If it's CUT - it's cut ...right?

[Guest guest]

Hello everyone,

I know this has been asked but I either don't see a response or

don't understand the answer.

If the sphinctor muscle is CUT during the Heller - then how/why is

it that some people need to have the proceedure repeated after say 5

years? If it is cut - then it is cut...right? It can't " uncut. " If

the muscle is gone...it can't tighten back up?....right?

Joy (in Michigan)

[Guest guest]

In my case it was the fact that scar tissue that formed after the surgery.

F

If it's CUT - it's cut ...right?

> Hello everyone,

> I know this has been asked but I either don't see a response or

> don't understand the answer.

> If the sphinctor muscle is CUT during the Heller - then how/why is

> it that some people need to have the proceedure repeated after say 5

> years? If it is cut - then it is cut...right? It can't " uncut. " If

> the muscle is gone...it can't tighten back up?....right?

> Joy (in Michigan)

>

>

>

>

>

>

[Guest guest]

Hi ,

You wrote.... " In my case it was the fact that scar tissue that

formed after the surgery. "

You are now the lucky recipient of another question......

1. Can't they do anything to reduce the scar tissue - ie. cortizone

shots or something? Wouldn't a repeat proceedure make the similar

scar tissue and end in similar results?

2. The cut would be healed and any scar tissue formed within a

relatively short time after the surgery....so how is it that some

people are reporting getting in need of a repeat myotomy after, say 5

years?

I hate to bug you but I just don't understand.

Thanks,

Joy (in Michigan)

[Guest guest]

Hi Joy,

Either it was not done properly in the first place, cut high up or down enough or the most likely reason is scar tissue. Scar tissue tends to contract so it makes the opening smaller. Some people's scar tissue contracts more than others and some quicker than others.

Joan

If it's CUT - it's cut ...right?

Hello everyone, I know this has been asked but I either don't see a response or don't understand the answer. If the sphinctor muscle is CUT during the Heller - then how/why is it that some people need to have the proceedure repeated after say 5 years? If it is cut - then it is cut...right? It can't "uncut." If the muscle is gone...it can't tighten back up?....right? Joy (in Michigan)

[Guest guest]

Hi Joy,

Sorry for the rather short answer to you previous question. I will give you

hopefully the short version of my experience with the myotomy I had. I had

a myotomy and a fundoplication in 1976, at first everything seemed to go

just fine, however in about 6 months I began to have problems swallowing

again. My Dr. did an endoscopy and found scar tissue, which he said

surprised him he tried to scrape a little bit of away hoping it would reduce

the size of the tissue and it did. Several weeks later he went in again and

took a little bit more of it, he said it looked smaller than it did

originally. I really noticed a difference about a week after the second

endospcopy and began again to feel more comfortable swallowing. 12 months or

there abouts I began to have problems again, I ended up in the emergency

room with severe pain, upon examination he said the esophagus because of the

fundoplication began to twist and cut off the passageway. This resulted in

immediate surgery to take down the wrap, and for what ever reason after all

that I was back to square one, same problems swallowing as before the

myotomy. I lived with it that way until 1993 when I had the esophagectomy

with more scar tissue following that surgery, that seems to be a pattern for

me. I know there are many in this group who have had successful myotomies,

and may go forever without any other problems, others do have some problems

after a time. It seem to be different with everyone. I can tell you that

after taking down the wrap my Dr. suggested a retry on the myotomy without

the wrap and I said absolutely no way. You asked: " so how is it that some

people are reporting getting in need of a repeat myotomy after, say 5

years? " . I just don't know the answer to that maybe someone here will. I

do think that today surgical procedures regarding myotomies are much

improved and certainly the technology has improved as they do that surgery

laproscopically. I am not sure I answered all your questions but this is my

story and I am stuck with it.

F

Re: If it's CUT - it's cut ...right?

> Hi ,

> You wrote.... " In my case it was the fact that scar tissue that

> formed after the surgery. "

> You are now the lucky recipient of another question......

> 1. Can't they do anything to reduce the scar tissue - ie. cortizone

> shots or something? Wouldn't a repeat proceedure make the similar

> scar tissue and end in similar results?

> 2. The cut would be healed and any scar tissue formed within a

> relatively short time after the surgery....so how is it that some

> people are reporting getting in need of a repeat myotomy after, say 5

> years?

> I hate to bug you but I just don't understand.

> Thanks,

> Joy (in Michigan)

>

>

>

>

>

>

>

[Guest guest]

Joy,

Whatever is done, especially inside the body where there are automatic functions like heartbeat and swallowing the body will normally try to repair or return to normal or as near as possible.

Cells are don't last for ever, the time that is taken to replace a cell depends on the type. (Skin cells 3 weeks, Blood Cells 4 months, Bone Cells 15 to 20 years) but ultimately they are replaced so it is natural for them to be replaced as they were originally, or as near as possible.

Of course different people have different metabolisms so results after surgery differ, in the case of the cells of the oesophagus there are pacemaker cells (rather like those in the heart) to initiate the peristaltic action (a vital function), so it is likely they may react differently after surgery than simpler tissue cells such as those of the skin.

However if your skin is cut or subcutaneous muscles are cut they don't stay cut, but repair. Again it all depends on the type and severity of the cut and the person and how healthy they are, but things won't stay static.

Really then it is no surprise that the results of a Myotomy change after a few years.

Hope this is of some interest to you.

Bernard

Re: If it's CUT - it's cut ...right?

Hi ,You wrote...."In my case it was the fact that scar tissue that formed after the surgery."You are now the lucky recipient of another question......1. Can't they do anything to reduce the scar tissue - ie. cortizone shots or something? Wouldn't a repeat proceedure make the similar scar tissue and end in similar results?2. The cut would be healed and any scar tissue formed within a relatively short time after the surgery....so how is it that some people are reporting getting in need of a repeat myotomy after, say 5 years? I hate to bug you but I just don't understand. Thanks,Joy (in Michigan)

[Guest guest]

To tack onto Joy's question. Couldn't they cauterize the incision to

reduce the chance of scar tissue. OR, instead of a simple incision,

what about a small strip of muscle removed to make this gap wider.

Also, isn't cutting the muscle supposed to break the spasm. Even if it

grows back together w/ scar tissue, shouldn't it be kind of a limp

noodle now?

> Hello everyone,

> I know this has been asked but I either don't see a response or

> don't understand the answer.

> If the sphinctor muscle is CUT during the Heller - then how/why

is

> it that some people need to have the proceedure repeated after say 5

> years? If it is cut - then it is cut...right? It can't " uncut. "

If

> the muscle is gone...it can't tighten back up?....right?

> Joy (in Michigan)

[Guest guest]

Hi Jade,

Couldn't they cauterize the incision to reduce the chance of scar tissue

I do remember being told that cautery causes worse scar tissue, but can't quote a reference ! Where ever the body is cut, it will try and regrow, so even if you made a bigger gap it would still try and fill the distance - more scar tissue. Scar tissue is often tough and retracts (shrinks with time) so may distort and warp. So even if the muscle is a 'limp noodle' I imagine it can become twisted and distorted by scar tissue. Some one else may have a better answer !

Joan

Re: If it's CUT - it's cut ...right?

To tack onto Joy's question. Couldn't they cauterize the incision to reduce the chance of scar tissue. OR, instead of a simple incision, what about a small strip of muscle removed to make this gap wider.Also, isn't cutting the muscle supposed to break the spasm. Even if it grows back together w/ scar tissue, shouldn't it be kind of a limp noodle now?> Hello everyone,> I know this has been asked but I either don't see a response or > don't understand the answer.> If the sphinctor muscle is CUT during the Heller - then how/why is > it that some people need to have the proceedure repeated after say 5 > years? If it is cut - then it is cut...right? It can't "uncut." If > the muscle is gone...it can't tighten back up?....right? > Joy (in Michigan)

[Guest guest]

My understanding from the surgeon was that the mucosa is very thin,

yet very strong. When the esophagus muscles are cut the mucosa pops

out, kind of like a balloon. I asked about protection from other

things and he said as long as nothing was around to cut it then it is

very strong, that should keep the ends from trying to grow together

where the muscles were cut. This is basically how I remember it.

Remember I'm the odd ball w/o a wrap.

I'm back to some old habits such as swallowing a couple of vitamins

at a time, then drinking water. That all goes down well. I don't

get reflux. I'm talking about those vitamin packs w/ about 6 pills

for a day. I have a box and take a set every once in a while.

I can visualize the mucosa keeping the esophageal muscles apart, at

least for a while. I can somewhat visualize those cut muscles trying

to catch onto something to attach. I have heard of women having

their tubes tied years ago and the doctor just let them dangle. Then

they attached to the abdominal wall or other things and got

adhesions, which caused other problems and often required surgery.

But you can heard a lot of wives' tales in ob/gyn waiting rooms.

I don't have any specifics and could be using the wrong

terminology. Seems to me, logically that cut edges of anything will

try to grab onto something, isn't that the idea of grafting?

Depending on what they grab onto it could cause growth and

scarring.

> > Hello everyone,

> > I know this has been asked but I either don't see a response

or

> > don't understand the answer.

> > If the sphinctor muscle is CUT during the Heller - then

how/why

> is

> > it that some people need to have the proceedure repeated after

say 5

> > years? If it is cut - then it is cut...right? It

can't " uncut. "

> If

> > the muscle is gone...it can't tighten back up?....right?

> > Joy (in Michigan)

>

>

>

[Guest guest]

Jeepers, that all makes very morbid sense to me. How horrible... I

wouldn't want the LES attaching to something and getting all funny.

Interestingy tales.

> > > Hello everyone,

> > > I know this has been asked but I either don't see a

response

> or

> > > don't understand the answer.

> > > If the sphinctor muscle is CUT during the Heller - then

> how/why

> > is

> > > it that some people need to have the proceedure repeated after

> say 5

> > > years? If it is cut - then it is cut...right? It

> can't " uncut. "

> > If

> > > the muscle is gone...it can't tighten back up?....right?

> > > Joy (in Michigan)

> >

> >

> >