From bowel to bowl ...

A cousin has been diagnosed with bowel cancer, and her rectum will be resected next Tuesday morning, Remembrance Day. Discussing it with another cousin, I learned that, since her mother had survived bowel cancer 21 years ago, aged 71, she has followed a screening regime: occult bloods annually, and a colonoscopy every three years. So, yesterday I toddled off to my GP. It has been a traumatic week on a number of fronts. I have taken on way too much here at home, but if you know me, you will understand that is simply par for the course. Kirsten has now reorganised our arrangement. I was getting very weary, and tumbled into bed each evening exhausted. My weight has dropped down to 41 kgs, and my balance is "fragile". My area of the house will be separated from the rest, with the girls not just walking in whenever. I am not to do cleaning, or washing (other than my own), and I have been allocated two days of childcare only, which is similar to that allocated to Grandad. Not so much child-care as a visit.

At the GP, not only did I enquire about bowel health, how to assess iut, and how to maintain it, but I also agreed to return to the neurology circuit for a second opinion. I am not convinced by the diagnosis of CANVAS, and really need for my suspicions of Parkinsons to be eliminated. We discussedsymptoms, with the conclusion that I am asymtomatic. We discussed the risk factor. No first degree relative has been diagnosed. I am not over-weight. My diet contains roughage, and veggies. I do not smoke, and my alcohol intake is down to a glass per month ... otherwise my balance is a joke! So, asymptomatic, and low-risk. I am, however, 66 years of age. So, let's get a plan. Unfortunately, medical testing needs to be cost effective, otherwise everyone would have a colonoscopy every year, and this would simply not be an effective allocation of resources. Colonoscopies are effective investigative tools for about seven years. Bowel cancer is slow-growing as the patient ages. The older the patient the more likely the cancer is found before it is too far gone. So, occult bloods are used to narrow down the population who require a colonoscopy. I had a colonoscopy in 2003, because I had pain in the stomach, and around the kidneys. It came up clear. They were not to know that there was a tumour growing on my ovary! Not using a colonoscopy!

Of every 30 patients who have occult bloods done, one patient will need to have a colonoscopy. This is the average for Australia. Occult blood results are "valid" for about three years. Therefore, my GP recommends that I have an occult-blood screening every three years, and I might never need a colonoscopy. The screening company will send me an annual questionaire. As well as the results going to him (Stephen), they will ome to me also. He listened to my qualms about my neurologic diagnosis. I was more a researc subject, than a patient. I was given the "mushroom" diagnosis. How serendipitous was it that I should end up in the clinic of the very neurologist who had defined, and named, the CANVAS Syndrome. All the symptoms that I show are also symptoms of Parkinsons Disease. Stephen said he did not think it disrespectful to get a second opinion. One of the pitfalls of modern medicine, is that other doctors simply accept the diagnosis of their celebrated peer without question. Dr John Parratt is a neurologist at Royal North Shore Hospital who specialises in Multiple Sclerosis. He will get me started on a second opinion. Now, I am just waiting around for a stool ...