1. A CMH Community DocTalk with Robert Wayne, MD, FACS

2. My Background Board Certified General Surgeon in Astoria for 30 years Performing endoscopies since starting practice in 1978 Membership in the Society of American Gastroentestinal and Endoscopic Surgeons (S.A.G.E.S.) Attended numerous lectures and updates on endoscopy Personal experience with my own 3 colonoscopies

3. What is a Colonoscopy? Examination of the lower intestine Using a 5 foot fiber optic flexible telescope Done in an outpatient setting Using conscious sedation (strong amnesia) Average time varies from 20 to 60 minutes Diagnostic and therapeutic exam Biopsies and removal of polyps can be done

4. The Colon

5. Colonoscopy

6. What are the major indications for colonoscopy? Blood in the stool Change in bowel habits Anemia (low blood count) Personal history of colon cancer or polyps Family history of colon cancer or polyps History of colitis Screening

7. What is screening? Preventive Medicine Evaluation of the asymptomatic patient for disease Examples of screening: Pap Smear Mammogram Prostate rectal exam

8. Why colonoscopic screening? Early detection of colon cancer Removing precancerous polyps Potential for better survival

9. State of the art equipment High definition monitor 6 colonoscopes Wide angel viewing 180 degree Internal stiffener Variable phase lighting Anesthetist conscious sedation

10. How much will it cost? The physician charges $487 for the basic procedure Medicare will pay $197 to the physician Facility costs are several thousand dollars

11. Where can I get a colonoscopy done? Hospital Free standing clinic

12. Hospital or outpatient? Sedated position

13. Are there other less invasive screening colon tests? Stool cards Sigmoidoscopy Barium enema Virtual colonoscopy

14. What is virtual colonoscopy? Evaluation of the colon using a CT scanner Less invasive Less expensive? Non therapeutic Radiation exposure Similar preparation

15. What is the preparation for a colonoscopy? A cleansing drink taken over several hours the day prior Lots of potty training A half day at the hospital the day of the procedure

16. What are the complications of this procedure? Colon perforation Bleeding Incomplete colonoscopy (BE)

17. What are the major colon cancer risk factors? Age over 50 Family history of polyps or colon cancer Personal history of colon cancer or polyps Personal history of colitis

18. Colonoscopy humor Google

19. Screening colonoscopy in the news Flat Polyp Time of withdrawal Left verses right colon accuracy Perforation risk Fleets prep

20. Which physicians do colonoscopies? Gastroenterologists General surgeons Colorectal surgeons Others

21. Physicians available in Clatsop County to perform a colonoscopy Robert Gustafson, M.D. FACS William Merry III, M.D., FACS Truman Sasaki, M.D., FACS Lee Swanstrom, M.D., FACS Robert Wayne, M.D., FACS

24. Normal colon

31. What can be done to decrease the risks of colorectal cancer? Increase dietary fiber Lose weight Exercise Low fat diet Decrease smoking and alcohol

34. A busy colonoscopy day.

35. Dancing with the stars!