Giggity, Giggity, Giggity, Let's Have an Endoscopy!

I had the pleasure of upper endoscopy December 6th at the VA hospital. It was performed without a hitch because I had a great team. During an Endoscopy, the patient is sedated, but awake and instructed to swallow a tube with a camera on the end. The gastroenterologist performing the procedure examines the tissue of the esophagus, stomach, upper intestine, and takes biopsies for further diagnoses. It’s one of my annual routine tests to monitor the progression of Scleroderma, Sarcoidosis and its complications. I don’t mind endoscopies because I never remember a thing and I wake up feeling very relaxed, but there was one time that was not the case. In 2002, because of a lousy IV placement and an overscheduled doctor at Hemet Hospital more concerned about his quota, I was conscious during my endoscopy procedure. (I had an HMO. This has NEVER happened at the VA.) If you are ever asked to do one of those awake because your doctor is a douche bag, just say no, but I digress.

Diagnostic procedures have become as routine as annual dentist visits and flu shots. My GI tract doesn’t get any special treatment. I have routine tests every year for my heart and lungs. My liver, blood platelets, white cell count and kidneys are monitored by frequent blood work, but tests for my GI tract are the most invasive. I don’t remember much about my first GI test in 1996, but it did involve a dark room and two radiologists (Giggity). While lying face down on an x-ray table, one radiologist fed me a drink, while the other operated a camera and kept telling me to hold still and swallow. The camera was an x-ray machine, the cocktail was a chalky barium drink that felt like Pop-Rocks going down my throat and the procedure was called a barium esophagram. Luckily, I only needed to take the test once. The radiologists worked hard to provoke reflux symptoms and unfortunately, they were very successful. The good news; no more chalky Pop-Rock cocktails, the bad news; it only took one of these tests to determine Scleroderma was targeting my upper digestive tract and my doctors needed more information. I had been promoted to upper endoscopy.

I don’t remember my first endoscopy. Probably because of the great drugs they gave me to forget about it. (Roofies?) Eventually, a world of ways to view my digestive tract was opened and an endoscopy was just the beginning.

In 2005, I was given a test to determine my ability to swallow called a barium swallow study. A swallow study is performed by a speech pathologist and a radiologist. I was given barium-laced banana, chocolate pudding and juice while filming the food traveling down my throat made possible by x-ray. The radiologist doing the study was surprised it took four seconds for food to travel down my esophagus. That doesn’t sound like a long time, but next time you’re eating, take a bite and swallow, then count one one-thousand, two one-thousand, etc… It’s longer than you think. Later, an endoscopy confirmed what the radiologist and speech pathologist hypothesized: My esophagus had slow motility due to scar tissue caused by reflux. In addition, I had a hiatal hernia which prevented my stomach from closing and causing stomach acid to flow into my esophagus while sleeping. I also received the diagnosis of Barrett’s Esophagus, a pre-cancerous condition where the white lining of the esophagus is replaced by red tissue. It is caused by long term repeated damage from chronic acid reflux. The pre-cancerous part of it sounds ominous, but the percentage of Barrett’s becoming cancerous is low and treatable if diagnosed the early stages.

Barrett’s Esophagus must be watched by my doctors, but maintaining my esophagus is a full time job. After the swallow study, I was given a series of exercises I practice every day in the shower and techniques to protect my airway when swallowing. I have to sleep in an elevated position. The current medication prescribed for treatment of my symptoms is Nexium- 40 mg twice a day and Ranitidine (Zantac) 300 mg twice a day. The Ranitidine was prescribed by my physician as an as-needed med. My diet (mostly) consists of foods that will not cause reflux. I start out my day with a protein shake to assist with swallowing of my meds and allow an easily digestible form of protein to jump start my day. I keep my meals small. Size really does matter and too large a meal can cause reflux. I love Mexican food and have switched my salsa from a chilie-base to a mango or fruit salsa. Ranitidine is great before meals with ingredients that can cause reflux. It’s different for everyone but for me it’s anything with garlic. For my own sanity, I have to have some of the foods I love but shouldn’t eat once in a while. Things with onions in them etc… Nothing too crazy, but when I do, I plan the meal in the middle of the day or stay up very late, take my Zantac and drink lots of water the rest of the day. Regular exercise is also helpful, but movement is always a good idea- as long as it’s not upside down on a full stomach. Stress management has helped me manage my symptoms with a great deal of success. Divorce almost cured my reflux, but because I have to share custody of my son, the Ranitidine really comes in handy along with a good sedative- but that’s a whole other entry.

Esophagus Pictures

Quagmire's Horniest Video Clips
Check these out:
Bounce to a Cure
Ironman for Scleroderma

It's A Trap!

And Now, a Tease...

Excuse my grammar, but I want to get this out there. I will have a more detailed blog in a day or so, but is you have any circualtory problems, look into this finding. I'm on my way out the door for the VA, but I just wanted to say something about the recent findings having an immediate effect on blood vessels. This is an step toward better education about the toxins around us and how it effects the smallest parts of us we take for granted. The first thing I was told back in 1992 when my fingers turned blue and tingled for what appeared to be no reason is, "Stop smoking".

18 years ago doctors knew nicotine was a vasoconstrictor. If you get a chance, do some more research about it. I will be posting a full entry about it in a day or two if you don't get to it.

Have a great Thurs. everyone!

More to read: Livestrong

Me, Myself and Viagra

Back in 1996, the results of an arteriogram had shown that the arteries of my thumb were completely closed. The only nutrition the tip of my thumb received was from retrograde blood flow from one vein. What started as a small sore on the tip of my thumb had became huge, gangrenous and black, which is how I got to have an arteriogram at age 25. At the time, there were two treatment options: digital sympathectomy or a sympathetic block. I opted for the digital sympathectomy. By the time I got to the VA Hospital four hours away, I was already in a percocet, and then morphine induced haze. The most invasive and drastic intervention appeared to be the most logical. I will never know if I made the right choice. I know it won't happen, but I still cling to some fantasy that one day I will wake up and the tip of my thumb will be back and I will have forgotten it was gone.

The biggest influence to have the procedure was a dangerous idea I would have normal hands back. It was the wish of 25 year old young woman in denial of what was really happening to her. A digital sympathectomy is a microscopic surgical procedure that removes sympathetic muscle tissue, the involuntary muscle tissue of “fight or flight” surrounding arterial walls of the hands. When the body gets cold, blood vessels and capillaries constrict to preserve the vital organs, such as the heart, lungs and digestive system. For a person without Raynaud’s, this is a gentle constriction, allowing some blood to flow. In extreme conditions without taking precautionary measure, the blood flow would eventually stop to the distal places such as fingers and toes causing frostbite and eventual tissue death. With Raynaud’s, sometimes just a slight drop in temperature can trigger this reaction to the cold as if the muscle tissue is on crack resulting in an ischemic or Raynaud’s attack. A Raynaud’s attack is the sympathetic nerves signaling muscle tissue surrounding blood vessels to over constrict where the Raynaud’s is more prevalent. It can be as obvious as fingers and toes or as stealth as the blood supply to part of the digestive tract. Fun right?

Back in 1996, Viagra was still in the very early stages of development. Fast forward to 2010, I take Viagra three times a day, plus Niphedepine once a day so I can keep blood flowing to my fingers and toes. But despite all the medication I have on board, my best defense is exercise. I still need the medication to maintain because my Raynaud’s is so bad. So why blog about it?

I feel very self-centered writing about my experiences. I want to share them and maybe they could be more interesting if I added some fiction and write in third person instead of first, but I don’t have time for all that. I want to get this information out so maybe someone who is having these symptoms can take the steps I didn’t. There are times I became so depressed and let denial rule my life and my weight dropped to 96lbs. I didn’t realize it, but I had stopped eating. I would have meals but I would only take a few bites. So, there it is. I’m self centered; I want people to learn from my mistakes. Mistakes that aren’t all mine. Mistakes my body continues to make at a cellular level that I have no control over. Blaming myself makes me feel like I have control, because once I relinquish the reigns, my ride is over. So I continue to convince myself my mistakes are not made in vain and I really do this to help others. But really, I want a cure, treatment or reversal of what is happening to me. Yes, all about me.