Good afternoon, beloved readers. First, I want to tell you some things. Then I am going to ask you to lie for me, and to get every adult under age 50 you care about to lie their asses off for you, too.
My heart is heavy today. I awoke to news of the death of actor Chadwick Boseman, at age 43, from colon cancer.
Whether or not you’re a fan of Black Panther and the Marvel Universe movies, or of Boseman’s portrayals of iconic Black historical figures like Jackie Robinson, Thurgood Marshall and James Brown, this man – by all accounts a kind person and talented beyond measure – has left our world too soon. And he is gone because of a preventable disease.
And as you might imagine, beyond my sadness at this tragic loss lies a fair amount of…well, RAGE. If you or people you love happen to live in the U.S. today, you are living in a country where this is true:
There’s nothing to stop insurers from covering the tests starting at age 45, and some are likely to do so, but at this time insurers are not required to (and some might not) cover the cost of colorectal cancer screening before age 50.
Needless to say, a first colonoscopy* at age 45 would not have saved Chadwick Boseman. But what if he got one at 30? In fact, the youngest victim of colorectal cancer I know of (via a Nurse Practitioner on my surgeon’s team) is a young woman who died at age 29.
You see, our wise and benevolent for-profit health insurers know that it’s simply not profitable to pay for colon cancer screenings at an earlier age. Insurance companies don’t rack up record profits by screening people in their 20s, 30s or 40s to detect polyps before they turn cancerous. That would just be silly! Instead, they insist that statistical outliers who get colon cancer young – like me, and Chadwick Boseman – suffer and die needlessly.
Makes perfect $en$e.
So. I want you – yes YOU, the person reading this right now – to get a motherfucking colonoscopy, no matter your age. Unless you are a Trump voter or any other species of Republican. In that case, you can fuck right off.
And then, I want you to convince every single adult you care about to also get a motherfucking colonoscopy, no matter their age. And there is only one way I know of to get around the age restriction and not become another (highly profitable) statistic:
If you have health insurance.
Familiarize yourself with symptoms and risk factors for colon cancer, and pick a few you think you can sell to a doctor. If your (very, very profitable) insurance company requires referrals, the type of doctor you want to see is a gastroenterologist.
Symptoms of colon cancer include: a persistent change in your bowel habits including diarrhea or constipation; rectal bleeding or blood in your stool; persistent abdominal discomfort, e.g. cramps, gas or pain; the feeling that your bowel doesn’t empty completely (btw, this is called “tenesmus,” and you DO NOT want it. Ask me how I know.); weakness or fatigue; and unexplained weight loss.
Risk factors besides being over age 50 🙄 include: African-American ethnicity; chronic inflammatory diseases of the colon (e.g. ulcerative colitis, Crohn’s etc.); family history of colorectal cancers; low-fiber high-fat diet; sedentary lifestyle; diabetes; obesity; smoking; heavy alcohol use; and abdominal radiation therapy for other cancers.
Obviously, some of these are easier than others to lie about to a doctor. (Oh hey, doc! I’m, uh, African-American! And I’m also very overweight!) I included these here in case they are true for you – then by all means, pile those on too!
NOTE: I have given this very same advice to friends and family previously. At least two of them took it, and succeeded in getting “under age” (non-profitable!) colonoscopies. IIRC, they used a fake “family history” and “rectal bleeding or blood in stool” to accomplish this mission. One of them found polyps early enough to make a difference (i.e. before they turned cancerous), and the other came back perfectly clean. Either one of these outcomes is a WIN.
Here is a fun exercise. After you pick out your preferred lies, memorize them in the form of something like the following, and practice it out loud in front of a mirror:
“Doc, I keep having diarrhea, it’s been over a month now, and there’s been blood in it. Also, my aunt Trudy died young from colon cancer – I think she was in her early forties? My mom’s sister. And I know my mom’s had a lot of polyps over the years. Can I get a colonoscopy?”
If you do not have health insurance
There are low-cost/sliding-scale fee clinics that perform colonoscopies. Same lies apply.
(I have no idea what the requirements are for colorectal cancer screenings in the many decent and humane countries with single payer healthcare. If need be, feel free to adapt your lies accordingly.)
Do it for me. Do it for yourself. Do it for those who love you, care about you and depend on you. Or do it to make for-profit health insurance companies juuuuust a little less profitable next quarter.
BE A LIAR 4 IRIS!
*Yeah, about those colonoscopies. I am a pro at this by now, but I get it. Exceedingly few people would actually want a colonoscopy, not that there is anything wrong with that. But I can tell you, as several people told me beforehand, that it is nowhere near as dreadful as you are probably imagining. And no I didn’t believe them either, but it turns out they are right about this.
The worst part is the bowel prep the day before, but even that is over with mercifully swiftly. The procedure is not painful, and if they green light the Good Drugs™ you will be knocked out and neither feel nor remember anything at all. I’ll tell you something else, too, and this is important. A colonoscopy is nothing – and I mean nothing – compared to the many other horrific procedures, disfiguring surgeries, multiple indignities and hellish treatments you will be facing if you ignore my advice and it turns out you waited too long to get one.
So go get one.