The hardest part of getting a colonoscopy was telling the doctor I needed one.
Turns out there is no ladylike way to say, “Sometimes I bleed from my butt.” I’m pretty dismissive of the concept of ladylike behavior. That term is just a way to keep women quieter, milder, more malleable. But stuff that has to do with my ummmm my bottom line? I can’t even find the words. All of my irreverence and frankness disappears. Talking about it just never felt...right.
But after years of on and off symptoms, I knew I needed to know what was happening inside of my body. I made a doctors appointment. Sat in the office in a paper gown and said the words,
“Sometimes, and it’s not even that much, when I’m on my period, I bleed? But like not just from my ummmmm vagina. I also bleed from my YOU KNOW.”
That last bit was followed by an incredibly awkward pantomime that was surely worse than the word butt. The doctor raised her eyebrows,
“If it's been going on as long as you say it has, it is probably not colon cancer. You wouldn't be alive right now.”
Then she gave me a referral for a colonoscopy.
Probably not colon cancer wasn’t as reassuring as the doctor seemed to think it was. I sat in my car in the parking lot. I cried when I made the colonoscopy appointment. I cried when I called my husband. I wasn’t just worried about mortality when I told him. I was mortified too.
Telling him I needed a colonoscopy meant conceding I had a colon that performed colon work. I just wasn’t sure I was ready for that reveal.
We’ve been married for fourteen years. We’ve had three children. We have an egalitarian, transparent marriage. But that transparency stops at the bathroom door. Not through some agreement between the two of us. This was my own imposed border. Telling my husband I needed a colonoscopy meant conceding I had a colon. A colon that performed ummmm colon work. I wasn't ready for that reveal.
First, I cried about the moment the doctor said cancer. He crooned, it's okay, it's okay. And then, I cried out of mortification. With a little bewilderment, he assured me he’d long known I had a colon and assumed it did the work that all colons do. He had, in fact, always been very comfortable with my colon ownership. Then he asked me to wait to drive home until I stopped crying. He took the next few days off work.
To paraphrase Harry Burns: When you realize you need somebody to insert a tiny camera up your rectum, you want someone to insert a tiny camera up your rectum as soon as possible. I wanted to know on which side of probably not colon cancer me and my bowels stood. The camera had a simple mission. It would look for lesions, tumors or, most commonly, polyps. Colon polyps are groups of cells that form on the lining of the colon. These growths are mostly harmless, but sometimes they develop into colon cancer.
I felt ashamed of the shame that kept me from asking for the screening years earlier.
Colon cancer can be cured when you find it early enough, but you need to get a colonoscopy to diagnose it. It's often symptomless until it's metastasized. When I got home, my perspective found its place. I was afraid of something much bigger than my husband finding out I had a colon. The week before my exam I panicked about abnormal growths. What if my embarrassment had delayed the test for too long? I felt ashamed of the shame that kept me from asking for the screening years earlier.
Shame. Let's quickly talk about it, huh? Shame isn’t a universally bad thing. A paper in Proceedings of the National Academy of Sciences, argues there's a type of shame that is a healthy evolutionary tool. This shame motivates us to be better community members, it moves us to repair and restore. Daniel Sznycer, an author of the paper, said “The function of pain is to prevent us from damaging our own tissue. The function of shame is to prevent us from damaging our social relationships, or to motivate us to repair them.”
The multinational study found that other feelings, like sadness, do not guide people to repair like healthy shame does. Healthy shame can keep people from harming their communities in the first place. Shame after the harm can restore in two ways. People feel moved to restore the community they’ve harmed. But those that feel shame and so act to repair are also restored to the community. (Which might make forgiveness an evolutionary tool too? Something to explore another day.)
It was a secret shame. An abnormal growth; a collection of experiences, expectations and cultural norms that had formed a malignant clump.
The shame I felt was not a functional, community repairing shame. It was, instead, a secret shame. This shame was an abnormal growth; a collection of experiences, expectations and cultural norms that had formed a malignant clump. The outline of that clump looked something like this:
I am a woman. So I am allowed to acknowledge I have a butt - how else would I look desirable in Madewell high rise jeans? But my woman’s butt is only allowed to be a Butt in form, not in function. Talking about the function, or dysfunction, of my butt is a violation of …. something.
Like all secret shames, this one was as illogical as it was harmful. Desirability isn’t the point of my human experience. Being a human with a colon doesn’t diminish my desirability. And also, Madewell, please don't stop making your high rise jeans.
It’s a good thing that I made my peace with being a person with a colon, who is known to be a person with a colon by their partner. Because the night before the colonoscopy my ummmm colon-having was in extreme evidence.
I was certain it could not get worse. It did, of course, get worse.
The day before the colonoscopy, you can only drink clear liquids. I sipped on iced water while my family ate Popeyes for dinner. I was certain it could not get worse. It did, of course, get worse.
The night before a colonoscopy you drink this thing my doctor and pharmacist called Prep. (Not to be confused with PrEP, which is a very effective medicine for preventing HIV and should be made affordable and accessible to everyone.) Prep sounds like a fun heart shaped pill Lindsay Lohan’s too-adventurous friend slips her in an early 2000s teen comedy. You’ve got to Prep before your party! Pep with Prep! You get it. The scene writes itself. But Prep is not a fun heart shaped pill.
I did not want to keep my physician from either abstract or concrete understanding of my bowels.
It is instead a gallon size bottle of laxative that tastes the way a brake shop smells. Prep prepares your colon for its camera debut. Having a camera shoved up your butt is only an effective way to find polyps, lesions and tumors if they aren’t covered by ummmmm colon stuff. (Please don’t make me say it.) The pre-op team was adamant that I follow every Prep step. I love how the Mount Sinai colonoscopy page puts it, “if your prep is inadequate the physician may not be able to visualize the entire colon.” Something about the phrasing sounds transcendent. I did not want to keep my physician from either abstract or concrete understanding of my bowels.
Prep is Magnesium Citrate dissolved in a ton of water. With a couple of other things thrown in because why the hell not. Magnesium citrate is so much salt plus so much citric acid. My full gallon of the stuff came with a lemonade packet to make it taste better. It just ended up tasting like a brake shop with one single lemon air freshener hung above a closed door. I’ll skip the lemon packet next time.
I had to drink the Prep in big glasses spaced 15 minutes apart over the course of a few hours. I did this in two shifts. Because my colonoscopy was very early in the morning, I drank shift one in the evening before the surgery. The second shift started around 3am the morning of the surgery.
There isn't much mystery left after fourteen years of marriage. Any remnants of the mysterious were shredded when I had to call through the bathroom door for a particular kind of assistance.
Prep causes “bowel-clearing diarrhea". This is a gentle way to say, “If you are not within two strides of a bathroom at all times, you’re probably going to shit yourself.” (Is it shitting yourself if everything exiting your body is liquid?) The drink’s effects were swift and sustained. Listen. There isn’t much mystery left after being married for fourteen years. Any remnants of the mysterious were shredded when I had to call through the bathroom door for a particular kind of assistance,
“Hey, sugar? Could you go buy a plunger? Quickly."
Yeah, so much poowater can exit your body it clogs the toilet. I don’t really understand the physics of that but there I was. There we were. I fell asleep on the couch at 4am, more than two strides from the bathroom. We’ll just move on from that to the rest of the morning.
My husband drove me to the procedure. He stayed in the waiting room while a nurse led me to a room of beds full of people who'd also just been Prepped. They looked drained. The nurse helped me get into the hospital bed. After a night of Prepping, I was too weak to climb up by myself. She gave me socks for my cold feet. Pulled a blanket up over my chest. She was kind. Sometimes colonoscopy results are okay and sometimes they are not.
When the results of a screening are not okay, time gets divided into Before the Diagnosis and After the Diagnosis.
When the results of a health screening are not okay, time gets divided into Before the Diagnosis and After the Diagnosis. This nurse was in her fifties. She told me she'd been a nurse since her twenties. She's been a part of many Befores. So some socks, a blanket, a smile. I blessed her for my warm feet. She told me she’d see me after the procedure. I hoped when I saw her I wouldn't be in my After.
Another nurse wheeled me into the procedure room. She reassured me that I’d sleep through everything and remember nothing. My doctor was a woman. She said she couldn’t wait to see my colon and everything was going to be alright. An anesthesiologist came in and helped me into a twilight sleep. She hooked me up to an IV, put a plastic cone over my nose and counted down from ten. I remember getting to seven. As I fell asleep, I felt safe. Which could have been the stuff I was inhaling. But I felt safe before those drugs started wafting up my nose too.
I slept through everything and remembered nothing. I woke up in recovery with warm feet and a blanket pulled up to my chest. The kind nurse was there but instead of socks, she held out a series of pictures of my colon,
“Hey there, honey. It all looked fine. I showed these to your husband and explained everything in it. There were some hemorrhoids. The doctor would like you to get checked for endometriosis in your bowels. You’ll want to schedule a follow-up appointment.”
Oh! So I am still in my Before. Because, of course, After comes to us all. But this nurse, that blanket, these socks were all still Before. It was more than I hoped, but also what already was. I just didn’t know it until a camera snaked its way through my body.
My colon looked like a tunnel carved out of pink opal.
She handed me the photos and I stared at them. My colon looked like a tunnel carved out of pink opal. Next to one of the images was a typed note from the doctor - incredibly clean colon. I felt kind of proud. Hell yes, I cleaned that colon. Wait. That colon. No. My colon. She'd shown my husband a whole series of photos of my bowels.
“You showed these pictures my husband?”
“Yes, honey. Is that okay? You’d signed a form saying that was fine.”
I laughed and cried. “Oh sure, it’s okay. Our insides are kind of beautiful, aren’t they?”
Declaring my bowels beautiful was an emotional labor she was simply not ready to perform.
She looked uncertain. She’d been very supportive all day. Declaring my bowels beautiful was an emotional labor she was simply not ready to perform. I get it. Instead, she smiled,
“Well, honey. You’re going to be tired for the rest of the day. I’ll walk you out to your husband as soon as you feel steady enough. Feel free to keep the socks.”
If there is something going on inside of you that needs some checking in on, physically or mentally? Please know you deserve to say the words that get you the help you need. There is no shame in them. 60% of colon cancer deaths could be prevented with screening. Affordable at-home screening exists. But healthcare, including access to screening, remains out of the reach of too many Americans. Learn more here.
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