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147426 tn?1317265632

I had my test - Ugggh!

I had the esophageal manometry test yesterday and it was one of the more horrid things I have had to do.  Given the choice between prepping for the colonoscopy and doing this - I'm afraid I would opt for drinking the gallon of GoLytely.

They put a tube that had pressure transducers every inch or so down my nose into my stomach.  For some reason my nasal passages are very small, and the pain in my nose from the pressure was very intense.  I was able to tolerate the 30 minutes of small movements in and out and the swallowing of water, but when they brought it back up to test the upper sphincter at the top of the esophagus the pain was excrutiating.  It felt like I was giving birth through my nose....   I was lying still and obeying, but I was crying and the tech stopped the test because of the pain. Now, I just hope that section we didn't do isn't the section that the GI doc was most interested in.

I'm sure my esophagus performed flawlessly.  I am dreading the follow up visit where I get to hear that everything looks just fine.  The doctor is too nice to imply that nothing is wrong, but it is hard anyway.  I feel like I've made a mountain out of a molehill.

Which brings up the visit with the Physical Medicine doc on Friday.  My arm which has hurt for the last 10 months is feeling quite good this week.  But, it has improved before only to get really bad agian.  I had to wait 6 weeks for the appointment so I am going to see him anyway and describe it as best I can.  I really do think it is an inflammatory process.  I feels just like a bad tendonitis I once had - escept that it involves my hand, my entire forearm, most of my upper arm and part of my shoulder (sometimes).

Also it gets much better after my steroid infusions.  I've gotten to the point that I am using my left hand and arm (non-dominant side) far more than my R side.  I note that my R biceps stays really firm and rounded like I was working out with it instead of using it less.  I wonder if there is some spasticity there.

Everything in my wants to take a break from seeing doctors, BUT.....my urinary troubles are getting much worse.  A year ago I had urge incontinence and would occasionally leak several drops on my way to the BR.  I have found that I cannot rush to the BR to try to get there in time.  The faster I try to go, the stiffer my R leg gets and the slower I end up going AND the more I leak.  (BTW - that is a perfect example of the "velocity-dependent" quality of spasticity.  The fast you attempt to move the spastic muscles the more they lock up and stiffen.  I'm sure many of you can relate)  I have to just saunter along, trying to squeeze muscles that I can no no longer feel, and hope for the best.

Well, in the last several months, it is not just a drop or two.  If "any" leaks out then the whole bladder just merrily empties.  I am mopping the floor 2 to 4 times a week now.  Thank goodness for hardwood floors!  So, it is time for me to see her.  A year and a half ago she wanted me to do pelvic muscle physical therapy.  She said she had a PT that was just fabulous.   I just didn't want to be bothered  AND it seemed embarassing to go to this person for pevic exercises.   Besides, I had always done the Kegel exercises and was proud of the strength I had.  Now when I try the Kegels nothing contracts, nothing moves.   Sheeesh...

So, I am down an upper endoscopy (fine), a colonoscopy (fine), a gastric emptying study (I assume it was fine because they cancelled the 2nd half of it (liquids) and the only reason for that would be it the first half (solids) were normal, and now an esophageal motility study that appeared to be normal, but that I could not tolerate.  (That was a blow to my self-esteem, too.)  I appear to have a rather perfect GI Tract......maybe I could sell it on eBay...

Just an update.

Quix

22 Responses
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405614 tn?1329144114
Well, shoot!  If you ever want, I mean need to try that  test again, you can go for the left side.  It still doesn't sound like it would be comfortable, but at least maybe not as horrendous.

Reminds me that I should finish filing all my many MRI's, CTs, X-rays, discography, MRA, nuclear medicine scans, DEXA scan, Pulmonary function test, EEG, etc. etc. etc.  I suppose an index of all the tests would be a good idea, too, to help keep things straight, and remind me of things forgotten.

I also have piles of papers sitting around, plus the bags that I stuffed piles of paper in when I had company coming!  I think that's pretty normal. Well, for me and my friends, anyway!  :o)

Kathy
Helpful - 0
147426 tn?1317265632
I feel silly.  My sis and I were straightening up a couple years of paper I had piled on my desk.  I cam across a CT of my sinuses I had a few years ago.  I have a deviated anterior septum on the R side.  Yes, the side and the location of my exquisite pain.  If we had just tried the left side.  Sheeesh!

Well, now I know.  Had not clue of this before.

Q  :o))
Helpful - 0
488264 tn?1226520307
Just to add in as a narcotic induced constipant (is there such a word?).  Sodium picosulphate laxatives are the best for counteracting inertia of the plumbing, they stimulate the gut movement.  Some, like macrogol, even work quite quickly (well they do with me anyway).  If things are really hardening up the indigestible sugar versions of laxative  (lactulose?), will bulk up the nasty little undesirables as they draw water into them, and as a bonus soften them up, downside is not to have anyone standing downwind of you, they do have a musical and 'aromatic' side effect which put me off them to be honest.  Senna is an old faithful, I take a bit more than the recommended dose, pharmacy leaflets are a bit too conservative with their estimates when you buy over the counter, not that I'm recommending anything - just telling you what I do.  Glycerin suppositories also do the job but you have to have the self control to hold them in long enough for them to dissolve, which is hard as they make you want to eject them pretty quickly (it's fine to put two in - put them in flat side first, the opposite to what you'd think, and some KY gelly will help, but not too much, or they'll shoot out of your hand)

For the serious nothing else will shift this monster situation a phosphate enema or two (not together, see if one works FIRST)  will work almost immediately and are absolutely horrible, but get the job done if somewhat explosively - save them as a last resort, they can cause internal damage with the strength of their purging effect, but my goodness they work. They will only clear lower bowel problems, if you are constipated higher up you need to deal with this with the oral laxatives at the same time.  Also diffiicult to do yourself, as you run the risk of inserting air in with the liquid, this is not harmful but is excruciatingly painful when you try to void minutes later.  Best thing is not to get into such need in the first place.

Never ignore constipation, left untreated the toxins built up in the body are very bad.  If you get to the point where you are vomiting you need to get to the hospital, the bowel has likely impacted, beyond anything you yourself can do for it, and the food has nowhere to go from your stomach but back up again.  

If like me you take regular narcotics, or have reduced bowel motility from MS, or from lack of movement, best to take a prophylactic (preventitive) laxative most or ever day.  Also those fibre supplements which you can add to drinks are pretty good.

Am not proud of having so much knowledge on this subject, but have, so must share.

I know less about the upper GI tract other than what I said earlier, any problems ensure you take small mouthfulls and leave enough time between one swallow and the next.  Used to hate it when care staff rushed elderly patients throught their meals.  Trying to rush your food when your swallowing is compromised is not safe.  

Right, third mug of tea needed and some cartoons needed to be caught up on.  Have the silly mags piled up on the bedside table.  Back to reality this afternoon - oh, it is this afternoon, well then lunch too and then back to normal.

Good health to all

wish

One more thing I thought of.  If you find you are 'messing' yourself, but feel constipated, you probably are.  What happens is the normal stools further up the gut push around the impacted bit and come out spontaneously.  This is known as overflow incontinence, and stops as soon as you clear your bowel.  Many people mistake the incontinence as diarrhoea, it isn't, it is constipation.  The indication is you are still straining to go, but producing liquid without control.

Lovely area of expertise I have here.  Maybe lunch can wait.

Helpful - 0
338416 tn?1420045702
Is that what you call it?   Colonic inertia is a nice way of describing a very unpleasant experience.  Nothing was moving, so all the water was absorbed, and it felt like I had been filled with cement.  Not to be too graphic, but I had to take matters into my own hand... yuck!  I hope that never happens again.

This went along with a shortness of breath (weak diaphragm?) and weak legs, and these weird seizure-spasm thingies, so now the neuro thinks something is going on in the spine.
Helpful - 0
147426 tn?1317265632
Both of those problems are classic MS problems.  Please do speak to your doctor.  For everyone:

There are several GI disorders that are typical in MS.  One is Esophageal Motility Disorder.  this means the esphagus does dont move food toward the stomach in an amooth, active way.  There is often spasm and tightness or an area that doesn't contract properly and food sticks there.

Another is constipation where the colon doesn't move stool smoothly and promptly toward the...exit.  It can be Colonic Inertia (Inertia=doesn't wanna move.  I have that all over.) or it can be spasm of the anal sphincter or slowed transit time from many of the relaxant meds or narcotics.  Plus, less physical activity contributes to constipation.

Another problem that can occur is incontinence, where the sphincter does not have enough tone or sensation and the stool exits without sensation.

Quix
Helpful - 0
649926 tn?1297657780
Dear Quix,
   You are having sooo many issues I feel terrible for you but you have helped me stop feeling sorry for myself (thanks).
   Also, I had the EM test done and choked through the whole thing. Mine came back abnormal with a diagnosis of Esophageal Motility Disorder. I also had a test on the other end ( if you no what I mean) and that came back abnormal. Diagnosis severe colonic interia. My doctors just gave me the results and blew me off. This was before my MS diagnosis and my new doctor. Maybe after hearing your problems I should bring them up to the new doc. I didn't know that this could be part of MS. I just suffer quietly like we all do most times.
   Thanks to your post maybe I will be brave and bring up yet more things in December when I have my next visit. Thanks and I hope things turn around and you have a good spell soon.
   Erin
Helpful - 0
Avatar universal
Hi,
Thank you for all your support on this forum.  Sorry I can't offer you any as I know nothing about the test you had and it sounded horrid.  I hope that they did get to look at the right bit.  Having had 3 children I think birth sounds easier!!  The things we have to go through.

I am interested in the pelvic floor thing?  The exercises you said you do??  I too have had puddles on the floor and urge incontinence as well.  I do pelvic floor exercises, the standard ones but hadn't heard of this?

Take care, you have had tests that I didn't even know existed!!  Although I am only new to this forum I read all your posts with interest.  You have contributed some very interesting  posts and articles and from what I can see a very loved and valued member of this forum.  Thank for sharing your wisdom, and taking time to help others who are scared or confused.  Take care of yourself and I hope you recover from your test soon.
Cheers,
Udkas


Helpful - 0
338416 tn?1420045702
That ordeal sounds worse than the LP!  I do hope they find something, if only because you had to go through all that.

You know, I've been having a lot of trouble lately with stuff going down the wrong pipe.  Juicy stuff, like apples or soup, I have to swallow very carefully, and really think about where it's supposed to go!
Helpful - 0
382218 tn?1341181487
Just saying hello and that I'm sorry for all that you went through this week.  It sounds tortuous and I hope that you never have to repeat that testing.  It is so frustrating to go through any testing, but especially painful/uncomfortable testing, and still have no answers.

You give so much support to the members here, expending a lot of precious energy with your detailed, thoughtful, and often hilarious posts, even as you are going through so much of your own stuff.  We are really fortunate to have you here.
Helpful - 0
405614 tn?1329144114
Wow.  I really love that you can be humorous about all that hell you've been going through (liike the 'teaching moment' about "velocity dependent" quality of spasticity, and the e-bay suggestion), but I really hate that you've had to go through it all.

My sister did the pelvic PT stuff, and she said it was wonderfully helpful.  I discussed it with the urogynecologist, but my strength from my earlier kegeling seems to be intact so far...

As for depends, I heard from a friend that Serenity makes a more comfortable product, if you do decide to go that route.  The economy versions are awful!

I get water down my windpipe; if I try to take some pills while mostly reclining, I do an impression of a fountain, as my body doesn't like to have water go there.  I've caught myself doing it with soup lately, while out to eat.  I manage to cough politely into a napkin, since I'm sitting up and not quite as much goes "down the wrong pipe" as my mom used to say.  Heck, sometimes a bite of an apple gets juice in there and sets off my choking and sputtering.  

I had my gastroenterologist check my throat a few years ago, because I felt like stuff was getting stuck (I could cough up a small piece of apple a half hour later), and he just inflated a tube in my esophaguse during my endoscopy, and said everything looked fine. Um, but this is not about me, we were talking about you.  OK, I'm relating to what you're going through.

My right arm has been very painful; I think I mentioned it once quite a while ago.  Mine was like tennis elbow, thumb tendonitis, and ulnar neuropathy all rolled together.  I had DeQuervain's tenosinivitis (sp?) when I was a grocery checker, and thought I was just getting tendonitis again, but I really haven't done much repetitive motion, and it still is bad.  I use my left hand for a lot now, too, and still have a nice right bicep for a relatively inactive arm.

When I saw my MS specialist with my flare of symptoms, my right arm was hurting really badly.  I haven't seen her chart notes yet, doggone it, but she did a lot of testing of my arms, especially my right.  She suggested I increase my Lyrica,even sent a note to my PCP, so I take that to mean that she thought it was nerve pain.

Does your arm get more painful when you use it a lot?  Maybe chop some vegetables for soup before your appointment tomorrow, and see if your arm starts bothering you more.  Not that I want you to have pain; just answers.

BTW, I think running around the house in long loose gaments without underwear is very healthy!  No compression of body parts or nerves, no irritation from elastic (no matter how nicely they cover it, just not real comfy), and much easier access to the bathroom facilities!  I have to confess that in this weather, I like to wear what my roommate calls a Granny-Gown; a long flannel nightie.  

Bunches of hugs,

Kathy

Helpful - 0
488264 tn?1226520307
Sorry to hear what you are going through.

Re the mopping exercises -  do you have "Tena" products in the States.  Their range of underwear is terrific, really.  Sounds like right now you could do with their products.  If they don't have them can you order online?  They control odour too, really excellent stuff.  And in case you're wondering I'm not on commission from them!

Just wondering what sort of preparation you had for the test, did they give you tranquilizers?  Surely if it was so painful they should have helped you with that, the gut motility would be affected a little, but they could have factored that in rather than letting you suffer.  Too late now, but if you ever need it done again maybe ask about all this first.  I am not so brave as you, if a test hurts I tell them to stop.  But you are I think much more resilient.

Anyone ever suggested EMG/ nerve conductivity testing on your arm, or have you had that done?  Just a thought if the muscles are really playing up.

I don't know what symptoms you are getting with your swallowing etc. but please be sure you only ever take small mouthfuls of food.  Am now scared of you choking!  I wonder if even if all shows up okay, but you don't know yet, the answer might be just to eat slowly.  I know you are far from old but that is what elderly people, with their slowed up oesophagal tubes, were encouraged to do when I worked with them.  If there is something compromising your passage of food to the stomach (lesion?), then maybe that's a way forward.

Always feel so awkward giving health advice on your posts, as you know so much more than me, but gave my little effort any way.

Hope you recover soon from this ordeal, and please save yourself some work and get some good continence products!  Don't like to think of you having to clean up all the time.

Let us know how you get on.  Wish you better very soon.

wish
Helpful - 0
Avatar universal
Hi Quix

The test sounds like it was torture.  You are a stronger person than I..............I would have probably gotten up and ran!!!!

I'm with you on the bladder problems, but I have to add bowel problems too.  Like you, "depends" are just not something I want to think about right now.  I'll just stay close to the potty and hope for the best.....hee....hee.....hee......

Spasticity in the arms is tough, it sounds like it might be some of your problem with your right arm. Yes, keeping that appt is a good thing.

I am so sorry that things seem to be happening in numbers now.  I hope and pray the symptoms will all just go back in their little hidey hole and give you a break.  No one deserves it more.

Hugs
doni
Helpful - 0
198419 tn?1360242356
My gosh Quix,

I can't imagine, and I wish it seemed more worth it in the end.  Least childbirth produces life,  and nosebirth? All that, and, didn't even produce answers, just pain and disappointment.  So sorry.

Well, I have had the liquids go into the windpipe. It's not constant though.  I just always chalked it up to sucking wind while drinking or something...lol...It's so not funny though.  Is that what you mean? I'll poke around and see what I can find case wise.

My arm is chronic.  It subsides a little now and again, but it's daily.  I take naproxen, with minimal results. I hope the PT works, though I see why you are hesitant to go if it's giving you a break for the moment.

I know you will move forward w/the bladder/urgency issues right?

How on this earth do we find out otherwise if certain problems are MS related or not? The only way to do so is to follow through. I'm glad you did, just wish you found out more.

ttys,
Shell
Helpful - 0
195469 tn?1388322888
Well it seems that the doctors have found ever "hole" possible to stick something in you.  Are they sure they don't want to drill a hole in your brain and insert a tube to look at your rectum?  Geesh.  You have been through the wringer.

I know of all the swallowing and eating troubles you have been having and I don't expect they will disappear, just because the tests couldn't find anything wrong "at the moment."  Remember to take smaller bits, eat slowly and if you can't swallow it, spit it out.  It's not worth choling on.  Luckily I only go through periods of having this happen occasionally and it is scary as you know what.

I hope they get to the bottom of this soon.  Sorry to use the word bottom.  I think your butt has seen enough action too.  Hey at least you know that your innards look good.  All shiny and clean.  That's a plus.

Keep us updated on your progress.  Let us know how the labotomy goes.  I am sure that is next on their list of tortures.

Much Love and Big Hugs, Momma Bear-Quizzle

Heather
Helpful - 0
Avatar universal
Quix, that test sounds like torture.  I am so sorry you had to go through that.  I don't think I would have gotten as far into the test that you did.  

When I have had bladder infections, I have had to wipe the floor many times.  It is very frustrating.  I sincerely hope you can get to the therapist after you see the doctor.  The exercises sound like at least an option to investigate.  

Maybe after the GI doc and the doc for the bladder issues, you can spend the holidays steering clear of doctors.  And take a break from them.

Thinking of you...
Elaine
Helpful - 0
486038 tn?1300063367
Quix... um, not sure if you wanted me to answer your question here, but yep. I have problems with water or anything like that going in my windpipe and causing a big 'stir', seems worse this year than ever.

Also, about those pelvic excercises... here's a good one to do, that I learned last month in PT to help stregnthen your pelvic muscles, it's designed to keep your bladder from leaking. Don't ask why? You lay on your back on your bed, and prop your knees up, with your feet near your keister and a few inches apart, and then you tuck a pillow between your knees (bend the pillow in half) and gently squeeze your knees together squeezing the pillow tightly. Repeat the squeezing motion 30 times a day... (it helped me, amazingly!!!). Let me know if I didn't explain this enough.

I hope all this lets up for you, and that you are able to cope!! were you tested for any lactose or wheat intolerances during this whole 'fun' rigamarole?
~Sunnytoday~
Helpful - 0
147426 tn?1317265632
ess - yes, Depends are next on the list, but I just don't want to go there (in a manner of speaking)  I run about the house in caftans and just hate wearing underwear -- TMI??)  I don't think it is vanity - well, maybe it is.

Lulu - No I was sitting in a special chair.  I misspoke about lying there.  I tried so hard to concentrate on my breathing and did really well, despite the pain, not to swallow except when they wanted me to.  But, everytime she moved the catheter tears just poured down my cheeks and then at the end - Well I think I did birth a small rhinoceros.  It was quite a scene.  Oh, and I kept choking on the water.  I can't swallow leaning back.  It just runs down the back of my through into my trachea.

Anyone else with difficulty keeping liquids from running down their windpipe?

Quix
Helpful - 0
378497 tn?1232143585
That sounds horrible. And boy are you getting poked and prodded. I'm not sure whether to wish you all well on the esophagus or that they find something--anything--to explain your symptoms. Given how those of us who are undx'd for the neuro stuff feel, I'm going to go for the latter. I hope you find an answer with this. It's the least you should expect for giving birth through your nose.

Bio
Helpful - 0
572651 tn?1530999357
Hi Q,
Sorry to hear the EM was so difficult for you - you said that you were lying down.  Did you really go prone or was it done with you sitting in a special exam chair ? I hope you were at least upright.  I hadd this one done too after the GI Doc did my upper GI and spotted what he thought were spasms.  My test was also ok, but I suspect we're going to go back and look again since I now have the ever present lump/knot/bubble in my throat.

As for your bladder, I want to tell you how much I appreciate your candor in discussing your problems.  I, along with many others here, am following right behind you with mounting symptoms.  I would prefer to pretend these bladder problems aren't going to happen to me but I pretty much figure they will because I'm already having all the associated issues of urgency/frequency/hesitation and leakage.  Hearing you discuss the problem helps me come to terms with the possibilities emotionally before I have to deal with the physical reality of incontinence.  

So Thanks Quix for sharing - but next time how about it being some good news?  LOL

My best, Lulu
Helpful - 0
Avatar universal
D@mn, where's my post? I just added to this thread and that shows up on the main page but not here.

MedHelp, please find it and give it back!

ess
Helpful - 0
Avatar universal
Hoh-boy, things are tough with you these days. The urinary problem sounds especially horrific. I hate to suggest this, but could you try some Depends? That at least would save the mop-ups. But why would you be embarrassed to go for pelvic exercises? There ain't nothin' they haven't seen before. Why not try it?

I'm so sorry about all the digestive tract stuff. Wow, it sounds agonizing, and then for them not to find something! How maddening. I hope you don't have to finish out the last part. That just wouldn't be fair. I cringe at the whole thought, because I've been having some bad esophagus symptoms lately, and now my stomach has decided to get into the act.

Man, after 40 it's patch, patch patch.

ess
Helpful - 0
Avatar universal
You are a trouper and you show qreat courage to go through this test when your body won't behave for the test - like it ought to!

Richard
Helpful - 0
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