Just in Case You Didn’t Know

CW: Medical stuff that all works out in the end but maybe you’ll find it upsetting.

I’m going to tell two stories. The first is one about a medical experience Sage had. She was so unaware that it was even a possibility that she ended up sharing the experience on social media since if she didn’t know this could happen someone else might not either and they could learn from it

A few years back, Sage started having really heavy periods. Thinking they were relatively normal she just dealt with them. Nobody around her had ever said anything worrisome about it so she just left it at that.

Then one month she felt really bad along with this. She laughs about it now but there was one night where she woke up at 1AM and said “Todd, I think I’m going to throw up.” and I ran so fast to get a bucket for her that I literally woke up as I was running. The next day when she went to the washroom she called out to me “I’m not feeling good.” I ran to her in time to catch her as she slumped to one side on the toilet, unconscious. I asked Daegan to call 911. 30 seconds later, while he was on the phone, Sage woke and was confused as to what happened – she didn’t even know she’d fainted.

It took them about 10 minutes to get there and 10 minutes to get us to the emergency room. (Hooray for living in a big city) Once there they checked her blood pressure and asked a few questions. The results must have been concerning because soon we were actually being seen by someone. Lots of people talk about long wait times in Canada, especially in emergency rooms. This can be true. However, in my experience it’s always related to triage. I waited 3 hours to be seen when I’d cut the very tip of my finger off with a knife while cooking. Daegan was seen and treated immediately when he had an infection in his foot that seemed to be tracking up his leg. So the fact that we saw someone right away was concerning. Of course it was also reassuring to know we were on our way.

After a full day and night in the hospital, a bunch of different drugs and a transfusion of one unit of blood, all was good. It turned out to be related to ovarian cysts and as Sage was approaching menopause the treatment was to just initiate it through medication. That was the last issue.

So yes, a very serious medical condition with a relatively simple treatment that was almost missed just because “Nobody talks about this.”

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Then there’s my (much less dramatic, thanks) story:

Two years ago, I got the worst birthday gift ever. Donald Trump was elected again. On that election night I went to a Malaysian Restaurant and ordered “Devil Chicken” – the waitress warned me it was very spicy. But then, nearly everywhere I go that could be the warning. This is because there are actually two spice scales operating in parallel here. The first is “The average Canadian” scale. This scale goes from 1-10 where 1 is pierogi with sour cream, 5 is butter chicken, and 10 is what anyone from a country with spicy food would call “Normal”. Anything above that is unimaginable. I know of one person who made a meatloaf and in the whole thing used a single clove of garlic. Their guests said it was too spicy.

The other is what I’d consider a normal scale – what I might typically find in India. Kadhi pakora might be around a 2, a misal pav ordered on the street in Mumbai might be a 6, and a 10 there would be like the chicken curry I ordered in Bangalore at an Andhra Pradesh style restaurant. I asked for it spicy, they were so worried I’d find it too spicy they brought out just a tiny bit for me to try. I said it could be a little spicier and they were shocked. When they brought it back it was close to what I had at the Malaysian restaurant. Burned like fire but tasted so good. The next day my colleague who took me there asked me in the morning if I was OK. I was totally fine – this was nearly ten years back, mind you.

Most restaurants in the Toronto area default to the first “Average Canadian” scale, some take one look at me and assume that regardless. And I don’t blame them. People can be horrible: “I know you said spicy but this isn’t good at all – what are you trying to do to me!?!” However, there are a few restaurants that will listen to you when you ask for spicy food and go by their local scale. These include a couple Sichuan Chinese restaurants, most Sri Lankan restaurants and this Malaysian place.

Otherwise, nobody posts which scale they use, and there is no conversion like between Imperial and Metric measurements. You just have to guess. If you want spicy flavourful food, ordering “Extra Spicy” might get you “Thai Normal” or it may get you “Inferno”.

So you might see why I might just order the devil chicken and ignore the warnings of the server. And to be fair, I would enjoy it either way. It was at the edge of my tolerance but so delicious. I could only comfortably eat a bit but I was always raised to eat what I ordered and so I ate it all, and tried to soothe my mouth with rice but even that didn’t help.

For my friends in India, a bit of research shows me that this is related to vindaloo in that it was influenced by the Portuguese colonists. It looks like this (so you can see why I was interested)

This time the next day was not great. Trump had won, that turned my stomach and the chicken had left my stomach acidic and burning. Soon, acid reflux would wake me most nights with anxiety and a hungry feeling stomach. A couple months later it was still happening so I went to my doctor. She did some tests to see if there was anything obvious – for example an ulcer and suggested that if it didn’t get better to go for an endoscopy to see if there was anything. In between the visit and the lab results coming back I figured something out: Doomscrolling and reading news about the US and their intention to annex our country was playing a big role. I cut that out and while it didn’t disappear it improved a great deal over the next few weeks and I did nothing more about it.

In late April a colleague was leaving the company as their contract ended. We all went to a Thai restaurant nearby that I hadn’t been to in almost 20 years. I ordered a Jungle Curry chicken “Thai hot”. This restaurant does not operate on the Average Canadian spice scale and when it came out it was as hot as the Devil Chicken. Once again it was delicious and I soldiered through – and you can guess what happened. I was doomscrolling less but still my stomach hurt for a few days after and just like that it was all back: a few days of burning stomach and more prone to acidity.

This time after six weeks, I went to my doctor again and she made the same assessment but went straight for the endoscopy. “And while you’re at it – and at you’re age, let’s get a colonoscopy too.” – even though there was no particular reasons other than age.

Now there are less invasive screening methods for colon cancer available. They can send a little packet you bring with you to the washroom, smear a bit on the stick and send to the lab. It always sounded like a good idea when compared to a colonoscopy but the logistics always escaped me. I let two of those kits expire with good intentions to do it right away. If I was already going for an endoscopy, then this would be a way I couldn’t put it off until the kit expired again. It would be done.

For those outside Canada curious about how long it took to schedule this and get in. My doctor put in the referral on a Wednesday, a call came in a few days later on the following Monday. I was given a few options including the following Monday. That seemed too soon so I chose to wait an extra week to get myself mentally ready for it. That said, based on my experience wouldn’t need to get mentally ready – it’s fine.

I was really overwhelmed about the prep part as it sounded awful – it wasn’t but I’ll save that for later – I’ll put it at the end for the curious. But what I will do is share the outcome of the check: Nothing worrisome – my esophagus still looks a bit irritated so I should keep taking Nexium that my doctor prescribed. A couple of minor items to remove and check from the colonoscopy but the doctor literally said “nothing to be scared of” and to come back in 5 years. So all good. Get yourself checked, friends.

But if you’re thinking of something like this and are worried or overwhelmed, I can help with that. Both procedures and their preparation were fine so read on. Or, you know, end here if you don’t need/want to know:

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OK so there wasn’t really any prep for the endoscopy other than to have an empty stomach. The colonoscopy prep ensured that would be the case.

The colonoscopy prep sounded rough but it wasn’t too difficult and I actually learned some new skills as a result.

It all started four days before the procedure. During that time you have to eat, as I joked to Sage, much like an stereotypical American. Pretty much no fruits (except bananas or melon) or veggies (cooked or canned only – as long as there are no seeds), low fibre, white bread, no nuts, seeds or anything fermented. Starches were fine as long as they were low fibre. White rice, potatoes, white bread. It felt like what I might’ve had as a kid: hamburger with mashed potatoes, ham sandwich on Wonder bread with green jello for dessert.

I made a huge miscalculation here on my first day. I got on my bike at 6AM and rode 28 km, burning a bunch of extra calories. Then I got home and had mostly bread, postponing my usual egg breakfast to lunch. I felt ravenous for the entire day and never caught up and despaired of finding anything to eat. My stomach felt so hungry all day that it was hard to drink coffee so I felt groggy and headachy all day also.

Then I realized I’d made another miscalculation. That day was five days before. I could have a nice dinner and go grocery shopping and start the diet on the next day.

And here’s my learning from that. My air fryer was my friend. I peeled and cubed potatoes and sliced some chicken. Then I made spice mixtures for both, tossed them in that and added a bit of oil and cooked them. I always used to turn my nose up at onion and garlic powder but now I see that they’re actually really useful in this sense. My first day’s attempt was passable but once I figured out the method, my dinner the second night was something I’ll definitely make again. A spice mixture of onion and garlic powder, garam masala, cumin, coriander, salt, pepper and Kashmiri chili (not hot for prep reasons). This one was definitely a keeper for a quick dinner – add a simple non-dairy (for me) raita, salad or some other veggies and it’s done. I could easily do this with tofu as well now that I know this.

This plus going back to my childhood for ham sandwiches and potato chips for lunch made a huge difference. I felt pretty much normal the whole time. Yay me!

The final day before is a bit harder: Liquid only. I had to be really careful how much coffee I drank (I usually have 4 mugs/day so this was tough) to avoid feeling yucky. I stocked up on instant beef broth, jello, ginger ale, orange Gatorade, and apple juice. The trick for me here was to pay attention to calories in what I drank – if I felt hungry I could drink something sugary and it seemed to improve. It was not fun and I don’t understand how people can do intermittent fasting intentionally but it was manageable. The day ended with two doses of a purgative. By how it’s described (basically to leave you 100% empty end to end) it sounded pretty rough and horrible – like a terrible case of food poisoning. In reality it was much less dramatic. It did the job as advertised but without drama. So if this is something that is overwhelming you, worry not. It’s no big deal.

The other thing that I was worried about was the night ahead. In my experience if I don’t eat dinner my stomach is very unhappy and I don’t get to go to sleep until I do eat something. If I ate poorly I might even wake in the night. So how would it go if I had basically nothing in me for the night? The answer is that it was surprisingly fine. I did stay up a couple hours later (partly to make sure I was tired but also to ensure the preparation phase was over). I slept beautifully.

Then there’s the procedure itself. It was surprisingly easy. Here’s how it went:

When I arrived and checked in (with Sage – there would be sedation so they needed a responsible human to make sure I got home safely and didn’t drive) they asked a few questions mostly about the last time I ate or drank. 2-3 minutes later I was inside changing into a hospital gown.

Outside the procedure room they put in a cannula on my hand to administer drugs and brought me in the room. They made sure I was comfortable and the anesthesiologist introduced himself to me and asked a few questions, mostly to assess my level of fitness. “What do you do for exercise? Walk, run, cycle?” “I cycle” “How far?” “Two weeks ago I rode 140 km” That was all the info he needed. He was comfortable I’d do OK with the anesthesia. They put a nasal cannula on me for oxygen and I turned on my side.

They put a small mouthpiece in my mouth to prepare for the upper endoscopy. Then I felt a bit of pain in my hand. I said “There’s a bit of pain in my hand near the cannula”. The anesthesiologist said that that was normal and not to talk. (I later read that it is, indeed a side effect of this drug).

Then I felt kind of out of it and could tell they were doing something related to the colonoscopy – a little bit of work-related talking was going on. Looking back I now see that at this point my eyes were closed. I’m not sure when that happened. Then within a very short time they said “OK you’re done – we’re taking you to the recovery room.” I was surprised. “What about the upper endoscopy?” “Oh we did that first.”

So yeah, apparently those drugs that gave me minor discomfort in my hand? They were the equivalent of the Vulcan Nerve Pinch. There was no “Hmmm, I feel sleepy” – none of the “Count backwards from 100” I remember reading about as a kid. Just “Hey this kind of hurts” then “OK we’re all done”

Once in the recovery room they brought me juice and digestive biscuits and I was pretty much up and ready to go in 5-10 min. Sage came to get me and while I was a little bit sleepy and would definitely not have wanted to ride a bike, aside from a tiny bit of unsteadiness on my feet, feeling a bit spaced out and oddly enough my arms/legs feel like I actually did a long bike ride, all was pretty normal. I probably could have managed to get home by transit on my own but I’m glad I had someone to come with.

So all in all, the procedure felt easier and preferable to a dental cleaning or filling – and even the prep was only a minor discomfort that actually ended up teaching me a bit of cooking through “creative restriction” – so I guess now I know what to do in 2031 when I’m back for it again.

And if this is something looming and overwhelming for you, consider this your friend telling you it’s going to be alright and it’s 100 times more manageable than you think it is.