It was the end of May. Months of trying to get my swallowing issues resolved had led to nothing. I finally had a referral and it linked me to a potentially non-existent doctor’s office. That was the [insert straw and/or camel-related cliche here]. I decided to change physicians. It couldn’t possibly take any longer to start from scratch than I had wasted in the prior few months. My gamble met with reward.

I chose a doctor Erika recommended. Her office is within walking distance. It sits in a block comprised entirely of medical facilities and a hospital. Almost all of the tests and visits I would later undergo would occur within this block—less than a mile from my apartment. These buildings are clean, well-kept, and what one expects from a medical facility (very unlike my Westlake experience). Never have I welcomed the sterile environment of a bland doctor’s office so happily. I contacted my insurance and had my Primary Care Physician changed to her. I called to schedule an appointment. Less than a week later, I was in her office. She was friendly and listened without interruption. Then came the clincher. She has suffered from GERD since childhood. She has decades of experience dealing with its many intricacies. Fate was dealing me a kind hand. The following week she had me in a specialist’s office (conveniently located in a nearby building in that same block). He too was helpful and attentive. I had my blood drawn at a clinic down the hallway. The nurse’s technique was surprisingly good. It was as if he was able to slide the needle into my vein, extract the blood, and remove it in one well-honed movement. It was the first time in years I’d had blood drawn without leaving a bruise. Two days later the testing began.

I awoke early and walked to the hospital (still on the same block), received my armband, and headed upstairs for my Barium Esophagram. They placed me against a vertical bed on a hinge with an x-ray cannon aimed at my throat. I was asked to swallow odd-tasting barium solutions of various viscosity and a barium pill. Sometimes, the bed would rotate 90 degrees like a miniature amusement park ride. Occasionally, I could see a small monitor displaying an x-ray image of my digestive tract. At one point I was able to see the small pill shoot down my throat into my stomach. I was a little upset when it was over. It was kind of fun and I was looking forward to more strange liquids and entertaining live video from my innards.

A few weeks passed before the main event—Esophageal Endoscopy. No food the night before or the morning of. Starving, I jumped on a bus in the early afternoon of July 1st (this was the only test requiring me to go to a facility outside of the especially convenient medical block). I would be sedated and driving was not allowed. I had already arranged for Erika to pick me up after work. I was met with a little paperwork, a stylish gown, my own cot, and an IV feeding me saline. Then a rather long wait with intermittent conversations with passing nurses. The main event neared. I was a bit nervous, but not exceptionally. I was mostly bored. Having little experience with surgical procedures, I didn’t expect to be lying in a bed for so long awaiting the operation. I should have brought a book. Two saline bags later, I was rolled into the arena. I reminded the nurse I was there for the esophageal endoscopy and not the colonoscopy. She assured me that wouldn’t be a problem as my pants would get in the way. Then came the anesthesia. My lids drooped a bit and I was drowsy, but still somewhat coherent. When my teeth were cut out, I blacked out instantly and came to much later with no memory of what had transpired. In this case, I have memories of the entire procedure, albeit swimmy-drunken-surrealist painting-style memories. I didn’t feel the full effects of the sedative until the very end of the procedure. That being said, there was no pain or anxiety, although I do recall numerous odd gurgling noises coming from my throat. An endoscope is much wider and intimidating than you may expect. I imagined a small fiber-optic cable with a bulbous end. Instead, it was like a very long—yet flexible—desk lamp probing the depths of my throat. It was a strange experience, especially considering the drunkenness induced by the anesthesia. I was told to expect a sore throat, but it turned out to be very minor. A few days later I was rafting and kayaking whitewater in Kernville with no discomfort or weakness.

Thus ended my introduction to the world of esophageal medicine. It began badly, but ended rather well. I am currently on omeprazole—a valiant warrior against my over-abundant stomach acid. My doctor believes that my primary problem is not GERD, but Eosinophilic Esophagitis—an allergic inflammation of the esophagus. Based on my history with allergies, I think he is correct. My father has been seeing great results with his problems by taking allergy shots. He recommends I do the same. I intend to look into that soon. The swallowing problems have not disappeared entirely, but the medication has been helping.

The story of my throat does not end here. It continues, but I’m better armed for the quest ahead.

My swallowing difficulties are shared by my father and at least one of my uncles. There is also a history of acid relflux and heartburn. Thus far, my issues with heartburn have been few, but I often awake with an acidic sour stomach that makes me not want to eat breakfast. Early in the year this was becoming worse along with the constriction in my throat. One night, while eating especially dry chicken, I applied my usual forced swallowing by gulping water maneuver. It backfired. The food became lodged in my throat, the water resting atop it—bubbling occasionally as I struggled to breathe. I leapt from my chair and began tensing my esophagus in an attempt to force it to move in some direction. Up, down, I didn’t care as long as it went somewhere. A few seconds of gagging, Erika’s frightened face, minor flailing, and finally success. Pieces of chewed chicken and water hit the carpet. I was shaking. It was time to get this malady addressed.

I had contacted my doctor’s office roughly a week prior. I was informed my doctor was “out of the country for a month” meaning I couldn’t set up an appointment sooner than a month away. After the choking incident I called back. I wanted to see a gastroenterologist as soon as possible. All I needed was a referral. I was assured that was impossible. “The doctor is out of the country.” My only option was to pay full price if I didn’t have a referral and apparently there was no substitute doctor in the office during her time away to see me. I contacted my insurance. They were equally unhelpful and unsympathetic. Thus, I waited and ate carefully (and with trepidation).

Three weeks later I visited the glorified cubicle masquerading as a doctor’s office. Instead of a referral, my doctor decided I should be tested for H. Pylori first. If the results were negative, as I knew they would be, she would then write me a referral. Blood work. An additional week of awaiting results. Despite being told the results would be mailed to me, they never arrived. I called the doctor’s office. They assured me they had been mailed. If I didn’t receive them in a few days, “call back.” Unsurprisingly, I found myself calling back a few days later when my mailbox continued to turn up empty. Thankfully, I received the results the following week. Negative. It only took three additional weeks to discover what I already suspected. Meanwhile, I still had not seen a specialist and continued to have difficulty swallowing food.

Finally, a referral! Success? Hardly. I called the number for the specialist expecting a receptionist, but instead I was rewarded with the sounds of an operator—a recording. This was no longer the number or the office hadn’t been paying their bills. The recording didn’t specify which nor give me a new number to try. Google. A quick search brought me to the website of the specialist. The only contact information available was an email address. A week later and my email had not been returned (to this day it still has not). This was enough! Three months of trying to get a referral to a gastroenterologist and I was no closer. It was time to say goodbye to my primary care physician.

Throughout life, especially dry foods have been difficult for me to swallow. I drink large portions of water when I eat and often can be seen taking large gulps to push food down. The difficulty varies drastically based on numerous variables I haven’t entirely figured out. It was only within the last few years that I realized this was abnormal and that perhaps I should get some medical assistance.

I moved to Los Angeles seven years ago. I was depressed and broke and it took a few years to get my life and finances in order. It also meant a few years with no medical coverage. I am a generally healthy person and have been lucky enough to avoid doctor’s offices and hospitals for most of life. Thus, when my employer offered me health care a few years ago, I didn’t spend much time thinking over my choices. I chose a doctor near the office and was happy to have medical options again.

I was approaching thirty and had not seen a doctor in several years—not since my food poisoning fiasco in the early part of the decade. A physical seemed like a good idea. Thus, began my relationship with my third-world doctor’s office. Not quite downtown, but nearly, is an inner-city area near MacArthur Park called Westlake. It is a low-income area known for gang violence and drug dealings. MacArthur Park was the location of the infamous May Day Melee in 2007. My previous experiences with the location were daily bus transfers during my bus-riding years where I was often lucky enough to meet people suffering from varying degrees of psychosis. This has little bearing on the doctor’s office other than to reinforce the setting: a run-down urban area that is relatively ignored by those that needn’t frequent it.

The doctor’s office was tiny—wedged between two other tiny offices (one a market and the other a dry cleaner I believe). The door opened onto a carpeted wheelchair ramp, yet the waiting room was so small the declining section working as a ramp offset the levelness of the entire room. The few chairs placed along the wall were nearly teetering on the edge of the decline. The carpet was a patchwork of stains, the walls decorated only in nails and chipping paint. An old window unit blared above the door. A small window and a door separated this miniscule waiting room from the rest of the office: two tiny rooms, a desk, and a small area for bloodwork. There was also a staircase above the chair used for bloodletting that I imagine lead to an upstairs apartment. The unit masquerading as a doctor’s office was clearly meant to be used as a small bookstore or cafe. My apartment is probably larger than the entire office. I would end up visiting this office several times and never did I see another male patient. The waiting room was always full of pregnant women or mothers with young children. It was obvious from the beginning that the office’s expertise would lie there.

I approached the window to announce my appointment and make my copay. I was informed that the office only accepted cash and was ushered across the street to a small grocer where I could use an ATM. I met the doctor, who was very personable and underwent the examination. Everyone at the facility was friendly and competent and although I felt like I was in a run-down free clinic or planned parenthood center, I shrugged it off. I don’t visit the doctor often. I would regret that decision early this year when my swallowing problems intensified.