How to Have an Upper GI Test

Author: U.S. National Institute of Diabetes an...Image via Wikipedia

After approximately 8 months of dietitian appointments, psychologist chats, doctor visits, a detour to a cardiologist for cardiac clearance (happily, nothing wrong), and reams of paperwork for insurance, I’ve managed to (insert amazement emote here) finally get a date for lap-band surgery. Dr. Chua’s going to do the surgery on October 27th for those of you who wish to pray and/or think positive thoughts on this day. For those of you who read this because you can’t stand me, it’s scheduled for some time in 3011, so save your evil black thoughts for that year.

Last week I had to drive up to the hospital to have the pre-op testing. I thought it was going to be just one test. It turns out I had to have a whole bunch of tests, including an EKG (despite the fact that I had just seen the cardiologist), blood tests, pre-op interview, chest x-ray, blood pressure, pulse oximetry, urinalysis and pregnancy test, investigation of my fingernail clippings, collection of any toejam (none for me, I’d showered that morning), and counting the number of wrinkles on my kneecaps. This was done in a giant hospital gown that could be used as a sheet for five queen sized beds, it was so large. Now, I know that this hospital is a bariatric center, and we big people are a normal patient base for them. However, a Volkswagon Beetle could have fit under that gown and there still would have been enough material left over for the 18 people stuffed inside the car. After pulling up on my gown because the neckline had fallen off my shoulder umpteen times, I decided to rename it a toga. I walked proudly through the hospital hallways to the various stations, one shoulder exposed for all the world to view.

One of the tests required before weight loss surgery is the famous ‘Upper GI’. This is a nice way of saying “Here, we’re going to make you drink a cup of liquid white chalk and irradiate you until you glow in the dark”. That test description doesn’t fit on insurance forms very well, however. As we all know, we must never make insurance companies do any work, or they’ll charge us another 666 dollars. Per letter. Now you know why test names are so short and cryptic.

Anyway, after hearing any number of people complain about this test, I decided that I, a woman proudly wearing a Beetle-sized blue-diamond print white toga, would not complain. I would suck it up and deal with it. When I introduced myself to the radiology techs, I was “Jae, the Toga Woman”. I then politely asked if I could pick my flavor of barium. This immediately amused the technicians, who then cheerfully informed me they only had one flavor. They assured me the liquid chalk would ‘taste faintly like bananas’. Now, I’ve made fake-banana flavor in organic chemistry, although we gave it the fancy term ‘isoamyl acetate‘ in class because we had to show off our chemical knowledge. I was pretty sure I didn’t want fake-banana flavor on an empty stomach, but I had vowed not to complain as they handed me the cup of liquid ‘faintly banana-flavored’ chalk. Instead, in a completely geeky manner, I noted out loud that the cup was quite heavy and asked them what the atomic weight of barium was (137.33 g·mol−1 for the truly curious). Neither of them knew, but I could tell by the pleasant surprise on their faces that they were expecting complaints, and this was something different for them. I didn’t feel so bad when the radiologist couldn’t remember the atomic weight, either. Normally, it would make me a tad nervous that a doctor didn’t remember this trivia, especially a radiologist, but I figured as long as he knew how to do his job, we didn’t have to care about something that was only required for medical boards and had no relevance to Real People Medical Care.

After the tech handed me the heavy cup, she then told me I had to first swallow a medicine cup full of white crystals, followed by 2 teaspoons of water. Mind you, I had not had anything to drink since my last sip of decaf coffee at 11:59 pm the night before, because you can’t have anything after midnight the night before you have the “drink liquid white chalk and get irradiated til you glow in the dark” test. I could not begin to imagine how I was going to swallow dry crystals when my mouth was already dry as the Sahara. These crystals were described as something that would ‘make an air bubble in the stomach’ and would taste like ‘really fizzy 7-Up’. Good thing I like 7-Up. After the tech mixed the 2 teaspoons of water into the crystals for me to immediately toss back like a shot of something that would likely have been far more tasty like, say, rum, I discovered it was not like ‘really fizzy 7-Up’ at all. It was more akin to drinking an entire case full of Pop-rocks poured into said 7-Up. It was a good thing I didn’t try to to knock the crystals back dry. My mouth probably would have done a marvelous Mt. Vesuvius eruption.

I then discovered ‘make an air bubble’ was a euphemism for ‘this will cause massive gas’. The staff had neglected to specify the size of the air bubble, which was quickly approaching Hindenburg proportions. Next, I followed the instruction to gulp the barium down as fast as possible. This did not help the air bubble (read, massive gas) situation one bit. Then they laid the table back and urged me not to burp. This is equivalent to gulping a 2-liter bottle of pop in 20 seconds and then being told that belching is not allowed. I did my best guppy impersonation, swallowing every quarter second to keep that air bubble from exploding. I was afraid that if I burped at that point, the force of the gas would rocket me out of the x-ray machine. I told the staff when I did finally get to burp, I was going to be able to outdo my 12 year old son. That’s quite an achievement, by the way, because we all know that 12 year old boys can burp at a volume approaching heavy metal rock concert level.

An upper GI test is not your ordinary ‘lie still’ test, either. They asked me to do a couple log rolls to move the barium around, lie in a variety of poses, one of which I called the ‘Cleopatra pose’ to the further amusement of the staff, do a variety of gyrations I hadn’t done since 6th grade gymnastics, and rest on my stomach. If you’ve ever had ‘an air bubble’ in your stomach, and you’re not allowed to burp, the last thing you want to do is lie ON your stomach. I went back to guppy-gulping to keep the air in, knowing that I was going to pay for it when it came out the other end.

After quite the photo shoot, I got to see my stomach, my reflux, and my esophageal muscles not quite doing their job correctly. The pictures would have been even more cool if they hadn’t been mine. Hopefully after the surgery and weight loss, that will improve. I won’t be able to entertain the staff in my Cleopatra pose once the reflux is healed, but I’ll take that one for the team. Yes, I did let out a giant burp or three (or ten) when we got done. No, I didn’t get blown through any walls.

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