Thursday, March 27, 2008

easement by proscription - maintenance of utility lines

Tomorrow begins with the Rotor Rooter guy cramming a camera up my butt. Needing to understand this unfortunate procedure, I queried that bastion of peerless-reviewed knowledge, wikipedia.

Let’s run the tape …

Colonoscopy is the endoscopic (end--, emphasis on end--) examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber (I don’t get enough fiber, so I think this is a good thing) optic camera on a flexible tube passed through the anus (through … the … anus. This just isn’t right. It’s going in the wrong direction. Things that pass “through the anus” are supposed to be traveling north to south, not south to north. I do not approve.). It may (may? You mean I am being compromised and all you can give me is “may”? That is just not good enough. I do not approve.) provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy or removal of suspected lesions. Virtual colonoscopy, which uses 2D and 3D imagery reconstructed from computed tomography (CT) scans or from nuclear magnetic resonance (MR) scans, is also possible, as a totally non-invasive (yes, this is what I want. “Non-invasive” has a nice ring to it. Very melodic, like “cellar door.” Kinda rolls off the tongue. Could one say that the non-invasive procedure “may provide a visual diagnosis”? If so, please help me understand why we are losing the prefix. I do not approve.) medical test, although it is not standard and still under investigation (so is JFK's assassination. And did you see the article today about RFK’s shooting? Seems he was shot in the back, but Sirhan Sirhan (a dude so nice they named him twice) was in front of him. I have no problem with “still under investigation.” None whatsoever.) regarding its diagnostic abilities. Furthermore, virtual colonoscopy does not allow for therapeutic maneuvers such as polyp/tumor removal or biopsy (and if there is not a need for “therapeutic maneuvers” then there is not a need to invade me, now is there?) nor visualization of lesions smaller than 5 millimeters (I measured this. Five mm is small. Tiny, in fact. There’s like over 25 of them to the inch. I got no problem with missing these. We’ll catch them in five years when they grow bigger and your tech gets better.). If a growth or polyp is detected using CT colonography, a standard colonoscopy would still need to be performed (Duh. OK. So let’s do open heart surgery just in case there’s something there. If there is, we’re going to have to go in anyway. You people are cruel.). Colonoscopy can remove polyps smaller than one millimeter. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not. (Yeha, whatever. All of a sudden, prefixes are important. Great.)

Colonoscopy is similar but not the same as sigmoidoscopy (in case you haven’t been reading and taking notes, Sigmoid left the building several years ago). The difference between colonoscopy and sigmoidoscopy is related to which parts of the colon each can examine. Sigmoidoscopy allows doctors to view only the final two feet of the colon (that’s true), while colonoscopy allows an examination of the entire colon, which measures four to five feet in length (WHAT?!? FIVE FEET! Are you nuts? This is humiliating and totally unnecessary). Often a sigmoidoscopy is used as a screening procedure for a full colonoscopy. In many instances a sigmoidoscopy is performed in conjunction with a fecal occult blood test (FOBT), which can detect the formation of cancerous cells throughout the colon. (Yeah, OK, whatever. Where’s my Fleets?)

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