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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22280
Experience:  Over 20 yrs of Family Practice
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Im still nervous about the EGD. I think I should cancel i

Customer Question

Im still nervous about the EGD. I think I should cancel it
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
Hi--what's your concern about the EGD?
Customer: replied 2 years ago.
Uh the sedation
Expert:  Dr. Chip replied 2 years ago.
Why the concern with that?
Customer: replied 2 years ago.
What if i die
Expert:  Dr. Chip replied 2 years ago.
You understand the term "conscious sedation?"
Customer: replied 2 years ago.
Ya but i still worry
Expert:  Dr. Chip replied 2 years ago.
Understandable, but so far I haven't had a patient die with conscious sedation.
Customer: replied 2 years ago.
I just worry
Expert:  Dr. Chip replied 2 years ago.
You'll be fine--it really isn't anything that comes near an overdose.
Customer: replied 2 years ago.
If im dehydrated or hypoglycemic on that day it wont matter
Expert:  Dr. Chip replied 2 years ago.
What won't matter?
Customer: replied 2 years ago.
Im afraid if im dehydrated/hypoglycemic during the egd i will some how end up dying. I know that that is an unrealistic thought
Expert:  Dr. Chip replied 2 years ago.
Yes--unrealistic--the procedure itself will not take any water from you or drop your blood sugar any.
Customer: replied 2 years ago.
I think i just dont want to get it done
Expert:  Dr. Chip replied 2 years ago.
I kinda knew that but I wasn't going to go there.
Customer: replied 2 years ago.
Do you think I need it done
Expert:  Dr. Chip replied 2 years ago.
Not as a semi emergency procedure, but yes for a check on peptic ulcers, gastritis, reflux, H pylori, etc.
Customer: replied 2 years ago.
Thats not the answer i
Was looking for
Expert:  Dr. Chip replied 2 years ago.
So what was the answer you were looking for?
Customer: replied 2 years ago.
That you dont think i ever need one
Expert:  Dr. Chip replied 2 years ago.
Can't tell you a falsehood just to make you happy with the answer.
Customer: replied 2 years ago.
I dont think its something i need next week
Expert:  Dr. Chip replied 2 years ago.
No, especially if you supercede it with going into treatment, but, otherwise, it would just be a put-it-off thing.
Customer: replied 2 years ago.
I guess
Expert:  Dr. Chip replied 2 years ago.
No guessing--you would just be procrastinating for no good reason.
Customer: replied 2 years ago.
Its not for no good reason. Its because it scares me
Expert:  Dr. Chip replied 2 years ago.
As good an excuse as any. It may scare you but we've already discussed that your fear is somewhat overblown.
Customer: replied 2 years ago.
I know. It just seems soon
Expert:  Dr. Chip replied 2 years ago.
Soon?
Customer: replied 2 years ago.
I dont know why it cant wait til the end of summer. Instead of in a week. It doesnt give me time to think about it
Expert:  Dr. Chip replied 2 years ago.
Nothing more to think about--you won't have anything new to come up with by the end of summer.
Customer: replied 2 years ago.
Ok
Expert:  Dr. Chip replied 2 years ago.
OK
Customer: replied 2 years ago.
What else
Expert:  Dr. Chip replied 2 years ago.
That's entirely up to you.
Customer: replied 2 years ago.
Not sure i want to be away from my family if i do the eating disorder treatment
Expert:  Dr. Chip replied 2 years ago.
Well, from what you've told me it would sound like a welcome relief from your mother and maybe your father, and by your own admission, it doesn't sound like your sisters will miss you much. And, looking at it another way--a little silly, I know--a two week vacation is something many people take.
Customer: replied 2 years ago.
But i love my family and 2 weeks away is a long time. And my little cousin is only here til august
Expert:  Dr. Chip replied 2 years ago.
Two weeks is not a long time and you owe it to your cousin to get well so you can be there for him--let's not get into excuses and if onlys and what if's.
Customer: replied 2 years ago.
Maybe im not ready to
Go
Expert:  Dr. Chip replied 2 years ago.
I never said you were ready, but that doesn't matter--in a case like yours I'd be very surprised if you said you were 100% sure it was time to go.
Customer: replied 2 years ago.
I dont think im even 15% sure anymore
Expert:  Dr. Chip replied 2 years ago.
It doesn't matter
Customer: replied 2 years ago.
It does matter. I dont know if i want to mention it to my dr
Expert:  Dr. Chip replied 2 years ago.
No, whether or not you want to go doesn't matter. It's just like the alcoholics and drug addicts I work with--hardly any of them are ready to go to treatment, or so they say. I just say I never expect them to be fully ready and, if they refuse, I just say they're entirely welcome to continue to suffer and to get worse.
Customer: replied 2 years ago.
Im ok with suffering and getting worse
Expert:  Dr. Chip replied 2 years ago.
Fine--you have my permission to do so.
Customer: replied 2 years ago.
I think that you are angry with me
Expert:  Dr. Chip replied 2 years ago.
Not at all--if you will, it's called tough love. I just won't fall into your trap of agreeing to feeling sorry for you along with yourself.
Customer: replied 2 years ago.
I dont think i feel sorry for myself
Expert:  Dr. Chip replied 2 years ago.
I do.
Customer: replied 2 years ago.
How so
Expert:  Dr. Chip replied 2 years ago.

Doesn't really matter for the point of our discussion but your saying you were OK with suffering and getting worse was one clue. But we've neatly gotten off course here--back to just because you don't want to go to treatment or don't think you're ready is absolutely no argument against biting the bullet and going.

Customer: replied 2 years ago.
It is an argument for not going. If i dont think im ready to gonwhat do you think the odds are that i will work on my issues
Expert:  Dr. Chip replied 2 years ago.
You can argue all you want--it won't change facts. I've known you long enough to be straight and to the point here--I don't think you can ever make any progress with the eating problem without inpatient treatment.
Customer: replied 2 years ago.
Thanks for that. It was a real confidence booster. Just what i needed to end my already crappy day
Expert:  Dr. Chip replied 2 years ago.
Now you are definitely feeling sorry for yourself. Don't ever expect me to tell you something I don't believe just to make you feel better--that won't help you in the least. Let me put it this way--if you do go into treatment, I would consider that to be a greater show of power on your part than if you refused to go.
Customer: replied 2 years ago.
I need my family. I cannot be away from them for 2 weeks
Expert:  Dr. Chip replied 2 years ago.
Pardon my French--that's BS but let's drop the subject. I'll just finish with saying that if you refuse to go, you're in a deep denial and you aren't capable of recognizing that. Not your fault--I've had a lot of experience with it.
Customer: replied 2 years ago.
Everyone makes it seem like my fault. The drs ive seen in the past week make me feel like this is all my fault. That all i need to do is deink/eat and i would feel better. Yes they are correct but its not that easy for me to do
Expert:  Dr. Chip replied 2 years ago.
I never once have said the disorder is your fault.
Customer: replied 2 years ago.
Not you. But everyone else does
Expert:  Dr. Chip replied 2 years ago.
So stick with me and let go of what they think
Customer: replied 2 years ago.
No because it makes me so mad. I am not stupid. I know that if i eat/drink i will feel better. But they dont realize that i cant do that. I may have an eating disorder but i still deserve to be treated with respect. They could atleast try to treat the symptoms
Expert:  Dr. Chip replied 2 years ago.
Remember what I said long ago about resentments--like resenting the fact they don't treat you with respect--they don't lose any sleep over that. Getting angry over others' ignorance is really a waste of energy.
Customer: replied 2 years ago.
I dont care
Expert:  Dr. Chip replied 2 years ago.
Thanks for sharing that--so what?
Customer: replied 2 years ago.
Im just having a really bad day. But im sure tomorrow will be better
Expert:  Dr. Chip replied 2 years ago.
Do you realize how much anger you have right now?
Customer: replied 2 years ago.
Yes i do
Expert:  Dr. Chip replied 2 years ago.
Important--very important--who all are you angry at and why?
Customer: replied 2 years ago.
I feel like Im angry at everyone which i know is impossible. Ive just been angry lately
Expert:  Dr. Chip replied 2 years ago.
Not any anger towards yourself? And, another important point--why exactly does one get angry?
Customer: replied 2 years ago.
I am constantly angry with myself
Expert:  Dr. Chip replied 2 years ago.
Why?
Customer: replied 2 years ago.
I get angry at myself for getting angry at others
Expert:  Dr. Chip replied 2 years ago.
That's the only reason?
Customer: replied 2 years ago.
That and for continuing to let this disorder kick my butt. But mainly because im angry at others is why im angry at myself
Expert:  Dr. Chip replied 2 years ago.
OK--so we're basically talking about a control issue, or, rather a lack of control over other's reactions and your anger towards that and towards your not having the power to control the eating disorder by yourself.
Customer: replied 2 years ago.
Huh?
Expert:  Dr. Chip replied 2 years ago.
What part of that wasn't clear?
Customer: replied 2 years ago.
Nvm. I read it again.
Expert:  Dr. Chip replied 2 years ago.
And your response?
Customer: replied 2 years ago.
That its true
Expert:  Dr. Chip replied 2 years ago.
OK--at least with my alcoholics and drug addicts I tell them that the only way you regain control is to let go and admit that you're powerless over the addiction--that you've tried your best to beat it and it just didn't work. If you don't stop fighting an unwinnable battle, all you do is exhaust yourself.
Customer: replied 2 years ago.
But i still think its winnable
Expert:  Dr. Chip replied 2 years ago.
That's the denial part
Customer: replied 2 years ago.
So what
Customer: replied 2 years ago.
And i dont have plans on it ever getting bad enough that i would need to be admitted
Expert:  Dr. Chip replied 2 years ago.

Too late--it's already that bad.

Customer: replied 2 years ago.
It is not that bad. I still have the say whether or not i be admitted
Expert:  Dr. Chip replied 2 years ago.
You've missed my whole point, but no matter.
Customer: replied 2 years ago.
What exactly was your point
Expert:  Dr. Chip replied 2 years ago.
You're in denial and you either don't see things clearly (which I think is the case and not your fault) or you're just ignoring and refusing to talk about how you need the treatment. Either way, it will probably mean you won't agree to treatment. It's the old analogy of one expression of insanity is doing the same thing over and over expecting different results or the guy that keeps pushing the already illuminated elevator button again and again thinking it'll make the cab arrive faster.
Customer: replied 2 years ago.
I see things clearly
Expert:  Dr. Chip replied 2 years ago.
If that's true, then you have decided to go to treatment--congratulations.
Customer: replied 2 years ago.
I can think clearly and decide i dont need treatment
Expert:  Dr. Chip replied 2 years ago.
OK--I've heard the same thing from drug addicts and several times they were dead not long after they made that statment.
Customer: replied 2 years ago.
Thats comforting.
Expert:  Dr. Chip replied 2 years ago.
Just the facts, ma'am. Listen--whether you realize it or not, what I've been trying to do with all this is to hold a therapy session with you, limited as it is with this internet thing. My goal was not to convince you of anything in particular like going to treatment, just to make some comments that hopefully made you think for a moment. My experience with the denial problem is you usually can't get through the wall but sometimes you can chip away a small piece of it so that a little water seeps through the dam. Then, later, maybe the dam will eventually burst. Sometimes, though, the wall holds no matter what. I'm not at all angry if you don't accept anything I've said and if you think I've got it all wrong--I wasn't trying to win any battles here.
Expert:  Dr. Chip replied 2 years ago.
Sleep well--either get back to me early in the morning or tomorrow evening if you'd like.
Customer: replied 2 years ago.
i have taken 50 mg of metoprolol. Instead of 12.5
Expert:  Dr. Chip replied 2 years ago.
How did that happen?
Customer: replied 2 years ago.
Sometimes ill just take a whole one instead of taking it twice a day. I just took one about 5 mins ago but im pretty sure i took One this am
Expert:  Dr. Chip replied 2 years ago.
Could cause a significant drop in your blood pressure--are you able to measure that?
Customer: replied 2 years ago.
Even if its just 50mg. Half hour ago it was 118/82
Expert:  Dr. Chip replied 2 years ago.
That's still double the usual dose but so long as your pressure doesn't drop to say a less than 100 systolic, you'll be OK. Were you to see your doctor today?
Customer: replied 2 years ago.
I saw him earlier
Expert:  Dr. Chip replied 2 years ago.
And?
Customer: replied 2 years ago.
Nothing
Expert:  Dr. Chip replied 2 years ago.
OK--'nuf said.
Customer: replied 2 years ago.
Oh and i may have take 3 25 mg tabs
Expert:  Dr. Chip replied 2 years ago.

Same answer--watch your blood pressure.

Customer: replied 2 years ago.
For how long. Right now its 112/58
Expert:  Dr. Chip replied 2 years ago.
At least for another two hours.
Customer: replied 2 years ago.
I feel dizzy and woozy but my bp is fine
Expert:  Dr. Chip replied 2 years ago.
So long as it stays above 100, no problem.
Customer: replied 2 years ago.
I know its stupid of me
Expert:  Dr. Chip replied 2 years ago.
Well, no real harm done.
Customer: replied 2 years ago.
Im just really sad
Expert:  Dr. Chip replied 2 years ago.
About?
Customer: replied 2 years ago.
I dont really know
Expert:  Dr. Chip replied 2 years ago.
Well--I really don't see a need to talk much about it, but I assume you've decided not to go into treatment?
Customer: replied 2 years ago.
Ya basically.
Expert:  Dr. Chip replied 2 years ago.
OK--no need ever to discuss that again.
Customer: replied 2 years ago.
Nope I guess not
Expert:  Dr. Chip replied 2 years ago.
So what does that leave for us to talk about?
Customer: replied 2 years ago.
Nothing really. What would happen if i took the whole bottle of metoprolol
Expert:  Dr. Chip replied 2 years ago.
I won't go there--that's against JA regulations.
Customer: replied 2 years ago.
Ok
Expert:  Dr. Chip replied 2 years ago.
What else?
Customer: replied 2 years ago.
So i dont have to worry about my bp later this evening or tonight.
Expert:  Dr. Chip replied 2 years ago.
No
Customer: replied 2 years ago.
K i have nothing more to say. I think i wont need you anymore
Expert:  Dr. Chip replied 2 years ago.
Entirely your choice, but I'll be here if and when you do. Hope at least you consider all the things I've said and what we've talked about.
Customer: replied 2 years ago.
im admitted to the hospital. Just a plain hospital mind u not an eating disorder one
Expert:  Dr. Chip replied 2 years ago.
OK--what's the plan?
Customer: replied 2 years ago.
Get lots of fluids. Talk to a psychiatrist and ya
Expert:  Dr. Chip replied 2 years ago.
How did you end up in the hospital?
Customer: replied 2 years ago.
I called my dr cuz i had blurred vision and seeing spots and thats what he recommended
Expert:  Dr. Chip replied 2 years ago.
So what has the physical workup shown?
Customer: replied 2 years ago.
Low blood sugar. Idk what else
Expert:  Dr. Chip replied 2 years ago.
Well, what about the cause of all the problems--just low blood sugar? Any testing to see why it was low?
Customer: replied 2 years ago.
The cause if the low blood sugar is prob cuz i havent eaten
Expert:  Dr. Chip replied 2 years ago.
OK--so is this a new psychiatrist you'll be seeing?
Customer: replied 2 years ago.
Its someone ive never seen before
Expert:  Dr. Chip replied 2 years ago.
OK--earlier you said you didn't think you'd need me anymore. While I'm glad you came back, can I ask why you did?
Customer: replied 2 years ago.
Im lonely right now. Early when i said that i had plans on taking my whole bottle of pills
Expert:  Dr. Chip replied 2 years ago.
OK--I'm here like I said I would be.
Expert:  Dr. Chip replied 2 years ago.
You still with me?
Customer: replied 2 years ago.
Sorry fell asleep
Expert:  Dr. Chip replied 2 years ago.
How long you gonna be in the hospital?
Customer: replied 2 years ago.
I dont know im hoping im out today sometime
Expert:  Dr. Chip replied 2 years ago.
Have you seen the new psychiatrist?
Customer: replied 2 years ago.
No
Expert:  Dr. Chip replied 2 years ago.
Aren't you supposed to before leaving the hospital?
Customer: replied 2 years ago.
Ya
Expert:  Dr. Chip replied 2 years ago.
So I guess you'll be there until you do.
Customer: replied 2 years ago.
I was thinking id grt out today but am not so sure anymore since i developed diarrhea
Expert:  Dr. Chip replied 2 years ago.
Anybody visited you yet while you've been in the hospital?
Customer: replied 2 years ago.
My fiance came last night for an hour
Expert:  Dr. Chip replied 2 years ago.
How did that go?
Customer: replied 2 years ago.
It went alright
Expert:  Dr. Chip replied 2 years ago.
What about your sisters?
Customer: replied 2 years ago.
Havent talked to them
Expert:  Dr. Chip replied 2 years ago.
Still sad and lonely?
Customer: replied 2 years ago.
Ya
Expert:  Dr. Chip replied 2 years ago.
How can I help?
Customer: replied 2 years ago.
You cant
Expert:  Dr. Chip replied 2 years ago.
That's very cynical or defeatist, but if and when you think I can, let me know. And we need to close this page--much too long again.

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