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‘Ohana > More OhanaSpring 2008 IS Magazine7/2/08 IS Online

It Took a Village

When Dad needed a colonoscopy, his entire family got into action.

By Lucy Jokiel

Lily Anne Souza was approaching what she calls “the golden age of 50” and knew she would soon need a screening test to prevent or diagnose colorectal cancer. “I kept putting it off,” she says. In the early 1990s, Lily Anne had worked as a hospital technician and faithfully cleaned the colonoscopy scopes for Ronald Ah Loy, M.D., a gastroenterologist at Kona Community Hospital.

Then, her mother began calling to report that Lily Anne’s 85-year-old father was having continuing problems with stomach pains and diarrhea. He had rarely seen a doctor, had never been hospitalized, and strongly resented anyone telling him what he should do. “All his life, Dad has been hardworking and always helping others,” says Lily Anne. “But he would never admit to needing help himself.”

Over the next two years, his symptoms worsened, but he stubbornly resisted any treatment. Lily Anne finally got tough with him: “Dad, you are going to go to the doctor, and you need to follow up on whatever tests he recommends.”

Lily Anne, her husband, and seven brothers and a sister had a family meeting. “We knew our dad, and that it would require a miracle to get him through this,” she says. They decided on the best approach and who would take him to his medical appointments. “We wanted to be sure he got the attention he needed and to do it in a loving way. If we were to force him, he would turn away from us and never do it.”

The strategy worked, and an appointment was scheduled with Ah Loy at the Big Island Endoscopy Center in Kamuela. “I knew he was one of the best,” says Lily Anne. When the day arrived, she took off from her job as a schoolteacher and headed for her parents’ home in Honaunau. “Dad was dressed, quiet, and ready to go,” she recalls. “He was also mad.” Lily Anne realized she had to tread lightly and keep the peace. “I talked with him about the things he loves, especially his animals, so he would forget about the appointment and relax a bit.”

They arrived on time but encountered a wait of several hours. “Dad was no longer relaxed,” says Lily Anne. “He said the doctor was no good. But I was determined.” When Ah Loy recommended a colonoscopy, Lily Anne said she would also agree to have the procedure. “I knew that was the only way I could persuade him.” (Her mother also consented.) “I didn’t really want to deal with it until two more years when I would be 50, but I was willing to make the sacrifice for my dad.”

Lily Anne was pleased with the outcome of that visit but had no idea of the struggle ahead.

Part of the pre-colonoscopy preparation requires that the bowels be adequately cleaned, which requires drinking a laxative. The colonoscopy had to be canceled when it was discovered that Lily Anne’s father had only ingested a small amount.

The day before the re-scheduled colonoscopy, her father was coaxed into taking all of the laxative. But the next morning, he adamantly refused to go through with the procedure. After an hour-long conversation with the physician, Lily Anne interrupted with an appeal to his wallet: “Dad, are you going to do this or not? It will cost you $100 if we have to cancel because you didn’t give them notice.” He nodded his head in agreement.

The tension in the air was thick. “Everything Mom said to make Dad feel comfortable only made things worse,” says Lily Anne, who acted as referee. “Then, Dad walked out of the examining room with his gown upside down and over his aloha shirt.” Lily Anne and her mother had to suppress their laughter, but the incident helped ease the tension.

In a traditional colonoscopy, a long, thin tube is inserted and snaked through the large intestine. Generally, any polyps that are spotted are taken out. After the colonoscopy on her father was completed, Lily Anne asked the doctor if he had found anything wrong. “Right at the opening,” said Ah Loy, who showed her photos of a large mass and said further tests would be needed. (Lily Anne and her mother then had their colonoscopies done, and each had a small polyp removed.)

Fortunately, the mass was not cancerous but nevertheless needed to be removed. “Now we had to get Dad to surgery the next week at Kona Community Hospital,” says Lily Anne. “He was really ticked off and very suspicious about anybody cutting him open. But he ended up becoming good friends with the surgeon and finally agreed to the surgery.”

But after the operation, he decided it was time to leave the hospital. He asked his grandchildren to tie the bed sheets together so he could escape by lowering himself out of the window. “He planned to bust out by having them drive a getaway car to take him home,” says Lily Anne. When the plan was discovered, he was forced to stay in the hospital for another two weeks.

After he was discharged, he told Lily Anne: “You know, if I didn’t have that colonoscopy and surgery, I would probably be dead by now.” He had tears in his eyes, Lily Anne recalls. “That was my reward. It was priceless when he acknowledged he probably would otherwise not be alive. That split-second acknowledgment by him was the greatest victory. Nobody else had to see it, but I did. I took it as a thank you.”

Then, family members began to panic about their own possible health problems. Lily’s husband, Stratton, was the first to have the procedure, as he had just turned 50. He told Lily about it and said it was important as he had watched his father die of prostate cancer treated too late. Then, her brother and sister-in-law decided to have colonoscopies. Later, other family members and friends did the same. “I talked to everybody about my experience,” says Lily Anne. “I told them it was shameless and painless. And that, most of all, it gave me peace of mind.”

Lily Anne’s family has a history of colon cancer, with her mother’s brother dying from it while in his early 40s. “Sharing my experience has benefited so many people,” says Lily Anne, who is quite comfortable talking about it. “It’s no longer a topic to keep inside.” She also hopes her discussions will make her kids more aware when the time comes for them to have a colonoscopy.

 
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