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.
