Saturday, May 05, 2012

My Mexican Colonoscopy

I have colitis, albeit a very mild form of the disease, but still, I have colitis.  My mother, my brother, and both of my mother's parents died of cancer. Colitis increases the chances of colon cancer. Colon cancer is easily treated when detected soon enough, and a killer if left too long. Keeping all of this in mind, I'm fairly good about getting colonoscopies.

Since I was first diagnosed with colitis, I have had four colonoscopies. The first three were covered by Canada's universal health care system. The one I had yesterday was not.
This is what a healthy colon looks like

Prep for a colonoscopy is worse than the procedure itself.  Prior to the first two, I took a strong laxative called Fleet. The gastroenterologist was clear, no food for twenty-four hours prior to the procedure, to drink plenty of water after drinking the Fleet, and the morning of the procedure to have nothing, including water.

Each colonoscopy required a pre-colonoscopy visit to the gastroenterologist. The third colonoscopy was a killer, I couldn't eat for two days, and the alternative laxative, used instead of Fleet, made me very ill. At the time, I had no idea why the gastroenterologist had changed laxatives, and pre-op method.

Prep for my Mexican colonoscopy was very lax. The general practitioner (GP), who treats most of the extranjeros here in Oaxaca, told me to purchase two bottles of Fleet, and to drink one bottle at 7 p.m. the night before, and the other at 7 a.m. the morning of the procedure. The procedure was scheduled for 11 p.m. Nothing was said  about food or water. The GP scheduled the colonoscopy with the gastroenterologist, but there was no pre-procedure appointment.

I wondered why my Canadian gastroenterologist switched to another type of laxative. With a little research, I discovered that in 2006 the US FDA issued its first warning regarding Fleet's potential to cause acute kidney damage. Obviously, Health Canada had followed suit. My first impulse was to cancel the colonoscopy. Then I decided to go through with it, because I found that the alternative laxative to be absolutely horrible, and if given a choice, I'd take my chances with Fleet.

I decided to follow Canadian instruction, and didn't eat for twenty-four hours prior to, and although incredibly thirsty, didn't have anything to drink the morning of the procedure. Good thing too, because the gastroenterologist asked me about my food and liquid intake. I knew I'd done good.

In Canada, with each of my colonoscopies, there was a long line of people waiting for the procedure, which took place in a hospital. We were all prepped, each of us lying on a gurney, wearing hospital gowns, with a needle stuck in one hand.  One at a time we would be wheeled into the operating room, transferred from our gurney onto an operating table, and the IV placed into the needle. A nurse, the gastroenterologist and an anesthesiologist welcomed us into the operating room, all wearing surgical attire.

When a colonoscopy was over, each patient was placed on their gurney and wheeled back into the waiting area line. After each of my Canadian colonoscopies, when I awoke, sitting on the hospital tray, there were precisely two sugar cookies and a glass of orange juice.  With the shot of sugar thoroughly ingest, I was free to go, accompanied by a friend.

 Yesterday, here in Oaxaca, I went to a clinic that looked more like a run down motel. When I arrived, a young woman was waiting for me. Looking back on the experience, she actually stayed with me the entire time. I had a personal nurse. I don't know if she is a credentialed nurse. I didn't think to ask.

As far as I know, I was the only colonoscopy patient that day. I filled out forms. It was at this point I became very nervous. Although my Spanish is good enough that I can understand pretty much anything being said to me, most of the time, I do not understand nuances, nor do I get the culture. I am a foreigner in this land, and always will be.

My hands wouldn't stop shaking. I was nervous primarily because the way things were being handled was strange to me. The doctor came out of his office, introduced himself and returned to his office.

My nurse escorted me to the washroom, where I was instructed how to put on a hospital gown. When I came out of the washroom, into a room that looked like an examining room, she and the doctor were waiting. I don't remember, but I do not believe either one wore anything other than street clothes.

We had a problem. I thought I was to lie on my stomach; apparently I was to lie on my back. I didn't know what the heck they were saying. The problem was they didn't use the words I know "estomago" and "espalda," Eventually we got things straightened out.

I closed my eyes; I do that with medical procedure 'cause I'm chicken. I explained I was Canadian. I told them how things are done in my country. Basically, the doctor said, "None of that is necessary." I told him that in general I agreed, but I was very nervous because this was not what was usual for me.

I could feel him wrapping my arm in what felt like a wooden sling, I felt the prick of the IV, and I commented on how I was still awake afraid. I was afraid of the possibility that he'd begin well I was conscious. Then I had a lovely dream about yellow doors.

In Canada the results are sent to the GP, and it takes maybe three weeks for the GP to get the result, gastroenterologist are very busy. Any of the reports that I've seen that were sent to my GP were simply in letters reporting the results.

Here in Mexico, I get results, and I keep all my medical records in a file. There belong to me.  I left the clinic with a report, a DVD of my colon, I can assure you it is very boring, and photos, which I think are stills of the most pertinent parts of the DVD.

My nurse didn't have cookies and orange juice waiting for me. Luckily I had the good sense to bring a small bottle of water, and asked for more. I was determined to get out of there, I was hungry and wanted to eat. I wobbled out the door and down the street with my friend Aome.  Oh yes, one other thing, the results were good. I have nothing to worry about. I read my repor, cancer free, and clean colon. Maybe I do not have colitis? How did it disappear?

1 comment:

Peter said...

Hi Oreen
This experience of yours made me laugh out loudly. Okay, you obviously did not think that it was very funny. So next time I get my colonoscopy here in Mexico I know what to expect - thank you.