Interview 24

Age at interview: 59
Brief Outline: Screened in 2001 and 2003. Results were normal. In 2005 he did another Faecal Occult Blood (FOB) test. The result was unclear. Another test was abnormal, so he had a colonoscopy, during which two polyps were removed. These were not malignant.
Background: A white English man, a bus driver, married, with 2 children.

More about me...

He was screened for bowel cancer in 2001 and 2003. The results of both those tests were normal. In 2005 he did another Faecal Occult Blood (FOB) test). This time the result was unclear, so he was asked to do another test. The result was abnormal, so he had a colonoscopy, during which two polyps were removed. These were not found to be malignant. He is due to have another colonoscopy in December 2006 to make sure that all polyps have been removed. 


Says that screening might prevent disease and save life.

What were your feelings about that letter?

I thought, well you know why not really, I mean you need to know and if that service is available then obviously you take advantage of it. It's no good ignoring things, knowledge is much better and if this thing is found out early well obviously it's to be advantageous. I mean left a long time it could mean a nasty operation, I mean but if caught in time could save a lot of pain, a lot of trouble and obviously it could save your life, which is a good thing.


He kept his test kit in a little container on a bathroom shelf out of direct sunlight and away...

Where did you store it between the different times that you had to use the test kit?

I kept it on the bathroom shelf in a little container, so that it was away from everything you know. But I suppose really you could either keep it in your bathroom cabinet, somewhere convenient you know, somewhere where it's not liable to be contaminated by any liquids or direct sunlight.


The Faecal Occult Blood test detects hidden blood in a person's motion. Blood in the motion...

What do you think is meant by screening, when we say screening for bowel cancer?

Basically it's to detect blood in your stool, that's the indicator which says to them it needs further investigation. If there's blood in your stool it shouldn't be there and if the reason, I mean it could be a simple reason, people have piles, it could be any reason, but if it is to do with a malignant bowel cancer then the earlier it's treated, and I believe it can be treated successfully and obviously it's to the good and you must have it done. It won't go away, it's no good burying your head in the sand, it needs to be investigated and treated and then your chances of coming out successfully obviously have got to be much better.


Explains that if you had frequent bowel motions you could do the test on three different...


In about 2001 I first received the test kit through the post. It's really a simple kit with three individual little envelopes and it comes with three sticks and basically what you do you need to take a sample of your motion from a different part each time, not necessarily every day but you can do it from a different motion every time. So possibly I mean anybody who could, you know probably goes to the loo a lot, which I do, could do the test kit really in a whole day [laughs] which I normally did. But it is quite simple and straightforward and then obviously you pop the little lid on the envelope down and then once you've completed the three test kits, the three envelopes, you pop it in the post and that's it really. And if, you know if you get the all clear they'll send you the information back telling you that the test was clear or it's not obviously you'll receive information to advise you how to proceed further.

So the test kit comes through the post, can you explain in detail exactly what you have to do please?

Yes you do, you take your test kit and you take a smear of your motion, pop it into the little, the little envelopes. Each, each motion, each part of the motion has to be taken from a separate part. You take your stick and you pop your little bit of smear of your motion in there and then you pop your little envelope down and seal it up. Finally the next, the next time you do a motion again you need to do a separate part of your motion again and also smear with your little stick onto your envelope and pop your little flap down. Finally on the third part you need to do the same again but it has to be from a different part of your motion.


His abnormal test result made him so agitated that he went to his GP, who was reassuring.

And then can you say a little bit more about your feelings when you had the one that came back that said it was unclear?

Ah well, I was quite concerned because when it came through the post and I read it and it said it was unclear, yes I was rather concerned, yes, because I naturally assumed, I know it sounds ridiculous but I just assumed that it would come back always clear, possibly because I considered I'd led a very healthy lifestyle, I'd exercised regular and I'd also eaten all, very good diet. I mean I haven't eaten red meat since I was in my thirties so consequently you assume you're bullet proof [laughs].

So that was a bit of a shock?

It was a shock, yes it was a shock indeed yes.

And then they asked you to repeat it again?

They sent the test kit yes and I sent it back without delay, the following day actually, I always managed to do the test kit in a day. And then that came back quite quickly and this time it said the result was abnormal. Apparently later I was told that in one, only in one of the envelopes was there trace of blood so, but even then though it was still classed as abnormal and I was advised that I should seek further investigation.

Can you tell me again about your feelings when you heard it was abnormal?

Oh gosh, I was absolutely, I was very nervous actually. It worried me that much that I made an appointment to see my GP [laughs] to tell him what had happened you know and I was quite agitated, and extremely upset I suppose really, yes I was. Possibly more so than I should have been but I suppose as an individual that's how I am [laughs].

And what happened when you went to the GP?

He spoke to me, quite, you know reassuring really and he just gave me a general talk. He was very good and just, he tried to calm me down a bit because I was really rather on edge you know.

Of course, understandably. So he reassured you.

Yes he did, yes he did.


He was given all the relevant information, and understood that a colonoscopy is considered to be...

Yes they [the specialist nurses] give you the information, they tell you the exact problem, they tell you about the polyps, they show you pictures of, you know, how they develop, they tell you about the, the procedure itself, and the aim of the procedure and obviously if they do locate polyps in, you know, in your bowel they explain how they can remove them with an electronic snare. And obviously if they can catch them in time and if they're not too big they can remove them with this snare via the colonoscopy, which if left, in time would possibly need major surgery. But obviously if it's caught in time they can be done quite easily and quite painlessly. They explained as well that a nurse, a specialist nurse from the hospital, will come to the hospital where the procedure is carried out and they will be with you from the time you arrive at the hospital and then they'll be with you in the procedure room as well to oversee the procedure.

And did you get any written information about the colonoscopy at that stage?

Yes, they'll give you leaflets that give you the information that you need to know really, yes.

Were you aware from reading the information that there might be some side effects or possible dangers in having a colonoscopy?

It's described as a very safe actually but there is, obviously there's also, there's always the possibility of perforation, but that's the main possible danger. But apparently it's a procedure that is considered very safe.

So were you convinced it was the right thing to do to go ahead and have the colonoscopy?

Yes, I was really, because if there was problem there, or a potential problem and I think really you need to know and it needs to be investigated because if there is a problem it's not going to go away by itself and it's no good ignoring it you know.

Did you feel you had a choice though, was it presented as a choice?

Oh of course, absolutely yes. Whether you want to proceed any further, yes it's your own individual choice, you have to make up your mind. They can give you the information, they can tell you the dangers, or if there is any problem. Also the benefits and they explain exactly what will be done. So yes, you're in possession of all the relevant information, yes.


On the morning of the colonoscopy he gave himself an enema to really clear his bowel of faeces.

You're given an appointment for the procedure [the colonoscopy] at your local hospital. A few weeks before the actual appointment time you receive through the post certain medications. There's sachets of a very strong laxative and also there's an enema kit. It comprises of a tube, a container of liquid and that has to be administered four hours prior to visiting the hospital for the procedure. But the actual granules themselves, they need to be mixed with cold water and stirred vigorously and they're taken a few days prior to the procedure, obviously to make sure that your large intestine is really clear, so that the procedure can be done accurately and properly.

And then you had to give yourself an enema?

You did actually. That was on the morning of the procedure, when the procedure took place in the afternoon. It's not too bad actually, it sounds worse than what it is, but it's just the final, it's the final thing to make sure that your large intestine is perfectly clear because obviously if it's not it would hinder and possibly make the procedure not possible.

For people who don't know what an enema is do you mind explaining a little bit more?

Yes certainly yes. You get a large plastic container with a tube and a nozzle, you need really to use a little bit of Vaseline to make it less painful. It's slightly uncomfortable, you have to insert that into your opening [anus], you have to squeeze the liquid and it has, all the liquid has to go in. You really have to lie on your side; you have to let the liquid stop there for a reasonable amount of time until you need, feel the urge to pop to the toilet quite quickly and that absolutely clears anything that may be remaining.

Can you manage that on your own or did you need help?

No I did it by myself actually [laughs] but it can be embarrassing for people, obviously, because it's not the nicest of things is it?

But if you do need assistance it's possible, you know it depends on the individual, some may prefer to do it on their own, and some may prefer to have it done for them. But possibly if you can't manage yourself they will do it for you at the hospital but they like you do it, really, a few hours before. But all in all if you can't they will administer it for you at the hospital.

Were the instructions quite clear what you had to do?

Yes they were, they were very clear yes, there was you know no problem with that.


After the colonoscopy he felt slightly 'woozy' and rested in a side ward until the sedative had...

What's it like after the colonoscopy, how do you feel?

Slightly woozy obviously because you know the effects [of the sedative] will last several hours. I wasn't too bad. What they do, they wheel you onto, on your trolley into a little side ward and it's what you might call a recovery ward and you're allowed to stay there really for an hour or so or as long as you wish until you feel able to get up and walk really. So you're not rushed, you know, they look after you quite well.

Did you feel you had any side effects at all after the colonoscopy?

No, I didn't no, fortunately none whatsoever no, I was perfectly okay. I was able to go the loo, no problem the next day, and I had no discomfort. No it was, for me it was problem free.


He took about a week off work because he felt he needed to be strong and alert for his job as a...

Please can you tell me, how long did you have to take off work for the colonoscopy?

Well I had approximately a week actually. Possibly most people wouldn't possibly need that much but with my job as a bus driver I need to be alert and the diet is quite severe actually and the thing is that you need energy and I mean driving buses is not a manual job as such but you do need the strength of your food to keep you alert. And obviously I found it, myself, wise to take the week off because the diet itself is a three day thing, and also you need to recover at least a day after the procedure with sedation. So I think a week really for most people is probably the ideal.

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