No one can say I do things half-assed. I got a perfect 9/9 score on the Boston Bowel Preparation Scale. Clean as a whistle! 🙂 (I didn’t even know that there was such a scale.)
Yesterday’s colonoscopy went well, although it was a little different from the last one I had six years ago. The last one, I was knocked out with anesthesia and don’t remember the procedure at all. This one, I had “moderate (conscious) sedation” and was able to have conversations with the team and watch the procedure on a monitor, although my mind was drifting in and out of focus throughout.
Before we started, I had a good conversation with the doctor about my salvage radiation therapy and the possibility of radiation proctitis given the occasional blood in my stools. She was appreciative of the detailed information to help her in doing the procedure. I really stressed that I didn’t want the scope or the inflation of my colon to do more damage than what may already be there.
There were two polyps that were removed during the procedure and will be sent off for pathology. The first was in the transverse colon, and the second in the sigmoid colon, not far from the rectum. (I didn’t think to ask how long it will take for the pathology to come back, but I’m assuming it will be about two weeks.)
The sigmoid polyp was described as, “erythematous and friable.” Erythematous means the mucosa is red and inflamed due to a buildup of blood in dilated capillaries; friable describes how easily the mucosa can be damaged by a biopsy instrument or endoscope.
Because I didn’t read her printed report—with 13 color photos and map of my colon—until I got home, I didn’t get to ask if she thought that could have been caused or aggravated by the radiation therapy being closer to the rectum.
She also found “a few non-bleeding small angioectasias in the rectum, consistent with chronic radiation proctitis,” which are dilated, thin-walled blood vessels (think spider veins) that can occur anywhere in the gastrointestinal (GI) tract. I watched her zap those with “argon plasma coagulation (APC).” She described that as cauterizing the vessels to stop them from possibly bleeding into the GI tract.
Pending the outcome of the pathology on the polyps, she recommended a follow-up colonoscopy in three years. Yippee!
Time will tell if the sigmoid colon polyp removal and APC did the trick to stop the blood in my stools (hopefully, there are no new side effects from the APC). I guess time will tell on both counts.
Next up: Get through the holidays and PSA test sometime in late January.
Happy Thanksgiving! (I’ll get a 0/9 score after Thanksgiving dinner. 🤣)
Header Image: San Diego, California skyline at dusk.
