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Oesophageal Manometry

Jitters.  Have you ever had real jitters?  When you're on tender hooks and feeling incredibly apprehensive and your stomach is going ten to the dozen.  Well that is how I felt on the morning of this test.  It felt different to being nervous but just as bad.  The thought of a tube going up my nose and then down into my stomach made me shudder.  How on earth was that going to happen?


Having had many tests now the car seems to know it's own way up to Papworth - point it north and off it goes.  As always Roy was with me.  He knows when I'm quiet - I'm bad.  I was quiet.  We made our way to the Respiratory Physiology Department - waited our turn and then eventually heard those words - "we're ready for you now".  They may be but I wasn't.  For the sake of anonymity I will call the two wonderful Respiratory/Oesophageal Physiologists - Louise and Andrew.  I was then weighed and measured and then went into the room.


Louise was lovely.  She asked how I was and I told her that I was hungry, nervous and very nervous. She said she quite understood how I felt and said that as soon as it was over she'd get me a cup of tea and some biscuits.  The good old British cup of tea seems to put all situations to right.  I said it was a deal.  She asked me loads of questions and then it was time for the deed to be done.


I got onto the table and sat upright.  We all put on plastic aprons.  "Why aprons?" I thought but said nothing.  I asked her if she minded me counting whilst it was all happening.  "Whatever makes it best for you is just fine by me" was her reply.  From that one reply I knew she was going to be caring - I just knew it and suddenly I felt my jitters falling to one side.  All of a sudden I felt that we were a team of 3 and we were going to do it.  I wasn't still quite sure how but just knew we would.  Then Louise asked me if I had a preferred nostril?  Of all the questions that I have been asked I never saw that one coming.  To be honest my nose has just been my nose.  I said I hadn't so we went for the left one!!  It was duly sprayed with a local anaesthetic and then it was time to get going.


For some reason Louise suggested I took my glasses off - not quite sure why but in truth it was a good idea as I can't see very well without them and maybe she thought the less I saw the easier it would be for me.  I closed my eyes and starting counting.  Well have you ever tried counting with a tube going up your nose? Not easy and I very quickly realised this would not work.  Trouble was I hadn't got another plan.  The tube went up the nose and then I felt it coming down the back of my throat. Andrew was standing by with a cup of water.  The idea being is that you drink a bit and then as you swallow the tube is eased down and this is repeated until the tube reaches the stomach. Theory and practice don't always go together.  And this was certainly one of those occasions.  Well did I gag? You bet.  And the water I had just drunk flew at top speed out of my mouth.  I now realised why we all were wearing aprons.  I of course was very apologetic.  I don't normally do this kind of behaviour but it just can't be helped.  Louise and Andrew were absolutely fine about it.


We had more attempts but nothing was working.  The tube would get so far - 20cm in fact but had to be pulled out time and time again either because I just kept on gagging or it was hitting the upper sphincter muscle which wouldn't relax and open or indeed the tube would come out of my mouth.  I felt like I was in The Alien.  I was just thinking all I need now to happen is for the tube to come out of one of my ears!!  


Time out I thought.  This Team of 3 needed to regroup and work out another plan.  We came up with the "thumb up - thumb down - hold my hand" strategy. The idea being I would put my thumb up when I was ready for Louise to start.  The moment I felt myself tightening up the thumb would go down indicating to Louise to leave the tube exactly where it was and not to move it but just to let me settle again and then when I was ready the thumb would go back up and we would be off again.  I also thought it would be a good idea if I held Andrew's hand - not for his sake you understand but for mine.  I just felt reassured if I did but I am sure he didn't realise how tight the grip would be.  I didn't think how he was going to manage as a one-armed Physiologist but he was so kind he didn't say a word.  Then Louise said instead of sipping how about taking a good glug of water when we were close to that stubborn sphincter muscle.  Out of nowhere I visualised the Niagara Falls.  I saw in my head masses of water falling over the edge and then falling at great speed and volume.  That was it. Niagara Falls it had to be.  With the amount of water I was going to take in - nothing was going to stop my muscle from opening.  It was in for a big shock.


So we were off again - tube up and down the nose and then Louise told me to glug as we were at that point.  Well this was the moment.   I can honestly say I have never drunk so much water in such a short space of time.  One-armed Andrew just held the cup to my mouth as it all disappeared.  Had it worked? Yes.  That muscle had given in.  The tube was now on it's way to my stomach.  Just as well as I certainly didn't have another plan up my sleeve. From there onwards it was easy.  A few tests had to be done which only involved me swallowing more water. After all the tests were completed the tube was removed completely.


One test down just one more to go.  However, that involved another tube going all the way down again but what could go wrong?

We'd cracked it surely.  

Or had we?


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