Beth Israel Hospital – Your Dilation Station

Only two days now till I’m back at work. Work? Whatever is that? Oh, I remember, it’s where I used to go every weekday for shots of coffee and stress. It’s going to be quite a shock now I’m used to breakfast in the sun on the deck most mornings. Actually, going back to work is probably a good idea, as after seven weeks of recuperation and having Kath meet my every need, she has started to expect me to perform light housework duties. Things like picking up my clothes from the bedroom floor and putting them in the clothes basket, putting my used plates and cutlery directly into the dishwasher instead of on the worktop just above it, and so on. I’m just not ready for this much responsibility I’m afraid.

Because of those sunny breakfasts, I’ve developed a nice fall suntan, so I look very healthy. I feel healthy too although last week was a bit of a setback. I suddenly developed difficulty swallowing again. It’s a common occurrence so I’d been expecting it and actually for it to not happen until seven weeks after the operation is pretty good. Its cause is a build-up of scar tissue at the anastamosis; that’s the join between the esophagus and the stomach. It narrows the lumen; that’s the inside diameter of the swallowing tube. Have you noticed how many cool medical words I know now? I’ve learned such a lot that I’m actually thinking of doing some evening classes at the local community college and becoming an esophagus doctor. I wouldn’t need to learn the whole body, just the esophagus. Hey, these ologist guys make a fortune; if I did one every two weeks I’d be able to sit on the deck in the morning most days and still be well off.

So anyway, when this scar tissue builds up, you need a dilation. That’s where the ologist sticks a tube down your throat down to the narrow bit and then expands a balloon attached to the tube to break up the scar tissue and expand the opening. It seems to have worked, I can now swallow whole sides of beef. Well, that’s an exaggeration actually; it’s more accurate to say that my porridge doesn’t get stuck any more.

While he was there, he also performed an esophagoduodenogastroscopy and a bronchoscopy. That’s medical terminology for “had a good look around” but the long words means he can charge more. I think the going rate for procedures now is $194.37 per letter in the name of the procedure. All was well apart from my feeling a bit jaded for a couple of days afterwards. While he had me at his mercy, he took out the port-a-cath that had been fitted to help with chemo treatments and changed the feeding tube which frankly had become just disgusting. It was covered in sticky residue from the tape used to help secure it in place and was impossible to clean. So now I have a new pristine tube hanging out of my rapidly shrinking belly. I’d rather have had the tube removed completely but as I’m still losing weight he wants to keep it in place in case I need inflating again.

By popular request?

Having announced the end of the blog, I have received a flood of complaints asking for it to continue. Well, a flood is perhaps pushing it a bit, more like a puddle, but quite a number of people have made the comment. I can’t get past the feeling that they’re just being polite and secretly everyone is quite relieved that my outpourings of self-centered medical information have ceased. If that’s the case, it’s too late now, I’m going to post another entry. It’s your own fault, you should have told the truth in the first place.
It’s been five weeks since the operation. My recovery is actually going very well indeed, although it seems very slow to me on a day to day basis. Talking of day to day, how about that day time TV? There’s Martha Stewart, Ellen DeGeneris, the View, Regis and Kelley, and boy, that Dr. Phil is sooo righteous. I can see why Kath gave up the commute to stay at home all day.
I only recently came off the heavy pain-killers, so I’m now able to drive and to string more than two words together to make a sentence. I’m walking quite a lot; actually managing to avoid Starbucks sometimes and walk a less rewarding but more strenuous route. I’m very short of breath but once again the breathing seems to be getting better each day.
The biggest issue is feeding – learning to cope with putting food and drink into my reconfigured system. It’s a well known issue called Dumping Syndrome. I believe I’ve mentioned it before. Now there’s a name that conjures up immediate visions of what the problems could be. Without going too far into the detail, the lack of stomach causes food and drink to go almost directly into the intestine after swallowing. My poor old intestine has been used to pretty well pre-digested grub being delivered to it from the stomach. Now suddenly there’s big bits of undigested food coming in and it doesn’t know what to do. So it rebels. Violently. In various ways including cramping, nausea, and diarrhea. It can be quite debilitating, but there are ways to control it. Don’t drink with meals. That one is hard, particularly when entertaining or going out for a meal. How can I go out to our newest local bar/restaurant, the British Beer Company (that’s true, and it’s great, with a good selection of beers) and choose between eating or having a beer? Actually, I’m not sure I can drink beer in the future anyway as it’s mostly sugar and that’s another of the no’s – no sugary stuff. I’ll have to experiment with that one. A lot. Other things to do are to eat six small meals a day instead of three large ones, choose food more carefully (sugar), and so on. The big trick seems to be the chewing. How I remember my dear old mum telling me to chew my food 32 times before swallowing. “Yeah, right mum” I’d think, while ripping off another chunk of meat, gently compressing it twice with my teeth, then swallowing it so I could take another bite. But chewing is the trick. Reducing a mouthful of grub to a mush prior to swallowing it seems to take most of the issues away. It will take some getting used to though.
After the op, I was tube feeding for a couple of weeks at home. I’ve scaled that back to zero now so I’m taking in everything by mouth. I’m losing weight (on purpose) although the doc suggested that I avoid doing that. However, it’s coming off slowly and I feel it’s under control. After a lifetime of being fat boy, this is a definite benefit. Not quite as important as being alive, but right up there.
I’m also having trouble sleeping, but I’ve now got some different pills for that. As I suggested in a previous posting, the Ambien I was initially offered was not really doing anything so yesterday I got some Lunesta. Took the first one last night, went to bed and laid there thinking “Well, perhaps sleeping pills don’t work on me. I’ve taken this pill and it doesn’t seem to…zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz”. Yes, it actually seemed to work pretty well, so I’ll take them for a few days and try to get myself into a good sleep rhythm.
So the bottom line is, the post-op pain is now more like discomfort and controllable with Tylenol, I’m exercising well, my head is slowly clearing, I’m getting more comfortable with food. And I’m still here, so all is going very well indeed.