CAT Tracks for August 17, 2010
POINT OF PERSONAL PRIVILEGE

Today would have been my wife's 60th birthday...


Readers of my other website (julieanewell.com) know that Sister Rachel and I will be looking high and low today for "signs" of Julie's continued presence. Oh, it's (mostly) a lark, an endeavor that represents our search for triggers of fond memories...once-happy days now tempered by feelings of melancholy.

So, when I saw this editorial in today's New York Times, was it any wonder that I would take it as the first sign of the day?!

Of course, I would have hoped for a something "lighter". Colon cancer, colonoscopies, sigmoidoscopies...whatever!

Maybe it's a sign...that on this day, we shall follow protocol. You know..."I've got good news (signs) and bad news (signs). Which do you want first?"


(And, lucky for you, Dear Reader...I just hit the delete button on an hour's worth of wallowing in self pity. This may be the time, but it's definitely not the place. If I "return to the scene of the crime", it will be on my aforementioned other website.)


Maybe I do have a dog in this hunt after all...

Julie had several colonoscopies, including one a week or so before surgery revealed an inoperable, malignant intestinal mass. Every one of her colonoscopies were CLEAR, prompting one doctor to inform her that she had a "beautiful colon". (Obviously, it's not only scientists who wander off into the wilderness of Utah to study the brain's addiction to technological devices who don't get out very much! Geez...in the eyes of the beholder.)

Being a typical man...I've managed to avoid a colonoscopy. At 65, I should have had four of those suckers by now! (Hey, before you nag...I went to Paducah for a colonoscopy just last week. I was the designated driver for a sensible relative. Don't I get points for that?)

Anyway...

If I should wake up some morning and decide that it's time to repent - or simply get the urge to schedule an invasive medical procedure - I think I might check into the sigmoidoscopy thingy. That might be the best "sign" that Julie every sends...


As all y'all ponder which procedure is best for you, I will share my colonoscopy "humor" from last week...

As my relative was being wheeled out of the exam room toward the procedure room, I bid him adieu with "Up yours, fella!"

However, in a more sympathetic mood following the procedure, I assured him that "When the end's well, all's well!"

Before you groan too loudly, I have an excuse...a medically proven excuse.

Since I was not the one having the colonoscopy, I didn't have to drink the nasty stuff in preparation...with the resultant effects.

I'm full of it!


From the New York Times...


Link to Original Story

Editorial
Colon Cancer Prevention

A provocative new analysis suggests that the colonoscopies many people get to detect and eliminate colon cancer before it can kill them may be no more effective than a less invasive (and cheaper) procedure would be. The analysis, more thought-provoking than conclusive, illustrates the kind of evidence scientists will need to develop as leaders of the American health care system struggle to define which treatments are more effective and more cost-effective than others.

Over the past two decades, colonoscopies have become the preferred method for trying to detect and remove cancers and precancerous polyps in the colon. They have largely supplanted their main rival, sigmoidoscopies. The sigmoidoscopy looks at only part of the colon; the colonoscopy inspects the whole length. For many patients and doctors, it seems only common sense that the more comprehensive exam is the safest choice.

Yet there is scant evidence to support that belief. A recent commentary by two Columbia University experts in the Journal of the American Medical Association suggested that colonoscopies may be no better at preventing cancer deaths than sigmoidoscopies, which are easier on the patient and have fewer complications.

Three studies conducted abroad over the past two years found that colonoscopies did indeed reduce colorectal cancer mortality or incidence by essentially the same amount that sigmoidoscopies did in separate studies. The colonoscopies achieved their effect by eliminating only growths found in the part of the colon that sigmoidoscopies can also reach and identify, not by eliminating growths deeper inside.

Experts have been scrambling for explanations. Their theories include: a failure by many doctors abroad, who are often less experienced than American specialists, to inspect the entire colon; a failure by many patients to cleanse their bowels sufficiently; and molecular or anatomical differences that might make growths in the distant reaches of the colon more difficult to spot.

It would seem premature for patients to abandon colonoscopies based on these studies. The critical need now is for researchers to determine how well colonoscopies perform in the United States and to identify how to improve their effectiveness. Meanwhile, those who have shunned colonoscopies as too arduous may prefer a sigmoidoscopy. Either technique can substantially reduce the risk of colon cancer.