barium swallow and modified upper GI

Some of you may remember last August when I was eating and then suddenly could not breathe (again) and Marc had to jump up and give me the heimlich and my granddaughter was sitting there witness to the whole pissy mess, if not you can read about it here, and I promised everyone I would go to the doctor about it.  Well, I had my annual last week and I mentioned to my primary care doc in an oh-by-the-way manner about the freaky spasms and the choking thing and before I was finished talking she was writing down orders for a barium swallow test, a modified upper GI test, a chest x-ray, and a referral to an ENT. So there was plenty of fun to be had in my immediate future.

I got the x-ray right away and they scheduled the other two tests for last Monday and they had to be on an empty stomach, so nothing to eat or drink past midnight. First I talked with a speech therapist trying to tease out exactly what happens and when and how often and for how long, if there is any unifying element. There’s two issues here, one the whole spasm thing where when I swallow, the food scrapes or scratches (or something but it's always a sensation so I know what's coming even if I'm powerless to stop it) the inside of my throat and I start coughing and then sneezing forcefully and more coughing and eyes tearing and my vocal cords freeze up and I can’t talk but I can breathe fine throughout the whole event. And then there are the three times when I couldn't breathe and I think I’m choking and Marc does the heimlich on me which opens my airway barely but enough air to work through it myself, inhaling with that horrible sound and exhaling as hard as I can until I can gradually breathe completely again. And then there's the times when I aspirate tiny amounts of liquid, a few drops getting past before the glottis or larynx closes off the airway. Or when food starts to fall into my esophagus before I'm ready to swallow. Eating, it's all fun and games kids.

The speech therapist isn't convinced I'm choking in the literal sense, in that she doesn't think I've aspirated liquid or food since there is no food being expelled when Marc heimlichs me and also because if I was choking in the literal sense, once the obstruction was expelled then the airway is immediately cleared and that's not what happens with me. It's more like I'm suffocating because my airway has been closed off. She says it's a possibility that my vocal cords (larynx) are responding to some sort of stimuli which causes them to flatten out and obstruct my airway. Turns out two things happen when you swallow...the glottis closes and the larynx flattens out, both of which act to protect the airway.

So the first test was to swallow this thin barium liquid while she and the radiologist watched and conferred on the x-ray. I was turned to the screen so I could watch too. The first thing I did when they turned the screen on and I could see my skull and jaw and teeth was laugh. I mean we all know there's a skeleton inside us but to see it in real time and watch myself swallow was weird. The point of this test was to see if whatever it is that happens that causes either the spasm or suffocation happens while they can watch but of course, it never does. There were four thicknesses of this stuff but she passed over the middle two and went straight to the thick 'pudding' of barium, then with a bit of graham cracker mixed in but still no cigar.

Then they had me drink a bit of fizzy stuff to get air in my stomach and then this other medium thickness barium stuff a few swallows at a time while they watched further down the esophagus and from different positions. I couldn’t see that part. Then I had to drink a whole cup of the thick barium which was about the consistency of a milk shake but it didn’t taste nearly as bad as I had feared and they took x-rays every 30 minutes or so until it reached where the upper and lower intestines came together. They said everything looked good and I could go. They’ll send the test results to both my doctor and the ENT I went to see the following Thursday. The speech therapist also gave me a lot of printed info on swallowing disorders and strategies for coping with it. I went home and finally got to eat around 3 PM.

TMI? Not yet.

It would have been nice had they given me a little warning about what to expect when it all came out the other end. Seriously ooky.

wrapping up the week

Today we leave for Dallas. We found an alternate route that keeps us off the interstate almost the whole way and it only takes 3 minutes longer...5 hours and 15 minutes in all. I thought it would take 6 minimum. We are going to attend and celebrate our great-nephew's Bar Mitzvah. I can't believe that kid is 13 already, especially since we went to his father's Bar Mitzvah. 

While we're in Dallas I hope to be able to drop in on the gallery there that has some of our work, Kittrell/Riffkind, especially since we got a check in the mail from them this week. They sold the Wren Box.

I finally got a start on the new flower bed I've been wanting to put in towards the back of the Big Backyard but in front of the one where the poppies and banana trees are. Eventually I'll connect it with the long bed on the side. Anyway, I got the perimeter stones moved back there and put in place. And put the plants still in their pots inside the perimeter. Now I'm slowly digging up the grass, something I'm less than enthusiastic about. It will all have to wait now til we get back.

My sister and I went to another estate sale today but it was, like the last half dozen or more lately, just a bunch of junk, although I did buy one item at this one and one at the one before, both purchases setting me back $2 each. One was this little cluster of vases which I've had filled with pansies this week but forgot to take a picture when they were fresh 

and the other, a glass chimney for a lamp. I bought an antique lamp a year or so ago at one of these sales and decided it used to have a chimney that helped keep the top globe in place so I've been on the lookout for one. This sale was out in the middle of nowhere and it confused Siri as she was telling us we had reached our destination when there wasn't a house to be seen in any direction. You never know what you are going to come across driving on these county and small town back roads and so on our way back we passed this field full of plastic car bumpers. 

I suppose you could say they have a bumper crop! (OK, I stole that joke from my sister.)

So some of you might remember when I choked last summer (and all the other grisly details)? Well, I had my annual physical Tuesday and I mentioned to her about the whole spastic throat thing and the whole choking thing and the having to be heimliched three times thing and before I was through talking she was ordering an x-ray, which they did then, and now I have to go back Monday for a modified upper GI and a barium swallow on an empty stomach and my appointment isn't until almost noon and then I have to go see an ENT doctor. So, I've kept my promise and been to the doctor about it.

I meant to take a picture of the baptismal bowl slumped in the mold that our friend Gene was making here last week but I forgot (you can see a picture of the fused blank here) but this is what the finished bowl looks like.

Well, I guess I ought to get these last minute things taken care of so we can get on the road.

of all the ways to die

I used to think I was going to die in a car wreck since I had been in so many but then that stopped happening though I am aware, every time I get in the car on the freeway, that that is a possibility. I used to be afraid of drowning, not because I couldn't swim, but because I always thought it would be a terrible way to die but I've since read that it isn't as painful and horrible as I imagined. I would like to die of old age in my bed, peacefully, without being ravaged by some disease but I'm thinking now I will probably just choke to death.

Anyone who has known me for a long time and has shared enough meals with me knows that sometimes my throat goes into a spasm while I am eating when something scratches or touches a sensitive spot which produces coughing, sneezing, frozen vocal chords but no choking. And then there are the times I actually aspirate liquid or food and choke a little because that little flap that covers your airway when you are eating or drinking doesn't always work properly. This is one of the reasons I'm a slow eater.

Once, I was dreaming I was eating candy and my mouth started watering and I aspirated saliva to the point where I could not breathe at all and Marc had to Heimlich me a couple of times. That was kind of scary since I wasn't even eating or drinking anything and was sound asleep. And another time eating, that was worse, when my eyesight started going gray around the edges before I could breathe again.

So last night we had just sat down to dinner, roast with potatoes and carrots and I'm chewing my first bite of roast and all of a sudden I can't breathe, my airway was completely blocked and my first attempts at trying to clear it were unsuccessful. Marc jumped up and Heimliched me a couple of times which dislodged the obstruction just enough that I could start forcing some air in and out.

This was the third time he's had to do that but this was the first time I pissed myself. And by that I don't mean I just wet my pants a little, I mean my bladder totally let go and by the time I could breathe a little easier but still struggling, I was standing in a puddle of urine and my pants were soaked. I knew it was happening in a distant way, just as I knew Autumn, who is visiting for her week, was watching with a look of horror on her face, but my whole focus was on dragging air into my lungs and expelling it as forcefully as I could to remove whatever was blocking my airway. At this point I knew I wasn't going to die and after a few more minutes I could breathe more or less regularly. 'Well', he says, 'that hasn't happened in a long time'. 'It's happened before?!', Autumn exclaimed.

'I'm sorry you had to witness that', I told Autumn as I went to change clothes. The only word I heard of her reply was 'traumatic'.

Yep. For me too.