Last summer (2019) I noticed I was occasionally having trouble swallowing. The sensation was similar to getting peanut butter stuck; a quick gush of milk or water and its taken care of.
Monday, August 26, 2019
I saw my family physician Dr. Ruth Pacis with a list of little ailments including some difficulty swallowing. She speculated it was a “Schatzki ring is a circular band of mucosal tissue that forms at the end of the food pipe closest to the stomach. The ring of tissue causes the food pipe, or esophagus, to narrow. When a ring forms, a person may have no symptoms. Or, they may have difficulty swallowing, which the medical community calls dysphagia.” (from Medical News Today). She asked her nursing assistant to make a note to send me for additional testing.
In Novmember, Dr. Pacis office called to confirm an upcoming appointment for Janet and I mentioned I hadn’t heard anything about the test for my problem with swallowing. Two days later I was notified with a date to have a Barium Swallow test on Thursday, November 28th.
Thursday, November 28, 2019
From Wikipedia regarding a Barium Swallow – An upper gastrointestinal series, also called an upper gastrointestinal study or contrast radiography of the upper gastrointestinal tract, and often known as a barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest.
In people-speak, I couldn’t eat or drink for hours before. At the Dartmouth General, I stand on a platform which starts in a vertical position. I then gulp down a foul-tasting white chalky liquid while the clinicians watch and record my swallowing action tracking the route of the liquid through my esophagus. Then the table tilts back so I’m horizontal and I swallow more of the chalky drink as they track its path into my stomach.
Monday, December 2, 2019
Dr. Pacis’ office calls and to ask that I come in that afternoon as she has the results of the Barium Swallow and wishes to discuss it right away. My thought at the time is this rapid response is to make up for dropping the ball with getting the test scheduled after my August 26th appointment.
In actuality, the results indicated a constriction in the bottom 8 cm of my esophagus and thickening of the wall along the top of my stomach. It was a suspected case of esophageal carcinoma which are abnormal cells that divide without control.
My reaction was one of “well let’s get on with it.” Ruth (Dr. Pacis) touched my arm as I think she thought I didn’t appreciate how serious the news was. In fact, I did but I’m more a cup-half-full kind of guy and so my interest is about what we do next.
The short answer was to send my diagnosis to a specialist.
Wednesday, December 18, 2019
Janet and I took the bus over to the VG for a test called an Endoscopy under the care of Dr. Alison Wallace. We didn’t want anyone else in the loop at this point until we had more information and I would be giving drugs to make me drowsy and consequently not permitted to drive home.
In this test, I’m slightly sedated and a device with a camera on its tip is passed through my mouth into my stomach. In addition to looking around, several tissue samples are harvested to be sent to the lab for further analysis. I will get the results of these biopsies in a January 13th meeting with Dr. Wallace.
After the sedation wore off, although still a little groggy, Janet and I met with Dr. Wallace. She confirms that what is clear and evident is that I have esophageal cancer and in the new year she will start me on a 5-week regime of chemotherapy and radiation treatments in preparation to remove the bottom of my esophagus and the top section of my stomach.
As a note, although we’ve just met, I know I’m in good hands with Dr. Wallace as the lead on my case at this time.
Janet and I decided to keep this diagnosis a secret until the new year. We do not wish that any future memories of Christmas and the wedding of Jade and Drew on New Years Eve in Toronto include that Dad is heading down a road of cancer treatment. This proved to be an extremely difficult secret to keep but it was the right decision. I’m confident anyone seeing my heightened emotional state at the wedding interpreted it as overwhelmed with joy. That was only partially true.