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Courthouse News Service Courthouse News Service
Op-Ed

Listen to Your Doctor

September 27, 2019

"You're one of the lucky ones," the doctor beamed. But sitting in a waiting area after a colonoscopy, 40 pounds lighter than nine months earlier, I didn't feel lucky.

Chris Marshall

By Chris Marshall

Western Bureau Chief for Courthouse News Service since 2014. San Francisco Federal Reporter and Northern California Bureau Chief from 2006 to 2014. Passionate about photography, camping and history.

"You're one of the lucky ones," the doctor beamed.

Sitting in a waiting area after a colonoscopy, 40 pounds lighter than when I first came down with sometimes debilitating gastroenteritis nine months earlier, I didn't feel lucky.

I felt like the protagonist in the Stephen King novel “Thinner,” though I don't recall being cursed by an old gypsy. The intense illness came on suddenly after a weekend celebrating a friend's birthday in San Francisco and brewing beer.

By Monday afternoon I was doubled over moaning in my bathtub in the worst pain I can remember. I'll spare you the details, dear reader, but I made an appointment with my doctor's office when the situation hadn't improved much after a week.

The physician's assistant said I probably had a stomach bug but noted doctors recommended people like me with a history of irritable bowel syndrome undergo a colonoscopy before the age of 45 as doctors now recommend for the general public. She referred me to a specialist. I didn't think to ask why nobody mentioned that during a previous physical. To be fair, it had been a few years since I'd been in for one, and I don't know when doctors started recommending getting the procedure early.

She also ordered tests to check for food poisoning, parasites and other blood work. The tests came back negative and the blood neither revealed problems nor provided insight.

As time passed the symptoms came and went during the day but returned like clockwork every night.

Scared, stubborn but also hoping the symptoms would go away entirely, I delayed making an appointment with the specialist.

My own worst enemy, I researched online and convinced myself I would die five times over.

Six weeks in I finally made an appointment. The doctor agreed I probably had a bad stomach bug but recommended the colonoscopy and a breath test that might help with the diagnosis. He also put me on a new diet that eliminated sugars likely to cause digestive problems in people with weak stomachs.

The diet helped some, the symptoms abated a bit more, and I delayed again. But the pounds continued to fall off, and I never felt more than halfway recovered.

Seven months and 20 pounds lighter I returned to the specialist for the breath test and scheduled a colonoscopy.

"Your results are positive," the doctor said over the phone a few days later. The breath test revealed I had SIBO, short for small intestinal bacterial overgrowth, caused when bacteria from one part of the digestive tract end up in the small intestine or bacteria in the small intestine increase to unsafe levels.

Though often associated with older people, those who have had previous bowel surgery or recently completed a course of antibiotics, anybody can come down with SIBO and doctors are discovering it's more common than once thought.

The specialist wasn't certain how I got it, but the cause didn't matter. The treatment was the same: a two-week dose of a powerful antibiotic usually given to patients suffering from traveler's diarrhea.

After paying $800 out of pocket because my insurance company refused to cover the medicine, the doctor insisted I wait until after the procedure to take it.

Accepted wisdom holds that prep is the worst part of a colonoscopy. It wasn't pleasant, but most people hadn't gone through what I had. It was nothing in comparison.

The nurse's difficulty finding a vein to start the IV in my flabby, malnourished, dehydrated arm was the worst part.

After what seemed like an eternity the anesthesiologist wheeled me into the operating room. Before putting me under the specialist asked me a few questions, including what I did for work. I told him I was a bureau chief for a news service, said I still remember then-Today show host Katie Couric broadcasting her colonoscopy years ago and that I might write about my experience. He said I should.

The anesthesiologist said it usually took no more than 12 seconds for patients to go under once the drugs were administered. At 10 I feared the drugs weren't working.

Next thing I remember was waking in my bed in the interior waiting room. The nurse gave me some juice and told me to hold tight because the doctor wanted to talk to me.

I tried not to let the voices in my head predicting my imminent demise silence the others telling me everything would be all right.

Turns out I was lucky. The doctor found and removed a polyp that he could tell was benign. Otherwise pretty clean.

It took four weeks of antibiotics to clear up the SIBO, and another two months to gain back a few of the pounds I'd lost. Now more than a year since I first got sick, I'm slowly introducing foods I've avoided.

And hey, a decade ago I committed to exercising and eating better to lose weight. SIBO was quite effective, but I wouldn't recommend it.

Don't be like me. Don't delay. See your doctor. Get an annual physical. Follow recommendations.

It could stop you from worrying. It could help you heal. It could save your life.

Categories / Health, Op-Ed

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