EGD without Sedation, help my nerves?

I should add that my severe pain is gone, all of my pain is gone.  I drank 1 beer a week ago which was unpleasant on my stomach but I only had 4 hours of sleep and had to take a final exam and needed my nerves to level out.  I had two sensations previously, one was in the "kink" of the kidney bean, and the other felt like rug burn, maybe where the duodenum begins.

When I would drink cold food I could feel it trickle over the upper ulcer (what I am assuming was an ulcer), and when I didn't take an antacid or ate anything other than oatmeal I would feel abrasion and pressure at a much lower spot.

Both pains are gone, and most of the discomfort of the distension is also gone.  Though, I am still very distended.  My gut remains visibly more distended than it was 1 month ago.

Not sure if I already mentioned my liver enzymes were slightly elevated.

I'm drinking coffee even though I shouldn't and I feel it mildly irritating my stomach, though the discomfort is a mild pressure and astringency.  The kind you forget about unless you remember to remember it.  Like when you havent eaten in several hours.

I was drinking a lot of home fermented kefir, which my stomach tolerated oddly well and I think may have helped heal things up in there.

I think I'm taking it too fast though and need to go back to bland foods for a good month for good measure.

As a reminder, I was having intense dizzy spells and severe anxiety leading up to thanksgiving.  I could not even have sips of water, I could only drink half and half.  I would wake up feeling so weird and in pain.  I could only eat a bite or two of food and I would feel stuffed.  I remain concerned at the stiff distension in my upper abdomen and hoping its not cancer, which honestly would make more sense than any other explanation.  But I'm not there yet so I'm just enjoying each pain-free day.  In 2 days I see my new primary and I'll be lobbying for a new ultrasound.

Also I am eating 10 prunes per day for regularity, and pooping in a full squat.  When I ceased my daily alcohol intake, my stools turned pale yellow and became crumbly and hard.  I was not regular and would only poo every 2-3 days.  After introducing the prunes my poos began to darken.  Not sure if the prunes are responsible for the darkening, or if abrupt cessation of alcohol intake temporarily caused an insufficiency of bile.

My stools are healthy, probably the healthiest they have been in over 8 years.  I am sharing all of this information in the event someone else may find it useful for themselves.

I will report back after my edg in january or if something turns up after my visit with my primary.

Hi Elijah.

I, too, am a bit of a "nervous Nellie."  I decided to have an EGD without sedation after a medical billing clerk assured me that her non-sedation EGD was a breeze, she felt nothing, etc. 

Well that decision was a big mistake for me for a couple of reasons:

1. I was new to the experience, so very nervous to begin with;

2. I had terrible sinus congestion, which made it very difficult to breathe through my nose (the only possible way to breathe with a tube down one's throat); and

3. Worst of all--the doctor took multiple tissue biopsies of my esophagus during the procedure (which is routinely done only when tissue looks inflamed for any reason).

To be honest, although it was probably only 10-15 minutes, to me it seemed an interminable hell, especially the biopsies, which felt like someone was stabbing holes in my gut with a sharp needle, every time she took a new one.  I also had a constant gag reflex sensation during the entire procedure, like I wanted to--but could not--throw up the scope tube in my throat. 

I don't say these things to frighten you but to be as honest as I can.  I'm sure each person's experience varies, and the skill and gentleness also varies with each doctor.  That said, I also get the impression that those who report "easy" unsedated EGDs are folks with "normal"-looking tissue who perhaps didn't require extensive, thorough tissue exams and biopsies like I did.

As an aside, I would strongly urge you to significantly reduce or entirely quit the booze and coffee.  Both are well-known, big time acidic gut irritants, esp. if used daily and/or long-term!  And, docs tell me, the coffee actually relaxes or weakens the esophageal sphincter (the "gateway" muscle between the esophagus and stomach that is supposed to protect the esophagus from stomach acid reflux).

I'm scheduled for another EGD soon.  This time around, I'm opting for sedation.  I'm also due for a colonoscopy so I decided to get both done during the same procedure so I don't have to go through this "fun" twice...:-).

Best of luck to you, and Happy Holidays!!

Kate

Hello everyone, I am here to update.  I had the procedure today.

First things first.  No serious problems were observed.  I have a hiatal hernia and gastritis.  They are recommending an ultrasound, weight loss, and remaining alcohol free.  Tonight I am cheating and drinking 1 glass of wine because I just deep-throated a robot.

It was stressful and relieving to postpone the procedure.  There was a lack of communication which was frustrating, but I was in no hurry to get scoped.  I am afraid of anesthesia and wasn't sure I could get scoped without having a panic attack.

So, the experience was not fun at all, but was made tolerable by a very supportive staff.  When I was getting prepped the people that were actually performing the procedure did not seem to think me wanting to go unsedated was such an alien thing.  One of the nurses had has the procedure done unsedated.

I was a wuss, a big baby.  That lady let me squeeze her hand.  I am both ashamed for purely conceited reasons as well as deeply grateful for the nurses support.  Honestly they were all coaching me through it.  For me the whole procedure lasted about 2 minutes.  Somehow he said everything looked fairly normal, which is surprising to me as you might imagine from everything I described in my previous post.

I was hoping my wife could attend, but that was not permitted.  I think it would have been a distraction, and the nurses had a genuine sense of empathy throughout that helped enable me to fight my urge to panic throughout the procedure.

The pain itself can be endured.  However, for me, the feeling of immobilization causes me to panic, and one is never more imoblilzed than when one is tethered to the wall at the throat.

They administered a throat spray twice.  It was not like pump hairspray, but aerosolized.  It tasted like numb bananas.  I am adventurous when it comes to foods so I think they expected I would find it to be more repulsive than I did.  Mostly it was odd.

I had already signed a consent agreement which I ammended myself, stating that I reserve the right to withdraw consent for the procedure and for any sedative or anesthesia at any time, if I produced any gesture which might be reasonably be interpreted by any person indicating to stop the procedure.  Such is my fear of anesthesia or being administered anesthesia without my consent.

No anesthesiologist was present because I would not sign those papers.  Much of the paperwork was expedited since much of it addresses anesthesia.  There was never an air of contentiousness, I laid myself bare, was vulnerable, and was also willing to walk away.  My wife asked me "what if you can't do it without..."

"there is no if.  I am doing it."

One of the newer staff members was not very experienced with IVs, which added to my anxiety but she didn't do a bad job and was excited to have the practice.  I was happy for her and simultaneously afraid for myself.  The IV regurgitated some blood which was pushed back in with saline.  As soon as the saline "hit" I could detect it mentally.  It compounded my anxiety, but I got used to it as I waited.  I showed my wife the SNL parody Thanksgiving skit of Adele's new song.  The staff sang along, which we heard on the other side of the curtain.

I had all of these cords on me, IV, O2, pressure cuff, hospital socks, gown and was in the stretcher.  Something about all of this is dehumanizing, surreal.  Being stripped down to nudity and being burdened with all of this other stuff seemed to be true both physically and symbollically.  I feel nervous, robbed of some part of myself.  Its no one's fault, but it is a reality of being in such a sterile setting.

Back to the throat spray.  Well, wait a minute.  The staff and and banter and goings on all seemed very Scrubs like.  I mean seriously.  Everyone was good looking and funny and how is this going so spectacularly?

Ok, so I'm in this room being given instructions on how to breathe.  They tuck my left arm under me, I roll onto my side with my head on a slight incline and I get the mouthpiece.  They are talking to me and the doctor does not seem to be explicitly aware that anesthesia is off the table, though he understands it is my preference.  So I try to talk through the moutpiece.  He advises that I stop, and I do after I understand that he understands.  So here we go.

The scope is .75 the diameter of my pinky.  Smaller than I expected.  As it goes down it feels abrasive, I feel it pressing on the sharp corners of the cartilage in my throat.  I heave, hard... "HRRRRRRRGGGHHHH"

I'm squeezing the ladies hand, they keep reminding me to breathe through my nose.  This sounds like a no brainer doesn't it?

Well, when you've been deprived of oxygen what is your first reaction?  to breathe violently through your nostrils?  No.  You open your mouth.  Years of evolution have produced this reflex.  But if you follow your instincts you'll just keep gagging.  In between pushes of the scope I feel fine.  I can tolerate the scope, it feels small and tubular.  But when its starts moving I heave, it feels like a square peg going down my throat.  I can initiate peristalsis from the rear of my throat without performing a full swallowing motion.  This was fine, but if I attempted a full swallow I would heave.

The rapidly expanding gas made me heave.  I heaved out the gas.  I found I could tighten my abs and let out the gas so as to avoid heaving, but then the doc would pump in more gas.  Which was fine, but it seemed to be the rapid nature of the expansion that made me heave.  Do not underestimate the saliva that your mouth is producing and how badly you want to swallow it.  Just drool.

Every time the scope stops I am fine.  I felt none of the biopsies.  They only took 3.

The final push into the duodenum was the most painful.  I felt the whole apparatus stiffen up a bit as entry was attempted.  as it "popped" through into the duodenum it hurt like hell.  I heaved once, twice, 3 times, yelling through my nose, and almost lost my ****, I kicked, and I squeezed that ladies hand hard.  They kept coaching me.  I was reassured that it was almost over.  But then I was fine, again, only movement of the scope caused problems (penetration, not manipulation of the scope).  They got the biopsy, and began withdrawing the scope.  This was not as quick as I had been told, perhaps in part due to the fact I heaved as they took it out.  The doc told me to try extra hard not to heave as they pulled it back through the esophagus to avoid a tear.   I mean, I did my best.

Nothing comes out when you heave.  The problem is that you can't breathe when you are heaving.  And since you are breathing through two tiny holes, 3 back to back heaves sucks.  Also, vomiting gives me panic attacks.  Even before I ever had real panic attacks, vomiting would produce not only discomfort but a panicky feeling.

Does that seem like hell?

I would do it again over anesthesia.