Colonoscopy 肠镜

原文在这里。

Colonoscopy is a routine exam recommended by doctors for adults over 50 in the USA: as a precaution checkup for the signs of colon cancer. 在美国一般医生会建议50岁以上的人去做一次肠镜，以检查是否有肠癌的迹象。I heard colon caner is among the top two cancer in the US. I did mine at Mercy St. Louis - it's the hospital both my girls were born and I also worked for Mercy in the IT department for about 18 months between Nov 2013 and May 2015.



It takes some efforts and courage to take the exam. First some Overview by Mayo Clinic. Also, it's not the only way to detect colon cancer. There are 2 ways. Both have pros and cons. I did this Fecal occult blood test about 13 or 14 months ago, partially because it's less invasive, and partially because my doctor then is also a bit soft spoken, and he agreed. This time I am not this lucky. I got a new doctor and when I mentioned testing for colon cancer, and he directly chose the colonoscopy.



Prep



The doctor performs colonoscopy will usually provide the prep instructions. Alternatively, because this is a quite common procedure, there are lots of resources online: I shared some below. One common question is the low fiber food before and after (see below), also the liquids to drink the day before, as well as the special medicine (liquids) to drink about 12 to 15 hours before the procedure.



Day -3 and Day -2



Low-fiber diet do's and don'ts - Mayo Clinic || Also note Mayo Clinic and Kaiser Permanente are both highly reputed hospital chains in the USA.



Day -1



Clear-Liquid Diet for Colonoscopy Preparation | Kaiser Permanente 



I did drink some chicken broth (sold at Costco): I drunk a few cups. I added a bit salt to the broth and microwaved it. I also drunk coffee and sprite that day, because I need to start the Colyte liquid (prescribed medicine, power mixed with water, see below) at about 3 pm my time (due to my schedule). I took a break between 6 to 8 pm, and resumed it until about 11:30 pm to consume about 3 L (or 2.75 L to be precise). I finished the rest in the early morning before procedure.



– Very important: You may not eat any solid food or drink alcohol for 2 days! In the morning on day 1 of your prep (2 days before your colonoscopy), fill 1 jug of Colyte as written on the jug and place in the refrigerator.



The Day



Today I went. The results are out and they seemed good.



Btw, the GI lab at Mercy seems quite busy, and they are a few steps and a few things to keep in mind (or tips, if I may).



They have a sign says don't bring any valuables. I understand where they come from, but if you think you like to read on phone, I say bring it (I didn't bring, and was somewhat bored during my about 45 minutes wait in the waiting room/bed). Don't take any picture or videos due to privacy concerns.



I noticed I may not be the youngest in the patients group. Obviously they are people who are a bit older. And they seems to be people who are younger than me as well. I did see a lady brought her phone.



The anesthesia: I believe this is the 1st time I was knocked out completely. The drug is actually is from the needle, rather it's from the IV infusion (挂盐水/葡萄糖), which I did recently (see this American Healthcare System II – 美国医疗系统之二). Btw, it's a smaller punch or less pain for me this time, as the nurse put the needle at a spot that's better, I guess.



Serious matter/Q: do you have a will or living trust?



I got this question asked many times. I actually started this "will" process but my wife didn't sign. Later I learned Warren Buffett let his wife and kids view the will before official. Probably something I will do too as my 13 (soon to be 14) year old can understand some of that.



This reminds me of a related question - We each have an average of 100 online accounts. Here’s how to make sure they aren’t a nightmare for your family if you die. Btw, my wife and kids know my iPhone passcode, but that's probably not enough. I told my wife investing in S&P 500 index funds when I die. Hopefully she take notes or registered in her brain. Otherwise she can come to this blog (wait, I probably need to renew the domain as well as pay the hosting fees in advance :-)



Waiting



Most time seems to have been spent on waiting. Fairly routine procedure. Felt a bit drowsy after being woken up. But I feel I can drive after probably 4 hours of this. Again a smart phone may help, if you have the energy. Or just rest instead of doom scrolling :-)



The people and humor



"You got another 10,000 miles" (this is actually from nurse at primary care office, after the annual physical)



"Just take a nap" (today's nurse, referring to the anesthesia).



"What you want to eat after this? (a big meal :-)"



Because usually people were on the "liquids only" food the day before. And no food on that morning. || My answer: I am going back to the low fiber diet as I read it from What to Eat After a Colonoscopy



I think it's always the people and the humor made the difference.



PS



Why Mercy: in St. Louis area there are a few large hospital chains, in the order of size, they are BJC, Mercy, SSM and St. Luke's (not to be confused with the Kansas City St. Luke that's going to merge with BJC), respectively. BJC (and Washington U Physicians) is nationally recognized, and it appears their service sometimes could be a bit expensive than others (not quite scientific, just a recent observation). Mercy is the closest for me, and it also has some unique strength. For example, they were the 1st to using Epic EMR in the region. A while ago I worked at MyMercy patient portal, and now I got to use it as a consumer (customer). Btw, the patient portal is based on MyChart. BJC is also using Epic software now. And both BJC and Shriner Children's hospital used MyChart. One thing though: each MyChart is standalone, you cannot share credentials between the different hospitals.



Back to the topic, I think the prep part: both physically and mentally is the hardest part. The low-fiber diet, the liquids only diet, and the colyte (too much water to drink in a short duration of time). Then there is this unknown part of "short nap" :-(