Thursday, July 03, 2014

The benefits of medical screening - a personal story

I haven't taken Fentanyl or Midazolam before - apparently they are recreational drugs as well as being pre-procedure medicines if you need to be sedated! So this blog could be more than usual rubbish if the effects haven't worn off. Bear with me!

A couple of weeks ago I was called to St George's Hospital, Tooting because a routine test had shown a small amount of blood in a stool sample. This can be a sign of bowel cancer although, overwhelmingly, mostly it isn't. The test and follow up is part of the NHS bowel cancer screening programme now being conducted across the country. 

My further screening took two parts. I spent some time a few days ago with a nurse trained in colonoscopy - the exploration of the bowel by a Doctor using a minute camera which travels the whole length of the bowel looking for abnormalities. She explained the procedure to me and answered my questions. She was knowledgeable, engaging and comforting. She knew her stuff. It was my decision whether or not to go ahead but it was pretty much a no-brainer.

Today I had the colonoscopy and that's why the sedatives were administered. The Doctor was friendly, looked the part and as with the nurse he had time to engage with me. Nothing was rushed, I won't describe the procedure in detail other than to say I could follow the camera's view in full HD colour as it made its way to my appendix and back. The close ups were crystal clear and the Doc. commented as he piloted the camera on its journey. 

Any anxiety I had was alleviated as the Doc. and I saw with him what was mostly a very normal bowel. Three very small polyps showed up and they were removed - along with the camera a tiny device travels along which can cut off an polyps and extract them for laboratory analysis. I was also shown to have "Diverticular disease" which the Doctor described as an area of the bowel which looks like Swiss cheese - it has holes in it. It is not a source of concern but can cause abdominal pain from time to time - there is no treatment other than a high fibre diet.

This was NHS treatment at its best. Screening for serious disease is always a good idea and particularly for bowel cancer which responds well to treatment if there is early diagnosis. The Cost/Benefit Analysis is hugely positive. A cancer diagnosed early and treated saves the NHS thousands compared with late diagnosis and intensive emergency cars. And of course it saves lives.

The test I apply to the NHS for me personally is this - can I imagine that if I had "gone private" I would have had better care? The answer in this one instance is an emphatic "No". The facility at St George's is modern, comfortable and confidence-building. The timespan from the abnormal test to the colonoscopy was two weeks! The staff at all levels were skilled, kind and helpful. I was never someone on a conveyor belt but at all times I was treated like an individual. Of course one should avoid extrapolating from one good (or bad) experience and drawing general conclusions. But for me this was a most reassuring and brilliantly handled event. Thanks are due to all at the St George's Endoscopy Unit. Thank you all. 

(And now for something completely different - how will the residual Fentanyl  and Midazolam in my system react to a small glass of Guinness? I'll let you know!)


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