Hepatitis C Esophageal Varices Banding
My friend Mary Lou at hepcsupport.org is having her first esophageal varices banding. We have been messaging back and forth like crazy. She had a lot of fears and questions. As your best friend in the battle, I thought that you too might want to eavesdrop on our private messages. Also be sure and read Varices Stages and Grading here.
Mary Lou: OK. I have this banding coming up. What can I expect?
Moi: Well, you have had an endoscopy, so you already know what the prep for the scope is like. This starts out the exact same way. No food after midnight the night before. Ask your doctor if you can have enough water to take your meds in the morning.
When you arrive at the outpatient center, they will take you back and put you in a peek-a-boo gown and start an IV. Wear a little bit of blush and lipstick. Send pics! lol. All of your personal belongings will stay with a family member, wear pretty panties – makes you feel better. They take your vital signs and cover you up with a warm blankie. You will answer a lot of questions about dentures, medications, hepatitis c, and whether or not that is your real hair.
Soon they whisk you back and your doctor chats you up. They give you a gargle that is a nasty tasting mess and has the consistency of owl snot. I hate that part. (shuddering gag) The next thing you know, someone is putting you in a wheelchair. Really. There is no sense of time. On my last banding, my daughter said that I tried to wheel myself out to look for my red shoes. If you get my drift, it is la-la-land time.
Once you get home, it is a good idea to take some pain medication. You will not feel bad at first, but sedation wears off, you know? Then you just curl up in your own bed and drool on the pillow.
Mary Lou: I don’t drool. Ever. It’s not lady-like. How long does this take?
Moi: I am usually gone from the house about 3 hours total except the time we stopped at McD’s for an ice cream cone.
Mary Lou: What? You were out of it. How long before sedation wears off?
Moi: Since you have cirrhosis, your body does not process the sedation quickly. It kinda cycles in your bloodstream cuz your liver can’t cleanse it out. That zoniness lasts for several days in my case. I think people may do better if their liver is in good shape. But think about it… You can get a lot of mileage out of that.
Mary Lou: When can I eat? My liver processes food so crazy that I have to eat frequent meals or my blood sugar gets wacked. BTW – I get your drift. I need the mileage. So I can’t cook or clean for 6 weeks? (sly grin)
Moi: Exactly! Eat popsicles, jello, and soup for a couple of days. Have some protein shakes on hand. Somebody brings them to me in the bed for the first several hours….. uhm, I mean weeks. haha!
Mary Lou: Get serious. Will I have pain? How much? How long? What kind of pain meds? (jaw clenched already)
Moi: Chill sister… You may experience some discomfort. Talk to your doctor Before the banding. I had spasms one time and took mega meds, but usually a little acetaminophen cuts the pain ez.
Mary Lou: Why? What hurts?
Moi: Your esophagus. See, they put the scope down and see how many varices that you have. They put rubber “bands” around them with the scope. That causes them to kind of die and fall off within several days. Then they just go through your digestive system eventually. If they only have to band 2 or 3, you will have less discomfort. You might even eat toast within 48 hours. I stay with liquids and then soup for a few days. I know when the doctor was banding 5 varices, I had more soreness – it was not easy to swallow n e thing for about 4 or 5 days. Matter of fact, it hurt swallowing anything but liquid. They usually will not band more than 4 or 5 at once.
Mary Lou: Sounds gross. What if I have more varices? There is not a lot to read about it.
Moi: You may. I really hope not though. If you do, the doctor will schedule you to go back in every month and get more removed. I’m already 6 ahead of you. Wanna race? Ha. He will probably put you on a higher dose of Nadolol – the beta blocker that slows down the portal hypertension. That keeps the ones you have from growing and also can prevent new ones from forming.
Mary Lou: Were you scared?
Moi: Are pigs pink? Heck yes! The first one was in ER – ICU, blood and platelet transfusions. I can’t talk about it – that was a scary nightmare that I try and block. When I got home I just knew that I would never be able drink coffee, eat nachos, or anything other than homemade soup and popsicles for the rest of my life. They discontinued my hepatitis c treatment. Geez! I was a huge heap of sad, tired, and sorry. It took me a few weeks to manage a higher dose of the beta blocker and learn to chew everything extremely well. My teeth are officially as good as any food processor now. THAT is important information also. Do not try and swallow oatmeal without chewing. It is awful when it gets lodged in the middle of your esophagus. (Shaking my head) Nasty mess. (crying)
All of the other bandings were planned. By then I learned that there is life after portal hypertension and varices bandings. Anything else? It’s hard not knowing… I’m sorry.
Mary Lou: I’m sorry you had the bleed out. So the banding will prevent that. I think I’m about ready. Not really - but that sounded good, didn’t it? Any more tips for your girl friend?
Moi: Yes – bandings done regularly can prevent bleeding esophageal varices. Try and schedule the banding at the earliest possible time slot so you will not be too hungry. Blood sugar does drop with liver disease and fasting is hard. That makes you look pale. Put on more blush and lipstick.
Also, calm your sweet self while you’re waiting your turn. When I am all ready and lying on the hospital gurney, I ask for the lights to be dimmed. That gives me some time to take some slow deep breaths and pray or meditate. I need it. I always get a little jittery. I even tell my daughter that she is the only person allowed to get in my personal belongings if I should die before I wake. I’m lol, but it is part of my routine. I don’t wanna scare you. It is never easy to go under sedation, even if just a light one. Once you’ve stared death in the face, you treasure each moment and know that it is a gift, right?
Mary Lou: That I know sweetie. I have confidence in my doctor. I know that this is necessary. It is just an unknown. I feel better hearing about your experience. I’m just ready to get it over with.
Moi: Within a week, you will forget that you had it done. Even after my first emergency one, I was back at work in a week.
Mary Lou: I know that many others have survived this. It’s a part of the disease progression.
MOI: Yipper. Hay! You could pull a Katie Couric and have it all shown live on the Today Show!
Mary Lou: Honey, I think it’s time for you to go to bed. You know why? You are talking crazy stuff! I’ll talk to you tomorrow. Thank you.
MOI: You’d do the same for me. I know you’ll use this like you do every experience. You will reach out to others who are going through it. It’s such a gift you have. Making something good out of something bad. TTYL. I gotta go call the Today Show… Gnite.
Mary Lou: Forget the Today Show. Get some sleep hon.
P.S. So that was our little varices chat. Another friend – a guy – is probably going to have to be banded too. You know who you are…. so this is for you also. Just don’t do the lipstick thing. haha! I hope this helped. We’re all in this together. The good, the bad, and the ugly of cirrhosis, hepatitis c, and on and on… xoxo Karen:)