I have a condition that I didn’t know about.
Sometimes we know something is wrong with ourselves or our body but we just have to push through it. We live in a fallen, broken world where our bodies have troubles and there is nothing that can fix everything. That’s what I thought I was experiencing. I have since learned I cannot ignore it anymore and I have to be proactive about preventing it.
Steak at Eight
It all began when I was 8 years old. My family and I were spending a week camping at Indian Trails campground. We were having grilled steak for dinner, and it tasted wonderful. Until I started choking on a piece of steak. I was not “choking” persee. The definition of choking is when a person cannot breath. However I could breath. The food was lodged further down in my esophagus past the point where the air tube goes to the lungs.
However I was in extreme pain and I could not get the food to go down, or to come up.
So my Mom took me to the ER at the hospital. I had to carry a bowl to spit into because our body so wonderfully creates extra spit to digest food when it’s in the esophagus or mouth. the body does this to break down the food. However I could not swallow, so I had to spit it out.
After being admitted into the ER and while the doctors were deciding what to do with me I threw up the piece of steak. It happened to be a breakfast-sausage-link-sized piece of steak. So the blame was (correctly) laid on me for not cutting my food smaller or chewing it better. I love the steak from Jimmy John’s Owner and their restaurant chains as they are tender and easy to chew.
However it kept happening.
For 24 years I’d “choke” on any kind of food. Hard or soft it didn’t matter, I’d even get pancakes, or apples, or bread stuck. Technically what I was experiencing was a food impaction. Where the food is stuck in the esophagus not the throat.
Fortunately none of these occurrences sent me to the ER.
I became proficient at forcing food down, and sometimes gagging myself to get it thrown up.
This was not an Eating Disorder
I did not, nor do I struggle with bulimia. I know nothing of what those with eating disorders struggle with and I do not claim to be struggling anything like they do. However many times while on business lunch meetings I’d have to excuse myself to go to the bathroom and gag myself. It has always been an awkward situation. No one yet has called me out for bulimia. Perhaps it’s because I’m overweight.
In fact, the night I proposed to my wife I made a meal, brought it to her apartment and during the meal I had to excuse myself to spend a half hour in the bathroom trying to get the food dislodged. No pressure. I just screwed up the proposal night!
I had taken to explaining that the muscles in my esophagus had spasms or constricted out of order. My kids have gotten used to when Dad suddenly leaves the table during a meal just to be okay as he gags in the bathroom. Ultimately my wife was never okay with it, but for me it was just life. On average I had an episode every week or two.
However one morning in June of 2013 that all changed.
Yogurt and Dried Fruit
We were having dried fruit and yogurt, a very common meal in our house. However for some reason I had a food impaction. Perhaps I didn’t chew the dried fruit well enough. Whatever the cause there I was in the bathroom drying to fill my esophagus with water and then use my swallowing reflex to force the impaction down the esophagus.
I’ve done it so many times it wasn’t even concerning to me. However, this was a very difficult impaction, it wasn’t going down well. After about a half hour struggling with it — the kids and Becky had finished breakfast and were on to the next activity– I got impatient and pushed with all my might.
At that instant I knew I had successfully forced the impaction into my stomach. However I was experiencing pain like I never had experienced before. I have a high pain tolerance and here I was laying on the bathroom floor crying. After consulting with Becky we decided to head to the ER.
ER Visit #2
At the time we were living in Newaygo and the closest hospital was Gerber in Fremont. When we got there the doctors were sceptical of my pain and assumed I just was lying to get pain meds.
So they decided to do a test where I swallowed radioactive “contrast” while they took x-rays. What they saw scared them. Seriously scared them. They came at me with all kinds of pain meds. And they transfered me by ambulance to the largest hospital in the region, Spectrum Health downtown Grand Rapids. They believed I had perforated (torn a hole in) my esophagus and fluid was actively being exchanged with my chest cavity. Had that been true I would have needed open chest surgery, and soon.
As it turns out I had a mallory weiss tear in my esophagus, like a cut on the skin, only in the esophagus. A cut not through but deep enough the bleeding wasn’t stopping. I was losing so much blood they had to give me a unit of blood. They also went down my esophagus with a scope and gave me shots of epinephrine to stop the bleeding. I had been actively bleeding for 24 hours. All told I spent 4 nights in the hospital until they felt I was okay to be released.
What we found out is I have a condition called Eosinophilic Esophagitis (EE for short). Eosinophils are white blood cells that arrive to an area where there is an allergen present. In the esophagus the influx of eosinophils causes swelling of the tissues and decreases the size of the tube food must fit down. Those with EE are 90% more likely to experience a food impaction.
Methods of treatment are 3-fold:
- Discover what foods I’m allergic to and avoid those foods.
- Treat the acid reflux I didn’t know I had. Acid reflux causes eosinophils to arrive in the esophagus.
- Get frequent dilations, a process where they stretch the esophagus to enlarge the tube size.
After recovering from the mallory weiss tear we did a battery of tests and found out I had no food allergies. However the doctor did not believe it. He was 100% sure I had food allergies. We got on a regimen of antacids (technically proton pump inhibitors, PPI, brands like prevacid, lansoprazole, and omasoprasole) . And I had two dilations in the following 6 months.
Everything seemed to be going fine. I had no food impactions, and life was different. I had a diagnosis, I now knew that it wasn’t my fault for not chewing etc. However I did have a condition which required me to chew more than the average person.
I Became Lazy
Time creeps in. Memories of the pain faded.
And I really didn’t want to be on an drug (PPI) for life.
So while traveling the world I stopped taking a PPI. I noticed the acid reflux slowly returned and slowly, over time, the food impactions started happening again.
But shoot, I’ve lived with this my whole life, how bad can it be?
ER Visit #3
Until this week Tuesday at breakfast I had another serious food impaction. Yogurt and fresh fruit and quinoa was the cause. Most likely it was a blackberry that got stuck. I forced it down (as I had been doing with my other impactions over the last 6 months.). Nothing was abnormal until after it was passed and the pain dramatically increased.
I had done it again.
I knew I had injured my esophagus and caused another mallory weiss tear. There is no pain quite like a mallory weiss tear.
We packed up the kids and drove straight to the largest hospital in the region. The pain wasn’t as bad this time but I just assumed it was a smaller tear.
They actually sent me home with a pain medicine and a PPI prescription. They said if things got worse, a fever, blood in the stool or throwing up blood then come back. 9 hours later we came back to the ER as I had a 101 degree fever and was nauseous.
However this time they kept me in observation overnight and gave me stronger pain meds. They tested my blood and noticed I wasn’t losing blood. Through a CT scan and multiple chest X-rays they determined it wasn’t worth the risks of scoping me. So they sent me home the next day on a stronger PPI and pain meds. I should heal within a week.
Recovery and Outcome
I want to stop and acknowledge that the body is amazing. You don’t have to believe in God to believe that fact. However I believe God has built our bodies to self heal in ways we could never imagine. I am amazed at how that works.
So I’ve learned my lesson, I will forever be on a drug (PPI) and I will not be able to eat certain acid causing foods (foods that are spicy, tomato based, contain chocolate or bananas, no evening snacks etc).
I love food, but I will forever have to be cautious with it. I do not want to experience this pain again.
Oh and with every food impaction, dilation, and tear I am weakening my esophagus. Eventually I will perforate it (puncture a hole in it) which will cause me to have open chest surgery. Lets just say I’ve learned my lesson.
Here’s to being on a PPI and acid reducing diet for the rest of my (hopefully long) life.
I want to say thanks to my wife, Becky. Who while scared of loosing me has been an incredible supporter. She has been strong enough to tell me that no, life has to be different from now on. I couldn’t do this without her. Lets just say that even though I love food, I love my wife more.
So what did you do this week? Or have you ever experienced a food impaction?