Saturday, October 24, 2020

M*E*S*H

During an ordinary physical five or six years ago, my doctor noticed I had a hernia – you know, uh, down there.

“Does it hurt?” she asked. Negative. “Does it cause any discomfort at all?” Negative. “Then let’s just leave it alone,” she advised. And we did.

Five or six years later, and five or six well checks later, it did begin to bother me. Long story short? I consulted a specialist and we scheduled surgery to fix the damned thing.

There are various types of hernias. Mine was inguinal, which according to a Google search is among the most common. The inner groin, if you’re curious. Nationwide about eight hundred thousand of these are fixed each year, and something like ninety percent involve a synthetic material called mesh. As I understand it, mesh is a kind of thin fabric used to reinforce the abdominal wall and is associated with a lower rate of hernia reoccurrence.

Interestingly, the surgeon did not use the word “mesh” during our initial consult. The surgery would be laparoscopic, he explained. Robotic. He sketched it out on a piece of paper and drew a rectangle representing the stuff he’d use to reinforce the repair.

Only after I got home and Googled it did I realize that what he was talking about was mesh. I’d heard of it. “Almost every mesh is made, at its base, of polypropylene,” an ambulence-chasing lawyer's website advised. Polypropylene is a petroleum-based plastic. Same stuff disposable water bottles are made of. The potential for nasty side effects is high. It can stiffen and harden in the body.

So I called the surgeon’s office and spoke with him again the next day, explaining my newfound reservation to having that shit put in me.

“Look, I’ve been doing this a long time,” the surgeon said, with a hint of exasperation. “I’ve done hundreds of these things. Anymore, mesh is standard. If there was a serious issue with it I’d be sued left and right. I sure as hell don’t want that.”

That was enough; I relented. We scheduled the surgery for a week later.

Then, a few days before, I learned my brother-in-law had a hernia repaired about a year and a half earlier. Mesh was used. Afterward everything was fine – at first. But within weeks he began suffering debilitating pain. My sister said he had to prop his legs up just to relieve the pain and pressure – a real textbook bad reaction, based on my Googling. He had just undergone a second operation to remove the mesh.

Only sometimes does the moon enter its seventh house, and Jupiter align with Mars. This felt like one of those times. The cosmos sending me a message. I called the surgeon’s office yet again – this time, just one day before the procedure (by which time I had cleared the pre-operative COVID screening).

They were very accommodating, but there was a potential hitch. The insurance company had signed off on Plan A, and now I wanted Plan B – open surgery, no mesh. I won’t bore you with the details beyond saying I sat on pins and needles all afternoon, waiting for the callback saying the change had been approved.

As this is written it’s the day after the surgery. There is no mesh in me. Since it was open surgery I’m left with a ghastly wound – if wound is the right term for a corrective procedure I submitted to voluntarily. Very hideous in appearance, with swelling and bruising. No obvious stitches; they are either internal (most likely) or not there. On the surface there is some glossy crap, as if the incision had been superglued back together. I have pain pills but am not taking them. Not because of macho dementia, but because of the known side effects. And maybe a few unknowns.




Thursday, October 1, 2020

Bowel Prep

F
or most people the mere thought of a colonoscopy is frightening. As one who has had several I can assure you: they really aren’t that bad. One minute you’re lying in a hospital bed with a needle stuck in the top of your hand. Next minute the sedation flows and you drift away. Before you know it, you’re waking up and it’s over. You can eat again.

So fear not; there is nothing to worry about. There is no lingering, post-procedure discomfort. You barely know what happened. As FDR said in a much different context, the only thing you have to fear is, etc etc.

There
s a bad part, of course. There always is. It comes the day before, when you have to drink a magic potion known generically as a purgative.
Purgative. Noun.
|pur-guh-tiv| 1. A purging medicine; stimulates evacuation of the bowels. 2. A strong laxative.
Its evil stuff, and there are several liters to glug down. Drinking this brew, and enduring what happens afterward, is referred to as bowel prep.

Bowel prep.

I cannot say that enough. Bowel prep. It is so suggestive, and sounds so repulsive.

Bowel Prep

When you Google bowel prep” you get hits like “Six Tips for Easier Colonoscopy Prep,” “Eight Expert Tips,” “4 Steps on How to Prepare for...”and so on.

Articles like this are not entirely useless. But theyre all pretty much the same, the number of tips notwithstanding. If you’ve read one, you’ve read ’em all.


The WebMD site, for instance, shares this pearl: “Your colon has to be empty and clean for your doctor to get a proper look at it. To make that happen, you’ll have to fast and use strong laxatives beforehand.

Strong laxatives? Pwah.

The bowel prep is usually in liquid form: a noxious swill (mine was lemon-lime) that’ll give you diarrhea like you have never experienced – not in this life. You blast out hamburgers, pâté de foie gras, and pork rinds lite you ate six months ago. Talk about a world of shit!

Why am I writing this? I just had another colonoscopy the other day. There is a history of colon cancer in my family, so its my pleasure to get one every few years. For most people ten year intervals is sufficient. This time it got delayed twice, thanks to COVID-19. I am pleased to report a clean bill of health.

Colonoscopies really are the best way to detect and prevent a killer disease. But the bowel prep is a total drag. The procedure itself? A piece of cake!