It has been approximately a year and a half since I had my second bowel resection. This morning I had my forth Flex-Sigmoidoscopy. This is a modified colonoscopy to check the sigmoid region of the colon. This is where the cancer was located the last two times. It has been a procedure on two levels. Preparation and procedure.
The preparation is different than a colonoscopy. The preparation has consisted of me taking two enemas at home in the evening and then one at the hospital right before the procedure. The idea is to clean out the the lower part of the colon so the Dr. can see the area clearly. In a colonoscopy you drink a prep that is a powerful laxative and flushes the colon all the way to the small intestine so the Dr. can get a clear view of the entire colon. Both are effective procedures for what they are intended.
The procedure is nothing. The prep is a pain. The last time I had a flex-sig my system did not react well. I soiled myself in the recovery room, I soiled myself on the way home and had to hit the shower and take my clothes off. My system does not seem to tolerate invasive inspection and I have a heck of a mess. Plus for a day maybe two I can have accidents and it is humiliating.
This time I prepped a little differently. I took a whole bottle of laxative, I think the name is Magnesium Calcitrate. It is a fairly strong laxative but not of the flushing variety. I stopped eating any solids at noon the day before the procedure. I took the laxative in two doses one at 4 PM the other about 5:30 PM. It worked, I went quite a bit and was fairly comfortable except my lower abdomen felt bloated and crampy. I took the first enema about 8 PM. I ended up going until about 1 in the morning and wore adult paper diapers because I don't have control when I am prepping.
Had one funny incident. I had plumbed the hot water heater in our trailer that afternoon before the prep. I was going over to check on the repair so I did not end up with water on the floor. I went over there about the time I thought the trips to the john had slowed down. However upon trying to return I couldn't take ten steps without heading to the toilet. I was wearying sweat pants and briefs on the bottom. You learn to wear clothes you can pull down easily when you prep. Also, tuck your tee shirt into your sweats. That way you don't waste any time fumbling with a long tee trying to get you pants down. Well, anyway, I had a couple of accidents. Soon I was reduced to nakedness on the bottom and it was raining cats and dogs out, it was cool, in the 40's and I'm stuck in the trailer. Finally my situation eased to the point I thought I could make it back to the house. It is a short distance, some 30 feet, but with few clothes on, and heavy rain and cold air on you butt the trip back was rather stimulating.
I was finally able to go to sleep about 1 AM. I figured on getting up at 3 to take the second enema. I slept in until 4, Terry woke up and started the morning ritual so we could be off to the hospital. I was supposed to be there at 5:30 AM. I got up, did the enema with good results I felt no cramping of bloating so I think my prep from the day before was paying off. The drive into the hospital was uneventful.
After checking in I was taken directly to the procedure room. No stop in the prep room, the hospital was overflowing with patients and in fact the procedure prep room was half full of regular patients because they had no more rooms. So the nurses that participate in the procedure helped in the prep. Everything went well and I was feeling good. Now usually I have to take one more enema, but because everyone was out of procedure it was overlooked and I was not going to say anything. I've had some pretty disastrous episodes in the prep room when I take that enema and I did not want to repeat. Especially since I was so far from the bathroom and so many people I had to walk/run/scamper past.
I do not take any drugs for this procedure. During a colonoscopy they give you amnesia drugs so you don't remember the discomfort.
The flex-sig is only going up a short distance and is not uncomfortable. Well, if you are a guy and had a prostrate check you know the feeling and it isn't even that bad. I was awake, the Dr. and I carried on a conversation. He did go up the colon some and ran into a dirty area. He asked if we did a prep and I said yes, I told him what I had done and asked if it wasn't enough. He said it was OK for our purposes.
The procedure concluded and I am fine. The surgeon did have an observing Doctor. Terry said she looked Indian, (SE Asia) and was quiet. I was in the same room as my doctor dictated his findings. He went on to explain to the visiting doctor my situation. I learned a few things. First the procedure shows no indication of recurrence and everything looks fine. There are some titanium stitches working their way out but no cause for concern.
The biggest information I learned from the conversation between the two Dr.s. follows. My surgeon explained that I had had an initial resection in 2007. The tumor recurred on the anastamosis which is the surgery point of the initial surgery. This type of recurrence is very infrequent. That I knew. What I did not know was that the Dr.s considered this case to be complicated and were maintaining an above average monitoring of the situation. On one hand that made me feel good. On another level it was scary. I also learned that which I suspected that the "rectum cavity" is for all intents and purposes gone. He showed me where the outer skin had been brought around into the anus to make up for the lack of internal material. The rectum cavity is a collection point. Most fecal material accumulates in the rectum and when it is full we feel that need to evacuate and so we have a BM. I don't have any storage facility so I end up going a lot. I also don't have the normal warning system. When I get that feeling I'd better get to a bathroom. That is good to know, I suspected that was the reason for my frequent BM's it also explains the low level of control I have. The sphincter muscles have been weakened by surgery and it becomes difficult to hold back the tide so to speak.
After all I learned today I am happy that recovery seems to be going well. I am happy that there are mechanical reasons for some of the issues I face. I am happy to be pain free and to feel somewhat normal. However, like many cancer victims I have times of apprehension and concern. Every time you feel a pain or a swelling you spend endless amounts of time figuring out the cause so you can convince yourself you do not have stage four cancer and only six months to live. It is a common mental state we survivors end up putting up with. I am happier than I have been in years, I feel better than I have in years. My wife notices a big change in my willingness to get projects going and to make repairs around the house. I am deeply in love with my wife. She has really been a strong support through all of this and has not shrunk back once but done things I know she has a great distaste for just to help me. She is one fine partner.
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