the waiting game
i’m impatient. generally, but also in this specific case: i hate waiting for pathology reports. my gastroenterologist took (his words) “lots and lots of biopsies,” this morning and expects them to be back from pathology in 2-4 weeks.
quick update on the scope: this is my nth scope, where n represents “lots and lots.” (10? 15?) i knew what i was expecting. of course it still makes me nervous and of course when they first push the drugs into the iv it surprises me. the pain meds wore off about 4pm and my chest hurts a little. i won’t know anything concrete on the barrett’s esophagus until the pathology reports come back, but my doc did double up my meds based on the visual inspection. he said it was clear that more proton pump inhibitors would help. he also (before i went under) said that he’d like me to schedule a follow-up to discuss treatment options. note that this is the doc that preferred the ‘watchful waiting’ approach (which is the american medical associations defined standard of care for low grade dysplasia). he told me to read up and come with questions if i had them.
i’d love to get the slides back from pathology, but my doc doesn’t even get that. no, i don’t think i could do a better job than someone who does this for a living; i’m curious! it’s probably significantly weirder than asking a dentist if you can keep the tooth they pull. “can i keep my biopsies”?
johns hopkins did a study on the consistency (since accuracy isn’t possible with a subjective grading of samples) amongst pathologists and found that some samples commonly have large variability between individuals. 12 pathologists saw 24 individual samples twice (without knowing which they’d already seen). most pathologists were “internally consistent” and graded the same sample the same way both times. some samples had variation from “low grade dysplasia” all the way to “high grade dysplasia”, depending on the pathologist. i can’t find the original study, but they’ve published some guidance for pathologists based on that study.
in a few days, i’ll get a full color glossy print-out from my scope (yes, ew) with some notes scribbled up to reflect the conversation i had with the doc. they don’t expect you to remember much, since the versed, thankfully, has a side effect that gives you amnesia.
i’ll post an update when i get that.