Barium Enema - Part 1

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I arrived early for the BE and checked in at the counter between the two “teller” ropes. “I am Charles Alexander and I am checking in for my test at 9:30 am. I requested a female tech since this test is so embarrassing.” “No problem” said the receptionist so I headed over to the large waiting room with the two large wood and glassine glass doors directly in front of me.

It turned out that they were running behind as I heard a conversation between another patient and the receptionist so I waited until about 9:50.

An attendant dressed in a white blouse and blue medical tech pants walked through the doors and into the waiting room. “Charles Alexander?” she called out so I got up and walked past her into the X ray staging area. A series of small changing cubicles wrapped the walls while another X ray room ran along the right side, forming a narrow hallway. I was escorted to a cubicle right at the back of the hallway. “Take everything off but your shoes, then put on the gown, it opens in the back.” She then slid the cloth screen in front of the cubicle.

It was hard to maneuver in the cube with a chair taking up half of the space. I unbuttoned my shirt and hung it up first, then stepped out of my shoes. I unbuckled my belt and unzipped my jeans, unbuckling them and dropping them to the floor. I hung them up on top of the shirt and then slipped my underpants down and stepped out of them, hanging them on top of the pants. I opened up the gown that was lying on the chair and looked for the cloth ties after I shook it out. I slipped the right shoulder over first and then the left, letting the cloth fall around me, just covering my bare behind at the edges. I searched for and found the upper ties and sort of looped them together, then reached around the lower part of the ties at the small of my back, tying them together. The lower ties were to one side so that when they were tied the opening fell to my left side. I stepped into my shoes and slid the heavy cloth screen to one side.

I decided I needed to use the restroom before we got started so I went to the first doorway but found that it was locked. I then ambled over to the bathroom near the swinging doors and went inside. I didn’t need to use it but I wanted to see how the gown was falling so I turned to one side and then the other, making sure that the fabric wasn’t too far separated so that as little of me was exposed as possible. I walked out of the bathroom and went back to the cubicle.

About 15 minutes passed as I somewhat nervously waited. I wasn’t sure if I was clear this time and was concerned about being able to have the test done. To the left of my cubicle was a door swinging into an X ray room where the “scout” film was done on me a couple of weeks before. The room had an X ray table and transmitter but I believed was only used for this first test to determine if the patient was clear for the actual barium enema.

A slightly heavy woman walked past my cubicle and gave me a somewhat casual look as she headed for her cubicle; maybe she was a prior patient for this test I thought. She had not been there during the time that I had arrived. A Hispanic woman who was obviously a tech due to the large black heavy apron that she was wearing walked past my cubicle and down the hallway before exiting into a control

room that I think was used to print out the X rays.

A few minutes pass then this same tech came back toward my cubicle. “Please come with me” she said so I got up off of the chair and followed her into the same scout x ray room that I had been in a couple of weeks before. The darkened room was pinkish in color and there was an IV stand at the foot of the table. I wasn’t sure why it was there because I expected that if I am clear that I would be taken to a separate x ray room for the test itself. “I want you to get up on the table and lie on your back for me” she said. I slipped off my shoes without socks and laid down on the table. “I have been having some real cramps with blood in my stool and pain in my rectum because of the prep” I said. But she kind of ignored my comment. She walked out of the room returning in just a few seconds with a metal plate that she shoved under the table beneath my hips. As she was again walking out of the room she said “I want you to hold your breath so ‘hold it, ok you can breath” I heard the familiar buzz as the x ray was taken. She then walked back into the room. “Stay right here, I need to go and check this.” “The last time I was here my system still wasn’t clear” I told her. “Did you follow the prep completely?” she asked. “Yes, I did” I commented. She then walked out of the room and back down the hallway.

A few minutes went by as I laid on the cold steel table. Then, she suddenly reappeared. “Your test came back fine so we are going to proceed. Now I am going to be giving you a test that your doctor described to you, which is a barium enema. I am going to insert a tube through your rectum and then fill your intestines with barium. The test takes about 20 minutes” she said. “This doesn’t sound too good” I said. “It is very unpleasant” she said. She reached around to a short cabinet at the foot of the table that contained a large plastic container that looked to hold the barium in a dried form. “I need to go prepare a bag for you” she said as she walked into a doorway to the right of the table almost closing the door behind her. I could still make out some movement inside of the room but couldn’t really hear anything.

It dawned on me that in fact the actual test was going to happen right where I laid. I sat up on the table to try and peer between the crack in the doorway but could only determine random motion inside of it. I must have waited for five or so minutes. The thought kept flashing through my mind about the IV stand and the fact that this was going to be the real thing. I finally decided to lie back down on the table and I reached around and loosened the ties on my neck and lower back just to make sure that I didn’t feel restrained as the soon to be invading fluid was poured into me.

The tech then walked back into the room with an enema bag and hose brimming with the white chalky fluid, hanging it on to the IV pole. The door between the X ray room and the hall was still opened and I hoped that no one was in the waiting area watching what was about to happen. “I want you to roll on to your left side for me” she said so I very nervously did as I was told. “This is going to feel a little cold” as I felt her lift the fabric off of my right hip, exposing me, where she then applied some lubricant between my cheeks. “Move your right leg forward” she said. I then felt sudden pressure as the heavily lubricated plastic nozzle touched my anus, with the tube then shoved into my rectum. “Ow” I said. “Can you take that out for just a moment please” I asked. “Let me roll on to my stomach” “You realize that you are going to have to be on your left side for me don’t you” she declared. “Yes, but let me do this “I asked. She slid the nozzle back out and I rolled on to my stomach, putting my hands at my side. I felt her left hand separate my cheeks and the tube was slipped back in, this time a little more forcefully and a bit deeper. “I am going to expand a balloon inside of you” and I felt as if a hard rubber ball had been suddenly expanded inside of me, forcing the tube higher up. “Ow, ow, ow that really hurts” I said. “Now roll over on to your back please” she said. I slowly turned over, twisting the tube inside of me seemingly higher. I could see the bag and tube with the barium fluid cut off by a clip. For a moment the tech disappeared, and I reached underneath the gown and felt where the tube was coming out of my rectum. There was a lot of KY jelly all pushed into place between my cheeks, ensuring that the insertion of the nozzle was as painless as could be. I sat there for another minute or two and then the doctor walked in. I was still in distress from the cramping from the prep and the doctor was concerned about the origin of my pain. “Ok” he said, “lets get started’ and I heard a click and felt the rush of the barium fluid out of the elevated bag and into my colon as the process of taking the x rays began.

Barium Enema - Part 2

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I arrived at the radiology office early because I wasn’t sure whether the appointment was at 9 or 10 am. After checking in and filling out the paperwork, I sat down on a chair that would allow me to watch for the nurses and patients coming in and out. I must have been there for 40 minutes, just watching the clock. I was really hoping that I would have a female tech since this is such an embarrassing exam.

Suddenly the door opened and I saw this rather pretty blond nurse walk out as she called my name. She was a real sweetheart so if I had to have this done, I was hoping she was going to be it. “Charles Alexander” she called and I stood up and walked toward the door. “How are you doing” she asked? “That is the worst prep ever” I told her. “Did you complete the prep? Yes, I said I did. She then pointed to the back cubicle. Take off everything including your shirt, pants, underpants, shoes, and socks she stated. Here, let me get you a gown as she reaches for one and hands it to me. Open the curtain when you are ready as she slid the curtain closed.

I proceeded to undress, taking off the blue checkered shirt, stepping out of my shoes, unhooking the belt and unzipping the jeans, dropping them to the floor and then hanging them on the hook. Finally, I slid the underpants down and sort of stood there for a moment. This is not going to be good I thought. I than opened the gown, sliding it on, and was able to find one tie but not the other. I finally flipped the left side of the gown over and found the other tie, tying the two together. I reached around for the lower mid back tie and was able to find it, tying the two strands together. The fact that she wanted my shoes and socks off too was interesting as well since I was going to have to walk barefooted to the x ray room. Hope the floor is clean I thought. Thinking about having this done without wearing socks and shoes made this process somewhat innocent and interesting I thought. I guess she doesn’t want me feeling encumbered.

I then slid the curtain to the left, opening up the cubicle. I felt that I needed to get a drink of water so I walked out barefoot into the hallway and into the restroom that was adjacent to the x ray room. I closed the door and locked it, then proceeded to look at how the fabric was falling around me. There was just a slight hint of my right cheek so I cupped my hands under the faucet and got a drink, then went back to the door and opened it. I took one step out. “Charles are you ready” the nurse asked as she peered at me from inside the x ray room doorway. I guess so I said as I walked into the room feeling a little surprised that she was ready to begin so quickly. The room didn’t have any of the obvious tools needed to perform the exam which was surprising to me. I again thought that if I had to have this, she was the one I wanted to perform it. “I need to make sure your system is clear so I need you to lay on your back with the pillow under your head.” I then climbed onto the table and laid as she had requested. “Have you had this exam before” she asked. A couple of years ago I had to swallow some liquid so I assumed this was the same test. “No, the swallow is to look at your esophagus, stomach and sometimes the small intestine. This exam is for your colon and lower GI tract. I’m going to be giving you a barium enema. I’ll lubricate and insert a tube into your rectum and then we’ll fill your colon up.” “Yikes,” I said. “Ok, now don’t breath” and I heard a buzz and that was that. I’ll be right back the nurse said and she walked out of the room.

She shortly then returned to the room. “Ok you are clear so we can proceed. Please turn onto your left side for me” so I just sort of turned slightly but not so much that I couldn’t see what she was doing. “This will take just a moment to set up.” The tech then walked out of the room through the door into the hall. A few moments passed and she then walked in rolling an unextended IV stand to the foot of the table. She then left the room for a moment and came back with what looked like a reservoir that she placed under my bottom so that if there was a leak it would be contained. “Ok now roll over onto your left side” she again requested, meaning that the barium enema was already put together and ready. I sort of rolled onto my left side but again not completely. One second she said and she walked out of the room and into the side doorway. In a flash she walked back holding a very large enema bag completely full of the barium liquid with a clear connected tube and large nozzle, hooking it to the stand that she then elevated three feet above the platform. Can I see the nozzle I asked? Sure, and she handed it to me and then squeezed the plunger showing how the balloon expanded. The balloon is meant to keep the barium inside of you she said. The nozzle was not yet lubricated which made me a little concerned. “Ok now I need you to roll onto your left side” as I slowly but not quite completely did so. I felt her lift the gown over, exposing me for the first time. “This is going to feel a little moist” as she than applied the KY jelly with her gloved right fore finger onto my anus and slightly in. Now this is when the problem started. “I am going to insert the tube through your rectum now, Charles” and she just touched the tip and inserted in slightly. “Ow,” that hurts I said. “Ok now take it easy.” “Ohh, that hurts.” The nurse said “try to relax” as she pushed the nozzle just a little higher. “Oh can you withdraw it and let me lie on my stomach?” “No now just relax you are tightening up!” as she pushed the tube still higher. Flex both knees please she demanded, at which point the nozzle plopped in. “How are you doing?” “Oh man this really hurts.” “Ok we are in. Now I am going to inflate the balloon” and I felt the pressure as it expanded inside my anus, as if a hard rubber ball was inside. Oh that really hurts I pleaded as the taut balloon pressed inside my anus. She then pulled the gown back around me. Roll back onto your back and I felt the nozzle and hose twist inside of my rectum. Ok now you stay here while I get the doctor. The pain was intense and every time I moved even slightly it hurt worse.

This nozzle was really starting to hurt as I laid on my back, seeing the hose snake out from under me up to the bag itself. I kept trying to flex my rectum to relieve some of the pain but it wasn’t helping.

After several very long minutes, as I tried to peer around the x ray camera that blocked my view to the waiting bag, the doctor came in. Now this is going to go pretty quick he said. I then felt a fast rush of cool barium into my colon. Oh that hurts I said. Just try to relax as I felt the fluid rush up my gut. I heard a hissing and then felt the air forced inside eliciting a very large cramp. “Ow, oh how much longer do we have to do this?” I asked. We’ll be done in a few minutes, now turn onto your stomach and I felt the nozzle twist inside of my rectum. Now more air the doctor said and the cramping returned in full force.

After about a half hour of this, the tech unhooked the bag from the IV stand and dropped it to the floor, allowing the barium to flow out of me. And 30 minutes later we were done.

Barium Enema - Part 3

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Boy this was quite a morning.

The suppository I had to take before going to the radiologist left me burning and cramping simultaneously.

I arrived at their office and went up to the reception desk where a nice looking gal in her early 30s asked me how she could help me. I told her my name and, feeling rather weak, asked her for a glass of water. Ok but just a sip she said, having checked out that I was about to have a barium enema. I gave her my insurance card and signed a document for billing. It should be just a moment she told me and pointed me toward the reception area. I then saw her exit the reception area and head into the x ray suites with what I thought were my paperwork and envelope for the final results.

I took a seat in front of the glassine doors and waited for about ten or so minutes. Then a young Indian gal about five feet 3 called out “Charles Alexander” so I got up and walked through the doorway into the radiology area. My bottom really hurts and is on fire I tell her but she continues to walk me toward the changing closets without commenting on my remarks. She points me to the nearest open cubicle that is within a couple of feet of the x ray suite itself and says “take everything off and put on the gown, open in the back. She then pulls the cloth curtain closed. I proceed to take off my green shirt and then step out of my shoes, unbuckling the belt on the pants then unzip the zipper then unbutton the top button, then slid my underpants off. It is pretty claustrophobic and I can barely turn. I pick up the gown that was lying on the chair and try to shake it out. Its all sort of twisted around and I find one sleeve but not the other. Feeling a bit trapped I twist the fabric and look for a second arm hole but it is inside out. The tech, standing outside the curtain says “please come out when you are ready” attempting to hurry me and the women next door tells her she is ready, but I know the tech is speaking to me so by this moment I find the second arm hole and slide the gown on, but not tying it together from behind so it just hangs apart. Since I am only going a few feet into the x ray suite to my left I figure it doesn’t matter and the tech didn’t say anything about tying it together anyway. I open the curtain and follow the female tech into the darkened room. I notice an older woman sitting on a chair in the staging area to my right who I guess got a good look at my behind but at this moment I didn’t care.

I want you to get up on here and lay on your back for me so I do as directed as she points to the table. She then walks out of the room. Ok breath, now don’t breath and I hear the buzz of the machine for a moment. Ok you stay right here so I just lay there with the flimsy gown on, than I decide to sit up and sort of twist myself around with my feet at the edge of the table facing the work area. She then comes back. No now please lay down on your back. So I do that. You have had this test before and I tell her I don’t think so. Do you know what this test is about she asks? Not sure I reply. Ok let me get your file she says and walks out of the room. I hope I haven’t pressed her to hard about this since I need this exam to be done I think to myself. She returns and asks my date of birth and I tell her. Ok you have had this test done twice in the last two years. I nod ok. So what I am going to do is to give you a barium enema. I’ll insert a tube through your rectum and fill your colon with barium. Oh no I respond. She looks at me in a very stern manner. And then knocks on the door adjacent to the room. “Do you have the bag” she asks. And I hear a voice ah no I don’t. She then walks out of the room back toward the changing closet area and disappears. I roll over on to my right side to kind of see what is happening and nothing does for a minute or two. The tech then walks back in through the main door carrying an enormous bag filled to the top with the barium solution. A clear hose snakes out from the bag and the brown nozzle is already attached. This is the nozzle I’ll put into you she says as she holds it up in the air than lays it on the far end of the table She then reaches around and pulls out a clear reservoir I need to have you lay in this and she swings it under my hips. She then walks around out of my sight and I hear the rattle of an IV stand that she rolls on the floor to the foot of the table. Roll on to your left side and face the wall she orders. Please uncover yourself but the gown is caught up in the reservoir and I can’t lift up high enough to pull it apart. I struggle to do this while somewhat watching her put KY jelly on the table and then rolls the nozzle around in it.

She leaves the nozzle on the table and reaches around and strongly pulls the fabric away from my bottom. Feeling very exposed she then picks up the nozzle and I tighten up. Ok now try and relax as she touches the nozzle to my rectum and then inserts it quickly into me. Ow, ow, ow I say. The edge of the nozzle is sharp and it feels like it is jagging into me scraping the inside of my rectum to the back wall. I then feel the balloon expand inside forcefully. That hurts. Ok now I want you to roll onto your back for me as she pulls my hips back onto the table. Not much people skills with this one I think. I’ll go get the doctor and she then leaves the room with the door still opened. I have a feeling that older woman saw the insertion but at that moment I didn’t care.

The doctor then came back with the Indian tech in tow. So you have had this test done before but not here but the tech says no he had two here the last two years. And you don’t recall having this done? I told him I may have blocked the memory out since this was so painful. Now I have done thousands of these and sometimes it is tougher on the younger patients. Have you ever been scoped and I tell him I have. He then says that the barium x ray illuminates the outside of the colon as well where pockets can occur. Ok I’m going to open the barium and you will feel it going inside. The tech says please hold onto the nozzle as the doctor releases the clamp and the thick fluid rapidly starts flowing in. Now I am going to stop this and I need for you to roll on towards me he says. I do so and he then releases the next wave of fluid. Now I want you to roll onto your left side for me to coat the other part of your colon and I do so. Than I feel the nozzle begin to slip out as I am laying on my left side. Its coming out I tell them. And he stops for a moment and tells her to advance the tube higher up. Hold onto the tube the tech declares. That happens in a flash as I feel her push it higher up, striking the inside of my colon. Ow I say. Boy this nozzle really hurts I tell them. I then feel the next wave of barium flowing inside of me and start to cramp up. Ok just a bit more and he releases the flow one last time. For whatever reason the tech remains stern. There is intermittent air being pumped in simultaneously as well which I haven’t felt happen in a long time.

The nozzle is left in considerably longer, probably the longest ever since I’ve had this test. The tech takes over after the doctor leaves and continues to push and prod and move me in all sorts of positions to gather the remaining images she needs. A second tech who is rather pretty then comes into the room to assist the Indian in some way. The gown keeps creeping up past my hips but I’m not about to deal with that myself. They both continue to get a good look as the procedure continues. Not supportive she was, not one bit. Another fifteen or so minutes of this with her barking commands at me.

She then reaches up to the bag and drops it onto the floor. Don’t let any of the fluid leak out or you will make quite a mess. While the fluid starts to flow out of me I find I don’t feel much better. Now roll back onto your left side and I’m going to pull the tube out of you. Use this towel to catch any of the fluid so you don’t make a mess. Yikes, she needs to be in a chem lab somewhere mixing ingredients. She reaches around and grabs the nozzle in one quick motion as the nozzle is pulled out of my rectum, eliciting a cry out of me because she is so rough. Now go use the restroom and I’ll come back to get you in 10 minutes. And then we are done.

Barium Enema - Part 4

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I arrived the Valley MRI at about 9:35 am, ten minutes before the scheduled start.

Hi, I’m Thomas Kennedy here for the exam at 9:45. I can’t believe I have to have this awful exam again, it was terrible last time I said. The receptionist with two other girls behind her said well let me get a copy of your insurance card. Is there a water fountain around here I asked. Well you can only rinse your mouth out you can’t swallow any of the water due to the test. Where is the rest room I ask and she points me to a hallway to the right side and says first door on your right so I head off over there. As I return she is bringing in a case of water and hands me a bottle. Ok I’ll be right back so I than head back to the bathroom to swish some water in my mouth and then spit it out. She hands me the insurance card back and I shove it into the wallet.

I come back to the main waiting area and have a seat, than realize I should just leave my wallet in the truck so I tell the receptionist I’ll be right back. I go to the car and drop the wallet in the middle box and walk back to the facility. As I walk back in the door the receptionist asks if I have the doctor’s slip for the test and I tell her no and that she should call Dr. Watts office on Parnassus to get it. I had told David that I was having a problem with the diverticulitis in an email sent and responded to by him just yesterday. Anyway, several minutes pass and I am wondering if the test will actually happen. The receptionist than calls out to me and says that she should have the requisition form in hand in the next few minutes.

So I sit back and watch the minutes slide by, having now spent an hour in the in waiting room. Finally I saw the receptionist walk the documents into and the through the swinging doors and thought it would be only a few more minutes. Well a half hour later a blond heavy set woman in her early 30s walks through the double doors and into the reception area and calls out my name. I stand up and follow her into the familiar x ray suite itself. It is surprisingly dark. I can’t believe I have to have this stupid exam so soon. I was up until 4 am with the prep and everything is on fire down there. Did you have it just recently she asks. Last August I tell her. She is carrying a gown with her and walks me into a very dark and fairly large cubicle. Ok take off your shirt, pants, underpants and if you want you can keep on your shoes and or socks. Open the curtain when you are ready. It is so dark I can barely see what I am doing. There is just one little hook attached to the wall so I take off my blue checkered shirt than remove my shoes and socks, than remove my levis and hanging them on top of the shirt. Then I remove my briefs and hang them up. I pick up the gown from off of the chair and sort of turn and twist it around to try and find the arm holes, finally doing so. I pull the gown around me and decide to just tie the ties at the mid back leaving the upper ties unbound. I pull open the curtain and there is no one in the area, so I head over to the adjoining bathroom and step inside, locking the door behind me. I look at the mirror and determine that I am not particularly exposed, and can see that I should make the looped ties looser so I untie and retie it with more room in the fabric for me to move. I rinse out my mouth and then open the door returning to the dark cave that is my changing room.

A moment or two go by and Julie returns. Ok Thomas follow me so I follow her into the x ray suite. I spot the IV stand just outside of the room on my left as I walk into the suite. So you did the entire prep she asks and before I can answer she says well if you were up until 4 I guess you did. She picks up a metal film tray and slides it into the cassette holder at the end of the table. Ok up on to the table and lay on your back as I adroitly anticipate what needs to be done. I need to make sure you are clear so she walks out of the room. Breath, now don’t breath and I hear the familiar buzz. I’ll be right back as she walks through the doorway and into the main area to review the film.

A few minutes pass and she walks back in. Are you allergic to lidocaine like you would get at the dentist and I said no I wasn’t. You know I can mix a little lidocaine into the lubricant that might make the nozzle going in easier to take she said. She than walks to the foot of the table to an open cabinet against the wall and grabs some lubricant and a small emesis container. I sit up to watch as she sits in the open doorway to the right of the table and begins mixing and stirring the concoction into the jelly. She then picks up one of air hoses for the inflator that is to go inside of me and crimps it off. She then walks past me through the main doorway and I can hear the stand chatter as she rolls it into the suite just to where my hips are. From inside the side room she picks up the enema bag filled with the fluid with the clear plastic hose and brown nozzle attached and hooks it to the IV stand next to me. Next she releases the barium inside the bag into the hoses up to the point where the stop cock rests just behind the nozzle. Do you see how the balloon expands she asks, when the nozzle is inside of you I’ll expand the balloon to keep the barium from leaking out. I need to make sure the doctor has the prior file to refer to before I tip you and I sort of nod in agreement.

She walks out of the room and is gone for maybe a minute.

When she returns she has the small inflatable reservoir in hand. Let me slide this under your hips she says as I lift off to let her do so. Ok now Thomas I want you to roll onto your left side for me and as I do so she pulls the fabric out from under me so that it is loose. Ok lets get started as she pulls the fabric away from my hips so that my bottom is completely exposed from the waist down. Smearing the lubricant around the nozzle itself, she drags the breadth of the nozzle forcefully against my rectum, spreading the lidocaine jelly across my anus, than more forcefully pushes the tip straight in in a very convincing matter. I shriek from the pain of this seemingly huge nozzle being pressed so high into place. Ok now I want you to roll back onto your back for me and as I do so she says now I’m going to expand the balloon and I feel this monstrous nozzle push the nozzle higher and causing an acceleration of the pain. The doctor standing next to me says ok this will be quick and I feel the flow of the barium into my gut causing an immediate cramp that sort of takes control. You are doing good he says as they begin rolling me into place commanding to move and stop and breath and don’t breath and after about 20 minutes of struggling the task is completed.

The doctor tells me that there are some diverticula but not too bad nothing that he is concerned about.

And that is that.