The ordeal began the night before: no food or drink after midnight. I have found this to be one of the true pains about many medical tests. The worst part about this one was that my appointment wasn't until 2pm the next day. I knew it would be difficult to get through both the morning and afternoon without a drop of water or a bite to eat (especially when an empty stomach seems to be the strongest trigger for my stomach pain).
By the time I arrived at the hospital the next day I was absolutely starving. All the nervousness I previously experienced about the procedure was soon overcome by the overwhelming urge to eat. I now anxiously awaited the procedure (and the meal that was to follow!).
The nurse called me in at 2pm to ask some routine questions, take blood pressure, and get me into my favorite outfit -- the jonny shirt. What I wasn't expecting was an intravenous needle (How did I not think of this???). I cursed the nurse in my mind. I thought that chemo would mean the end of IVs for a while! I only managed to escape 5 weeks without any needles?
I sucked it up. I had to. So, after some pitiful arguments with myself and some serious labouring with that dreaded needle on the nurse's behalf, the IV was finally put in place.
I was soon taken into a day surgery room, where I was met by Dr. Butler and a very upbeat nurse who welcomed me and directed me to lay on the hospital bed. The nurse assured me that this procedure would be a "piece of cake" and that the worst part about it all would be the Xylocaine that would be sprayed in the back of my throat. Xylocaine is a local anesthetic which, in this case, is sprayed in the back of the throat to numb the area and thereby prevent gagging and coughing when the tube is inserted. The nurse warned me that the spray tasted absolutely horrible and not to panic when my throat became numb--it may feel swollen but it really is not.
I took a deep breath and hung on to the side of the bed as she approached me with the spray: "Open up!" She sprayed 10 sprays into the back of my throat. Horrible was not the word to describe this taste. Disguisting, revolting, stomach-churning. I gagged and I could feel every muscle in my face twist and turn. The nurse copied my expression and looked as though she felt sorry for me: "We need to do that two more times." Two more times? Ahhh! "Don't worry it gets easier each time," she explained. She came at me with ten more quirts of that putrid stuff. And then ten times once again. After 30 squirts of xylocaine, my throat was completely numb. I did not like the resulting feeling, however: swallowing became difficult and my throat felt extremely swollen. I looked at Dr. Butler and blurted: "I am not enjoying this sensation ONE BIT!" He looked at me in a very nonchalant manner and replied: "Yes, I know. I had this procedure done and I really didn't like that sensation either. It almost feels as though your airways are constricted." Airways constricted. Yes, that is the sensation. Oh no. I cannot breathe!
I began to panic. Suddenly that miserable experience I endured in November came rushing back to me. I remembered my face tightening up, my jaw locking, my teeth clenching, and the muscles in my mouth and tongue spasming--I felt as though I couldn't swallow or breathe. The numb sensation the Xylocaine produced caused a very similar feeling. Put me out, put me out, put me out. I want to be asleep!
Within 3 or 4 minutes (which seemed like an eternity at the time), the nurse told me to roll over on my side: "Now for the best part of this procedure: the drugs!" She laughed as she came toward me with a needle full of anesthetic/ sedative. She pumped drugs into my intravenous tube and I could instantly feel myself becoming sleepy. Dr. Butler came toward me and said: "Melanie I am just going to place this tube in your mouth and when I say 'swallow' I want you to swallow okay?" "Okay," I replied. Everything went black.
The next thing I remember was feeling the tube wiggling around in my throat. It didn't hurt and I didn't care. I just remember feeling it very briefly and then feeling Dr. Butler pulling it out of my throat. It seemed to me as though I 'came to' in perfect time. Just as he pulled the tube out of my throat it was as though I awoke and bounced up, not remembering a single thing. Cool! "So what did you find?" I asked. "There was some esophageal erosion." Some time passed, although I cannot tell you how much. I repeated: "So there were no ulcers?" "Nope. Just some erosion of the esophagus. What medications did you say you have tried?" I told him I tried Zantac, Losec, Pantaloc, and Pariet. I suggested that Nexium may be a good choice, as I heard it has worked wonders for many people and I hadn't yet tried it. He quickly agreed to prescribe Nexium and told me to go to his office and pick up six weeks worth.
The rest of the day (including anything else the doctor may have told me after the endoscopy) was a complete blur. It seemed as though as each moment occured to me I felt absolutely normal (maybe a little more upbeat and happy). However, as each hour passed, I seemed to forget the last. I kept repeating to myself: Did I do that? DId that actually happen or was I dreaming? What did I do all day? The drug created a very bizarre amnesiac-like experience which remained with me for at least four hours after it was administered.
So, the experience was funny and rather bizarre, more than anything. I can assure any of you who have to undergo this procedure that it is really nothing to worry about. It's a "piece of cake" and may even give you something to laugh about a little later.
The best thing about having the procedure done for me is the reassurance that I have a treatable illness (no cancer) and that I finally know exactly what it is that has been causing me so much pain over the years: erosion of the esophagus. Although I can remember nothing of what Dr. Butler told me about my condition (besides the fact that it is esophageal erosion), I have done a small amount of research to feed my curiosity until I meet with Dr. Butler again in six weeks. I learned that the "esophageal erosion" Dr.Butler spoke of is actually refered to as "Esophagitis" and indicates a wearing away of the lining of the esophagus. This wearing away is most often caused by GERD (or acid reflux), where stomach acid is refluxed or pushed into the esophagus. This can cause inflammation, irritation, or erosion of the esophagus. Esophagitis occurs when GERD has become severe and it eventually leads to ulcers. Here's the scary part: approximately 10% of patients with eroded esophagus have a condition known as "Barret's Esophagus." This is an abnormal change in the cells of the esophagus caused by chronic exposure to acid, which may eventually lead to cancer (in a small number of patients). Eeeek. Let's just hope that those biopsy results don't come up with any abnormal cells!
To read more about Esophagitis, visit the following links:
- http://www.webmd.com/heartburn-gerd/tc/Gastroesophageal-Reflux-Disease-GERD-What-Happens
- http://www.webmd.com/hw-popup/Esophageal-erosion-and-ulcers-caused-by-GERD
To read more about Barret's Esophagus, visit the following links:
- http://en.wikipedia.org/wiki/Barrett%27s_esophagus
- http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/index.htm
Dr. Butler has prescribed me with a proton pump inhibitor called Nexium to deal with acid production in my stomach. Nexium basically works to decrease the amount of acid produced in the stomach. Nexium can heal erosive esophagitis in 4-8 weeks. I will take Nexium for six weeks and then meet with Dr. Butler to discuss whether or not it was successful and where to go from there.
Until next time ...
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