UKH

At the tender age of 55, a letter arrived this morning.

I am to be invited to an NHS appointment where "a specially trained doctor or nurse puts a thin fexible tube (& some carbon dioxide) into your anus and looks inside your large bowel using the tiny camera" (a.k.a. bowel scope screening or fexible sigmoidoscopy screening)

I suddenly feel rather alone.

Does anyone have any advice / gotchas / pros & cons / resources to read.  It seems I'm now on the start of a conveyor belt of testing having reached that age.  There'll be more at 60 (faecal immunochemical) and no doubt other NHS reasons to be poked and prodded for my protection.

I am happy, and healthy, and active and a just a teeny bit ambivalent about this testing.

In reply to yorkshire_lad2:

Take something to bite on.

In reply to yorkshire_lad2:

Had one of these a few years ago, it's nothing to worry about. They'll give you an enema to clear you out, insert camera and have a look around and then you can go home. You'll even be able to see it on the screen. It just feels strange.

You might feel a bit bloated and need the loo for a short time afterwards.

There's a tiny risk of a perforated bowel, which requires surgery to fix, but it's more of a standard disclaimer than anything else. The surgeon that did mine said it had only happened twice in his career.

In reply to yorkshire_lad2:

The surgeon that did mine said it had only happened twice in his career.

Did he mention you were the third one he'd ever done?

In reply to yorkshire_lad2:

(Speaking from my experience of Italian health service screening...very positive)

I had to a give stool sample...they found blood or whatever...called me in for the "tube up the bum"...worst bit was having to drink I think it was 4 litres of some concoction to give me full on diarrhoea...towards the end I was "peeing out me bum". (more info than everyone needs I'm guessing). The tube-up-the-bum part was totally fine. They found I think it was 4 polyps which they removed. My doctor friend said it was a good result that I'd been called in for the bum scope because the standard screening isn't infallible and I can now rest easy for the next x number of years knowing they've removed all my polyps. I did have a nasty burning sensation in abdomen for a day...I guess it's caused by them cutting out the polyps.

So...as my doctor friend said, think of it as a good result that they're going to give you "the full treatment".

In reply to yorkshire_lad2:

Do you need to take picolax the day before. If so the picolax experience is likely to be more memorable. There are some amusing anecdotes on the internet although maybe not that amusing if you are likely to be consuming the stuff.

You might want to take some ear defenders to the exam as you'll end up farting like a pit pony.

In reply to Ian_Cognito:

Did he say how many times he had had it done to him and whether or not it was a real nurse that carried out the 'procedure'?

In reply to Removed User:

I have no memory of what product I had to take but I do know that drinking vast quantities of the stuff at regular intervals was the worst part of the whole experience. 

In reply to yorkshire_lad2:

I had this last year; as a good friend who routinely ignored this sort of stuff had died of complications following an operation for bowel cancer a year or so previous, non-attendance wasn't really an option.

Treat it and the people performing it for you with good humour and you'll be fine.  The most awkward bit for me was lying on my side trying to get the enema suppository thing up my jacksie at home beforehand, and even that was a source of amusement later on.  

T.

In reply to yorkshire_lad2:

A good book to read is The Patient Paradox. This explores screening (amongst other things). The chapters on screening discuss how investigating people with no symptoms of disease may seem like a good idea, but there are downsides to be considered too, such as further unnecessary and intrusive treatment.

In reply to yorkshire_lad2:

I've had a camera up my arse and down my throat and I'd choose to have it ten times up the arse before I let them near my throat again.

But the subsequent farting will be mighty.

In reply to yorkshire_lad2:

You don't have to go to them!

In reply to yorkshire_lad2:

I had a BMW driver attempting to do the same thing to me on the M62 this morning 

In reply to Tom Valentine:

you can say that again.

strangely, the one up my nose and down my throat which I thought would be horrific was a doddle

In reply to Tom Valentine:

I hope they cleaned it before putting it down your throat.

In reply to yorkshire_lad2:

Don't worry about it, it's fine.  With any luck you'll have a dirty great TV screen in front of your face so you can have a good luck as well.  Proud to say I was shiny and pink and clean as a whistle, competitive to the end, as it were!!

Some people pay good money for that sort of thing.

In reply to yorkshire_lad2:

Man up, it's a fairly small tube and a bit of air, not an Extra-Large Anal Invader.

It isn't very comfortable, but nothing worth getting worked up about, and as Tom says above there is the consolation that you'll get to do some particularly impressive farts afterwords.

In reply to Removed User:

Certainly more unpleasant than the procedure itself.  Not as unpleasant, however, as what you have to take before a virtual (CT) colonoscopy.  That's something called gastrografin which explosively empties your entire GI tract at the same time as coating it with contrast medium so it shows up clearly on the CT scan.  And it tastes like death.  It really reminded me of the bit in Harry Potter where Dumbledore has to drink Voldemort's fiendish potion to reach the horcrux.  I got my son to make me drink the later doses.

If you want the full experience be sure to ask for the CT angiography too.  During the process they inject you with another contrast medium that amusingly makes you feel as though you've pissed yourself.  Just when you'd got used to the idea it couldn't get any more humiliating.

All worth it though.  I imagine it's a walk in the park compared with having your bowel resected because of cancer.

In reply to yorkshire_lad2:

I've had full colonoscopies both without sedation and with sedation, I would never do it again without. Get the drugs!The ghastly salty orangey laxative you have to force down is the worst part by miles if you're knocked out.

Last Friday I had the down the throat version attempted with a throat spray on recommendation of charming nurse, worst three minutes of my life before they agreed to stun me, get the drugs!

In reply to Removed User:

Ah picolax. 

That means time for the infamous singletrack picolax thread.

https://singletrackworld.com/2009/02/the-picolax-thread-returns/

Fair warning, you may cry with laughter... 

In reply to yorkshire_lad2:

It is interesting that the NHS in England appears to be doing this type of screening via colonoscopy, whereas in Scotland the same thing is done by testing your shit for traces of blood.

I know somebody who had a positive in the Scottish test and, on subsequent detailed investigation via colonoscopy, was told that the anomaly found was so small that it would probably have been missed in a routine colonoscopy screening. So ever since then I have been wondering which type of screening is overall more effective. Certainly, the Scottish one requires fewer resources, and seems easier to scale up.

To the OP: I suggest you take it like a man - early detection of any form of cancer is very good idea.

In reply to Dave Garnett:

Angiograms are such fun. You’re told that after the procedure you need to drink lots of fluids. Why? Because the dye they inject you with is toxic and you need to flush it out of your system. Oh great, so I have a bad heart and now I’m being injected with a poison. It’s an odd feeling laying on a high tech bed watching a bunch of monitors showing a wire being threaded through your heart. Normally they insert the probe into your arm and after the procedure you wear an inflatable cuff that gives the hole in your artery time to heal. But not the last time. They couldn’t find the artery in my arms (perhaps those arteries had got wise to what was coming and were sensibly keeping a low profile) and so they had to go in via the groin. Talk about loss of dignity.

So they had a good look around my heart and great news, the aneurism that had formed around one of my stents was almost gone. And we’re off to recovery. As they can’t use the cuff on my groin I am told to lay flat on my back and try not to move for a few hours. About two hours in I’m still flat on my back and I need a pee from all the fluid I have had to drink. Before I can get hold of a nurse there is some excitement further up the ward which is keeping everyone busy. I’m doing my best to hold it in but can feel wetness, oh great, now not only do I need to get the nurse to show me how I am supposed to pee laying down but I’ve pee’d myself as well. Eventually a nurse come around and asks how I feeling. So I tell her that I think I have pee’d myself. She says ‘let’s take a look’ and starts removing the bandage things around my crotch and I’m watching her. Suddenly her face is covered with blood and its squirting all around the cubicle. All I can think of is ‘that’s mine and it’s escaping’. So now instead of having to expose myself to one nurse there are about 6 fiddling around my groin and the clock is reset for another couple of hours of having to lie still while they try and clean me, the bed and the cubicle.

At least during my last visit with the cardiologist she said that as the aneurism has gone down and I’m feeling fine (well as fine as you can with the meds I have to take), that they don’t need to see me anymore so no more Angiograms for now.

In reply to yorkshire_lad2: 

I do the same procedure and have had one done (not screening but symptomatic investigation) so know what it feels like. 

There is evidence for a 40% reduction in the risk of dying from bowel cancer with Bowel Scope as pre-cancerous polyps can be removed or early stage cancer picked up and sorted. This, at the expense of an enema and 15 minutes of what feels like indignity. Being the other side, it's not undignified, it's a straightforward and important test. 

Better to get it done when asymptomatic and most likely normal, or some minor interventions are required, than the other. 

Hope all goes well with you. 

In reply to yorkshire_lad2:

To echo everyone else, it's important and not that bad. The stuff they give you to clean you out is startlingly effective but nowhere near as unpleasant as diarrhea from the more usual sources. 

Just make sure you have plenty of reading material or some other form of entertainment - you won't stray more than  about three feet from the porcelain for a considerable amount of time so avoiding boredom is the main thing.

In reply to MJAngry:

I'll add to your warning that not eating while reading it is to be advised due to the risk of choking.

Possibly the funniest thing on the Internet! 

In reply to yorkshire_lad2:

Its all very straightforwards, don't worry, I had mine in Sheffield, stuff is posted to you in advance with instructions. Procedure is quick and painless.

In reply to Rob Parsons:

We get the shit screening in England as a matter of course beyond a certain age, done postally every couple of years.

In reply to Tom Valentine:

Oh right, thanks.

In Scotland, it's offered every two years from the age of 50.

In reply to Mark Edwards:

Mine was more interesting than anything else.  For me the worst part of of any of these procedures is having the cannula inserted (hate needles, despite having inserted plenty myself).  Since they put one in anyway (for sedation, muscle relaxant, extra pain relief as required) it's no extra trouble and the sensation of the contrast medium surging round is interesting.  And you get to see a 3D picture of your bowel including all its blood supply!

Yours was a different procedure and a different experience but I'd like to say that, despite the inherent humour, colonoscopy is pretty trivial and can save your life.  And the expert team performing it really have seen it all before!

In reply to Dave Garnett:

I have had the pleasure of a couple of them (we have a family tradition of being killed by bowel cancer) and on my dad's recommendation I refused the sedation twice. No pain or discomfort and you don't feel sick and can drive home afterwards, whilst trumping like a trooper.

It's also fascinating to watch and discuss with the consultant as you get a tour of your body - up to my appendix I think they got. 

The worst part is indeed the pre-hospital preparation which involves taking laxatives and not eating for about 24 hours. As others have said, these can best be described as "most effective"

In reply to Mark Edwards:

Good Lord.

In reply to Dave Garnett:

When I was told by my cardiologist that he thought I should have what turned out to be my last Angiogram, I asked if he thought it was really necessary. I told him that I found that part painful and he said I shouldn’t feel anything because of the anaesthetic. I said I didn’t remember any anaesthetic. I was told it was the wipe they use before inserting it. I thought that was just an antibacterial wipe. He said he understood because he was the same i.e. it takes a while for it to work on some people. So just before they put it in the nurse said to say every time I could feel a tap on my groin. Yes...Yes...Yes...Yes... then the nurse said “done”. Perhaps if they made a point of telling you that they were putting anaesthetic on, then either the placebo effect would kick in or you could tell them it didn’t work.

In reply to yorkshire_lad2:

My elderly mother had a colonoscopy and benign polyp removal. She spends part of the year in India so had it done there and relayed all the gruesome details to my father and other relatives who were back in the UK. The problem was, she is a drama queen and described it vaguely to them as a “cancer procedure”, “getting the bowel surgeon in to remove things” and so on and so forth making it sound like she’d had an incision in her guts to take half her insides out. At some point I started reassuring him, saying her flight back home was in six weeks so he would see her fairly soon.. he said “Uh, doesn’t that assume she has recovered well enough in the next six weeks to travel? She might not be up to it by then!” At that point I nearly spit my drink out and said “I have had the same procedure myself. I was told to take a half day off work and then I was absolutely fine for a full day in the office the next day.”  My father was a bit less worried after that.

In reply to yorkshire_lad2:

I had this done.  It was such a disappointment after reading the Picolax thread.  I was hoping for a good story at least.  The new rinse you out drug is weak, I've had worse curries and I think the tube and camera are tiny now.  I didn't even bother with any drugs (I'm not afraid or nervous in hospitals though, nice and relaxed!!).  As an engineer I found it fascinating but rather stumped the group of nurses, 3-4 women clustered around me, when asked if I had any questions mine was.  How are you imaging that?  They had no idea (as you might expect it not really being a medical question)?

Huge disappointment, nothing to worry about (hopefully).

Good luck.

Cheers

Toby 

In reply to yorkshire_lad2:

Firstly good luck.

Secondly have you considered how you will mask your unwanted erection during the procedure?

In reply to TMM:

That made me laugh!

In reply to yorkshire_lad2:

Just remember to keep breathing when the colonoscopist turns on Wagner’s Ride of the Valkyries (The Ring Cycle) and drops the lights.

also it’s normal to applaud once the performance is over.

In reply to TMM:

I always find that more worrying in a one to one digital rectal examination. 

In reply to Mark Edwards: I think you post has just encouraged me to take extra care of my heart health, especially the bit with the escaping blood, it must have been quite alarming. I don't sleep well enough and eat more sugar than I should (diabetes hypo treatment), which can both be factors apparently. I do cycle everywhere, but one never knows, it's probably good to aim to be 'more active' wherever one comes on the spectrum. 

In reply to Timmd:

Nobody knows what genetic factors are in play. I was told (whilst in an ICU bed) that it probably wasn’t due to anything I did yesterday, last week, last month or in the last 10 years. It could well have accumulated over events 20-30 years ago (although the previous day had been especially stressful).

In my 20’s I never expected to live very long (long story) and lived accordingly. Now I am pushing 60, boy, am I pleasantly surprised.

Live every day as if it was your last, as someday you will be right. But at least you will have fun getting there.

No, it wasn’t alarming at all. After all, where better to have a medical crisis than lying in a bed in a teaching hospital.

Sleep, LOL, in my 20’s/30’s 3 hours was considered a luxury.

In reply to Mark Edwards: Apparently the distance between your knuckles is meant to be an indicator of heart attack likelihood, and mine are 'miles apart'. I was self destructive during my teens, and knocked that on the head by the end of them, including smoking, and have been pretty healthy since then, except for developing type 1 diabetes. I have always been active, if I can sleep more and eat more greens and fruit, I'll focus on that and put thoughts of mortality to the back of my mind. The first thing I was asked by the diabetes specialists was if I'd been very stressed, which I had been so that was interesting, which marked a changed in how I try to live, in trying to be calmer about life in general. Living each day as if it were my last seems kinda stressful, but living life more fully I can embrace (which is possibly what is meant by that).

There's information about the 'blue zones' around the world where people have longer and healthier lives, which I keep meaning to look into, I gather that being active as an integral part of daily life (rather than sporadically in going to the gym) and having a sense of community or connection to other people, as well as enough sleep are common themes, and eating healthily along certain lines are all common themes, cooking from scratch is involved in all cases too 

In reply to Timmd:

just checked on a bunch of other indicators for easy diagnosis of heart problems to go along with knuckle size and relative length of index/ring finger: while I would probably accept that blue lips is a bit worrying,  I wouldn't panic if I had a bit of an indentation in my earlobe.

In reply to Tom Valentine:

Just make sure the doctor hasn’t got a hand on each shoulder during the procedure 

In reply to kevin stephens:

I worry more when the dentist has his knee on me as he needs more force as he pulls a difficult tooth - this really happened to me a long time ago!

In reply to wercat:

I usually grab my dentist between his legs before he does any 'work' on my teeth and say "we aren't going to hurt each other are we?" 

In reply to brianjcooper:

His name isn't Harper is it?

In reply to brianjcooper:

https://illinoishealthagents.wordpress.com/2008/04/23/the-farside-insurance...

In reply to yorkshire_lad2:

I have this every year! (Wish it was ever ten!) It's fine, just leaves you a little bloated at times.

In reply to yorkshire_lad2:

Many thanks for all the useful and helpful advice.  As expected ukh came up with some positive and supportive ideas.