Manometry/24 hr Impedance Test Experience

Want to share my experience thus far while it's fresh in my mind. I went into this knowing very little about what to expect. I was told to not drink water after 6 AM & went to the hospital for my 8:30 AM appointment. I was sat down on a hospital bed with clothes on. A hospital gown and blankets were draped over me.

The nurse I had was very compassionate & thorough with her explanation of the procedure & using the computer that would be involved with the impedance study. I wasn't prepared for pain, so I was a little taken aback when she said it would involve some level of discomfort. Perhaps not knowing was for the better because I had minimal anxiety leading up to the appointment. After talking through the process she took my vitals and injected lidocaine gel into my right nostril which I indicated was the nostril that felt more clear. She alternated injecting gel into my nostril, asking me to take small sniffs while I closed my other nostril, and spraying numbing agent on the back of my throat. I didn't think the numbing agent tasted that bad. After a few rounds of this she said it was time to do the esophageal manometry test. She started to stick the tube up my right nostril, but she quickly noted she was going to have trouble on that side. So, she put gel on my left nostril & inserted the tube more easily. Note the gel will drip out of your nose, but your provider will probably have tissues on deck.

Insertion of the manometry tube: The tube stung as it passed through my nasal cavity, but I managed the pain through some deep breathing. She had me tilt my head forward and take several sips of water through a straw to help the tube down. Because it felt like something was stuck in my throat my gag reflex started going off the charts and started puking up liquid. The nurse was prepared with a little tub. After a couple minutes this subsided. I think my body just needed to get used to what was going on. The gag reflex also made me uncontrollably tear up. But that settled down along with the gag reflex. Once I was stable the nurse lowered the hospital bed so I was laying down at about a 45 degree angle. This entire process moved pretty quickly. Maybe about one or two minutes. The discomfort of the insertion was about a 7 out of 10 for a couple seconds.

Manometry Test: First I was asked to not swallow for 30 seconds. I was able to easily accomplish this through practicing deep breathing. Then she did a test where she would squirt some water/saline solution, have me swallow once and then not swallow for several seconds. I can't recall how many rounds of this happened. But I'm guessing this portion of the test took about 10 minutes. At the end she quickly pulled out the manometry tube. The removal stung for a second.

Insertion of impedance tube: The nurse gave me some more nasal numbing gel & inserted the impedance test tube. The discomfort associated with this was far less than the manometry test. I would say the discomfort was a 3 out of 10. Again she had me tilt my head and swallow water to help the tube down to where it needs to go. She then took a couple minutes to adjust the tube and taped it onto my face. I would be lying if I said I couldn't feel the tube. It's clearly there and poking at the back of my throat, however, it's not activating my gag reflex.

Post Insertion: After insertion the nurse once again walked through how to record info on the computer attached to the tubing. There are 4 buttons: 1) push when I take medication, 2) push when I start/finish a meal, 3) push when I lay down/sit up more than 45 degrees, 4) push if I'm having symptoms. I don't need to push if I'm drinking water. As I started to sit up I felt really dizzy. It wasn't like a blood pressure dizziness. Honestly it felt weird and I started to have double vision. The nurse checked my vitals and said everything looked good. She grabbed me some cranberry juice and animal crackers. I used the opportunity to show her I knew how to use the gadgetry haha. Even after eating the animal crackers and drinking juice and water I still felt really off. So she walked me down to the lobby so I could wait to get picked up. I rode my bike to the hospital & it was clear it wouldn't be a good idea to ride myself home. Again, I didn't know what I was getting myself into beforehand.

The nurse told me that if I continued to feel terrible that I could go to the ER or remove the test. In total I was at the hospital a couple of hours. I assume if everything went smoothly it would only take 1.5 hours.

I let my work know that I wasn't feeling well and wanted to take the remainder of the day off. I got home and immediately lay down for a while. It's been about 5 hours and I feel better. A couple of hours ago I had a light meal. I definitely feel the tube when I talk or when I swallow. So I'm taking it really easy and not eating much. I know the test instructions say to go about a normal day and to eat normally, but there's no way I could workout and eat a full meal in my current state. I don't know if that will mess with the results.

My husband is going to pick up my child and explain the tubing situation before he sees me. Since I didn't know what the test would entail we didn't talk about it at all. This would probably be distressing for a young child to see without explanation. I thought I would be able to go out tonight, but I wouldn't want to even if I felt better because the tubing and the box are quite conspicuous. I don't want to run into someone and have to explain the whole situation.

All in all I wouldn't be scared about getting this test. It isn't comfortable, but it's not off the charts painful. The discomfort can be managed through mindfulness and breathing. Depending on one's anatomy be prepared to have a very low-key day. Anyways, I'm eager to get the information that this test will provide. It's interesting to see how ph levels change with food and position.