1) colonoscopy questions 2) foreign body up the kazoo

[made cummsies]

Hey Dr. Steve,

LOVE the show. Think the info is awesome and presented perfectly!

Gratuitous sucking up aside I have a couple of questions for you, one serious and one not so much.

1) I'm a 36 year old guy who other then carrying about 25 extra pounds am in good health. Only chronic health problems are depression and an arthritic L talus (post MVA). For the depression I'm taking 40mg Paxil bd and for the arthritis 275mg Naproxen bid prn. I've been diligent with seeing my family doc for a physical every 2 years and during my last visit I had inquired about a colonoscopy. Now reason for the inquiry wasn't just out of idle curiosity but also because of family history. My father was diagnosed with stage 4 colon cancer (which had metastasized to the liver) at the age of 56 and passed away six months later. My doctor had agreed that given the circumstances getting scoped up the bum wouldn't be a bad idea and he sent the request into a specialist. After evaluating the request the specialist declined saying that it isn't normal protocol for anyone under 40 to receive a non-specific colonscopy. While I've never had any GI issues, no blood in my stool, etc. I'm still concerned. Should I press the issue and insist or safe to wait till my 40th? Oh, should also add that I'm in Canada (and no our socialized medical system isn't perfect, its actually pretty fucked up) and this procedure if approved by a specialist would be covered by the provincial insurance.

2) I came across the following video on another site and was shocked to say the least. While I'm not gay and certainly not homophobic (really don't care who fucks who) the mechanics of what this guy did seems to defy normal anatomy. How is it that the dildo can be stuck so deep up his ass you can see its profile against his stomach? Even if it makes it to the descending colon isn't that towards the posterior and make it difficult to show against the stomach?

warning about the video link, it might be considered by some to be disturbing: http://www.uselessjunk.com/article_full.php?id=106897


Thanks!!!

mc

[Dr Steve]

Hey Dr. Steve,

LOVE the show. Think the info is awesome and presented perfectly!

ha, you rule and will get special attention!



Gratuitous sucking up aside I have a couple of questions for you, one serious and one not so much.

ah, so that WAS sycophantry :-) I still like it!



1) I'm a 36 year old guy who other then carrying about 25 extra pounds am in good health. Only chronic health problems are depression and an arthritic L talus (post MVA). For the depression I'm taking 40mg Paxil bd and for the arthritis 275mg Naproxen bid prn.

That Paxil MAY be contributing a bit to the extra 25 lbs, by the way. Don't stop taking it or anything, but Paxil and Zoloft are famous for causing some weight gain. Just a fun fact.

I've been diligent with seeing my family doc for a physical every 2 years and during my last visit I had inquired about a colonoscopy. Now reason for the inquiry wasn't just out of idle curiosity but also because of family history. My father was diagnosed with stage 4 colon cancer (which had metastasized to the liver) at the age of 56 and passed away six months later. My doctor had agreed that given the circumstances getting scoped up the bum wouldn't be a bad idea and he sent the request into a specialist. After evaluating the request the specialist declined saying that it isn't normal protocol for anyone under 40 to receive a non-specific colonscopy.

Canadian criteria for doing colonoscopies may indeed differ from American criteria...see below.

While I've never had any GI issues, no blood in my stool, etc. I'm still concerned. Should I press the issue and insist or safe to wait till my 40th? Oh, should also add that I'm in Canada (and no our socialized medical system isn't perfect, its actually pretty fucked up) and this procedure if approved by a specialist would be covered by the provincial insurance.

Ok, the american cancer society says that you're at risk because you have a first degree relative (your dad) who had colon cancer before the age of 60. They recommend the following for "at risk" people:

colonoscopy at age 40
OR
Colonoscopy 10 years before the youngest person in the family was diagnosed.

So...if your dad was 56, get a colonoscopy when you're 40. If your doctor detects blood in your stool before then, or ANY symptoms whatsoever related to the colon, you can do it before then.

If your dad had been, say, 46 when he was diagnosed, you would have to get your first colonoscopy at age 36.




2) I came across the following video on another site and was shocked to say the least. While I'm not gay and certainly not homophobic (really don't care who fucks who) the mechanics of what this guy did seems to defy normal anatomy. How is it that the dildo can be stuck so deep up his ass you can see its profile against his stomach? Even if it makes it to the descending colon isn't that towards the posterior and make it difficult to show against the stomach?

OK, I didn't actually watch the video, but your colon is pretty mobile and flexible (all the better to manipulate turds and gas without exploding). So if he had a foreign body shoved up his rectum (and kids, please don't try this at home), he could indeed angle it forward and see it anteriorly behind the abdominal wall if it was long enough. I swear I could see the light deep in my abdomen when they did my anesthesia-free colonoscopy, but I may have been hallucinating from hyperventilating.

your pal,


steve

[made cummsies]

ha, you rule and will get special attention!
LOL, thanks! I feel special already. If I could I'd let you do my next prostate exam (even if you have had your finger up Tippy Tom's ass).....trust me that is a compliment and a sign of my respect for you! :)

ah, so that WAS sycophantry :-) I still like it!
Better living through flattery! ;)

That Paxil MAY be contributing a bit to the extra 25 lbs, by the way. Don't stop taking it or anything, but Paxil and Zoloft are famous for causing some weight gain. Just a fun fact.
As much as I'd like to blame the Paxil for the extra weight I can't. I just enjoy eating (e.g. damn pasta, BBQ'd animal flesh, cheese, red wine, scotch, etc.) too much and don't get to the gym as often as I should. That said, even if the meds were responsible I wouldn't stop. I've poorly made the decision in the past to quit the Paxil cold turkey and it was f'in brutal. I'm normally a very stoic and level headed guy but when I stopped taking the drugs I'm a blithering idiot and have the emotional stability of a slug.

Canadian criteria for doing colonoscopies may indeed differ from American criteria...see below.

Ok, the american cancer society says that you're at risk because you have a first degree relative (your dad) who had colon cancer before the age of 60. They recommend the following for "at risk" people:

colonoscopy at age 40
OR
Colonoscopy 10 years before the youngest person in the family was diagnosed.

So...if your dad was 56, get a colonoscopy when you're 40. If your doctor detects blood in your stool before then, or ANY symptoms whatsoever related to the colon, you can do it before then.

If your dad had been, say, 46 when he was diagnosed, you would have to get your first colonoscopy at age 36.
That was GREAT information and quite different then the Canadian Cancer Society's recommendation:
We recommend that men and women age 50 and over have a fecal occult blood test (FOBT) at least every 2 years. FOBT testing helps identify polyps before they become cancerous.

Follow-up for a positive test could include a colonoscopy, double contrast barium enema (an x-ray of the large intestine) and sigmoidoscopy.
High risk individuals

Those who are at higher than average risk of developing colorectal cancer should discuss an individual plan of surveillance with their doctor. High risk individuals include those with:
* a first-degree relative with colorectal cancer (such as a parent, sibling or child)
* a personal history of colorectal cancer
* inflammatory bowel disease such as ulcerative or Crohn's disease
* some inherited syndromes such as FAP (familial adenomatous polyposis) or HNPCC (hereditary non-polyposis colon cancer)
* benign polyps of the colon or rectum
link to complete source (http://www.cancer.ca/Alberta-NWT/About%20cancer/Types%20of%20cancer/Screening%20for%20colorectal%20cancer.aspx?sc_lang =en&r=1)

Personally, and would love to hear your thoughts, is that the reliability of FOBT's are marginal in its effectiveness. Granted I'm only speaking from the anecdotal evidence from my Dad's situation but he had his poop checked for blood every two years as per the guidelines and when his cancer was discovered (and not because of a FOBT) it was already considered inoperable.

OK, I didn't actually watch the video, but your colon is pretty mobile and flexible (all the better to manipulate turds and gas without exploding). So if he had a foreign body shoved up his rectum (and kids, please don't try this at home), he could indeed angle it forward and see it anteriorly behind the abdominal wall if it was long enough. I swear I could see the light deep in my abdomen when they did my anesthesia-free colonoscopy, but I may have been hallucinating from hyperventilating
Ya, you're not really missing anything by not watching the video. It's like a cross between an al queda beheading video and 2 girls 1 cup. :unsure: No doubt that the average person's colon is quite flexible (god knows I've had some Indian food that has made it do backflips) but wow, the guy in the video has obviously worked on being as limber as possible.

An anesthesia-free colonoscopy? You're a braver man then me!! I want to be drugged like Courtney Love before they stick the camera up my ass :blink:

your pal,


steve
And back at ya!!

A sincere (not just sucking up now) thank you for your answers to my question and the GREAT contribution to the board!!! :)