My T and A Man in Here Be Dust

I told my surgeon, “I’m actually more worried about the colonoscopy than I had been about the lumpectomy.”

My surgeon is a general surgeon, but his particular skills include both breast surgery and colonoscopy. That makes him literally my T and A man.

My first colonoscopy is overdue by – *cough* – six years, but I will finally have one. I have accompanied my partner to three of her own colonoscopies. Her family medical history includes colon cancer and polyps, but her colon has been clean as a whistle, thank goodness.

She goes to a gastroenterology clinic, and I like her GI doctor very much. But my surgeon knows my body. He has operated on me twice, first to remove my tumor and then to insert my chemo port. During one of my follow-up appointments I raised the issue of needing a colonoscopy, along with my concerns, and I showed him the long scar on my stomach. My flesh puckers in over there, because of all that had been removed.

Unfortunately, I can’t get any more specific than that. I was seven years old at the time and those hospital records had been destroyed long ago (I checked). I assume I’d had a bowel resection, because I do know that my intestines had been ripped open and that peritonitis had almost set in.

Do I have internal scar tissue? Adhesions? I have no idea.

“Colonoscopic perforation (CP) is widely recognized as one of the most serious complications following lower gastrointestinal endoscopies,” writes Varut Lohsiriwat in the World Journal of Gastroenterology. “Although CP is a rare complication, it is associated with a high rate of morbidity and mortality. This unpleasant complication could result in operation, stoma formation, intra-abdominal sepsis, prolonged hospital stay, or even death.” Risk factors include “previous intra-abdominal surgery…and female gender.”

Granted, the other risk factors (advanced age, particular co-morbidities, GI problems) do not apply to me, but still. I simply don’t know how my colon had been affected by my abdominal surgery way back in 1966. As a caregiver, I have a phobia against anything that could seriously incapacitate me.

My surgeon reassured me: if anything, having lost part of my bowel should make a colonoscopy easier, leaving less territory to navigate. If anything challenges that navigation, he will back out.

Another reason I chose him to do the procedure is because he works at our hospital, not in a separate clinic. If anything did happen that required hospitalization, I’d already be on site.

I know that my fear is irrational to some degree (perhaps some large degree). “The incidence of CP could be as low as 0.016% of all diagnostic colonoscopy procedures,” writes Lohsiriwat. That’s fewer than two in ten thousand.

My lifestyle should decrease my colon cancer risk: good diet, good exercise, no smoking or alcohol, along with no personal or family history of colon cancer or polyps that I know of. My father’s first cousin had suffered from diverticulitis, but her death had come from ovarian cancer.

That said, as an Ashkenazi I’m in a higher-risk group for colon cancer, just as with breast cancer. With respect to the latter I’d had myself BRCA-tested and been negative for mutations. But other genetic mutations could conceivably make me more susceptible to colon cancer.

As my surgeon put it, people exhibiting no risk factors for colon cancer can still get colon cancer – just as with breast cancer. Both my GP and my partner have been on my case to get this colonoscopy done.

I finally feel as ready as I can be. The prep is just an inconvenience, no big deal especially when compared with something like chemo. Potential complications from my long-ago abdominal surgery were what had me running scared.

It took reassurances from my surgeon to turn me around. He’s saved my life, after all. He’s done a great job with both my lumpectomy and my port insertion. The bottom line is that he’s earned my trust, and that goes a long way toward calming my admittedly overblown jitters.

Now he’ll just get to see me from a new angle. :-)

My TinkerLab TinkerSketch Sketchbook Challenge doodles continue:

Prompt: “Stamp.” This uses manipulated imprints from stamps I had carved from erasers back in the 90s.

Prompt: “Ink Splots.” Done using fountain pen ink, Sharpies, and pastel pencils.

Prompt: “Corners.”

Prompt: “Silhouette.” Based on one of my hair growth profile shots.

Prompt: “Junk mail.” All the images in this photo collage and the text at the top are taken from scanned junk mail.

More art pieces from the challenge are here.

My partner discovered this ambitious cribellate web in our garage …

… which I then turned into this mosaic: