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Humiliating. Painful. Hilarious.

My first sigmoidoscopy was not only the most uncomfortable experience of my life, but likewise the most humiliating. But fear not, if you approach this invasion of your body with a good sense of humor, you will survive with only slight psychological damage.

First of all, I am 28. In other words, I am far, far younger than the usual suspects for this procedure. But having major gastrointestinal issues, which were ultimately diagnosed as ulcerative colitis, I showed up to the GI department to book my appointment.

"You sure you want to do this?" said the bemused and dismissive nurse.

 "Umm, I obviously don't but my doctor said I need it done."

"Oh" she said, as if my incredibly logical answer had caught her by surprise.

"Well, do you want to have a consultation first?"

"No, I want to get this over with. Why would I need a consultation?"

"Well, many patients are very uncomfortable with this procedure, so they want to discuss with the doctor ahead of time, and then return for another appointment to actually get the procedure done."

Great, the rumors were true-- the freaking test had an optional meet and greet. I declined. "No thanks, I just want to get this over with," I responded to the nurse. She gave me a disapproving look and scheduled me in. I tried to make some small talk about how I was too young for this, to which she deadpanned that a 16 year old had just been here. Somehow, knowing someone else is in a greater pain than me was supposed to make me feel better. Not surprisingly, it did not-- in fact, it made me queasy.

She handed a sheet of instructions to me and one of those ridiculous medical pamphlets. You know the type. In three illustrated pages, they make the procedure seem "challenging but overcomable." There was a ridiculous illustration of a guy lying on his side, facing out, and some activity going on behind him. The look on the guy's face was quite similar to Mona Lisa's smile. I'm quite certain he wasn't as happy as she was. I bet you there's one of these pamphlets for brain surgery with a guy smiling as a cartoon drill opens up his skull. But I digress.

My fun fun fun experiences with the preparation are detailed in entries under "Sigmoidoscopy/Colonoscopy Preparation."

Finally, after "prep" was complete, I showed up at my local HMO exhausted and frazzled-- and immediately stood out like a sore thumb. Surrounded by middle aged people and senior citizens, they looked at me with that half quizzical, half disgusted (HQHD), "I wonder what in the world must be wrong with him?" look. I, in turn, looked to them for some measure of comfort, some reassurance about the procedure I was about to undergo. Of course, I got nothing but HQHD.

After a nervous few minutes of flipping through the inane magazines from ten years ago (gingerly, of course- "I wonder what in the world was wrong with the people who touched this before me!") I was called in by a very large and seemingly angry woman, someone you might expect to be driving a bus, perhaps.

Driver led me into a room that looked clean and dirty at the same time. All around me were machines with lots of tubes and knobs, a big sink talking about NEVER allowing contaminated items (ugh) to come into contact with the "clean" side, and the requisite drawing of the digestive tract sponsored by some drug company. This woman was not talkative; she told me matter of fact to go to the attached bathroom and take my clothes off, replacing them with a gown that-surprise!-opened in the back.

"My shoes too?" I asked. She said, "I wouldn't walk around without shoes in THIS room." Driver followed up with a potentially friendly: "Have you had this done before?" AhHA, maybe I can relate to this woman after all, I thought. WRONG. I said "No, and I'm a bit freaked out." She nodded her head as if she could not have cared less what I just said, and then she shut the door. Be still my beating heart.

The gastroenterologist came in, an older gentleman, accompanied by Driver. Normally I like to chat for a while with a doctor,  you know, establish some rapport prior to spilling my guts-- and that just when I'm there because I have a head cold. This guy was about to violate me like no one before, in fact ENTER my guts, and yet niceties were of no interest to him. Abandoning all hope for a remotely acceptable experience, at this point, I tried to focus on the divine comedy that had clearly become my life.

Doctor ordered me to lie on my side, with my butt facing him in all of its glory.  At this point, I'm thinking that it is going to be hard to feel more vulnerable and/or humiliated again. Doctor brusquely orders Driver to "prepare the scope." Even the equipment terminology was daunting. Doctor sort of grunts at me that I can watch the proceedings on a television monitor in front of me. I respond back that I want no part of that, and that I just want to get the hell out of here as soon as possible. As per custom, it matters not what I say as my comment is entirely ignored. "

OK you're going to feel a lot of discomfort right now, try to relax."

And then I felt a LOT of discomfort. Like a LOT. Discomfort to the point where "try to relax" becomes the most preposterous thing one might request of you. He was shoving, and yes shoving is indeed the appropriate word, the base of the machinery into my rectum. In response, my poor rectum was sounding the CODE RED full body alarm-- "INVASION, INVASION!!!" At that point I made noises I knew not possible from a human. I don't remember them. I just know some might consider them unnatural...

"OK we're in" said Doctor Evil to Driver. Then he told her something to the effect of "Begin inflation."

You see, once they set up base camp, they have to pump your intestines full of air to be able to see what's going on. They don't dwell on this part of the procedure in the literature. Oh they should. As an air compressor (I kid you not) went off in the background, I felt my entire abdomen fill up with air. The only image in my mind was that of my innards expanding like one of those balloons you make balloon animals out of. And I also imagined them popping, a creative escape that the AGONIZING PAIN made almost necessary.

Courtesy aside, I yelled "OWW that REALLY hurts." Expletives may or may not have appeared."Stop inflation" said Dr. E.

Then he started moving these objects inside of me, which I only deduced from his comments to Driver. I felt nothing of this, as I was focusing on the temporary relief of the agony and anxiety of the air pump and balloon animal formerly known as my colon.

"Aha, there it is" he said to himself. Nevermind I had no idea what "it" was. "We're going to take some biopsies and we'll be done" he grunted. I didn't care what he was going to do, I just wanted this misery over with. It had been merely minutes but felt like days and nights-- and not just any nights, but those nights where you can't sleep and seem like they're 50 hours long.

He then began yelling off numbers at Driver, "15mm" and then it seemed they began playing some odd game of pinball, particularly the part where you first launch the ball, but this time with my *** instead of an amusement device. The number represented the depth of the scope, after which he yelled "close!" I then sensed some clearly violent ,but thankfully painless, pulling movement followed by a snap and some retraction.

"We'll go a little higher for the next one" and I sensed what was coming. The return of the air pump! Oh dear agony. I could barely stand it, and I could clearly feel it. Near the point of exhaustion, I yelled at them to stop-- they did. He took another biopsy at that point and said that "we were done."

He pulled the giant base thing out of me which relieved some of the outrageous pressure. I was simply relieved.They told me to go to the bathroom and "expect some bloody gas." Listen, NEVER in your life do you anticipate being told to "expect some bloody gas." But you should, if and when you're getting a flexible sigmoidoscopy.

After unleashing liters of air over the next hour, I felt emotionally and physically drained. It may seem like an exaggeration, but I honestly felt extremely violated by the violent, sudden, unfriendly and painful procedure performed by a couple of cold strangers. It didn't help that my ultimate diagnosis was ulcerative colitis, an experience I describe in another entry (under the ulcerative colitis->diagnosis section).

To be fair, I had a follow-on sigmoidoscopy months later-- after my intestinal issues had subsided. This time they used a pediatric scope in deference to the agony I had experienced, and in combination with a colon that wasn't already extremely tender, things went a lot better.

To close, I most certainly *would* wish this procedure on my worst enemy. It won't kill you, but you will certainly remember it.