Husband due endoscopy next Tuesday

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My 76 year old husband is due the above next Tuesday. He has aneamia and has lost over 2st in weight. He went for the preliminary appointment yesterday. He is rather deaf so I typed out a list of his medications. He apparently can take them all up until the night before procedure which is at 10.30am Tuesday morning. He is on Esomeprazole 40mg 2 x a day for acid reflux? Should he be taking this the week before an endoscopy?  I notice from the information that he is not supposed to drink alcohol for 24 hours afterwards. This is going to be very difficult for him and although I will stress this to him, how dangerous would it be if he has his usual vodka? I do know alcohol can thin the blood........I am his carer and whilst he has 'mental capacity' his deafness does sometimes make me wonder if he is passing information on correctly or has indeed heart it at all. I now go to all his dermatologists appointments with him , since his dermatologist is Russian and speaks with quite a strong accent, and at least I can ask him to clarify things, which in fairness, he does when asked. I basically just want to hear about how other especially older people coped. It does say that he has to have an adult with him for 12 hours afterwards but they will not take me with him in the ambulance but I will make sure I keep Tuesday free and Wednesday too. Thanks for reading.....    

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  • Posted

    For most upper GI endoscopy it is normal to continue on acid suppressant medication. If not, there's a risk of recurrence of oesophagitis which may make the job more difficult for the endoscopist.

    Occasionally patients are requested to abstain from meds for a while before when a gastroenterologist wishes to assess the efficacy of the drugs.

    (Frequently hospitals erroneously provide instructions to discontinue PPIs for a few days before. This old advice has largely been superceded so anyone receiving one of those letters should phone their gastroenterology department to check.)

    Your husband presumably will be receiving sedation for his scope which is why he'll need to have someone with him afterwards. I don't know the full dangers of mixing alcohol with sedatives but I think it could cause him to pass out. I guess you could ask at his appointment or ask a pharmacist.

    I'm surprised they won't let you travel in the ambulance with him.

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  • Posted

    Thanks Barretts -  I do feel reassured re the acid reflux medication. They are very strict in this area, with regard to relatives coming with patients even though I did mention his age and the fact he is deaf! It is around £70 to the infirmary by taxi. I do not think I need to go with him on Tuesday just be responsible for him when he arrives home by ambulance which is fine.  The GP does know he is alcohol dependant and stopping drinking completely for the 24 hours after, and the 12 hours before, could cause yet more medical problems. Frankly, I think the GP was a  bit ambivalent about suggesting this, but the consultant and dermo felt it was necessary to rule out internal bleeding or bleeding varices and various other things, many of which could be treated and managed. 
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    • Posted

      Krug22, I very much doubt whether they'll give him any sedation at his age. Even if they do, it will be a minute dose. I was only 69 and in excellent general health when I had an emergency gastroscopy two years ago, and even I was given only a minimal dose of sedation. I therefore doubt whether a small tot of vodka later on the same evening would do him much harm. (I'm a former nurse, btw.) But obviously, you'll need to make sure he's fully regained the ability to swallow before risking anything except plain water, as they'll probably give him a numbing throat spray. Vodka going down into his lungs would have a catastrophic effect.

      I'm so sorry to hear they're being difficult about letting you go with him in the ambulance. I had the same problem on the day my father died, and again on multiple occasions in my mother's last illness. However, I'm afraid I simply got into the transport on each occasion and politely refused to leave. I found they always backed down in the face of steely determination!

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    • Posted

      Yes - but my case was different!redface I'd managed to swallow my large, spiky, one-tooth denture and it had been stuck in my throat for three weeks while I was thrown out of successive hospitals on the grounds that I must have imagined the whole thing. By the time they finally believed me and got it out, my throat was ulcerated and infected. But in spite of all that, it still only felt sore for a few days. I think most people have slight soreness in their throat, and sometimes their stomach, after gastroscopy, but it doesn't last very long. It's really not a very major procedure, and well worth it given your husband's symptoms.
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  • Posted

    Goodness Lily, what a nightmare to have to go through. Unfortunately, my husband has been complaining of a sore throat/blocked nose the last couple of days....if he is not better tomorrow, we may well decide to phone the department for advice. I really do not want him to cancel but if he has a throat problem then it may not be safe to proceed? He is complaining that he feels as if one of his tablets are stuck in his throat. He has 11 pills in the morning, 7 at night and up to 16 painkillers a day. But I would have thought if it had been a tablet it would have dissolved?  
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    • Posted

      Yes, you're right - a tablet would have dissolved. The sensation he's complaining about is almost certainly part of his acid reflux problem. A blocked nose isn't a barrier to having a gastroscopy, as the tube doesn't prevent you from breathing through your mouth. However, it might well be that if the hospital thinks he has some kind of flu virus they might prefer not to have him on the premises until he's recovered. I think your idea of calling them tomorrow is the best one in the circumstances. I hope it all works out well in the end. Maybe you'll find the time to post a little message telling us all how it went?
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    • Posted

      Thanks. Plan is to decide when he gets up at 11ish tomorrow and if he is still feeling as if he has  a cold and sore throat, to phone department and ask for advice. He has been on max dose esomeprazole 40g x 2 a day for nearly 2 years so  I thought the acid reflux was under control but yes, tablets would surely be water soluble. I will let you know what happens.......
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  • Posted

    Well he has gastiritis moderate erthematous/exudative with no bleeding within. But they have taken 2 biopsies from one site and 4 biopsies from another. Paperwork says awaiting pathology result. I guess this could take a few weeks? He has a blood test for the dermatologist next week and I now ask for copies to be sent to the GP. I will obviously phone GP and ask if blood test results still show aneamia/low protein/high MCV, because as yet we do not have a dermo appointment and he has been on the Fumaderm now for 3 weeks and tomorrow we have to go to the higher dose. Just hope he will relax  now and maybe sleep!  
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    • Posted

      Thanks for letting us all know. I'm glad you managed to get it over with and that he's OK.

      It's normal that they would have taken biopsies - they always do that once they're down there. I think it depends on preliminary findings as to how long it will take to get the results.

      I'm assuming his GP and gastroenterologist both know he's on Fumaderm, given his history of gastric problems?

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    • Posted

      Yes they do. I typed out a list of drugs he was taking when he went for the preliminary appointment. But he has only been on it for 3 weeks and we are now go to the higher dose. The Dermatologist wants internal bleeding ruled out because if the Fumaderm does not work, then he wants to try various injections. These co -morbidities are a nightmare not just for the patient but for the various medics involved too!
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    • Posted

      Well the only thing that seemed to work was the ciclosporin but that caused high creatine and liver/kidney problems. They tried reducing it but blood tests meant he had to come off it. But if it is not treated, then there is the risk of cellulitus...I do know Fumaderm is not licensed in the UK but has been used for years in Germany. He is also on acecretin but i think they want to wean him off that when the Fumaderm kicks in. He has lupus but that is dormant at the moment but they cannot go for light therapy for the psoriasis in case it sparks the Lupus so round and round we go...... 
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