Barium. It’s a chemical element, number 56 in the periodic table. An earth metal, kind of silvery. They use it in fireworks when they want them to come out green. It’s used in electronics. And this week, we used a bit of it with Tess. Because if your gastroenterologist wants to check out how you swallow and how things travel down your esophagus, they’ll order what’s called an upper GI series. And they have you drink this chalky contrast liquid made from barium.
Tess’s swallowing has been off. She lives to eat, but lately she’s been having more difficulty getting food down. Things get stuck. Even small bites cause problems. She’s gotten food impactions where everything stops and won’t go down and we have to intervene with her suction unit. So her GI doctor ordered a barium swallow to see what’s happening.
The Prep
No food or water after midnight. No medications in the morning. And she’d have to drink this chalky liquid in an x-ray machine.
I was worried about two things. First, every single morning follows an identical routine for Tess, and it always starts with breakfast. Taking that away was going to be hard. Second, she swats away drinks pretty consistently. Even when we know she’s thirsty, she’ll wait hours before finally guzzling water. So there was a real chance we’d make all these arrangements, get to the hospital, and she’d refuse to drink a drop.
We talked to Tess about it. How she wouldn’t be taking the bus. How she’d need to go on a ride and have a test done. After it was over, she could have her breakfast and head to school. But she’d need to be patient.
The Morning Of
We got her up. Let her take a nice long hot shower. Got her dressed, talking throughout everything. Taking a ride. Not going on the bus. You can do hard things. She was listening. She was quiet.
When I went to put her in the car, she resisted. She wanted to head to the kitchen, to her usual breakfast perch. But she didn’t make a sound. I said we could eat later but that we had to go for a ride first. She relented.
In the car, she didn’t squawk. Not a sound. As we arrived at the medical center and made the long journey to the radiology department deep in the basement (side note: if you need 10,000 steps, might I suggest going to your local hospital), she stayed quiet.
The Test
She got into position with her back against the x-ray machine. I stood next to her with the barium drink, a straw sticking out the top. When the moment arrived, she took a sip. It was tiny, but the doctors said it was a good start. They could see the barium on the images. She took another sip, then a few all at once, drinking it down so the inside of her GI tract was clearly visible on the screen. The doctors were getting everything they needed.
Then she took a breath a bit too early while still sipping on the straw, got some liquid down the wrong pipe, and coughed. The doctors noted concerns about aspiration. She recovered quickly and kept drinking. Eventually she was done. There was a lot left, but she’d had all she was willing to take.
The Results
Her GI doctor called later that day to confirm the images looked good. No structural issues with swallowing. The only concern was that aspiration event, so he wants us to do another barium swallow with a speech pathologist present to assess the risks.
The number of times we told Tess how proud we were after this test? Something like 50. We couldn’t stop expressing our admiration for her patience. It gives us such hope to know that we can talk to her in advance of unexpected schedule changes and medical appointments, prepare her, and know that she’s getting it. Her receptive language has improved so much. And this barium swallow was anything but routine. She’d never done it before. And still, because we prepped her, because we talked about it at length and told her what to expect, she handled it with incredible grace and resilience.