Medicine: "And the survey says..."

My husband answered a survey online last week that helped him realize how much he knew about fuel efficient driving habits and how his driving fit in with those around him. My brother answered a personality quiz that told him he was most like the character of the boa constrictor that swallowed an elephant in Antoine de Saint-Exupery’s The Little Prince.

Surveys are used in research and medicine all the time. I use questionnaires such as the Cleveland Clinic Constipation Score, the Fecal Incontinence Severity Index, and the Fecal Incontinence Quality of Life Survey to measure patients’ response to specific treatments and procedures. Market researchers use surveys to understand a product’s performance.

Any reader of women’s magazines such as Glamour or Cosmopolitan will tell you that we can use surveys and quizzes to learn more about ourselves as well. Who hasn’t glanced at results of quizzes on sex or relationships to see how they measure up?

March is Colorectal Cancer Awareness Month. Please visit the American Society of Colon and Rectal Surgeons’ website to take a quiz that could save your life. Let me know how you did!

Science: Tangled Bank

For an exciting glimpse into the latest and greatest blogging on science and medicine, check out the Tangled Bank #23, hosted by grrlscientist, on her blog Living the Scientific Life.

Medicine: Family History

A 61-year-old retired nurse came to see me in my office. She had an ascending colon cancer, and I scheduled her for a right hemicolectomy. The frightening thing was the circuitous route that she took to end up in my care. The only thing that had ever really bothered her was her knees. She retired several years ago to care for her husband, who died just last year from complications of diabetes. These last three years, spent mostly at her ailing husband’s bedside, she gained a tremendous amount of weight, and the arthritis in her knees grew worse and worse. Now, as a widow, trying hard to move on with her life, she was finding it difficult to get around at all. Her average 5 foot, 6 inch frame was no match for her 278 pound body. She consulted an orthopedic surgeon who recommended both knees be replaced.

In preparation for her knee operation, she was found to be anemic (low red blood cell count). The orthopedic surgeon started her on Procrit, a medicine to help boost her body’s ability to make fresh blood. Her internal medicine doctor insisted she have a workup to rule out any source of gastrointestinal blood loss, and sent her to a gastroenterologist. The gastroenterologist did an upper endoscopy and found some minor gastritis (stomach inflammation). The same day he did a colonoscopy and found her cancer. The gastroenterologist sent her to me.

I spoke with my patient’s family after her operation yesterday. I met her two sons, her daughter and son-in law. I explained how her size had made the operation more difficult, and how important it would be to have her up and out of bed as soon as possible. They thanked me for all the hard work, and for taking care of their mom, and explained that it was truly her knees that saved her. In the past ten years, her youngest son had had some benign polyps removed at colonoscopy, her daughter had polyps of a premalignant nature removed, and her older son had actually had a cancerous polyp removed endoscopically. Their mother, so busy caring for their father, had not gone for a colonoscopy in fifteen years, and never, never would have gone for one again if it had not been for her aching knees.

A family history of colorectal cancer is a serious risk factor for colorectal cancer. Your risk is higher when cancer occurs in primary relatives, which include your parents, your brothers and sisters, AND your children. For more information about colonoscopies, colon cancer screening, and what you can do to decrease your own risks of colorectal cancer, visit the ASCRS website.