They're gonna shove what down my throat?

Next Week I'll be under the knife so to speak. Every 4-6 months I go in for an outpatient surgery. There's not really a knife involved there is however a scope, some bands and other odd-looking tools. The procedure is called an Endoscopy.

The regular procedure started occupying my calendar after an incident in 2011. I felt weak, light headed, had unusual breath, stomach pain and black tarry stool. I pushed through it for five days before going to urgent care where they explained to me the severity of what was happening. I was bleeding internally through ruptured veins in my esophagus. Since there was a lot of blood in my stomach they used a Balloon Tamponade.

Balloon Tamponade

When I went in the first time, they used this incredibly painful contraption, made all the more painful thanks to the ambulance ride across town. I had the pleasure of watching the dried blood get pulled from my stomach through my nose for a few hours. They also gave me morphine, which just makes me feel like I'm on fire.

Since then, bleeds have happened half a dozen times, varying from catching it on my routine endoscopy, to a blood transfusion and trip to the ICU.

There are several versions of an endoscopy. What I will be doing next week is an Upper GI Endoscopy, which means they'll be looking at my esophagus down to the stomach entrance. It's a rather quick procedure typically taking a few minutes, longer when banding occurs. In the US we use anesthetic to minimize the discomfort and make the process faster. Some people will retch regardless,
I am unfortunately one of those people. When you've got a tube down your throat and you begin to retch, it becomes more likely to burst a vein.


But that's probably the best time to burst a vein, since the doc can fix it real quick.

The banding process is interesting. Essentially a rubber band ties off the bleeding vein, causing them to balloon and completely rupture. The residual blood is digested and reabsorbed.

Banding 

If you happen to get banded, the throat becomes incredibly sensitive, and it's a soft food diet for a few days to a week. So if you suspect you've got varices have some pudding, soup, milk, juice, yogurt at the ready.

I also prep by shaving my face the day prior, while it's not necessary, it does help make sure they don't break your lips, or give ya some hardcore chaffing from the gag.

an example of an endoscopy gag

It can also be a pain in the neck, literally. The discomfort from an endoscopy typically sticks with me for four days to a week. If i get banded, it's a week to three depending upon the bleeders and how much i retched during the procedure.

Typically the discomfort goes away quickly, unless you retch a lot, then it sticks with you.

In addition to my procedure next week, i may find out a little more about the future of my treatment.

Ink Blots and Arm Chairs

The last time i was here, i asked for my photo to be taken where they draw my blood.

I was excited to finish treatment, i told the ladies behind the desk "I'll see ya in six months!"

I should have taken this blood test when my doc ordered it. But I'm two weeks later than i should've been. I didn't want to go back, to come face to face with my failure again. In a weird way, this was my way of stalling, of taking in small aspects of my failure, to help myself deal with it.

When i smiled and said hello, they knew.

When i wrote my name down, they knew.

Concern hidden in their face as they quickly searched for busy work.

The phlebotomist looked at the orders and explained to me what i already knew:

"There's a test here, one I've never seen ordered, ordered for you before. It'll take a moment to see how they need this."

She readied the orders, and vials as i wait.

I've sat in this chair, in this hallway dozens of times. The earth tone swirls on the floor haven't inspired me to imagine what they could be, a Rorschach test of carpet it's not. But that doesn't stop me from trying.

I could go to any number of places to get my blood drawn, but i go here.

Perhaps i find myself similary, in the hallways seemingly perpetually under repair. Perhaps it's the fact that they have not bruised me yet, whatever the reason I'm here.

In this chair. It's just comfortable enough to want to leave after a few minutes. So beyond my worry regarding this test, i am growing more antsy with each moment.


The door just out of sight taunts me, creaking slowly as it shuts to a hushed slam.

As time passes, the earth-toned ink-blots dance on the floor in my imagination since the wifi won't give me access to reddit.

The girl behind the counter informed me "it'll take a while to get the information and to see what lab and where it needs to go."

So I left, waiting for them to call with an update.

"Tomorrow," she explained, "...tomorrow come in and get drawn in the morning."

The test, as it turns out is a delicate one and needs to be as fresh as possible.

This is the test that will help me determine what's going on. My now larger team will be analyzing every bit of the data, if not for my sake, then simply for curiosity. Failing Harvoni isn't unheard of, it's just very unlikely. So data like this is helpful in understanding what can and does go wrong.



Hopefully sometime next week we'll know what's going on.