Re: Laporoscopic Heller Mytomy - in VA

[Guest guest]

First of all, Hi Sandi in N.CA! I am so very confused!!! I have to

just chuckle because in " real life " (off the internet) I think I am

probably just as confused. But, now I realize that I thought I was

asking a in VA about her recent operation with Dr. Rice. But,

in reality I posted under Sandi from Ca......o.k.

Well..... (from VA) - I would still be interested to hear

from you about your experiences.

And, Sandi (from CA) - I was a couple hours south of Cancun.

After a Heller operation - do symptoms usually return?

It sounds like people have to go back for repeated dilations

and such after a few years down the road. What is the Heller

actually correcting then?

> > Hi ,

> > The pains you are writing about are my greatest fears!!

After

> > even a botox injection I will suffer these horrid spasms and

pains

> > for up to 3 days!! Dr. Rice will also be doing my surgery next

> > month. Since I do not like wriggling on the floor in pain/tears

> > helplessly in the middle of the night wishing I could either get

> > someone to drive me to the emergency room for a big shot of

> something

> > or......jump from the roof (but then who would get the kids off

to

> > school?) Anyway, so I asked Dr. Rice point blank what was

> the " PLAN "

> > for dealing with these pains. (I really wanted him to tell

me " you

> > will have a perscription for something powerful that your husband

> can

> > fill while you are resting here before you drive home - you will

be

> > prepared and not have to suffer. " ) But instead he said something

> > like he wasn't fixing a dishwasher and there were no guarantees

and

> > those pains didn't really fall under his jurisdiction - it was

the

> > realm of my regular Dr. or something. So, basically that is what

> > horrifies me about this surgery.....I KNOW I am going to get the

> > spasms I always get after ANY esophagus proceedure PLUS maybe or

> > maybe not get the air/gas shoulder pain that sounds not so fun

too!

> > Now maybe I didn't understand his answer, and of course you

realize

> > that I am paraphrasing......but as far as I know - I am looking

at

> > facing PAIN!

> > Anyhow, I have never had any type surgery but the gas in the

> > shoulders at least they seem to have a plan for alleviating it

> > through manipulation/ breathing and exercises - right? Some

people

> > don't even experience it and in others it isn't very intense to

be

> a

> > problem....so I am holding out hope here.

> > , since I will also be coming from out of town....I

would

> > like it if you can let me know how your proceedure logistics went?

> > I immagine you went in for a few hours of pre-op (blood

> work /chest

> > X-rays) on Tues. and then spent the night in a local hotel? Wed.

> > morning you checked in to TCC. Fill me in with as much info as

you

> > can ie. time in, lenght of surgery, how long till you could see

> your

> > husband or family, etc. Then, Thur. did you get discharged to a

> > hotel and then return Fri. for a barium swallow before leaving

town?

> > I wasn't quite sure how he was explaining all this to me.

> Something

> > about being in a hotel nearby and then coming back before

returning

> > home. How was your drive home? You can just pop into a car and

> > someone drives you home.....or are you in p.j's feeling crummy

etc?

> > Please let me know.

> > Thanks so much.

> > Joy in Michigan.

> >

> >

> > > > > Hi,

> > > > >

> > > > > I am new to the group and after suffering with achalasia

for

> > > almost

> > > > > ten years and six balloon dialations later, I saw Dr.

Achkar

> at

> > > the

> > > > > Cleveland Clinic in May and he immediately referred me to

Dr.

> > > Rice in

> > > > > Thoracic Surgery. I had a Laporoscopic Heller Myotomy July

> 14.

> > I

> > > have

> > > > > not done very well afterwards...lots of shoulder pain and

> then

> > > the

> > > > > horrible spasms returned last week. Has anyone else had

this

> > > > > procedure and the shoulder pain as well as the spasms? Dr.

> Rice

> > > said

> > > > > he could not guarantee that the myotomy would help with the

> > > > > spasms...that in some instances it does, others it does

not.

> I

> > > > > imagine I am destined to always have these. Unfortunately,

I

> > > cannot

> > > > > take channel blockers or nitroglycerine (side effects from

> > both).

> > > > > What is causing my shoulder pain now? Right after I awoke

> from

> > > > > surgery, the pain was so bad in my shoulders that they had

to

> > > give me

> > > > > a pain med pump, but they said it was from where they had

to

> > pump

> > > me

> > > > > full of C02 for the surgery. Should I be having the

shoulder

> > pain

> > > two

> > > > > weeks after surgery? Any help or advice would be greatly

> > > appreciated.

> > > > >

> > > > > (andria, VA)

> >

> >

> >

> >

> >

> >

[Guest guest]

Hi,

I had my Lap Heller on July 14; the spasms, which I have had for

years came back about a week later after the Lap Heller! I went back

to TCC this past Friday, the 6th, where Dr. Rice found that food was

not moving through my esophagus as it should, so Dr. Rice,

endoscopocially stretched it Friday afternoon. I flew home that night!

I have asked Dr. Rice about the spasms too since I cannot take

procardia or nitroglyerine type drugs. He said that the only way they

will stop is to remove my esophagus......grrrrrrrrrrr. However, he

did give me a prescription for Ativan on Friday; I have also heard

others in this newsgroup mention Zoloft and Paxil, but he would not

write me a prescription for either of those. I don't understand why,

as Ativan is also an anti-depressant. I started taking the Ativan

Saturday evening, and keeping my fingers crossed, I have not had a

spasm since Saturday.

The shoulder pain is bad; I will not kid you. I have had it daily

since my surgery. I find that taking Ibuprofen helps and also buying

those Icey-Hot patches at your local drug store helps too, especially

at night. Those shoulder pains will go away, from what I am told, but

it takes time, sometimes six weeks after surgery.

My husband and I drove to the Cleveland Clinic on Tuesday before my

surgery on Wednesday, the 14th. I had flown up just for the day the

Friday before for the pre-op stuff. I went into surgery around 9 am

on Wednesday and saw my husband around 1:30. I spent the night in the

hospital and he took me back to our hotel the next evening

(Thursday). I then went back to see Dr. Rice on Friday morning, and

on Saturday, we headed for Washington.

Good luck to you. There is nothing easy about this. Just remember

when you return home, please take it easy. No lifting

anything...don't do anything. Just rest, take your Ibuprofen for your

shoulder pain and get some of those Icy Hot Patches. Good luck with

your spasms. My prayers are with you.

Let me know how it goes.

> First of all, Hi Sandi in N.CA! I am so very confused!!! I have

to

> just chuckle because in " real life " (off the internet) I think I am

> probably just as confused. But, now I realize that I thought I was

> asking a in VA about her recent operation with Dr. Rice.

But,

> in reality I posted under Sandi from Ca......o.k.

> Well..... (from VA) - I would still be interested to hear

> from you about your experiences.

>

> And, Sandi (from CA) - I was a couple hours south of Cancun.

> After a Heller operation - do symptoms usually return?

> It sounds like people have to go back for repeated dilations

> and such after a few years down the road. What is the Heller

> actually correcting then?

>

> > > Hi ,

> > > The pains you are writing about are my greatest fears!!

> After

> > > even a botox injection I will suffer these horrid spasms and

> pains

> > > for up to 3 days!! Dr. Rice will also be doing my surgery next

> > > month. Since I do not like wriggling on the floor in

pain/tears

> > > helplessly in the middle of the night wishing I could either

get

> > > someone to drive me to the emergency room for a big shot of

> > something

> > > or......jump from the roof (but then who would get the kids off

> to

> > > school?) Anyway, so I asked Dr. Rice point blank what was

> > the " PLAN "

> > > for dealing with these pains. (I really wanted him to tell

> me " you

> > > will have a perscription for something powerful that your

husband

> > can

> > > fill while you are resting here before you drive home - you

will

> be

> > > prepared and not have to suffer. " ) But instead he said

something

> > > like he wasn't fixing a dishwasher and there were no guarantees

> and

> > > those pains didn't really fall under his jurisdiction - it was

> the

> > > realm of my regular Dr. or something. So, basically that is

what

> > > horrifies me about this surgery.....I KNOW I am going to get

the

> > > spasms I always get after ANY esophagus proceedure PLUS maybe

or

> > > maybe not get the air/gas shoulder pain that sounds not so fun

> too!

> > > Now maybe I didn't understand his answer, and of course you

> realize

> > > that I am paraphrasing......but as far as I know - I am looking

> at

> > > facing PAIN!

> > > Anyhow, I have never had any type surgery but the gas in the

> > > shoulders at least they seem to have a plan for alleviating it

> > > through manipulation/ breathing and exercises - right? Some

> people

> > > don't even experience it and in others it isn't very intense to

> be

> > a

> > > problem....so I am holding out hope here.

> > > , since I will also be coming from out of town....I

> would

> > > like it if you can let me know how your proceedure logistics

went?

> > > I immagine you went in for a few hours of pre-op (blood

> > work /chest

> > > X-rays) on Tues. and then spent the night in a local hotel?

Wed.

> > > morning you checked in to TCC. Fill me in with as much info as

> you

> > > can ie. time in, lenght of surgery, how long till you could see

> > your

> > > husband or family, etc. Then, Thur. did you get discharged to

a

> > > hotel and then return Fri. for a barium swallow before leaving

> town?

> > > I wasn't quite sure how he was explaining all this to me.

> > Something

> > > about being in a hotel nearby and then coming back before

> returning

> > > home. How was your drive home? You can just pop into a car and

> > > someone drives you home.....or are you in p.j's feeling crummy

> etc?

> > > Please let me know.

> > > Thanks so much.

> > > Joy in Michigan.

> > >

> > >

> > > > > > Hi,

> > > > > >

> > > > > > I am new to the group and after suffering with achalasia

> for

> > > > almost

> > > > > > ten years and six balloon dialations later, I saw Dr.

> Achkar

> > at

> > > > the

> > > > > > Cleveland Clinic in May and he immediately referred me to

> Dr.

> > > > Rice in

> > > > > > Thoracic Surgery. I had a Laporoscopic Heller Myotomy

July

> > 14.

> > > I

> > > > have

> > > > > > not done very well afterwards...lots of shoulder pain and

> > then

> > > > the

> > > > > > horrible spasms returned last week. Has anyone else had

> this

> > > > > > procedure and the shoulder pain as well as the spasms?

Dr.

> > Rice

> > > > said

> > > > > > he could not guarantee that the myotomy would help with

the

> > > > > > spasms...that in some instances it does, others it does

> not.

> > I

> > > > > > imagine I am destined to always have these.

Unfortunately,

> I

> > > > cannot

> > > > > > take channel blockers or nitroglycerine (side effects

from

> > > both).

> > > > > > What is causing my shoulder pain now? Right after I awoke

> > from

> > > > > > surgery, the pain was so bad in my shoulders that they

had

> to

> > > > give me

> > > > > > a pain med pump, but they said it was from where they had

> to

> > > pump

> > > > me

> > > > > > full of C02 for the surgery. Should I be having the

> shoulder

> > > pain

> > > > two

> > > > > > weeks after surgery? Any help or advice would be greatly

> > > > appreciated.

> > > > > >

> > > > > > (andria, VA)

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

Joy wrote:

"It sounds like people have to go back for repeated dilations and such after a few years down the road. What is the Heller actually correcting then?"Joy,

A Heller myotomy is the name for the operation in which they cut the muscle of the lower oesophageal sphincter (LES) to break its spasm. The LES then no longer works as before.

In Achalasia one of the problems, apart from the loss of peristalsis, is that because of nerve damage the lower oesophageal muscle no longer relaxes to let food go through to the stomach - it remains spastic - tight shut or it only works at odd times, not when it should. The only way to get the LES to open is to break the spasm either surgically or by tearing it during dilatation. During surgery they cut through the entire muscle and that not only breaks the spasm but makes it incapable of closing again.

After surgery there is some scar tissue that forms around the cut. With time this may contract to make the LES tight and the 'hole' smaller again. Some people form scar tissue quickly and others not so much as to make a difference. That is one reason why some people have to have further treatment after a Heller's myotomy. Another reason is that the cut in the muscle was not deep or long enough.

Because the LES now stays open all the time there is the problem of stomach acid getting up into the oesophagus especially when you lie down or bend down. To prevent this the surgeon may do a 'fundoplication' or 'wrap'- a piece of the stomach wall is folded over the LES to protect it. This must be done by an experienced surgeon, and if it is made too tight can also cause the blockage or prevent the food from getting into the stomach.

Please remember that those who are OK and not having problems often leave the board and do not return until they are again in need of support and reassurance, so the fact that there are a lot of us at the moment with negative experiences does not mean that there are not plenty of others who have had very good and positive experiences.

It is a pity that they do leave and not stay to reassure those who are new and struggling with the decision to have surgery.

Hope this helps, Do ask the questions that are bugging you no one minds if they have been asked before.

Joan

Johannesburg

South Africa

----- Original Message -----

From: Joy > > > > > > > > > >> > > > > > > > > > > >

[Guest guest]

Joy wrote:

After a Heller operation - do symptoms usually return?

It sounds like people have to go back for repeated dilations

and such after a few years down the road. What is the Heller

actually correcting then?

Joy,

The symptoms don't necessarily return in everyone, but we are all

different. We've had our surgeries at different stages of the disease,

different surgeons performing the myotomies, and as Joan mentioned, scar

tissue grows back faster in some people than it does in others.

The Heller myotomy is meant as a means to improve our quality of life by

relaxing the sphincter pressure at the LES so food can pass through.

There are no guarantees that go along with the surgery, but if you're

lucky, maybe it will last a lifetime!

Sandi in No CA (sorry to have confused you...I knew you were posting to

in VA but I had just wanted to respond to your original post

because you were so concerned about the spasms. I thought you knew you

were posting back to me!)LOL