Wednesday, January 31, 2007

An Unwanted Journey: Day 0434 - My National Geographic Special

"Would you like us to take your glasses, Mr Spencer?" asked one of the nurses in the endoscopy unit.

"No, that's alright. I'd like to watch the monitor."

Just a few moments later, "OK, Mr Spencer, first my finger.", was how my surgeon got started.

"Now, the scope," again, from the surgeon.

Because the procedure was a flexible sigmoidoscopy and was being done only to examine the anastomosis, there was no sedative involved, no intravenous hook up, nothing but those marvelous blue hospital gowns and slippers and my assumption of "the position."

"Are you watching, Mr Spencer?", the nurse asked.

"Yes," I responded, but I was thinking, "You bet my ass I'm watching!"

"Don't be alarmed, Mr Spencer, if you see some blood. It's coming from the biopsy sampling and is minimal," explained the surgeon.

As Robin Williams once said of his own colonoscopy, in which he decided to forego any sedatives, it truly was like "having my own, personal National Geographic documentary." Everything was so clear and clean. The surgeon moved the camera lens for me so that I could see the tissue surrounding the anastomosis as well as the bowel passageway. It was awesome, despite the humiliating posture and the daunting prospects of finding more cancer through this exercise.

My surgeon, a person not known among medical staff and patients as someone who offers a lot of bedside chatter, offered useful commentary to me to put me at ease as well as to explain exactly what he was doing. He took five biopsy samples, and there was blood, but no pain since the rectum does not have nerve endings. The only unnerving aspect of what I was seeing on screen was the size of the "jaws" which took the biopsy samples. On screen, they looked enormous, but are really very small.

"That looks to me like granulation tissue," he said as he took the samples. He then went on to explain that the visual evidence of the sigmoidoscope was what he expected. It did not look to him like recurrent cancer, but he was happy to defer to the expert opinion of the gastrointestinal tumor board's recommendations to do the sampling earlier than he had originally recommended. He also suggested that we will be doing another flexible sigmoidoscopy in about 3-4 months from now, again, just to be safe and to see how the granulation tissue appears at that point.

It was very reassuring to hear him speak with such confidence about the visual evidence. Of course, the five samples will be closely examined by a pathologist and possibly an immunologist and we will meet again in about one week's time to review the reports. But...I feel pretty good about what I saw on screen and his confident demeanor.

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