Wednesday, 12 November 2014

Crohn's Disease - DIARY - Endoscopy

This is the 8th endoscopy/banding session since June 2012. You'd think by now I'd be an old hand at it. Of all the tests/procedures I've undergone I'd stick this high on the list of unpleasantness.

Monday 10th November 2014 - Endoscopy Day

All my previous appointments had been early morning affairs but this one was set for the afternoon - 2:00pm. We arrived at St.Thomas' 30 minutes early, after a short walk up from Waterloo Station. The new Endoscopy Suite is on the first floor, with the waiting area overlooking the Houses of Parliament.
Arriving at St.Thomas' Endoscopy Suite
I booked in and we'd only been sitting there for a few minutes when I was called in by a nurse to run through the pre-procedure checklist -

Have you got someone with you to escort you home? Yes, my wife
Do you know what is involved in this procedure? Yes, I've had it before
When did you last eat or drink?  7 o'clock this morning
What medications are you on? Omeprazole, Propanolol, Loperamide
Are you having sedation? Yes

Answering "Yes" to the last question meant needing a cannula. The nurse chose a good vein and it was inserted without any fuss. She explained that there was one other patient ahead of me but they were having both an endoscopy and colonoscopy in one go and it would be quite a lengthy procedure. I said that I hoped the two cameras didn't meet, which I thought was quite amusing, but she replied that they are done separately and I just looked stupid. That will teach me to try and be funny.
I was shown to the waiting room and my wife was told to come back and get me in 2 hours time. She wandered off up Whitehall to the National Gallery to see some of her favourite paintings.
The Cenotaph in readiness for Remembrance Day
Back in the waiting room another nurse appeared to explain what was causing the delay to my procedure and that I would be seen shortly. He described the patient ahead of me as being "topped and tailed". He asked if I had seen a doctor yet to which I replied "No". After another few minutes the doctor duly arrived and briefly ran through the risks before asking me to sign the consent form. One thing he said, which I hadn't been told before, was that the risk of the varices bleeding was at its greatest around a week after the procedure at which point the banded section should have formed scabs.

I was then lead into the Procedure Room where three nurses were waiting and I lay down on the bed. I explained that I had one request - "please don't put the gag in until I'm about to go under". One of the nurses, who was looking at me in a strange way, asked "what gag?" I explained is was the green, plastic object which goes between your teeth to protect them and stop you biting the endoscope. "Oh the mouthguard. When you said gag... well let's not go there!"

Time for the Xylocaine spray - a local anaesthetic that tastes of burnt bananas and deadens the back of the throat.  This was the bit I was dreading as just the thought of the spray makes me want to retch. It wasn't too bad! Next the oxygen supply was positioned under my nose and I was asked to roll onto my left side.

Now the bit I was looking forward to - sedation. The doctor injected two syringes of Midazolam and Fentanyl. One of the nurses was stroking my head, telling me to concentrate on my breathing to visualise something pleasant. At this point I expected to slip away into temporary darkness....

For previous procedures I have been put out cold and then woken up in Recovery. This time I was aware of what was going on and must have been awake, although very drowsy. I managed to take a photo of the endoscope but don't remember doing it! Sad on both counts.
I spent a while in Recovery and then walked round to another waiting area where my wife joined me. A nurse removed my cannula and gave me a copy of the Endoscpy Report. They had found two large varices which had been banded. Bad news as I was hoping they had not grown any worse since last year. Worse news - I need a further procedure in 4 weeks time to see how successful this banding session was.
Endoscopy Report - but no pictures taken
We made our way back to the train station and then had a lift home. I spent most of the evening asleep. I don't know why I feel so weak this time. The whole procedure has hit me for six. I was pleased with the advice not to go to work the following day but extended it a further day as I really didn't feel up to traveling up to London to work.

It's left me wondering if the varices will continue to grow at their current pace and that the time between procedures is going to get less and less. A question for the doctor in 4 weeks time