That evokes all kinds of warmth and fuzziness, right? Like I just performed on (or, heck, even off) Broadway. Or maybe I just completed a mind-blowing piano recital. Or perhaps I just knocked you right out of your seat with my lightning fast and technically superb tap dance routine.
It’s none of those.
When “Bravo” is used in a conversation involving me (at least as of late), it means the Bravo capsule that is used in a 48-hour esophageal Bravo pH study. This Friday, a “Bravo” capsule will be implanted in the lining of my tender little esophagus in order to measure my acid reflux over a 48-hour period.
Let me back up a second. Oh, hell, who are we kidding? This is going to take a while, so you may as well grab a snack, a beverage, and maybe a pillow.
In early February (it was the first Thursday in February, to be exact), I woke up feeling awful. My throat was so sore and irritated, and I felt like I couldn’t swallow anything. In fact, swallowing saliva made me wince. We’re talking a lot of pain here. But that was really the only symptom. No fever, no cough, no runny nose, no congestion, nothing. Just a throat that made me feel like I had downed a carpet tack cocktail with a battery acid chaser.
So, I struggled through the next several days, self-medicating until I could get in to see my doctor on Monday morning. My doctor phoned in an antibiotic and cough syrup, which I very willingly took like clockwork. Each morning I thought I would feel better when I woke up but I didn’t. In fact, it seemed like I was getting worse. On Saturday, I decided to go to the emergency room because I felt worse than I had in the 10 days since I’d first gotten sick.
They did a strep test and a mono test and took a chest x-ray. They couldn’t really find anything wrong with me; I didn’t even have a fever. The solution? Prescribe a Z-pack, a new cough syrup, and Lidocaine (gargling with it numbs the throat). And they sent me on my way. Fabulous.
By Monday morning, I felt no better. I was miserable. I called my ENT doctor (yes, I actually have an ENT doctor) and they took pity on me and squeezed me in that afternoon. Yay! Of course, I wasn’t exactly shouting “yay” when the doctor sprayed a numbing agent up my nose and then threaded a scope up my nostril and down my throat so he could look around. And, what do you know? My throat was raw…because acid was eating through the lining of my throat.
What in the world? I didn’t even realize I was suffering from heartburn. So, the ENT doctor told me I was probably suffering from acid reflux, prescribed Prilosec and recommended that I prop up the head of my bed on blocks. I was also told that I should read up on acid reflux and adjust my diet accordingly.
Here’s what I did. Immediately.
- Stopped taking Naprosyn (which I had been taking twice daily)
- Started taking Prilosec
- Raised the head of my bed by seven inches
- Stopped eating and drinking foods and beverages that would aggravate the acid reflux
And guess what? It didn’t help. At all.
A few days later, I saw my GI doctor (yes, I have a GI doctor), who scheduled an upper EGD and told me I was doing everything I was supposed to be doing. Yay me. My upper EGD confirmed GERD and also discovered a hiatal hernia. The biopsies came back normal. Yay me again. (By the way, that’s pretty much how you look when you’re having an Upper EGD done. Charming, no?)
But I was still miserable. At this point, we’re headed into late February. So my GI doctor changed my medication to Dexilant, which I tried for 10 days, to no avail. He then prescribed something really old school, Carafate slurry, a medication that is apparently so infrequently used, my pharmacy doesn’t keep it in stock. (True story.) I noticed a slight — and I do mean slight — improvement.
Around this time, my GI doctor ordered a “gastric emptying test,” where I ate a scrambled egg containing a small amount of radioactive material. X-rays of my abdomen were then taken every hour, to monitor how the radioactive eggs moved through my digestive tract. If, after four hours, 10% or more of the eggs remained in my stomach, then I would be diagnosed with “gastroparesis.” After three hours, less than 10% remained in my stomach. Diagnosis: Negative. Yay.
I went to the GI doctor again, still suffering, still trying to figure out what was wrong. It was at this point that he ordered a Bravo pH study. I have to go to a hospital in Camden, New Jersey to get this done. More yays. This whole shindig will go down with an upper EGD — I’ll be put out and have the Bravo capsule inserted into the lining of my esophagus. My GI doctor also added Nexium to my mix of medications, in the hopes of getting the acid reflux under control. It hasn’t worked so far.
Sometimes, the Bravo pH study is done without an upper EGD. For those unlucky sons of guns, the procedure is done while you sit in a recliner. They spray your throat with a numbing agent called Cetacaine and the Bravo capsule is passed through your mouth and suctioned to the wall of your esophagus. Um. No thanks.
I also saw my ENT doc again, to follow up on my throat issues. He sprayed the numbing solution into my nose and threaded the scope through and, what do you know? There had been no change in the condition of my throat. So the acid reflux was still doing damage. Fantastic.
In preparation for the Bravo pH study, I had to stop taking my GI medications for a week…and I can’t take them through the period of the study, either. They also recommend eating “normally” throughout the Bravo pH study, as in foods that would normally cause the acid symptoms, so it can measure the acid and pH and whatnot in your esophagus.
So, while there will be no one manning the Bravo capsule like Dennis Quaid in Innerspace (which, of course, would be a much more interesting experience!), I will be hosting this Bravo capsule for a while…until it sloughs off and is expelled naturally.