WEBVTT - Talking Sh*t: Colonoscopies, Stool Sizes, and Potty Talk 0:00:03.400 --> 0:00:06.040 Welcome to Bill and Juliana the podcast. 0:00:09.640 --> 0:00:12.920 Hey everyone, welcome to the Bill and Juliana Podcast. 0:00:13.520 --> 0:00:16.920 We are very lucky to have doctor Ruckham, who actually 0:00:17.000 --> 0:00:19.320 is our doctor. You're doctor my doctor. He gave us 0:00:19.760 --> 0:00:23.919 both our colonoscopies. He has over forty years of experience. 0:00:24.720 --> 0:00:29.240 He's done over forty thousand colonoscopies, if you can believe 0:00:29.240 --> 0:00:33.440 that at Northwestern well between Northwestern University of Chicago. That's huge. 0:00:33.560 --> 0:00:36.320 It's currently the head of the department at Northwestern Medical 0:00:36.360 --> 0:00:39.640 Center here in downtown Chicago. Yes, and he's a lovely man, 0:00:39.920 --> 0:00:42.360 great Chicago, and he's a big deal. Yeah, he's a 0:00:42.360 --> 0:00:42.879 big deal here. 0:00:43.080 --> 0:00:47.520 So literally, you guys, everyone in Chicago's like, oh, doctor Ruckham, 0:00:47.560 --> 0:00:49.640 Doctor Ruckham, Like he's like such a big deal. This 0:00:49.680 --> 0:00:53.080 is an important episode because doctor Ruckham did my colonoscopy 0:00:53.080 --> 0:00:56.080 as well as bills and that is actually the reason 0:00:56.960 --> 0:00:58.800 we are doing this podcast. We came up to his 0:00:58.840 --> 0:01:01.040 podcast ideas because I was googling all this stuff in 0:01:01.040 --> 0:01:03.120 the middle of the night about the colon off speaker 0:01:03.120 --> 0:01:05.200 is I could not finish the prep the liquid that 0:01:05.240 --> 0:01:09.279 gross liquid for the life of me. And let's get dirty. 0:01:09.360 --> 0:01:12.360 Let's get our hands, get our hands dirty. Welcome to 0:01:12.440 --> 0:01:15.800 the show, Doctor Ruckham, thank you for having me. I mean, 0:01:16.280 --> 0:01:19.600 as people know, you are just a pillar at Northwestern, 0:01:19.600 --> 0:01:22.720 which is one of the great institutions in Chicago. You've 0:01:22.720 --> 0:01:27.399 done Julianna's kolonoscopy, my colonoscopy, coming right out of the gate. 0:01:27.959 --> 0:01:29.000 Who's got a better colon? 0:01:29.200 --> 0:01:30.600 I knew you were going to ask that. 0:01:30.959 --> 0:01:33.480 I knew he was going to be a very competitive company. 0:01:33.520 --> 0:01:34.959 We are who does be honest? 0:01:35.120 --> 0:01:39.039 Always the woman? Yeah? Okay, smart answer. Speaking of bowels. 0:01:39.240 --> 0:01:41.040 As long as we're on the subject, we were talking 0:01:41.080 --> 0:01:43.959 about this. You know, how often should you make a 0:01:43.959 --> 0:01:46.479 ball movement? Is it twice a day, once a day, 0:01:46.480 --> 0:01:47.320 three times a day? 0:01:48.200 --> 0:01:48.680 Size? 0:01:48.920 --> 0:01:51.440 You know? Shape? Like we're with the internet now, you 0:01:51.480 --> 0:01:53.480 get so much information at your fingertips. You don't know 0:01:53.480 --> 0:01:53.920 what to believe. 0:01:54.120 --> 0:01:56.000 What do you really wander? How often? 0:01:56.360 --> 0:02:00.559 Believe it or not? The definition of normal is three 0:02:00.640 --> 0:02:03.560 times a day to three times a week. That's where 0:02:03.640 --> 0:02:05.440 ninety five percent of people will. 0:02:05.320 --> 0:02:05.800 Be with that. 0:02:05.800 --> 0:02:06.600 That's a huge range. 0:02:06.720 --> 0:02:07.559 That's a huge range. 0:02:07.600 --> 0:02:11.320 But it's important because you don't want to needlessly say, hey, 0:02:11.320 --> 0:02:13.440 I need to go every day. If you go every 0:02:13.480 --> 0:02:16.679 two or even every three days, and you're very comfortable 0:02:16.720 --> 0:02:17.880 and it's regular for you. 0:02:18.280 --> 0:02:19.919 That's your norm. That's fine. 0:02:20.720 --> 0:02:24.960 Interestingly enough, too, the consistency is irrelevant. So if someone 0:02:25.040 --> 0:02:28.800 said I have one watery bowel movement a day or 0:02:28.840 --> 0:02:32.880 I have lumpy stool every other day, and that's their normal. 0:02:33.080 --> 0:02:35.680 If they fit within three a day to three a week, 0:02:35.880 --> 0:02:36.480 it's normal. 0:02:36.560 --> 0:02:38.920 I had a fermented plumb once. I'm sorry what I 0:02:38.960 --> 0:02:41.240 was at a health food store and this guy Khalil 0:02:41.880 --> 0:02:45.000 on SUNLIGHTE so you got to try this fermented plumb 0:02:45.240 --> 0:02:48.480 and it was like a gusher. I mean, I no offense, 0:02:48.520 --> 0:02:51.720 but I was in the bathroom all day. I woke 0:02:51.800 --> 0:02:53.640 up in the middle of the night with abdominal pain 0:02:53.919 --> 0:02:55.079 like it was bad. 0:02:55.760 --> 0:03:00.640 The whole thing with fermentation. There's a lot of very good, 0:03:00.880 --> 0:03:04.520 healthy foods that when we eat them, they are not 0:03:04.680 --> 0:03:08.960 fully digested, and they as we get older and older, 0:03:09.040 --> 0:03:12.040 could be thirty five or forty, but you're older than 0:03:12.080 --> 0:03:14.400 you were when you were twenty. Things that you used 0:03:14.400 --> 0:03:17.040 to digest you may not digest as well. So let 0:03:17.120 --> 0:03:24.880 me give you a few examples. Beans, onions, mushrooms, broccoli, calliflower, spinach, kale, garlic, 0:03:26.040 --> 0:03:28.600 A lot of those foods. You eat them, they go 0:03:28.680 --> 0:03:32.840 in your stomach, they go through twenty feet a small intestine, 0:03:32.520 --> 0:03:36.400 much fee twenty feet where food is digested and absorbed. 0:03:36.640 --> 0:03:39.200 And then if it's not fully digested and it gets 0:03:39.280 --> 0:03:43.080 into your colon, the bacteria in the colon see this 0:03:43.200 --> 0:03:46.680 food and they can literally ferment it. And ferment it 0:03:46.720 --> 0:03:48.680 means they chew it up and they make gases. 0:03:49.400 --> 0:03:52.640 I have a question. It is a question that is 0:03:52.680 --> 0:03:57.240 a mystery to many. It is an incredibly embarrassing question 0:03:57.360 --> 0:03:59.880 for some. I'm going to ask you. I don't know 0:03:59.840 --> 0:04:01.600 if you have the answer to this. You might have 0:04:01.640 --> 0:04:03.800 to get back to us because you've probably never been 0:04:03.840 --> 0:04:07.680 asked this in your entire career. Are you ready? 0:04:07.760 --> 0:04:08.320 I'm ready? 0:04:08.440 --> 0:04:11.200 But I think there are millions of people like myself 0:04:12.080 --> 0:04:16.839 affected by this, Okay, since I was younger. I'll walk 0:04:16.880 --> 0:04:19.880 into like a Barnes and Noble, okay, and all of 0:04:19.880 --> 0:04:22.200 a sudden, within five minutes, I don't know if it's 0:04:22.240 --> 0:04:24.440 the smell of the books, I don't know what I'm like, 0:04:24.640 --> 0:04:26.839 where's the bathroom? I have to like immediately make a 0:04:26.839 --> 0:04:29.520 bee line. And then I found I thought I was 0:04:29.600 --> 0:04:31.480 the only person in the world who had this weird 0:04:31.520 --> 0:04:34.400 thing happened. And then I've seen other people on social 0:04:34.520 --> 0:04:38.240 media talk about this phenomenon and some people it's a target. 0:04:38.320 --> 0:04:43.080 Some people it's like a TJ Max. You know, isn't 0:04:43.080 --> 0:04:44.960 that weird? And what do you think it is? 0:04:45.120 --> 0:04:47.880 So I don't think I can give you an answer. 0:04:48.000 --> 0:04:52.080 That's a vedical that's definitive, but if one was to 0:04:52.200 --> 0:04:53.440 speculate it. 0:04:53.680 --> 0:04:55.520 You know how your mind. 0:04:57.080 --> 0:05:02.279 Holds back impulses and when you feel relaxed, if you're busy, 0:05:02.360 --> 0:05:05.240 you're working, your your mind is doing other things. There 0:05:05.279 --> 0:05:08.080 may be just the natural suppression of needing to go 0:05:08.160 --> 0:05:09.880 to the bathroom. 0:05:10.880 --> 0:05:11.440 Kids try. 0:05:11.720 --> 0:05:13.800 Not that you're even holding it in school, but a 0:05:13.800 --> 0:05:16.160 lot of times kids won't go to the bathroom in school. 0:05:16.279 --> 0:05:18.599 And it's not that they're I mean, some are holding it. 0:05:18.760 --> 0:05:21.320 They have accidents and that's an issue, but many of 0:05:21.400 --> 0:05:24.760 them just don't. Many people, you'll hear this all the time. 0:05:25.040 --> 0:05:27.200 During the work week, they don't go to the bathroom 0:05:27.240 --> 0:05:30.440 as much. Saturday and Sunday, when they're home, they go. 0:05:30.839 --> 0:05:35.000 So it probably has to do with just the relaxation 0:05:35.160 --> 0:05:37.599 that you're feeling and you're not in hip that you're 0:05:37.640 --> 0:05:40.839 in the store and you weren't running and doing errands 0:05:40.880 --> 0:05:45.680 and catching a cab ort and relax, and you're letting 0:05:45.760 --> 0:05:49.240 mother nature take over, which is what it should have done. 0:05:49.320 --> 0:05:51.880 Maybe a little while. That's just my guess. That's great, 0:05:51.960 --> 0:05:58.839 But I don't have a medical for sure. Either that, 0:05:59.000 --> 0:06:01.120 or I would tell some of my constipated people that 0:06:01.240 --> 0:06:02.600 go to by the. 0:06:02.520 --> 0:06:07.000 Way doctor feel free to take them mile. Yeah, if 0:06:07.000 --> 0:06:08.359 I haven't got to the bathroom in a while, I'm like, 0:06:08.360 --> 0:06:11.000 I should just go to the bookstore. I should probably 0:06:11.000 --> 0:06:13.680 just go grab something at home goods. So Doctor Ruckham, 0:06:13.760 --> 0:06:20.080 the literally the impetus for this podcast was my experience 0:06:20.120 --> 0:06:23.080 getting my colonoscopy. You don't know this yet, okay, but 0:06:23.320 --> 0:06:26.479 when I was doing the prep for my colonoscopy, I 0:06:26.520 --> 0:06:29.000 heard all these stories about the liquid. The liquid is 0:06:29.000 --> 0:06:31.920 the worst, The prep is the worst. The colonoscopy itself 0:06:32.000 --> 0:06:34.800 isn't bad, that's what everyone says. It's the prep that 0:06:34.839 --> 0:06:38.360 people get nervous about, as you probably know. And so 0:06:39.560 --> 0:06:41.679 when I was doing the prep, I got all my stuff, 0:06:41.720 --> 0:06:43.520 I went to the pharmacy, picked it up, and the 0:06:43.560 --> 0:06:45.720 first couple of SIPs, I was like this isn't bad? 0:06:45.760 --> 0:06:49.279 Why does everyone complain about this? As the day went on, 0:06:49.480 --> 0:06:51.520 it was still fine, fine, fine, and then kind of 0:06:51.520 --> 0:06:53.200 by the end of the day, I started getting a 0:06:53.200 --> 0:06:56.440 little like exhausted from drinking. It wasn't loving it anymore. 0:06:56.880 --> 0:06:59.520 And then I had to set my alarm in the 0:06:59.560 --> 0:07:02.960 middle of the I to wake up to finish the prep. 0:07:03.960 --> 0:07:05.760 And so in the middle of the night when I 0:07:05.800 --> 0:07:08.800 woke up, I kid you not, I literally I had 0:07:08.839 --> 0:07:11.680 like this much left, and I was like, I physically 0:07:11.680 --> 0:07:14.760 cannot take one more sip of this stuff. Okay, so 0:07:14.880 --> 0:07:16.560 much so, and you don't know this, but so much 0:07:16.560 --> 0:07:19.080 so that I thought I have to cancel my appointment, 0:07:19.080 --> 0:07:20.960 Like I'm gonna have to email his office or call 0:07:21.040 --> 0:07:23.200 the emergency line and be like, hey, I'm not coming 0:07:23.240 --> 0:07:27.840 in because I had an early morning appointment and I 0:07:27.920 --> 0:07:31.560 literally could not finish the prep. So I went online 0:07:31.720 --> 0:07:35.760 and I searched do I have to finish the prep 0:07:35.880 --> 0:07:40.920 before a colonoscopy? And there were a million different reports. 0:07:40.960 --> 0:07:43.040 Couldn't get a straight answer. And then finally it was 0:07:43.080 --> 0:07:46.800 actually on Reddit that I saw a line that said 0:07:47.280 --> 0:07:52.600 I am a colonoscopy nurse of twenty years and dot 0:07:52.600 --> 0:07:55.640 dot dot. So I clicked it, and she said, if 0:07:55.680 --> 0:08:00.400 you're healthy, it's your first colonoscopy, there's no nothing scary 0:08:00.440 --> 0:08:03.480 going on that you know of. Then yes, you could 0:08:03.560 --> 0:08:07.520 leave some of the liquid behind. You don't have to 0:08:07.560 --> 0:08:11.440 take it all. And so that gave me reassurance I 0:08:11.480 --> 0:08:14.000 could go back to bed. I came in the next day, 0:08:14.400 --> 0:08:16.040 and I don't know if you remember, but when I 0:08:16.120 --> 0:08:19.040 came out of the colonoscopy and you guys woke me up. 0:08:19.080 --> 0:08:21.880 You were there, Bill, Yeah, I think I asked you. 0:08:21.960 --> 0:08:25.720 I said, how was I in there? You know, I 0:08:25.720 --> 0:08:27.480 wanted to know, like, was. 0:08:27.440 --> 0:08:30.480 I yeah, well slensed down? Yeah? 0:08:30.720 --> 0:08:33.520 Did I do my job? Because I was curious by 0:08:33.559 --> 0:08:36.200 not having that final bit? Was it still okay? 0:08:36.800 --> 0:08:40.240 That's a common question and people think about it. 0:08:40.400 --> 0:08:40.600 You know. 0:08:40.840 --> 0:08:45.240 Part of the issue is not everyone scheduling a colonoscopy 0:08:45.360 --> 0:08:48.480 has a doctor's appointment where you'd have a chance to 0:08:48.559 --> 0:08:49.400 discuss things. 0:08:49.400 --> 0:08:49.920 Most of them. 0:08:50.080 --> 0:08:53.520 Yes, I turned forty five, I'm getting a procedure. Do 0:08:53.559 --> 0:08:55.120 I need to waste the time to go to the 0:08:55.240 --> 0:08:58.360 office and GI doctors don't require. 0:08:58.040 --> 0:09:00.400 That it's scheduled, you can do it. 0:09:00.600 --> 0:09:04.040 So you really never had the chance simplest answer is 0:09:04.520 --> 0:09:07.400 if when you're going to the bathroom it's coming out 0:09:07.440 --> 0:09:12.080 like clear water or like almost like urine, like just 0:09:12.080 --> 0:09:15.760 a yellow tinge pure water, then you're done. You're clean, 0:09:16.080 --> 0:09:18.200 so you don't have to drink anymore because you're as 0:09:18.240 --> 0:09:22.360 clean as you need to be the other part to 0:09:22.480 --> 0:09:25.679 it is there's different types of bowel preps. So some 0:09:25.720 --> 0:09:29.760 people get the whole jug, the four lid, which is 0:09:30.280 --> 0:09:33.360 more to drink, more potent because it'll flush you out. 0:09:33.720 --> 0:09:38.319 Some people get the shorter, the smaller two bottles, and 0:09:38.440 --> 0:09:42.120 when you do the shorter one, it's ideally you'd rather 0:09:42.200 --> 0:09:45.160 not take a short cut from the short cut got 0:09:45.480 --> 0:09:48.240 you know, So those people I would try to encourage 0:09:48.320 --> 0:09:52.080 to drink at all. But again, if they're clear or 0:09:52.440 --> 0:09:55.520 yellow and watery, you're done. God, so you don't have 0:09:55.600 --> 0:09:56.079 to finish. 0:09:57.120 --> 0:09:59.800 I had the four liter or whatever it was it was, 0:10:00.080 --> 0:10:01.600 who's quite powerful. 0:10:02.040 --> 0:10:03.040 And you finishers. 0:10:03.160 --> 0:10:05.720 I finished mine. And the good news is when I 0:10:05.800 --> 0:10:08.520 went in, you said, i'll see in ten years, So 0:10:08.600 --> 0:10:10.240 I had I had a clean bill. 0:10:10.400 --> 0:10:13.760 It's a clean bill, and what that means no poll ups, 0:10:13.800 --> 0:10:15.600 because that's what we're looking for when. 0:10:15.440 --> 0:10:15.920 We do this. 0:10:16.679 --> 0:10:20.440 Most pulps will never become cancer. Looking the other way, 0:10:20.880 --> 0:10:25.240 most cancers started as a poll up, So by removing them, 0:10:25.600 --> 0:10:28.240 you'll eliminate the chance. I mean, what's the odds of 0:10:28.280 --> 0:10:31.440 a healthy fifty year old having a poll up? It's 0:10:31.480 --> 0:10:34.920 probably in the thirty five to forty percent range, So 0:10:35.240 --> 0:10:38.280 that's not uncommon. At age forty five or fifty they 0:10:38.320 --> 0:10:38.880 have a polyp. 0:10:39.040 --> 0:10:39.959 I did have a poll up. 0:10:40.040 --> 0:10:43.520 Yeah, but how many people? How many people will get 0:10:43.559 --> 0:10:47.160 colon cancer? It's about four percent. No test is one 0:10:47.240 --> 0:10:50.120 hundred percent. There's things that could be missed. There may 0:10:50.160 --> 0:10:52.800 be cancers that don't start as a pollup. Yeah, but 0:10:53.440 --> 0:10:56.520 in general we're reducing the risk of colon cancer by 0:10:56.520 --> 0:10:57.400 about eighty percent. 0:10:57.440 --> 0:10:58.040 That's incredible. 0:10:58.080 --> 0:11:00.480 You might find some say ninety percent, some say seven 0:11:00.480 --> 0:11:02.839 by doing ascopy, doing a plenoscopy. 0:11:03.120 --> 0:11:07.000 Now I have to ask you, so when you go 0:11:07.080 --> 0:11:10.000 do a colonospay, you go under correct like you're you're out, 0:11:10.080 --> 0:11:12.440 I mean, or twilight what is it called twilight? Twilight? 0:11:12.520 --> 0:11:15.560 So it's not general anesthesia. You're breathing on your own. 0:11:15.880 --> 0:11:19.200 You're in a sedated to be comfortable. That's the focus 0:11:19.280 --> 0:11:20.320 is comfort. 0:11:20.040 --> 0:11:23.720 Okay, And obviously that's what you know. Like I was 0:11:23.720 --> 0:11:25.840 like excited about that because of course, like the last 0:11:25.840 --> 0:11:28.120 thing I want to do is be awake during a kolonoscopy. 0:11:28.679 --> 0:11:33.439 Yet the person in my right, my husband opposite psycho, 0:11:33.880 --> 0:11:37.920 he what was your reaction when my husband said, I 0:11:38.000 --> 0:11:39.920 don't want to go under. I want to be awake 0:11:40.280 --> 0:11:41.520 for my colonos. 0:11:41.160 --> 0:11:42.800 I've never been under in my life. And I even 0:11:42.800 --> 0:11:45.320 did a shoulder surgery. Yeah, and I didn't go under, 0:11:45.679 --> 0:11:47.439 So you know, I will. 0:11:47.880 --> 0:11:51.520 Look, I've done this sounds like a crazy number, but 0:11:51.559 --> 0:11:56.680 I've done over forty thousand. Wow, okay, and I will 0:11:56.720 --> 0:12:01.840 probably do maybe ten twelve a year. Where people request 0:12:01.960 --> 0:12:06.440 no sedation, I try to discourage it. Why not just 0:12:06.520 --> 0:12:10.360 be relaxed and comfortable. You just don't know how you're 0:12:10.400 --> 0:12:14.840 gonna feel. Everyone's got their own nerves sensitivity. The part 0:12:14.920 --> 0:12:19.400 that makes a colonoscopy potentially uncomfortable is when you're pushing 0:12:19.440 --> 0:12:22.400 it in the stretch. That can occur and if there's 0:12:22.440 --> 0:12:24.920 a loop, If there's a loop and you wouldn't know it, 0:12:25.440 --> 0:12:27.360 your colon could have a loop, and we go in 0:12:27.400 --> 0:12:30.440 and we just twist with our wrists, unravel and straighten it. 0:12:30.640 --> 0:12:34.680 When we're coming out. There's no discomfort, it's just it's straight. 0:12:35.200 --> 0:12:38.400 But you just don't know how people react, and some 0:12:38.480 --> 0:12:42.520 do amazing. And you know, I say this objectively, no 0:12:42.720 --> 0:12:47.360 sexism and vowel. As a general rule of thumb, general 0:12:47.920 --> 0:12:50.760 men's colons tend to be a little straighter than women's. 0:12:50.800 --> 0:12:54.600 Women's tend to have a little more twists. As they 0:12:54.600 --> 0:12:57.160 get older and they've had some children, their pelvic floor 0:12:57.240 --> 0:12:59.880 may drop a little and there may be that twist. 0:13:00.840 --> 0:13:03.000 Is that why men go number two more often? 0:13:03.400 --> 0:13:05.319 And I hear that all the time from the wives? 0:13:05.520 --> 0:13:08.440 Why am I constipated in my husband goals every day? 0:13:08.640 --> 0:13:09.640 And as a rule. 0:13:09.440 --> 0:13:12.320 Of thumb, men tend to go a little more regularly 0:13:12.400 --> 0:13:15.360 than women. Still, there's no way that it can be 0:13:15.880 --> 0:13:17.080 not uncomfortable. 0:13:17.120 --> 0:13:18.960 I won't do it. I will never. When I come 0:13:19.000 --> 0:13:23.079 back to you when I'm sixty out, I am going under. Yeah, 0:13:23.120 --> 0:13:25.360 so I've never been under my life. Still to this day, 0:13:25.400 --> 0:13:28.440 I've never been under. But I can't. I'm not what 0:13:28.720 --> 0:13:29.439 you fear. 0:13:29.480 --> 0:13:31.080 Bill hold on, let me ask you, because my fear 0:13:31.120 --> 0:13:33.319 when I go under, I've been under a lot. I'm 0:13:33.320 --> 0:13:38.520 not even scoliosis, breast cancer, IVF I've been under a lot, right, 0:13:38.559 --> 0:13:40.800 I've had a lot of propofol, a lot of all 0:13:40.840 --> 0:13:46.040 this stuff. My fear is like God forbid something happens, 0:13:46.040 --> 0:13:47.640 and like I don't wake up, right. I mean, that's 0:13:47.679 --> 0:13:49.640 I think most people's fear. What is that your fear? 0:13:49.720 --> 0:13:52.800 What is your fear? I spend a lot of time 0:13:53.000 --> 0:13:57.640 googling medical treatments and things like that, and in Europe, 0:13:57.679 --> 0:14:00.760 believe it or not, they don't go under for poscopies 0:14:00.800 --> 0:14:03.480 in many parts of Europe, right from what I was googling, 0:14:03.520 --> 0:14:08.120 And I'm like, because it's unnecessary, and I just I've 0:14:08.160 --> 0:14:11.120 never been under. I think it's also a lack of control. 0:14:12.080 --> 0:14:13.679 You know, I don't know what I'm going to say. 0:14:14.320 --> 0:14:16.920 That's the comment that I The two things that I 0:14:16.960 --> 0:14:19.400 hear the most when someone says they don't want to 0:14:19.880 --> 0:14:23.680 is they say, I have this fear of losing control, 0:14:24.360 --> 0:14:28.080 and I go like, like, what control are you looking 0:14:28.160 --> 0:14:33.520 for in the next thirty minutes? You know? And occasionally 0:14:34.040 --> 0:14:37.360 some people want to. They literally say I have a 0:14:37.400 --> 0:14:39.560 meeting to get to. I don't want to be sedated. 0:14:39.600 --> 0:14:42.920 I want to just get up and leave. And you know, 0:14:43.120 --> 0:14:45.920 we'll work with them. We'll always give them an ivy 0:14:46.600 --> 0:14:49.520 okay in case, in case their blood pressure got a 0:14:49.560 --> 0:14:52.040 little lower, we can give them fluids in case they 0:14:52.760 --> 0:14:56.760 throw in the white towel and say, you know that 0:14:56.800 --> 0:14:59.280 way we can put But you know if you hate 0:14:59.320 --> 0:15:02.600 when you do that, when someone mid stream says give 0:15:02.600 --> 0:15:04.680 me the medicine, because you say, why did I have 0:15:04.720 --> 0:15:08.920 to put you through this comfort before you said it? 0:15:09.720 --> 0:15:12.160 So if people ask for they don't want the propofol, 0:15:12.240 --> 0:15:15.360 they do the milder one. Do you do people still 0:15:15.400 --> 0:15:16.480 say crazy stuff. 0:15:17.000 --> 0:15:20.800 They people are always worried that they're going to say 0:15:20.840 --> 0:15:23.800 something to most people, they never they never do they 0:15:23.840 --> 0:15:24.200 never do. 0:15:24.360 --> 0:15:25.680 You know, people they just. 0:15:25.600 --> 0:15:29.040 Go to sleep and they're just relaxing, and you know, 0:15:29.120 --> 0:15:33.160 as the procedures going on, I'm constantly with the nurse 0:15:33.240 --> 0:15:36.720 in the room. We're going like Bill, you know, open 0:15:36.760 --> 0:15:40.040 your eyes and if you started like opening them, give 0:15:40.080 --> 0:15:42.960 them another milligram because we're trying to be two to 0:15:43.040 --> 0:15:46.440 three minutes ahead of when you may actually wake up 0:15:46.480 --> 0:15:50.520 a little more. Because it's tye traded to the person's need. 0:15:51.000 --> 0:15:53.960 There's no fixed dose that's going to work for everybody. 0:15:54.080 --> 0:15:57.400 We go a little at a time, another dose, another 0:15:57.440 --> 0:15:58.200 and then you're ready. 0:15:58.440 --> 0:15:59.040 I'm excited. 0:15:59.160 --> 0:16:01.360 I'm looking forward to But I always but I will 0:16:01.440 --> 0:16:05.200 tell you when when people ask me that and there's 0:16:05.200 --> 0:16:08.560 spouses in the room, I always go, you said, I 0:16:08.600 --> 0:16:09.440 love my husband. 0:16:10.760 --> 0:16:27.160 Oh that's interesting. Just a lot of people have so 0:16:27.200 --> 0:16:27.840 many questions. 0:16:27.920 --> 0:16:29.600 I have some questions written down from viewers. 0:16:29.760 --> 0:16:32.520 We literally have people who were so excited that you 0:16:32.560 --> 0:16:36.080 were coming on. Our best friends were very excited. We 0:16:36.160 --> 0:16:39.040 have a good friend in Chicago named David Wells, and 0:16:39.160 --> 0:16:40.960 we told him you were coming on and he said, 0:16:41.080 --> 0:16:42.520 do you know what I want to know? Because we 0:16:42.560 --> 0:16:43.840 asked our friends like what do you want to know? 0:16:44.680 --> 0:16:48.080 And he said, I would love to know if they 0:16:48.120 --> 0:16:49.280 all look the same. 0:16:50.880 --> 0:16:54.800 Like, what do you mean that's whole? He said, Like, 0:16:55.080 --> 0:17:01.120 are some he's looking a knucklehead? Yeah, there's a prettier 0:17:01.160 --> 0:17:07.800 colon than the other one. Any attractive? Like, no, it's not. 0:17:08.080 --> 0:17:09.840 Do they all look the same? I think is actually 0:17:09.840 --> 0:17:10.639 a very good question. 0:17:10.880 --> 0:17:14.640 Well, they look the same if they're healthy, but there 0:17:14.720 --> 0:17:19.600 might be subtle turns and twists and the diverticulum that 0:17:19.920 --> 0:17:23.320 you know, if some colons have so many it almost 0:17:23.359 --> 0:17:26.160 looks like Swiss cheese. And you got to be really 0:17:26.200 --> 0:17:28.359 careful you, meaning you've got to say which one's the 0:17:28.400 --> 0:17:32.120 real opening and which one's the diver if they're bigger. 0:17:32.359 --> 0:17:34.880 If they're bigger. A lot of people are are now 0:17:34.920 --> 0:17:38.480 taking GLP ones. It's causing a lot of problems with 0:17:38.520 --> 0:17:43.480 their ball movements, irregular ball movements, freezing right of the colon. 0:17:44.119 --> 0:17:47.119 What are you seeing now in the industry with so 0:17:47.200 --> 0:17:48.840 many people taking GLP ones. 0:17:49.200 --> 0:17:53.720 Okay, So, so glp ones in general work in two 0:17:53.720 --> 0:17:57.240 different ways. One in the brain they decrease your appetite. 0:17:57.680 --> 0:18:02.320 Two they slow your gut motility, so your stomach doesn't empty. 0:18:02.400 --> 0:18:05.920 So imagine how hungry you would be if you said 0:18:06.240 --> 0:18:08.520 you want a meal after you've had a meal, you'd say, no, 0:18:08.600 --> 0:18:12.160 I'm full. Their stomachs don't empty as well, and that's 0:18:12.200 --> 0:18:14.639 the other reason they don't want to eat as much. 0:18:14.920 --> 0:18:18.240 But it can also affect the colon. People do get 0:18:18.280 --> 0:18:21.080 sometimes diarrhea from it, but a little more commonly is 0:18:21.520 --> 0:18:24.600 constipation that your bowel doesn't move as well because it 0:18:24.760 --> 0:18:28.360 slows gut motility. So when someone's on a GLP one, 0:18:28.920 --> 0:18:31.560 we tell them to not take it for at least 0:18:31.560 --> 0:18:34.200 seven days, got it. The last dose should be seven 0:18:34.280 --> 0:18:37.920 days before the prep so that it's wearing off by 0:18:37.960 --> 0:18:40.160 the time you're taking the bowel prop and you clean out. 0:18:40.200 --> 0:18:44.359 Okay, what's the story with hemorrhoids, Like, at what point 0:18:44.560 --> 0:18:47.600 should you worry go to a doctor about a hemorrhoid? 0:18:47.960 --> 0:18:50.399 You know, sometimes like you get a hemorrhoid once in 0:18:50.440 --> 0:18:52.320 a while and it kind of goes back in and 0:18:52.359 --> 0:18:54.800 then you know, like bye bye, you know it's gone. 0:18:54.920 --> 0:18:58.400 But then sometimes like it can be a little feisty, 0:18:58.560 --> 0:19:01.080 keeps coming, you know, keeps popping out and stuff like that. 0:19:01.160 --> 0:19:04.000 Like, what could tell me about your issues right now? 0:19:04.280 --> 0:19:07.440 I mean, I can admit, I mean. 0:19:07.359 --> 0:19:11.879 We hamorrhids are a very it's a very common question. 0:19:12.000 --> 0:19:14.000 Yeah's a common thing that people come in to see 0:19:14.000 --> 0:19:17.159 a doctor about. Hemorrhids are just blood vessels. So the 0:19:17.480 --> 0:19:19.720 good news is that they don't turn into anything bad. 0:19:20.119 --> 0:19:22.679 You know, people often wonder, well, if I don't do anything, 0:19:22.680 --> 0:19:24.240 we'll turn It's just a blood vessel. 0:19:24.280 --> 0:19:24.600 Okay. 0:19:24.840 --> 0:19:28.040 So now there's two types, and it's important to know 0:19:28.119 --> 0:19:31.159 the distinction. You know, how people use the term rectum 0:19:31.160 --> 0:19:36.439 and anus sometimes interchangeably, but medically, the rectum is the 0:19:36.520 --> 0:19:40.639 end of the colon. That's the end and the after 0:19:40.720 --> 0:19:43.320 the rectum is the anus, which is the muscle that 0:19:43.640 --> 0:19:45.720 you know, if you want to hold it, you can 0:19:45.760 --> 0:19:49.840 tighten it. So the anus has nerves to it. That's 0:19:49.880 --> 0:19:54.240 where external hemorrhoids are in the anus. So external hemorrhids 0:19:54.320 --> 0:19:58.520 can bleed and they can hurt. Internal hemorrhoids are in 0:19:58.560 --> 0:20:03.080 the rectum. They can bleed, but they don't hurt. Warm 0:20:03.119 --> 0:20:05.199 water though, you know, like when you go on a 0:20:05.200 --> 0:20:07.840 hot bath, you know, not no salts, you don't need 0:20:07.880 --> 0:20:11.119 any of that absence. That's old folklore. Just warm water. 0:20:11.359 --> 0:20:13.680 You know how your fingers can shrivel up like brooms. 0:20:14.000 --> 0:20:16.359 When you've been in the bathroom long enough that your 0:20:16.400 --> 0:20:19.960 fingers are shriveling, the hemorrhoids can shrink and that's what 0:20:20.680 --> 0:20:23.600 helps them. Hemorrhos can be caused by a lot of things. 0:20:23.600 --> 0:20:26.199 It could be just bad luck. It could be you 0:20:26.240 --> 0:20:29.000 have diarrhea and you're going frequently. It could be a 0:20:29.040 --> 0:20:33.720 long plate, I'm a runner, a biker on those narrow bikes, 0:20:33.840 --> 0:20:37.639 pregnancy when you're pushing. So a lot of things cause them, 0:20:37.720 --> 0:20:39.480 but most get treated easily. 0:20:39.680 --> 0:20:42.080