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Three Cheers for Preventive Maintenance


I have technically been out of the office this past week. Unfortunately, I have not been on vacation but rather taking care of unfinished business in Lancaster County, which includes seeking a buyer for a home here that I will miss. I am writing from Marietta, PA, where I am currently between two preplanned maintenance visits. I just dropped my truck off with a trusted mechanic who will oversee an inspection and scheduled changing of the spark plugs and transmission fluid. And, speaking of preventive maintenance, I had my third colonoscopy on June 10, and I'm only 48 years old.

Due to a family history of colorectal cancer, I have to be knowledgeable, defensive, and proactive about the disease. Thanks to cancer crusaders like Jan Bouse-Stoddard of New Albany, the recent Wyalusing Relay for Life honorary chairperson who was also one of many supporters of more accessible colorectal screenings for all Americans to march on Washington, DC almost 15 years ago, my insurance company acknowledges the value of early screening for people like me and helps a little bit with the cost.

When I was 42, my family physician here readily agreed with my father’s suggestion that I schedule my first colonoscopy. I scoffed at the notion at first, asserting that my healthier-than-average lifestyle, which has always included regular exercise and a well-balanced diet with plenty of fiber and water, would significantly reduce my chances of getting colorectal cancer, even though I couldn’t deny that some form of the cancer is likely to at least flirt with most of us in our lifetimes. I scheduled the procedure and found my employers to be fairly cooperative and understanding about the approximately 30-hour stretch of time needed to properly prepare for the event. The first time I went through it, I considered the purification process to be a moderate inconvenience and the 90 minutes spent at Lancaster’s primary gastronomical specialists center to be educational. After briefly arguing with the staff members as my anesthesia wore off that I didn’t believe they had actually done anything, I was shown some unattractive photos of my perfectly healthy intestinal tract. I was told to come back in five years.

The center mailed me a reminder at age 47, and I quickly set myself up for what I was sure would be another routine procedure. This time, however, the doctor informed me that he had found two polyps and a “fold,” the latter of which was of particular concern because such abnormalities in the lining of the colon are “breeding grounds” for cancer to take hold. It was a wakeup call that I took seriously. As I waited for about a week for the results of my biopsy, I researched colorectal cancer to get an idea of what I was up against should the test results be positive.

A cursory scan of the symptoms directly associated with the function of the colon offered some relief, as I had never experienced some of the things on the list, such as blood in the stool. As for the remainder of the symptoms, which focus on changes in bowel habits, I had never experienced any in the long term. Reading over the list of “systematic” colon cancer symptoms, which include unintentional weight loss, loss of appetite, unexplained fatigue, nausea or vomiting, low red blood cell count, and jaundice, also gave me the sense that I was OK, which was confirmed by a much-anticipated call from the doctor’s office. The caveat, however, was that I now had to return in a year—rather than in five years—because of the fold.

Obviously, I was relieved to learn that the polyps were benign, but I remained concerned nonetheless because I had also learned about the importance of detecting colon cancer—and all other forms—as early as possible. If left untreated, colon cancer begins to grow into the muscle layers underneath the lining of the bowel. From there, it spreads into the lymph nodes and becomes incurable. While the specialists confirmed that my diet and exercise regimen are right on target for a man my age, the colonoscopy has become my lifeline for prevention of this one disease.

I approached last Friday’s procedure with a bit more concern than in previous years, and, perhaps because of the added anxiety, the preparation period seemed more drawn out and more uncomfortable. The procedure itself was seamless, and I was happy to hear that my “fold” had evened itself out and I had only one new “normal-looking” polyp, which was removed and sent to the lab for a biopsy. Despite the good news, a quick torso twist in the wrong direction that evening brought about some pain, some swelling, and brief panic. I fell asleep with an icepack over the affected area, and the discomfort has eased considerably.

Given the post-procedure pain and the fact that I am still producing polyps, I’ll admit that I’m a bit unnerved by the fact that the doctor doesn’t think that I need another colonoscopy for five years. I countered with a suggestion that I return in five years, but it apparently isn’t negotiable at this point. What I will have to do is to keep the symptoms in mind and alert my family physician if I feel that anything is wrong. In the meantime, I strongly recommend any readers with a family history of colon cancer to speak with your own family physician and determine whether the time is right for your first colonoscopy. To learn more about the disease, readers may log on to www.cancer.org.

Oh yeah, the truck is doing well too. Hooray for preventive maintenance.



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