I Got a Colonoscopy; If You're Over 50 and Living With HIV, Please Do It Too

My primary-care physician is tall, dark, and criminally handsome. He is a consummate professional, completely above board, and married. He is a fantastic doctor whom I trust, but still, I have a twinkle of doctor-patient fantasy. In my fantasy, he diagnoses my butt as being adorable, shapely, and gravity-defying in its perkiness. In reality, he’s never referred to my ass in any fashion that wasn’t medical.

Case in point: A few months ago, my dreamy doctor made the subtle command that I have a colonoscopy. When you reach your fabulous 50s, it’s recommended that you get one. I’m 52, so it’s about time. As much as the entire colonoscopy process is icky, I know the value of it. I have two friends who are my age-ish, both living with HIV, who have both survived anal cancer that came to light because of a colonoscopy. And Latinx people in the U.S. are more likely to be diagnosed with a late-stage colorectal cancer, as well.

The entire colonoscopy experience is not cool. The preparation for the procedure not only includes fasting for a day, but also taking a magical potion that gives you five or six humiliating hours of diarrhea to make sure everything is clean and minty fresh down there. For the procedure itself, you’re in a medical gown open to the back, IV in your arm, lying on your side with your knees bent. They put you to sleep with propofol (that’s the only part that I like), and the doctor sticks a fiber-optic camera on a flexible tube through your anus, up your rectum, to examine your lower innards to see if there are any signs of cancer.

I had the procedure a few years back, and I was loath to repeat the experience. I asked the doctor if there were other options. I’ve seen ads on television for a stool screening test that comes to you in the mail, and you crap in the box (I can only imagine) and then send it away for analysis. My doctor poo-poo’ed the idea and recommended a gastroenterologist. I gritted my teeth and made the appointment.

The day of the procedure, I arrived on time, feeling completely empty inside. The team was right on schedule and processed me with kindness and professionalism. It amazed me how many people were involved in the colonoscopy: the doctor, anesthesiologist, nurses, etc., so many people invested in my ass.

Afterwards, while I was in the recovery area, groggily coming to, the doctor visited to tell me how the colonoscopy went. “Well, Mr. Sanchez,” he began, “everything looked pretty good. We found one polyp, which we removed and are sending to have biopsied. We also found condylomata acuminata, human papillomavirus (HPV) warts, in your rectum, and you’re going to have to have them surgically removed.” He handed me a business card with the name of a colorectal surgeon to make a date for surgery.

I was still woozy from the anesthetic, but I thought, “Wait. What?”

The doc sent me home with a packet filled with all the details of the colonoscopy, including full-color images of my rectum that no one ever needs to see. Later, I got on my computer and looked up condylomata acuminata, and let’s just say it ain’t pretty. Because it’s HPV, it was sexually transmitted (for me, the social occasion had to have been way pre-COVID), and because of where it presented (in my rectum), surgery is the only treatment option.

According to the journal Clinics in Colon and Rectal Surgery, condylomata acuminata, or genital warts, is the most common sexually transmitted disease, surpassing herpes for the honor. The condition affects 5.5 million Americans every year, and people living with HIV have a 30% chance of getting it. If left untreated, the HPV warts could lead to cancer. As much as I didn’t want any kind of surgical device being near my most delicate nethers, I didn’t want the condition to get worse and become more complicated. I booked a time for the outpatient procedure of anal-wart exorcism.

In the weeks between making the appointment and the surgery, I talked about the upcoming ass operation with a few friends. One friend said when he’d had it done, he couldn’t ingest anything but smoothies for a month. Another pal told me that when he’d picked up a friend post-procedure, his friend had so much bleeding that he needed to use sanitary napkins, and that there was a lot of post-surgery pain. Holy Kotex! I sent a panicked message to my surgeon, who assured me that for my condition, the procedure would be relatively simple. I’d be put asleep with propofol (just like for the colonoscopy) and also given a local anesthetic for the surgery site. There would be minimal post-surgery bleeding, and pain could be managed with over-the-counter Tylenol.

A few weeks later, I arrived at the surgery center for yet another team of medical professionals to care for my behind. This time, they would be delving deep and burning off the gross growths in my rectum. When the doc reminded me that burning was the method, I wondered if he’d shout, “Fire in the hole!” during the surgery. I also recalled that an ex-boyfriend used to call me “Hot Butt,” and now it would be literally true.

In the operating room, I was wearing two hospital gowns—one opened to the front, the other to the back—and those cute hospital socks with little grips, with an IV in my arm. I had to lie down on the operating table, face down. Once I was on the table, the medical technician adjusted it so that it was shaped like an upside-down V, with my ass at the point. I have had many medical procedures in my life, including two hip replacements, but this one made me feel the most fragile. Luckily, the anesthesiologist was right on time with the propofol, asking me to take deep breaths and count backward from 10.

The next thing I knew, I was in the recovery room, lying face up in a bed. The attending nurse brought me a little bottle of water and a bag of pretzels. The doctor checked on me and said that everything had gone as planned. I was told that I could resume regular eating, no special diet necessary. Once I was awake for a bit, they let me get dressed and told me that my friend was waiting in the waiting area to take me home.

The first few days were uncomfortable, but not terrible. There was some blood when I went to the bathroom, but no maxi pads necessary. Bleeding stopped after about 10 days. The pain was totally manageable with Tylenol, and after the second day, even that wasn’t needed. Within two weeks, I was completely back to normal.

Moral of the story: When it’s time, get a colonoscopy. Had I put it off or just done the poop-in-a-box test, they wouldn’t have caught the warts. And, by the way, the polyp they discovered came back completely benign. A colonoscopy is gross, it’s uncomfortable and utterly uncool, but it could save your life. Personally, I look back on my colonoscopy and rectal surgery as the thing that rejuvenated my inner beauty.