The American Cancer Society (ACS) recommends a colonoscopy for everyone starting around age 50. The goal of the screening procedure is always to search for existing colorectal cancer or symptoms the illness may develop. Extra colonoscopies are encouraged thereafter at 10-year intervals, assuming no problems are found. In the ACS site, the procedure is known as 'uncomfortable and invasive' and suggests 'some one drive you home following the procedure.' Planning for colonoscopy involves 'washing of the colon' employing a special diet and laxatives for each day prior to the procedure. There are many possible complications of a colonoscopy, including death, bleeding and perforation, again based on the American Cancer Society. The most common complication is perforation, developing approximately once in every 1,000 processes, based on a 2009 review published in 'Genetics in Medicine.' Death does occur in every 12,500 procedures.
You can find other, less invasive alternatives for colorectal cancer screening, including virtual colonoscopy and stool tests, such as fecal immunological tests or fecal DNA. Naturally, these are not what American physicians call 'the gold standard.' A ColonoscopyMD.com is the gold standard.
A colonoscopy requires the insertion of a thin, tube-like instrument equipped with a small camera named a 'colonoscope' (what else-a periscope?). This device is introduced up the rectum where it's threaded through the entire colon. The colonoscope allows a visual examination of any incipient colorectal cancer and a treatment and biopsy of suspicious lesions. If no lesions are located, suspicious or otherwise, two things happen before the device is removed while the patient remains under sedation: 1) The doctor who performed the procedure is given plenty of time to escape town and begin a new life under a government witness protection-like program; and 2) When the drugs wear off and the patient is fully revived, an experienced psychologist says some thing like this to the patient: 'Sorry, we did not find a thing wrong with you. You really didn't need to go through this. Your colon is fine. Keep coming back and see us again in a decade. We'll do this for you again.'
No, I am just kidding-I made that up because here's the truly wonderful fact of the matter: The individual is prepared with this highly probable situation! And he went through with it, anyway. He is not gobsmacked to learn for naught-he might have been good if he missed everything that it was. All he's is a few reassurance that he does not have this kind of disease or likely to get it quickly. You can still find numerous the others laying in wait for the passage of time. Exactly how many more tests can he have to discover that he doesn't have one of them? Regardless, this is what he really thought to be told about the outcomes of the colonoscopy. At this point, the in-patient is not only expected NOT to get the neck of the medicos who did this to him but, on the other hand, he has been programmed to be happy about any of it all. Hence, he's likely to say something similar to this: 'Oh, thanks therefore much. Thank you, thank you. I'm sooo pleased. You folks are the best. I will hardly wait till you repeat in my experience in ten years.'
I've never paid much attention to what the ACS or other medical organizations recommend concerning one test or another. I've been wary of all such medical imprecations, examinations, preventive assessments, risk assessments and medical tests. There is a significant amount of of the. Such actions have been part of the medicalization of health for at least fifty per cent of a century. I became aware of the issue as a health coordinator starting in the late 60's. I was absorbed in medical policy and analysis for five years before shifting into my current role of wellness advocate. I have a Ph.D. in health and public policy. I saw close up and personal the reality and the bad, frequently dangerous effects of our bloated, structural medical system. I have written extensively about it.
The situation of health being made a medical issue has only gotten worse. In a recent Progressive Policy Institute (PPI) record, Peter Orszag, director of the Congressional Budget Office, is mentioned for his estimate that 5 percent of the country's gross domestic product--$700 million per year - goes to tests and procedures that don't really improve health outcomes. He believes that the 'unreasonably high cost of medical care in the Usa is a deeply entrenched problem that has to be attacked at its root.'
Physicians claim that colonoscopies are the gold-standard of preventive medicine. Well, that may be, but who really wants the gold standard? Everybody more than 50, every ten years? The jury is going. What's more, if you are 50 or over (or someday allow it to be that much), you should do some checking to establish if the court has completely rendered a judgment on colonoscopies-and plenty of other tests and procedures done routinely.
In 2008 the American Cancer Society deemed as the test the colonoscopy. Medicare pays for colonoscopies and the new health reform legislation (PPACA) compels insurance companies to cover them.
Yet, I've good reasons for resisting this procedure, besides a general understanding the medical system is rife with unnecessary testing, some of which may be hazardous to health and success. As an example, a colonoscopy is three to four times more expensive than a simpler test-a sigmoidoscopy. This includes but a partial 'probe' that lasts but a few minutes. There's no sedation, no need to take some time removed from exercise or work, no jug of laxatives or awful clearing of the colon the night before and perhaps no need for a gastroenterologist-family or primary care doctor could do the procedure.) Best of all, the possibility of complications (infections, bleeding, incontinence or, worst case scenario death), is seven times significantly less than for the Entire Monte big D ordeal.
And here is the gripper: the founder of the colonoscopy, Al Neugut, wrote an article in the JAMA this summer stating that he regrets creating the colonoscopy. Neugut explained, 'If today, we were where we were in 1988, I'd not institute colonoscopy based on the current evidence.'
As one wag put it, the gold-standard of preventive medicine might only be wonderful from the point of view of medical practitioner salaries.
All of this is private. I am nearly 74 and I've never had one. Many of my friends find this terrible. My spouse and my daughter have been after me to get it done. And, certainly one of my best mates, a person who I hold in the highest regard for half a dozen distinct reasons, has taken out almost all stops to tell me to show myself in the colon corps else drastic steps is likely to 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 professionals and cons of the method, I continue to wrestle with a go/no go decision. I have employed my ouija table, astrology information and prayer book. Still, the cases for and against having a colonoscopy appear to balance out. (Yes, needless to say I'm kidding about the chart and prayer book. )
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I admit that, in weighing the two options, I started and remain biased in support of the 'give it a cross' choice. The prospect of starting this indignity seems tragic, to paraphrase Mr. Chaplin, when observed in close-up. But, I suspect that if I were to undergo with it and find that the test results help me to keep on top of our planet a great while longer, my delay appears to be comedic, in retrospect.
Important people in my own life have been after me for many years to have this process. This important group includes my son, my primary-care medical practitioner and my spouse. Their well-intended concerns are naturally respectable and appreciated. But, I think they are affected by an excessive amount of caution about lurking future problems coupled with too little concern for the unpleasantness of the entire process, and the high probability that it'll prove to have been unnecessary. Unfortuitously, the pressure to fight no more-to just do-it, is almost insufferable.
The assault started about a month ago within a training trip. A cycling friend and champion athlete about my age whom I'll contact 'Sandy' asked me if I have had a colonoscopy, currently. I answered that I had not. Upon further interrogation, I had to admit that I'd no plans to get one any time in the future. I thought that was the conclusion of it. Not so. Later that day, I got a long email from him. He claimed that as a 'expert of wellness,' my audience expects that I'll also take an interest in my own health. He claims that modern colonoscopies (versus what - the sort doctors conducted in the Middle Ages?) are quite easy and that, at my advanced age, I quickly increase things (besides nose hair). By this, he meant there's a higher likelihood that one or maybe more polyps could be within my colon. He called me 'a stubborn old goat.' But he softened that by adding that 'those of us who respect and love you'll be sad if my opposition proves fatal. He ended by warning that if I do not get yourself a colonoscopy and colon cancer causes my collapse, he'll boycott my funeral and stop reading my weekly wellness newsletter.
All this was motivational and very helpful, specially the areas involving flattery. I asked a number of associates, including several medical practitioner friends, due to their ideas on the matter. About half suggested it was unnecessary; the remainder said it's advisable. The latter, however, did so for reasons that amounted to this: 'It'll make everyone who is concerned with your best interests feel great when you have it done.'
I realized that if I did have this test, it would be performed in order to please my wife, my child, my doctor, Sandy and others who are big fans of colonoscopy Los Angeles. These people as a way to be on the safe side. all prefer a bit discomfort now
But, a doctor friend in Perth noticed that some medical groups, like the Preventive Services Task Force, set 75 as the age to avoid program colon cancer screening. His view is that those (like myself) who eat a diet rich in fibre and normally stay correctly probably do not need the procedure. He also noticed that colonoscopies aren't promoted in Australia nor are they covered by the Aussie universal health insurance program. He fundamentally does not recommend it. Numerous others expressed the same position, some quite clearly presented the background in this country of excessive testing, which can be risky as well as high priced to society.
Well, I'm still on the proverbial wall. I made a visit with a doctor strongly suggested for early February. I intend to take my hesitations and problems along. Maybe the good medical practitioner will help me to see the light. Maybe not.
Naturally, now I am not recommending for or from the colon display for anyone else. But, I do recommend you do what I did-read up on the professionals and cons and collect your entire problems and questions-and discuss them with a knowledgeable healthcare professional. If necessary, obtain a 2nd or third opinion. When contemplating almost any invasive medical test or treatment It is a good idea. Then, do what you think is rational. Don't submit to testing or whatever else to please family relations or friends. Even though they threaten to boycott your funeral.
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