Preventive Medicine Column
Dr. David L. Katz
As I write this, I am just back from my colonoscopy. All went well, but I am still shrugging off the lingering tendrils of my sedation. So let’s chalk up any grammatical snafus to that, shall we?
The U.S. Preventive Services Task Force recommends screening for colon cancer starting at age 50. I am a Preventive Medicine specialist, committed to practicing what I preach, and as of last month, 50 years old- so the math here was pretty simple.
As noted, all went well. This was partly thanks to my outstanding gastroenterologist, Dr. Harry Schwartz affiliated with Griffin Hospital in Derby, CT. A good share of credit also goes to the staff of the GI suite at Griffin, where the care could not have been more professional, efficient, compassionate, or…patient centered. This is to be expected, perhaps, at the global headquarters of the Planetree Alliance for Patient-Centered Care. But expectations are not always met. These were, and then some.
The procedure was very easy to tolerate, for those who may have anxiety on that front. Admittedly, the prep is not fun. But as for the colonoscopy itself- I got my sedative, and woke up to find the procedure over, while wondering when it was going to start.
To some extent, this is thanks to Dr. Schwartz. All gastroenterologists pump air into the colon during the procedure to expand the bowel wall and allow for a clear view. Not all repeat their steps to suction that air back out- rather than leaving that work to you, courtesy of the time-honored method. Suctioning that air out pretty much eliminates post-procedure bloating and discomfort, and all that goes with it, and I thank Dr. Schwartz for such meticulous care. Since it can be done, be sure to ask for the same when your turn comes.
Things went well, also, because I brought a pretty good GI tract along with me. I take the best care of it I can, by taking the best possible care of my whole self. I eat optimally, exercise vigorously every day, have never smoked, drink moderately, try hard to get enough sleep, manage my stress, and have lots of love in my life. That’s a good recipe for health from head to toe, and mouth to…well, you know.
But, even so- I had a polyp. I am awaiting the pathology report, but by appearance this is a hyperplastic polyp or simple adenoma. Such polyps are very common. Neglected for many years, they can evolve into cancer. But unless neglected for years, they are a long way from doing so.
My good friend, Mehmet Oz, famously had similar results from his screening colonoscopy. His on-air coverage of it suggested it rocked his world, and my brief private discussion with him about it did not suggest anything different. He, too, takes excellent care of himself-and so the polyp was a shock.
I see it a bit differently. At 50, I certainly don’t have baby-soft skin. I’ve been wearing this skin in all kinds of weather for 5 decades, and there are indications of that wear and tear. A dark spot here, a rough patch there, a skin tag…well, you don’t need to know. Let’s just accept that skin succumbs gradually to age and cumulative abuses, even if cared for well. My wife loves me anyway.
Our skin is the outer surface. The lining of our GI tract is our inner surface. So it, too, is exposed to wear and tear- just from within rather than without. Therefor, my attitude is: my guts have put up with everything run through them for 5 decades. They are no less entitled to sprout a polyp, than my skin is to sprout a mole. Stuff happens.
This is exactly why screening colonoscopy is strongly recommended in the first place. Find and remove polyps at age 50, and the potential for them coming to attention as a cancer years later is eliminated. This is preventive medicine working exactly as it should. I’m glad to be a beneficiary of it.
As for the effects of my healthy living: across a truly great surface area, my innards were (I am told) in great shape. No other lesions, no other polyps, no diverticula. That one isolated, and almost certainly benign polyp is the toll of 50 years; all those acres of healthy bowel are the dividend of my on-going efforts.
And so, my conclusions: Take good care of yourself, and you will be taking good care of your GI tract. Take good care of your GI tract, and it will very probably take good care of you. But it is working hard every day, and may well suffer effects of wear and tear as a result, much like your skin. Unlike you skin, however, you’ll need expert help to have a look.
Get a colonoscopy at the recommended time and intervals and let a competent gastroenterologist turn any consequences of such wear and tear from tomorrow’s potential heartache into today’s inconsequential pathology specimen.
Dr. David L. Katz; www.davidkatzmd.com