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Endoscopy today

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Aside from the delay (1 hour late, stewing in my anxiety), the procedure went well. I was shocked they took 4 biopsies. I'm going to the ugly place. First concern is mets from lobular to throat or stomach…or would it be worse if it were a new primary gastric cancer. UGH.

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  • maggie15
    maggie15 Member Posts: 855
    edited June 2023
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    @wallycat , There is a general procedure for endoscopy where biopsies are taken from 4 locations. My first one was done when I was hospitalized for an upper GI bleed. The camera showed esophagitis (the cause of the bleed) and the biopsies showed Barrett's esophagus, a precancerous condition. I now have an endoscopy every 3 years to make sure the Barrett's hasn't become malignant, something that doesn't happen too often. I had silent GERD (no symptoms) so I have to take PPIs and follow some dietary restrictions. BC mets to the esophagus are pretty rare (4/1000). A Cleveland Clinic study showed a statistical association between bc and Barrett's.

    I hope your pathology shows nothing of concern but there are things other than cancer that can show up. Hopefully the results won't take too long; the waiting never gets easier.

  • wallycat
    wallycat Member Posts: 1,245
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    Thank you, Maggie.

    They took a weird gastric cell from very upper esophagus; I asked if Barrett's and she said too high up; stomach, duedendum and one other spot….the tummy one and small intestine one are what are freaking me out. I appreciate your post very much.

  • maggie15
    maggie15 Member Posts: 855
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    Wallycat, I had some flat polyps in my stomach and duodenum which turned out to be benign. I hope yours are, too.

  • wallycat
    wallycat Member Posts: 1,245
    edited June 2023
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    ❤️

    Forgot to mention they also want me to do a swallow study. Ugh.

    Editing to add: I just found this on reversing Barrett's. It was quite interesting.

    https://www.medscape.com/viewarticle/546830

  • wallycat
    wallycat Member Posts: 1,245
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    Thank you again for posting your reply, Maggie. I have not received a call from the doctor yet, but from what I saw on myChart, I think I'm in the clear. Gastritis irritation and silent reflux. No mention of Barrett's. Interestingly the gastric cells in the upper esophagus are called "inlets," I think, and are a congenital thing.

    We'll see how the swallow challenge goes. Thanks again, very much!

  • maggie15
    maggie15 Member Posts: 855
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    Wallycat, That's great news! You might be prescribed a PPI or H-2 blocker for the gastritis and silent reflux. I've never had a swallowing study done but took my mother to one. She ended out needing thickened liquids to prevent aspiration.

    On another occasion I had a laryngoscopy where a camera is put down your throat to look at the voice box and vocal cords. I had been transferred to a larger hospital for an emergency thyroidectomy since a CT had shown a goiter almost totally compressing my trachea. I was suspicious they did this to train an ENT resident who later in the day got to do his first awake patient intubation on me (under supervision.) A long time ago some high schoolers had to put up with my learning curve when I was a student teacher so I guess this was payback time.

    Thank you for the Barrett's reversal reference. I hope your swallow challenge goes well!

  • wallycat
    wallycat Member Posts: 1,245
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    They did want a ppi but I said H2 blocker …at least 2 weeks. Silent reflux is unsettling since we don't know it is happening.

    Best to you!

  • maggie15
    maggie15 Member Posts: 855
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    They can actually measure esophageal acidity level with two tests. The older one involves inserting a tube through your nose into the esophagus where a sensor relays pH levels to a monitor on your belt for 24 hours. A newer method called the Bravo pH inserts a capsule containing sensors that sends data to a wrist monitor and eventually is eliminated after about 96 hours. I just went with the gastro's opinion that the bleeding and esophageal damage was caused by silent reflux. I never had any pain even when bleeding profusely (and vomiting blood) which the doctor said was evidence my nerves had been destroyed by acid long ago. I don't like taking PPIs forever (some bad possible side effects) but as he said, another GI bleed not near an ER would kill me sooner than Alzheimer's, my major concern. Hopefully a short course of an H2 blocker will clear things up for you.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    I'm popping into this thread because I've had increasing esophageal issues. I've had more trouble swallowing with pain in my chest like my esophagus is contracting really hard. I had a swallow study which didn't show any aspiration, but it did show some areas of concern.

    The past two mornings, after taking my Ibrance I had severe spasms a vomited 5 or 6 times. I do have an appointment with GI, but not until September. They can't get me in earlier unless my doc makes the referral "stat." Working on that. This sucks.

    This morning I was on my way to get a brain EEG and started coughing and vomiting. Canceled the appointment and rescheduled it. I won't take my morning meds next time before I go.

    Wallycat, the swallow study is not traumatic. Even the barium stuff wasn't too bad. I wish I had taken one of the pills that seems to get hung up along with me for the study, but I didn't think of it. She did give me a barium pill to swallow at the end and that hung up about halfway down my esophagus. I couldn't feel it, but it showed up on the monitor.

  • maggie15
    maggie15 Member Posts: 855
    edited June 2023
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    Sunshine99, It sounds like you may have esophagitis or a stricture which can be caused by many things including GERD, meds and allergies. Being unable to take your Ibrance should be a good enough reason to get an endoscopy done soon. If necessary get your MO to advocate for you.

    EGDs are often hard to schedule since the same doctors and procedure rooms are used for all those screening colonoscopies. I hope you get a "stat" appointment so they can figure out what is going on and solve the problem.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    Thank you, maggie. (I hope I didn't hijack this thread.) I did get an appointment for next Wednesday. It's a video visit, but I'm OK with that because I'll be able to tell them everything that's been happening and hopefully get an endoscopy scheduled. I'm delaying taking my meds this morning. My housekeeper is here and I don't want to be barfing while she's here.

    Carol

  • wallycat
    wallycat Member Posts: 1,245
    edited June 2023
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    I have still not gotten the call for the swallow test so I guess I will have to phone them.

    Sunshine, sorry you are dealing with this. It is unnerving and scary. I'm glad my endoscopy is over, in terms of "finding" anything sinister. The surgeon said they can easily dilate the esophagus if it needs it. Maybe that is all you will require. Best to you. And no, you did not hijack this thread. I invite anyone to post their stuff as we all learn from one another.

  • maggie15
    maggie15 Member Posts: 855
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    Sunshine, I'm glad you got an appointment for next week. Hopefully it will lead to an EGD in the near future. You and everybody else are welcome on this thread. It's good to know we are not alone in all of this. Keep us posted.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    Thank you for your encouragement and kind words. I was able to take my Ibrance and Arimidex this afternoon with no significant spasms. I waited about 30 minutes before I ate some soup. So far, that's been OK, too.

  • wallycat
    wallycat Member Posts: 1,245
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    I finally called the radiology dept. myself; mad they never bothered to phone. My appointment is on July 5th at 8:15am. Too early but since they said no food or water, glad it will be done. They didn't indicate how long this takes; hopeful not a drawn out process.

    Sunshine, let us know how you do with the endoscopy and what, if anything they will do for the spasms.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    Wallycat, I'm glad your appointment is scheduled. I hope you get some answers. I think I'd prefer early appointments. I'd rather get it over with sooner, rather than later in the day.

    I'll see the GI PA on Wednesday and will hopefully get the endoscopy scheduled. I can't believe I'm actually hoping to have a tube put down my throat, but I really need some answers. I'll see the pulmonologist tomorrow. I really do think this is all related.

    Carol

  • maggie15
    maggie15 Member Posts: 855
    edited June 2023
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    Wallycat, I'm glad you got a swallowing study appointment. It's early in the morning but at least you won't spend much of the day hungry. I hope you get some answers.

    Sunshine, The EGD is actually not an uncomfortable procedure since you are put into twilight sleep. One doctor controls the biopsy scope with camera while another one observes the relayed "movie" on a tv screen looking for abnormalities. There's no real prep other than not eating or drinking for a specified time. Ask the pulmonologist about the possibility of microaspiration of stomach acid causing cough or interstitial lung abnormality. I found out about this the hard way when I lost about 50% of my lung function due to radiation. Most bc drugs can also cause ILD, more likely to happen if you have ILA. Some pulmonologists are not familiar with this since it's uncommon. My RO referred me to an ILD specialist pulmonologist after seeing the scarring on a CT.

    I have a gastroenterologist appointment on Thursday. My doctor has assigned me to his fellows since I'm pretty much in GI maintenance mode. I get to say goodbye to my current fellow who will complete his three year stint at the end of the month. I don't mind since they are already internal medicine MDs, the doctor supervises them closely and he steps in if anything complicated turns up.

    Here's to productive appointments for all!

  • ctmbsikia
    ctmbsikia Member Posts: 752
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    I hope all of you with these issues find some answers and relief. 😮

    I have been doing well in regard to GI troubles. A couple of years ago I was having intermittent problems with swallowing, having to either waiting for it to go down, or throwing whatever it was back up. One time I actually got water stuck. One night I was with friends and the bite of chicken parm went down and it got impacted. I had to go to the ER. They did the endoscopy and took the 4 biopsies and nothing bad was found, just a schatzki ring which I had dilated months later. Just recently I have felt that feeling again. I think people who have this can have it again, so I've been watching what I'm eating because having food get impacted, or even throwing it back up, sucks. It also sucks that the GI doctors practice, something like 7 or 8 docs are always booked. I have never gone back for a follow up because you just can't get in. I was on the PPI for a while but I didn't want to be on it long term, so my GP has me taking 40mg Famotidine daily which is cheaper than buying it over the counter.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    ctm, I hear you about it being hard to get in to see the GI doc. I had to ask my MO to give me a stat referral so that they could see me sooner. I'll see the PA tomorrow via a video visit, which I'm fine with. I have a list of all the issues, including such severe spasms that I've started vomiting. I want this thing looked at ASAP. Hopefully the visit with the PA will get things moving toward an endoscopy.

  • wallycat
    wallycat Member Posts: 1,245
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    I hope you can get in fairly soon. That has to feel scary and awful all at once.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    Just saw the NP (not a PA) and she put in a stat order for an endoscopy. They offered me one for June 30, which I couldn't do, so it's now scheduled for July 5th.

  • maggie15
    maggie15 Member Posts: 855
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    Good news about the quick appointment; the 5th is not far off. They can't treat you until they figure out what's wrong so I'm glad something is happening.

  • wallycat
    wallycat Member Posts: 1,245
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    July 5th is my swallow test so we'll be doing esophagus stuff together! Good luck in finding out the issue.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    wallycat, I'll be thinking of you on the 5th.

  • wallycat
    wallycat Member Posts: 1,245
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    You are so kind. I will also keep you in my thoughts. Maybe it will hold down my stress!

  • wallycat
    wallycat Member Posts: 1,245
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    Sunshine, I was thinking of you this morning and hope they can figure out what is going on with you.

    Shocked how quickly the swallow test goes. my update: Barium
    initial swallow went well, second swallow and the sphincter between
    stomach and esophagus wouldn't open.  Waited and waited...I said,  "did I
    break the machine again?" and nope...they had me lay down and the
    sphincter opened right away. I said, "that should mean no reflux, right?" 
    He laughed.  Had me take a very wide, flat, dry tablet about 4-1/2 mm
    wide.  Went down perfectly. He said no strictures since the pill didn't
    get stuck. That is the limit on stricture definition and mine went
    through just fine.  I said, "so possible spasm?" and he said that is
    probably it. He didn't know if there were pills to fix that and I told
    him there were. He asked how I knew and I told him dr. google, LOL. So I guess if I continue with issues, I can reschedule another endoscopy in 3-5 years and they can see if there are any changes.

    Hope anyone dealing with this sort of stuff gets some good results.
     

  • maggie15
    maggie15 Member Posts: 855
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    Wallycat, I'm glad the swallowing test showed no strictures. I suppose the tech might not know about meds for spasms. If spasms had shown up that would have been reported to the gastroenterologist who could prescribe something. Mint lozenges are supposed to be a useful OTC aid for esophageal spasms. It's also a good excuse to have a piece of candy (if you like mint.)

    My current doctor who has just finished his three year gastro fellowship is staying but only seeing liver transplant patients. I was his first hospital admission from the ER during his initial week of internal medicine residency five years ago so I've seen him progress through his practical medical training. He tweaked my GI meds and scheduled my next surveillance endoscopy. He also picked one of the incoming fellows to be my doctor for the next three years. Before she went to med school she taught math abroad and was a breast cancer clinical trial research assistant so he figured we had several common interests.

    Sunshine, I hope your EGD went well and they came up with some answers for you.

  • wallycat
    wallycat Member Posts: 1,245
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    Maggie, I'm not a big fan of candy but do have peppermint oil; I'll keep that in mind. I had a doctor watch the procedure and coordinate this with the tech and it was the doc who didn't know about the meds; I know…nuts. Maybe he's "just" the radiologist and he is not GI specialty.

  • sunshine99
    sunshine99 Member Posts: 2,591
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    Wallycat, I’m glad your swallow test went OK, but sometimes it would be nice if it showed something that could be treated, right?

    My endoscopy went well. Here is the copy/pasted post from another thread:

    Good morning, ladies. I'm still feeling a bit muddle-headed, so I'll just give you a brief update.

    Procedure went well. I remember some discomfort, but no gagging, etc. The nurse who admitted me said I was getting the "best" doctor there. She kind of whispered it, and gave me a thumbs up.

    Summary said normal mucosa, no esophagitis, no Barrett's and no ring seen. However, esophagus appeared spastic, and distal esophagus was very tight. They had to switch to a smaller scope and noted the procedure was "difficult." That was probably what I felt during the procedure.

    Woke up fine, put my shirt and shoes back on and they wheeled me out to Marty's truck. A little nausea after I got home, but not bad. Slept on and off most of the day.

    Oh, and he took some biopsies. I should hear within a week.

    Thank you for the encouragement. It really helped.

    Love to all,

    Carol

  • wallycat
    wallycat Member Posts: 1,245
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    Sunshine, glad to see your post. Did they indicate if they dilated your esophagus? I was told if I could swallow the 4.5mm tablet, I'm "good" to go…so it seems spasms are more common than I thought.

    I hope your biopsies come back unremarkable. Let us know how they proceed with you. Unless I hear differently, I'm done with this and can revisit a 3-5 year follow up to see if there are any changes.