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but would you agree it's also kind of hilarious?
july 1, 2016
Q: Why are you limping?
A: I stubbed my left big toe really bad. Like, really bad. This was a couple of weeks ago. I woke up in the middle of the night feeling this incredible pain in my left foot, fell back asleep, woke up later, realized again my left foot really hurt, fell back under.
When I woke to get out of bed around four in the morning, my usual time to rise, I had a lot of difficulty making it to the door of the bedroom. Hobbled down the length of our dark kitchen wincing, and climbing the carpeted stairs to the second floor required me to lean heavily against the wood side rail.
Once I was at the desk in my study, lighting a cigarette, turning on my computer, I leaned forward in my swivel chair to take a look at my left foot. The big toe side of it was rose red and swollen. The bottom joint of the toe raised above the rest of the bones in my foot. It felt dislocated. Probably a good thing I didn't look at it until I got upstairs. I don't know what I did. Evidently I woke in the night, got out of bed to urinate, and really whacked the fuck out of my big toe against the hard metal base of our recumbent bicycle. That's happened before, but never this bad.
Normally I only smoke upstairs, because of Mary's stroke fourteen years ago, but with her approval I decided to have my cigarettes downstairs, in our bed, until my toe healed, so it wouldn't be repeatedly stressed by stair-climbing. Even so, each night when we turned off the lights, it was hard to fall asleep, because the toe hurt so much. Like a toothache. I couldn't even bear having the weight of a bed sheet on it, the first few nights.
Q: That's unfortunate, but would you agree it's also kind of hilarious? There's a lot of humor to be mined in someone with a bum foot. Did you fall over at any point?
A: I didn't, thank God. But here's where the humor comes in.
I was due for a follow-up colonoscopy. I had one in 2012, which I wrote about in great detail in a previous Lately, and was supposed to have my next one in 2015. I decided to wait until after my birthday in November of 2015, because then it would be covered under Medicare (my first colonoscopy cost Mary and me about three thousand dollars in out of pocket expenses; my second, under Medicare, less than two hundred dollars). I wanted to have the colonoscopy early in December so I wouldn't have it hanging over my head during Christmas season, which is supposed to be a time of joy, not a time of nervously anticipating someone running a garden hose up your ass. So I called up, asked to have the procedure scheduled. A couple of weeks later, I was given a date. Because of Mary's stroke she has aphasia, so among other problems, she can no longer read. For that reason, I wanted to be the gastroenterologist's first patient that day, so Mary wouldn't have to sit out in the waiting room too long just staring at the door to the back rooms (the first time I saw this gastroenterologist, four years ago, once I was brought into the back rooms, I was told the doctor was running late, and my colonoscopy, instead of happening in the next ten minutes, was going to be delayed by about three hours. That's a long time to lie naked on an uncomfortable gurney with a syringe head stuck in the back of your right hand. Just saying. And it's a long time to sit in a waiting room, unable to read, staring at a door.)
The office called me. I was going to be the doctor's first patient on a Friday prior to Christmas. Great. Eight-thirty in the morning. I'd have to arrive at seven-thirty. No problem.
That meant that the Thursday prior to that Friday, I'd have to not eat any solid food at all. Liquids only. And no red or purple liquids, because they might be mistaken for blood during the colonoscopy. I'd have to take two tiny laxative pills at two in the afternoon, stop taking any liquids at all, even water, at five o'clock, and at seven o'clock, start drinking four fucking liters of laxative-spiked water. Trust me, that is a hell of a lot of water to gulp down. A fresh glass of water every fifteen minutes, for the next four hours. Sixteen glasses of water. Doesn't seem like a lot? Try it, my friend. And because each glass of water is spiked with a powerful laxative, a lot of each precious fifteen minute water-drinking time is spent on the toilet. I won't get more graphic than that. And after all that is over, you stop drinking anything. Water included. No water during the night. No water when you wake up. No water while you shower, get ready to go to the facility. So it's a big, fucking deal. You have to put yourself in the right mental space to get through this. Which I had done.
But then late Wednesday, just before I was about to start the purge the next morning, I got a call from the gastroenterologist's office, asking if I would agree to reschedule the colonoscopy for the following Friday. The doctor had a conflict in scheduling.
And it pissed me off. He had to know how hard this is to emotionally prepare for (plus you're put under with intravenous anesthesia, which is dangerous). I talked to Mary, and we decided to cancel the appointment, and look for another doctor.
The next morning, I got a call from the doctor's scheduling manager. She apologized profusely for the change. I could have blown up, because calling off the procedure at the last minute really is inconsiderate, but I didn't. Don't burn your bridges behind you. There's a lot of truth to that. I was polite with her. Explained that I didn't blame anyone for anything, but thought I'd probably be better off going to someone else.
Christmas came and went. New Year's.
I looked on the Internet for other gastroenterologists I could use.
And found out that almost all of them, in our immediate geographic area, were all members of the same gastroenterology clinic. And my PCP told me that from her experience, in order for me to switch to a different doctor from that clinic, I'd have to get the first doctor's permission.
I could go outside that clinic, but that would mean going to a different city. There was a gastroenterologist from Nigeria in a nearby city who looked promising, but that involved a lot of highway miles. Since I'd be under IV anesthesia, Mary would have to drive us home afterwards, and because of her stroke she's only driven a couple of times since her stroke fourteen years ago, and that would be asking an awful lot of her, to negotiate all those roads in heavy traffic.
(In America, the standard practice is to put you under with IV anesthesia during a colonoscopy. You don't experience any of the procedure. In some other parts of the world though, my impression is IV anesthesia is not used, and instead the patient is simply given a sedative to keep them calm, and consequently is able to watch the monitor as the colonoscopy proceeds up inside you. In this age of monetization of everything, it astounds me that companies have not seized that opportunity to have pop-up ads appear on the monitor as the probe glides inside you. And they could be targeted ads! Kale recipes for patients, to encourage diets heavy in fiber, lots of smiling people having fun at a lake; promotions aimed at the gastroenterologists for memberships in high end golf courses, and great mini-mall acquisition deals.)
So finally, around May of this year, we talked it over, and decided it really made the most sense to just go with my original gastroenterologist. He did have a great reputation, which is why I chose him in the first place, his assessments were almost always accurate, and he had a warm, friendly group of people working for him. And trust me on this. Warm and friendly is what you want when you're about to go in for a colonoscopy.
So here's the humorous part.
That laxative-spiked water you're drinking? Four fucking liters? It is powerful. I mean, you have to race to the toilet every fifteen minutes as the next wave kicks down. Hard enough to do under any circumstances, but imagine doing it over and over again with a severely stubbed big toe, hobbling and hopping across white tile to hit the toilet in time.
Not me at my most graceful.
Q: Anything else? You were going to talk about some other stuff as well, weren't you?
A: Yeah, but I'll have to wait for the next Lately. I want to end on this though: I had some fun talking about my colonoscopy, but the truth is, if you're fifty or older, you really do need to get a colonoscopy. Colon cancer is easily preventable if it's caught in time. There's no reason at all to not get a colonoscopy. Do you have to drink a lot of water? Sure. But isn't that better than dying of something so easily preventable? Dying because you're afraid of having a simple, widespread procedure performed is just stupid. The procedure itself is easy. Takes about half an hour. And you're completely unaware of it because you're under IV anesthesia. They wheel you into a room, everything goes black, and you wake up in another room, finished. That's it. If you're skittish about having a colonoscopy, please contact me at email@example.com. We'll get through this together. I'll help you.