The Thing You Don’t Want to Talk About

It’s sure not the screening of “The Final Contract!”  That was last Wednesday night. You’ve probably seen it on What Is It And How Did I Get It? Early Stage Chronic Kidney Disease’s Facebook page, but do you know it won a Gold REMI Award? If you get to see it, I play Anne Howard – a supporting role in this independent Christian film.  I’m Jewish, but have no problem with the film’s message of hope, family and freedom of speech.  These Five Talent Films are my payback for all the good fortune I’ve had since moving to Arizona (yes, I do remember I have CKD, but that is not my whole life).

According to Wikipedia, The Remi Award is inspired by the creative genius of the western artist Frederic Remington, famous for his paintings and sculptures of cowboy life in Texas and The West. [Well, that’s appropriate since the movie was filmed in Arizona.] The Grand Remi Statuette is presented for the top award in each major category. The Special Jury Awards are Grand Remi Nominees, they are the highest awards for creative excellence in each major category. Then the Platinum, Gold, Silver and Bronze Remi Awards are 1st, 2nd, 3rd and 4th place in each sub-category. There are ten major competition categories that can win the Remi Award; Shorts, Features, TV Productions, Student Productions, TV Commercials, Experimental, New Media (including Interactive and Websites), Music Videos, Unproduced Screenplays and Film & Video Production (which includes Documentaries of various genres). WorldFest receives a total of more than 4,500 category entries in all ten categories.

Thank you for being my cheering squad Kelly, Bear, Amy, an acting friend –Nancy Panossa, Michelle & Ed Davis, and Carleta and Gilbert who are so newly married that I don’t know their last name yet. Notice the cast of characters here is entirely different (except for Bear, but he’s my person) than that for the premiere. My person took a picture of me all gussied up – something I rarely am in our hot state. In the picture, I’m showing off my nails which were done to match my dress.  What fun!  (Can I remove the nail polish yet?  This is not in character for me!)

But enough about me, as an unnamed celebrity often says.  So, what is it you never want to talk about?  Your colonoscopy, of course. This is something readers have asked about and it’s time to deal with it, unsavory thought or not. If this is a new word for you, once you read WebMD’s description, you will realize why no one ever wants to talk about this:

Colonoscopy is a test that allows your doctor to look at the inner lining of your large intestine (rectum and colon). He or she uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding. During a colonoscopy, tissue samples can be collected (biopsy) and abnormal growths can be taken out. Colonoscopy can also be used as a screening test to check for cancer or precancerous growths in the colon or rectum (polyps).

The colonoscope is a thin, flexible tube that ranges from 48 in. (122 cm) to 72 in. (183 cm) long. A small video camera is attached to the colonoscope so that your doctor can take pictures or video of the large intestine (colon). The colonoscope can be used to look at the whole colon and the lower part of the small intestine. A test called sigmoidoscopy shows only the rectum and the lower part of the colon.

Before this test, you will need to clean out your colon (colon prep). Colon prep takes 1 to 2 days, depending on which type of prep your doctor recommends. Some preps may be taken the evening before the test. For many people, the prep for a colonoscopy is more trying than the actual test. Plan to stay home during your prep time since you will need to use the bathroom often. The colon prep causes loose, frequent stools and diarrhea so that your colon will be empty for the test. [Delightful prospect isn’t it.] The colon prep may be uncomfortable and you may feel hungry on the clear liquid diet. If you need to drink a special solution as part of your prep, be sure to have clear fruit juices or soft drinks to drink after the prep because the solution tastes salty. [You have CKD; this is not the prep you will be using.]

The National Digestive Diseases Information Clearinghouse (NDDIC) at The National Institutes of Health (NIH) says this about when to start being tested:

Routine colonoscopy to look for early signs of cancer should begin at age 50 for most people— [Don’t you just love these gifts that come with getting older?] earlier if there is a family history of colorectal cancer, a personal history of inflammatory bowel disease, or other risk factors. The doctor can advise patients about how often to get a colonoscopy.

Their material about colonoscopy is well worth looking at, but you need to remember you have CKD and so, cannot take certain substances in preparation for your colonoscopy. You cannot take the usually prescribed Fleet enemas or anything with oral sodium phosphate. Get it?  Sodium?  Phosphate?  Both bad news for CKDers.  One possible alternative is a polyethylene glycol (PEG) solution such as Miralax and (I think) Ducolax.  As usual, check with your nephrologist.

This is the link to NIH’s information on this subject: http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/

During my own colonoscopy last year [yay!  I’m home free for nine more years since it’s suggested the test be performed every ten years], several polyps were removed; some because they were bleeding, some because they were the larger kind that could become cancerous (adenoma). Apparently, bleeding polyps are troublesome because they can be the source of your fatigue if you already have low levels of iron as most CKDers do. At least, that’s what my nephrologist said, but I’m still tired (sleep study coming up next month).

More often than not, you are anesthetized before the procedure, both to insure you do not move which might cause a perforation and for your own comfort.  You are a medically comprised patient.  I’ll repeat that – you are a medically comprised patient.  As such, you need to be treated differently as far as anesthesia. I have to admit that the research I found was far too medical for me.  BUT two things were very clear: 1.The dosage of the anesthesia may have to be changed and 2. You must let your doctor know on your first visit that you have Chronic Kidney Disease.

I was both disgusted and fascinated by the photos my gastroenterologist sent me after the procedure.  I saw the polyps.  I saw the inside of my colon.  And I was aghast to realize it looks just like a winding slide at a water park.  Once I stopped laughing, I was able to really take a look.

That’s the end (couldn’t resist that pun) of this column.

Until next week,

Keep living your life!

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