor had come close to perforating my colon and I was rushed into another area of the building, with the doctor running alongside my wheelchair holding my IV aloft. He looked as white as a sheet at a Klan rally, which did much to ease my concerns and fears.

Some x-rays were taken and there was some whispering between the doctor and the x-ray tech before the tech insisted on having a real opinion of the x-ray rendered by the Resident doctor on call. This was done very quickly and it was decided that my colon had not been perforated, which would have resulted in a need for the same type of surgery which began my mother’s march toward death. So that was good.

The reason I am writing this is to help dispel a troubling concern I have about these procedures being done at an alarmingly increasing pace, with no regard for the individual patient and any special medical needs which our rapidly aging population may require. There seems to be no criteria for the impaired or special needs patient when it comes to a colonoscopy.

My advice; for what it may be worth; would be to perform this procedure in a hospital, where the patient can be “prepped” while attached to an IV, with any applicable daily medications infused through the IV. The patient can also recover from the procedure without the threat of having to be transferred to the hospital if they don’t “wake up.” That is exactly what happened in my case; I was scolded awake, in extreme pain, dehydrated, and being yelled at; threatened with hospitalization unless I “woke up.”

Millions of these procedures are performed each year without any problems at all. While this is laudable, it has also ushered in a sense of complacency which is completely at odds with the severe complications that may arise when dealing with a patient who is both elderly and compromised. And, it is especially galling when you have provided a “road map” showing every concern and pitfall which might be expected while dealing with your body.

The doctors who perform these procedures, and the staff who support them, all have degrees and certifications in their fields. And I respect those as emblems of their knowledge. On the other hand, I bear every scar and mark of trauma from anything which has ever happened to me. In that respect there is no greater authority on my body than I. You might say that I hold a Post Doctorate in being me. The only thing which I ask is that this knowledge be granted the same respect as I grant theirs.

Interesting note; the people at the facility where the doctor performed my procedure have called me, apologizing for the problems which occurred, and asking how I was doing. The doctor fled the scene faster than the assassins in Dealey Plaza, and in spite of a call which I have placed to his office, as of this writing, I have not heard back yet.

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