Past Due, Part 2

BySaleh Aldasouqi, MD, FACE, ECNU

I had my colonoscopy on Wednesday. My gastroenterologist, also a good friend, called me a couple of hours ago. I had just finished my morning procedures (thyroid biopsies) and was interviewing a fellow candidate.

“It’s benign,” he started.

What relief I felt!

“Thank you,” I said.

“But you scared me!” he followed up.

“Why?” I asked.

“I got concerned when I saw the polyp,” he explained. “It was large.”

In part one of this post Past Due, I concluded: “So, now I am not sure if I am scared, anxious or hopeful; or a combination of all? I will write again after the colonoscopy, which has been way past due.”

While I thank God for this good news, I wish to thank my family for the great concern and support. As important, I wish to thank all my friends, co-workers and colleagues who sent me “good luck wishes” when they read the last post.

However, I wish to express that this story was not meant to be about me, personally. It was meant to demonstrate, in real time, what it feels like when someone goes through a health care ordeal. As a doctor, I wished to share this personal experience to express what has happened to me as a patient, so that I could relate to that when one of my patients goes through such a health care encounter.

Now that I have received this great news, and have shared it with family, friends and colleagues, let me go back to part one of this post. I wrote:

“So, in summary, I have declined colonoscopy, and now it is 9 years past due. Why have I been non-compliant? It is complicated.”

Well, I was discouraged to undergo colonoscopy not because of the procedure per se, but because of the pre-procedure prepping — the bowel cleansing ordeal!

Believe me, it is very rough.

I could imagine the roughness from talking with friends and family members; people take that variably. Some take the prepping like the worst task of their lifetime (like me), and some take it like a breeze, like many of my patients and friends.

I do not wish to give myself excuses for my shortcomings. But, I wish to share with the readers a related sad memory, which may have contributed to my non-compliance with colonoscopy screening all those years. This was my experience with my late father (1930-2008). Over a decade ago, he was hospitalized in a large teaching hospital in Amman, Jordan, with a severe case of pneumonia with complications due to diabetes with acute kidney impairment. In the process, he also had severe anemia. That coincided with a trip I made to Jordan to visit my father and extended family.

Inpatient colonoscopy was ordered for my father by the gastroenterologist, who was a friend of mine. Because the procedure was ordered on an urgent basis, my father was to undergo the prepping in a precipitous manner. I stayed at his bedside throughout his hospital stay. During the colonic prep task, which began in the evening to be completed by early morning, I was the only family member in the room, as the rest of the family went home for the day.

I do not wish to disgust or annoy the readers with the details of how rough the colonic prepping for my father was. What really struck me was that, for the first time, I saw how weak and helpless he was. Though he was in his mid-70s, my father had been reasonably in fair health (minus vision loss from diabetic retinopathy and kidney impairment from diabetic nephropathy). Prior to the diabetic complications later in his life, my father was a very strong and healthy man. He was quite a charismatic and wise man in our extended family, and the whole extended family would resort to him for advice and wisdom whenever a family problem ensues (and I have a very large extended family back home in Jordan).

During the colonoscopy prepping, my father became so weak, physically. More saddening was how weak, frustrated, helpless and overall acutely depressed he became during this prepping ordeal.

My father recovered from the illness, but about a year later, he passed away with deterioration of his diabetic nephropathy. I was in Cape Girardeau, Missouri, at the time when my youngest brother called me from the hospital. I had just started my morning clinic at St. Francis Medical Center’s endocrine clinic. He told me that “our father was at the ER, and the doctors asked if they could talk to you.” My brother said that there were more than 10 doctors in the ER room attending our father’s case. I knew what that meant. When I spoke with the doctor, he told me my father was dying, with acute kidney failure and a potassium of over 10. He passed away a couple of hours later, and when I arrived in Amman, it was too late to see him.

But the good news was that I had a very long phone call with my father just 3 days prior to this final illness. That phone call felt like it was the longest conversation I had ever had with my father. While my father had been a widower for 6 years prior, struggling with the diabetes complications, especially the vision loss, crippled him. He had seemed so happy over the phone: his first great grandson (my eldest brother’s first grandson) was expected in 3 months.

While that sad memory of my late father’s colonoscopy prepping may have left me with an aversion towards colonoscopy, it is not an excuse for my non-compliance. This time I got away with that, but I hope that this experience will serve as a teachable moment for me.