The Colossal Colonoscopy That Collapsed My Cognition

By now most of you who follow me on social media know that I am writing a new book, I HATE THE MAN I LOVE that will be released in February, 2020. Between attending to my office, clients, researching, writing and caring for my home and fur baby, leaves me little leisure time. I’m not complaining, just sharing facts. In order to stay present to my responsibilities, I must stay focused on all my self-imposed obligations. I say, “Self-imposed”, because I am the creator of my own chaos, as we all are. I have a deadline to deliver the manuscript to the publisher by the end of September. The book has 11 chapters and I have just completed 6, so I was in a pressure cooker to rev it up. The last thing I needed at this time of my life was a colonoscopy!

A few years ago Dave Barry, writer and editorialist for the Miami Herald wrote a comedic article about his first colonoscopy. Approaching my 80th birthday in October, I had my first colonoscopy since my last one, more than ten years ago. Medicare denies payment for a five year colonoscopy check-up once you reach the ripe old age of 75. I however, had the honor of having another just this week because my doc could document and substantiate my need. This qualified me for Medicare reimbursement. YUK!

Just a brief history: I’ll try to spare you the scatological details, but a little background is necessary to give you the bigger picture. I had been struggling with bowel issues for more than five years. Nothing major, mind you, however as this age, everything seems to be major. I figured after five years if I’m still breathing and living my life with these issues, I ruled out cancer. I assumed if I had it, I would have been long dead.

I had just gone thru a second and third lung cancer, treated with cyber knife six times. As of my last lung scan, the doc seemed happy with the results. Of course, its’ not over yet. I need another scan in a few more months. After the scan, I left thinking all was well—at least until the next scan. Getting old is not for sissies!

It was when I saw some bright red blood that prompted me to make the undesirable appointment with a gastroenterologist. He concluded that a colonoscopy was necessary to determine the cause as well as to find a diagnosis for my chronic bowel issues. Having taken probiotics for a few years had been helpful, however my issues were still chronic and interfering with the quality of my life. I was preparing for the prep, perhaps the worst part of the ordeal. Anyone who has ever had a colonoscopy would agree they would rather have a baby—at least that’s how I felt and I had given birth five times. To think that a delivery would trump a colonoscopy, would be hard pressed to believe. For me, it would have been a no brainer.

The Miralax was impossible. I vomited three times, certain that I would not be clean enough to have a good outcome. However that was not the case. I guess the prep was powerful enough to destroy whatever remained, even after puking my guts out. In one unforgettable day I used three rolls of toilet paper, mopped the floors of two bathrooms seven times, did four loads of laundry, took 13 showers and never slept a wink the night before the procedure. It was perhaps, the shittiest day of my life!

Good News, Bad News

I’m at the hospital at 6:30 AM as instructed. Looking like death warmed over with a bloated belly, I found my way to the out- patient facility. After I registered at the front desk I was instructed to register at another desk where I was to wait until being called. After about a 20 minute wait I was called to begin my process. By the time a nurse came in to greet me, take my vitals, history, set up an IV and dressed me in my baby blue tie back nightie, I was anxious to get it over with and even more excited to soak up the propofol. At least while some doctor was poking up my behind, I could be free of everything—the house, the dog, my clients, my boyfriend, my kids, grandkids, Trump, and last but not least, the bills. It would be too soon forgotten as I am sure you all know. Forgetting all your troubles doesn’t last long enough because when you open your eyes, you ask curiously, “when are you going to begin?”

When I was fully awake and realized the procedure was over, the doctor delivered the results.

“I’ve got good news and bad news. Your colonoscopy was fine, but you have a lesion in the cecum. The tissue is very fragile so it is too risky to remove. If I tried to take it out, I could perforate your colon. However, more good news is that the biopsy is benign, but the bad news is that it has to come out.”

In five sentences I heard good news, bad news twice. He explained that he did not feel comfortable trying to scope it out and recommended a surgeon who would remove it laparoscopically.

“Oy vey! Surgery? Why surgery especially if it’s benign?”

“Because it could convert into a malignancy or it could cause a blockage and then you would require emergency surgery.”

I sat there wanting to go back under. I tried to digest his good news/bad news but all I kept hearing was surgery. I can’t have surgery. I have a book due in September. I am taking my kids to Israel to celebrate my 80th birthday in November and I am chairing and hosting our high school 80th birthday party in November and have no one to take over my job. The temporary bank account I opened to deposit the checks from the people attending were in my name only. There was no way I was going to agree to surgery until of course, I had no options.

I decided to choose my own surgeon. I went to the Cleveland Clinic to see their colon-rectal surgeon, the internationally renowned and well-respected Dr. Steven Wexner.

Dr. Wexner explained in detail the strategy that would be necessary. They would attempt to perform it laparoscopically, however, considering that I most likely had scar tissue from previous abdominal surgeries, it may not be possible. He went further to tell me that a resection of the colon may be the only possibility. Moreover, on rare occasions, complications during or after surgery could potentially result in a stoma. A stoma is an opening on the abdomen that can be connected to either your digestive or urinary system to allow waste (urine or feces) to be diverted out of your body. Over the top of your stoma you wear a pouch, which can either be closed or have an opening at the bottom; in other words, a temporary ileostomy for approximately 3 months.

Uh Uh…No, no, no! There is no way that going to happen. I was feeling great. I was working out 3-4 times a week. I had been a vegetarian for eight years, didn’t smoke, drank occasionally and lived a very clean life. No surgery! If it ain’t broken, don’t fix it was my philosophy. I was approaching 80 and there was no way my life was going to be interrupted especially when I was feeling great–until reason won out over resistance and I scheduled my surgical date on July 24. However Dr. Wexner told me that he could potentially consider other possibilities after he received and reviewed the photos of the polyp and the pathology slides of the biopsies taken from the polyp taken during the colonoscopy.

Soon after my visit, I received a call from Dr. Wexner.

“Based on our review of your photos and the slides, I think that our gastro guy here at the clinic can scope out the lesion. He’s pretty confident that he can do it. Let’s see if we can avoid surgery.”

I always thought that if you only had a hammer, everything looked like a nail. But not so. Wexner was hopeful to try the alternative. I was overjoyed and very appreciative of his consideration and personal interest in both my emotional and physical welfare.
Long story short, I made an appointment to see the gastroenterologist. Dr. Erim was very thorough, compassionate and felt confident that he could do it. I requested something other than the last prep as I was not going to put myself through that ordeal once again.

Dr. Wexner called the next morning.

“We have to prepare you for surgery the following day just in case Dr.Erim is not successful. There is always an outside chance he might not be. It will be easier for you to undergo surgery the next day rather than having to repeat the bowel prep for a third time at a later date”

My anxiety level rose to a new high. Dr. Wexner made all the arrangements for surgery as if I was going to follow up the day after the colonoscopy. I had to have a scan of my abdomen and pelvis a few days before the colonoscopy. I was told to purchase antibiotics that I would begin taking the previous day and to buy special soap to cleanse my body. An appointment was scheduled with the surgical nurse for a stoma tutorial only an hour after the colonoscopy would be complete.

I have always been a person who looked at the glass half full—the quintessential optimist! Suddenly the glass was beginning to look half empty. I began to feel a sense of panic. Would I get through this without having to wear a bag? I went into panic mode. I made my arrangements as if I was going to die instead of having a colonoscopy. I had my daughters come over so I could show them how to find everything in case something should happen to me. I pulled out my living will to take to the hospital. I paid most of my outstanding bills and wrote a personal letter to all of my children. I even met with a high school classmate putting her on notice how to handle the high school birthday party in the event of my incompetency or impending death. Talk about drama! As days turned into nights and nights turned into days, the big day arrived. Before I knew it, I had to do the prep and be ready to go to the hospital the next day to see if they could scope out the lesion and avoid surgery.

The new prep, although somewhat better tasting and a lot less fluids than the Miralax, still made me sick. The mop ups, change of panties, showers, laundry and toilet paper were equal to my past experience. I thought the first round with the Miralax was the shittiest day of my life. This was worse. It felt like a hydrogen bomb went off inside me. The explosion could have easily installed a post- traumatic stress disorder. The thought of having a bag created an iatrogenic phobia, a phobia unwittingly induced by a physician. He was just explaining the worst case scenario so I could be prepared both physically and academically.

All this time I continued to work seeing clients which was a great distraction for me as was my writing, although it definitely made a huge impact on my cognitive functioning. I found myself numbed out often and writer’s block became my constant companion. Finally the day arrived that I had to take the prep once more within a month of the last prep. I was anxious and with good reason about the forthcoming torture I was about to endure.
I arrived at Cleveland Clinic as instructed. It was run like a Swiss train. Everything was on time and ran efficiently and smoothly, albeit I was a nervous wreck. The nurse prepared me for the procedure and I wore the same baby blue tie back gown as I had the previous month. Dr. Erim arrived with a smile and a reassuring look with words to match. My blood pressure that usually is 110-120 over 70 was 175. The procedure was scheduled for 1:00PM. I looked at the clock on the wall as they wheeled me into surgery. It was precisely 12:56.

Dr. Erim is a teaching physician so he was accompanied by his interns and residents. My ass was going viral! I had always wanted to be on center stage, so now, finally, my time had arrived. The welcomed propofol seeped into the IV the nurse had installed and before I knew it I was wide awake with Dr. Erim telling me I did great. The lesion was removed successfully. NO SURGERY! The stoma tutorial that I was scheduled to have at 3:30 following my procedure with the surgical nurse never happened. I was overjoyed! Dr.Erim won my heart as well as my ass and I went home with a new lease on life.

I must acknowledge the professionalism of Drs. Wexner and Erim. They are exemplary physicians that deserve the highest recognition of quality of care. The Cleveland Clinic is equal to their high standards. I am now looking forward to my manuscript being ready on time, the trip to Israel with my children, and the high school 80th birthday party.

The lesson learned: Live each day as if it were your last, because one day it will be!

– Joan E. Childs

Joan E Childs, LCSW is a renowned psychotherapist, inspirational speaker and author of Do You Hate the One You Love: Strategies For Healing and Saving Your Relationship. In private practice since 1978, she specializes in individual and couple’s therapy, grief therapy, EMDR, NLP, inner child work and codependency. Learn more about her services at www.joanechilds.com.