What I Learned at the Gastro Appointment

So I finally did it, I saw my gastroenterologist to discuss my digestive problems. For more than five years, my long-suffering MS body has systematically protested the introduction of most kinds of foods into my stomach and intestines. The resulting gas pains consistently register a 10 on the pain scale despite swallowing digestive enzymes before each meal. Why do gas pains rate a 10? Because a) I’m doubled over with pain while employing patterned breathing for childbirth and b) I beg God for deliverance despite being an atheist. When the pain subsides I feel a moment of shame about the false promises I’ve directed on high, but if he’s the magnanimous dude Jeffrey Hunter said he was in KING OF KINGS, then he won’t hold it against me.

The gastro spent a long time asking me questions, some about medications, several of which can cause digestive problems, and lots about my symptoms and when they occur in relation to eating. I mentioned having severe gas pains several times. Then she pressed me to describe the gas pains.

“What do you mean by gas pains, what does it feel like?” She said, leaning towards me.

“I don’t know,” I snapped, thinly veiling my irritation, “it feels like gas pains.” Who doesn’t know what that feels like, I grumbled to myself.

“Is it a sharp pain?” she asked, turning back to her computer and clicking away at the keyboard.

“Yes, sharp.”

“Feel like a cramp?”

“Yes, a sharp cramping pain. Brilliant,” I barked back. How often I have wished a doctor would show this kind of curiosity during an intake session and so meticulously explore my symptom history. Be careful what you wish for, I mused.

The fact is, I had become exhausted by the interrogation. The last time I was asked so many questions was in 1967 during Catholic confirmation rehearsal one week before Bishop Fulton Sheen ritualistically slapped my cheek and pronounced me a soldier of God. We were to prepare ourselves for what he might ask us. I recall 25 as a number being thrown out there for possible questions the Bishop might ask. It might as well have been 25,000.

Unlike for my gastro appointment, I did not prepare well prior to the Confirmation ceremony; at ten years old, I was much too terrified of the Franciscan nuns to be able to have a coherent thought.

My 58-year-old lapsed Catholic self is still terrified of authority figures but very practiced at smoothing over it by obsessively reciting facts in my head. Since I’d waited five years to talk to the gastro, I wanted to be thorough and updated my meds list to present to the nurse, rehearsing the litany of symptoms for days beforehand, being sure to note the various ways I’d attempted to relieve the discomfort, treating it as if it is IBS—to no avail.

At the end of the interrogation, the doctor presented her differentials, of which gastroparesis was not included. I asked why.

“You didn’t complain of nausea,” she explained. “That would be a red flag for delayed stomach emptying.” My momentary confusion was immediately displaced by relief. One less thing to test for, I told myself. It’s all good. The gastro ordered blood work to test for Celiac disease (gluten allergy), a metabolic panel, CBC, an upper endoscopy and colonoscopy.

The tests came back quickly. Everything was normal except my potassium was dangerously low at 2.9. I was told to contact my primary doc and ask if I should discontinue my diuretic. My primary doc advised me to do so and ten days later, my ankles swelled up like dirigibles ready to float their gastric-challenged cargo over the Atlantic. I gained six pounds during those ten days, too, which was, to my mind, obviously water weight. I resumed taking the diuretic and immediately deflated, my weight returning to normal within a week. Doctors don’t always give you great advice. She’d forgotten, as I had, that I started the diuretic years ago because of ankle edema. Gotta stay on top of my history, can’t expect my docs to retain these details.

June 9th is my upper and lower endoscopy/colonoscopy. I had them done the first time seven years ago, before my gastric problems began. I’m banking on negative findings and a plan to treat my condition as IBS, controlled with diet and supplements. My continuous belly distension and bloating will not go away if this is my fate. I’ll have to learn to love digestive enzymes and big tops that hide my Humpty Dumpty belly. I suspect that not much will change.

The paths to religious salvation and gastric healing are paved with small humiliations. Spiritual humiliation promises succor in heaven. Irregular bowel habits promise a lifetime of dependence on adult diapers.

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