And The Beat Goes On... Revision AGAIN!?

Nov 14, 2018

I've managed to drop almost 15 lbs since we've moved to paradise. The active ocean and beach lifestyle compliment my weight loss efforts. Snorkeling, swimming, paddleboard, kayaking. I'm keeping active. 

A month back I finally decided to meet up with my new primary care MD, Dr. Roderick Morgann. When I talked about my history of bariatric surgery and my reflux, he referred me out to the GI doctor, Dr. Scott Kuwada. I met with him and did a few tests. One of which was a manometry and the other an upper endoscopy with Bravo. They installed a temporary sensor in my esophagus to take measurments of the PH (Acid) in my esophagus. This would be used along with the images of the EGD to score me in terms of how extensive the Gerd is. 

POST-PROCEDURE DIAGNOSES:
1. Abnormal 48-hour Bravo pH study with DeMeester scores elevated at 48.5 on day 1 and 91.7 on day 2 with normal being up to 14.72.   WHAT!!!! I guess I already knew this. 10 years of band regurgitation + Sleeve heartburn. 
2. Heartburn was correlated with reflux on both the symptom index and symptom association probability scales 

So Dr. Kuwada referred me to Dr. Kenrick Murayama. He is one of the head surgeons at the John Burns School of Medicine. We talked on Monday and he sent me for an Upper GI barium swallow to get some images of the pouch and shape of the sleeve. 

This morning the Barium swallow was a train wreck. No really, it was laughable. I explained my history to the rooming tech. The tech and the radiologist were both there for the procedure, which I though was a little weird. The radiologist has never been so hands on during the procedure before at least at other facilities. And after today, he may change his mind about being so involved. After the bubbling pop rocks I swallowed, I stepped on the foot of the bed and they handed me the barium. I took my first few sips. We joked about my limited real estate in my belly. I told them I really thought there was too much barium for me to get down at one time. After a few larger sips, I told him I felt I had hit my max and he assured me there was more room than I realized. He could see it on the screen after all. A few more sips and I got it down just as he said. They took a few pictures and started tipping the bed. As they tipped me back I started swallowing trying to keep it down. I told them it felt like it was coming up. I was flat on my back at that point. I gulped another bit of air trying to get it to stay down but then they tipped the bed just a little more so I was now upside down (ish).

"It's coming up!" The assistant ran to get the blue puke bag but was too late. I hurled that thick barium all over myself, the machine, and the radiologist shoes. Because he was so fixated on the screen, he didn't move out of the way fast enough. He said he'd never seen reflux so extensive. He said, "WOW! So you never eat before bed right?"  It was like there was no sphincter at all above my sleeve. Is the sphincter working? Am I broken? Is it the pouch that was created too high? IDK! 

He decided that he got all the images he felt they needed and that we did not need to proceed with more thick barium and certainly no thin barium. They got me cleaned up and he said he would indicate his observations in the report. I call the referring MD and told them I wasn't able to complete the test and was looking for direction if any were needed before my follow-up on Monday. Oh what fun... and the beat goes on. 

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