Waiting around

Friday, September 22, 2006

So I can't chew

Ok, ok. I know it's been forever. But I have a couple excuses, one of which is medical school, and one of which is being a patient.

Medical school first. I just took my first Gross Anatomy exam. The exam covered everything about the upper and lower limb. So, in theory, I should know everything there is to know about the arm and leg: the muscles, arteries, nerves, veins, and lymphatics. In reality, who knows. All I know is that it is now over, and I am going to start buckling down for the neuro exam on Wednesday of next week. It's hard to believe that we are a third of the way through Gross. I think that's a lot because Gross is the class you think of when you think of medical school. And I am a third of the way through it.

Now for the part about chewing. My parents came down this weekend, and we decided to have dinner at the Cheesecake Factory. I've had a couple bad experiences there in the past, but I really like the food, so for some reason, I keep going back. I ordered my normal buffalo chicken sandwhich, and start eating that. About halfway through, I feel something a little wrong, and I start coughing up some of the food that I had been eating. There is a lot of phlegm involved, and I excuse myself to allow my esophagus to rid itself of the food that was there. This continued for about 20 minutes, with me getting up numerous times in an attempt to expel whatever it was. We leave the restaurant, and I get home and sit for around 2 hours, and I decide to drink some water. After drinking that water, I pretty much threw up right away. I didn't think too much of it, and just went to bed. I woke up Monday morning, and again tried drinking some water with the same result. This was starting to get curious for me.

I waited until dinnertime before I ate anything else, and at dinner, I attempted eating some pizza. Why pizza? Well it was free. So I ate that. And guess what? I threw that up. So by now, it had been about 24 hours since I had eaten or drinken anything. I talked to a couple doctors, and they thought it would be best for me to head to the ED so that I can get some fluids in me. I got the ED around 8, though I don't get seen until 10. At 1, I finally got out of the ED, with the diagnosis of "I have no idea what's going on. If there is food down there, the medicine I gave you should have taken care of that." Frustrated, I went home to sleep, hoping that miraculously in the morning I would be ok.

I wasn't. I drank water, and the same thing. By now I was really starting to get concerned. I hadn't eaten or drinken anything (except 1.5L of IV fluids) in 36 hours, and there was no end in sight. I decided I should talk to the dean of students to let her know something was up, especially considering that we had exams in the next few days. She suggested that I go to Student Health for a second opinion, which is something I just needed to hear, even though deep down that is what I knew I had to do. Off I went to student health, and after 5 minutes with that doctor, she referred me to a GI doc (gastroenterologist) for Wednesday morning at 8:30. So back to the library I went, studying on nothing more than 1.5L of IV fluid over 48 hours. I left somewhat early because I was pretty drained.

That morning before I went to the doctor, I weighed myself. I had lost 10 pounds in 3 days. Yikes. Meeting with that doctor, it seemed like an end was in sight, but not for another day. She originally decided that I needed to have a barium X-Ray to see if there was an actual blockage, and from there, she could do an upper endoscopy, using the X-Ray as a guide down my esophagus, however, the upper endoscopy probably wouldn't take place until the next day (being Thursday at this point). While I was happy something was getting done, I wasn't sure I could make it another day without food or water.

After 10 minutes, my doctor comes in and tells me that the X-Ray people wouldn't be able to do it that day, meaning we would be delayed even further. But then the good news. M y doctor decided that my symptoms made were essentially pathgnomonic (99% certainty) for a food impaction in my esophagus and therefore she decided that she would do a "blind" upper endoscopy at 3 o'clock that afternoon. While it would take a little longer since she didn't have a guide, relief was probably in sight.

So that's what happened. I showed up, got my second IV, and underwent an upper endoscopy. See right (image is from Britain, hence "oesphagus") The drugs completely knocked me out. At one point the nurses told me they were going to give me some drugs, and the next thing I truly remember was standing in the Boston Market getting some mashed potatoes. And even that is really fuzzy. I was apparently very alert, had a conversation with my parents and my doctor, got into the car, talked to my sister and directed my dad to the Boston Market in Arlington (my procedure was done in Chevy Chase... and they found a piece of chicken at my gastroesophageal junction).

I ended up having a really fuzzy night that night. I have pieced together the big chunks. Like calling the dean. Getting to school. Taking a practice practical. I did all 3 of those things, and hardly remember. So basically, it was as if I drunk dialed the dean of students at the medical school. I talked to her yesterday afternoon letting her know I really have no recollection of our conversation and she laughed, saying that she would keep that secret I told her. Mystified, I was really curious, and she told me she was kidding. Whew. She also comforted me by letting me know I didn't say anything stupid. And on the practice practical, I only got 5 wrong.

So then I spent yesterday from 8:30 til 9:30 studying. Which was lots and lots of fun. My throat is still a little soar, but I think anyone's would be considering a tube was shoved down my throat. The lesson I learned this week: Chew my food better.

Still waiting,
-wait