Saturday, March 20, 2010

Voyage to the Bottom

$2200 SGD Capsule (Pill) camera... PillCam® SBImage by David Yeo T. B. via Flickr
More on my poor GI system:

Just had a capsule endoscopy, which is basically swallowing a camera that takes pictures of the small intestine.   According to the Mayo Clinic's web page on capsule endoscopies, capsule endoscopies are done for the following reasons:
  • Gastrointestinal bleeding. Capsule endoscopy may help your doctor find the cause of gastrointestinal bleeding if other tests and procedures haven't been conclusive.
  • Crohn's disease. Capsule endoscopy may reveal areas of inflammation in the small intestine that can help your doctor diagnose inflammatory bowel diseases, such as Crohn's disease.
  • Cancer. Capsule endoscopy may show tumors in the small intestine or other parts of the digestive tract.
  • Celiac disease. Capsule endoscopy is sometimes used in diagnosing and monitoring celiac disease.
  • Polyps. People who have inherited syndromes that can cause polyps in the small intestine may occasionally undergo capsule endoscopy to screen for polyps.
  • Follow-up testing after X-rays or other imaging tests.
I am starting to wonder about all this poking about.... The medical profession is not doing a really good job at explaining if they what they are looking for  and what the path is to trying to diagnose conditions.  All I can see from both mine and other people's problems is that they seem to have a panel of tests, many of which are pretty invasive or not discussed in polite company,  that they seem to like to do.  The whole thing would be a lot more bearable, if the doctor could say, I am looking for the following conditions with this test.  Now, with the results of this test, I am confident that you don't have X, Y, or Z... so maybe, let's press on and look at disease A, B, or C.  But, I don't quite get much of an explanation as to what we are doing and where we are going.  All, I know is I've done an endoscopy, colonoscopy, fluoroscopy (you know, this is starting to be a lot of "oscopies"), given some blood and other samples and we are coming up bupkis....except that we are noticing some problems with fat malabsorption, vitamin deficiencies of B12 and D (first noticed by a nutritionist),  and some wheat and lactose intolerance.  Now we want to do another test.   So, here goes.

Yet, if there's any hope at getting to the bottom of this (forgive my pun), I must do what the doctor wants as gracefully as I can.  So, I keep my gripes to myself... well, maybe my poor family gets to hear them!  I don't suffer that silently or endure as graciously as the ever patient Griselda of Chaucer's Canterbury Tales! But, in the interest of being a good, compliant patient, that the doctor is happy to labor upon, I am quiet in the hospital about all the poking.

The day before, I had nothing to eat except chicken broth, sprite and jello.  Took some Miralax before I went to bed to start making sure that my digestive system was moving along nicely.  The day of the procedure, I get up bright and early... well, actually, I slept in till the last possible moment because I didn't want to wake up and think about being hungry or wanting coffee. Had some more Miralax and then rolled back to sleep.  At the last possible moment, I threw on my clothes and then jumped into the car to be at the hospital by 7:15 am.

When I got to the hospital, the nurse took me in right away and started attaching a series of electrodes to my chest and abdomen.  The electrodes are attached to a recorder which is about the size of 2 Sony Walkman's.  I wear the recorder on a belt.  The nurse made a remark about being careful if I go through airport security these days.... She said the old recorder was even more suspect when it was read on airport security machines... as it was a harness with a belt that looked suspiciously like a suicide bomber's harness.

She had me swallow the pillcam that you see in the above picture.  The pillcam has a camera and a lens which transmits pictures to the recorder.  Despite its size, the pillcam went down the hatch easily and began its voyage to the bottom. 

The rest of the day was OK.  I had a small amount of nausea and food in my GI system moved a bit too swiftly along.  I spent the day at home, not wishing to go to far afield.  Later in the day, I returned to the hospital where the removed the leads and the recorder.  The nurse told me I would receive the report in about 7-10 days as someone downtown in Philadelphia will read the pictures and send a report back to my doctor.

Here's a video of what a capsule endoscopy can see of the small intestine.