Stomach Woes (Part 2)

Before I went to see this new doctor, I saw that he wrote a lot of articles about the gut. He also uses the trans-nasal endoscopy method which is scoping the stomach through the nose. I've never heard of this before!

So the appointment day came and I went to see him. 

He was very attentive, patient and thorough. He asked about my gut history and listened like how Mr. Gastro did when I first saw him. 

Not only did he listen, he explained the works of the gut and how he had to do a endoscopy and colonoscopy to make sure nothing was wrong with my gut before moving on to solving my stomach woes. He drew diagrams and explained how the gut works and how all the digestive parts are interlinked to each other and how symptoms in one part could be totally something else instead. 

The best part was he does not want his patients sedated during the endoscopy and colonoscopy because he wants them to be aware and ask him questions! He wants to educate his patients. 

Wow!

This was the first time I was hearing this. 

He was very alert as he noticed that I was wearing a Medic Alert bracelet. He then asked me about the history of my allergies. 

He is also a doctor who does not want his patients to suffer. Thus, the drinking of the gasoline-tasting-diarrhoea-inducing-drink was not to be taken at night. I was to be in the hospital by 7am and I would start the drinking then. He did not want his patients to be up all night shitting their guts out and then be like the Walking Dead in the morning before the scope has even started. 

The day before the scope, I received a phone call from the nurse. She instructed me to only have porridge the whole day and to stop eating after dinner. I was not to have any fruits, vegetables or dairy products. Only fish or chicken porridge. 

I took an Aerius after lunch to safeguard myself since Lydocaine could no longer be found in Malaysia. I had to have a different numbing spray: Cophenylcaine. This was taught by Dr. Yadav my immunologist/allergist. 

When I arrived at the endoscopy department, the nurse took some blood for tests and left the IV needle in my right hand. They said that the doctor had told them about my allergies and they had prepared hydrocortisone just in case I became allergic to the nasal spray. She then instructed me to finish drinking the 1st bottle of Fortrans within 1 hour! And then I was to proceed with the 2nd bottle. 

Before I was even done with the second bottle, my bowels were cleared. And it was done within two hours.

I then went into the room to be scoped. The nurse placed my Epi-Pens on the table next to me (which was a first time!). 

And then I heard heavy metal music! I wondered whether I had shat my guts out to the point that I was hallucinating. It turned out that this gastroenterologist loves heavy metal music and he played Iron Maiden while he scoped me. 

The doctor then started with the colonoscopy first. He uses the pediatric size scope! Less discomfort and the accuracy and function is as good as the dinosaur-sized scope. Halfway through the scope as the colonoscopy tube was turning in my intestines, I suddenly felt a very sharp pain. I immediately grabbed the railing of the bed like I always did back with Rock Star. This doctor immediately stopped and told me to relax and not grab the railings. By doing so, I would clamp up and that would make the scope painful. He then asked me to point to him the location of the pain. He then pulled the scope out and slowly moved in again on the opposite side of the colon. There was no pain and he continued. It took about a bit more than 10 minutes to finish the colonoscopy. He explained a lot and told me what he was looking for as the scope was going on. I asked a lot of questions too. 

And then the nurses turned the bed around while he changed his gloves and gown. 

He then checked which of my nostrils had a clearer passage. After he had determined that my right nostril was the way the scope would go in, he sprayed Cophenylcaine and waited for 5 minutes for any allergy reaction. Once 5 minutes passed with no allergy reaction, he then sprayed 4 to 5 times at an interval of every 5 minutes. The spray was a decongestant and also a numbing agent. 

He then placed the trans-nasal endoscopy (which is less than 6mm in diameter) into my right nose. I could SPEAK as he did this scope. I did not gag. There was no horrible discomfort of the giant tube going down the esophagus. He showed me the back of my nasal cavities, my voice box, my esophagus and my stomach. 

My stomach was inflamed! It looked like I had measles inside my stomach. 

I had no H pylori, no ulcers and no bleeding. He had no idea why my stomach was inflamed too. It could have been triggered by the chicken pox and my stomach just couldn't heal. All biopsies were clear. 

I was placed on two months of Pariet which is a PPI. And he told me to cut down on VEGETABLES! He believed that the amount of vegetables that I was eating was the culprit to my IBS. I was hesitant as I needed the vegetables to poop. He told me to bulk up on fibre and increase my liquid intake. 

"DRINK LOADS OF WATER!" was his advice. 

With nothing else to lose, I embarked on a 'less-vegetable-diet'. The IBS actually settled! I became almost normal. Plus with the PPI, the upper middle abdomen pain which I had 24/7 for 8 months lessened. As the days and weeks went by, I had bigger pockets of pain-free period. I could eat again. The only set-back was going to the toilet, wasn't as smooth and short as before. The doctor said I had to experiment and find out what works best for me. As I experiment, he would guide me and work together with me to help me get back my life on track. Even if it's not 100%, it would at least be better than what I was. Of course I would be lying if I said I wasn't sceptical. But he said one must have hope. I replied that I've been hoping for so many years now that I've reached the stage of complete burnt out. He told me to take it easy and to try again.

And so that's what I have been doing. 

(I did not have any side effects from the spray nor the trans-nasal endoscopy.)

Here is the the LINK to go to if you are in Malaysia and in need of a gastroenterologist.

Click HERE to read his article on 5 Foods You Don't Have to Cut Out From Your Diet in 2018!

Click HERE to read his article on More Than One Way to the Stomach.

Click HERE to read his article on To the Stomach and Beyond - Via the Nostril?

..... to be continued

A Case of An Accessory Pancreas & IBS

Last week and a half was very rough. Joel was down with diarrhoea and excruciating abdominal pain. He would wake up at 1 am, 4 am, 5 am and fly to the bathroom. He would be moaning in pain. He lost a lot of weight as a result.

I took him to see the pediatrician gastroenterologist which he saw a few months back due to the same problem. But this time, it had gotten worse.

So Joel was admitted and had an endoscopy and colonoscopy done. His colon looked good but they found a lump in his stomach.

They took samples of it and we would get the results by next week. But the doctor said that it is most probably an accessory pancreas and that he was born with this. But they want to be positively sure that it isn't cancerous.

So the conclusion of his bowel attacks would be most likely to be IBS. Which means there is no clear cut answer to what had happened to him. The doctor strongly believes that Joel is unable to process fructose and glucose based on the history of his attacks and diet.

Joel does not eat sugar as I do not cook with sugar. We've even been cutting down rice and have no-rice meals a few times a week. The culprit for all these attacks would be FRUITS! Citrus fruits, to be exact. Joel LOVES citrus fruits. I think that life can be a bitch many times. If the cause of the IBS were to be junk food, or highly processed food, I could accept it. But FRUITS?! Damn.......

Since I have IBS and gastro-esophageal reflux which triggered an episode of esophagitis, it is a 99.999999% probability that Joel has my genes. Double damn.......

So it's food experimenting all over again. When I have the IBS attacks, papaya soothes my stomach. But for Joel, even at normal times, papaya causes him to have diarrhoea......

With the renovation and packing and dismantling of our wardrobes and cabinets going on, it was really a stressful time.

FODMAPs and GAPs diet is a good thing to have right now. I will blog on that when time permits. Can't wait to finally move to our new place and settle down.

The Crippling Pain, The ER Visits & THE Scope (Part 2)

As you can see, I was to drink 1L of the horrible-diesel-tasting-diarrhoea-inducing-drink at 7 pm (and must be finished doing so by 8pm) and ANOTHER 1L at 8pm (and must be finished doing so by 9pm). You will gag drinking this. And this is not an exaggeration. The taste will be in your mouth, nostrils and brain. You will smell and taste it in everything and everywhere. By 9 something, I was already running to the toilet. If you're ever going to go through this procedure, don't even attempt to wear back your undies or walk out of the toilet. You will never make it before the next wave hits. Put a stool or a chair next to the 'throne' and wait for the next wave. You won't have to wait for long, I assure you. There will be times when you will think that you're done. You will be wrong.

The very helpful nurse at the endoscopy department said that we must excrete to the point where the last stage of excrement looks like liquid that resembles a-somewhat-clear-water (pictures 7 and 8 of the diagram below).

I was up until 2am and had arrived at stage 7 by then. Thoroughly exhausted, I scrubbed the throne clean, showered and went to bed.

By 4 something I was up to make the last 1L to drink (which I had to begin drinking at 5am and was to be finished by 6am). I was sorely tempted to not drink that as my excrement was clear at 2am. But I remembered what the nurse told me the day before. I was to finish all three sachets. Obediently, I chugged down the last one liter. Boy, was I glad I did that as the next toilet visits became stage 5 again which finally cleared up by the time I arrived at the hospital at 8.30am. (Another important point: Wear diapers! The morning rush hour is mad and you might not be able to hold it. I managed to hold but ran and dashed to the endoscopy department's toilet. And the nurse who checked my stools said I was good to go!!!! Yippeee! No need another 1L of that drink called death.) We met a woman who did not drink her 5am drink as she thought her bowels were cleaned enough. She had to drink another 1L of that drink while I could go ahead with my scope. The relief that I felt was euphoric. But I felt terrible for her. She looked disgusted at the drink and totally demoralized sitting there.

So I changed into the hospital gown and got ready to be wheeled into the scoping room.

I would be lying if I said that I wasn't nervous or anxious. The colonoscopy is one awfully painful procedure when one is not sedated. My dad said when my mum had hers, she was screaming even though she was sedated. They had to give her another shot of sedation.

As I was wheeled in, I saw Dr. Rockstar preparing a syringe to sedate me!

Me: NO WAY DOCTOR! I am not to be sedated. I don't want another problem added to my stomach problems. I have enough problems as it is. So no, I do not want to take the risk of having an allergy attack which can spiral into an anaphylactic attack.

Dr. Rockstar: Yes lah. Take it lah. It's going to be very painful.

Me: I know. But you'll be gentle. (That was me hinting very directly at him to be gentle. But of course I know that there's no way of him turning the scope at the corners of my intestines without causing pain.)

Dr. Rockstar: I can be gentle but you'll still be in pain.... Well ok. If you're up to it. (Of course, he wasn't too pleased. But I was stubborn and adamant and he could not change my mind.)

And so it began.........

Nurse: (Turns me on my left side and sprays Xylocaine (to numb my throat so that the scope can enter without me vomiting and gagging non-stop. Once my throat was numb, she placed a plastic mouthpiece to keep it open.)

Dr. Rockstar: (As he is about to start the scope, he discovers some buttons/knobs are missing! Turns to one of the nurses and barks.) Where are the buttons/knobs? I WANT ALL OF THEM!

One of them disappears like Speedy Gonzales or the Road Runner and returns with the parts that the doctor had demanded. (Later when I told hubby what had happened, he said that now he knew why the nurse ran out and returned with such speed.)

Dr. Rockstar then proceeds and inserts the scope into my esophagus.

Dr. Rockstar: Ok, let's start. (Realises that he couldn't proceed as the monitor would not light up and he is about to blow again.) Why isn't this working??!

Nurse: (Answers real quick) The station outside has not registered the patient.

Dr. Rockstar: (He sounds like he is about to eat everyone in the room.) HOW NOW? THE SCOPE IS IN THE PATIENT ALREADY! HOW LONG YOU WANT PATIENT TO WAIT? WHY WAS THE PATIENT PUSHED INTO THE ROOM WHEN SHE WASN'T REGISTERED?! HOW NOW?!!!!

Nurse: (In a very timid voice) We have to wait for them to register before we can proceed.

Dr. Rockstar: HOW LONG MUST THE PATIENT WAIT? HOW LONG DO YOU EXPECT THEY PATIENT TO LIE DOWN HERE? CALL THEM!!!!!!

The nurse makes the call and squeaks faster than a speeding bullet train telling the outside counter to speed it up.

Bear in mind that I was awake, hearing all this and I had this tube down my esophagus into my stomach and I had to wait until I was 'registered'. I could hear my heart rate accelerating and felt a panic attack creeping in. I started breathing in and out to calm myself down (sounding somewhat like a Darth Vader squeaking) and grabbed the pillow with my left hand. I also started chanting in my head, 'I CAN DO THIS. I CAN DO THIS. I CAN DO THIS. I CAN DO THIS.......' My heart rate actually started to slow down.

Dr. Rockstar: (Bangs on the keyboard urgently and impatiently.) WHAT'S TAKING THEM SO LONG???!!!!

SUDDENLY, the screen lights up and everything started to work. I shouted Hallelujah in my mind and praised every god that exists. HAHA! (Yes, I can laugh now. But I assure you, I wasn't laughing then.)

Dr. Rockstar proceeds with the endoscopy and completes it in a few minutes.

They then turned me around and prepped me up for the colonoscopy.

I continued to grab the pillow with my left hand and I then grabbed the bed railing with my right hand. And I started chanting 'I CAN DO THIS' in my mind again. The first turn came and I turned my face into the pillow and groaned. I gripped the bed railing so hard that my hand still hurts today. This round I didn't scream the hospital down. Hubby was worried as it was so quiet that he thought I might have passed out! When he found out I didn't pass out and did not scream, he promoted me from 'Woman of Steel' to 'Woman of Titanium'. HAHA!

Finally they arrived at the end of the large colon.

WHEW! The nurse pried my right hand from the railing. I immediately went and grabbed it again. She then told me that the excruciating-intestine-twisting procedure was over. Only then did I slowly let go of the railing.

Now here's the good news. My esophagitis has healed. I have no lesions, no ulcers, no polyps, no tear, no nothing in both upper and lower gastrointestinal section. There's no sign of acid reflux burning my esophagus. The Hpylori test came back negative.

Dr. Rockstar concluded that it was a severe IBS attack which he firmly believes was triggered by stress. (Yes, everything is triggered by stress.) I wasn't stressed. But I remember the gassiness started after eating french beans. And then during the weekend, I had garlic! I love garlic. But garlic is a major trigger for episodes-from-hell for me. DAMN IT! It's healthy food. It's not even cake or ice-cream. It's goddamn GARLIC! G.A.R.L.I.C.

All this stomach-throwing-hissy-fits started after I fell sick two months back. I guess it'll take time and I have to build it back up again.

The pain is still on and off. At least there are bouts of relief now. Last week it was 24-hours of pain.

The horrible-diesel-tasting-diarrhoea-inducing drink triggered some allergy reaction. I was itching and had some red patches here and there. I had to take a Puriton antihistamine on Friday night itself. Everything cleared up the next day.

It's adapting period again. I hope things will get better soon.

The Crippling Pain, The ER Visits & THE Scope (Part 1)

The pain started last Sunday. I had thought that it was my usual (GERD) reflux problem which was acting up again. So I took my usual GERD meds - Nexium, Motilium and some milk of magnesia. There was no relief at all. This time, it became a full-blown attack which had me doubling over in pain. I increased the meds and took a double dose. The pain did not abate. And I was extremely-super-gassy.

By Tuesday I was a slow-moving-hunched-over-shuffling Evelyn. I added Ganaton to the list of meds.

I went to the ER at the hospital which is a stone's throw away from my place on Wednesday. Hubby had to take an emergency leave. When I told the doctor the list of meds I've been ingesting, he said that I was already on the highest range of medication for reflux. The only option left was to IV the medicine into my system. Since I am allergic to painkillers, this was what they could do for me.  He asked me whether I would want to be admitted! They could IV the meds round the clock.

NO WAY!

I went home after they IV-ed the meds. It gave some slight relief.

By nightfall, I could feel the medicines wearing out.

By Thursday, I could not eat more than 2 spoonful of anything. The pain came back with vengeance. And I developed a mild fever. And my stools became loose stools.

What could it be? I don't have an appendix anymore as I had an appendicitis 8 years ago. I just had an MRI done last month which covered my stomach, gallbladder, liver, pancreas, spleen, ovaries, and bladder. All my blood tests were normal.

What was this pain?

Hubby rushed back and brought me to the ER again. This time we went to the hospital where my gastroenterologist works. I actually had an appointment later with my gastroenterologist but the pain was awful and I couldn't wait for the appointment time.

----------------------------------------------------------

The doctor at the ER was a ........... (I'll let you fill in the blanks yourself to whatever names you can think of.)

Below is the conversation between ER doctor and me.

ER Doctor: So what pain is this you're having?

Me: It's my stomach. I have reflux and this pain which started on Sunday will not let up. (I then proceeded to tell him the list of meds that I have taking and the visit to the ER on Wednesday which I had more meds IV-ed into me.) I actually have an appointment later with Dr. Rockstar but I couldn't wait for it as the pain is horrible and I'm having a mild grade fever. Maybe you could page him to come down to see me instead?

ER Doctor: (Chooses to ignore me and looks bored to death and gives me the impression that I am either on a trip to the hospital for fun or I am making all this up just to make this trip to the hospital so that I can contribute to his September salary. He then proceeds to ask me to lie down and started to press my abdomen to pinpoint to where the pain was.)

ER Doctor: (After pressing my abdomen for awhile...) I think it's your kidneys. I think you might have stones. Let's do an urine test. Also, I would like to give you Tramadol for the pain. (Tramadol is a painkiller).

Me: WHAT?! It's my stomach that's hurting. My kidneys are FINE! F.I.N.E!!!!!! I don't want that Tramadol. Anyway, I have an appointment with my gastroenterologist, Mr. Rockstar later. I'll go see him.

ER Doctor: Ok then. (He had such a look of disdain and an air of boredom about him.)

----------------------------------------

Hubby then wheeled me over to Dr. Rockstar's clinic.

When we arrived at his clinic, Dr. Rockstar's assistant asked to why did the ER not page him to go see me? I told them about ER Doctor's wonderful behaviour and superb diagnosis. They just shook their heads.

Dr. Rockstar was actually quite frustrated with me as I have been seeing him for the few months with this same pain in the same area (though the intensity of the pain wasn't this terrible). (That was why he had sent me to have the MRI done last month.) At that time he was worried that it was my pancreas. My grandfather had died of stomach cancer and my dad's cousin died of some stomach ailment screaming in pain in the hospital until he died. Maybe it is some kind of stomach ailment genes in our family. Imagine MY level of frustration when even my doctor is frustrated and perplexed.

Since everything came back fine, we just left it at that last month.

This round, since there was no answer, and the pain was so debilitating and crippling, an endoscopy and colonoscopy was recommended. And I was to have it on Friday morning, (which was yesterday).

The last meal was to be at 6pm and I was not to have any vegetables, fruits, red meat, bread, oats, cereal and etc. And I was to drink this (picture below) horrible-diesel-tasting-diarrhoea-inducing-drink to prepare for the colonoscopy.

(...to be continued.)