I'm 47. If I'm being brutally honest, I don't have a lot of happy age landmarks to look forward to.
I guess I'll celebrate turning 50. I'm already semi-retired after taking a newspaper buyout in 2018, so I don't think turning 65 is going to be the year I buy an RV and celebrate the end of a long career by starting my golden years.
Maybe I'll hit 100 before I die, and if I do, I'll let them throw me a big party with strippers and bottle service, if that's still allowed.
That's about it!
Yet one age-related milestone has loomed large for me for the past decade: the dreaded colonoscopy. I knew it was coming, sometime, but when? When would I be old enough to have my asshole explored in a very clinical, very not-for-arousement way?
The thinking has shifted a bit for men of a certain age. Last year, the American Cancer Society lowered the age suggested for when men with average colon cancer risk (meaning you're not high-risk due to family history) should get their first colonoscopy. It was 50 years old; now it's 45. The ACS's webpage with this information features a photo of a gray-haired African-American couple staring at their gigantic 25-inch laptop, both holding their chins, like, "Goddamn, I guess we're doing this. You first?"
And you should! The scariest piece of information on that page is that when you combine men and women, colorectal cancer is the second-leading cause of cancer death in the U.S. Not to scare you, but this is some serious shit. About your ass. Not literal shit, but still important!
I don't know how you grew up, but my only knowledge of what goes on in a colonoscopy came from my dad, who I never bothered to ask for any details because why would I?
For me, I've got some decent health insurance these days, and I figured it was time to take advantage of my plan's cheap telemedicine and health screening options. I have two daughters and I'm not interested in dying early and missing their high school graduations and my potential future grandkids because I don't take good care of myself.
I did a short session with a general practitioner, who asked me a bunch of general health questions. She set up a blood-work screening. Within a week, I'd gotten my blood tested. It was nothing surprising: a slight Vitamin D deficiency treatable with gummy vitamins and higher-than-normal cholesterol, which I already knew I needed to work on with diet and exercise.
She also suggested I get a colonoscopy. I don't know how you grew up, but my only knowledge of what goes on in a colonoscopy came from my dad, who I never bothered to ask for any details because why would I? Oh, and from pop culture references like this scene from Fletch.
So, they… put a finger? Or a whole hand… up your butt? And they feel around and make sure nothing bites back like in those holes from Flash Gordon? Is that what happens? That's what I thought colonoscopies were for many years, until I began to hear that they now use tubes with video cameras and basically do a Twitch streaming video deep inside your cheeks. Please do not like or subscribe.
About a month before my looming colonoscopy appointment, the clinic where I was due to be butt-spelunked sent a long list of instructions involving fasting and what to expect the day of the colonoscopy, which I completely ignored until a few days before the procedure. I did secure my prescription ahead of time for a liquid called PLENVU that is meant to clear you out before your appointment. It comes in a big, white vertical box the size you might use for a fancy bottle of tequila, but inside is just a clear 20-ounce plastic container and lid, three powder packets, and a bunch of paper instructions.
The main ingredient in PLENVU is PEG, or polyethylene glycol. I know this because the website for this medication has a mascot (I'm not making this up) named Little PEG, a blonde custodian for your colon who uses a push mop to, I suppose, help clear out the disgusting remnants of the Pizza Hut Stuffed Crust you ate a few days ago.
The PLENVU sat on my kitchen counter for three weeks like a dark reminder of how my clogged fecal affairs would need evacuation. About three days before C-Day, I finally opened the email, and I'm glad I did. I received a warning that prep for a colonoscopy begins two days before the procedure and there's a lot to know. Apart from the online paperwork I needed to fill out in advance, I discovered that I was not to eat "nuts, seeds, and raw vegetables" starting two days before the appointment. I had to cancel the pesto pasta I'd just made with pine nuts.
The same day I was avoiding raw vegetables (by a doctor's orders, strangely) I went to the grocery store and loaded up on supplies for the long fasting day ahead. I bought a jar of beef bullion and made jokes about accumulating so many cubes I'd be a bullionaire. Then I bought a jar of something called Better Than Bullion in chicken flavor because why not treat myself? As per the orders of what I could and couldn't eat the day before, I loaded up on ginger ale, apple juice, and flavors of Jell-O and candy that aren't red or purple due to their food dye. To my surprise, you can drink all the coffee and tea and sugar you want before a colonoscopy, you just can't put any milk or cream in your drinks.
Other dietary rules: no fruit juices with pulp (sorry, OJ). Popsicles and honey are allowed.
To my surprise, the day of eating mostly clear liquids went smoothly. I rediscovered that beef broth is a salty, tasty treat. The Better than Bullion I tried was not better than the bullion. My kids made me pineapple Jell-O and I ate that as dessert after each serving of broth. I usually avoid sugary sodas and juices, but I gave myself a hall pass to enjoy ginger ale and apple juice to keep myself from getting hungry in between drinking lots of water.
Things were going well. Then came the pooping.
At about 5 p.m. the day before C-Day, I did as instructed and drank half of the PLENVU, about 16 ounces of yellow powder and water. If you've ever had powdered lime Gatorade, it tasted like that, but much saltier. If you hate the taste, it would be a miserable experience to have to drink so much of it, but I didn't mind it too badly.
I was wheeled into the procedure room. I didn't see any gnarly claws or alien surgical gear, just a bunch of monitors. The doctor greeted me, asked me to turn onto my side, and said not to worry.
About 30 minutes after I downed the container of PLENVU, a song by The Weeknd started playing in my head… I could feel it coming. I sat on the toilet and had the first of about eight trips to the bathroom. By the second or third time, things took a dramatic turn from solid to not so solid. (I will understand if you want to stop here and skip ahead to the appointment. I wish I could have.)
So, here's the thing about the liquid diet and the PLENVU: The goal is not just to clear out the gunk inside you, but to clear it out so well that the doctor can get a clear view of any polyps or damage in your guts. That means not just excavating the poop, but basically washing you out enough that your bowels are like a gleaming porcelain urinal at a brand-new sports stadium. And that means a lot of defecation, until what you're putting out is just clear (or yellow-tinted) liquid. My appointment was for 7:30 a.m., which meant I was scheduled to take the second dose of PENVU at 2:30 a.m. Which also meant I was pretty much up all night shitting increasingly clear liquid.
This was the worst part of the experience, just sitting on the toilet for a long time, unaccustomed to the feeling of basically peeing out of my ass, and forcefully. I'd go back to bed, but couldn't really sleep because I worried that, in the words of Biggie, I might “fuck up my sheets.” So I'd go back to the bowl and wait. By sunrise, I felt clean and hollow, and not in a bad way.
I'd been drinking water all night in addition to the PLENVU, but the instructions are for you to stop drinking anything for three hours before your colonoscopy. I brushed my teeth, being careful not to swallow any water, and got dressed blearily. I wondered if I should take a change of underwear. (Turns out, it wasn't necessary.)
I showed up an hour before my appointment, as directed, and filled out more forms, showed my ID and insurance card and waited. They took me back, weighed me, gave me a hospital gown to wear, and let me put all my things in a compartment behind the hospital bed. They asked if I wanted Propofol as anesthetic. I thought about Michael Jackson and asked what the difference would be. "If you take it, you'll just be out. If you don't, you'll be awake and you'll feel everything."
That didn't seem like much of a choice, and as much as I wanted to share the experience of being awake through a colonoscopy, I was exhausted from the all-night Poopathon™ and just wanted this shit to be over. I opted for the drugs.
I was wheeled into the procedure room. I didn't see any gnarly claws or alien surgical gear, just a bunch of monitors. The doctor greeted me, asked me to turn onto my side, and said not to worry. The aesthetician gave me the Propofol and told me it would work within 10 seconds. My disbelief lasted exactly that long.
And then I woke up. The procedure was over. I took some pictures of my bleary face and posted to Instagram to prove I was still alive, sense of humor intact.
I got dressed slowly, got my things, and they gave me a printout with lots of data I didn't bother to read and garishly colorful small images of the inside of my colon. Without getting into too much detail, they spotted a small polyp that would be tested. Otherwise, it was a success. The PLENVU worked! Thanks, Little PEG!
I was told to go enjoy a big breakfast and that there was nothing else I needed to do apart from not driving myself home. Several breakfast tacos later, I was home and taking a long nap.
In the end, a colonoscopy was nothing to be afraid of. It took some effort to break up my routine and to prepare, but I've had dental appointments that were far more painful and that took much longer. If you're hitting 45, schedule that appointment. Your ass takes care of you, day after day, every year. The least you can do is look out for your ass with a colonoscopy once every decade.