Wednesday, January 13, 2016

TMI. but who cares?

I went through the once-every-10-years fun of a colonoscopy on Monday Like everyone always says, the procedure itself isn't bad -- how could it be? You're unconscious for it -- but the prep really sucks. After Sunday's evening's torment, I never want to see Miralax again. Granted, the prep is a little more tolerable now because you get to mix the solution yourself so can actually drink something you like, but even so. . . I mean, I wound up missing most of both "Downton Abbey" and "Sherlock." The S.O. and I had actually sprung for a motel room in Hancock so we wouldn't have to be on the road doing a 45 mile drive before the plows were out on Monday morning, and I didn't even get to watch much television.  I was not a happy camper.

But my personal hell spent huddled on the porcelain throne while puking into a wastebasket* is not actually what I'm thinking about this morning, or at least not much. What hit me at the hospital was what an assembly line they had going at Portage Health. Monday is colonoscopy day, and there were no empty cubicles in the Outpatient surgical area. I asked one of the nurses just how many procedures they did in a morning. They're not a very big hospital, so typically it's about 8. They cycle patients in on the half hour starting at 6:30 a.m. I have no idea what the charge is per procedure, but it's not cheap. Anytime you've got an anesthesiologist involved, you know there's going to be a comma in the price tag. Not that the price tag matters much -- colonoscopies are one of the preventive care procedures that the Affordable Care Act mandates be totally covered by every insurance plan. There is no co-pay or deductible. No wonder it's an assembly line procedure these days.

The first time I had a colonoscopy, back in about 2004, it was at the end of the year, not the beginning, because I'd already met part of the deductible for the insurance I had then. Even so, the co-pay wound up being high enough that I had to do monthly payments to the Nebraska Medical Center -- despite having a pretty decent job, I couldn't pay it off in one lump sum. Shoving a tiny camera up someone's butt is not a cheap procedure. But now, thanks to the Affordable Care Act (aka the infamous Obamacare) quite a few people can be screened for colon cancer and not have to worry about a dime of out of pocket expenses. Given that (a) colon cancer is the third most common type of cancer (something like 133,000 new cases are diagnosed annually and (b) approximately 50,000 people die each year in the U.S. from colon cancer regular screening for it is undoubtedly a good thing. Everyone knows the earlier you find cancer, the easier it is to treat and the more likely you are to survive. And, thanks to the Affordable Care Act, the number of people having colonoscopies has gone up considerably. Ergo, fewer people are going to die from this particular type of cancer.

It'll be interesting to see what happens if/when the Republicans succeed in repealing the ACA. Will cancer deaths start to rise again? Will voters freak out when they discover something they'd started taking for granted is no longer there? For that matter, will anyone even notice? We Americans are pretty good at distracting ourselves and avoiding reality.

*The fact the prep solution now tastes better doesn't guarantee you won't experience some of the side effects of Miralax, e.g., bloating, nausea, and vomiting. 


  1. Had my 2nd one a few months back. I was two years later than I was supposed to be after being two years late for the first one. Next one should be the last. I didn't have any side effects, but the missus sure did. No fun, but necessary as you pointed out. I have several younger friends who died from colon cancer.

  2. I had my first one last year but the prep didn't seem like any big deal to me.

  3. I drank the same stuff when they fixed my hernia, piece of cake.

  4. Reactions to the prep are another proof that everyone is different. The S.O. also had no problems when he had a colonoscopy a few years ago. No nausea, nothing, just kind of a general dislike for the way the solution tasted (when he had his, it was still a case of buying a jug of pre-mixed solution).

  5. The prep made me sicker than a dog. I threw up most of the night after forcing down the prep. I won't need one again at my age.
    the Ol'Buzzard

  6. Funny system. I had one a few years back and prep was no big deal. No anesthetic involved either. They were looking for bowel inflammation. None.


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