I've Never Liked Liquorice

A Restless Anticipation

I had a good enough night's rest, setting my wake-up alarm for 7:00 AM in anticipation of my oesophagogastroduodenoscopy procedure. In the end, the main thing that weighed on my mind was whether this apparently simple but unpleasant procedure could lead to complications.

I did not prepare myself for adverse outcomes, instead steeling myself with the inclination that everything would turn out right. I had already expiated my deepest concerns in the blog "Tubing Down the Gullet", which I wrote yesterday.

Setting Off to Hospital

After chatting to Brian, whose words of comfort and support meant a lot to me, I called an Uber to take me to the hospital, and sent a message to my neighbour about what was going on.

Arriving at the endoscopy unit, I was registered by the desk clerk at the reception. I had hardly settled into a comfortable seat before the coordinator of the unit invited me in for a preprocedural assessment, checking my details, gaining my consent, and explaining what the procedure would entail.

Briefed Before the Bed

It would last 7 minutes. You could add "long" or "short" as a qualifier of time; the personnel opted for "short", which was to minimise the conceptual understanding the patient might have of enduring such a long and uncomfortable intrusive activity.

The most important piece of advice was to keep breathing: in through the nose and out through the mouth. I ended up breathing entirely through my mouth, as my nose was slightly blocked when we started.

After that engagement, I was led to another waiting room to wait for the consultant who would conduct the endoscopy.

Meeting the Consultant

The consultant arrived: pleasant, amiable, and professional, doing his best to keep me at ease. After introductions, we walked to the examination room, well-lit and neat, with nurses giving off a warm aura of encouraging mien that could disarm every sense of anxiety.

She took my bag, cane, coat and hat, and had me sit on the bed. I was asked for the third time if I had any allergies. I always respond with "jealousy", something I learnt from the song "Footsteps Following Me" by Frances Nero, which contains the line, "I am allergic to jealousy". It is quite an icebreaker, I think. [Footsteps Following Me (Lyrics) / (YouTube)]

As I was not going to be sedated, I had this foul-tasting numbing spray squirted down my throat and larynx before I lay down on my left side on the bed. A mouth guard was inserted to stop me from biting on the camera tubing.

The Endoscope Goes Down

The endoscope, which I had seen earlier, looked like a generously thick length of liquorice, just a little over 1 cm in diameter from my estimation. It was introduced into my mouth and wound its way into my throat, where I had to swallow to give it access, and then I began to gurgle. My head was held still as I was advised to keep breathing.

I was breathing, but my gag reflex was triggered so many times that I was retching violently, somewhat scared I might aspirate any fluids. The nurse used a suction tube to draw out the fluid, and there were moments I was comfortable just breathing through my mouth before I was retching again, with my body and legs reacting wildly to the inconvenience.

The camera travelled down to the deepest reaches of my duodenum within two minutes, and for thorough examination, the endoscopist had the camera look back on itself, which is called retroflexion. With air being blown in to allow for a better view, all of it was coming back up in the gurgling and retching.

Biopsies and Relief

Towards the end, I was asked if biopsies could be taken. I'd rather suffer this once than have it done again, so I signalled my consent, and a thin red line was channelled into the camera stem for that purpose.

Imagine the relief when the endoscope was finally extracted, only for me to find that despite all the preparation, my top was soiled to the back of my left shoulder. I tried to dry up before being taken to recovery, where I awaited the preliminary findings of the procedure.

Another set of blood pressure, blood oxygen, and temperature measurements was taken, showing my blood pressure had fallen some 20 points between when I arrived and soon after the procedure.

The Findings

The findings indicated a hiatus hernia, suggesting my stomach had moved slightly above the diaphragm. This is apparently common and could be age-related. Further along, there was an incomplete Schatzki ring not causing any significant narrowing. This is a circle of tissue in the lower oesophagus that might make it difficult to swallow food.

These findings might not fully explain the food impaction and choking events, but they might indicate something to be aware of. The nurse in the recovery ward suggested I give more time to chewing and mastication before swallowing.

The histopathology of the biopsies is expected in anything from 6 weeks, scribbled in over the printed two weeks. I also had to wait an hour after the application of the numbing spray before ingesting anything.

Heading Home

Then I was discharged and walked back home to take a long bed rest. While I feel alright, the invasion of my innards was quite a shock to my system, bringing on exhaustion and tiredness.

I could have written this blog in the hospital, but it has taken hours afterwards, using AI to explain all the medical terms that are inscrutable to the layman, and trying to understand everything that happened: the findings, and the possible issues that might result. The premise is that there is nothing to worry about, just knowledge that explains some historical issues.

A Parting Thought

One final thing: I was their first customer, and it looked like 3 others had cancelled their appointments. I was never once addressed as a patient. Was I the bigger fool for attending what others were not ready to endure? I have no answer to that question.

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