EGD.

On March 10, 2010, in Uncategorized, by Andrea

3/10/2010 Full sheet

Okay so I’m home and I’m still feeling pretty crappy — but not from the drugs exactly.  I have a crappy ass headache — either from a change of weather, a lack of carbs from the fast (although I’ve eaten?), a combination of the drugs and the above?  I don’t know and frankly I don’t really care at this point.  I just don’t feel good.

In any case, I’m back.  And because people want to know what to expect during these routine tests before and after RNY, thought I would document everything about it.

I got to the hospital (Franklin Regional Hospital in Louisburg, NC — and let’s be frank — it’s tiny, but decent) at 7:10am.  We’re a bit late — it’s a 45 minute drive, and it’s hard to get the kids up and around that early.  Shortly after, I go for labwork.  I’m a woman of childbearing years, so it’s “pee in a cup” time — but I’ve had RNY and I’ve not been allowed to have anything to drink since midnight so there is no pee to pee.  So I give her a vein.  She’s a bit shocked, but goes for it (and gets another 3 vials “just in case” they will need it.. I like this tech).

As soon as I’m done with that, I get called back to the pre-op area.  Kiss my kids good-bye (not because I’m worried but because Kaitlin gets sad if I don’t say bye).  Walk back, get changed, get my IV.  And immediately go back to the room.

This room, of course is pretty interesting.  Monitors, blood pressure monitors, cardiac monitors, computers, drug lockups, various equipment, nurses — some of which can be somewhat scary and intimidating.

I’m put on a cardiac monitor, a blood pressure cuff, O2, and oxygen saturation monitor.  While waiting for the doc, joke around with the nurses, but also discuss with the nurse why I’m there.  She’s familiar with RNY and by hearing what my pain is, she knows what tools to have on hand just in case there’s a suture that needs clipped or a staple that needs pulling, or whatnot.

As soon as the doc comes in, he signs the release for the meds and in goes the versed.  Pretty soon, I get a spray in my throat to help numb my throat that tastes horrible.  Another within a few moments — and yes I remember these.  I know she pops the fentanyl in and I remember asking if that’s what she pushed, and remember her saying “We’ll see you in a little while…”

I remember, for the first time, actually waking up this time, with the camera down my throat.

I’ve had several EGD’s — this being my 3rd with this doctor — and this is the first time I’ve ever woken up.

I know I panicked a bit.  I remember being told to calm down — and I remember seeing the nurse push more meds.

And then I remember waking up in recovery.

9/17/2008

I’ve included some photos for you from the two procedures.  I have to apologize — while we have multiple computers (6?), several game systems (4?), etc — we don’t have a scanner.  But we DO have two DSLR cameras so I can take photos of the photos..

First photos are from 9/17/2008.  These are the ones from when I had 3 ulcers on my anastomasis.  When looking at these photos, the white “spots” are the ulcers.

9/17/2008

9/17/2008 -- One large ulcer visible

9/17/2008 - Ulcer visible on the far upper left

9/17/2008 - All 3 ulcers visible (Largest towards the back, then one closest to front, and one to side)

So that’s what my pouch and anastomasis looked like in mid-September.  Was put on Carafate 4x a day and Prilosec 2x a day for a period of time — 3 months I think?  When I still had pain, we did exploratory surgery and discovered that I also had a ton of adhesions.  But it’s very obvious that I had quite a bit of ulceration.

Today?

3/10/2010

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So what does all of this mean?

Well, there are no ulcers in my pouch.  There is not irritation in my pouch.  In fact, I was told it was one of the cleanest, healthiest looking stomachs seen by the Nurse who was taking care of me (not the Endo nurse, the recovery nurse).

So we are going to get a CT scan to rule out an internal hernia — which is the next thing.  And is a possibility since I did some heavy lifting on Sunday (mulching the front yard).  If that comes up negative, then the doc gets to order a new toy (and he’s a bit gleeful about it — he has to show a need for it with two patients — I’m number two..)  This new toy actually allows him to scope the remnant stomach — so yay for technology.  So for now I’m off the Carafate (since it won’t do me any good anyway), with no changes in diet and just adding Prilosec in case there’s ulceration in the remnant stomach.

This also goes to show that the occasional caffeine, coffee, soda, RedBull, spicy food, etc. will not hurt your pouch.  I mean, c’mon!  I had coffee on Monday morning before my attack, and some on Saturday morning — and I’m pink as can be.  Just goes to prove that these things are not as horrible as they’ve been vilified to be.

Now if you’ll excuse me?  I think it’s time for a nap.

We’ve seen some of the stats before — that RNY’ers are not compliant with their supplementation.  There was a study out that measured the efficacy of a multivitamin alone after RNY and in the process we learned that only 33% were actually compliant. You’d think we learned?

No.  We didn’t.

Now, this study was published in 2009 — but is from patients from 2006-2007.  I’m hoping, hoping, HOPING that people out there understand how freaking important their vitamins are, and if not perhaps they will see after reading these two studies.

Keep in mind, these are two studies in order — and neither are very good.  Both show that people, at least around 2005-2007 did not feel like they needed to take their vitamins.  Don’t become a statistic.

A few takeaways:

  • 33% took a multivitamin
  • 5.1% took b12
  • 7.7% took calcium
  • 11.1% took folic acid
  • 12.0% took iron
  • 61.5% took incorrect medication formulations
  • 34.7% took non-immediate-release medications
  • 25.0% took enteric-coated medications
  • 40.3% took enteric-coated non-immediate-release medications

How many do you think were getting appropriate protein levels?  Or their lab work?

The article abstract can be read here.

This simply continues the point that we need to educate ourselves AND our physicians.