Dr. Andrea and My Colon

Dr. Andrea and My Colon

by Verne Maree

The murky and complex workings of stomachs, intestines, livers and gallbladders are not entirely fun to contemplate, let along devote your life to. So, although I was expecting a woman – the clinic name was a bit of a giveaway – I wasn’t expecting someone as bubbly as the beautiful Dr Andrea Rajnakova.

Choosing medicine was easy for her. “I never thought of anything else,” she admits. “I was always going to be a doctor. At four, I got my first doctor’s briefcase, and I never looked back.
“In high school, we had to fill in a form with our first, second and third choice of profession. The socialist regime in Slovakia was rather rigid at that time, and they refused to process my form unless I filled in the second and third options – so I wrote ‘Medicine’, ‘Medicine’, Medicine’, in each of the three rows.

Why Choose Gastroenterology?

Dermatologists, plastic surgeons, trichologists and chiropodists have it relatively easier, because it’s all out there and visible, isn’t it? Even a hearing or eye specialist doesn’t have to dig too deep to get at the truth. So what made Andrea choose some of our innermost organs as her area of study?

After graduating from Comenius University in Slovakia, she says, she wanted to specialise in a field that was very hands-on and procedural, so she chose gastroenterology – this despite an unpleasant personal encounter with a gastroscope at the age of 14.

“Back then, they used the old-fashioned, rigid type of gastroscope; nowadays, it’s a thin, flexible tube, far more comfortable. And what’s more, there was no anaesthetic for the procedure as there is now.”

Who Needs Screening?

You don’t want to wait till you start experiencing the symptoms of colorectal cancer before going for a screening. As early as his fifties, my own father managed to grow a grapefruit-sized tumour in his colon before it was diagnosed. Happily, he recovered to live for another 25 years, but a high percentage of patients do not survive this advanced stage of the disease.

What are the symptoms of bowel cancer? They include: erratic or deteriorating bowel habits, constipation, a sense of incomplete evacuation, blood in the stool, pain or even a lump that’s detectable by external examination.

If you’re already showing one or more of these symptoms, however, the colonoscopy you undergo will not be regarded as a screening, Dr Andrea explains. “We will know that the problem is already there.” That’s because in the early stages of the disease, the cancerous growths are confined to the lining of the colon and do not cause any symptoms.

A colonoscopy screening is indicated for everyone at the age of 50, and then at ten-yearly intervals if it is normal. And if (like me) you have a family history of the disease, you should have your first one 10 years earlier.

The purpose of this screening, she explains, is not to find cancer; the purpose is to find the pre-cancerous lesions or polyps that will in time develop into colon cancer. And the beauty of the 15 to 20-minute procedure – if you can indeed find beauty in the insertion of a fibre optic tube into the colon via the anus – is that if the physician finds any of these mushroom-like growths, he or she can simply snip them out.

My First Colonoscopy

Several years ago, I interviewed another specialist physician who stressed the importance of screening for colon cancer. In the light of my family history of the disease, I vowed to follow up that interview with a colonoscopy screening. I never got around to it.

Better late than never, however; after my meeting with Dr Andrea Rajnakova, I let her efficient assistant make a booking for me at the Mount Elizabeth Endoscopy Centre.

Why did it take me so long to get around to having this absolutely essential screening done? For one thing – unlike other necessary maintenance like visiting the hairdresser or having a pedicure – it was never going to be fun.

Before a colonoscopy, you have to undergo colon cleansing; either at the hospital on the morning before an afternoon procedure, or at home, the night before a morning procedure. I did it at home, but with hindsight I’d recommend the less drawn-out option of doing it all at the hospital. To flush out the colon involves drinking three litres of “cleansing water” over a period of three hours, followed by a dose of laxative and yet more water; after this you need to be either on or very near a lavatory for quite some time.

Performed under monitored sedation as a day procedure, the colonoscopy itself was a breeze; a cool stream of oxygen wafted up my nostrils, they gave me a Dormicom injection and the next thing I knew I was waking up in the recovery ward, clamouring for the tea and biscuits I’d been promised.

Later, when Dr Andrea showed me a series of full-colour photographs of my internal nooks and crannies and explained what she had found – two precancerous polyps, which she’d removed before they could develop into anything more threatening – I was glad I’d come to her.

This was my first colonoscopy, but it won’t be my last.

Published in Expat Living, December 2012

 

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