Colonoscopy ?

[lucky13000]

Got the first one scheduled as part of a routine check-up.

As a confirmed /exclusive bottom guy who enjoys his butt played with, is this any big deal ? Seems like the fears / anxieties about this procedure comes more so from the percentage of the population not accustomed to butt play. TIA for any feedback.

[+ Cash4Trash]

It is no where near as uncomfortable for us bottom guys as it is for the general population. Try to avoid moaning and getting a boner when they start.

 

Preparation, on the other hand, is a bitch. You really have to follow instructions and do a good job of cleaning out beforehand.

 

Assume you will be put under some local anesthetic.

[whipped guy]

As noted above, the worst part is the "preparation"... actually not being able to eat solid foods was the most difficult part... the consequences of the "cleansing" were simply an aggravation. After that it is a piece of cake. I was awake for the initial portion of the procedure and actually made a joke about it which the MD did not appreciate... I heard him tell the assistant to have the anesthesiologist "up" the anesthesia... after that I remember nothing.

 

I then went home and ate the biggest freaking breakfast imaginable...

[Guest Merlin]

Most people are asleep before they start to use the instrument, and don't wake up until the Dr is done. "Bottoms" have no advantage expcept perhaps in the anticipation.

[Greathands]

The only advice I have may depend upon the type of prep you're doing. For my prep, I also had to not eat solid foods, but was allowed broth, jello, etc. Then I had to mix a powder into 64 oz. of a drink (Gatorade) and drink it over a short period of time.

 

The drink didn't taste bad at all, even though I'm not a fan of Gatorade. However, because I had been eating broth and jello, I found it very hard to drink the 64 oz. It's hard to drink 64oz of something when you're not thirsty. If I had to do it again, I would refrain from consuming the broth and jello for a period of time before having to take the 64 oz. mixture.

[JT Brooklyn]

Being a Pro or Amateur BOTTOM I doubt will have anything to do with the Procedure! As others have and will say "The Prep" at least for me was a Bitch! I had it done First Time last September!

 

A few Bottles of Citric Acid, which you can MIX with O.J. or anything as long as it is NOT RED! ALSO a few Pills, very little sleep because of the On and Off "Cleaning Out" the Night before etc..Well you'll get the Instructions from the Doc! You will be asleep for the procedure and very groggy afterwards, but it will probably wear off after a few hours. BUT again everyone is different in that regard! DRIVING is a No No! The little pix's you are shown afterwards are real cute also! ;-)

[lucky13000]

When I was in the doctor's office discussing the procedure, he was urging the "gold standard" of prep being a full 3 days beforehand on the clear liquid diet. The instructions which came in the mail a day or 2 later from the hospital endoscopy dept. indicated starting the liquid diet just the day before at breakfast - which if good enough for them will be good enough for me. Drinking the colyte solution & taking the laxative pills are all on the menu. Having a supply of baby wipes for (many) repeated visits to the john seems sensible to reduce irritation. In the what to expect section of the instructions, they don't indicate a full sleeping anesthesia but rather just an IV with pain medication for a dreamy state, likely demerol from what I've heard. I have a designated driver for the ride home. Apart from having the patient show up clean & ready, this seems to be the point they emphasize the most. With an expected clean bill of health afterwards, hopefully this won't have to be repeated again for 10 or 15 years or so.....from what I understand.

Thanks guys for all the input.

[JT Brooklyn]

lucky 13..The Best Part of this Procedure is the 10 Years Later Part! Enjoy!;-)

[SoCal]

I've had 3, my 4th scheduled for next week - the frequency issue being benign polyps in my family history and a benign polyp (or two?) from me 3 years ago.

 

Coincidentally, the GI doctor who performs the procedure is also my primary care internist - and he does a significant number of these 4 mornings a week via referrals from all over my local area. For me the drug cocktail is usually demerol and an un-named "pyscho-tropic" drug the assistant says "helps you forget about it". I've had mixed results of being awake (and watched on the TV one time!), and falling asleep. Last time they did an endoscopy (sp?) at the same time - I joked with him to be sure and do that procedure first with a clean probe, lol!

 

No matter who I talk to, the "prep" day(s) seems to be the most diverse of any part of the procedure! I've heard the 3 day prep, enema prep, etc. I used to drink some solution in a tiny bottle that I added to clear juice or water, I think two little bottles of that in the fluid the night before, it was obviously a powerful laxative. I was just told that's been taken off the market due to kidney damage - caused by extended overuse (it was available without prescription) not from doctor approved preps. This time they are giving me "MoviPrep" which appears to be a large box with a plastic bottle and powders to mix in, one batch of that at 5PM the night before, and another batch at 5AM the next morning, 4 hours before the procedure. We'll see how this works.

 

There was some study done, in Canada I think where they found a greater incidence of colon cancer in the "top" 1/3 of the colon. There was research into some sort of link to this and patients not being properly and *completely* prepped for the procedure, i.e. they can't see what's going on up there if you're not prepped.

 

Finally I would say don't sweat it - it's not that bad - the day of prep is much more of a pain then the procedure!

[whipped guy]

"...the "gold standard" of prep being a full 3 days beforehand on the clear liquid diet."

 

Lucky... Just one more thought for what it is worth... I was told to do the one day prep as well. However, on my own I made sure I had a very "cleansing" high fiber diet the day previous to the prep. Evidentially this proved to be beneficial as my MD subsequently told me that he had never seen anybody that was "cleaned out so well." Fortunately he then said that I didn't have to do a repeat for 10 years...

[+ Axiom2001]

>Most people are asleep before they start to use the

>instrument, and don't wake up until the Dr is done.

>"Bottoms" have no advantage expcept perhaps in the

>anticipation.

 

 

I liked your genuine and candid response. I've had two in ten years, and it's tame in comparison with some other procedures. As been stated in some of the other posts-- follow the instructions precisely and have a "needle" given to you prior to the actual procedure, and you should be fine.

 

When I had my first one-- the prior in-office prep took longer than the actual procedure. When I woke up, I told my attending this and then complimented him on his red tie. It was all so amusing to my friend (who was by my bedside) and me.

[Guest ncm2169]

Well, chiming in. }(

 

I've had four of them, three which began and finished as two-stage colonoscopies (total scopes) and one which began as a colonoscopy and finished as a sigmoidoscopy, the latter being a minor procedure in which polyps are excised and examined to insure there are no cancerous cells present (or, if there are cancerous cells present, they are dealt with post haste).

 

With the (sorry for the coarse reference, that I've only been fucked twice), but all of the medical procedures were a piece of cake. As in, NO pain involved whatsoever, NONE at all. Yeah, some ludes to dull the moment, but all in all, like I said, a piece of cake.

 

If you're over 45 and haven't had the exam, you're a total fool.

 

Yeah, the overnight prep can be a bitch - think farting your guts out (to be rude) - but the alternative is hardly preferable.

 

Look at the stats - colon cancer is among the most common causes of death in middle-aged males, and the cure/prevention is simple.

 

DO NOT avoid the exams. Or, do so at your own very huge risk. x( x(

 

I helped bury a 48 y/o male relative of mine earlier this year. Cause of death? Three guesses. x( x( x( x(

[Guest zipperzone]

I have asked my GP for this exam on more than one occasion. Normally he is very cooperative in arranging for any test he or I think may be prudent.

 

However when I ask for a colonoscopy all he will prescribe is the test where you (sorry I don't know the name for it) where you scrape three samples of stool onto a card and take it to the lab. He says if there is no blood in the samples you I am OK and don't need the full deal.

 

Would any of you doctors here care to comment on the validity of this approach? Please!!!!

[Guest ncm2169]

Zip, first, I'll happily defer to any MD's here.

 

I had the stool sample/card scrape when I was in my 30's. All my medical advice then was to begin having the scope when I turned 40. I've since had several growths analyzed, all of them heretofore benign, thankfully. There is still a chance I'll have more growths, and if they're malignant, with recurrent checks they'll be found "in time."

 

The message: DO NOT RISK IT. DEMAND that your MD do the procedure. DEMAND that your insurance pay for it. Period.

 

P.S. You're too much fun around here. Don't disappear on us. :* :*

[Samai139]

I am also not a physician, but will contribute my "three cents" based on family history and personal experience:

1. There are many variables----family history being extremely important. If ANYONE in your family has a history of colon cancer and/or polyps, you should absolutely demand a more significant exam than the stool sample technique---you NEED a colonoscopy. Age is also a significant factor---if you are over 40, you also should demand the colonoscopy. Other incidents regarding colon problems should be explained or related to your physician, even if they are only suspicious.

2. Enough has been said about the prep, as far as alternatives---be SURE you follow the directions precisely and you should be cleansed appropriately.

3. You NEED to have someone drive you home after the procedure---most hospitals will not let you leave, walk, take a taxi, etc., if you do not have a driver with you who will ensure that you get home, get into your residence, etc.

4. To be free of colonoscopies for 10 years is probably NOT an option if you are over 50 or if polyps, benign or otherwise are found--each patient's needs are different.

5. For those of you reading this thread who have never had a colonoscopy and are worried/concerned about ANYTHING to do with it----get over it. Forget minor difficulties, embarassments and make sure you have it done. As has been said, this is a common cancer that can and should be prevented.

6. Lucky: Hopefully you will be given a clean bill of health and even as important, brought others on this FORUM to the point where they follow your example.

[JT Brooklyn]

Samai..Exactly. For those who have not had the "Procedure" Done..Now is the Time!

 

I am pretty sure this is a Procedure that is a "Referral" in many cases to a DR. WELL EXPERIENCED in Colonoscopy, which was my experience in NYC.

[+ Charlie]

Because my mother had colon cancer at 70 (she had successful surgery and lived, without any recurrence, till 102), I have had a colonoscopy every five years since I was 55. It's a nuisance but not a big deal. However, I read recently that there is a new non-invasive procedure which actually does a better job of detecting the polyps, but it will probably be a while before it becomes a standard procedure.

[+ Lucky]

But even the virtual colonoscopy requires the task of cleansing the area to be examined, which is the difficult part of the whole procedure, at least for some people. A night on the toilet and hours of starving, then the scan, and if that is not conclusive, you have to have the old-fashioned kind anyway.

 

http://www.sciencedaily.com/releases/2005/04/050422170630.htm

[Guest arbee]

I am a doc.

 

Unless you are an "at risk" patient (i.e. family history, history of bleeding, history of prior colon tumors, both benign and malignant), you should have a routine screening colonoscopy at age 50. This is both the ACS (American Cancer Society) and WHO (World Health Organization) recomendation as I recall.

 

The stool card test you describe is likely the old guaiac method which is not super-accurate; newer, more accurate stool "scrape" tests are around but are more expensive and have to be sent to a lab. The older method can be "analyzed" at your doctor's office... and he can/likely will charge you for this. Hmmmm... And stool occult blood testing is not a substitute for a routine screening colonoscopy anyway.

 

As an aside, I should tell you that I bristle when patients "demand" something of me. But then again, I'm not an asshole like your doc seems to be (at least I think/hope I'm not!) so they don't need to demand anything. I generally know what I'm doing (but hey, nobody can know everything) and am at least willing to discuss things with patients.

 

I think you might have another chat with your doc and perhaps bring a copy of this thread to him... uh, no wait a minute... perhaps not this thread. Do a little hunting on the 'net and visit him with some ammunition.

 

Good luck.

[Guest msclonly]

The BEST part of the examination!

 

Upon completion, the Dr said, your are normal! COme back in 20 years!

 

Being very Senior, I take supplements, that prevent the duplication of cancer cells!

[tealady]

and they found.... High Grade Squamous Intraepithelial Lesions

 

had it done, and cancer was not the problem, thank god they found it....

 

High Grade Squamous Intraepithelial Lesion

 

If a high grade squamous intraepithelial lesion or condyloma is detected by a colposcopy exam, immediate treatment is necessary. Such a disorder doesn�t necessarily mean that cervical cancer is present, but is a warning that cancer may occur later, if immediate treatment isn�t performed and abnormal cells are not removed. A Pap smear test and colposcopy with biopsy can diagnose these conditions. If a high grade squamous intraepithelial lesion or condyloma is detected by a colposcopy exam, immediate treatment is necessary.

 

if you are looking for a great great new york city the only one to go to is...Dr. Stephen Goldstone md. he will take very good, kind, and will make you totaly at ease.

 

http://www.healthgrades.com/directory_search/physician/profiles/dr-md-reports/Dr-Stephen-Goldstone-MD-8E6F6485.cfm

[tealady]

Anal Cancer in Gay and Bisexual Men

 

here is another link for you to look over, i am so glad i had my test at age 50.

 

http://www.lgbthealthchannel.com/msmcancer/index.shtml

 

Anal Cancer in Gay and Bisexual Men

 

 

Overview, Types, Symptoms, Diagnosis

 

Physician-developed and -monitored.

 

Original Date of Publication: 01 Aug 2001

Reviewed by: Stanley J. Swierzewski, III, M.D.

 

Original Source: http://www.lgbthealthchannel.com/msmcancer/index.shtml

 

Home » Anal Cancer in Gay and Bisexual Men » Overview, Types, Symptoms, Diagnosis

 

 

Anal cancer is an uncommon, often curable cancer that produces slow-growing tumors and lesions in the anus and nearby anal anatomy. Most anal cancers are associated with human papillomavirus (HPV), which causes warts on the anus and genitals, similar to cervical and other cancers of the reproductive system. Providers recommend annual anal Pap smears to HIV-positive men who have sex with men (MSM), and biannual Pap smears to HIV-negative MSM.

 

Pap smears screen for HPV and abnormal tissue growth (dysplasia). Routine anal Pap smears may reduce the incidence and progression of anal cancer, as they have for cervical and uterine cancer. The prognosis is good if the cancer is discovered early

 

Incidence and Prevalence

Anal cancer affects men and women, but it is the only cancer with a greater prevalence among men who have sex with men (MSM) than in the general population. About 35 in every 100,000 MSM develop anal cancer, compared to less than one in every 100,000 heterosexual men. The risk for anal cancer in HIV-positive men is twice as high as that for HIV-negative MSM.

 

The American Cancer Society estimates that there will be 3,500 new cases of anal cancer among men and women in 2001 and 500 deaths resulting from it. Cancer of the perianal skin around the anus is more common in men, while tumors of the anal canal more often affect women.

 

Anal cancer accounts for only 4% of all cancers affecting the digestive tract.

 

Types

Anal cancers are skin cancers. The majority of anal cancers are squamous cell carcinomas (in situ or epidermoid), which originate in the first layer of anal tissue and may spread to deeper layers. This type is associated with HPV. About 15% of anal cancers originate in the glands near the anus; this is called adenocarcinoma, or Paget's disease. The remaining anal cancers are basal cell carcinoma and malignant melanoma. Melanoma in the anus is difficult to see and is often discovered at a late stage, after the cancer has spread through layers of tissue.

 

Risk Factors

The exact cause of anal cancer is unknown. Aside from general cancer risk factors, like smoking and alcohol consumption, certain risk factors increase a person's risk for developing anal cancer. HPV and anogenital warts are a significant risk factor. This includes past and current infections. Some strains of HPV that cause larger warts are not associated with cancer.

 

Most men that develop anal cancer are over 50 years old, although coinfection with HIV increases the chance of early development.

 

Symptoms

 

Many men have no visible symptoms of anal cancer. However, because the cancer is strongly associated with HPV infection, a history of anogenital warts is likely. Although most lesions are benign, any visible anal sore or bump should be examined. They may be a sign that others have developed in the anal canal.

 

Other signs include the following:

 

Abnormal discharge from the anus

Bleeding from the rectum and anus

Itching of the anus

Pain or pressure around the anus

Sore around the anus that does not heal

All of these signs warrant an examination by a physician.

 

Diagnosis

 

Anal cancer is diagnosed with an anal Pap smear, in which a cotton swab is inserted past the anus and swirled to capture a tissue sample. The tissue cells are examined under a microscope for signs of dysplasia. An abnormal Pap smear shows signs of excessive cell growth and is followed by a colposcopy, the internal examination of specific lesions or areas of cell growth for biopsy. Acetic acid (vinegar) is introduced into the anal canal to prepare the cells before an anoscope, a plastic tube, in inserted. The provider inserts a colposcope through the anoscope to visualize the cells in the anus with magnification. The procedure is painless. During a biopsy, a biopsy forceps is inserted in the suspect tissue to obtain a sample for close examination. Lesions and tumors found during a colposcopy are typically biopsied.

 

 

 

Advertising Disclaimer

Anal cancer may be discovered during a routine digital rectal exam (DRE), in which a medical professional inserts a gloved finger past the anus to feel for abnormalities.

 

Staging

Staging is the evaluation of the size and location of a tumor to determine a prognosis and appropriate treatment. Initially, abnormal tissue growth is classified as high- or low-grade squamous interepithelial neoplasia (LSIN or HSIN; high- or low-grade abnormal cell growth), or as cancer. This is determined by the biopsy performed during colposcopy.

 

If cancer is detected, its stages are described in the following way:

 

Stage 0 Cancer is found only in top layer of anal tissue (squamous cell carcinomas).

 

Stage I Cancer has metastasized (spread) beyond first layer of tissue but is smaller than 2 centimeters.

 

Stage II Cancer is larger than 2 centimeters but confined to tissue.

 

Stage III A Cancer has metastasized to nearby organs (bladder, reproductive) or lymph nodes.

 

Stage III B Cancer has metastasized to organs and lymph nodes in the abdomen, groin, or rectum.

 

Stage IV Cancer has metastasized to distant organs.

 

The TNM system is also used to stage anal cancer. In this system, T corresponds to tumor size, N refers to whether or not the lymph nodes are affected, and M refers to whether or not the cancer has metastasized (spread) to other organs.

[Lookin]

RE: and they found.... High Grade Squamous Intraepithelial Lesions

 

Glad you dodged a bullet, tealady!

 

Many thanks to you and the other posters who have passed on such good info.

 

After hearing of a couple people who had cancer diagnoses when it was too late to do anything about it, I asked my GP what kinds of cancer screenings were available to catch it early on. She said that some of the tests were not without risk, so they're usually done based on risk factors. For men over fifty, screening for prostate and colon cancer is a no brainer. I guess mammograms and PAP smears are pretty standard for women.

 

Are there any other cancer screening tests that folks are familiar with?

[Justice]

As others have said, the actual procedure is no big deal. (I took the subway home.) They found some polyps, so I get to do it again this year. Oh, joy.

 

The preperation was awful. I didn't mind the no solid food the day before -- apple sauce, lemon jello, and some Ensure, etc, etc., but the liquid that your supposed to drink (even with the addition of the "cherry" flavor packet was awful. It took forever to get the taste out of my mouth. I drank massive amounts of ginger ale (which was allowed according to the instructions) and vented to a friend about how bad the taste was in between trips to the bathroom.

 

I know 7 people who had colon cancer. Three of them died. One of them was only 38. It spread to his liver before they found it. Another friend was just diagnosed, she's only 43. Unless you have a family history (I have a friend who has to get a colonoscopy every year because her father died at 55 from colon cancer), or unless you have some sort of symptoms, insurance won't pay for a colonoscopy until you reach a certain age. It's a very expensive procedure. The gastrointerologist billed my insurance company over $2,000 (my co-pay was $40) and that doesn't include the $2,000 bill from the anesthesiologist. (Again, my co-pay was $40.) I also had a $25 co-pay for the vile substance that I had to drink. Given what my friends (and their families) are going through (or went through) paying $105 in co-pays, drinking a vile liquid, and living in the bathroom for a couple of hours is a small price to pay.

 

Everyone who is over certain age (check with your insurance company first -- mine won't pay until your reach 50) should get colonoscopy. As unpleasant as it is, it can safe you life.

 

Just my $0.02.

 

Justice

[BARR1965]

My mom is 76 and she will have her colonoscopy tomorrow. She is drinking whatever her doctor's prescribed and drinking lots of juices (white grape juice and apple juice), eating lots of jellos and chicken and beef broth. Her last colonscopy was more than 10 years ago and lately she has been complaining about her stomach. So her doctor ordered her to get this procedure done. She is not a happy camper today and I know for sure tomorrow she will be the same thing. I am hoping the results will be negative.