Today’s Medical Report

Today was my appointment with Dr. V. Alin Bottoman, who I saw because a friend highly recommended him. If you haven’t read my insurance saga, it might be appropriate reading. You may read that at: April 2007. My previous medical update is at March 2007, and lastly if you don’t remember when it started there’s this blog post September 2006 and this post August 2006. That will get you up to date. Done reading? Good. Now, I can start where we left off. This bit will take you from the March 2007 post to today.

As you’ve seen, I spoke with Doctor Newman a few days later and he said the results were excellent. There were no tumours, ulcers, or any sign of any problem whatsoever. He said I had a very small hiatal hernia, which is normal in people my age and it was nothing to worry about and wouldn’t be the cause of the reflux. As you can also see, as evidenced by my anti-insurance posts, I went back to Doctor for my follow up visit. He used the camera through the nose device, said nothing was wrong, and referred me back to Doctor Newman who he said was my doctor for everything except the granuloma. Not overly happy with being shunted off, I called Doctor Newman who said to continue the twice per day Nexium and add a Zantac mid-day. I’m doing that, but I don’t want to take drugs long-term. Something caused this, and if we can find the cause we can fix it.

The simple fact is my acid reflux is not getting better despite all these medications. I can taste it in my mouth on-and-off on some days a sour taste in the mouth. I have embarrassing large quantities of gas all day and all night. My throat is very sore, especially on my left side near the top and swallowing is a chore — if I press the spot with my finger, I can swallow with almost no pain. I find that odd. My voice sounds terrible. The problem is worse in the morning, especially when I first wake up.

My stomach has a constant dull ache that has only started since the Endoscopy (though I don’t think that it’s related) I suspect it’s the gas build-up. I am also getting sharp-stabby pains in a few very specific spots of my stomach, also which started since the Endoscopy. They don’t last long (2 or 3 seconds) but I sure as hell can notice them. One spot is worse than the other two. It happens 3 or 4 times per day, randomly and in varying degrees. And now, you’re up to today before Doctor Botoman. Aren’t you glad I had all this free time to type this for your reading pleasure?

The doctor’s office gave me a ream of paperwork to fill out: questionnaires, surveys, and the usual health crap. Then, of course, I waited. There’s nothing like a doctor’s office to wait in for the sheer boredom effect. Then they called me in and the nurse came in with a laptop and asked me many detailed questions, and typed them into the computer. Prior to my visit, I had faxed a two-page report on everything that happened to date (which, happily, was already in my folder). I also vented about my Aetna problem and she laughed (friendly) and said they’re all bad so I shouldn’t be too mad. Then she said the doctor would be with me shortly. She also informed me I look like him (I disagree) and I’d see when he came in.

A good 35 minutes later, he appeared. And he immediately apologized for the delay. I liked him already. No doctor has ever apologized for the wait. He explained the network went down and he needed all the stuff the nurse typed in, so he had to wait for it to come up. He asked me lots more questions.

First, he agreed that there’s obviously something wrong despite the fact there was nothing on the Endoscopy. Second, he believes Nexium doesn’t work in some cases and I may be one of them. He is postulating that my body is metabolizing the Nexium faster than it’s released from the capsules, though he recommends I continue to take it 2x per day for at least 3 more months. He also said the morning dose is far more important than the evening dose which is against conventional wisdom.

(The part from here to the end of the post is heavily edited for on-line viewing. I’ve left most of it out; lots of gory details, and the bulk of the results. The report is available to friends and family by inquiring via e-mail.)

First up for me is a poop test. Once I pass that I get my first pH test which is done by inserting several electrodes into my nose and down into my esophagus which stay there for 24 hours. I then wear what looks like a purse for 24 hours (it contains the recording devices and such).

He feels there are several outcomes. If I do nothing, I have an extraordinarily high-risk of esophageal cancer, and can die from it. Associated with that, I run a higher risk of many other severe and possibly fatal medical conditions. As such, this is a very Bad Option, though some days it looks pretty good 🙂

There are several options: all of which involve surgery, none of it minor. There’s actually an even worse-case option, and that is the source is not found. Since the drugs aren’t working, this would present Big Problems.

However, he’s confident we’ll figure it out. My Acid Reflux suddenly changed and there has to be a cause. It’s a matter of systematically finding that cause. He doesn’t want to operate unless there is absolutely no other choice, and I whole-heartedly agree.

And if you’re not a doctor, please don’t offer advice. Some of the helpful advice I’ve received so far has seriously worsened my condition, so if you’re not a Gastrointestinologist, your advice is appreciated deeply but entirely unwelcome.

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