TEE

from a

Patient's Perspective

Yours truly just underwent another "not my favorite thing to do" medical procedure: Transesophageal Echocardiography or TEE . Exactly the same imaging process as the the standard echocardiogram (Transthoracic Echocardiography or TTE), but with a small probe placed into the throat (esophagus) instead of being held externally on the chest. While rather insignificant, compared to Cardioversion, I was still not too happy at the thought of having it done. In the off chance that there is someone else in this world that shares my apprehension of all things medical, especially those things that are invasive, I decided to share my experiences here...


I was told that I was not allowed to eat or drink anything (for obvious reasons) after midnight the day of the procedure. I was to be at the hospital at 7:30 AM, so it didn't seem like an unreasonable request. Oh how wrong I was...

Strange thing how the mind works. The closer it got to midnight, the thirstier I became. As the forbidden hour approached, found I was drinking more and more water with each tick of the clock. By the time midnight rolled around, I must have consumed gallons! Even so, I'd never felt thirstier in my life.


I did manage to get to sleep and up early enough to make my check-in time. Unlike the Cardioversion experience, check-in was a breeze. The Endoscopy Department had their own registration clerk so it went very quickly.

All was not well however. The clerk told me I was supposed to be there at 7:00 AM, not 7:30 like they told me in my doctor's office. My mind, already on the fast path to panic, shot back to a time in my youth when I was late to the dentist's office. The dentist told me he didn't have time to wait for the Novocain to kick in, so would have to start without it.

I asked the clerk it this lost half-hour was going to "cost me" and told her about my experience with the dentist. She had a good laugh, as did everyone else in the office.


Next stop was the prep room. This was a large room separated into small stalls by curtains. There I changed into a hospital gown, an IV was started, and the nurse ran down the check list... "Anything to eat or drink (don't I wish), any allergies (hospitals) ..." and so it went.

Lastly she asked if there was anything else she should know about.

Still thinking about the 30 minutes and my experience with the dentist, I told her that I gag on tongue depressors (perhaps hoping that would get me an extra dose of whatever they give you). "That's nothing", she says, "most of my patients tell me they gag when brushing their teeth." It's then I realized that: (a) she's heard it all before, and (b) I'm not her first "reluctant" patient.


I'm not sure how long I was in the prep area, probably about 30 minutes. As the time approached, the doctor that would be doing the test stopped by to explain what was going to happen. He grabbed the cord to the call button clipped to the bed and said the probe was about the same diameter (the cord, not the button). He explained that first he would administer a spray that would numb my throat, and then a sedative via IV to help me relax. He said the spray tasted like bananas and took about 10 minutes to start working. A few minutes later I was off to the examining room.

After the nurses got me settled, the doctor administered his "banana spray". Well let me tell you, either this doctor has never eaten a banana, or, more likely, he's never had this stuff sprayed in his mouth. Imagine the worst tasting, most bitter thing that ever rolled down your throat at the dentist's office, multiply that by 100 on the "yuk" scale, and you have some idea what this stuff tasted like. It was awful!


Next, the I heard the nurse say she was going to administer the "happy juice" (not sure that is the term she used). Within seconds I felt relaxed, without a care in the world. I remember the doctor having me bite on some sort of plastic thing which he said would make it easier to breath.

I should add at this point that, with bad sinuses, adenoids, etc. I've always had trouble breathing through my nose. In fact that was one of my major concerns with the procedure (the other was the gagging bit). I mentioned this to the nurse when she placed the oxygen tube in my nose. I told her that it probably wouldn't do any good and explained why. She assured me it would work, and it did. At no time through the entire procedure did I feel short of breath or have any problems breathing.

The rest is sort of a haze. I was told the procedure took 20 minutes, but it could have been 20 seconds for all I knew. I got a brief glimpse of the probe. My guess is the cord attached to the probe was about the same diameter as that of the call button, but the probe it self was a tad larger, perhaps 3/8" (10 mm) or so (might have been smaller). I remember the doctor telling me to swallow, but didn't feel anything go in or down (nor did I feel it when the probe was later removed). I could hear the doctor giving instructions to the echo tech and nurses, but really wasn't aware of what they were doing. At some point there was the slight sensation of something in my throat moving up and down and perhaps twisting a bit, but it more of a pressure than anything else. I guess the closest thing to it would be that feeling you get when you swallow a pill and it goes down sideways. No pain and no sensation of gagging what so ever (I guess the "banana spray" wasn't so bad after all...).


As I said, thanks to the nurse's "happy juice", I was feeling pretty good. I really had no idea of how much time had passed before the doctor told me it was over and I was on my way back to the prep area. The sedative and banana spray wore off soon after that.

The nurse told me I'd have to stick around for a while just to make sure that there were no ill effects from the medication. All of a sudden I had this feeling that I had to go to the bathroom. Strange I thought since I hadn't had anything to drink for what seemed like forever. When I couldn't stand it any more I called the nurse over and told her how uncomfortable I was, but that I knew it couldn't be real. She pointed up at the now, nearly empty IV bag hanging above my head and asked... "Where do you think all that goes?" Fortunately she said it was OK to get out of bed, outfitted me with a rolling IV stand and away I went. Oh what relief...


The last step of the day was to have me to drink some juice, I guess to make sure I didn't have any trouble swallowing. She asked me what kind of juice I wanted, but for some reason, I ended up being wheeled out of the hospital before it arrived (perhaps this is where that lost 30 minutes was collected).


You are requested not to drive after the procedure (probably because of the sedative). I took a taxi to the hospital, and for the return trip home, the hospital's "Road Runners" shuttle service. (If you find yourself in a similar situation, check with your local hospital about their shuttle service. These are usually staffed by volunteers and operated by the Hospital Auxiliary. It is a much more pleasant trip than in the taxi, less expensive, and for a good cause. It certainly will be my preferred mode of transportation for future hospital visits.)


Well that's about it. A total of 2 1/2 hours, with no pain and no problems. There was absolutely no sensation of gagging or choking. No difficulty breathing. Pretty much a nonevent. If I had to name one positive and one negative, I'd say the nurse's "happy juice" was the positive, and, you guessed it, the doctor's "banana spray" was the negative.


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Page Updated: 9-Dec-2001