Endoscopy (upper GI)

I'm due to have a urgent upper GI endoscopy and a colonoscopy (joy).

My GP (who actually just left, but she put the referral in) used to be an anaesthetist and, knowing how brittle my asthma can be and how I go into total bronchospasm in response to minor things like temperature changes, has requested that it be done under general so that I don't have the trauma of a severe attack and then being intubated - her feeling was that they need to manage my airway throughout.

There's also a bit of a pre-existing PTSD aspect for me, so staying calm is likely to be challenging even if I don't go into bronchospasm.

I'm just wondering whether anyone else with sudden-onset nasty asthma has had an endoscopy and whether it was done under GA or under local + sedation?

Thanks!

Cx

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Hi curiouser,

I had my last gastroscopies done with heavy sedation, I coped very well afterwards in terms of my lungs - and with respect to the procedures, I don't remember a thing. This was decided (sedation rather than GA) because when I had my cardiac ablation done, they decided to give me a GA to be 'on the safe side' and as I came round I had a massive long asthma attack - it seems that since the deterioration in my lung function, my lungs dont cope with GA's.. but everyone is different. For me, a GA is avoided at all costs unless Im in a dire situation. However, alongside the asthma I also have severely restricted lung capacity and only 11% small airway flow, so its probably a bit like comparing apples and pears. All my previous GA's (Ive had lots) have been without incident, but that was the only one I've had since my lungs and asthma have been unpredictable in terms of sudden deterioration.

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I don't know if you've had the procedure yet - if so, hope it was painless and you are recovering well. If you are still waiting, hoping it is a less anxiety producing/triggering experience than you are anticipating.

Take care, beth

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Thanks NF and Beth - I'm in St James's again on the gen med / endo / diabetes ward as I went into full adrenal crisis on Weds morning last week. Grim.

I'm having the endoscopy hopefully on Monday, but not the colonoscopy yet. I've decided to just let the anaesthetists decide what is best - they prefer not to have to intubate semi-awake patients in bronchospasm or kill the young healthy-ish ones as far as I can tell, so as long as they know it's a possibility I'll be happy with their choice.

At this point no procedure could be worse than how unwell I was on Wednesday. We had an appt at the diabetes clinic here that same morning, so after doing an emergency HC injection at home my partner managed to somehow get me to that (having literally had to hose me down and bin my PJs - awful) and then the consultant admitted me direct to his ward without having to do any A&E/MAU shenanigans. I'm in a bay with no dementia patients as well, so that's nice - it's almost quiet enough to sleep at night.

My asthma is actually behaving as I'm on sick-day-dose HC and double Seretide.

Was five-stone-twelve on admission... the purpose is to find out what's causing the GI issues, whether my oral candidiasis is systemic (and treat it), get a better picture of the diabetes and try out some treatment for it before I go home, so I'm eating and drinking tons of carbs as they want to find out just how knackered my insulin production is and then see which treatment option (insulin production enhancement or insulin itself) is the right 'fix'.

They are also looking at grand-unifying-theories-of-everything in a House style... kind of fun as long as none of them actually turn out to be correct!

The staff have all been lovely apart from the consultant who came round today who was a total idiot. I could hear him being rude to all the nurses and HCAs and helper staff on the ward as he made his way along, clearly doesn't really 'do' patients normally. Luckily the nurses and aux staff all did appropriate eye rolling and so on after he had gone and made it clear that he's always like that.

Ta for well wishes, will let you know how it goes!

Cx

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Oh no! So sorry to hear you have been so unwell. Im pleased you seem to be being well looked after on the whole and hope you feel much better soon.

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Thanks for the update. That sounds rather scary (the first bit - full adrenal crisis). Hope no fancy ""House"" theory pans out and it turns out to be something that is easily correctable. You've had such a rough year and really deserve some good news.

Glad to hear that at least the asthma is behaving.

How are you managing all the carb loading given all of your food/GI issues? Or are there certain foods you can eat with abandon without too much discomfort?

Keep us posted as to how things go.

Hoping you feel better very soon.

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Thanks guys,

Beth - basically I'm in huge discomfort. Feels awful - every swallow is now pretty much agony, and I feel sick as a dog due to the high blood sugar. And can't take any painkillers other than paracetamol as all would further aggravate the GI issues. Things that are less aggravating are all low-carby, and the purpose of being here is to tax my pancreas in a safe environment so even if we could score it, chicken-soup wouldn't be suitable.

But I'm consoling myself with the fact that at least when they shove the camera down there they will have plenty to look at, and the benchmarks we're setting for sugar levels when eating carbs will allow us to tackle the diabetes head-on as soon as I've been scoped.

It has been a bit of a rough year, but I'm hoping this is the final hurdle. There have been patches of great health as well so I'm in many ways still in a better place than I was at Xmas when the asthma was just spiralling with no 'reason' why.

In the end nothing is quite as debilitating as not being able to breathe - so although the crisis was awful, we at least know how to treat it and you are never left sitting in A&E with them scratching their head over your peak-flow!

I'm setting myself the goal of running a proper 10k or, ideally, a half-marathon, September next year, and being 15% heavier than I am now at the time!

Off to sleep now...

Sx

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Just checking in to see how things are going. The marathon goal sounds wonderful. Hoping you figure out a way to make it happen.

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Hi Beth,

camera-down-the-throat went well really. Unfortunately I had a bit of an asthma flare up (just a few puffs of reliever required) in response just to the throat spray, so they only gave me half the sedation they were planning. Hence I was very much aware all the way through, but I did manage to handle my airway. They said it would be safest if I was with it enough to know that I was having trouble, and they had my inhaler and spacer and epi-pen right there, and I just had to raise my hand to use them (didn't need them thank goodness).

I had such a killer sore-throat afterwards though - where the camera pipe rubbed up and down against one of my tonsils. That was unexpected - I've only had worse tonsillitis once I think. But it's getting better slowly.

They found an assortment of minor things - I have a 3cm hiatus hernia that I've probably had since childhood, and which explains why I've never liked eating lots in one go or high fat content foods, and also explains why my airways get so aggravated when I eat certain things (eg anything with sulphur dioxide in) - nice to have that confirmed as not-just-in-my-head! Minor gastritis (a bit of ulceration) probably from the anti-fungals. The candidiasis is restricted to my mouth and the top of my throat.

I had a very good consult with the dietitian - she said there's not really much else I could be doing with my diet.

I'm now waiting to have a scan of my pancreas and some other bits and bobs... they said it's almost certainly 'just' the diabetes messing everything up, but they want to be 99% sure that they haven't missed something else significant.

I'm hoping that if they do decide that the diabetes is the likely culprit then I can start on micro-doses of fast-acting insulin at mealtimes pretty much immediately. There are other drugs that give you an alternative but they're much newer and the dietitian said that in the end insulin is the best match to how our own body works and gives you the most flexibility in terms of tailoring for exercise, sick days etc. The other alternative - gliptins - is meant to make your pancreas more responsive, but nobody has lived with them for very long yet - and I don't really want to be in the first batch of users who find out 20 years later that they cause serious long term problems. If I was 70 it would be different I think...

Sx