James Miller - Coeliac Diary

 

Friday, October 03, 2003

My Endoscopy

 

I have written this in quite a lot of detail so that it can help others who are undergoing the procedure.

The only thing I might say, is that I am a reasonably fit, fifty-six year old, who has a strong scientific training. So on the one hand, my body should be able take most things and on the other I do have a basic understanding of what's going on!

Before

I wasn't that sure to expect when I went for a endoscopy.

I am also not the bravest where hospitals or operations are concerned!

I had the instructions, which said that there was a 1-in-10,000 chance of something going wrong, that I was to wear comfortable easily washed clothes and that I wasn't to eat or drink anything for six hours before.

It also said that there was the choice of a sedative or a throat spray and if I had the first I wouldn't be able to drive, use machinery or drink alcohol for 24 hours.

Hmm!

Would I be brave enough to have the throat spray, as it would also mean I wouldn't have to find someone to go with me? Not easy when your wife works full time and your children live miles away!

It said phone if you wanted any help. So I did!

I was given a direct line by the receptionist and after a couple of tries, I got through to a helpful nurse who said that most people are alright with the throat spray.

So it was to be the throat spray!

I also remembered the advice given to me by a scientist who created some of the world's best anaesthetics. He said to avoid them at all costs!

I didn't sleep too badly the night before, but I did get up about six.

Nothing unusual here, as Celia is often out by half past on her way to all Courts east, west, north and occassionally south. I also find that the early morning is the best time to work!

But I did want to have a last drink of a cup of tea before the requisite six hours of abstinance arrived at half past six.

It was a long wait, as I am one of those who just like others have a thinking cigarette, when I work I have a thinking drink, or a snack. I did bite my fingers a bit, until I realised that could count as food!

In the end I gave up on work about twelve and disappeared off on a series of useful, but on the whole rather time-wasting errands.

I had tried to arrange a game of tennis before, but that all came to nothing. I was dressed for the game though, as the clothes fitted the requirements.

I drove all the way to Bury St. Edmunds to collect my spare car keys from last night and then wasted a good fifteen minutes talking to the salesman about the new higher powered MG-ZT-T-230. (I would have bought one a few years ago, but now cars are just a means of getting around. Well not quite, but they aren't so important!)

I then picked up the enlargements of the family photo taken at Imogen's christening. I think I paid a cheque into the bank!

All things that needed to be done, but they could have waited until the Saturday!

Finally, about two I parked the car in the lane that leads to Addenbrookes.

When I visit the hospital I tend to do that, as on a sunny day (It was!) it is a nice walk and you avoid all the hassle of finding a car parking space.

Procedure

If you don't know Addenbrokes it is not the most attractive of buildings, being a 60's, brutal construction designed by an architect, who probably designed down to a cost, rather than up to a standard.

It's also rather a maze, so when I entered the Out-Patients I looked around for someone to give me directions. As when I came for my first appointment, I was given proper directions to Endoscopy, which seemed to be rather an afterthought for the building, reached up what looked to be a fire-escape!

As I had forgotten to bring some suitable reading, I bought a magazine. I think it was Autocar.

Often when I go to the doctors, I'll take a rather academic book, so that I don't get treated like an idiot. Also something with substance and length as that seems to ensure I get seen quickly!

I waited for perhaps half an hour until twenty minutes after my appointment before I was seen by a nurse, who then asked whether I was taking the sedative. I said not, but I got the impression that most of the others were taking one.

She also said that as I have a crown on a front tooth, I was less likely to break that if I had a spray, as I wouldn't bite so hard on the mouth piece through which the probe would pass.

Then at about a quarter past three, I was called in by the doctor.

The doctor, a Mr. Hardwick, again asked about the sedative and then outlined the procedure.

I did question him, as to why the consent form asked so many silly questions! I really don't care at all about what happens to my body after I die, so long as it gets the respect it deserves. If it deserves any that is!

A few minutes later and he walked me through to the room where it was to be carried out.

Now I realised that except for the facts that a camera was being passed down my throat, through the stomach and into the duodenum, before a biopsy was to be taken, I didn't know much else.

Would I be standing, sitting or lying? How big was the camera tube? After all I did know that sword swallowers appeared to take something substantial!

It's funny, but whether because I was apprehensive or whether I didn't want to interfere with the procedure, I didn't take a look at the equipment out of my normal rather excessive curiosity. All I can remember is that it was made by Olympus. I hoped it gave better pictures than the last camera I bought of that make!

I was told that the throat spray was rather unpleasant and tasted of bananas. Why should bananas be unpleasant? I've always eaten at least one a day since I first saw one at the age of about five! (There weren't any in London for several years after the war!)

The spray was fine and after a couple of sprays, I could feel my throat going numbish. But I still had full control and could swallow as required.

I was then asked to lie on the trolley and then I was turned onto my side.

Other instructions were given to try and swallow the probe and also to breathe normally. He also said that it was easier as I had not had the sedation and could co-operate with him. That sounded very reasonable!

I now had the mouth piece between my teeth and the doctor started to pass the probe down into my stomach. The probe was perhaps three to four millimetres in diameter. In other words considerably smaller than the occassional mint imperial, that I have swallowed by accident.

At this point, I should say that I am predominately a mouth breather and even with the mouth piece in, I was still breathing almost normally through my mouth, rather than the nose. Although I was trying to use it! I don't think I was very successful!

As the tube progressed, I was asked to swallow and after a few attempts was able to progress it down my throat. I didn't swallow more than about six to eight times.

I had also been worried because dentists have told me I have a strong gag reaction. It didn't seem to be a problem!

Obviously, I was quiet and couldn't talk. However, I did have a rather macabre thought as to whether they used the same probe if they were looking from the other end! I never asked the question!

It wasn't that unpleasant and was no worse that having teeth drilled! It was a lot quieter and I only dribbled a very small amount.

It was also certainly better than the day in a dentist's surgery in Smithdown Road in Liverpool, when I had the first crown fitted on my front tooth. I can still remember the smell of burning teeth!

I had been warned to expect wind as the probe entered my stomach, but really didn't notice much and after perhaps two to three minutes the probe was in the duodenum. I hadn't felt anything inside as the probe progressed. Was this due to the spray? I suspect it was.

So the first part was over and it wasn't too bad at all! I hadn't broken out in a sweat or anything like that, but it did find a bruise later on my knee, where the other one had been pushing into it, whilst I was trying to lie still!

They then took two biopsies by passing a tool down the probe. I thought I might have felt a slight prick as each was taken, but it may be that I was looking for something!

And that really was that!

A couple of minutes later, the probe had been removed and I was sitting on the trolley.

I was told that everything appeared normal and that they had got a couple of good biopsies. What constitutes a good one?

I was then told not to drink or eat anything before twenty to four and after a few minutes sitting on a chair, I walked out of the department, out of the hospital and back to my car.

My throat seemed slightly sore, but after a drink and some crisps as I filled up with petrol at the garage, everything seemed fine!

I ate a hearty meal that evening.

Conclusions

I think the first thing I should say, is that everything at Addenbrookes was very professional and I would have no complaint as to care.

Or any complaint about anything else for that matter!

Take the case of phoning before the procedure for advice about the throat spray!

This should always be available and I certainly found it very helpful as looking back, I think I made the right decision to have the spray rather than the sedative :-

1. The very fact that I was awake and fully conscious during the procedure must be a help to the staff, as they could tell me to do things and at least I could try to carry them out!

2. This must make the procedure quicker and more efficient, especially as there is no need for a recovery bed.

3. The nurse also told me that as I have full control of my jaw, which I wouldn't have with the sedative, that there is less chance of dental damage.

Now having crowns fitted is definitely not pleasant!

4. But the biggest advantage to me of the throat spray, is that I walked out a few minutes later, drove home and within half an hour I was almost back to normal.

There is only one thing I would do to improve the system and that is to give more information to the patient.

If I had known more before I went to the hospital and had perhaps read an experience like this, I would have been less apprehensive.

It probably didn't make any difference to me in the end, but someone of a more nervous disposition than myself, might just decide to be sedated rather than choose the spray.

So looking back about a week later as I write this, it doesn't seem terrifying at all and I would recommend anybody who is asked to have a endoscopy, to have one without worrying too much!

And have the throat spray rather than the sedative!

Just relax and let the doctors and nurses get on with the job!

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