On the History of (Jack’s) ColonFiberOscopies

First, I have to begin with a word of caution. This biographical entry contains some materials of a medical nature that might make some people a bit queasy. Best to skip this article if you don’t like hearing about blood or poop.

I’m writing this after my most recent colonfiberoscopy at UT Medical Center, which stirred the memory of how I became about the 3rd person in the United States to be treated with that instrument.

My earliest recollections of serious medical issues involving my guts go back to when I was 8 years old. That’s when I first noticed that there seemed to blood in the potty when I went to the toilet. Although my parents were not exactly the most medically knowledgeable people in the world (an understatement of considerable proportion) they did understand that this needed attention. Our family doctor recommended that they take me to Mt Sinai Medical Center.

There, and at many other times throughout my childhood, I experienced all the diagnostic tools available multiple times: the barium enema, proctoscope, and sigmoitoscope. None could detect the problem, although the presence of blood was confirmed and indeed obvious. In those days, the only thing that might have worked was exploratory surgery and as it turned out, thank Heaven my parents chose not to put me through that. So I regularly found blood, and every few months, there would be quite a bit of it.

In the Fall of 1969 I headed off to the University of Wisconsin, which had and still has one of the finest medical research hospitals in the world. As a freshman living in the dorms I reported my issue to the Student Health Service and they put me through the same battery of tests with the same results. Yes, there is blood, no, we can’t figure out where it’s coming from.

In my sophomore year, I was living off-campus with several guys who have become my life-long buddies. As it happened, our landlord stopped by to chat. He had a brand new powder blue Cadillac he was showing off. I felt some pressure and went to the toilet where I expressed approximately half my blood supply. I staggered out of the bathroom and passed out. I woke up in the University Hospital ER. I learned later that my hematocrit was 18 (42 is low-normal for adult men), so they gave me a transfusion of two units of blood. By then, whatever had caused the hemorrhage had ended, so once again, they were stymied about what was causing this. 

The way I got to the hospital was that the aforesaid landlord, who we thought was kind of a joke, grabbed me and threw me into his brand new car and drove me to the ER. You can never tell how kind and gracious a person can be until you see how they react to unusual circumstances. I never joked about Sid Livsey again. But I have to say that the next time I saw him he was driving a different car–he said, “Well they got the stains out, but they couldn’t get the stink out.” So he bought a new car.

I spent a few days in the hospital recovering and on the day I was to be discharged an impeccably dressed man came to visit me. His name was Dr. John F. Morrissey. Dr. Morrissey had formed a strong relationship to a team of Japanese doctors who had invented a new device which was then called a colonfiberscope in 1969. Dr. Morrissey had used it for the first time that very week and he invited me to become the third patient. He explained that this was a flexible tube that could reach far higher into the intestines than a sigmoitoscope. And, depending on what they found, they could actually use the instrument to fix some sorts of problems. I didn’t need much convincing. So that is how I became patient number 3 for this new device in the US. 

When you hear about this procedure these days, mostly what you hear about is how difficult the “prep” is. Basically, the idea is that the physician using the scope has to be able to see the intestinal wall, and that’s hard if it’s covered in poop. So you have to do something to clean it up. In 1971 that meant not just laxatives, but enemas.

On the morning of the procedure, I arrived at the clinic and was strapped into a chair that could be inverted. When I was upside down, they pumped water into my colon until my bowels were bloated. Then they right-sided the chair and the water poured out of me. They did this three times.

Next, I was wheeled into the room with the instrument. In those days the instrument was much thicker than it is today and you can guess what that might mean in terms of comfort. Of course today, Propofol is the drug of choice and you really don’t feel a thing. But in 1971, as Dr. Morrissey explained, they could not use anesthesia because they needed my feedback (so to speak) on whether the instrument might be causing too much stress. But they did use an I.V. to provide me with valium (diazapam) which made me a bit loopy.

The scope was inserted and at intervals of 25, 35 and 45 cm (about 18″) they found large polyps. The deepest and largest of these was big enough to have produced the hemorrhage that nearly killed me. Dr. Morrissey used the scope to extract the polyps and cauterize the areas. A few days later the pathologist reported that while these were very large polyps, they were benign. For the first time since I was 8 years old I could go to the bathroom without seeing blood in the toilet.

A year later, I returned for a follow-up procedure. Major improvements had already been made and I don’t recall any pain or problems. The scope showed that my intestines remained in fine condition and no new polyps had grown. I was then 21 years-old.

I didn’t have another colonoscopy until I turned 50 when my family physician advised it as part of my regular checkup. As you can imagine, I was astonished by the difference those decades had made. I know it’s an over-used metaphor, but comparatively speaking, it was a walk in the park. On that occasion, they found 2 “diminutive” polyps and now they applied the more technical term “adenoma” to them which is the more dangerous kind because they can become malignant. Mine were benign, but they recommended 3-year follow-ups. So while we lived in Michigan, I went twice more and both times the results were “clean”–no more polyps.

We moved to Tennessee about 9 years ago and when the time came for a follow-up I had an unpleasant surprise. Our GI folks prescribed a “prep” which in it’s own way was as bad as what I went through in 1971. If you’ve had a recent colonoscopy, you know what I mean–a requirement to drink a full gallon of ghastly stuff. There are more palatable alternatives, but many health plans won’t pay for them. So I did what I knew to be the stupid thing and didn’t go.

This year my health plan, it turned out, had authorized the more palatable solution and so I scheduled my visit for today. The prep was awful, but less awful than drinking a gallon. The test itself was, as I said, a walk in the park. They did find three (again) “diminutive” polyps and my GI doc said there’s no chance that they are malignant. But that doesn’t mean I wasn’t stupid. I should have swallowed my pride and the prep and gotten the test earlier. I could have as easily allowed myself to get cancer for nothing as have this better result.

Don’t do as I did, do as I say: get the test when the docs tell you to.

4 thoughts on “On the History of (Jack’s) ColonFiberOscopies

  1. Jack – I have one last colonoscopy to do. I am 76. Since there is a history of colon cancer in our family I have had a colonoscopy every 5 years. I have been putting it off and don’t want to do it. This is the 7th year. Bren is pushing me. Maybe, after I get the vaccine, I’ll do it. Your very interesting, clinical article may have convinced me.
    Chip

  2. Dear David,

    First, thanks for commenting. Second, I’m a little concerned that your doc might have said some blood test would “clear you of any issues.” I’d be willing to bet that same blood work would have “cleared” me and then my 3 polyps would have gone merrily along. And true, they might never have caused a problem. But then they might have. And if you are certain that there is no family history of colorectal cancer, you are probably pretty safe. But then again, there’s none in mine.

    Insurance companies are getting worse and worse about putting pressure on doctors not to recommend expensive procedures. I already got my bill (which will be paid in full by insurance in my case) for $2,250. That includes the $250 for the mandatory COVID test but doesn’t include the $200 “prep” drugs.

    One of the things I hope my story illustrates is that it is quite possible to die from benign polyps. I came pretty close.

    All I’m saying is, maybe get a second opinion.

  3. Jack,
    I am glad to hear your polyps are benign. I turned 50 a year ago and at my last checkup I asked my primary physician if it was time for me to take the plunge. He told me that my blood work would show some kind of indication as to whether I needed to be concerned enough to get a colonoscopy. Fortunately my bloodwork cleared me of any issues.

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