July 28, 2009, 2:00 pm

I Went, They Scoped, Now Starbucks is History

lost voiceI hope you can read the print on this.

It’s a hoot!

Apparently, the Vacuum Tympan cures the most “desperate causes” of hoarseness and sore throat, massages vocal cords and gives immediate flexibility (to what?). Oh, and after it brings relief, “a permanent cure soon follows”.

Maybe it sucks out the phlegm. (Ewww…just writing that made me gag.)

It sort of looks like the old incentive spirometers we’d use for post-op patients.

Or maybe it’s a type of  nebulizer.

Frankly, it looks like a bong.


Vive le Grand Rounds!

This week Captain Atopic takes on the medical blogosphere carnival Grand Rounds using the Tour de France for a theme! Merci beaucoup, capitaine!

Next week, Grand Rounds will be right here at Emergiblog – there is a post directly under this one, but for the life of me I did not know how to make it “stick” up at the top.  Bottom line, I’m waiting for your submissions! : )

(PS – don’t forget to send your nurse-related posts to Man-Nurse over at Man-Nurse Diaries for the next Change of Shift!  Submissions can be sent to “mannursediaries at gmail dot com”.)


I’m at that age where certain tests involving scopes and colons are recommended, so I did my duty as the good custodian of my health and scheduled the pre-test appointment.

(Don’t worry, this will not be a case of “TMI”.)

I’m sitting there with the GI doc going over my health history, when he notices I’m on Protonix. Based on this fact (and the fact that my upper abdomen is sore on palpation – well, duh, you’re pushing on it!) he says “Well, you are going to be out anyway, I might as well take a look down there, too!”.

Say what? I’m here for a tube up one end and you want to put a tube down the other end, too?

I swear to (insert-your-own-deity-here), my first thought was “dude, you’re just trying to add a procedure to crank up the income.”

I’m not proud that was my first thought, but I’m being honest here. “Sure!” he said. It might be a structural problem, we can make sure you don’t have Barrett’s Esophagus (note to self: look that up) and basically just know what we are dealing with.

Well, okay. But I don’t have indigestion/heartburn when I’m on Protonix; I’m rather asymtomatic, actually.

“What kind of anesthesia would you prefer? We can use Versed/Fentanyl or if you want, we can use proprofol.

Propofol? Dude, you can stick a tube anywhere you want.  Go for it!


Easiest thing I’ve ever done. I have no idea why I waited so long. When I fell asleep Shania Twain was feeling like a woman and when I woke up, the Eagles were takin’ it easy and I wondered when the hell they were going to start!

I was done.

The procedure went well, the biopsies were taken (routine) and I would get my results by mail within two weeks.


My colon rocks. No problems except divertiulosis and I can live without nuts and seeds.

It was the endoscopy that I almost refused that showed the problem.

The biopsies showed acid-induced esophageal and gastric inflammation.

What??? How??? I thought the Protonix was taking care of that!


And then came the “treatment” boxes checked off.

“Keep taking your medicine for the next three months, then stop.”

Okay…if I have this inflammation now, why would I stop the medication? Won’t it get worse if I do?

“Please avoid Aspirin, Naprosen, and Motrin. Tylenol is okay.”

Aw man, Motrin is my best friend, my right hand! It’s gotten me through many a rough shift; 12 hours in the ER can make you ache. Tylenol isn’t worth the powder it is printed on.

I took a swig of my Diet Pepsi.

“Avoid fatty foods…”

Okay, doing that already with ol’ Richard Simmons’ plan.

“…chocolate, peppermint, spearmint and smoking”

Bah – I don’t smoke and I can live without chocolate and who wants spearmint anyway?

Took another swig of Diet Pepsi.


No biggie, I only have two Bud Lights a month, during Nascar races, and that’s only to support Kasey Kahne’s sponsor (and I know you all just doubled that to four per month…).

“Avoid caffeinated beverages…”

Uh oh.

Took a tiny swig of Diet Pepsi.

“Decaffeinated coffee…”

That…means…ohh nooooo…


Oh HELL no.

I will NOT give up Starbucks.

Damn it!

I don’t smoke, I barely drink, I don’t do drugs, my diet has more fiber that corrugated cardboard, I’ve lost close to 30 pounds and I’m working on the other 25.

My only “vice” is a total addiction to Starbucks and the goal of someday mainlining Diet Pepsi.

It will be a cold day in hell before I give those up.


I’m giving them up.

I know the effects of chronic esophageal and gastric inflammation can lead to bigger problems.

And in the scheme of things, given the impact a diagnosis can make on a life, this borders on laughable.

But we all talk about how the patient has to take responsibility for their health. I could keep on downing Starbucks twice a day and Diet Pepsi in my sleep and then whine because my Protonix isn’t working.

Or I can make the changes suggested and see if they will make a difference.

But how ironic that the main problem was found in a test I didn’t even know I needed; and how scary that I was essentially asymptomatic, but the inflammation was still there!

Kudos to the doc for being interested enough to find out why I had needed to be on Protonix to begin with.

I shudder to think what things would have looked like had I been on no medication.


Who knows?

Maybe I can go off Protonix if these changes work.

And I can still go to Starbucks, only my new drink will be a Grande Skinny Vanilla Steamed Milk.

With a little cinammon on top.

Hey, a girl’s gotta have something to look forward to…


  • Sean

    July 28, 2009 at 4:08 pm

    Kim, Glad to hear things turned out well. A big WHEW for you.
    I guess we all have to be the change we desire at some point in our life. Glad to see your battling it head-on.
    Best of luck!

  • Rachel

    July 28, 2009 at 4:31 pm

    Now that I’m thoroughly addicted, I couldn’t imagine giving up coffee. 🙁

  • anonymousRN

    July 28, 2009 at 8:03 pm

    Chai lattes are lovely…. and Starbucks has some nice tea lattes. I know they aren’t coffee… but it says somewhere that tea is good for you… 🙂

  • unsinkablemb

    July 28, 2009 at 8:30 pm

    Even though I still love my coffee, I’ve found that there is a plethora of tea just waiting to be explored! See if you have an Argo Tea or Tea Geschwender in town. They have many tasty options!

    Take care…

  • #1 Dinosaur

    July 29, 2009 at 3:43 am

    Actually, you had it right the first time — as in he was adding another procedure to jack up the fee.

    If someone, anyone, had bothered taking a HISTORY before prescribing you the Protonix, they would have noted your caffeine and ibuprofen consumption. Anyone with a brain would have advised you to decrease or eliminate the caffeine and ibuprofen and see if your symptoms went away, and if you would remain asymptomatic OFF the Protonix (which you probably would/will). The procedure would really only have been necessary if your symptoms continued.

    Nope; sorry. Another case of a specialist doing things bass-akwards while convincing you — THANK (insert-deity-of-choice) — that you really needed the procedure.

  • Beth

    July 29, 2009 at 4:01 am

    ha ha – “Tylenol isn’t worth the powder it is printed on.” – Amen to that.

    Kim, my heart goes out to you. I cannot imagine giving up coffee although I have toyed with the idea since it is such a ball and chain in my life.

    Best of luck to you and I’m glad everything else is okay, GI-wise!

  • Nurse Moffa

    July 29, 2009 at 6:52 am

    Just think of all the money you’ll save!

  • Pattie, RN

    July 29, 2009 at 7:01 am

    Hope you feel better—and you know that the really OLD battleax nurses (like moi!) tripled the Bud Light to SIX a month!! 😎

  • Nursing Anatomy

    July 29, 2009 at 8:20 am

    I’ve been there too…my GI doctor misdiagnosed me with Barrett’s Esophagus and they told me all the same things they told you. The difference was, my diagnosis came two days after my 21st birthday and the doctors told me I could no longer drink alcohol. That was a hard one for me, but I managed to do it, until I found out 5 months later that I didn’t really have Barrett’s. Just the same as you, acid-induced esophageal and gastric inflammation in a hypersensitive esophagus. So I hope you feel better, and good luck eliminating those Diet Coke’s!

  • Jenni Prokopy - ChronicBabe

    July 29, 2009 at 10:07 am

    oh babe, i’m with you – i have the same issue. but i REFUSE to give up my decaf coffee! so i cut out other stuff, and hope for the best. i see my doc regularly and take my meds and i guess i just feel like every other vice has been taken away from me…so what’s a little coffee? maybe i’ll pay later but for right now…i need it. tell me, though, am i being an idiot! xo

  • Trusted.MD Network

    July 29, 2009 at 1:08 pm

    Patients for a Moment is Hosted at Everything Changes…

  • Katherine

    July 29, 2009 at 5:33 pm


    The ad you have above is actually a case all law students study in Torts and Contracts!

    So funny to see it on your website!

  • Aviva

    July 29, 2009 at 8:41 pm

    I developed chronic ulcers from NSAIDs that ruined the lining of my stomach. Man, I was in denial for almost 18 months of chronic throwing up and intense stomach pain despite a variety of drugs from the GI doc. I finally caved in and gave up my Diet Mountain Dew (I never liked coffee), and that made a huge difference. You know what made an even bigger difference? Giving up all pop, even the non-caffeinated types. That was painful, but it *finally* allowed my stomach to heal and go pain-free.

    Anyway, I know it’s hard, especially when you feel like you don’t have any other vices. But I bet you’ll be glad you did within a few months!!

    Good luck!!

  • Mike Maisel

    July 30, 2009 at 4:52 am

    Glad to hear you endured the double header Kim. I get them, too, because I always figured if I am taking a day off, getting someone to drive me back and forth, then might as well go for it.

    I was diagnosed with Barrett’s and my GI started me on Nexium and not only have I been asymptomatic for two years since, but my last scope showed no change. I have none of the dietary restrictions you or any of the commentors must observe.

    Yes, the anesthesia is da BOMB, but not sure it’s worth the colonoscopy prep. @($#*#@(*#$!

  • Michael Kirsch, M.D.

    July 30, 2009 at 7:03 am

    I’m a GI. Keep in mind, pathologists nearly always give us a report of ‘inflammation’ on our biopsies. What does this really mean? Usually very little, but it gives us something to medicate and worry patients about. You have more to worry from the kerosene they serve at Starbucks.

  • Nurse Karin

    July 30, 2009 at 12:14 pm

    I don’t drink, I don’t smoke, I don’t gamble but I gotta have my Starbucks coffee.

    I can relate.

  • Julie Johnson

    August 3, 2009 at 5:48 pm

    New reader . . . big fan! I’ll have a starbucks for you (Tall, nonfat, no-whip, extra hot, half the syrups hot chocolate!)

  • Larry

    August 7, 2009 at 4:04 pm

    Your story sounds a lot like the health talks we routinely give at the specific chiropractc center. We talk about how people go in for a routine check up and are told they can only eat lettuce and can only breathe every other minute (okay that was an bit extreme) thanks for the great blog…good read!

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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