Colonoscopy - Why I Hesitate To Have One

Pros And Cons Of Health Care Reform - Colonoscopy - Why I Hesitate To Have One

Good morning. Now, I found out about Pros And Cons Of Health Care Reform - Colonoscopy - Why I Hesitate To Have One. Which may be very helpful if you ask me therefore you. Colonoscopy - Why I Hesitate To Have One

The American Cancer society (Acs) recommends a colonoscopy for everybody beginning colse to age 50. The purpose of the screening policy is to look for existing colorectal cancer or signs the disease might develop. Added colonoscopies are recommended thereafter at 10-year intervals, assuming no problems are discovered. At the Acs website, the policy is called "uncomfortable and invasive" and suggests "someone drive you home after the procedure." making ready for colonoscopy requires "cleaning of the bowel" using a extra diet and laxatives for a day before the procedure. There are several potential complications linked with a colonoscopy, including perforation, bleeding and death, again agreeing to the American Cancer Society. The most base complication is perforation, occurring approximately once in every 1,000 procedures, agreeing to a 2009 chronicle published in "Genetics in Medicine." Death occurs in every 12,500 procedures.

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Pros And Cons Of Health Care Reform

There are other, less invasive options for colorectal cancer screening, including virtual colonoscopy and stool tests, such as fecal immunological tests or fecal Dna. Of course, these are not what American doctors call "the gold standard." A colonoscopy is the gold standard.

A colonoscopy involves the insertion of a thin, tube-like instrument adequate with a small camera called a "colonoscope" (what else-a periscope?). This mini-dildo-like expedient is inserted up the rectum where it is threaded throughout the whole colon. The colonoscope enables a optic analysis of any incipient colorectal cancer and a biopsy and discharge of suspicious lesions. If no lesions are found, suspicious or otherwise, two things happen before the expedient is removed while the patient is still under sedation: 1) The doctor who performed the policy is given sufficient time to get out of town and begin a new life under a government seek protection-like program; and 2) When the drugs wear off and the patient is fully revived, a skilled counselor says something like this to the patient: "Sorry, we did not find a thing wrong with you. You admittedly did not have to go straight through this. Your colon is fine. Come back and see us again in ten years. We'll do this to you again."

No, I'm just kidding-I made that up because here is the admittedly wonderful truth of the matter: The patient has been ready for this very probable eventuality! And he went straight through with it, anyway. He is not gobsmacked to learn that it was for naught-he would have been fine if he skipped the whole thing. All he has is some reassurance that he does not have this single disease or likely to get it soon. There are still hundreds of others laying in wait for the tube of time. How many more tests will he have to learn that he does not have one of them? In any case, this is what he admittedly hoped to be told about the results of the colonoscopy. At this point, the patient is not only improbable Not to seize the throat of the medicos who did this to him but, on the contrary, he has been programmed to be happy about it all. Thus, he is likely to say something like this: "Oh, thank you so much. Thank you, thank you. I am sooo delighted. You people are the best. I can hardly wait till you do it again to me in ten years."

I have never paid much concentration to what the Acs or other curative organizations suggest about one test or another. I have been wary of curative tests, checkups, preventive examinations, risk assessments and all such curative imprecations. There is way too much of this. Such activities have been a part of the medicalization of health for at least half a century. I became aware of the qoute as a health planner beginning in the late 60's. I was immersed in curative policy and investigate for five years before transitioning into my current role of wellness promoter. I have a Ph.D. In health and group policy. I saw up close and personal the reality and the wasteful, often perilous consequences of our bloated, dysfunctional curative system. I have written extensively about it.

The qoute of health being made a curative issue has only gotten worse. In a modern Progressive policy manufacture (Ppi) report, Peter Orszag, director of the Congressional allocation Office, is cited for his appraisal that 5 percent of the nation's gross domestic product--0 billion per year - goes to tests and procedures that do not admittedly heighten health outcomes. He believes that the "unreasonably high cost of health care in the United States is a deeply entrenched qoute that must be attacked at its root."

Physicians claim that colonoscopies are the gold acceptable of preventive medicine. Well, that may be, but who admittedly needs the gold standard? everybody over 50, every ten years? The jury is out. What's more, if you are 50 or over (or someday make it that far), you might want to do some checking to ascertain if the jury has sufficiently rendered a verdict on colonoscopies-and a lot of other tests and procedures done routinely.

In 2008 the American Cancer society deemed the colonoscopy as the favorite test. Medicare pays for colonoscopies and the new health reform law (Ppaca) compels assurance clubs to cover them.

Yet, I have reasons for resisting this procedure, besides a general awareness that the curative ideas is rife with unnecessary testing, some of which can be perilous to health and wealth. For example, a colonoscopy is three to four times more costly than a simpler test-a sigmoidoscopy. This entails but a partial "probe" that lasts but a few minutes. There is no sedation, no need to take time off from practice or work, no jug of laxatives or ghastly emptying of the colon the night before and maybe no need for a gastroenterologist-family or primary care doctor can often do the procedure.) Best of all, the risk of complications (infections, bleeding, incontinence or, worst case scenario death), is seven times less than for the Full Monte big C ordeal.

And here is the gripper: the creator of the colonoscopy, Al Neugut, wrote an editorial in the Jama this summer stating that he regrets inventing the colonoscopy. Neugut said, "If today, we were where we were in 1988, I would not manufacture colonoscopy based on the current evidence."

As one wag put it, the gold acceptable of preventive treatment may only be golden from the point of view of doctor salaries.

All this is personal. I am approximately 74 and I have never had one. Many of my friends find this appalling. My wife and my son have been after me to get it done. And, one of my best mates, a person who I hold in the top esteem for half a dozen distinct reasons, has pulled out nearly all stops to persuade me to turn myself in to the colon corps else drastic steps will be taken, including unmasking me as a false wellness prophet.

Charlie Chaplin said, "Life is a tragedy when seen in close-up, but a comedy in long-shot." When pondering the pros and cons of this procedure, I continue to wrestle with a go/no go decision. I have consulted my ouija board, astrology chart and prayer book. Still, the cases for and against having a colonoscopy seem to balance out. (Yes, of policy I'm kidding about the astrology chart and prayer book.)

I admit that, in weighing the two choices, I began and remain biased in favor of the "give it a pass" option. To paraphrase Mr. Chaplin, when seen in close-up, the prospect of undergoing this indignity seems tragic. However, I presume that if I were to go straight through with it and seek that the test results enable me to stay on the surface of the planet a good while longer, my hesitation would seem comedic, in retrospect.

Influential people in my life have been after me for many years to have this procedure. This influential group includes my primary care doctor, my son and my wife. Their well-intended concerns are of policy very regarded and appreciated. However, I presume they are influenced by an excess of caution about lurking hereafter problems combined with too exiguous concern for the unpleasantness of the whole process, and the high probability that it will prove to have been unnecessary. Unfortunately, the pressure to resist no more-to just do it, has been nearly insufferable.

The most recent onslaught began about a month ago during a training ride. A cycling friend and champion athlete about my age whom I'll call "Sandy" asked me if I have had a colonoscopy, lately. I replied that I had not. Upon Added interrogation, I had to admit that I had no plans to have one anytime soon. I view that was the end of it. Not so. Later that morning, I got a lengthy e-mail from him. He claimed that as a "guru of wellness," my audience expects that I will also take an interest in my own health. He claims that contemporary colonoscopies (versus what - the kind doctors performed in the Middle Ages?) are quite simplistic and that, at my advanced age, I effortlessly grow things (other than nose hair). By this, he meant there is a high likelihood that one or more polyps would be found in my colon. He called me "a stubborn old goat." But he softened that by adding that "those of us who admire and love you will be sad if my resistance proves fatal. He ended by warning that if I don't get a colonoscopy and colon cancer causes my demise, he'll boycott my funeral and stop reading my weekly wellness newsletter.

All this was very sufficient and motivational, especially the parts spirited flattery. I asked a few associates, including several doctor friends, for their opinions on the matter. About half recommend it was unnecessary; the rest said it's a good idea. The latter, however, did so for reasons that amounted to this: "It will make everybody who is involved about your best interests feel good if you have it done."

I realized that if I did have this test, it would be done in order to please my son, my wife, my doctor, Sandy and others who are big fans of colonoscopy. These people all prefer a exiguous ache now in order to be on the safe side.

However, a doctor friend in Perth pointed out that some curative groups, including the Preventive Services Task Force, set 75 as the age to stop habit colon cancer screening. His view is that those (like myself) who consume a diet rich in fiber and otherwise live wisely probably don't need the procedure. He also pointed out that colonoscopies are not promoted in Australia nor are they covered by the Aussie universal health assurance system. He basically does not suggest it. Many others expressed a similar position, some quite strongly given the history in this country of immoderate testing, which can be perilous as well as precious to society.

Well, I'm still on the proverbial fence. I made an appointment with a doctor very recommended for early February. I plan to take my hesitations and concerns along. Maybe the good doctor will help me to see the light. Maybe not.

Needless to say, at this point I am not recommending for or against the colon screen for anyone else. But, I do suggest you do what I did-read up on the pros and cons and get all your concerns and questions-and discuss them with a knowledgeable health care professional. If necessary, get a second or third opinion. This is a good idea when considering any kind of invasive curative test or procedure. Then, do what you think is rational. Don't submit to testing or anyone else to please relatives or friends. Even if they threaten to boycott your funeral.

Be well.

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