Vague ramblings

Bottoms Up, Sigmoid!

Posted in Life, Personal, Reason by Ian Cundell on 28 February, 2016
Bobby_Moore_Cancer_Fund

Bowel Cancer killed Bobby Moore at the age of just 51

I can say, with a reasonable degree of confidence, that there is no sweet relief quite like the sweet relief that arrives the exact moment an endoscope is removed from your bottom.

I know because this Saturday morning was spent with said endoscope up said bottom. This was only slightly more painful than, later, watching West Ham labour to a win over – a frankly not very good – Sunderland.

It was in the name of bowel cancer screening (the endoscope, not West Ham v Sunderland) and once your age hits the magic number you get the letter. A friend cheerfully admits that when his number comes up, the letter is going in the bin. But I have reasons of family history to figure that a quick poke and a prod, to make sure all is in order, has its merits.

Quick poke and a prod.

That’s where I went wrong.

You see, many moons ago, for entirely cancer-unrelated reasons I’d had another medical device – the name of which is bleached from my brain – stuck where the sun doesn’t shine and, although it was a tad uncomfortable, I didn’t feel too humiliated in front of the two winsome medical students who observed that procedure. Lucky women.

With that initial misconception outlined, let me get this out of the way: the staff at the Endoscopy Unit at Milton Keynes General Hospital are absolutely fucking fabulous. Every bit as fabulous as the A&E staff who looked after me a month or so back. That cannot be said often enough.

The thing with a sigmoidoscopy (which is the name of the procedure used for screening) is that it relies rather a lot on the area being scoped having nothing to block the view. Now, we’re all grown ups and we know what the bowel is used for, so you can figure out what might block the view.

Enema below

There are far too many puns on the word ‘enema’ for me to be bothered, but the thing I didn’t know was that, these days, they are supposed to be self-inflicted. If this is what hippy-dippy types do as ‘colonic irrigation’, then they are utter, utter morons.

Here is where my problem started. The flushy-out kit is a squeeze-bag of some magical liquid, with a tube. I am sure you can work out where the tube goes prior to squeezing the bag. The instructions were clear and easy to follow, but unfortunately it turned out that the tube was a lot more flexible than me. I did the best I could, but the results did not seem to be consistent with those predicted in the instructions (I mean, technically yes, but not – um, how can I put this?  – as Amazonian in quantity). I suspect the problem is that my daily rhythms weren’t quite in the best sync with  the timings for my appointment.

Also, I doubt my cat will ever look at me the same way again.

the staff at the Endoscopy Unit at Milton Keynes General Hospital are absolutely fucking fabulous. Every bit as fabulous as the A&E staff who looked after me a month or so back. That cannot be said often enough.

So, one perturbed cat and an unsatisfactory-feeling cleanse, and off I toddle to MK General. I reported my cleanse concerns to the lovely young lady at reception (I really should have paid more attention to names because, as I said, these people are fabulous and deserve recognition). She said it shouldn’t be a problem.

Technically she was quite right.

After a few minutes I was called in to do the paper work and a few minutes after that was sent to a cubicle to don medical gown and the fabulously named ‘modesty pants’. They are like normal chap’s pants only the other way round (think about it). After a few minutes – which seemed a lot longer – I was called into the procedure room.

Now, from my previous experience with backdoor medical equipment, the only bit of diagnostic information I could recall was “clear to 9 centimetres”. I guess that was the standard back then and was considered an all clear. Remember that.

And so the professionals attempted to begin and, it turned out, my cleansing concerns were well founded. Before I knew what was happening I was having all sorts of liquids poured into my wrong end; as this was happening I was told that I would want to go to the loo very soon. This was true.

The problem is that the distance from the procedure room to the nearest toilet was approximately 15 miles. Coming back it was only 15 feet – space-time is funny like that when you have a colon full of effluvia generators. The Amazon flowed, as if fed by a storm of apocalyptic proportions. It was strangely unsatisfying, but this may have stemmed from the knowledge that everybody nearby knew exactly was was happening. At one point the charge nurse (I think that’s the title) tapped the door and called “Are you still alive in there?” which was very funny at the time. Nobody does gallows humour like nurses.

So, suitably effluved I now had to wait my turn, since it was busy and someone whose self-cleanse had gone to plan, rather than to pot, was dealt with first.

That’s nearly an ar… no, wait. What?!

Then the short trip back to the procedure room. Remember that 9 centimetres?

I am pretty sure I heard the consultant say “80 centimetres” at peak discomfort. You can, should you be so minded, watch the progress of the camera up your fundament, and I fully intended to until the first puff of air used to make a little room for manoeuvre. If you will excuse the expression, bugger me that smarted. That is when I remembered the gas-and-air. Whoever invented Entonox should be given a Nobel Prize for Making People Not Give A Damn.

Actually, that wasn’t why I didn’t look much. Very early on I saw something that looked polyp-y to my eye and at the same time I heard the consultant say “3 millimetres” as she excised it. After that I didn’t really want to know ‘as live’. With the Entonox in full flow, I was now very much in the realm of not giving a shit (not that I could have). The only other thing of note was hearing the word ‘diverticula’ and thinking “Oh, Mum had them”. Genetics, eh?

And then came the sweet, sweet relief, which is – so to speak – where we came in. My own ineptitude at not being able to use a squeezy bottle, combined with being too slow to hit the Entonox made for an amusing yarn at my expense (I hope you will agree) and all is good (pending biopsy). One 3mm polyp removed and three diverticula noted.

But here’s the thing.

The Endoscopy Unit was pretty damned busy this Saturday (that’ll be the 7-day NHS) and it was not just people like me getting their spot checks. There were samples handed over and people asked to wait at one end, and at the other end of the line…. Well, there was more than one ashen face, and the look of stoical grimness that only those in the midst of a really bad situation present.

In early 2001 Mum had a raft of procedures including a colonoscopy which removed a “rather large polyp”, as she said to me when I phoned to check. But over the following weeks she experienced more and more pain and finally, in early March I called the surgery in frustration to see what the hold up was with the results. Dr Khan had – literally – just opened them. Mum never knew that I knew she was dying before she did. Dr Khan thought months rather than years, but it turned out to be weeks rather than months. This kind, gentle doctor was visibly shocked at how fast the cancer progressed in this kind, gentle woman.

Don’t throw the letter away.

And if things don’t seem right down there, get it checked anyway. There is no dignified way to have an endoscope stuck up your arse. But half a day of no dignity and half and hour of sucking on the Entonox might just save your life.

Just make sure you have plenty of soft fibre in your diet.

 

 


Woo, woo and thrice woo!

Posted in Irritants by Ian Cundell on 28 February, 2013

In February 1941 (so 72 years ago, near as dammit, to the week) police officer Albert Alexander was dying as result of a rose-bush scratch, his body covered in bacterial abscesses.  Because he would certainly die if untreated, he was chosen to become the first human to be injected with penicillin. Overnight his temperature dropped, the infection stopped spreading and his appetite returned.

Sadly the supply of penicillin ran out after 5 days and Albert died in mid-March. It wasn’t the penicillin that killed him, but the absence of penicillin.

One year later, with production increased, Anne Miller of New Haven, CT became the first person saved by penicillin. She lived to be 90, eventually passing in 1999.

I mention this because I saw a spectacularly fatuous link of Facebook that implied that antibiotics are poison and we should go back to eating roots, whatever that means (no link, because the one I saw might give the impression that all vegetarians and vegans are anti-science, and that is certainly not the case).

We have lost rather too many of a great science communicators over the past few years. Much as I admire the current generation – the likes of Professor Brian Cox – for their boundless enthusiasm and joy in the universe, I think an element of the ‘why’ is being lost. Why does this matter? It matters because of the countless millions who followed Albert and Anne.

We need an unbending counter to the brain-dead certainties of homeopaths, chiropractors and other such quackery.

Science proceeds slowly, one step at a time and is all-too-used to having to take steps back when promising avenues prove to be dead ends. That is its strength: it is, perhaps, the only discipline that knows that it does not – and cannot – have all of the answers.

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