Bowel Cancer Screening

This morning I headed towards St George's Hospital to be screened for bowel cancer. I don't have any symptoms - and I don't have cancer - but it's something that happens under the National Health Service when you turn 55. You get a letter explaining what happens, then an appointment and, a couple of weeks before the appointment, you're sent an enema kit. You don't have to turn up, of course, you can decline the invitation but why do that? Especially since my mother had bowel cancer in the late '60s.

The day started with giving myself an enema. You need to do it an hour before leaving home for the hospital so you have time to clean out the bowel. Lie on your side and insert the thin tube into your bum as far up as possible and then squeeze as much as of the liquid into your bowel, hold it in for a few minutes and then head to the toilet to flush it out. Hey presto, clean bowel!

When you get to the hospital and it's your turn to be seen, the nurse sits you down to explain what's going to happen, sign the consent form and then leave you to get changed into a backless gown, some 'modesty' shorts (with a flap in the right place for ease of access) and some non-slip socks. All your clothes go into a plastic bag to take with you. The consultant came in to introduce himself and make sure I knew what was going to happen. He explained that he'd pump some air into my bowel to help open it up and if I needed to pass wind to feel free to do so with no need to be embarrassed. Then I just sat and waited my turn.

A nurse came to pick me up and walk me to the consulting room to be greeted by two more nurses or doctors - I missed what was said in the hubbub of meet and greet, get me onto the trolley on my side and have my bum exposed discreetly. And more talk to check I am who I am, show me the monitor I can watch to see what happens and then I feel a hand slathering on some lube and I'm prodded. Ooo er, it's happening. I suspect a lot of the talk is to distract the patient.

The camera is inserted at the end of a flexible tube, easing deeper into me and I can watch it on the monitor. My bowel is very pink and shiny and the camera pushes gently deeper through the folds of flesh and muscle and I can see inside myself. It slowly eases out so the consultant can check the walls of my bowel for polyps, little growths that might signal possible cancer. If you have any small polyps another function of the camera tube is to cut them off and that's what would be sent for testing to see if they were cancerous. Luckily, I have no polyps and my bowel looks entirely healthy.

The whole thing was over in around five minutes and I was wheeled out into a recovery room to get changed again, get papers from the nurse and then find my way out through the maze of corridors. Since I've been given a clean bill of health then that's it until I turn 60 when I'll be sent a do-it-yourself screening kit to check for any signs of blood. And that was that. It would've been different if they'd found any polyps or even cancerous growths - if they'd found any sign of cancer I would have been sent to the cancer department straight away but that wasn't necessary.

I was surprised by the response to my blog about the operation I had five years or so ago for a para-umbilical hernia, with people wanting to hear about it from someone who's had it done so I thought I'd share this experience in the same spirit. It didn't hurt at all - it was uncomfortable but not painful. It's also remarkable how the natural embarrassment of being in a room with four clothed people while you've got a camera up your bum displaying the inside on a telly seems to vanish. 

So there we are, another little gem from the National Health Service. Prevention and early intervention makes so much sense in terms of my health as well as to the budget of the NHS and aren't we all lucky in this country that such services exist? I'm terribly grateful.

Nurses, Care and Compassion

There's been a lot in the news about nurses and the National Heath and how caring for people seems to have left the system. I've just watched yet another discussion on telly blaming it all on "form filling' and "workload". I won't claim to be an expert on nursing practice but in the last 12 years I've had four operations in hospital and both my parents died in hospital. I've seen nurses and nursing assistants up close.

I'm terribly lucky to live in a country that has the National Health Service and I have quality health care as a right. I've certainly had my share of medical support in the last decade and it's not just the operations it's the follow-up support and treatment, the physiotherapy and the medication. Yes, I am very lucky. On the other hand, I've paid for it through taxes over the last 30-odd years.

I've seen good nurses and I've seen mediocre and unthinking nurses. More of the latter, sadly, but at least I've not seen any 'bad' nursing of the kind that's hit the news. In my experience it's not about "form filling" or "workload" or lack of role models or whatever excuses are offered - why do you need a role model to take a glass of water to someone who's thirsty? Something has changed in nursing, medicine and care and I don't now what it is.

A memory of nursing that stands out is when I was bedridden in hospital for a week after an operation for a slipped disc that could've gone better. One day I was being given a bed bath by, I think, two nursing assistants when the curtains around my bed were opened and two other nursing assistants came in, leaving the curtains open and started chatting about what had happened at a party the previous weekend.

After a minute or so of seeing other people walk past the open curtains while they chatted I said 'Excuse me' - that's all but it was enough. I could see the sudden realisation of what they'd been doing flit across the faces of the two interlopers as they realised there was a real person in the bed that could both see and hear what was being said. They didn't quite blush but apologised and left, closing the curtains. Having interrupted their chat, the two nursing assistants finished off the bed bath in a rather perfunctory manner, pulled the curtains back and went off to finish their chat.

That's hardly an earth-shattering experience and didn't lead to me dying in hospital through dehydration but it's symptomatic of a system not working quite right. At that point in time, those four nursing assistants wanted to chat about a party rather than do their job. "Form filling" wasn't involved and they weren't over-worked or stressed since they had time to chat and laugh while a patient was having a bed bath. It may come as a surprise to some of you but bed baths aren't something most people are brought up to consider normal. They're not terribly stressful but it's not normal. And I'd rather not have an audience, thank you.