Happy Friday! If you're new to Now I Know, you'll notice that today's format differs from the rest of the week. On Fridays, I pause to write the "Weekender," my  "week in review" type of thing, or to share something else I think you may find interesting. Thanks for reading! — Dan

What To Do At 45 Years Old (a PSA)

Hi!

Last year, I turned 46, so the title isn’t quite accurate. At age 45, if you’re at an average risk for colon cancer — and being a random person, I’m literally at an average risk — you’re supposed to have a screening called a colonoscopy. I had my first one this week.

A lot of people decided to not have a colonoscopy because the procedure seems intimidating and invasive — the doctor sends a camera up into your intestines through an opening that typically isn’t a point of entry, and that understandably bothers a lot of people. But dying from a manageable form of cancer is worse, so I’m here to allay those concerns and encourage you to get checked if you’re of age or otherwise in need of such a screening. Here’s my experience: I hope it convinces you, if you’ve been putting off getting checked, into scheduling an appointment.

The initial consultation was back in July. It just a meeting with a gastroenterologist. I made an appointment directly (this part was easy, as my wife had already used this doctor) and we sat down and talked. Coincidentally, his first name is Dan and his middle name was Lewis, but if you can’t find a doctor who shares your name, that’s fine; name-matching isn’t a required element of the procedure. He wrote me a script for Suprep, a drink mix (covered by my insurance) and put me on the calendar for a September 11 colonoscopy. I picked up the Suprep last week — the pharmacist was a bit confused why it had sat on their shelves for two months! — because you don’t use it until the day before. The Suprep is a very strong laxative — it empties you out so that, the next day, the doctor gets a clear view of what’s going on in your colon.

For the day before — September 10 — I didn’t eat anything solid, as directed. I drank a good amount of water and a bunch of yellow Gatorade. It was fine; you’re not really fasting because yellow Gatorade has calories, so even if you’re not good at fasting, this should be manageable. At 5p on September 10, I drank the first bottle of Suprep, diluted with a bunch of water. The Suprep was gross. It was a mix of sweet and salty, but in all of the ways that a Reese’s Peanut Butter Cup is not, and also had an odd metallic taste. Getting all 16 ounces of this mix down was totally manageable but I wasn’t a fan. The good news is that this was the second-worst part of the entire process, which is to say, the process wasn’t so bad at all.

I then drank two 16-ounce glasses of water within the next hour, as directed. I spent most of the next two hours in and out of the bathroom, watching Lord of the Rings: The Fellowship of the Ring (Extended Edition) for the umpteenth time in between bathroom runs. I felt pretty cold and tired. I think I drank another Gatorade but to be honest, I don’t remember — after finishing The Fellowship at about 10:30p, I went to bed. I had to get up at 4a to start the second bottle of Suprep.

At 4a, I did exactly that — 16 ounces of Suprep+water, then two more 16-ounce cups of water. By 5a or so I was very clearly (this is a pun) empty. You can’t have anything by mouth — not even gum — three hours before the actual procedure, so I had to stop drinking anything by 6a, but I effectively stopped an hour earlier. And then I fell back asleep.

This was the third-worst part: I dreamt that I had a glass of the Green Apple Skittles drink mix. (Weird, I know.) And that means I had to cancel the procedure — you can’t have anything by mouth three hours beforehand, and it was only 90 minutes! But then I realized I was still in my bed and that it was only a dream. All was fine.

I arrived at the doctor a bit before 9a, as scheduled; my wife drove me because you can’t drive yourself home afterward, as they give you Proforol, an anesthesia, and it’s not okay to drive right after coming off of that. My doctor was running a bit early, so they brought me to the prep area where a nurse started an IV, then wheeled me into the procedure room. The anesthesiologist started the Proforol and I asked how long it would take before I got sleepy, then immediately got very sleepy, and said “oh, I guess now.” And that is the last thing I remember except for the worst part, which, again, wasn’t so bad.

For most people, the next thing you’ll remember is being back in the prep room, but my colonoscopy had a minor complication — they needed to briefly position my body in such a way that I ran the risk of aspirating if fully under anesthesia. So they brought me back to kinda-sorta awake for about 90 seconds. I tried to ask “why am I awake” but I was not awake enough to fully articulate that, and someone (no idea who, really) said something like “you’ll feel a little discomfort for a moment but it’ll be done before you know it.” And that’s what happened — it felt just kind of weird for a few second and then it stopped. They said “okay, all done” and the procedure was complete — or so I thought. What actually happened was they finished that part of the procedure, re-upped the Proforol, and I fell back asleep and only came to when they had disconnected me from everything and brought me back to the prep room. But I was so fully knocked out that I didn’t realize that until about 20 minutes after I woke back up.

During the procedure, the doctor removed seven polyps, none of which were cancerous (but who knows what they’d have developed into). The polyp removals were 100% painless — I wouldn’t have known he did that unless he had told me. I’ve felt no side effects from the procedure at all. I had a few hours or wooziness from the Proforol for the remainder of the day but that was fine, because I watched Lord of the Rings: The Two Towers (Extended Edition) for the umpteenth time. I also started on Return of the King (Extended Edition) but ran out of time before getting back to regular life yesterday. Those movies are long!

My doctor wants me to come back for another colonoscopy in three years, which is sooner than typical because of the number of polyps he found. But that’s the point — had I not gone this year and waited until 50, it may have been too late. So please learn from my non-mistake: get your colonoscopy. And really, it’s not a bad experience at all.

One piece of advice, though: if you start The Lord of the Rings about an hour or two before you start the Suprep, you can probably finish the whole trilogy during the ordeal. Or just go with the non-Extended Edition version.

The Now I Know Week In Review

Monday: The Problem With Food Allergies on Mars: EpiPens don’t work in space?

Tuesday: When the Government Makes You Buy Gas: Singapore’s fill-up law.

Wednesday: The Squeegee That Saved Lives: A 9/11 story.

Thursday: A Different Type of Mug Shot: A couple of cups (and then some).

A Few Dollars = A Big Difference

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And thanks! — Dan

Long Reads and Other Things

Here are a few things you may want to check out over the weekend:

1) “Why AI can’t spell ‘strawberry’” (TechCrunch, 5 minutes, August 2024). I tried this out myself and had similar results — two “r”s.

2) “The World’s Biggest Bitcoin Mine Is Rattling This Texas Oil Town” (Wired, 15 minutes, September 2024). The subhead: “A cash-strapped city in rural Texas will soon be home to the world’s largest bitcoin mine. Local protesters are ‘raising hell.’”

3) “Wet Wipes and Jell-O: How to Prep for Your First Colonoscopy” (New York Times, 9 minutes, January 2023). To end (heh!) on the same note as the beginning, this is the article I read before I prepped, and it was very good, although I skipped the Jell-O want went with regular toilet paper. (Our plumbing doesn’t take kindly to wet wipes, as we learned the hard way — and that experience was much, much worse than the colonoscopy.)

Have a great weekend!

Dan