Colonoscopy Notes

Quote of the Day

So, in the face of overwhelming odds, I'm left with only one option: I’m going to have to science the shit out of this.

— Mark Watney, The Martian. I love this quote.

Figure 1: Appendix Opening. This is not a photo of mine. (Source)

I had a colonoscopy yesterday, and it was a great learning experience. I am fortunate that the anesthetic they gave me had little effect, and the doctor was open to answering questions from an inquisitive patient. It probably helped that the doctor was a mechanical engineer that decided to go into medicine – we had lots to talk about. I found it funny when he mentioned that he did not like engineering work on optics – of course, much of my life has been spent designing optics. In the course of this doctors daily work, he uses optics all day long. His gear was from Olympus, some of which is manufactured in Brooklyn Park, Minnesota, which is near my home. Minnesota is known for its medical technology.

Here are the notes I took on the procedure.

• What is the basic colon inspection procedure

  The doctor told me that they put the probe in all the way to the appendix without really doing any observations. The colon sort of hugs the probe and you cannot see much. Once the probe gets to the appendix, they inflate the colon with CO₂ and do their inspection on the way out.

• How long is the colon?

  Around four feet long – he said the length is correlated with your height. Here is a good image of the colon. You can see the appendix at the beginning of the colon.

  

  Figure 2: Colon Structure and Endoscope Detail. (Source)

• Why is carbon dioxide used to inflate the colon?

  While in my upper colon, the doctor told the nurse he wanted to use CO₂ to inflate that section. I asked the doctor why CO₂ instead of air. He said that CO₂ is absorbed by the colon into the bloodstream very quickly and you just breath it out. Air is not so quickly absorbed and, if used, would leave you feeling bloated after the procedure.

• Has the doctor ever seen an infected appendix?

  He said that he has seen two during his years of practice (I would put the doctor in his late 40s). He said that an infected appendix is no issue as long as it can drain into the colon. An infected appendix will eventually heal as long as it can drain. You get into trouble when an infected appendix cannot drain and it ruptures.

• I was floored at how much the technology has improved since my last colonoscopy.

  My last colonoscopy was 9 years ago. The screen images back then were low resolution and black and white. These were high-res and in color. The level of detail was amazing. He controlled how the probe moved using a hand control that reminded me of the old hand controls used for remote manipulators.

• I have seen two types of polyp removal.

  Nine years ago, I had a mushroom-room shaped polyp and it was removed with a lasso-type instrument that both cut and cauterized the polyp. The doctor extracted the polyp, put it into a bag, and sent it for tests (no issue). I had three very small polyps this time. A very small pliers-like instrument was inserted and he just grabbed the polyps, twisted them to remove them, bagged them, and sent them in for tests.

• Do people ever come in that were not "cleaned out"?

  I was told it happens all the time. They have to go back home and take more laxatives. The colon has to be cleaned out for the doctors to do their work. Personally, I cannot imagine someone following the procedure and not being cleaned out.