process

[Guest guest]

1 Jan 2006

Wallace H. Allan ---I am a retired physicist, age 84, I worked first

as a nuclear physicist, then many years as a rocket scientist.

Achalasia is very complex and it has taken me years to understand the

small amount that I know of the process. It is possible, without

surgery, to gain good control of Achalasia with this knowledge. It

will be hard for an medical doctor (MD) to treat a patient since the

most important blood test is not stable and can change from minute to

minute. An MD can be very valuable in curing, or controlling, the

many medical disorders that may contribute to Achalasia. I believe

the patient needs to observe and experiment, using the information

that I have uncovered, to further reduce Achalasia. I am afraid the

complexity will discourage many patients and even MDs.

Achalasia

Introduction

I believe that Achalasia relates to nerve transmission pulses. Nerve

transmission is done electrically and they may be upset by abnormal

changes in the conductivity of the nerves. The blood feeds the

nerves and keeps it alive and healthy and the blood itself can affect

the conductivity of the nerves. The body, and blood, contains

electrolytes. Electrolytes are atoms, or compounds, that in solution

can conduct electricity. They do this by dropping or gaining an

electron (becoming an ion) with a positive or negative charge. The

major electrolytes are potassium, magnesium, phosphate, sulfate,

bicarbonate and small amounts of sodium, chlorate and calcium. By

conductivity I do not mean the same as a metal with a flow of

electrons, the conductivity in nerves is caused by potassium plus ion

and sodium plus ions exchanges across the nerve fiber membrane. It

is a slow flow compared to electron flow and it reinforces along the

fiber as it proceeds. I will only consider potassium (K) and sodium

(Na) in this report since there is such a direct link to nerve

impulses. The cardia valve and the peristaltic action of the

esophagus can fail under misfiring nerves. The pioneering work in

this field was done by Dr. Harold Friedman and his work was published

as " Ionic Solution Theory " in 1962. This text treats solutions in

the body as well, as general chemistry.

Cause

One major cause of Achalasia is described in this article. There are

at least two other causes--see Scleroderma and Chagas in the latest

17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

informative to read the chapter on Esophageal Disorders which

includes Achalasia. What I have to describe is based on accepted

medical knowledge concerning nerves and transmission of nerve

pulses.

Achalasia (medical dictionary explanation) means failure to relax,

especially of the cardia valve muscle which results in retention of

food in the esophagus. A medical textbook explanation says the

defect appears to originate from a loss of motor innervation, by

fibers originating in the dorsal nucleus of the Vagus nerve. The

Vagus nerve is a packet of nerves that runs from the brain stem down

the neck into the body, most nerves run down the spinal column and

branch out to the body organs. The Vagus nerve (wandering nerve)

supplies some nerves to the ear, tongue, larynx, esophagus, cardia

valve, lungs, heart, etc but it is not the sole supply of nerves for

most of these organs.

As a point of interest, Achalasia was formerly called a Cardiospasm.

This was misleading since cardia implies the heart but the cardia

valve (splincter valve at the bottom of the esophagus) is just near

the heart. A spasm means a contraction of a muscle but in a

Cardiospasm the muscle does not contract but fails to relax. If the

failure to relax was because of a cramp on top of the normal

contraction of the cardia muscle I would think this would produce a

pain which might be perceive as an Achalasia spasm.

I have had Achalasia for 20 years and very early my body reacted to

the disorder by hyperventilation which brought me out of Achalasia.

From this I developed the reasoning why this was important to me but

I found out later that my technique would make some patients worst.

From reading letters to the Achalasia Forum I have been able to

understand some of the complex reasons for Achalasia. I find

experiencing Achalasia is very helpful in understanding it but I am

at a loss to understand spasms since I have never had one.

I have found K and Na to be the most controlling electrolytes in

Achalasia and I have not worked with the other electrolytes. I

suspect that low calcium may be involved in spasms since low calcium

is know to excite the nerves to a point that a muscle goes into a

spasm called Tetany. The low calcium can become even more of a

problem if the blood goes alkaline since this adds to the excitation

of the nerve system. Low levels of calcium in a blood test might

indicate if this is a problem. Possibly ingestion of calcium might

bring one out of the spasm. There are many reasons for low calcium

and one should consult an MD to uncover your own problem. Since a

cramp is a spasm, athletes often get leg cramps from loss of salt

during exercise. Leg cramps while sleep often arise from too much K

released into the blood from respiratory acidosis (shallow breathing

while a sleep).

There are two blood (serum) factors that one should be familiar

with in order to understand Achalasia. One is the pH of the blood.

This is a measure of the acidity or alkalinity of the blood.

Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

acid and 7-14 alkaline. The blood is normally slightly alkaline at

7.40. Thus 7.40 is considered neutral and anything lower is acid and

higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

lower or higher will lead to death within hours. pH is a logarithmic

scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

not change from 7.4 more that plus or minus 0.2 or one will get

sick. The body has a quick response to adjusting the pH to safe

values. Food, liquid, drugs and breathing can change the pH of the

blood but only by a very small, but important amount. If the blood

goes acid, a small amount of K falls out of the body cells into the

blood and if the blood goes alkaline a small amount of K is forced

into the body cells from the blood. The second factor in the blood is

the ratio of Na to K.

Blood serum requires a certain ratio of Na to K in the blood and this

is about 28 to 1. This ratio is the same as the ratio of Na to K in

sea water which is cited as a reason why man may have originated in

sea water. This ratio changes with the pH of the blood, because K is

either dropped out of the blood with acidity or forced back into the

cells with alkalinity. The ratio is not used in normal medicine but

I will use it since it provides clues to the patient as to when and

why he is in Achalasia. This ratio can not deviate very far from

this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

By misfire I mean that when the blood is alkaline the nerves become

over excited to, at a maximum, one could go into convulsions. When

in acidity it decreases its acidity to, at a minimum, one could go

into a coma. Different nerves and nerve pathways may have a slightly

different pH, and may also response differently to the same pH so all

the nerves do not fail at the same time. Nerves close to the gastro

tract may respond faster to food, drugs, and liquid changes than leg

and arm nerves because the food is in immediate contact with the

nerves. Also some of the organs (possibly the cardia valve) may be

supplied solely by the Vagus nerve.

I think of pH and Na to K as related since if the pH changes the

ratio of Na to K also changes. Thus if K is high the blood is acid,

and if K is low the blood is alkaline.

The body stores a large amount of K in the body cells and a much

smaller amount in the blood. Na stores a large amount in the extra

cellular fluids and blood and very little in body cells. There is a

mechanism to keep this in the proper balance called the Na-K pump.

There are other ways to balance the absolute amount of K in the

blood, some very fast and others slow, as a change of K by a factor

of three can kill. Na is not held under as strict a control. There

are clinical values for absolute values of Na and K and a variation

from these values can be an indication of something wrong in the body.

The nerves require the proper pH (or ratio of Na to K) for proper

firing of the nerves. The proper ratio can be changed temporarily by

foods, liquids, drugs or breathing. Then there are semipermeant

disorders that bias the ratio for long periods of time. I say

semipermeant because they may come and go over weeks, months or years

and the disorder create these biases might possibly be cured. For

instance, for 17 years I would go in and out hypothyroidism on very

irregular schedule related to my level of stress. Today, I am out of

it for many months and I fall into it for a week or two, at the

most. In my case high stress is apt to bring on hypothyroidism.

Hypothyroidism can be present without the patient or his MD being

aware of. My 17 year spell with hypothyroidism was never detected by

my MD even thought I suspected I was in it but my blood tests never

reveal it, probably because I drifted in and out of it and it never

was present when a blood test were taken. Also I tried to control my

excess of K by eating less K foods while in hypothyroidism to control

atrail fibrillation (a nerve firing problem). Thus, it is not

surprising that blood tests did not reveal excess K.

A temporary event can be created by breathing, either hyper, or

hypoventilation. Hyperventilation (respiratory alkalosis) will push

K back into the body cell from the blood serum and hypoventilation

(respiratory acidosis) will drop K out of the body cells into the

blood. This is very fast acting and I use it to alter the K in my

blood. Some short term events can last a long time, I normally

hypoventilate because of a sunken chest, thus a short term event

becomes a long term, event.

The longer term events come under the class of metabolic acidosis or

metabolic alkalosis. Metabolic means a chemical event. Respiratory

acidosis, or respiratory alkalosis, is also a chemical event but I

think it is separated from metabolic since is is such a quick event.

Eating acid foods will act the same as respiratory acidosis and drops

K in the blood but since is a food process it takes longer to work

(minutes instead of seconds) and last longer. An antacid (Tums or

milk) will also make the blood alkaline and push K back into the body

cells from the blood. An acid drink (cola syrup, soft drinks or

orange juice) will drop K into the blood. Acid foods such as pickle,

strawberries, tomatoes, and vinegar can drop K into the blood for a

limited time. Food, liquids, drugs are short term events but they

can extend into very long events.

Drugs can seriously change the pH. I recently read an ad in the NY

Times for Topamax (migraine headache) it states one side effect is

metabolic acidosis which will produce hyperventilation. The

hyperventilation will shift the blood towards neutral.

Hyperventilation was a part of my Achalasia.

Some 60% of those with achalasia have an epiphrenic diverticulum.

This is a pouch at the cardioesophageal junction. The pouch can

collect food which does not go into the stomach but ferments in the

pouch and in the fermenting process becomes acid. I have one of

these pouches and I sense if I swallow a chunk of meat which stays in

the pouch, that it will take up to a week before the meat passes into

the stomach and I have much Achalasia during this period. As much as

I try to chew thoroughly, if I eat a steak, there always seems to be

a chunk that drops into the throat. I try to avoid beef steaks but I

seem to be able to eat ham and pork without trouble. Ground beef is

safe to eat.

Long term events are diseases, such as hypothyroidism which elevates

K and depress Na in the blood, and hyperthyroidism which elevates Na

and depresses K. Low adrenal output elevates K and depress Na in the

blood. High adrenal output elevates Na and depresses K. Diuretics

can depress K, or K sparing diuretics can elevate K. Dehydration can

elevate Na in the blood.

The vast majority of the population escapes Achalasia. So what is

differ about patients of Achalasia. I propose that short and long

term events do not balance out but add up. I normally

hypoventilate. I have been in hypothyroidism, of and on, for many

years, I normally eat too may K foods and avoid salty (Na--sodium

chloride) foods. They all add up to a low ratio of Na to K or an

acid blood.

Treatment

One can see the vast complexity of Achalasis. In fact , this

disorder is so complex that my method of coping with it is very

difficult for most patients and even more so for MD's who have very

little to work with, since any blood test are fleeting and reveal

little. It would be very difficult to handle a case with a child.

There is one hope and that is to cure the diseases that place the

ratio out of balance. For instance, my Achalasia is much diminished

when I am free of hypothyroidism. A patient can try to balance the K

foods with the Na foods, and by balance I do not mean one for one,

but your own requirement that minimizes Achalasia. Also try to

balance acid liquids and foods with alkaline ones. A parent can also

place a child on the same diet.

There is a table in the 17th Edition Merck Manual that can help you

see how different disorders affect the Na and K levels it is on Page

2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

very helpful. One must evaluate what is one's problem whether too

much, or too little K. Na maybe the problem from too much ingestion

of Na (salt), which is easily solved.

I have developed a treatment to open up the cardia valve as I eat.

My problem is too much K and too little salt, this will makes

Achalasia worse for those who are normally high on Na and low on K.

If you have Achalasia I believe you probably fall into one or the

other case, although there must be many who just eat too much salt.

To bring myself into a normal ratio of Na to K, first, during the

meal I try to determine whether the meal contains enough salt or

whether I need to add salt. If one must add salt, it takes very

little salt to add the right amount. Then just before a meal I

mildly hyperventilated for about 15 minutes and take two Tums

(regular) antacids and this normally sets me up for a normal meal

without Achalasia. One must continue to hyperventilate during the

meal since normally one would hypoventilate while eating. Sometimes

in a restaurant, the meal comes too late, and I have been

hyperventilating too long, changing from too high in K to too low.

If I stop hyperventilating and wait about 10 minutes the ratio will

approach normal and I can then eat. Sometimes during the meal I will

eat too many K foods and Achalasia will kick in. If I eat a dill

pickle, strawberries, tomatoes, orange juice, etc then I will go too

acid which drops too much K in the blood and I am in Achalasia.

I have no experience with low K and high Na. I would think an acid

drink (cola syrup, soft drink, orange juice) and no alkaline drinks

(milk), would start one off correctly and the normal hypoventilation

while eating would also help. Eating less salty foods and more K

foods would also help.

If the Na to K ratio causes misfiring of nerves and prevents the

cardia valve from opening, then other nerves are apt to misfire. I

can sense that my atrail fibrillation occurs with Achalasia, and the

actions I take to lower Achalasia, also lower atrail fibrillation.

The cardia valve, esophagus, larynx, and part of the heart and lungs

are controlled by nerves in the Vagus nerve. When really bad from

too much hypothyroidism the nerves in my legs produce peripheral

neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

can appear when in hypothyroidism I wonder if gastroesophagel reflux

disease (GERD) might not be a different form of Achalasia in which

the cardia valve remains open rather that closed.

In addition to those with too much K or too little K, patients may

suffer from salt (water) retention which leaves too much Na in the

blood. Salt retention is difficult for an MD to detect, since there

are no clinical tests for it. I was in heavy salt retention for 9

months before I understood what was wrong. Salt retention can be

caused by some medications and also by stress. Those that take

diuretics may also suffer from low K unless the diuretic is a K

sparing diuretic and then they may have too much K in the blood.

Diabetes can also influence the K levels (more than one way) see the

17th edition Merck Manual Page 2549 Table 296-4 and read about K and

Na.

Hyperventilation must be used with caution, just breathe deeply and

exhale through pursed lips to avoid over doing. Very rapid deep

breathing can be dangerous as the brain can get overloaded with

oxygen and will cut off blood flow to the brain and produce a mild

stroke. I think it would be very hard for this to occur if one where

to limit oneself to mild hyperventilation to no more than 20 minutes

plus eating time. The operative word here is mild. However,

hyperventilation (possibly antacids) is of particular danger to those

subjected to epileptic fits and can cause epileptic convulsive

attacks.

Other controls

I usually am able to detect when food is building up in the

esophagus, there is the feeling of fullness plus the beginning of

hiccups. I must stop eating and continue hyperventilating until the

cardia valve opens usually accompanied by a burp and the esophagus

gradually empties. If I go too far, and fill the esophagus too much,

the cardia valve will not open and I must heave up the contents of

the esophagus. Eating slowly and chewing thoroughly gives more time

for the cardia valve to open.

I control nighttime regurgitation by eating early, cleaning my teeth

and mouth of food particles at the end of dinner and then drinking a

glass of water to wash every bit of food down the esophagus. If,

during the evening I burp and taste any food I have to go through the

routine again of hyperventilating, two Tums and water to open up the

cardia valve to flush the food from the esophagus. I count on 4 to 6

hours after dinner before going to bed and there must be no food or

liquids after dinner. Regurgitation is dangerous since it places

food near the trachea where it may aspirate into the lungs. Food

near the trachea will initiate a cough. This is important to

clearing the trachea of food. Aspiration can cause pneumonia and it

can infiltrate the lungs and reduce lung capacity. Anyway to reduce

regurgitation, especially while a sleep, is important. I would never

use a cough medication, or sleeping pill, since the cough reflex is

very important in preventing aspiration into the lungs. I believe

sleeping on one's side reduce the risk of aspiration.

I sleep with a wedge pillow plus a regular pillow and if I wake up in

regurgitation than I sleep sitting up in a reclining chair. I use the

hyperventilation and Tums treatment to open the cardia valve plus a

little bit of water to wash it down. Sometimes the cardia valve does

not open and if I take too much water the regurgitation is like a

fountain of water in my mouth (even filling my nose) so I don't like

to take much water at night. This is tempered by the fact that I may

go to sleep while trying to open the cardia valve thus failing to

open the valve. Some patients have severe regurgitation problems

(often throat cancer patient) and they can only sleep sitting up in a

reclining chair. I have noticed that some patients slip into

Achalasia without the MD being aware of it

Another hint is that I solve the hyperventilation timing problem in

restaurants by using buffets, or fast food restaurants since there is

no long wait for the meal to appear. I have the advantage of a vast

pick of foods in the buffet so that I can eliminate the acid foods

and balance the salt and K foods. I can start hyperventilating on

the car journey to these restaurants.

4

5

[Guest guest]

Wally Again,

I have had two operations in which my potassium levels have gone too

low. It is because before the operation they empty your stomach, this

is a precaution so that you do not vomit during the operation. In both

cases it was the second day after the operation and I would go into

atrail fibrillation from low potassium. Extra potassium brought me out

of it.

A third operation I was in atrail fibrillation for five days after the

operation and also a day before the operation. The fibrillation was

stopped during the operation by I believe a control on potassium. The

atrail fibrillation stopped after I left the hospital and could eat

again. I had nothing to eat for six days, only saline & sugar IV after

the operation. All of these operations were before I understood my

hypothyroidism and took up hyperventilating to control fibrillation.

I can not explain low oxygen and low potassium except that the stomach

seemed to override the lungs.

Feel free to show the report6 to your MD. MDs never read my reports. I

understand iritis very well and it very simple, but I can not get any

ophthalmologist to read my report on it. There is a type of

hypothyroidism that is very complex and no MD will read my report. Once

an MD at Rand Corp. was forced to read it by the US Army but she did not

believe me.

Re: achalasia process

I am fascinated with the hyperventilation theory. I am not sure how

the Na and K affects me. I suspect that since I am a shallow breather

that my K levels would be affected. I do know that when I had my

myotomy I was in the hospital for a week being pumped with potassium

because my potassium levels were so low post surgery and I was in ICU

because my oxygen sats were so low...but if my oxygen was low,

wouldn't my K levels have been high? Maybe I am confused...it is

complicated and I am not a chemist (my daughter is) but it fasinates

me all the same.

Well I decided to experiment this morning. I ate a bowl of oatmeal

with no sugar...just some margarine for a little added flavor. My new

years resolution includes a diet of no sugar...not even artificial.

Normally I would have added some berries to my oatmeal, but I am

trying to go for bland due to the ulcer I have developed in my LES.

This morning I had awoke to a throatful of acid which was unpleasant

and kept me coughing for some time this morning.

Well about the experiment...as I was eating and the oatmeal was

backing up in my esophagus, instead of reaching for the water, I began

mildly hyperventilating instead...I ate the entire bowl of oatmeal

without the aid of water. I still have a little bit or oatmeal left in

my esophagus which I think I will wash down with water, but for the

most part the hyperventilation seems like it may have helped.

Normally, if I was to eat a bowl of oatmeal without the aid of water

it would be sitting in my esophagus making me feel quite ill...maybe

this technique is working?

I received a call from Dr. Ostroff's office this morning. The

receptionist said she was left instructions from the nurse

practitioner to schedule me in for an appointment to see Dr. Ostroff.

I am scheduled for January 17th. I don't know what he will want to

discuss. It seems to me that he would need to do another endoscopy in

order to find out if the ulcer is healing. Guess I will find out when

I see him...I haven't even spoken to him " personally " yet since the

procedure.

Wally, if you don't mind, I think I will print up the message you

posted for him to read and speak to him about the hyperventilation and

Na/K level theory to see what he thinks about this!

Happy New Year to everyone..I plan to keep experimenting with this!

Sandi in No CA

>

> 1 Jan 2006

>

> Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> as a nuclear physicist, then many years as a rocket scientist.

> Achalasia is very complex and it has taken me years to understand the

> small amount that I know of the process. It is possible, without

> surgery, to gain good control of Achalasia with this knowledge. It

> will be hard for an medical doctor (MD) to treat a patient since the

> most important blood test is not stable and can change from minute to

> minute. An MD can be very valuable in curing, or controlling, the

> many medical disorders that may contribute to Achalasia. I believe

> the patient needs to observe and experiment, using the information

> that I have uncovered, to further reduce Achalasia. I am afraid the

> complexity will discourage many patients and even MDs.

>

>

> Achalasia

>

> Introduction

>

> I believe that Achalasia relates to nerve transmission pulses. Nerve

> transmission is done electrically and they may be upset by abnormal

> changes in the conductivity of the nerves. The blood feeds the

> nerves and keeps it alive and healthy and the blood itself can affect

> the conductivity of the nerves. The body, and blood, contains

> electrolytes. Electrolytes are atoms, or compounds, that in solution

> can conduct electricity. They do this by dropping or gaining an

> electron (becoming an ion) with a positive or negative charge. The

> major electrolytes are potassium, magnesium, phosphate, sulfate,

> bicarbonate and small amounts of sodium, chlorate and calcium. By

> conductivity I do not mean the same as a metal with a flow of

> electrons, the conductivity in nerves is caused by potassium plus ion

> and sodium plus ions exchanges across the nerve fiber membrane. It

> is a slow flow compared to electron flow and it reinforces along the

> fiber as it proceeds. I will only consider potassium (K) and sodium

> (Na) in this report since there is such a direct link to nerve

> impulses. The cardia valve and the peristaltic action of the

> esophagus can fail under misfiring nerves. The pioneering work in

> this field was done by Dr. Harold Friedman and his work was published

> as " Ionic Solution Theory " in 1962. This text treats solutions in

> the body as well, as general chemistry.

>

> Cause

>

> One major cause of Achalasia is described in this article. There are

> at least two other causes--see Scleroderma and Chagas in the latest

> 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> informative to read the chapter on Esophageal Disorders which

> includes Achalasia. What I have to describe is based on accepted

> medical knowledge concerning nerves and transmission of nerve

> pulses.

>

> Achalasia (medical dictionary explanation) means failure to relax,

> especially of the cardia valve muscle which results in retention of

> food in the esophagus. A medical textbook explanation says the

> defect appears to originate from a loss of motor innervation, by

> fibers originating in the dorsal nucleus of the Vagus nerve. The

> Vagus nerve is a packet of nerves that runs from the brain stem down

> the neck into the body, most nerves run down the spinal column and

> branch out to the body organs. The Vagus nerve (wandering nerve)

> supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> valve, lungs, heart, etc but it is not the sole supply of nerves for

> most of these organs.

>

> As a point of interest, Achalasia was formerly called a Cardiospasm.

> This was misleading since cardia implies the heart but the cardia

> valve (splincter valve at the bottom of the esophagus) is just near

> the heart. A spasm means a contraction of a muscle but in a

> Cardiospasm the muscle does not contract but fails to relax. If the

> failure to relax was because of a cramp on top of the normal

> contraction of the cardia muscle I would think this would produce a

> pain which might be perceive as an Achalasia spasm.

>

> I have had Achalasia for 20 years and very early my body reacted to

> the disorder by hyperventilation which brought me out of Achalasia.

> From this I developed the reasoning why this was important to me but

> I found out later that my technique would make some patients worst.

> From reading letters to the Achalasia Forum I have been able to

> understand some of the complex reasons for Achalasia. I find

> experiencing Achalasia is very helpful in understanding it but I am

> at a loss to understand spasms since I have never had one.

>

> I have found K and Na to be the most controlling electrolytes in

> Achalasia and I have not worked with the other electrolytes. I

> suspect that low calcium may be involved in spasms since low calcium

> is know to excite the nerves to a point that a muscle goes into a

> spasm called Tetany. The low calcium can become even more of a

> problem if the blood goes alkaline since this adds to the excitation

> of the nerve system. Low levels of calcium in a blood test might

> indicate if this is a problem. Possibly ingestion of calcium might

> bring one out of the spasm. There are many reasons for low calcium

> and one should consult an MD to uncover your own problem. Since a

> cramp is a spasm, athletes often get leg cramps from loss of salt

> during exercise. Leg cramps while sleep often arise from too much K

> released into the blood from respiratory acidosis (shallow breathing

> while a sleep).

>

> There are two blood (serum) factors that one should be familiar

> with in order to understand Achalasia. One is the pH of the blood.

> This is a measure of the acidity or alkalinity of the blood.

> Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> acid and 7-14 alkaline. The blood is normally slightly alkaline at

> 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> lower or higher will lead to death within hours. pH is a logarithmic

> scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> not change from 7.4 more that plus or minus 0.2 or one will get

> sick. The body has a quick response to adjusting the pH to safe

> values. Food, liquid, drugs and breathing can change the pH of the

> blood but only by a very small, but important amount. If the blood

> goes acid, a small amount of K falls out of the body cells into the

> blood and if the blood goes alkaline a small amount of K is forced

> into the body cells from the blood. The second factor in the blood is

> the ratio of Na to K.

>

> Blood serum requires a certain ratio of Na to K in the blood and this

> is about 28 to 1. This ratio is the same as the ratio of Na to K in

> sea water which is cited as a reason why man may have originated in

> sea water. This ratio changes with the pH of the blood, because K is

> either dropped out of the blood with acidity or forced back into the

> cells with alkalinity. The ratio is not used in normal medicine but

> I will use it since it provides clues to the patient as to when and

> why he is in Achalasia. This ratio can not deviate very far from

> this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> By misfire I mean that when the blood is alkaline the nerves become

> over excited to, at a maximum, one could go into convulsions. When

> in acidity it decreases its acidity to, at a minimum, one could go

> into a coma. Different nerves and nerve pathways may have a slightly

> different pH, and may also response differently to the same pH so all

> the nerves do not fail at the same time. Nerves close to the gastro

> tract may respond faster to food, drugs, and liquid changes than leg

> and arm nerves because the food is in immediate contact with the

> nerves. Also some of the organs (possibly the cardia valve) may be

> supplied solely by the Vagus nerve.

>

> I think of pH and Na to K as related since if the pH changes the

> ratio of Na to K also changes. Thus if K is high the blood is acid,

> and if K is low the blood is alkaline.

>

> The body stores a large amount of K in the body cells and a much

> smaller amount in the blood. Na stores a large amount in the extra

> cellular fluids and blood and very little in body cells. There is a

> mechanism to keep this in the proper balance called the Na-K pump.

> There are other ways to balance the absolute amount of K in the

> blood, some very fast and others slow, as a change of K by a factor

> of three can kill. Na is not held under as strict a control. There

> are clinical values for absolute values of Na and K and a variation

> from these values can be an indication of something wrong in the body.

>

> The nerves require the proper pH (or ratio of Na to K) for proper

> firing of the nerves. The proper ratio can be changed temporarily by

> foods, liquids, drugs or breathing. Then there are semipermeant

> disorders that bias the ratio for long periods of time. I say

> semipermeant because they may come and go over weeks, months or years

> and the disorder create these biases might possibly be cured. For

> instance, for 17 years I would go in and out hypothyroidism on very

> irregular schedule related to my level of stress. Today, I am out of

> it for many months and I fall into it for a week or two, at the

> most. In my case high stress is apt to bring on hypothyroidism.

> Hypothyroidism can be present without the patient or his MD being

> aware of. My 17 year spell with hypothyroidism was never detected by

> my MD even thought I suspected I was in it but my blood tests never

> reveal it, probably because I drifted in and out of it and it never

> was present when a blood test were taken. Also I tried to control my

> excess of K by eating less K foods while in hypothyroidism to control

> atrail fibrillation (a nerve firing problem). Thus, it is not

> surprising that blood tests did not reveal excess K.

>

> A temporary event can be created by breathing, either hyper, or

> hypoventilation. Hyperventilation (respiratory alkalosis) will push

> K back into the body cell from the blood serum and hypoventilation

> (respiratory acidosis) will drop K out of the body cells into the

> blood. This is very fast acting and I use it to alter the K in my

> blood. Some short term events can last a long time, I normally

> hypoventilate because of a sunken chest, thus a short term event

> becomes a long term, event.

>

> The longer term events come under the class of metabolic acidosis or

> metabolic alkalosis. Metabolic means a chemical event. Respiratory

> acidosis, or respiratory alkalosis, is also a chemical event but I

> think it is separated from metabolic since is is such a quick event.

> Eating acid foods will act the same as respiratory acidosis and drops

> K in the blood but since is a food process it takes longer to work

> (minutes instead of seconds) and last longer. An antacid (Tums or

> milk) will also make the blood alkaline and push K back into the body

> cells from the blood. An acid drink (cola syrup, soft drinks or

> orange juice) will drop K into the blood. Acid foods such as pickle,

> strawberries, tomatoes, and vinegar can drop K into the blood for a

> limited time. Food, liquids, drugs are short term events but they

> can extend into very long events.

>

> Drugs can seriously change the pH. I recently read an ad in the NY

> Times for Topamax (migraine headache) it states one side effect is

> metabolic acidosis which will produce hyperventilation. The

> hyperventilation will shift the blood towards neutral.

> Hyperventilation was a part of my Achalasia.

>

> Some 60% of those with achalasia have an epiphrenic diverticulum.

> This is a pouch at the cardioesophageal junction. The pouch can

> collect food which does not go into the stomach but ferments in the

> pouch and in the fermenting process becomes acid. I have one of

> these pouches and I sense if I swallow a chunk of meat which stays in

> the pouch, that it will take up to a week before the meat passes into

> the stomach and I have much Achalasia during this period. As much as

> I try to chew thoroughly, if I eat a steak, there always seems to be

> a chunk that drops into the throat. I try to avoid beef steaks but I

> seem to be able to eat ham and pork without trouble. Ground beef is

> safe to eat.

>

> Long term events are diseases, such as hypothyroidism which elevates

> K and depress Na in the blood, and hyperthyroidism which elevates Na

> and depresses K. Low adrenal output elevates K and depress Na in the

> blood. High adrenal output elevates Na and depresses K. Diuretics

> can depress K, or K sparing diuretics can elevate K. Dehydration can

> elevate Na in the blood.

>

> The vast majority of the population escapes Achalasia. So what is

> differ about patients of Achalasia. I propose that short and long

> term events do not balance out but add up. I normally

> hypoventilate. I have been in hypothyroidism, of and on, for many

> years, I normally eat too may K foods and avoid salty (Na--sodium

> chloride) foods. They all add up to a low ratio of Na to K or an

> acid blood.

>

> Treatment

>

> One can see the vast complexity of Achalasis. In fact , this

> disorder is so complex that my method of coping with it is very

> difficult for most patients and even more so for MD's who have very

> little to work with, since any blood test are fleeting and reveal

> little. It would be very difficult to handle a case with a child.

> There is one hope and that is to cure the diseases that place the

> ratio out of balance. For instance, my Achalasia is much diminished

> when I am free of hypothyroidism. A patient can try to balance the K

> foods with the Na foods, and by balance I do not mean one for one,

> but your own requirement that minimizes Achalasia. Also try to

> balance acid liquids and foods with alkaline ones. A parent can also

> place a child on the same diet.

>

> There is a table in the 17th Edition Merck Manual that can help you

> see how different disorders affect the Na and K levels it is on Page

> 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> very helpful. One must evaluate what is one's problem whether too

> much, or too little K. Na maybe the problem from too much ingestion

> of Na (salt), which is easily solved.

>

> I have developed a treatment to open up the cardia valve as I eat.

> My problem is too much K and too little salt, this will makes

> Achalasia worse for those who are normally high on Na and low on K.

> If you have Achalasia I believe you probably fall into one or the

> other case, although there must be many who just eat too much salt.

>

> To bring myself into a normal ratio of Na to K, first, during the

> meal I try to determine whether the meal contains enough salt or

> whether I need to add salt. If one must add salt, it takes very

> little salt to add the right amount. Then just before a meal I

> mildly hyperventilated for about 15 minutes and take two Tums

> (regular) antacids and this normally sets me up for a normal meal

> without Achalasia. One must continue to hyperventilate during the

> meal since normally one would hypoventilate while eating. Sometimes

> in a restaurant, the meal comes too late, and I have been

> hyperventilating too long, changing from too high in K to too low.

> If I stop hyperventilating and wait about 10 minutes the ratio will

> approach normal and I can then eat. Sometimes during the meal I will

> eat too many K foods and Achalasia will kick in. If I eat a dill

> pickle, strawberries, tomatoes, orange juice, etc then I will go too

> acid which drops too much K in the blood and I am in Achalasia.

>

> I have no experience with low K and high Na. I would think an acid

> drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> (milk), would start one off correctly and the normal hypoventilation

> while eating would also help. Eating less salty foods and more K

> foods would also help.

>

> If the Na to K ratio causes misfiring of nerves and prevents the

> cardia valve from opening, then other nerves are apt to misfire. I

> can sense that my atrail fibrillation occurs with Achalasia, and the

> actions I take to lower Achalasia, also lower atrail fibrillation.

> The cardia valve, esophagus, larynx, and part of the heart and lungs

> are controlled by nerves in the Vagus nerve. When really bad from

> too much hypothyroidism the nerves in my legs produce peripheral

> neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> can appear when in hypothyroidism I wonder if gastroesophagel reflux

> disease (GERD) might not be a different form of Achalasia in which

> the cardia valve remains open rather that closed.

>

> In addition to those with too much K or too little K, patients may

> suffer from salt (water) retention which leaves too much Na in the

> blood. Salt retention is difficult for an MD to detect, since there

> are no clinical tests for it. I was in heavy salt retention for 9

> months before I understood what was wrong. Salt retention can be

> caused by some medications and also by stress. Those that take

> diuretics may also suffer from low K unless the diuretic is a K

> sparing diuretic and then they may have too much K in the blood.

> Diabetes can also influence the K levels (more than one way) see the

> 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> Na.

>

> Hyperventilation must be used with caution, just breathe deeply and

> exhale through pursed lips to avoid over doing. Very rapid deep

> breathing can be dangerous as the brain can get overloaded with

> oxygen and will cut off blood flow to the brain and produce a mild

> stroke. I think it would be very hard for this to occur if one where

> to limit oneself to mild hyperventilation to no more than 20 minutes

> plus eating time. The operative word here is mild. However,

> hyperventilation (possibly antacids) is of particular danger to those

> subjected to epileptic fits and can cause epileptic convulsive

> attacks.

>

> Other controls

>

> I usually am able to detect when food is building up in the

> esophagus, there is the feeling of fullness plus the beginning of

> hiccups. I must stop eating and continue hyperventilating until the

> cardia valve opens usually accompanied by a burp and the esophagus

> gradually empties. If I go too far, and fill the esophagus too much,

> the cardia valve will not open and I must heave up the contents of

> the esophagus. Eating slowly and chewing thoroughly gives more time

> for the cardia valve to open.

>

> I control nighttime regurgitation by eating early, cleaning my teeth

> and mouth of food particles at the end of dinner and then drinking a

> glass of water to wash every bit of food down the esophagus. If,

> during the evening I burp and taste any food I have to go through the

> routine again of hyperventilating, two Tums and water to open up the

> cardia valve to flush the food from the esophagus. I count on 4 to 6

> hours after dinner before going to bed and there must be no food or

> liquids after dinner. Regurgitation is dangerous since it places

> food near the trachea where it may aspirate into the lungs. Food

> near the trachea will initiate a cough. This is important to

> clearing the trachea of food. Aspiration can cause pneumonia and it

> can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> regurgitation, especially while a sleep, is important. I would never

> use a cough medication, or sleeping pill, since the cough reflex is

> very important in preventing aspiration into the lungs. I believe

> sleeping on one's side reduce the risk of aspiration.

>

> I sleep with a wedge pillow plus a regular pillow and if I wake up in

> regurgitation than I sleep sitting up in a reclining chair. I use the

> hyperventilation and Tums treatment to open the cardia valve plus a

> little bit of water to wash it down. Sometimes the cardia valve does

> not open and if I take too much water the regurgitation is like a

> fountain of water in my mouth (even filling my nose) so I don't like

> to take much water at night. This is tempered by the fact that I may

> go to sleep while trying to open the cardia valve thus failing to

> open the valve. Some patients have severe regurgitation problems

> (often throat cancer patient) and they can only sleep sitting up in a

> reclining chair. I have noticed that some patients slip into

> Achalasia without the MD being aware of it

>

> Another hint is that I solve the hyperventilation timing problem in

> restaurants by using buffets, or fast food restaurants since there is

> no long wait for the meal to appear. I have the advantage of a vast

> pick of foods in the buffet so that I can eliminate the acid foods

> and balance the salt and K foods. I can start hyperventilating on

> the car journey to these restaurants.

>

>

>

> 4

>

>

>

>

>

> 5

>

[Guest guest]

I need to know, you speak of nerve damage...I am trying to find out why I got Achalasia and why my symptoms came on so fast and the only thing I can come up with is a correlation between a computer monitor falling on my shoulder and pushing everything down (including the shoulder blade) and compressing into the nerves. I at times feel like someone is pusing a sharp knife under my shoulder blade...is there any relation between my fast onslaught of Achalasia symptoms and this injury? The injury occurred July 17, 2004, the symptoms began appearing around November 2004...worsening over the winter until by April 2005 I couldn't eat a meal without problems. I had my heller myotomy in October and am again experiencing tightness in the area of the LES...Any assistance in my questions would be greatly appreciated by someone of your knowledge. Thank you in advance Crystal RodbournWally Allan

<whallan@...> wrote: 1 Jan 2006Wallace H. Allan ---I am a retired physicist, age 84, I worked first as a nuclear physicist, then many years as a rocket scientist. Achalasia is very complex and it has taken me years to understand the small amount that I know of the process. It is possible, without surgery, to gain good control of Achalasia with this knowledge. It will be hard for an medical doctor (MD) to treat a patient since the most important blood test is not stable and can change from minute to minute. An MD can be very valuable in curing, or controlling, the many medical disorders that may contribute to Achalasia. I believe the patient needs to observe and experiment, using the information that I have uncovered, to further reduce Achalasia. I am afraid the complexity

will discourage many patients and even MDs. AchalasiaIntroductionI believe that Achalasia relates to nerve transmission pulses. Nerve transmission is done electrically and they may be upset by abnormal changes in the conductivity of the nerves. The blood feeds the nerves and keeps it alive and healthy and the blood itself can affect the conductivity of the nerves. The body, and blood, contains electrolytes. Electrolytes are atoms, or compounds, that in solution can conduct electricity. They do this by dropping or gaining an electron (becoming an ion) with a positive or negative charge. The major electrolytes are potassium, magnesium, phosphate, sulfate, bicarbonate and small amounts of sodium, chlorate and calcium. By conductivity I do not mean the same as a metal with a flow of electrons, the conductivity in nerves is caused by potassium plus ion

and sodium plus ions exchanges across the nerve fiber membrane. It is a slow flow compared to electron flow and it reinforces along the fiber as it proceeds. I will only consider potassium (K) and sodium (Na) in this report since there is such a direct link to nerve impulses. The cardia valve and the peristaltic action of the esophagus can fail under misfiring nerves. The pioneering work in this field was done by Dr. Harold Friedman and his work was published as "Ionic Solution Theory" in 1962. This text treats solutions in the body as well, as general chemistry.CauseOne major cause of Achalasia is described in this article. There are at least two other causes--see Scleroderma and Chagas in the latest 17th Edition "Merck Manual of Diagnosis and Therapy". It will be informative to read the chapter on Esophageal Disorders which includes Achalasia. What I have to describe

is based on accepted medical knowledge concerning nerves and transmission of nerve pulses. Achalasia (medical dictionary explanation) means failure to relax, especially of the cardia valve muscle which results in retention of food in the esophagus. A medical textbook explanation says the defect appears to originate from a loss of motor innervation, by fibers originating in the dorsal nucleus of the Vagus nerve. The Vagus nerve is a packet of nerves that runs from the brain stem down the neck into the body, most nerves run down the spinal column and branch out to the body organs. The Vagus nerve (wandering nerve) supplies some nerves to the ear, tongue, larynx, esophagus, cardia valve, lungs, heart, etc but it is not the sole supply of nerves for most of these organs. As a point of interest, Achalasia was formerly called a Cardiospasm. This was misleading since cardia implies the

heart but the cardia valve (splincter valve at the bottom of the esophagus) is just near the heart. A spasm means a contraction of a muscle but in a Cardiospasm the muscle does not contract but fails to relax. If the failure to relax was because of a cramp on top of the normal contraction of the cardia muscle I would think this would produce a pain which might be perceive as an Achalasia spasm.I have had Achalasia for 20 years and very early my body reacted to the disorder by hyperventilation which brought me out of Achalasia. From this I developed the reasoning why this was important to me but I found out later that my technique would make some patients worst. From reading letters to the Achalasia Forum I have been able to understand some of the complex reasons for Achalasia. I find experiencing Achalasia is very helpful in understanding it but I am at a loss to understand spasms since I have

never had one.I have found K and Na to be the most controlling electrolytes in Achalasia and I have not worked with the other electrolytes. I suspect that low calcium may be involved in spasms since low calcium is know to excite the nerves to a point that a muscle goes into a spasm called Tetany. The low calcium can become even more of a problem if the blood goes alkaline since this adds to the excitation of the nerve system. Low levels of calcium in a blood test might indicate if this is a problem. Possibly ingestion of calcium might bring one out of the spasm. There are many reasons for low calcium and one should consult an MD to uncover your own problem. Since a cramp is a spasm, athletes often get leg cramps from loss of salt during exercise. Leg cramps while sleep often arise from too much K released into the blood from respiratory acidosis (shallow breathing while a sleep).

There are two blood (serum) factors that one should be familiar with in order to understand Achalasia. One is the pH of the blood. This is a measure of the acidity or alkalinity of the blood. Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is acid and 7-14 alkaline. The blood is normally slightly alkaline at 7.40. Thus 7.40 is considered neutral and anything lower is acid and higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything lower or higher will lead to death within hours. pH is a logarithmic scale so .7 is a change of 5X in acidity, or alkalinity. The pH will not change from 7.4 more that plus or minus 0.2 or one will get sick. The body has a quick response to adjusting the pH to safe values. Food, liquid, drugs and breathing can change the pH of the blood but only by a very small, but important amount. If the blood

goes acid, a small amount of K falls out of the body cells into the blood and if the blood goes alkaline a small amount of K is forced into the body cells from the blood. The second factor in the blood is the ratio of Na to K.Blood serum requires a certain ratio of Na to K in the blood and this is about 28 to 1. This ratio is the same as the ratio of Na to K in sea water which is cited as a reason why man may have originated in sea water. This ratio changes with the pH of the blood, because K is either dropped out of the blood with acidity or forced back into the cells with alkalinity. The ratio is not used in normal medicine but I will use it since it provides clues to the patient as to when and why he is in Achalasia. This ratio can not deviate very far from this 28 to 1 or the nerves (the pH changes the ratio) will misfire. By misfire I mean that when the blood is alkaline the nerves become

over excited to, at a maximum, one could go into convulsions. When in acidity it decreases its acidity to, at a minimum, one could go into a coma. Different nerves and nerve pathways may have a slightly different pH, and may also response differently to the same pH so all the nerves do not fail at the same time. Nerves close to the gastro tract may respond faster to food, drugs, and liquid changes than leg and arm nerves because the food is in immediate contact with the nerves. Also some of the organs (possibly the cardia valve) may be supplied solely by the Vagus nerve.I think of pH and Na to K as related since if the pH changes the ratio of Na to K also changes. Thus if K is high the blood is acid, and if K is low the blood is alkaline.The body stores a large amount of K in the body cells and a much smaller amount in the blood. Na stores a large amount in the extra cellular

fluids and blood and very little in body cells. There is a mechanism to keep this in the proper balance called the Na-K pump. There are other ways to balance the absolute amount of K in the blood, some very fast and others slow, as a change of K by a factor of three can kill. Na is not held under as strict a control. There are clinical values for absolute values of Na and K and a variation from these values can be an indication of something wrong in the body.The nerves require the proper pH (or ratio of Na to K) for proper firing of the nerves. The proper ratio can be changed temporarily by foods, liquids, drugs or breathing. Then there are semipermeant disorders that bias the ratio for long periods of time. I say semipermeant because they may come and go over weeks, months or years and the disorder create these biases might possibly be cured. For instance, for 17 years I would go in and out

hypothyroidism on very irregular schedule related to my level of stress. Today, I am out of it for many months and I fall into it for a week or two, at the most. In my case high stress is apt to bring on hypothyroidism. Hypothyroidism can be present without the patient or his MD being aware of. My 17 year spell with hypothyroidism was never detected by my MD even thought I suspected I was in it but my blood tests never reveal it, probably because I drifted in and out of it and it never was present when a blood test were taken. Also I tried to control my excess of K by eating less K foods while in hypothyroidism to control atrail fibrillation (a nerve firing problem). Thus, it is not surprising that blood tests did not reveal excess K.A temporary event can be created by breathing, either hyper, or hypoventilation. Hyperventilation (respiratory alkalosis) will push K back into the

body cell from the blood serum and hypoventilation (respiratory acidosis) will drop K out of the body cells into the blood. This is very fast acting and I use it to alter the K in my blood. Some short term events can last a long time, I normally hypoventilate because of a sunken chest, thus a short term event becomes a long term, event.The longer term events come under the class of metabolic acidosis or metabolic alkalosis. Metabolic means a chemical event. Respiratory acidosis, or respiratory alkalosis, is also a chemical event but I think it is separated from metabolic since is is such a quick event. Eating acid foods will act the same as respiratory acidosis and drops K in the blood but since is a food process it takes longer to work (minutes instead of seconds) and last longer. An antacid (Tums or milk) will also make the blood alkaline and push K back into the body cells from the blood. An

acid drink (cola syrup, soft drinks or orange juice) will drop K into the blood. Acid foods such as pickle, strawberries, tomatoes, and vinegar can drop K into the blood for a limited time. Food, liquids, drugs are short term events but they can extend into very long events.Drugs can seriously change the pH. I recently read an ad in the NY Times for Topamax (migraine headache) it states one side effect is metabolic acidosis which will produce hyperventilation. The hyperventilation will shift the blood towards neutral. Hyperventilation was a part of my Achalasia.Some 60% of those with achalasia have an epiphrenic diverticulum. This is a pouch at the cardioesophageal junction. The pouch can collect food which does not go into the stomach but ferments in the pouch and in the fermenting process becomes acid. I have one of these pouches and I sense if I swallow a chunk of meat which

stays in the pouch, that it will take up to a week before the meat passes into the stomach and I have much Achalasia during this period. As much as I try to chew thoroughly, if I eat a steak, there always seems to be a chunk that drops into the throat. I try to avoid beef steaks but I seem to be able to eat ham and pork without trouble. Ground beef is safe to eat.Long term events are diseases, such as hypothyroidism which elevates K and depress Na in the blood, and hyperthyroidism which elevates Na and depresses K. Low adrenal output elevates K and depress Na in the blood. High adrenal output elevates Na and depresses K. Diuretics can depress K, or K sparing diuretics can elevate K. Dehydration can elevate Na in the blood.The vast majority of the population escapes Achalasia. So what is differ about patients of Achalasia. I propose that short and long term events do

not balance out but add up. I normally hypoventilate. I have been in hypothyroidism, of and on, for many years, I normally eat too may K foods and avoid salty (Na--sodium chloride) foods. They all add up to a low ratio of Na to K or an acid blood.TreatmentOne can see the vast complexity of Achalasis. In fact , this disorder is so complex that my method of coping with it is very difficult for most patients and even more so for MD's who have very little to work with, since any blood test are fleeting and reveal little. It would be very difficult to handle a case with a child. There is one hope and that is to cure the diseases that place the ratio out of balance. For instance, my Achalasia is much diminished when I am free of hypothyroidism. A patient can try to balance the K foods with the Na foods, and by balance I do not mean one for one, but your own requirement that

minimizes Achalasia. Also try to balance acid liquids and foods with alkaline ones. A parent can also place a child on the same diet.There is a table in the 17th Edition Merck Manual that can help you see how different disorders affect the Na and K levels it is on Page 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also very helpful. One must evaluate what is one's problem whether too much, or too little K. Na maybe the problem from too much ingestion of Na (salt), which is easily solved.I have developed a treatment to open up the cardia valve as I eat. My problem is too much K and too little salt, this will makes Achalasia worse for those who are normally high on Na and low on K. If you have Achalasia I believe you probably fall into one or the other case, although there must be many who just eat too much salt.To bring myself into a normal ratio of Na

to K, first, during the meal I try to determine whether the meal contains enough salt or whether I need to add salt. If one must add salt, it takes very little salt to add the right amount. Then just before a meal I mildly hyperventilated for about 15 minutes and take two Tums (regular) antacids and this normally sets me up for a normal meal without Achalasia. One must continue to hyperventilate during the meal since normally one would hypoventilate while eating. Sometimes in a restaurant, the meal comes too late, and I have been hyperventilating too long, changing from too high in K to too low. If I stop hyperventilating and wait about 10 minutes the ratio will approach normal and I can then eat. Sometimes during the meal I will eat too many K foods and Achalasia will kick in. If I eat a dill pickle, strawberries, tomatoes, orange juice, etc then I will go too acid which drops too much

K in the blood and I am in Achalasia.I have no experience with low K and high Na. I would think an acid drink (cola syrup, soft drink, orange juice) and no alkaline drinks (milk), would start one off correctly and the normal hypoventilation while eating would also help. Eating less salty foods and more K foods would also help.If the Na to K ratio causes misfiring of nerves and prevents the cardia valve from opening, then other nerves are apt to misfire. I can sense that my atrail fibrillation occurs with Achalasia, and the actions I take to lower Achalasia, also lower atrail fibrillation. The cardia valve, esophagus, larynx, and part of the heart and lungs are controlled by nerves in the Vagus nerve. When really bad from too much hypothyroidism the nerves in my legs produce peripheral neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also can appear when in

hypothyroidism I wonder if gastroesophagel reflux disease (GERD) might not be a different form of Achalasia in which the cardia valve remains open rather that closed.In addition to those with too much K or too little K, patients may suffer from salt (water) retention which leaves too much Na in the blood. Salt retention is difficult for an MD to detect, since there are no clinical tests for it. I was in heavy salt retention for 9 months before I understood what was wrong. Salt retention can be caused by some medications and also by stress. Those that take diuretics may also suffer from low K unless the diuretic is a K sparing diuretic and then they may have too much K in the blood. Diabetes can also influence the K levels (more than one way) see the 17th edition Merck Manual Page 2549 Table 296-4 and read about K and Na.Hyperventilation must be used with caution, just breathe deeply and exhale

through pursed lips to avoid over doing. Very rapid deep breathing can be dangerous as the brain can get overloaded with oxygen and will cut off blood flow to the brain and produce a mild stroke. I think it would be very hard for this to occur if one where to limit oneself to mild hyperventilation to no more than 20 minutes plus eating time. The operative word here is mild. However, hyperventilation (possibly antacids) is of particular danger to those subjected to epileptic fits and can cause epileptic convulsive attacks. Other controlsI usually am able to detect when food is building up in the esophagus, there is the feeling of fullness plus the beginning of hiccups. I must stop eating and continue hyperventilating until the cardia valve opens usually accompanied by a burp and the esophagus gradually empties. If I go too far, and fill the esophagus too much, the cardia

valve will not open and I must heave up the contents of the esophagus. Eating slowly and chewing thoroughly gives more time for the cardia valve to open.I control nighttime regurgitation by eating early, cleaning my teeth and mouth of food particles at the end of dinner and then drinking a glass of water to wash every bit of food down the esophagus. If, during the evening I burp and taste any food I have to go through the routine again of hyperventilating, two Tums and water to open up the cardia valve to flush the food from the esophagus. I count on 4 to 6 hours after dinner before going to bed and there must be no food or liquids after dinner. Regurgitation is dangerous since it places food near the trachea where it may aspirate into the lungs. Food near the trachea will initiate a cough. This is important to clearing the trachea of food. Aspiration can cause pneumonia and it can

infiltrate the lungs and reduce lung capacity. Anyway to reduce regurgitation, especially while a sleep, is important. I would never use a cough medication, or sleeping pill, since the cough reflex is very important in preventing aspiration into the lungs. I believe sleeping on one's side reduce the risk of aspiration.I sleep with a wedge pillow plus a regular pillow and if I wake up in regurgitation than I sleep sitting up in a reclining chair. I use the hyperventilation and Tums treatment to open the cardia valve plus a little bit of water to wash it down. Sometimes the cardia valve does not open and if I take too much water the regurgitation is like a fountain of water in my mouth (even filling my nose) so I don't like to take much water at night. This is tempered by the fact that I may go to sleep while trying to open the cardia valve thus failing to open the valve. Some patients have

severe regurgitation problems (often throat cancer patient) and they can only sleep sitting up in a reclining chair. I have noticed that some patients slip into Achalasia without the MD being aware of itAnother hint is that I solve the hyperventilation timing problem in restaurants by using buffets, or fast food restaurants since there is no long wait for the meal to appear. I have the advantage of a vast pick of foods in the buffet so that I can eliminate the acid foods and balance the salt and K foods. I can start hyperventilating on the car journey to these restaurants.45

Photos Ring in the New Year with Photo Calendars. Add photos, events, holidays, whatever.

[Guest guest]

This seems rather speculative. It would seem that it wouldn't be

difficult to test many of your claims, but I didn't see any

experimental results in your " paper " . I fear that you are confusing

correlation and causation. While I have achalasia, I never

hyperventilate. I am a regular blood donor, so my blood chemistry is

checked frequently. I have never noticed a correlation between my

symptoms and what time of day I eat.

[Guest guest]

4 Jan 2006

From Wally

To Crystal

Corrections/  The reference to prednisone as an  inflammatory is wrong, it suppresses an

inflammation.  Also prednisone has been

generally replaced by methyl prednisolone which is more

potent with no salt retention problems.  In

the last sentence prednisone is misspelled as prenisone.   

Re: achalasia

process

I need to know, you speak of nerve damage...I am trying

to find out why I got Achalasia and why my symptoms came on so fast and the

only thing I can come up with is a correlation between a computer monitor

falling on my shoulder and pushing everything down (including the shoulder

blade) and compressing into the nerves. I at times feel like someone is

pusing a sharp knife under my shoulder blade...is there any relation between my

fast onslaught of Achalasia symptoms and this injury? The injury occurred

July 17, 2004, the symptoms began appearing around November 2004...worsening

over the winter until by April 2005 I couldn't eat a meal without

problems. I had my heller myotomy in October and am again experiencing

tightness in the area of the LES...Any assistance in my questions would be

greatly appreciated by someone of your knowledge. Thank you in advance

Crystal Rodbourn

Wally Allan

<whallan@...> wrote:

1 Jan 2006

Wallace H. Allan ---I am a retired physicist, age

84, I worked first

as a nuclear physicist, then many years as a

rocket scientist.

Achalasia is very complex and it has taken me

years to understand the

small amount that I know of the process. It

is possible, without

surgery, to gain good control of Achalasia with

this knowledge. It

will be hard for an medical doctor (MD) to treat a

patient since the

most important blood test is not stable and can

change from minute to

minute. An MD can be very valuable in

curing, or controlling, the

many medical disorders that may contribute to

Achalasia. I believe

the patient needs to observe and experiment, using

the information

that I have uncovered, to further reduce

Achalasia. I am afraid the

com plexity will discourage many patients and even

MDs.

Achalasia

Introduction

I believe that Achalasia relates to nerve transmission

pulses. Nerve

transmission is done electrically and they may be

upset by abnormal

changes in the conductivity of the nerves.

The blood feeds the

nerves and keeps it alive and healthy and the

blood itself can affect

the conductivity of the nerves. The body,

and blood, contains

electrolytes. Electrolytes are atoms, or

compounds, that in solution

can conduct electricity. They do this by

dropping or gaining an

electron (becoming an ion) with a positive or

negative charge. The

major electrolytes are potassium, magnesium,

phosphate, sulfate,

bicarbonate and small amounts of sodium, chlorate

and calcium. By

conductivity I do not mean the same as a metal

with a flow of

electrons, the conductivity in nerves is caused by

potassium plus ion

and sodium plus ions exchanges across the nerve

fiber membrane. It

is a slow flow compared to electron flow and it

reinforces along the

fiber as it proceeds. I will only consider

potassium (K) and sodium

(Na) in this report since there is such a direct

link to nerve

impulses. The cardia valve and the

peristaltic action of the

esophagus can fail under misfiring nerves.

The pioneering work in

this field was done by Dr. Harold Friedman and his

work was published

as " Ionic Solution Theory " in

1962. This text treats solutions in

the body as well, as general chemistry.

Cause

One major cause of Achalasia is described in this

article. There are

at least two other causes--see Scleroderma and

Chagas in the latest

17th Edition " Merck Manual of Diagnosis and

Therapy " . It will be

informative to read the chapter on Esophageal

Disorders which

includes Achalasia. What I have to describe

is based on accepted

medical knowledge concerning nerves and

transmission of nerve

pulses.

Achalasia (medical dictionary explanation) means

failure to relax,

especially of the cardia valve muscle which

results in retention of

food in the esophagus. A medical textbook

explanation says the

defect appears to originate from a loss of motor

innervation, by

fibers originating in the dorsal nucleus of the

Vagus nerve. The

Vagus nerve is a packet of nerves that runs from

the brain stem down

the neck into the body, most nerves run down the

spinal column and

branch out to the body organs. The Vagus

nerve (wandering nerve)

supplies some nerves to the ear, tongue, larynx,

esophagus, cardia

valve, lungs, heart, etc but it is not the sole

supply of nerves for

most of these organs.

As a point of interest, Achalasia was formerly

called a Cardiospasm.

This was misleading since cardia impli es the

heart but the cardia

valve (splincter valve at the bottom of the

esophagus) is just near

the heart. A spasm means a contraction of a

muscle but in a

Cardiospasm the muscle does not contract but fails

to relax. If the

failure to relax was because of a cramp on top of

the normal

contraction of the cardia muscle I would think

this would produce a

pain which might be perceive as an Achalasia

spasm.

I have had Achalasia for 20 years and very early

my body reacted to

the disorder by hyperventilation which brought me

out of Achalasia.

From this I developed the reasoning why this was

important to me but

I found out later that my technique would make

some patients worst.

From reading letters to the Achalasia Forum I have

been able to

understand some of the complex reasons for

Achalasia. I find

experiencing Achalasia is very helpful in

understanding it but I am

at a loss to understand spasms since I have never

had one.

I have found K and Na to be the most controlling

electrolytes in

Achalasia and I have not worked with the other

electrolytes. I

suspect that low calcium may be involved in spasms

since low calcium

is know to excite the nerves to a point that a

muscle goes into a

spasm called Tetany. The low calcium can become

even more of a

problem if the blood goes alkaline since this adds

to the excitation

of the nerve system. Low levels of calcium

in a blood test might

indicate if this is a problem. Possibly

ingestion of calcium might

bring one out of the spasm. There are many

reasons for low calcium

and one should consult an MD to uncover your own

problem. Since a

cramp is a spasm, athletes often get leg cramps

from loss of salt

during exercise. Leg cramps while sleep

often arise from too much K

released into the blood from respiratory acidosis

(shallow breathing

while a sleep). & nbsp;

There are two blood (serum) factors that

one should be familiar

with in order to understand Achalasia. One

is the pH of the blood.

This is a measure of the acidity or alkalinity of

the blood.

Chemically pH ranges from 0 to 14 with 7.0 the

neutral point. 0-7 is

acid and 7-14 alkaline. The blood is

normally slightly alkaline at

7.40. Thus 7.40 is considered neutral and

anything lower is acid and

higher as alkaline. The blood pH ranges from

7.0 to 7.7 and anything

lower or higher will lead to death within

hours. pH is a logarithmic

scale so .7 is a change of 5X in acidity, or

alkalinity. The pH will

not change from 7.4 more that plus or minus 0.2 or

one will get

sick. The body has a quick response to

adjusting the pH to safe

values. Food, liquid, drugs and breathing can

change the pH of the

blood but only by a very small, but important

amount. If the blood

goes acid, a small amount of K falls out of the

body cells into the

blood and if the blood goes alkaline a small

amount of K is forced

into the body cells from the blood. The second

factor in the blood is

the ratio of Na to K.

Blood serum requires a certain ratio of Na to K in

the blood and this

is about 28 to 1. This ratio is the same as

the ratio of Na to K in

sea water which is cited as a reason why man may

have originated in

sea water. This ratio changes with the pH of

the blood, because K is

either dropped out of the blood with acidity or

forced back into the

cells with alkalinity. The ratio is not used

in normal medicine but

I will use it since it provides clues to the

patient as to when and

why he is in Achalasia. This ratio can not

deviate very far from

this 28 to 1 or the nerves (the pH changes the

ratio) will misfire.

By misfire I mean that when the blood is alkaline

the nerves become

over excited to, at a maximum, one could go into

convulsions. When

in acidity it decreases its acidity to, at a minimum,

one could go

into a coma. Different nerves and nerve pathways

may have a slightly

different pH, and may also response differently to

the same pH so all

the nerves do not fail at the same time.

Nerves close to the gastro

tract may respond faster to food, drugs, and

liquid changes than leg

and arm nerves because the food is in immediate

contact with the

nerves. Also some of the organs (possibly

the cardia valve) may be

supplied solely by the Vagus nerve.

I think of pH and Na to K as related since if the

pH changes the

ratio of Na to K also changes. Thus if K is

high the blood is acid,

and if K is low the blood is alkaline.

The body stores a large amount of K in the body

cells and a much

smaller amount in the blood. Na stores a

large amount in the extra

cellu lar fluids and blood and very little in body

cells. There is a

mechanism to keep this in the proper balance

called the Na-K pump.

There are other ways to balance the absolute

amount of K in the

blood, some very fast and others slow, as a change

of K by a factor

of three can kill. Na is not held under as strict

a control. There

are clinical values for absolute values of Na and

K and a variation

from these values can be an indication of something

wrong in the body.

The nerves require the proper pH (or ratio of Na

to K) for proper

firing of the nerves. The proper ratio can be

changed temporarily by

foods, liquids, drugs or breathing. Then

there are semipermeant

disorders that bias the ratio for long periods of

time. I say

semipermeant because they may come and go over

weeks, months or years

and the disorder create these biases might

possibly be cured. For

instance, for 17 years I would go in and out

hypothyroidism on very

irregular schedule related to my level of

stress. Today, I am out of

it for many months and I fall into it for a week

or two, at the

most. In my case high stress is apt to bring

on hypothyroidism.

Hypothyroidism can be present without the patient

or his MD being

aware of. My 17 year spell with

hypothyroidism was never detected by

my MD even thought I suspected I was in it but my

blood tests never

reveal it, probably because I drifted in and out

of it and it never

was present when a blood test were taken.

Also I tried to control my

excess of K by eating less K foods while in

hypothyroidism to control

atrail fibrillation (a nerve firing

problem). Thus, it is not

surprising that blood tests did not reveal excess

K.

A temporary event can be created by breathing,

either hyper, or

hypoventilation. Hyperventilation

(respiratory alkalosis) will push

K back into the body cell from the blood serum and

hypoventilation

(respiratory acidosis) will drop K out of the body

cells into the

blood. This is very fast acting and I use it

to alter the K in my

blood. Some short term events can last a

long time, I normally

hypoventilate because of a sunken chest, thus a

short term event

becomes a long term, event.

The longer term events come under the class of

metabolic acidosis or

metabolic alkalosis. Metabolic means a chemical

event. Respiratory

acidosis, or respiratory alkalosis, is also a

chemical event but I

think it is separated from metabolic since is is

such a quick event.

Eating acid foods will act the same as respiratory

acidosis and drops

K in the blood but since is a food process it

takes longer to work

(minutes instead of seconds) and last

longer. An antacid (Tums or

milk) will also make the blood alkaline and push K

back into the body

cells from the b lood. An acid drink (cola syrup,

soft drinks or

orange juice) will drop K into the blood.

Acid foods such as pickle,

strawberries, tomatoes, and vinegar can drop K

into the blood for a

limited time. Food, liquids, drugs are short

term events but they

can extend into very long events.

Drugs can seriously change the pH. I recently read

an ad in the NY

Times for Topamax (migraine headache) it states

one side effect is

metabolic acidosis which will produce

hyperventilation. The

hyperventilation will shift the blood towards

neutral.

Hyperventilation was a part of my Achalasia.

Some 60% of those with achalasia have an

epiphrenic diverticulum.

This is a pouch at the cardioesophageal

junction. The pouch can

collect food which does not go into the stomach

but ferments in the

pouch and in the fermenting process becomes

acid. I have one of

these pouches and I sense if I swallow a chunk of

mea t which stays in

the pouch, that it will take up to a week before

the meat passes into

the stomach and I have much Achalasia during this

period. As much as

I try to chew thoroughly, if I eat a steak, there

always seems to be

a chunk that drops into the throat. I try to

avoid beef steaks but I

seem to be able to eat ham and pork without

trouble. Ground beef is

safe to eat.

Long term events are diseases, such as

hypothyroidism which elevates

K and depress Na in the blood, and hyperthyroidism

which elevates Na

and depresses K. Low adrenal output elevates

K and depress Na in the

blood. High adrenal output elevates Na and

depresses K. Diuretics

can depress K, or K sparing diuretics can elevate

K. Dehydration can

elevate Na in the blood.

The vast majority of the population escapes

Achalasia. So what is

differ about patients of Achalasia. I

propose that short and long

term even ts do not balance out but add up.

I normally

hypoventilate. I have been in

hypothyroidism, of and on, for many

years, I normally eat too may K foods and avoid

salty (Na--sodium

chloride) foods. They all add up to a low

ratio of Na to K or an

acid blood.

Treatment

One can see the vast complexity of

Achalasis. In fact , this

disorder is so complex that my method of coping

with it is very

difficult for most patients and even more so for

MD's who have very

little to work with, since any blood test are

fleeting and reveal

little. It would be very difficult to handle

a case with a child.

There is one hope and that is to cure the diseases

that place the

ratio out of balance. For instance, my Achalasia

is much diminished

when I am free of hypothyroidism. A patient

can try to balance the K

foods with the Na foods, and by balance I do not

mean one for one,

but your own requireme nt that minimizes

Achalasia. Also try to

balance acid liquids and foods with alkaline

ones. A parent can also

place a child on the same diet.

There is a table in the 17th Edition Merck Manual

that can help you

see how different disorders affect the Na and K

levels it is on Page

2551 Table 296-5. The Table 296-4 with Na

and K on Page 2549 is also

very helpful. One must evaluate what

is one's problem whether too

much, or too little K. Na maybe the problem

from too much ingestion

of Na (salt), which is easily solved.

I have developed a treatment to open up the cardia

valve as I eat.

My problem is too much K and too little salt, this

will makes

Achalasia worse for those who are normally high on

Na and low on K.

If you have Achalasia I believe you probably fall

into one or the

other case, although there must be many who just

eat too much salt.

To bring myself into a normal rat io of Na to K,

first, during the

meal I try to determine whether the meal contains

enough salt or

whether I need to add salt. If one must add

salt, it takes very

little salt to add the right amount. Then

just before a meal I

mildly hyperventilated for about 15 minutes and

take two Tums

(regular) antacids and this normally sets me up

for a normal meal

without Achalasia. One must continue to

hyperventilate during the

meal since normally one would hypoventilate while

eating. Sometimes

in a restaurant, the meal comes too late, and I

have been

hyperventilating too long, changing from too high

in K to too low.

If I stop hyperventilating and wait about 10

minutes the ratio will

approach normal and I can then eat.

Sometimes during the meal I will

eat too many K foods and Achalasia will kick

in. If I eat a dill

pickle, strawberries, tomatoes, orange juice, etc

then I will go too

acid which drops too much K in the blood and I am

in Achalasia.

I have no experience with low K and high Na.

I would think an acid

drink (cola syrup, soft drink, orange juice) and

no alkaline drinks

(milk), would start one off correctly and the

normal hypoventilation

while eating would also help. Eating

less salty foods and more K

foods would also help.

If the Na to K ratio causes misfiring of nerves

and prevents the

cardia valve from opening, then other nerves are

apt to misfire. I

can sense that my atrail fibrillation occurs with

Achalasia, and the

actions I take to lower Achalasia, also lower

atrail fibrillation.

The cardia valve, esophagus, larynx, and part of

the heart and lungs

are controlled by nerves in the Vagus nerve.

When really bad from

too much hypothyroidism the nerves in my legs

produce peripheral

neuropathy. Carpal tunnel syndrome, which is

a nerve disorder, also

can appear when in hypothyroidism I wonder

if gastroesophagel reflux

disease (GERD) might not be a different form of

Achalasia in which

the cardia valve remains open rather that closed.

In addition to those with too much K or too little

K, patients may

suffer from salt (water) retention which leaves

too much Na in the

blood. Salt retention is difficult for an MD to

detect, since there

are no clinical tests for it. I was in heavy

salt retention for 9

months before I understood what was wrong. Salt

retention can be

caused by some medications and also by stress.

Those that take

diuretics may also suffer from low K unless the

diuretic is a K

sparing diuretic and then they may have too much K

in the blood.

Diabetes can also influence the K levels (more

than one way) see the

17th edition Merck Manual Page 2549 Table 296-4

and read about K and

Na.

Hyperventilation must be used with caution, just

breathe deeply and

exh ale through pursed lips to avoid over

doing. Very rapid deep

breathing can be dangerous as the brain can get

overloaded with

oxygen and will cut off blood flow to the brain

and produce a mild

stroke. I think it would be very hard for

this to occur if one where

to limit oneself to mild hyperventilation to no

more than 20 minutes

plus eating time. The operative word here is

mild. However,

hyperventilation (possibly antacids) is of

particular danger to those

subjected to epileptic fits and can cause

epileptic convulsive

attacks.

Other controls

I usually am able to detect when food is building

up in the

esophagus, there is the feeling of fullness plus

the beginning of

hiccups. I must stop eating and continue

hyperventilating until the

cardia valve opens usually accompanied by a burp

and the esophagus

gradually empties. If I go too far, and fill

the esophagus too much,

the car dia valve will not open and I must heave

up the contents of

the esophagus. Eating slowly and chewing

thoroughly gives more time

for the cardia valve to open.

I control nighttime regurgitation by eating early,

cleaning my teeth

and mouth of food particles at the end of dinner

and then drinking a

glass of water to wash every bit of food down the

esophagus. If,

during the evening I burp and taste any food I

have to go through the

routine again of hyperventilating, two Tums and

water to open up the

cardia valve to flush the food from the

esophagus. I count on 4 to 6

hours after dinner before going to bed and there

must be no food or

liquids after dinner. Regurgitation is

dangerous since it places

food near the trachea where it may aspirate into

the lungs. Food

near the trachea will initiate a cough. This

is important to

clearing the trachea of food. Aspiration can cause

pneumonia and it

ca n infiltrate the lungs and reduce lung

capacity. Anyway to reduce

regurgitation, especially while a sleep, is

important. I would never

use a cough medication, or sleeping pill, since

the cough reflex is

very important in preventing aspiration into the

lungs. I believe

sleeping on one's side reduce the risk of

aspiration.

I sleep with a wedge pillow plus a regular pillow

and if I wake up in

regurgitation than I sleep sitting up in a

reclining chair. I use the

hyperventilation and Tums treatment to open the

cardia valve plus a

little bit of water to wash it down.

Sometimes the cardia valve does

not open and if I take too much water the

regurgitation is like a

fountain of water in my mouth (even filling my

nose) so I don't like

to take much water at night. This is

tempered by the fact that I may

go to sleep while trying to open the cardia valve

thus failing to

open the valve. Some patients have severe

regurgitation problems

(often throat cancer patient) and they can only

sleep sitting up in a

reclining chair. I have noticed that some

patients slip into

Achalasia without the MD being aware of it

Another hint is that I solve the hyperventilation

timing problem in

restaurants by using buffets, or fast food

restaurants since there is

no long wait for the meal to appear. I have the

advantage of a vast

pick of foods in the buffet so that I can

eliminate the acid foods

and balance the salt and K foods. I can

start hyperventilating on

the car journey to these restaurants.

4

5

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[Guest guest]

Hi Crystal.

I really think we have no exact answers to why. We just need to

accept that we have it and need to manage it. It can be hard on those

days you have those chest pains and everything gets you down. Beleive

me many of us have those days. I am going through a rough patch at

the moment now too, stress is not helping either. Am looking for ways

to escape my responsibilities coz I am not coping with them at all. I

had my myotomy the same time as you. My E is tightening too and some

meals times are worse than others. I can only presume that we are now

healing more with more scare tissue or muscle tightening down there.

I am experimenting with foods the PH thing is also a consideration. I

started drinking soft drinks for a while and have now cut them out,

don't think they help at all. They are something I couldn't drink

before and everywhere you go everyone has them. I think good old

water is a better option.

I have cut back my meal sizes again these last few weeks as well. I

think the extra water with meals is probably taking up the extra

space. I know I need to eat in between meals but I just feel like it.

It is hard to eat when it is so hot and horrible here at the moment

too.

Well that's my 2 cents for now, heres to hoping for some better days

for us all.

Regards

> 1 Jan 2006

>

> Wallace H. Allan ---I am a retired physicist, age 84, I worked

first

> as a nuclear physicist, then many years as a rocket scientist.

> Achalasia is very complex and it has taken me years to understand

the

> small amount that I know of the process. It is possible, without

> surgery, to gain good control of Achalasia with this knowledge. It

> will be hard for an medical doctor (MD) to treat a patient since

the

> most important blood test is not stable and can change from minute

to

> minute. An MD can be very valuable in curing, or controlling, the

> many medical disorders that may contribute to Achalasia. I believe

> the patient needs to observe and experiment, using the information

> that I have uncovered, to further reduce Achalasia. I am afraid

the

> complexity will discourage many patients and even MDs.

>

>

> Achalasia

>

> Introduction

>

> I believe that Achalasia relates to nerve transmission pulses.

Nerve

> transmission is done electrically and they may be upset by abnormal

> changes in the conductivity of the nerves. The blood feeds the

> nerves and keeps it alive and healthy and the blood itself can

affect

> the conductivity of the nerves. The body, and blood, contains

> electrolytes. Electrolytes are atoms, or compounds, that in

solution

> can conduct electricity. They do this by dropping or gaining an

> electron (becoming an ion) with a positive or negative charge. The

> major electrolytes are potassium, magnesium, phosphate, sulfate,

> bicarbonate and small amounts of sodium, chlorate and calcium. By

> conductivity I do not mean the same as a metal with a flow of

> electrons, the conductivity in nerves is caused by potassium plus

ion

> and sodium plus ions exchanges across the nerve fiber membrane. It

> is a slow flow compared to electron flow and it reinforces along

the

> fiber as it proceeds. I will only consider potassium (K) and

sodium

> (Na) in this report since there is such a direct link to nerve

> impulses. The cardia valve and the peristaltic action of the

> esophagus can fail under misfiring nerves. The pioneering work in

> this field was done by Dr. Harold Friedman and his work was

published

> as " Ionic Solution Theory " in 1962. This text treats solutions in

> the body as well, as general chemistry.

>

> Cause

>

> One major cause of Achalasia is described in this article. There

are

> at least two other causes--see Scleroderma and Chagas in the latest

> 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> informative to read the chapter on Esophageal Disorders which

> includes Achalasia. What I have to describe is based on accepted

> medical knowledge concerning nerves and transmission of nerve

> pulses.

>

> Achalasia (medical dictionary explanation) means failure to relax,

> especially of the cardia valve muscle which results in retention of

> food in the esophagus. A medical textbook explanation says the

> defect appears to originate from a loss of motor innervation, by

> fibers originating in the dorsal nucleus of the Vagus nerve. The

> Vagus nerve is a packet of nerves that runs from the brain stem

down

> the neck into the body, most nerves run down the spinal column and

> branch out to the body organs. The Vagus nerve (wandering nerve)

> supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> valve, lungs, heart, etc but it is not the sole supply of nerves

for

> most of these organs.

>

> As a point of interest, Achalasia was formerly called a

Cardiospasm.

> This was misleading since cardia implies the heart but the cardia

> valve (splincter valve at the bottom of the esophagus) is just near

> the heart. A spasm means a contraction of a muscle but in a

> Cardiospasm the muscle does not contract but fails to relax. If

the

> failure to relax was because of a cramp on top of the normal

> contraction of the cardia muscle I would think this would produce a

> pain which might be perceive as an Achalasia spasm.

>

> I have had Achalasia for 20 years and very early my body reacted to

> the disorder by hyperventilation which brought me out of

Achalasia.

> From this I developed the reasoning why this was important to me

but

> I found out later that my technique would make some patients

worst.

> From reading letters to the Achalasia Forum I have been able to

> understand some of the complex reasons for Achalasia. I find

> experiencing Achalasia is very helpful in understanding it but I am

> at a loss to understand spasms since I have never had one.

>

> I have found K and Na to be the most controlling electrolytes in

> Achalasia and I have not worked with the other electrolytes. I

> suspect that low calcium may be involved in spasms since low

calcium

> is know to excite the nerves to a point that a muscle goes into a

> spasm called Tetany. The low calcium can become even more of a

> problem if the blood goes alkaline since this adds to the

excitation

> of the nerve system. Low levels of calcium in a blood test might

> indicate if this is a problem. Possibly ingestion of calcium might

> bring one out of the spasm. There are many reasons for low calcium

> and one should consult an MD to uncover your own problem. Since a

> cramp is a spasm, athletes often get leg cramps from loss of salt

> during exercise. Leg cramps while sleep often arise from too much

K

> released into the blood from respiratory acidosis (shallow

breathing

> while a sleep).

>

> There are two blood (serum) factors that one should be familiar

> with in order to understand Achalasia. One is the pH of the

blood.

> This is a measure of the acidity or alkalinity of the blood.

> Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7

is

> acid and 7-14 alkaline. The blood is normally slightly alkaline at

> 7.40. Thus 7.40 is considered neutral and anything lower is acid

and

> higher as alkaline. The blood pH ranges from 7.0 to 7.7 and

anything

> lower or higher will lead to death within hours. pH is a

logarithmic

> scale so .7 is a change of 5X in acidity, or alkalinity. The pH

will

> not change from 7.4 more that plus or minus 0.2 or one will get

> sick. The body has a quick response to adjusting the pH to safe

> values. Food, liquid, drugs and breathing can change the pH of the

> blood but only by a very small, but important amount. If the blood

> goes acid, a small amount of K falls out of the body cells into the

> blood and if the blood goes alkaline a small amount of K is forced

> into the body cells from the blood. The second factor in the blood

is

> the ratio of Na to K.

>

> Blood serum requires a certain ratio of Na to K in the blood and

this

> is about 28 to 1. This ratio is the same as the ratio of Na to K

in

> sea water which is cited as a reason why man may have originated in

> sea water. This ratio changes with the pH of the blood, because K

is

> either dropped out of the blood with acidity or forced back into

the

> cells with alkalinity. The ratio is not used in normal medicine

but

> I will use it since it provides clues to the patient as to when and

> why he is in Achalasia. This ratio can not deviate very far from

> this 28 to 1 or the nerves (the pH changes the ratio) will

misfire.

> By misfire I mean that when the blood is alkaline the nerves become

> over excited to, at a maximum, one could go into convulsions. When

> in acidity it decreases its acidity to, at a minimum, one could go

> into a coma. Different nerves and nerve pathways may have a

slightly

> different pH, and may also response differently to the same pH so

all

> the nerves do not fail at the same time. Nerves close to the

gastro

> tract may respond faster to food, drugs, and liquid changes than

leg

> and arm nerves because the food is in immediate contact with the

> nerves. Also some of the organs (possibly the cardia valve) may be

> supplied solely by the Vagus nerve.

>

> I think of pH and Na to K as related since if the pH changes the

> ratio of Na to K also changes. Thus if K is high the blood is

acid,

> and if K is low the blood is alkaline.

>

> The body stores a large amount of K in the body cells and a much

> smaller amount in the blood. Na stores a large amount in the extra

> cellular fluids and blood and very little in body cells. There is

a

> mechanism to keep this in the proper balance called the Na-K pump.

> There are other ways to balance the absolute amount of K in the

> blood, some very fast and others slow, as a change of K by a factor

> of three can kill. Na is not held under as strict a control. There

> are clinical values for absolute values of Na and K and a variation

> from these values can be an indication of something wrong in the

body.

>

> The nerves require the proper pH (or ratio of Na to K) for proper

> firing of the nerves. The proper ratio can be changed temporarily

by

> foods, liquids, drugs or breathing. Then there are semipermeant

> disorders that bias the ratio for long periods of time. I say

> semipermeant because they may come and go over weeks, months or

years

> and the disorder create these biases might possibly be cured. For

> instance, for 17 years I would go in and out hypothyroidism on very

> irregular schedule related to my level of stress. Today, I am out

of

> it for many months and I fall into it for a week or two, at the

> most. In my case high stress is apt to bring on hypothyroidism.

> Hypothyroidism can be present without the patient or his MD being

> aware of. My 17 year spell with hypothyroidism was never detected

by

> my MD even thought I suspected I was in it but my blood tests never

> reveal it, probably because I drifted in and out of it and it never

> was present when a blood test were taken. Also I tried to control

my

> excess of K by eating less K foods while in hypothyroidism to

control

> atrail fibrillation (a nerve firing problem). Thus, it is not

> surprising that blood tests did not reveal excess K.

>

> A temporary event can be created by breathing, either hyper, or

> hypoventilation. Hyperventilation (respiratory alkalosis) will

push

> K back into the body cell from the blood serum and hypoventilation

> (respiratory acidosis) will drop K out of the body cells into the

> blood. This is very fast acting and I use it to alter the K in my

> blood. Some short term events can last a long time, I normally

> hypoventilate because of a sunken chest, thus a short term event

> becomes a long term, event.

>

> The longer term events come under the class of metabolic acidosis

or

> metabolic alkalosis. Metabolic means a chemical event. Respiratory

> acidosis, or respiratory alkalosis, is also a chemical event but I

> think it is separated from metabolic since is is such a quick

event.

> Eating acid foods will act the same as respiratory acidosis and

drops

> K in the blood but since is a food process it takes longer to work

> (minutes instead of seconds) and last longer. An antacid (Tums or

> milk) will also make the blood alkaline and push K back into the

body

> cells from the blood. An acid drink (cola syrup, soft drinks or

> orange juice) will drop K into the blood. Acid foods such as

pickle,

> strawberries, tomatoes, and vinegar can drop K into the blood for a

> limited time. Food, liquids, drugs are short term events but they

> can extend into very long events.

>

> Drugs can seriously change the pH. I recently read an ad in the NY

> Times for Topamax (migraine headache) it states one side effect is

> metabolic acidosis which will produce hyperventilation. The

> hyperventilation will shift the blood towards neutral.

> Hyperventilation was a part of my Achalasia.

>

> Some 60% of those with achalasia have an epiphrenic diverticulum.

> This is a pouch at the cardioesophageal junction. The pouch can

> collect food which does not go into the stomach but ferments in the

> pouch and in the fermenting process becomes acid. I have one of

> these pouches and I sense if I swallow a chunk of meat which stays

in

> the pouch, that it will take up to a week before the meat passes

into

> the stomach and I have much Achalasia during this period. As much

as

> I try to chew thoroughly, if I eat a steak, there always seems to

be

> a chunk that drops into the throat. I try to avoid beef steaks but

I

> seem to be able to eat ham and pork without trouble. Ground beef is

> safe to eat.

>

> Long term events are diseases, such as hypothyroidism which

elevates

> K and depress Na in the blood, and hyperthyroidism which elevates

Na

> and depresses K. Low adrenal output elevates K and depress Na in

the

> blood. High adrenal output elevates Na and depresses K. Diuretics

> can depress K, or K sparing diuretics can elevate K. Dehydration

can

> elevate Na in the blood.

>

> The vast majority of the population escapes Achalasia. So what is

> differ about patients of Achalasia. I propose that short and long

> term events do not balance out but add up. I normally

> hypoventilate. I have been in hypothyroidism, of and on, for many

> years, I normally eat too may K foods and avoid salty (Na--sodium

> chloride) foods. They all add up to a low ratio of Na to K or an

> acid blood.

>

> Treatment

>

> One can see the vast complexity of Achalasis. In fact , this

> disorder is so complex that my method of coping with it is very

> difficult for most patients and even more so for MD's who have very

> little to work with, since any blood test are fleeting and reveal

> little. It would be very difficult to handle a case with a child.

> There is one hope and that is to cure the diseases that place the

> ratio out of balance. For instance, my Achalasia is much

diminished

> when I am free of hypothyroidism. A patient can try to balance the

K

> foods with the Na foods, and by balance I do not mean one for one,

> but your own requirement that minimizes Achalasia. Also try to

> balance acid liquids and foods with alkaline ones. A parent can

also

> place a child on the same diet.

>

> There is a table in the 17th Edition Merck Manual that can help you

> see how different disorders affect the Na and K levels it is on

Page

> 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is

also

> very helpful. One must evaluate what is one's problem whether too

> much, or too little K. Na maybe the problem from too much

ingestion

> of Na (salt), which is easily solved.

>

> I have developed a treatment to open up the cardia valve as I eat.

> My problem is too much K and too little salt, this will makes

> Achalasia worse for those who are normally high on Na and low on

K.

> If you have Achalasia I believe you probably fall into one or the

> other case, although there must be many who just eat too much salt.

>

> To bring myself into a normal ratio of Na to K, first, during the

> meal I try to determine whether the meal contains enough salt or

> whether I need to add salt. If one must add salt, it takes very

> little salt to add the right amount. Then just before a meal I

> mildly hyperventilated for about 15 minutes and take two Tums

> (regular) antacids and this normally sets me up for a normal meal

> without Achalasia. One must continue to hyperventilate during the

> meal since normally one would hypoventilate while eating.

Sometimes

> in a restaurant, the meal comes too late, and I have been

> hyperventilating too long, changing from too high in K to too low.

> If I stop hyperventilating and wait about 10 minutes the ratio will

> approach normal and I can then eat. Sometimes during the meal I

will

> eat too many K foods and Achalasia will kick in. If I eat a dill

> pickle, strawberries, tomatoes, orange juice, etc then I will go

too

> acid which drops too much K in the blood and I am in Achalasia.

>

> I have no experience with low K and high Na. I would think an acid

> drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> (milk), would start one off correctly and the normal

hypoventilation

> while eating would also help. Eating less salty foods and more K

> foods would also help.

>

> If the Na to K ratio causes misfiring of nerves and prevents the

> cardia valve from opening, then other nerves are apt to misfire. I

> can sense that my atrail fibrillation occurs with Achalasia, and

the

> actions I take to lower Achalasia, also lower atrail fibrillation.

> The cardia valve, esophagus, larynx, and part of the heart and

lungs

> are controlled by nerves in the Vagus nerve. When really bad from

> too much hypothyroidism the nerves in my legs produce peripheral

> neuropathy. Carpal tunnel syndrome, which is a nerve disorder,

also

> can appear when in hypothyroidism I wonder if gastroesophagel

reflux

> disease (GERD) might not be a different form of Achalasia in which

> the cardia valve remains open rather that closed.

>

> In addition to those with too much K or too little K, patients may

> suffer from salt (water) retention which leaves too much Na in the

> blood. Salt retention is difficult for an MD to detect, since there

> are no clinical tests for it. I was in heavy salt retention for 9

> months before I understood what was wrong. Salt retention can be

> caused by some medications and also by stress. Those that take

> diuretics may also suffer from low K unless the diuretic is a K

> sparing diuretic and then they may have too much K in the blood.

> Diabetes can also influence the K levels (more than one way) see

the

> 17th edition Merck Manual Page 2549 Table 296-4 and read about K

and

> Na.

>

> Hyperventilation must be used with caution, just breathe deeply and

> exhale through pursed lips to avoid over doing. Very rapid deep

> breathing can be dangerous as the brain can get overloaded with

> oxygen and will cut off blood flow to the brain and produce a mild

> stroke. I think it would be very hard for this to occur if one

where

> to limit oneself to mild hyperventilation to no more than 20

minutes

> plus eating time. The operative word here is mild. However,

> hyperventilation (possibly antacids) is of particular danger to

those

> subjected to epileptic fits and can cause epileptic convulsive

> attacks.

>

> Other controls

>

> I usually am able to detect when food is building up in the

> esophagus, there is the feeling of fullness plus the beginning of

> hiccups. I must stop eating and continue hyperventilating until

the

> cardia valve opens usually accompanied by a burp and the esophagus

> gradually empties. If I go too far, and fill the esophagus too

much,

> the cardia valve will not open and I must heave up the contents of

> the esophagus. Eating slowly and chewing thoroughly gives more

time

> for the cardia valve to open.

>

> I control nighttime regurgitation by eating early, cleaning my

teeth

> and mouth of food particles at the end of dinner and then drinking

a

> glass of water to wash every bit of food down the esophagus. If,

> during the evening I burp and taste any food I have to go through

the

> routine again of hyperventilating, two Tums and water to open up

the

> cardia valve to flush the food from the esophagus. I count on 4 to

6

> hours after dinner before going to bed and there must be no food or

> liquids after dinner. Regurgitation is dangerous since it places

> food near the trachea where it may aspirate into the lungs. Food

> near the trachea will initiate a cough. This is important to

> clearing the trachea of food. Aspiration can cause pneumonia and it

> can infiltrate the lungs and reduce lung capacity. Anyway to

reduce

> regurgitation, especially while a sleep, is important. I would

never

> use a cough medication, or sleeping pill, since the cough reflex is

> very important in preventing aspiration into the lungs. I believe

> sleeping on one's side reduce the risk of aspiration.

>

> I sleep with a wedge pillow plus a regular pillow and if I wake up

in

> regurgitation than I sleep sitting up in a reclining chair. I use

the

> hyperventilation and Tums treatment to open the cardia valve plus a

> little bit of water to wash it down. Sometimes the cardia valve

does

> not open and if I take too much water the regurgitation is like a

> fountain of water in my mouth (even filling my nose) so I don't

like

> to take much water at night. This is tempered by the fact that I

may

> go to sleep while trying to open the cardia valve thus failing to

> open the valve. Some patients have severe regurgitation problems

> (often throat cancer patient) and they can only sleep sitting up in

a

> reclining chair. I have noticed that some patients slip into

> Achalasia without the MD being aware of it

>

> Another hint is that I solve the hyperventilation timing problem in

> restaurants by using buffets, or fast food restaurants since there

is

> no long wait for the meal to appear. I have the advantage of a vast

> pick of foods in the buffet so that I can eliminate the acid foods

> and balance the salt and K foods. I can start hyperventilating on

> the car journey to these restaurants.

>

>

>

> 4

>

>

>

>

>

> 5

>

>

>

>

>

>

>

>

>

[Guest guest]

hi, Crystal,

maybe your E is distored and the symptom is somehow similar to A.

Quincia

> > 1 Jan 2006

> >

> > Wallace H. Allan ---I am a retired physicist, age 84, I worked

> first

> > as a nuclear physicist, then many years as a rocket scientist.

> > Achalasia is very complex and it has taken me years to understand

> the

> > small amount that I know of the process. It is possible, without

> > surgery, to gain good control of Achalasia with this knowledge.

It

> > will be hard for an medical doctor (MD) to treat a patient since

> the

> > most important blood test is not stable and can change from

minute

> to

> > minute. An MD can be very valuable in curing, or controlling,

the

> > many medical disorders that may contribute to Achalasia. I

believe

> > the patient needs to observe and experiment, using the

information

> > that I have uncovered, to further reduce Achalasia. I am afraid

> the

> > complexity will discourage many patients and even MDs.

> >

> >

> > Achalasia

> >

> > Introduction

> >

> > I believe that Achalasia relates to nerve transmission pulses.

> Nerve

> > transmission is done electrically and they may be upset by

abnormal

> > changes in the conductivity of the nerves. The blood feeds the

> > nerves and keeps it alive and healthy and the blood itself can

> affect

> > the conductivity of the nerves. The body, and blood, contains

> > electrolytes. Electrolytes are atoms, or compounds, that in

> solution

> > can conduct electricity. They do this by dropping or gaining an

> > electron (becoming an ion) with a positive or negative charge.

The

> > major electrolytes are potassium, magnesium, phosphate, sulfate,

> > bicarbonate and small amounts of sodium, chlorate and calcium. By

> > conductivity I do not mean the same as a metal with a flow of

> > electrons, the conductivity in nerves is caused by potassium plus

> ion

> > and sodium plus ions exchanges across the nerve fiber membrane.

It

> > is a slow flow compared to electron flow and it reinforces along

> the

> > fiber as it proceeds. I will only consider potassium (K) and

> sodium

> > (Na) in this report since there is such a direct link to nerve

> > impulses. The cardia valve and the peristaltic action of the

> > esophagus can fail under misfiring nerves. The pioneering work

in

> > this field was done by Dr. Harold Friedman and his work was

> published

> > as " Ionic Solution Theory " in 1962. This text treats solutions

in

> > the body as well, as general chemistry.

> >

> > Cause

> >

> > One major cause of Achalasia is described in this article. There

> are

> > at least two other causes--see Scleroderma and Chagas in the

latest

> > 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> > informative to read the chapter on Esophageal Disorders which

> > includes Achalasia. What I have to describe is based on accepted

> > medical knowledge concerning nerves and transmission of nerve

> > pulses.

> >

> > Achalasia (medical dictionary explanation) means failure to

relax,

> > especially of the cardia valve muscle which results in retention

of

> > food in the esophagus. A medical textbook explanation says the

> > defect appears to originate from a loss of motor innervation, by

> > fibers originating in the dorsal nucleus of the Vagus nerve. The

> > Vagus nerve is a packet of nerves that runs from the brain stem

> down

> > the neck into the body, most nerves run down the spinal column

and

> > branch out to the body organs. The Vagus nerve (wandering nerve)

> > supplies some nerves to the ear, tongue, larynx, esophagus,

cardia

> > valve, lungs, heart, etc but it is not the sole supply of nerves

> for

> > most of these organs.

> >

> > As a point of interest, Achalasia was formerly called a

> Cardiospasm.

> > This was misleading since cardia implies the heart but the cardia

> > valve (splincter valve at the bottom of the esophagus) is just

near

> > the heart. A spasm means a contraction of a muscle but in a

> > Cardiospasm the muscle does not contract but fails to relax. If

> the

> > failure to relax was because of a cramp on top of the normal

> > contraction of the cardia muscle I would think this would produce

a

> > pain which might be perceive as an Achalasia spasm.

> >

> > I have had Achalasia for 20 years and very early my body reacted

to

> > the disorder by hyperventilation which brought me out of

> Achalasia.

> > From this I developed the reasoning why this was important to me

> but

> > I found out later that my technique would make some patients

> worst.

> > From reading letters to the Achalasia Forum I have been able to

> > understand some of the complex reasons for Achalasia. I find

> > experiencing Achalasia is very helpful in understanding it but I

am

> > at a loss to understand spasms since I have never had one.

> >

> > I have found K and Na to be the most controlling electrolytes in

> > Achalasia and I have not worked with the other electrolytes. I

> > suspect that low calcium may be involved in spasms since low

> calcium

> > is know to excite the nerves to a point that a muscle goes into a

> > spasm called Tetany. The low calcium can become even more of a

> > problem if the blood goes alkaline since this adds to the

> excitation

> > of the nerve system. Low levels of calcium in a blood test might

> > indicate if this is a problem. Possibly ingestion of calcium

might

> > bring one out of the spasm. There are many reasons for low

calcium

> > and one should consult an MD to uncover your own problem. Since

a

> > cramp is a spasm, athletes often get leg cramps from loss of salt

> > during exercise. Leg cramps while sleep often arise from too

much

> K

> > released into the blood from respiratory acidosis (shallow

> breathing

> > while a sleep).

> >

> > There are two blood (serum) factors that one should be familiar

> > with in order to understand Achalasia. One is the pH of the

> blood.

> > This is a measure of the acidity or alkalinity of the blood.

> > Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-

7

> is

> > acid and 7-14 alkaline. The blood is normally slightly alkaline

at

> > 7.40. Thus 7.40 is considered neutral and anything lower is acid

> and

> > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and

> anything

> > lower or higher will lead to death within hours. pH is a

> logarithmic

> > scale so .7 is a change of 5X in acidity, or alkalinity. The pH

> will

> > not change from 7.4 more that plus or minus 0.2 or one will get

> > sick. The body has a quick response to adjusting the pH to safe

> > values. Food, liquid, drugs and breathing can change the pH of

the

> > blood but only by a very small, but important amount. If the

blood

> > goes acid, a small amount of K falls out of the body cells into

the

> > blood and if the blood goes alkaline a small amount of K is

forced

> > into the body cells from the blood. The second factor in the

blood

> is

> > the ratio of Na to K.

> >

> > Blood serum requires a certain ratio of Na to K in the blood and

> this

> > is about 28 to 1. This ratio is the same as the ratio of Na to K

> in

> > sea water which is cited as a reason why man may have originated

in

> > sea water. This ratio changes with the pH of the blood, because

K

> is

> > either dropped out of the blood with acidity or forced back into

> the

> > cells with alkalinity. The ratio is not used in normal medicine

> but

> > I will use it since it provides clues to the patient as to when

and

> > why he is in Achalasia. This ratio can not deviate very far from

> > this 28 to 1 or the nerves (the pH changes the ratio) will

> misfire.

> > By misfire I mean that when the blood is alkaline the nerves

become

> > over excited to, at a maximum, one could go into convulsions.

When

> > in acidity it decreases its acidity to, at a minimum, one could

go

> > into a coma. Different nerves and nerve pathways may have a

> slightly

> > different pH, and may also response differently to the same pH so

> all

> > the nerves do not fail at the same time. Nerves close to the

> gastro

> > tract may respond faster to food, drugs, and liquid changes than

> leg

> > and arm nerves because the food is in immediate contact with the

> > nerves. Also some of the organs (possibly the cardia valve) may

be

> > supplied solely by the Vagus nerve.

> >

> > I think of pH and Na to K as related since if the pH changes the

> > ratio of Na to K also changes. Thus if K is high the blood is

> acid,

> > and if K is low the blood is alkaline.

> >

> > The body stores a large amount of K in the body cells and a much

> > smaller amount in the blood. Na stores a large amount in the

extra

> > cellular fluids and blood and very little in body cells. There

is

> a

> > mechanism to keep this in the proper balance called the Na-K

pump.

> > There are other ways to balance the absolute amount of K in the

> > blood, some very fast and others slow, as a change of K by a

factor

> > of three can kill. Na is not held under as strict a control.

There

> > are clinical values for absolute values of Na and K and a

variation

> > from these values can be an indication of something wrong in the

> body.

> >

> > The nerves require the proper pH (or ratio of Na to K) for proper

> > firing of the nerves. The proper ratio can be changed temporarily

> by

> > foods, liquids, drugs or breathing. Then there are semipermeant

> > disorders that bias the ratio for long periods of time. I say

> > semipermeant because they may come and go over weeks, months or

> years

> > and the disorder create these biases might possibly be cured.

For

> > instance, for 17 years I would go in and out hypothyroidism on

very

> > irregular schedule related to my level of stress. Today, I am

out

> of

> > it for many months and I fall into it for a week or two, at the

> > most. In my case high stress is apt to bring on hypothyroidism.

> > Hypothyroidism can be present without the patient or his MD being

> > aware of. My 17 year spell with hypothyroidism was never

detected

> by

> > my MD even thought I suspected I was in it but my blood tests

never

> > reveal it, probably because I drifted in and out of it and it

never

> > was present when a blood test were taken. Also I tried to

control

> my

> > excess of K by eating less K foods while in hypothyroidism to

> control

> > atrail fibrillation (a nerve firing problem). Thus, it is not

> > surprising that blood tests did not reveal excess K.

> >

> > A temporary event can be created by breathing, either hyper, or

> > hypoventilation. Hyperventilation (respiratory alkalosis) will

> push

> > K back into the body cell from the blood serum and

hypoventilation

> > (respiratory acidosis) will drop K out of the body cells into the

> > blood. This is very fast acting and I use it to alter the K in

my

> > blood. Some short term events can last a long time, I normally

> > hypoventilate because of a sunken chest, thus a short term event

> > becomes a long term, event.

> >

> > The longer term events come under the class of metabolic acidosis

> or

> > metabolic alkalosis. Metabolic means a chemical event.

Respiratory

> > acidosis, or respiratory alkalosis, is also a chemical event but

I

> > think it is separated from metabolic since is is such a quick

> event.

> > Eating acid foods will act the same as respiratory acidosis and

> drops

> > K in the blood but since is a food process it takes longer to

work

> > (minutes instead of seconds) and last longer. An antacid (Tums

or

> > milk) will also make the blood alkaline and push K back into the

> body

> > cells from the blood. An acid drink (cola syrup, soft drinks or

> > orange juice) will drop K into the blood. Acid foods such as

> pickle,

> > strawberries, tomatoes, and vinegar can drop K into the blood for

a

> > limited time. Food, liquids, drugs are short term events but

they

> > can extend into very long events.

> >

> > Drugs can seriously change the pH. I recently read an ad in the

NY

> > Times for Topamax (migraine headache) it states one side effect

is

> > metabolic acidosis which will produce hyperventilation. The

> > hyperventilation will shift the blood towards neutral.

> > Hyperventilation was a part of my Achalasia.

> >

> > Some 60% of those with achalasia have an epiphrenic

diverticulum.

> > This is a pouch at the cardioesophageal junction. The pouch can

> > collect food which does not go into the stomach but ferments in

the

> > pouch and in the fermenting process becomes acid. I have one of

> > these pouches and I sense if I swallow a chunk of meat which

stays

> in

> > the pouch, that it will take up to a week before the meat passes

> into

> > the stomach and I have much Achalasia during this period. As

much

> as

> > I try to chew thoroughly, if I eat a steak, there always seems to

> be

> > a chunk that drops into the throat. I try to avoid beef steaks

but

> I

> > seem to be able to eat ham and pork without trouble. Ground beef

is

> > safe to eat.

> >

> > Long term events are diseases, such as hypothyroidism which

> elevates

> > K and depress Na in the blood, and hyperthyroidism which elevates

> Na

> > and depresses K. Low adrenal output elevates K and depress Na in

> the

> > blood. High adrenal output elevates Na and depresses K.

Diuretics

> > can depress K, or K sparing diuretics can elevate K. Dehydration

> can

> > elevate Na in the blood.

> >

> > The vast majority of the population escapes Achalasia. So what

is

> > differ about patients of Achalasia. I propose that short and

long

> > term events do not balance out but add up. I normally

> > hypoventilate. I have been in hypothyroidism, of and on, for

many

> > years, I normally eat too may K foods and avoid salty (Na--sodium

> > chloride) foods. They all add up to a low ratio of Na to K or an

> > acid blood.

> >

> > Treatment

> >

> > One can see the vast complexity of Achalasis. In fact , this

> > disorder is so complex that my method of coping with it is very

> > difficult for most patients and even more so for MD's who have

very

> > little to work with, since any blood test are fleeting and reveal

> > little. It would be very difficult to handle a case with a

child.

> > There is one hope and that is to cure the diseases that place the

> > ratio out of balance. For instance, my Achalasia is much

> diminished

> > when I am free of hypothyroidism. A patient can try to balance

the

> K

> > foods with the Na foods, and by balance I do not mean one for

one,

> > but your own requirement that minimizes Achalasia. Also try to

> > balance acid liquids and foods with alkaline ones. A parent can

> also

> > place a child on the same diet.

> >

> > There is a table in the 17th Edition Merck Manual that can help

you

> > see how different disorders affect the Na and K levels it is on

> Page

> > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is

> also

> > very helpful. One must evaluate what is one's problem whether

too

> > much, or too little K. Na maybe the problem from too much

> ingestion

> > of Na (salt), which is easily solved.

> >

> > I have developed a treatment to open up the cardia valve as I

eat.

> > My problem is too much K and too little salt, this will makes

> > Achalasia worse for those who are normally high on Na and low on

> K.

> > If you have Achalasia I believe you probably fall into one or the

> > other case, although there must be many who just eat too much

salt.

> >

> > To bring myself into a normal ratio of Na to K, first, during the

> > meal I try to determine whether the meal contains enough salt or

> > whether I need to add salt. If one must add salt, it takes very

> > little salt to add the right amount. Then just before a meal I

> > mildly hyperventilated for about 15 minutes and take two Tums

> > (regular) antacids and this normally sets me up for a normal meal

> > without Achalasia. One must continue to hyperventilate during

the

> > meal since normally one would hypoventilate while eating.

> Sometimes

> > in a restaurant, the meal comes too late, and I have been

> > hyperventilating too long, changing from too high in K to too

low.

> > If I stop hyperventilating and wait about 10 minutes the ratio

will

> > approach normal and I can then eat. Sometimes during the meal I

> will

> > eat too many K foods and Achalasia will kick in. If I eat a dill

> > pickle, strawberries, tomatoes, orange juice, etc then I will go

> too

> > acid which drops too much K in the blood and I am in Achalasia.

> >

> > I have no experience with low K and high Na. I would think an

acid

> > drink (cola syrup, soft drink, orange juice) and no alkaline

drinks

> > (milk), would start one off correctly and the normal

> hypoventilation

> > while eating would also help. Eating less salty foods and more

K

> > foods would also help.

> >

> > If the Na to K ratio causes misfiring of nerves and prevents the

> > cardia valve from opening, then other nerves are apt to misfire.

I

> > can sense that my atrail fibrillation occurs with Achalasia, and

> the

> > actions I take to lower Achalasia, also lower atrail

fibrillation.

> > The cardia valve, esophagus, larynx, and part of the heart and

> lungs

> > are controlled by nerves in the Vagus nerve. When really bad

from

> > too much hypothyroidism the nerves in my legs produce peripheral

> > neuropathy. Carpal tunnel syndrome, which is a nerve disorder,

> also

> > can appear when in hypothyroidism I wonder if gastroesophagel

> reflux

> > disease (GERD) might not be a different form of Achalasia in

which

> > the cardia valve remains open rather that closed.

> >

> > In addition to those with too much K or too little K, patients

may

> > suffer from salt (water) retention which leaves too much Na in

the

> > blood. Salt retention is difficult for an MD to detect, since

there

> > are no clinical tests for it. I was in heavy salt retention for

9

> > months before I understood what was wrong. Salt retention can be

> > caused by some medications and also by stress. Those that take

> > diuretics may also suffer from low K unless the diuretic is a K

> > sparing diuretic and then they may have too much K in the blood.

> > Diabetes can also influence the K levels (more than one way) see

> the

> > 17th edition Merck Manual Page 2549 Table 296-4 and read about K

> and

> > Na.

> >

> > Hyperventilation must be used with caution, just breathe deeply

and

> > exhale through pursed lips to avoid over doing. Very rapid deep

> > breathing can be dangerous as the brain can get overloaded with

> > oxygen and will cut off blood flow to the brain and produce a

mild

> > stroke. I think it would be very hard for this to occur if one

> where

> > to limit oneself to mild hyperventilation to no more than 20

> minutes

> > plus eating time. The operative word here is mild. However,

> > hyperventilation (possibly antacids) is of particular danger to

> those

> > subjected to epileptic fits and can cause epileptic convulsive

> > attacks.

> >

> > Other controls

> >

> > I usually am able to detect when food is building up in the

> > esophagus, there is the feeling of fullness plus the beginning of

> > hiccups. I must stop eating and continue hyperventilating until

> the

> > cardia valve opens usually accompanied by a burp and the

esophagus

> > gradually empties. If I go too far, and fill the esophagus too

> much,

> > the cardia valve will not open and I must heave up the contents

of

> > the esophagus. Eating slowly and chewing thoroughly gives more

> time

> > for the cardia valve to open.

> >

> > I control nighttime regurgitation by eating early, cleaning my

> teeth

> > and mouth of food particles at the end of dinner and then

drinking

> a

> > glass of water to wash every bit of food down the esophagus. If,

> > during the evening I burp and taste any food I have to go through

> the

> > routine again of hyperventilating, two Tums and water to open up

> the

> > cardia valve to flush the food from the esophagus. I count on 4

to

> 6

> > hours after dinner before going to bed and there must be no food

or

> > liquids after dinner. Regurgitation is dangerous since it places

> > food near the trachea where it may aspirate into the lungs. Food

> > near the trachea will initiate a cough. This is important to

> > clearing the trachea of food. Aspiration can cause pneumonia and

it

> > can infiltrate the lungs and reduce lung capacity. Anyway to

> reduce

> > regurgitation, especially while a sleep, is important. I would

> never

> > use a cough medication, or sleeping pill, since the cough reflex

is

> > very important in preventing aspiration into the lungs. I

believe

> > sleeping on one's side reduce the risk of aspiration.

> >

> > I sleep with a wedge pillow plus a regular pillow and if I wake

up

> in

> > regurgitation than I sleep sitting up in a reclining chair. I use

> the

> > hyperventilation and Tums treatment to open the cardia valve plus

a

> > little bit of water to wash it down. Sometimes the cardia valve

> does

> > not open and if I take too much water the regurgitation is like a

> > fountain of water in my mouth (even filling my nose) so I don't

> like

> > to take much water at night. This is tempered by the fact that I

> may

> > go to sleep while trying to open the cardia valve thus failing to

> > open the valve. Some patients have severe regurgitation problems

> > (often throat cancer patient) and they can only sleep sitting up

in

> a

> > reclining chair. I have noticed that some patients slip into

> > Achalasia without the MD being aware of it

> >

> > Another hint is that I solve the hyperventilation timing problem

in

> > restaurants by using buffets, or fast food restaurants since

there

> is

> > no long wait for the meal to appear. I have the advantage of a

vast

> > pick of foods in the buffet so that I can eliminate the acid

foods

> > and balance the salt and K foods. I can start hyperventilating

on

> > the car journey to these restaurants.

> >

> >

> >

> > 4

> >

> >

> >

> >

> >

> > 5

> >

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

From  Wally

To  Debbi

I feel I have been struck down with a “I got you”. 

I will try to answer.  Of course,

my way is not the only way.   In the case

of Scleroderma , the skin (also esophagus, GI tract, lung, heart, and

kidneys)  thickens and becomes so thick

that peristalsis fails.  In the case of the

parasitic Chagas megaesophagus

develops (no explanation why) resulting in regurgitation and dysphagia similar to Achalasia.

Your references to destroyed, or lost,

nerves are all review articles.  They do

not describe how this is done, are what causes it.  I can think of ways for the nerves to be

destroyed.  The nerves can be cut during surgery.  They can be crushed, but this is hard to do as

it is buried in the neck.  They can die

for lack of blood, this is probably an old age problem

from a cholesterol buildup.  This must be

rare since Achalasia hits all ages from infants up.  .  Many

chemical agents can destroy, or disable, the nerves such as pesticides, etc.  It can be damaged chemically, possibly from

an acid or alkaline pH.

Since your references indicate destroyed,

or lost, nerves, why are there no reports (to my knowledge) with my much simpler

proposal concerning the pH factor which is well listed in the medical

literature in so far as nerve action.  This

nerve action is just not related to Achalasia in the

literature. 

The reversible action I observed with pH

may only apply when the pH falls with in + or - .2. of

7.40.  This is the range in which one

does not feel any sickness.  Beyond + or

- .2  one feels

sick and there may be permanent damage to the nerves beyond this range.  I never get sick from Achalasia

so I may control Achalasia to stay within the safe

range.  I have never had spasm which may

come with the larger changes in pH.  I

have never lost weight or become dehydrated from Achalasia.

  I seemed to achieved good control early

in my Achalasia..

All; of your references list Achalasia as a progressive disease, that is one that never

gets better, but under my treatment my Achalasia has

gotten progressively better.  My biggest

single improvement was coming out of hypothyroidism.

Upon this writing I do think nerve damage

can be a part of Achalasia.  I have permanent nerve damage in my right hand

from a coating of pesticide on my hand 20 years ago.  Within a minute my hand went into tremors and

I have them ever since..

Re: achalasia

process

Wally wrote:

Achalasia does not

permanently damage the nerves, it just makes them misfire and under the correct

pH the nerve will operate correctly again.

I am a bit confused by this statement. I have always heard

that achalasia is the result of nerves being destroyed/lost. I've

even seen pictures of destroyed nerve cells. And literature

explaining this part of achalasia is plentiful (see examples below).

So I guess I'm not sure if you're saying that ALL achalasia is

caused by a pH problem, or if this is just the case in your own personal

situation, but not necessarily the case for others with achalasia??? Or

are you saying that *all* the doctors are wrong and that the nerves that are

destroyed really haven't been destroyed?

Can you elaborate

on this?

Debbi in Michigan

--------------------------------------------------------------------------

For unknown reasons, in patients with achalasia, an

inflammatory reaction targets nerve cells in the esophagus, particularly those

that signal the LES to relax. This

reaction causes these cells to gradually disappear. The end

result is that the LES fails to relax and thereby creates a blockage for

swallowed material to enter the stomach. To make matters worse, nerve cells in the lower two-thirds of the esophagus are

also destroyed.

(from http://patients.uptodate.com/topic.asp?file=digestiv/4384

)

There is a loss of nerve cells

in the Auerbach plexus between the two muscle layers of the esophageal wall and

in the lower esophageal sphincter. (from http://hsc.usf.edu/medicine/internalmedicine/swallowing/swallowingnews.html )

In achalasia, there is a total loss

of peristalsis and the LES relaxes poorly. The disease results from a

neurologic deficit in the myenteric plexus. There is a marked decrease in myenteric

ganglion cells with marked inflammatory changes.3 The lower esophageal sphincter

dysfunction is due to the destruction of inhibitory nerve fibers which

normally reduce sphincter tone and control sphincter relaxation. Their absence

leads to poor reduction of the sphincter's resting tone. The cause of the

disorder is unknown.4

(from http://www.clevelandclinicmeded.com/diseasemanagement/gastro/motor/motor.htm#ppathophysiology

)

Primary achalasia is the most common subtype and is

associated with loss of ganglion cells

in the esophageal myenteric plexus.

(from http://www.emedicine.com/radio/topic6.htm#section~introduction )

The muscle

and nerve components of the esophagus are abnormal. The primary defect appears

to be a progressive loss of ganglion

cells within the myenteric plexus of the esophageal wall.

(from http://www.merck.com/mrkshared/mmg/sec13/ch105/ch105c.jsp

)

The

principal lesion is denervation

of the oesophageal smooth muscle.7 While muscular abnormalities are

also present, these appear to be secondary to the neural deficit. A decreased number of ganglion cells

in the oesophageal intramural nerve plexus has been found in patients with

achalasia, and the extent of this loss corresponds to the duration of the

disease.8,9 There may also be degenerative changes in the vagus nerve,

both in its branches to the oesophagus and in the dorsal motor nucleus.10

The interaction between nerve plexus and vagus nerve lesions is not yet clear.8

In both cases, the

loss predominantly concerns inhibitory neurons. 8,9,10

This would explain the increased basal LOS pressure as well as the

inadequate sphincteric relaxation observed on swallowing. Degeneration of the oesophageal

ganglion cells leads to permanent aperistalsis as the disease progresses and

favours oesophageal dilatation.7 (from http://www.tcd.ie/tsmj/2003/achcardia.htm

)

Studies show

that the nerves that control the muscle

contractions of the esophagus have deteriorated.

(from http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9405.html

)

[Guest guest]

Hi & Quincia; I remember how we had our surgery at about the same time. It is weird how we are both experiencing similar "setbacks"! I too have taken to eating smaller meals, because if I don't I get the feeling of needing to regurg...the only bright spot is that I am not coughing at night! The food must be getting through! I guess I am having a hard time grasping why this has happened so suddenly for me...when I read most of the posts, it seems that people here have suffered for years with symptoms while I've been so healthy up until earlier this year! Anyways, thank you everyone for the support and the one place I can vent my frustrations without feeling like I'm repeating myself!! Crystalqqqqqq_94118 <qqqqqq_94118@...> wrote: hi, Crystal, maybe your E is distored and the symptom is somehow similar to A. Quincia > > 1 Jan 2006> > > > Wallace H. Allan ---I am a retired physicist, age 84, I worked > first > > as a nuclear physicist, then many years as a rocket scientist. > > Achalasia is very complex and it has taken me years to understand > the > > small amount that I know of the process. It is possible, without > > surgery, to gain good control of Achalasia with this knowledge. It > > will be hard for an medical doctor (MD) to treat a patient since > the > > most important blood test is not stable and can change from minute > to > > minute. An MD can be very valuable in curing, or controlling, the > > many medical disorders that may contribute to Achalasia. I believe > > the patient needs to observe and experiment, using the

information > > that I have uncovered, to further reduce Achalasia. I am afraid > the > > complexity will discourage many patients and even MDs. > > > > > > Achalasia> > > > Introduction> > > > I believe that Achalasia relates to nerve transmission pulses. > Nerve > > transmission is done electrically and they may be upset by abnormal > > changes in the conductivity of the nerves. The blood feeds the > > nerves and keeps it alive and healthy and the blood itself can > affect > > the conductivity of the nerves. The body, and blood, contains > > electrolytes. Electrolytes are atoms, or compounds, that in > solution > > can conduct electricity. They do this by dropping or gaining an > > electron (becoming an ion) with a positive

or negative charge. The > > major electrolytes are potassium, magnesium, phosphate, sulfate, > > bicarbonate and small amounts of sodium, chlorate and calcium. By > > conductivity I do not mean the same as a metal with a flow of > > electrons, the conductivity in nerves is caused by potassium plus > ion > > and sodium plus ions exchanges across the nerve fiber membrane. It > > is a slow flow compared to electron flow and it reinforces along > the > > fiber as it proceeds. I will only consider potassium (K) and > sodium > > (Na) in this report since there is such a direct link to nerve > > impulses. The cardia valve and the peristaltic action of the > > esophagus can fail under misfiring nerves. The pioneering work in > > this field was done by Dr. Harold Friedman and his work was > published > >

as "Ionic Solution Theory" in 1962. This text treats solutions in > > the body as well, as general chemistry.> > > > Cause> > > > One major cause of Achalasia is described in this article. There > are > > at least two other causes--see Scleroderma and Chagas in the latest > > 17th Edition "Merck Manual of Diagnosis and Therapy". It will be > > informative to read the chapter on Esophageal Disorders which > > includes Achalasia. What I have to describe is based on accepted > > medical knowledge concerning nerves and transmission of nerve > > pulses. > > > > Achalasia (medical dictionary explanation) means failure to relax, > > especially of the cardia valve muscle which results in retention of > > food in the esophagus. A medical textbook explanation says the > >

defect appears to originate from a loss of motor innervation, by > > fibers originating in the dorsal nucleus of the Vagus nerve. The > > Vagus nerve is a packet of nerves that runs from the brain stem > down > > the neck into the body, most nerves run down the spinal column and > > branch out to the body organs. The Vagus nerve (wandering nerve) > > supplies some nerves to the ear, tongue, larynx, esophagus, cardia > > valve, lungs, heart, etc but it is not the sole supply of nerves > for > > most of these organs. > > > > As a point of interest, Achalasia was formerly called a > Cardiospasm. > > This was misleading since cardia implies the heart but the cardia > > valve (splincter valve at the bottom of the esophagus) is just near > > the heart. A spasm means a contraction of a muscle but in a >

> Cardiospasm the muscle does not contract but fails to relax. If > the > > failure to relax was because of a cramp on top of the normal > > contraction of the cardia muscle I would think this would produce a > > pain which might be perceive as an Achalasia spasm.> > > > I have had Achalasia for 20 years and very early my body reacted to > > the disorder by hyperventilation which brought me out of > Achalasia. > > From this I developed the reasoning why this was important to me > but > > I found out later that my technique would make some patients > worst. > > From reading letters to the Achalasia Forum I have been able to > > understand some of the complex reasons for Achalasia. I find > > experiencing Achalasia is very helpful in understanding it but I am > > at a loss to understand spasms since I

have never had one.> > > > I have found K and Na to be the most controlling electrolytes in > > Achalasia and I have not worked with the other electrolytes. I > > suspect that low calcium may be involved in spasms since low > calcium > > is know to excite the nerves to a point that a muscle goes into a > > spasm called Tetany. The low calcium can become even more of a > > problem if the blood goes alkaline since this adds to the > excitation > > of the nerve system. Low levels of calcium in a blood test might > > indicate if this is a problem. Possibly ingestion of calcium might > > bring one out of the spasm. There are many reasons for low calcium > > and one should consult an MD to uncover your own problem. Since a > > cramp is a spasm, athletes often get leg cramps from loss of salt > > during

exercise. Leg cramps while sleep often arise from too much > K > > released into the blood from respiratory acidosis (shallow > breathing > > while a sleep). > > > > There are two blood (serum) factors that one should be familiar > > with in order to understand Achalasia. One is the pH of the > blood. > > This is a measure of the acidity or alkalinity of the blood. > > Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 > is > > acid and 7-14 alkaline. The blood is normally slightly alkaline at > > 7.40. Thus 7.40 is considered neutral and anything lower is acid > and > > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and > anything > > lower or higher will lead to death within hours. pH is a > logarithmic > >

scale so .7 is a change of 5X in acidity, or alkalinity. The pH > will > > not change from 7.4 more that plus or minus 0.2 or one will get > > sick. The body has a quick response to adjusting the pH to safe > > values. Food, liquid, drugs and breathing can change the pH of the > > blood but only by a very small, but important amount. If the blood > > goes acid, a small amount of K falls out of the body cells into the > > blood and if the blood goes alkaline a small amount of K is forced > > into the body cells from the blood. The second factor in the blood > is > > the ratio of Na to K.> > > > Blood serum requires a certain ratio of Na to K in the blood and > this > > is about 28 to 1. This ratio is the same as the ratio of Na to K > in > > sea water which is cited as a reason why man may have

originated in > > sea water. This ratio changes with the pH of the blood, because K > is > > either dropped out of the blood with acidity or forced back into > the > > cells with alkalinity. The ratio is not used in normal medicine > but > > I will use it since it provides clues to the patient as to when and > > why he is in Achalasia. This ratio can not deviate very far from > > this 28 to 1 or the nerves (the pH changes the ratio) will > misfire. > > By misfire I mean that when the blood is alkaline the nerves become > > over excited to, at a maximum, one could go into convulsions. When > > in acidity it decreases its acidity to, at a minimum, one could go > > into a coma. Different nerves and nerve pathways may have a > slightly > > different pH, and may also response differently to

the same pH so > all > > the nerves do not fail at the same time. Nerves close to the > gastro > > tract may respond faster to food, drugs, and liquid changes than > leg > > and arm nerves because the food is in immediate contact with the > > nerves. Also some of the organs (possibly the cardia valve) may be > > supplied solely by the Vagus nerve.> > > > I think of pH and Na to K as related since if the pH changes the > > ratio of Na to K also changes. Thus if K is high the blood is > acid, > > and if K is low the blood is alkaline.> > > > The body stores a large amount of K in the body cells and a much > > smaller amount in the blood. Na stores a large amount in the extra > > cellular fluids and blood and very little in body cells. There is > a > > mechanism to

keep this in the proper balance called the Na-K pump. > > There are other ways to balance the absolute amount of K in the > > blood, some very fast and others slow, as a change of K by a factor > > of three can kill. Na is not held under as strict a control. There > > are clinical values for absolute values of Na and K and a variation > > from these values can be an indication of something wrong in the > body.> > > > The nerves require the proper pH (or ratio of Na to K) for proper > > firing of the nerves. The proper ratio can be changed temporarily > by > > foods, liquids, drugs or breathing. Then there are semipermeant > > disorders that bias the ratio for long periods of time. I say > > semipermeant because they may come and go over weeks, months or > years > > and the disorder create these biases

might possibly be cured. For > > instance, for 17 years I would go in and out hypothyroidism on very > > irregular schedule related to my level of stress. Today, I am out > of > > it for many months and I fall into it for a week or two, at the > > most. In my case high stress is apt to bring on hypothyroidism. > > Hypothyroidism can be present without the patient or his MD being > > aware of. My 17 year spell with hypothyroidism was never detected > by > > my MD even thought I suspected I was in it but my blood tests never > > reveal it, probably because I drifted in and out of it and it never > > was present when a blood test were taken. Also I tried to control > my > > excess of K by eating less K foods while in hypothyroidism to > control > > atrail fibrillation (a nerve firing

problem). Thus, it is not > > surprising that blood tests did not reveal excess K.> > > > A temporary event can be created by breathing, either hyper, or > > hypoventilation. Hyperventilation (respiratory alkalosis) will > push > > K back into the body cell from the blood serum and hypoventilation > > (respiratory acidosis) will drop K out of the body cells into the > > blood. This is very fast acting and I use it to alter the K in my > > blood. Some short term events can last a long time, I normally > > hypoventilate because of a sunken chest, thus a short term event > > becomes a long term, event.> > > > The longer term events come under the class of metabolic acidosis > or > > metabolic alkalosis. Metabolic means a chemical event. Respiratory > > acidosis, or respiratory alkalosis, is

also a chemical event but I > > think it is separated from metabolic since is is such a quick > event. > > Eating acid foods will act the same as respiratory acidosis and > drops > > K in the blood but since is a food process it takes longer to work > > (minutes instead of seconds) and last longer. An antacid (Tums or > > milk) will also make the blood alkaline and push K back into the > body > > cells from the blood. An acid drink (cola syrup, soft drinks or > > orange juice) will drop K into the blood. Acid foods such as > pickle, > > strawberries, tomatoes, and vinegar can drop K into the blood for a > > limited time. Food, liquids, drugs are short term events but they > > can extend into very long events.> > > > Drugs can seriously change the pH. I recently read an ad in the NY >

> Times for Topamax (migraine headache) it states one side effect is > > metabolic acidosis which will produce hyperventilation. The > > hyperventilation will shift the blood towards neutral. > > Hyperventilation was a part of my Achalasia.> > > > Some 60% of those with achalasia have an epiphrenic diverticulum. > > This is a pouch at the cardioesophageal junction. The pouch can > > collect food which does not go into the stomach but ferments in the > > pouch and in the fermenting process becomes acid. I have one of > > these pouches and I sense if I swallow a chunk of meat which stays > in > > the pouch, that it will take up to a week before the meat passes > into > > the stomach and I have much Achalasia during this period. As much > as > > I try to chew thoroughly, if I eat a steak,

there always seems to > be > > a chunk that drops into the throat. I try to avoid beef steaks but > I > > seem to be able to eat ham and pork without trouble. Ground beef is > > safe to eat.> > > > Long term events are diseases, such as hypothyroidism which > elevates > > K and depress Na in the blood, and hyperthyroidism which elevates > Na > > and depresses K. Low adrenal output elevates K and depress Na in > the > > blood. High adrenal output elevates Na and depresses K. Diuretics > > can depress K, or K sparing diuretics can elevate K. Dehydration > can > > elevate Na in the blood.> > > > The vast majority of the population escapes Achalasia. So what is > > differ about patients of Achalasia. I propose that short and long > > term events

do not balance out but add up. I normally > > hypoventilate. I have been in hypothyroidism, of and on, for many > > years, I normally eat too may K foods and avoid salty (Na--sodium > > chloride) foods. They all add up to a low ratio of Na to K or an > > acid blood.> > > > Treatment> > > > One can see the vast complexity of Achalasis. In fact , this > > disorder is so complex that my method of coping with it is very > > difficult for most patients and even more so for MD's who have very > > little to work with, since any blood test are fleeting and reveal > > little. It would be very difficult to handle a case with a child. > > There is one hope and that is to cure the diseases that place the > > ratio out of balance. For instance, my Achalasia is much > diminished > > when I

am free of hypothyroidism. A patient can try to balance the > K > > foods with the Na foods, and by balance I do not mean one for one, > > but your own requirement that minimizes Achalasia. Also try to > > balance acid liquids and foods with alkaline ones. A parent can > also > > place a child on the same diet.> > > > There is a table in the 17th Edition Merck Manual that can help you > > see how different disorders affect the Na and K levels it is on > Page > > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is > also > > very helpful. One must evaluate what is one's problem whether too > > much, or too little K. Na maybe the problem from too much > ingestion > > of Na (salt), which is easily solved.> > > > I have developed a treatment to open up the

cardia valve as I eat. > > My problem is too much K and too little salt, this will makes > > Achalasia worse for those who are normally high on Na and low on > K. > > If you have Achalasia I believe you probably fall into one or the > > other case, although there must be many who just eat too much salt.> > > > To bring myself into a normal ratio of Na to K, first, during the > > meal I try to determine whether the meal contains enough salt or > > whether I need to add salt. If one must add salt, it takes very > > little salt to add the right amount. Then just before a meal I > > mildly hyperventilated for about 15 minutes and take two Tums > > (regular) antacids and this normally sets me up for a normal meal > > without Achalasia. One must continue to hyperventilate during the > > meal since normally one

would hypoventilate while eating. > Sometimes > > in a restaurant, the meal comes too late, and I have been > > hyperventilating too long, changing from too high in K to too low. > > If I stop hyperventilating and wait about 10 minutes the ratio will > > approach normal and I can then eat. Sometimes during the meal I > will > > eat too many K foods and Achalasia will kick in. If I eat a dill > > pickle, strawberries, tomatoes, orange juice, etc then I will go > too > > acid which drops too much K in the blood and I am in Achalasia.> > > > I have no experience with low K and high Na. I would think an acid > > drink (cola syrup, soft drink, orange juice) and no alkaline drinks > > (milk), would start one off correctly and the normal > hypoventilation > > while eating would also

help. Eating less salty foods and more K > > foods would also help.> > > > If the Na to K ratio causes misfiring of nerves and prevents the > > cardia valve from opening, then other nerves are apt to misfire. I > > can sense that my atrail fibrillation occurs with Achalasia, and > the > > actions I take to lower Achalasia, also lower atrail fibrillation. > > The cardia valve, esophagus, larynx, and part of the heart and > lungs > > are controlled by nerves in the Vagus nerve. When really bad from > > too much hypothyroidism the nerves in my legs produce peripheral > > neuropathy. Carpal tunnel syndrome, which is a nerve disorder, > also > > can appear when in hypothyroidism I wonder if gastroesophagel > reflux > > disease (GERD) might not be a different form of Achalasia in

which > > the cardia valve remains open rather that closed.> > > > In addition to those with too much K or too little K, patients may > > suffer from salt (water) retention which leaves too much Na in the > > blood. Salt retention is difficult for an MD to detect, since there > > are no clinical tests for it. I was in heavy salt retention for 9 > > months before I understood what was wrong. Salt retention can be > > caused by some medications and also by stress. Those that take > > diuretics may also suffer from low K unless the diuretic is a K > > sparing diuretic and then they may have too much K in the blood. > > Diabetes can also influence the K levels (more than one way) see > the > > 17th edition Merck Manual Page 2549 Table 296-4 and read about K > and > > Na.> > > > Hyperventilation

must be used with caution, just breathe deeply and > > exhale through pursed lips to avoid over doing. Very rapid deep > > breathing can be dangerous as the brain can get overloaded with > > oxygen and will cut off blood flow to the brain and produce a mild > > stroke. I think it would be very hard for this to occur if one > where > > to limit oneself to mild hyperventilation to no more than 20 > minutes > > plus eating time. The operative word here is mild. However, > > hyperventilation (possibly antacids) is of particular danger to > those > > subjected to epileptic fits and can cause epileptic convulsive > > attacks. > > > > Other controls> > > > I usually am able to detect when food is building up in the > > esophagus, there is the feeling of fullness plus the beginning of >

> hiccups. I must stop eating and continue hyperventilating until > the > > cardia valve opens usually accompanied by a burp and the esophagus > > gradually empties. If I go too far, and fill the esophagus too > much, > > the cardia valve will not open and I must heave up the contents of > > the esophagus. Eating slowly and chewing thoroughly gives more > time > > for the cardia valve to open.> > > > I control nighttime regurgitation by eating early, cleaning my > teeth > > and mouth of food particles at the end of dinner and then drinking > a > > glass of water to wash every bit of food down the esophagus. If, > > during the evening I burp and taste any food I have to go through > the > > routine again of hyperventilating, two Tums and water to open up > the > > cardia valve to

flush the food from the esophagus. I count on 4 to > 6 > > hours after dinner before going to bed and there must be no food or > > liquids after dinner. Regurgitation is dangerous since it places > > food near the trachea where it may aspirate into the lungs. Food > > near the trachea will initiate a cough. This is important to > > clearing the trachea of food. Aspiration can cause pneumonia and it > > can infiltrate the lungs and reduce lung capacity. Anyway to > reduce > > regurgitation, especially while a sleep, is important. I would > never > > use a cough medication, or sleeping pill, since the cough reflex is > > very important in preventing aspiration into the lungs. I believe > > sleeping on one's side reduce the risk of aspiration.> > > > I sleep with a wedge pillow plus a

regular pillow and if I wake up > in > > regurgitation than I sleep sitting up in a reclining chair. I use > the > > hyperventilation and Tums treatment to open the cardia valve plus a > > little bit of water to wash it down. Sometimes the cardia valve > does > > not open and if I take too much water the regurgitation is like a > > fountain of water in my mouth (even filling my nose) so I don't > like > > to take much water at night. This is tempered by the fact that I > may > > go to sleep while trying to open the cardia valve thus failing to > > open the valve. Some patients have severe regurgitation problems > > (often throat cancer patient) and they can only sleep sitting up in > a > > reclining chair. I have noticed that some patients slip into > > Achalasia without the MD being aware of

it> > > > Another hint is that I solve the hyperventilation timing problem in > > restaurants by using buffets, or fast food restaurants since there > is > > no long wait for the meal to appear. I have the advantage of a vast > > pick of foods in the buffet so that I can eliminate the acid foods > > and balance the salt and K foods. I can start hyperventilating on > > the car journey to these restaurants.> > > > > > > > 4> > > > > > > > > > > > 5> > > > > > > > > > > > > > > > > >

[Guest guest]

Wally wrote:

From Wally

To Debbi

I feel I

have been struck down with a “I got you”.

I will try to answer.

I am going to jump in here. I find your idea interesting. I also

understand the question Debbi has brought up. Maybe I can help the two

of you find ground to discuss your ideas and how they may or may not

apply to some of the data out there about achalasia. Debbi is respected

in the group for her broad knowledge and ability to help others in

various achalasia topics. You are also someone who has given a lot of

detailed thought to at least one area of focus in achalasia.

Of course,

my way is not the only way. In the case

of Scleroderma , the skin (also esophagus, GI tract, lung,

heart, and

kidneys) thickens and becomes so thick

that peristalsis fails. In the case of the

parasitic Chagas megaesophagus

develops (no explanation why) resulting in regurgitation and dysphagia similar to Achalasia.

Your examples of Scleroderma and Chagas are both forms of secondary

achalasia. Generally, when Achalasia Cardia is unqualified it generally

refers to primary achalasia, which is what almost all of us in this

group have. I believe the references Debbi gave were in the context of

primary achalasia. I believe her interest expressed in her question is

regarding primary achalasia.

Your

references to destroyed, or lost,

nerves are all review articles. They do

not describe how this is done, are what causes it.

The accepted position on this is that know one knows what causes the

damage or loss and that, at any age achalasia is a neural degenerative

disease.

I can think

of ways for the nerves to be

destroyed. The nerves can be cut during surgery. They can be crushed, but this is hard to do as

it is buried in the neck. They can die

for lack of blood, this is probably an old

age problem

from a cholesterol buildup. This must be

rare since Achalasia hits all ages from

infants up. . Many

chemical agents can destroy, or disable, the nerves such as pesticides,

etc. It can be damaged chemically, possibly

from

an acid or alkaline pH.

The main theories of researchers is that it is either a virus or an

autoimmune disease. There is evidence for both of these, signs of

inflammation around the neural plexus and antineural antibodies. There

are also problems with both theories. Achalasia can also be secondary

to brain damage or vagus nerve damage.

Since your references indicate destroyed,

or lost, nerves, why are there no reports (to my knowledge) with my

much simpler

proposal concerning the pH factor which is well listed in the medical

literature in so far as nerve action.

I am interested in your answer to that.

The

reversible action I observed with pH

may only apply when the pH falls with in + or - .2. of

7.40. This is the range in which one

does not feel any sickness. Beyond + or

- .2 one feels

sick and there may be permanent damage to the nerves beyond this range. I never get sick from Achalasia

so I may control Achalasia to stay within

the safe

range. I have never had spasm which may

come with the larger changes in pH. I

have never lost weight or become dehydrated from Achalasia.

I seemed to achieved good control early

in my Achalasia..

If I understand you here, you are saying that any, or some, neural

loss seen in the data could be from those that are far out of range. If

this is the case, it would seem like more of us should be feeling sick.

I think most of us feel good other than the achalasia symptoms.

All; of your

references list Achalasia as a progressive

disease, that is one that never

gets better, but under my treatment my Achalasia

has

gotten progressively better. My biggest

single improvement was coming out of hypothyroidism.

Do you think it is possible that primary achalasia could have more

than one cause and some could find relief one way while others do not?

notan

[Guest guest]

From Wally

To Peggy

It took a little time for me to figure out what you where talking about.

SSRI = Social Security Research Institute

Your SSRI must be a neurotransmitter. I have not been aware that

neurotransmitter are a problem in Achalasia but it is a very good

possibility. I know very little about neurotransmitter, receptors and

second messengers. The 17th Merck Manual Chapter 166 covers

neurotransmitters, they say there are 18 different ones.

Years ago this Forum had many posts about arginine (second messenger)

and some thought it reduced Achalasia. In the 17th Merck Manual Page

1362 Table 166-2 under nitric oxide you will find arginine.

Re: achalasia process

How about SSRIs?

> 1 Jan 2006

>

> Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> as a nuclear physicist, then many years as a rocket scientist.

> Achalasia is very complex and it has taken me years to understand the

> small amount that I know of the process. It is possible, without

> surgery, to gain good control of Achalasia with this knowledge. It

> will be hard for an medical doctor (MD) to treat a patient since the

> most important blood test is not stable and can change from minute to

> minute. An MD can be very valuable in curing, or controlling, the

> many medical disorders that may contribute to Achalasia. I believe

> the patient needs to observe and experiment, using the information

> that I have uncovered, to further reduce Achalasia. I am afraid the

> com plexity will discourage many patients and even MDs.

>

>

> Achalasia

>

> Introduction

>

> I believe that Achalasia relates to nerve transmission pulses. Nerve

> transmission is done electrically and they may be upset by abnormal

> changes in the conductivity of the nerves. The blood feeds the

> nerves and keeps it alive and healthy and the blood itself can affect

> the conductivity of the nerves. The body, and blood, contains

> electrolytes. Electrolytes are atoms, or compounds, that in solution

> can conduct electricity. They do this by dropping or gaining an

> electron (becoming an ion) with a positive or negative charge. The

> major electrolytes are potassium, magnesium, phosphate, sulfate,

> bicarbonate and small amounts of sodium, chlorate and calcium. By

> conductivity I do not mean the same as a metal with a flow of

> electrons, the conductivity in nerves is caused by potassium plus ion

> and sodium plus ions exchanges across the nerve fiber membrane. It

> is a slow flow compared to electron flow and it reinforces along the

> fiber as it proceeds. I will only consider potassium (K) and sodium

> (Na) in this report since there is such a direct link to nerve

> impulses. The cardia valve and the peristaltic action of the

> esophagus can fail under misfiring nerves. The pioneering work in

> this field was done by Dr. Harold Friedman and his work was published

> as " Ionic Solution Theory " in 1962. This text treats solutions in

> the body as well, as general chemistry.

>

> Cause

>

> One major cause of Achalasia is described in this article. There are

> at least two other causes--see Scleroderma and Chagas in the latest

> 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> informative to read the chapter on Esophageal Disorders which

> includes Achalasia. What I have to describe is based on accepted

> medical knowledge concerning nerves and transmission of nerve

> pulses.

>

> Achalasia (medical dictionary explanation) means failure to relax,

> especially of the cardia valve muscle which results in retention of

> food in the esophagus. A medical textbook explanation says the

> defect appears to originate from a loss of motor innervation, by

> fibers originating in the dorsal nucleus of the Vagus nerve. The

> Vagus nerve is a packet of nerves that runs from the brain stem down

> the neck into the body, most nerves run down the spinal column and

> branch out to the body organs. The Vagus nerve (wandering nerve)

> supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> valve, lungs, heart, etc but it is not the sole supply of nerves for

> most of these organs.

>

> As a point of interest, Achalasia was formerly called a Cardiospasm.

> This was misleading since cardia impli es the heart but the cardia

> valve (splincter valve at the bottom of the esophagus) is just near

> the heart. A spasm means a contraction of a muscle but in a

> Cardiospasm the muscle does not contract but fails to relax. If the

> failure to relax was because of a cramp on top of the normal

> contraction of the cardia muscle I would think this would produce a

> pain which might be perceive as an Achalasia spasm.

>

> I have had Achalasia for 20 years and very early my body reacted to

> the disorder by hyperventilation which brought me out of Achalasia.

> From this I developed the reasoning why this was important to me but

> I found out later that my technique would make some patients worst.

> From reading letters to the Achalasia Forum I have been able to

> understand some of the complex reasons for Achalasia. I find

> experiencing Achalasia is very helpful in understanding it but I am

> at a loss to understand spasms since I have never had one.

>

> I have found K and Na to be the most controlling electrolytes in

> Achalasia and I have not worked with the other electrolytes. I

> suspect that low calcium may be involved in spasms since low calcium

> is know to excite the nerves to a point that a muscle goes into a

> spasm called Tetany. The low calcium can become even more of a

> problem if the blood goes alkaline since this adds to the excitation

> of the nerve system. Low levels of calcium in a blood test might

> indicate if this is a problem. Possibly ingestion of calcium might

> bring one out of the spasm. There are many reasons for low calcium

> and one should consult an MD to uncover your own problem. Since a

> cramp is a spasm, athletes often get leg cramps from loss of salt

> during exercise. Leg cramps while sleep often arise from too much K

> released into the blood from respiratory acidosis (shallow breathing

> while a sleep). & nbsp;

>

> There are two blood (serum) factors that one should be familiar

> with in order to understand Achalasia. One is the pH of the blood.

> This is a measure of the acidity or alkalinity of the blood.

> Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> acid and 7-14 alkaline. The blood is normally slightly alkaline at

> 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> lower or higher will lead to death within hours. pH is a logarithmic

> scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> not change from 7.4 more that plus or minus 0.2 or one will get

> sick. The body has a quick response to adjusting the pH to safe

> values. Food, liquid, drugs and breathing can change the pH of the

> blood but only by a very small, but important amount. If the blood

> goes acid, a small amount of K falls out of the body cells into the

> blood and if the blood goes alkaline a small amount of K is forced

> into the body cells from the blood. The second factor in the blood is

> the ratio of Na to K.

>

> Blood serum requires a certain ratio of Na to K in the blood and this

> is about 28 to 1. This ratio is the same as the ratio of Na to K in

> sea water which is cited as a reason why man may have originated in

> sea water. This ratio changes with the pH of the blood, because K is

> either dropped out of the blood with acidity or forced back into the

> cells with alkalinity. The ratio is not used in normal medicine but

> I will use it since it provides clues to the patient as to when and

> why he is in Achalasia. This ratio can not deviate very far from

> this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> By misfire I mean that when the blood is alkaline the nerves become

> over excited to, at a maximum, one could go into convulsions. When

> in acidity it decreases its acidity to, at a minimum, one could go

> into a coma. Different nerves and nerve pathways may have a slightly

> different pH, and may also response differently to the same pH so all

> the nerves do not fail at the same time. Nerves close to the gastro

> tract may respond faster to food, drugs, and liquid changes than leg

> and arm nerves because the food is in immediate contact with the

> nerves. Also some of the organs (possibly the cardia valve) may be

> supplied solely by the Vagus nerve.

>

> I think of pH and Na to K as related since if the pH changes the

> ratio of Na to K also changes. Thus if K is high the blood is acid,

> and if K is low the blood is alkaline.

>

> The body stores a large amount of K in the body cells and a much

> smaller amount in the blood. Na stores a large amount in the extra

> cellu lar fluids and blood and very little in body cells. There is a

> mechanism to keep this in the proper balance called the Na-K pump.

> There are other ways to balance the absolute amount of K in the

> blood, some very fast and others slow, as a change of K by a factor

> of three can kill. Na is not held under as strict a control. There

> are clinical values for absolute values of Na and K and a variation

> from these values can be an indication of something wrong in the body.

>

> The nerves require the proper pH (or ratio of Na to K) for proper

> firing of the nerves. The proper ratio can be changed temporarily by

> foods, liquids, drugs or breathing. Then there are semipermeant

> disorders that bias the ratio for long periods of time. I say

> semipermeant because they may come and go over weeks, months or years

> and the disorder create these biases might possibly be cured. For

> instance, for 17 years I would go in and out hypothyroidism on very

> irregular schedule related to my level of stress. Today, I am out of

> it for many months and I fall into it for a week or two, at the

> most. In my case high stress is apt to bring on hypothyroidism.

> Hypothyroidism can be present without the patient or his MD being

> aware of. My 17 year spell with hypothyroidism was never detected by

> my MD even thought I suspected I was in it but my blood tests never

> reveal it, probably because I drifted in and out of it and it never

> was present when a blood test were taken. Also I tried to control my

> excess of K by eating less K foods while in hypothyroidism to control

> atrail fibrillation (a nerve firing problem). Thus, it is not

> surprising that blood tests did not reveal excess K.

>

> A temporary event can be created by breathing, either hyper, or

> hypoventilation. Hyperventilation (respiratory alkalosis) will push

> K back into the body cell from the blood serum and hypoventilation

> (respiratory acidosis) will drop K out of the body cells into the

> blood. This is very fast acting and I use it to alter the K in my

> blood. Some short term events can last a long time, I normally

> hypoventilate because of a sunken chest, thus a short term event

> becomes a long term, event.

>

> The longer term events come under the class of metabolic acidosis or

> metabolic alkalosis. Metabolic means a chemical event. Respiratory

> acidosis, or respiratory alkalosis, is also a chemical event but I

> think it is separated from metabolic since is is such a quick event.

> Eating acid foods will act the same as respiratory acidosis and drops

> K in the blood but since is a food process it takes longer to work

> (minutes instead of seconds) and last longer. An antacid (Tums or

> milk) will also make the blood alkaline and push K back into the body

> cells from the b lood. An acid drink (cola syrup, soft drinks or

> orange juice) will drop K into the blood. Acid foods such as pickle,

> strawberries, tomatoes, and vinegar can drop K into the blood for a

> limited time. Food, liquids, drugs are short term events but they

> can extend into very long events.

>

> Drugs can seriously change the pH. I recently read an ad in the NY

> Times for Topamax (migraine headache) it states one side effect is

> metabolic acidosis which will produce hyperventilation. The

> hyperventilation will shift the blood towards neutral.

> Hyperventilation was a part of my Achalasia.

>

> Some 60% of those with achalasia have an epiphrenic diverticulum.

> This is a pouch at the cardioesophageal junction. The pouch can

> collect food which does not go into the stomach but ferments in the

> pouch and in the fermenting process becomes acid. I have one of

> these pouches and I sense if I swallow a chunk of mea t which stays in

> the pouch, that it will take up to a week before the meat passes into

> the stomach and I have much Achalasia during this period. As much as

> I try to chew thoroughly, if I eat a steak, there always seems to be

> a chunk that drops into the throat. I try to avoid beef steaks but I

> seem to be able to eat ham and pork without trouble. Ground beef is

> safe to eat.

>

> Long term events are diseases, such as hypothyroidism which elevates

> K and depress Na in the blood, and hyperthyroidism which elevates Na

> and depresses K. Low adrenal output elevates K and depress Na in the

> blood. High adrenal output elevates Na and depresses K. Diuretics

> can depress K, or K sparing diuretics can elevate K. Dehydration can

> elevate Na in the blood.

>

> The vast majority of the population escapes Achalasia. So what is

> differ about patients of Achalasia. I propose that short and long

> term even ts do not balance out but add up. I normally

> hypoventilate. I have been in hypothyroidism, of and on, for many

> years, I normally eat too may K foods and avoid salty (Na--sodium

> chloride) foods. They all add up to a low ratio of Na to K or an

> acid blood.

>

> Treatment

>

> One can see the vast complexity of Achalasis. In fact , this

> disorder is so complex that my method of coping with it is very

> difficult for most patients and even more so for MD's who have very

> little to work with, since any blood test are fleeting and reveal

> little. It would be very difficult to handle a case with a child.

> There is one hope and that is to cure the diseases that place the

> ratio out of balance. For instance, my Achalasia is much diminished

> when I am free of hypothyroidism. A patient can try to balance the K

> foods with the Na foods, and by balance I do not mean one for one,

> but your own requireme nt that minimizes Achalasia. Also try to

> balance acid liquids and foods with alkaline ones. A parent can also

> place a child on the same diet.

>

> There is a table in the 17th Edition Merck Manual that can help you

> see how different disorders affect the Na and K levels it is on Page

> 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> very helpful. One must evaluate what is one's problem whether too

> much, or too little K. Na maybe the problem from too much ingestion

> of Na (salt), which is easily solved.

>

> I have developed a treatment to open up the cardia valve as I eat.

> My problem is too much K and too little salt, this will makes

> Achalasia worse for those who are normally high on Na and low on K.

> If you have Achalasia I believe you probably fall into one or the

> other case, although there must be many who just eat too much salt.

>

> To bring myself into a normal rat io of Na to K, first, during the

> meal I try to determine whether the meal contains enough salt or

> whether I need to add salt. If one must add salt, it takes very

> little salt to add the right amount. Then just before a meal I

> mildly hyperventilated for about 15 minutes and take two Tums

> (regular) antacids and this normally sets me up for a normal meal

> without Achalasia. One must continue to hyperventilate during the

> meal since normally one would hypoventilate while eating. Sometimes

> in a restaurant, the meal comes too late, and I have been

> hyperventilating too long, changing from too high in K to too low.

> If I stop hyperventilating and wait about 10 minutes the ratio will

> approach normal and I can then eat. Sometimes during the meal I will

> eat too many K foods and Achalasia will kick in. If I eat a dill

> pickle, strawberries, tomatoes, orange juice, etc then I will go too

> acid which drops too much K in the blood and I am in Achalasia.

>

> I have no experience with low K and high Na. I would think an acid

> drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> (milk), would start one off correctly and the normal hypoventilation

> while eating would also help. Eating less salty foods and more K

> foods would also help.

>

> If the Na to K ratio causes misfiring of nerves and prevents the

> cardia valve from opening, then other nerves are apt to misfire. I

> can sense that my atrail fibrillation occurs with Achalasia, and the

> actions I take to lower Achalasia, also lower atrail fibrillation.

> The cardia valve, esophagus, larynx, and part of the heart and lungs

> are controlled by nerves in the Vagus nerve. When really bad from

> too much hypothyroidism the nerves in my legs produce peripheral

> neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> can appear when in hypothyroidism I wonder if gastroesophagel reflux

> disease (GERD) might not be a different form of Achalasia in which

> the cardia valve remains open rather that closed.

>

> In addition to those with too much K or too little K, patients may

> suffer from salt (water) retention which leaves too much Na in the

> blood. Salt retention is difficult for an MD to detect, since there

> are no clinical tests for it. I was in heavy salt retention for 9

> months before I understood what was wrong. Salt retention can be

> caused by some medications and also by stress. Those that take

> diuretics may also suffer from low K unless the diuretic is a K

> sparing diuretic and then they may have too much K in the blood.

> Diabetes can also influence the K levels (more than one way) see the

> 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> Na.

>

> Hyperventilation must be used with caution, just breathe deeply and

> exh ale through pursed lips to avoid over doing. Very rapid deep

> breathing can be dangerous as the brain can get overloaded with

> oxygen and will cut off blood flow to the brain and produce a mild

> stroke. I think it would be very hard for this to occur if one where

> to limit oneself to mild hyperventilation to no more than 20 minutes

> plus eating time. The operative word here is mild. However,

> hyperventilation (possibly antacids) is of particular danger to those

> subjected to epileptic fits and can cause epileptic convulsive

> attacks.

>

> Other controls

>

> I usually am able to detect when food is building up in the

> esophagus, there is the feeling of fullness plus the beginning of

> hiccups. I must stop eating and continue hyperventilating until the

> cardia valve opens usually accompanied by a burp and the esophagus

> gradually empties. If I go too far, and fill the esophagus too much,

> the car dia valve will not open and I must heave up the contents of

> the esophagus. Eating slowly and chewing thoroughly gives more time

> for the cardia valve to open.

>

> I control nighttime regurgitation by eating early, cleaning my teeth

> and mouth of food particles at the end of dinner and then drinking a

> glass of water to wash every bit of food down the esophagus. If,

> during the evening I burp and taste any food I have to go through the

> routine again of hyperventilating, two Tums and water to open up the

> cardia valve to flush the food from the esophagus. I count on 4 to 6

> hours after dinner before going to bed and there must be no food or

> liquids after dinner. Regurgitation is dangerous since it places

> food near the trachea where it may aspirate into the lungs. Food

> near the trachea will initiate a cough. This is important to

> clearing the trachea of food. Aspiration can cause pneumonia and it

> ca n infiltrate the lungs and reduce lung capacity. Anyway to reduce

> regurgitation, especially while a sleep, is important. I would never

> use a cough medication, or sleeping pill, since the cough reflex is

> very important in preventing aspiration into the lungs. I believe

> sleeping on one's side reduce the risk of aspiration.

>

> I sleep with a wedge pillow plus a regular pillow and if I wake up in

> regurgitation than I sleep sitting up in a reclining chair. I use the

> hyperventilation and Tums treatment to open the cardia valve plus a

> little bit of water to wash it down. Sometimes the cardia valve does

> not open and if I take too much water the regurgitation is like a

> fountain of water in my mouth (even filling my nose) so I don't like

> to take much water at night. This is tempered by the fact that I may

> go to sleep while trying to open the cardia valve thus failing to

> open the valve. Some patients have severe regurgitation problems

> (often throat cancer patient) and they can only sleep sitting up in a

> reclining chair. I have noticed that some patients slip into

> Achalasia without the MD being aware of it

>

> Another hint is that I solve the hyperventilation timing problem in

> restaurants by using buffets, or fast food restaurants since there is

> no long wait for the meal to appear. I have the advantage of a vast

> pick of foods in the buffet so that I can eliminate the acid foods

> and balance the salt and K foods. I can start hyperventilating on

> the car journey to these restaurants.

>

>

>

> 4

>

>

>

>

>

> 5

>

>

>

>

>

>

>

> _____

>

> Photos

> Ring in the New Year with Photo

>

<http://us.rd./mail_us/taglines/photos/*http:/pg.photos..c

> om/ph/page?.file=calendar_splash.html & .dir=> Calendars. Add photos,

> events, holidays, whatever.

> _____

>

> ! GROUPS LINKS

>

> * Visit your group " achalasia

> <achalasia> " on the web.

>

> *

[Guest guest]

From Wally

To Notan

Yes, let us talk of Primary Achalasia.

I did not know there is an accept cause of

Achalasia.  I

have never heard of a virus or autoimmune cause.  I would like to attack the possibility of an

autoimmune cause.  This autoimmune is a

catch all when there doesn’t seem to be any other good cause,  I am aware that

this is a big theory in iritis.  There are even clinics just for autoimmune iritis.  They even

cure people this way and it is a good cure. 

But it has nothing to do with an autoimmune action.  It was to do with a poor blood flow to the

eye that produces a malnourish eye with a poor oxygen flow to the eye.  Some of the autoimmune cures also promote a

better blood flow to the eye thus curing the eye.

I do not understand your question as to

the pH and nerve action.  Are you looking

for some source for my statement?  I

believe I found it in textbooks on Medical Physiology, probably Guyton and also

Ganong.   I can

not give a page number since I have old editions.

I was under the impression that many do

get really sick.

Yes there is probably more than one cause.  In some the neurotransmitter may be the

problem rather that pH.   I also believe

that when the surgeon operates he is going to cut some nerves producing

permanent Achalsisa. 

At the beginning of my Achalasia my MD wanted

to operate and remove my epiphrenic diverticulum.  I

refused because he thought there was a very good possibility he would harm the cardia valve.

\

\

-----Original

Message-----

From: achalasia

[mailto:achalasia ] On Behalf

Of notan ostrich

Sent: Thursday, January 05, 2006

11:20 PM

achalasia

Subject: Re: achalasia

process

Wally wrote:

From

Wally

To Debbi

I feel I have been struck

down with a “I got you”. I will try to answer.

I am

going to jump in here. I find your idea interesting. I also understand the

question Debbi has brought up. Maybe I can help the two of you find ground to

discuss your ideas and how they may or may not apply to some of the data out

there about achalasia. Debbi is respected in the group for her broad knowledge

and ability to help others in various achalasia topics. You are also someone

who has given a lot of detailed thought to at least one area of focus in

achalasia.

Of course, my way is not

the only way. In the case of Scleroderma , the skin (also

esophagus, GI tract, lung, heart, and kidneys) thickens and becomes so

thick that peristalsis fails. In the case of the parasitic Chagas

megaesophagus develops (no explanation why) resulting in regurgitation and

dysphagia similar to Achalasia.

Your

examples of Scleroderma and Chagas are both forms of secondary achalasia.

Generally, when Achalasia Cardia is unqualified it generally refers to primary

achalasia, which is what almost all of us in this group have. I believe the

references Debbi gave were in the context of primary achalasia. I believe her

interest expressed in her question is regarding primary achalasia.

Your

references to destroyed, or lost, nerves are all review articles. They do

not describe how this is done, are what causes it.

The

accepted position on this is that know one knows what causes the damage or loss

and that, at any age achalasia is a neural degenerative disease.

I can think of ways for

the nerves to be destroyed. The nerves can be cut during surgery. They

can be crushed, but this is hard to do as it is buried in the neck. They

can die for lack of blood, this is probably an old age problem from a

cholesterol buildup. This must be rare since Achalasia hits all ages from

infants up. . Many chemical agents can destroy, or disable, the

nerves such as pesticides, etc. It can be damaged chemically, possibly

from an acid or alkaline pH.

The main

theories of researchers is that it is either a virus or an autoimmune disease.

There is evidence for both of these, signs of inflammation around the neural

plexus and antineural antibodies. There are also problems with both theories.

Achalasia can also be secondary to brain damage or vagus nerve damage.

Since your references indicate destroyed, or lost, nerves, why are there no

reports (to my knowledge) with my much simpler proposal concerning the pH

factor which is well listed in the medical literature in so far as nerve

action.

I am

interested in your answer to that.

The reversible action I

observed with pH may only apply when the pH falls with in + or - .2. of 7.40.

This is the range in which one does not feel any sickness. Beyond +

or - .2 one feels sick and there may be permanent damage to the nerves

beyond this range. I never get sick from Achalasia so I may control

Achalasia to stay within the safe range. I have never had spasm which may

come with the larger changes in pH. I have never lost weight or become

dehydrated from Achalasia. I seemed to achieved good control early

in my Achalasia..

If I understand

you here, you are saying that any, or some, neural loss seen in the data could

be from those that are far out of range. If this is the case, it would seem

like more of us should be feeling sick. I think most of us feel good other than

the achalasia symptoms.

All; of your references

list Achalasia as a progressive disease, that is one that never gets better,

but under my treatment my Achalasia has gotten progressively better. My

biggest single improvement was coming out of hypothyroidism.

Do you think it is possible that

primary achalasia could have more than one cause and some could find relief one

way while others do not?

notan

[Guest guest]

-I know just how you feel Crystal. I have such a rough time lately.

We are at a point here with a lot of things happening at once and I

cannot cope with it. So, in turn I am having more spasms but at least

they are much much milder but still annoying.

I get upset really easy. Had considered going to talk to the doctor

but in our case we have to educate them first to try and get them to

help us. So I think at times I feel pretty lonely. The best thing I

ever done was found this group.

I am just so tired and ache over. I don't know if that flue type ache

and bone weariness is an A thing or not but I get it so regularly. I

have a whole list of symptoms that get worse when I get it.

I am having trouble getting on line too often. Will be away for 2

weeks and hope to have a rest and maybe feel better soon.

Best wishes to you.

-- In achalasia , Crystal Rodbourn <chrissyl67@y...>

wrote:

>

> Hi & Quincia;

>

> I remember how we had our surgery at about the same time.

It is weird how we are both experiencing similar " setbacks " ! I too

have taken to eating smaller meals, because if I don't I get the

feeling of needing to regurg...the only bright spot is that I am not

coughing at night! The food must be getting through! I guess I am

having a hard time grasping why this has happened so suddenly for

me...when I read most of the posts, it seems that people here have

suffered for years with symptoms while I've been so healthy up until

earlier this year! Anyways, thank you everyone for the support and

the one place I can vent my frustrations without feeling like I'm

repeating myself!!

>

> Crystal

>

> qqqqqq_94118 <qqqqqq_94118@y...> wrote:

> hi, Crystal,

> maybe your E is distored and the symptom is somehow similar to A.

> Quincia

>

>

> > > 1 Jan 2006

> > >

> > > Wallace H. Allan ---I am a retired physicist, age 84, I worked

> > first

> > > as a nuclear physicist, then many years as a rocket scientist.

> > > Achalasia is very complex and it has taken me years to

understand

> > the

> > > small amount that I know of the process. It is possible,

without

> > > surgery, to gain good control of Achalasia with this knowledge.

> It

> > > will be hard for an medical doctor (MD) to treat a patient

since

> > the

> > > most important blood test is not stable and can change from

> minute

> > to

> > > minute. An MD can be very valuable in curing, or controlling,

> the

> > > many medical disorders that may contribute to Achalasia. I

> believe

> > > the patient needs to observe and experiment, using the

> information

> > > that I have uncovered, to further reduce Achalasia. I am

afraid

> > the

> > > complexity will discourage many patients and even MDs.

> > >

> > >

> > > Achalasia

> > >

> > > Introduction

> > >

> > > I believe that Achalasia relates to nerve transmission pulses.

> > Nerve

> > > transmission is done electrically and they may be upset by

> abnormal

> > > changes in the conductivity of the nerves. The blood feeds the

> > > nerves and keeps it alive and healthy and the blood itself can

> > affect

> > > the conductivity of the nerves. The body, and blood, contains

> > > electrolytes. Electrolytes are atoms, or compounds, that in

> > solution

> > > can conduct electricity. They do this by dropping or gaining

an

> > > electron (becoming an ion) with a positive or negative charge.

> The

> > > major electrolytes are potassium, magnesium, phosphate,

sulfate,

> > > bicarbonate and small amounts of sodium, chlorate and calcium.

By

> > > conductivity I do not mean the same as a metal with a flow of

> > > electrons, the conductivity in nerves is caused by potassium

plus

> > ion

> > > and sodium plus ions exchanges across the nerve fiber

membrane.

> It

> > > is a slow flow compared to electron flow and it reinforces

along

> > the

> > > fiber as it proceeds. I will only consider potassium (K) and

> > sodium

> > > (Na) in this report since there is such a direct link to nerve

> > > impulses. The cardia valve and the peristaltic action of the

> > > esophagus can fail under misfiring nerves. The pioneering work

> in

> > > this field was done by Dr. Harold Friedman and his work was

> > published

> > > as " Ionic Solution Theory " in 1962. This text treats solutions

> in

> > > the body as well, as general chemistry.

> > >

> > > Cause

> > >

> > > One major cause of Achalasia is described in this article.

There

> > are

> > > at least two other causes--see Scleroderma and Chagas in the

> latest

> > > 17th Edition " Merck Manual of Diagnosis and Therapy " . It will

be

> > > informative to read the chapter on Esophageal Disorders which

> > > includes Achalasia. What I have to describe is based on

accepted

> > > medical knowledge concerning nerves and transmission of nerve

> > > pulses.

> > >

> > > Achalasia (medical dictionary explanation) means failure to

> relax,

> > > especially of the cardia valve muscle which results in

retention

> of

> > > food in the esophagus. A medical textbook explanation says the

> > > defect appears to originate from a loss of motor innervation,

by

> > > fibers originating in the dorsal nucleus of the Vagus nerve.

The

> > > Vagus nerve is a packet of nerves that runs from the brain stem

> > down

> > > the neck into the body, most nerves run down the spinal column

> and

> > > branch out to the body organs. The Vagus nerve (wandering

nerve)

> > > supplies some nerves to the ear, tongue, larynx, esophagus,

> cardia

> > > valve, lungs, heart, etc but it is not the sole supply of

nerves

> > for

> > > most of these organs.

> > >

> > > As a point of interest, Achalasia was formerly called a

> > Cardiospasm.

> > > This was misleading since cardia implies the heart but the

cardia

> > > valve (splincter valve at the bottom of the esophagus) is just

> near

> > > the heart. A spasm means a contraction of a muscle but in a

> > > Cardiospasm the muscle does not contract but fails to relax.

If

> > the

> > > failure to relax was because of a cramp on top of the normal

> > > contraction of the cardia muscle I would think this would

produce

> a

> > > pain which might be perceive as an Achalasia spasm.

> > >

> > > I have had Achalasia for 20 years and very early my body

reacted

> to

> > > the disorder by hyperventilation which brought me out of

> > Achalasia.

> > > From this I developed the reasoning why this was important to

me

> > but

> > > I found out later that my technique would make some patients

> > worst.

> > > From reading letters to the Achalasia Forum I have been able to

> > > understand some of the complex reasons for Achalasia. I find

> > > experiencing Achalasia is very helpful in understanding it but

I

> am

> > > at a loss to understand spasms since I have never had one.

> > >

> > > I have found K and Na to be the most controlling electrolytes

in

> > > Achalasia and I have not worked with the other electrolytes. I

> > > suspect that low calcium may be involved in spasms since low

> > calcium

> > > is know to excite the nerves to a point that a muscle goes into

a

> > > spasm called Tetany. The low calcium can become even more of a

> > > problem if the blood goes alkaline since this adds to the

> > excitation

> > > of the nerve system. Low levels of calcium in a blood test

might

> > > indicate if this is a problem. Possibly ingestion of calcium

> might

> > > bring one out of the spasm. There are many reasons for low

> calcium

> > > and one should consult an MD to uncover your own problem.

Since

> a

> > > cramp is a spasm, athletes often get leg cramps from loss of

salt

> > > during exercise. Leg cramps while sleep often arise from too

> much

> > K

> > > released into the blood from respiratory acidosis (shallow

> > breathing

> > > while a sleep).

> > >

> > > There are two blood (serum) factors that one should be

familiar

> > > with in order to understand Achalasia. One is the pH of the

> > blood.

> > > This is a measure of the acidity or alkalinity of the blood.

> > > Chemically pH ranges from 0 to 14 with 7.0 the neutral point.

0-

> 7

> > is

> > > acid and 7-14 alkaline. The blood is normally slightly

alkaline

> at

> > > 7.40. Thus 7.40 is considered neutral and anything lower is

acid

> > and

> > > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and

> > anything

> > > lower or higher will lead to death within hours. pH is a

> > logarithmic

> > > scale so .7 is a change of 5X in acidity, or alkalinity. The

pH

> > will

> > > not change from 7.4 more that plus or minus 0.2 or one will get

> > > sick. The body has a quick response to adjusting the pH to

safe

> > > values. Food, liquid, drugs and breathing can change the pH of

> the

> > > blood but only by a very small, but important amount. If the

> blood

> > > goes acid, a small amount of K falls out of the body cells into

> the

> > > blood and if the blood goes alkaline a small amount of K is

> forced

> > > into the body cells from the blood. The second factor in the

> blood

> > is

> > > the ratio of Na to K.

> > >

> > > Blood serum requires a certain ratio of Na to K in the blood

and

> > this

> > > is about 28 to 1. This ratio is the same as the ratio of Na to

K

> > in

> > > sea water which is cited as a reason why man may have

originated

> in

> > > sea water. This ratio changes with the pH of the blood,

because

> K

> > is

> > > either dropped out of the blood with acidity or forced back

into

> > the

> > > cells with alkalinity. The ratio is not used in normal

medicine

> > but

> > > I will use it since it provides clues to the patient as to when

> and

> > > why he is in Achalasia. This ratio can not deviate very far

from

> > > this 28 to 1 or the nerves (the pH changes the ratio) will

> > misfire.

> > > By misfire I mean that when the blood is alkaline the nerves

> become

> > > over excited to, at a maximum, one could go into convulsions.

> When

> > > in acidity it decreases its acidity to, at a minimum, one could

> go

> > > into a coma. Different nerves and nerve pathways may have a

> > slightly

> > > different pH, and may also response differently to the same pH

so

> > all

> > > the nerves do not fail at the same time. Nerves close to the

> > gastro

> > > tract may respond faster to food, drugs, and liquid changes

than

> > leg

> > > and arm nerves because the food is in immediate contact with

the

> > > nerves. Also some of the organs (possibly the cardia valve)

may

> be

> > > supplied solely by the Vagus nerve.

> > >

> > > I think of pH and Na to K as related since if the pH changes

the

> > > ratio of Na to K also changes. Thus if K is high the blood is

> > acid,

> > > and if K is low the blood is alkaline.

> > >

> > > The body stores a large amount of K in the body cells and a

much

> > > smaller amount in the blood. Na stores a large amount in the

> extra

> > > cellular fluids and blood and very little in body cells. There

> is

> > a

> > > mechanism to keep this in the proper balance called the Na-K

> pump.

> > > There are other ways to balance the absolute amount of K in the

> > > blood, some very fast and others slow, as a change of K by a

> factor

> > > of three can kill. Na is not held under as strict a control.

> There

> > > are clinical values for absolute values of Na and K and a

> variation

> > > from these values can be an indication of something wrong in

the

> > body.

> > >

> > > The nerves require the proper pH (or ratio of Na to K) for

proper

> > > firing of the nerves. The proper ratio can be changed

temporarily

> > by

> > > foods, liquids, drugs or breathing. Then there are

semipermeant

> > > disorders that bias the ratio for long periods of time. I say

> > > semipermeant because they may come and go over weeks, months or

> > years

> > > and the disorder create these biases might possibly be cured.

> For

> > > instance, for 17 years I would go in and out hypothyroidism on

> very

> > > irregular schedule related to my level of stress. Today, I am

> out

> > of

> > > it for many months and I fall into it for a week or two, at the

> > > most. In my case high stress is apt to bring on

hypothyroidism.

> > > Hypothyroidism can be present without the patient or his MD

being

> > > aware of. My 17 year spell with hypothyroidism was never

> detected

> > by

> > > my MD even thought I suspected I was in it but my blood tests

> never

> > > reveal it, probably because I drifted in and out of it and it

> never

> > > was present when a blood test were taken. Also I tried to

> control

> > my

> > > excess of K by eating less K foods while in hypothyroidism to

> > control

> > > atrail fibrillation (a nerve firing problem). Thus, it is not

> > > surprising that blood tests did not reveal excess K.

> > >

> > > A temporary event can be created by breathing, either hyper, or

> > > hypoventilation. Hyperventilation (respiratory alkalosis) will

> > push

> > > K back into the body cell from the blood serum and

> hypoventilation

> > > (respiratory acidosis) will drop K out of the body cells into

the

> > > blood. This is very fast acting and I use it to alter the K in

> my

> > > blood. Some short term events can last a long time, I normally

> > > hypoventilate because of a sunken chest, thus a short term

event

> > > becomes a long term, event.

> > >

> > > The longer term events come under the class of metabolic

acidosis

> > or

> > > metabolic alkalosis. Metabolic means a chemical event.

> Respiratory

> > > acidosis, or respiratory alkalosis, is also a chemical event

but

> I

> > > think it is separated from metabolic since is is such a quick

> > event.

> > > Eating acid foods will act the same as respiratory acidosis and

> > drops

> > > K in the blood but since is a food process it takes longer to

> work

> > > (minutes instead of seconds) and last longer. An antacid (Tums

> or

> > > milk) will also make the blood alkaline and push K back into

the

> > body

> > > cells from the blood. An acid drink (cola syrup, soft drinks or

> > > orange juice) will drop K into the blood. Acid foods such as

> > pickle,

> > > strawberries, tomatoes, and vinegar can drop K into the blood

for

> a

> > > limited time. Food, liquids, drugs are short term events but

> they

> > > can extend into very long events.

> > >

> > > Drugs can seriously change the pH. I recently read an ad in the

> NY

> > > Times for Topamax (migraine headache) it states one side effect

> is

> > > metabolic acidosis which will produce hyperventilation. The

> > > hyperventilation will shift the blood towards neutral.

> > > Hyperventilation was a part of my Achalasia.

> > >

> > > Some 60% of those with achalasia have an epiphrenic

> diverticulum.

> > > This is a pouch at the cardioesophageal junction. The pouch

can

> > > collect food which does not go into the stomach but ferments in

> the

> > > pouch and in the fermenting process becomes acid. I have one

of

> > > these pouches and I sense if I swallow a chunk of meat which

> stays

> > in

> > > the pouch, that it will take up to a week before the meat

passes

> > into

> > > the stomach and I have much Achalasia during this period. As

> much

> > as

> > > I try to chew thoroughly, if I eat a steak, there always seems

to

> > be

> > > a chunk that drops into the throat. I try to avoid beef steaks

> but

> > I

> > > seem to be able to eat ham and pork without trouble. Ground

beef

> is

> > > safe to eat.

> > >

> > > Long term events are diseases, such as hypothyroidism which

> > elevates

> > > K and depress Na in the blood, and hyperthyroidism which

elevates

> > Na

> > > and depresses K. Low adrenal output elevates K and depress Na

in

> > the

> > > blood. High adrenal output elevates Na and depresses K.

> Diuretics

> > > can depress K, or K sparing diuretics can elevate K.

Dehydration

> > can

> > > elevate Na in the blood.

> > >

> > > The vast majority of the population escapes Achalasia. So what

> is

> > > differ about patients of Achalasia. I propose that short and

> long

> > > term events do not balance out but add up. I normally

> > > hypoventilate. I have been in hypothyroidism, of and on, for

> many

> > > years, I normally eat too may K foods and avoid salty (Na--

sodium

> > > chloride) foods. They all add up to a low ratio of Na to K or

an

> > > acid blood.

> > >

> > > Treatment

> > >

> > > One can see the vast complexity of Achalasis. In fact , this

> > > disorder is so complex that my method of coping with it is very

> > > difficult for most patients and even more so for MD's who have

> very

> > > little to work with, since any blood test are fleeting and

reveal

> > > little. It would be very difficult to handle a case with a

> child.

> > > There is one hope and that is to cure the diseases that place

the

> > > ratio out of balance. For instance, my Achalasia is much

> > diminished

> > > when I am free of hypothyroidism. A patient can try to balance

> the

> > K

> > > foods with the Na foods, and by balance I do not mean one for

> one,

> > > but your own requirement that minimizes Achalasia. Also try to

> > > balance acid liquids and foods with alkaline ones. A parent

can

> > also

> > > place a child on the same diet.

> > >

> > > There is a table in the 17th Edition Merck Manual that can help

> you

> > > see how different disorders affect the Na and K levels it is on

> > Page

> > > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549

is

> > also

> > > very helpful. One must evaluate what is one's problem whether

> too

> > > much, or too little K. Na maybe the problem from too much

> > ingestion

> > > of Na (salt), which is easily solved.

> > >

> > > I have developed a treatment to open up the cardia valve as I

> eat.

> > > My problem is too much K and too little salt, this will makes

> > > Achalasia worse for those who are normally high on Na and low

on

> > K.

> > > If you have Achalasia I believe you probably fall into one or

the

> > > other case, although there must be many who just eat too much

> salt.

> > >

> > > To bring myself into a normal ratio of Na to K, first, during

the

> > > meal I try to determine whether the meal contains enough salt

or

> > > whether I need to add salt. If one must add salt, it takes

very

> > > little salt to add the right amount. Then just before a meal I

> > > mildly hyperventilated for about 15 minutes and take two Tums

> > > (regular) antacids and this normally sets me up for a normal

meal

> > > without Achalasia. One must continue to hyperventilate during

> the

> > > meal since normally one would hypoventilate while eating.

> > Sometimes

> > > in a restaurant, the meal comes too late, and I have been

> > > hyperventilating too long, changing from too high in K to too

> low.

> > > If I stop hyperventilating and wait about 10 minutes the ratio

> will

> > > approach normal and I can then eat. Sometimes during the meal

I

> > will

> > > eat too many K foods and Achalasia will kick in. If I eat a

dill

> > > pickle, strawberries, tomatoes, orange juice, etc then I will

go

> > too

> > > acid which drops too much K in the blood and I am in Achalasia.

> > >

> > > I have no experience with low K and high Na. I would think an

> acid

> > > drink (cola syrup, soft drink, orange juice) and no alkaline

> drinks

> > > (milk), would start one off correctly and the normal

> > hypoventilation

> > > while eating would also help. Eating less salty foods and

more

> K

> > > foods would also help.

> > >

> > > If the Na to K ratio causes misfiring of nerves and prevents

the

> > > cardia valve from opening, then other nerves are apt to

misfire.

> I

> > > can sense that my atrail fibrillation occurs with Achalasia,

and

> > the

> > > actions I take to lower Achalasia, also lower atrail

> fibrillation.

> > > The cardia valve, esophagus, larynx, and part of the heart and

> > lungs

> > > are controlled by nerves in the Vagus nerve. When really bad

> from

> > > too much hypothyroidism the nerves in my legs produce

peripheral

> > > neuropathy. Carpal tunnel syndrome, which is a nerve disorder,

> > also

> > > can appear when in hypothyroidism I wonder if gastroesophagel

> > reflux

> > > disease (GERD) might not be a different form of Achalasia in

> which

> > > the cardia valve remains open rather that closed.

> > >

> > > In addition to those with too much K or too little K, patients

> may

> > > suffer from salt (water) retention which leaves too much Na in

> the

> > > blood. Salt retention is difficult for an MD to detect, since

> there

> > > are no clinical tests for it. I was in heavy salt retention

for

> 9

> > > months before I understood what was wrong. Salt retention can

be

> > > caused by some medications and also by stress. Those that take

> > > diuretics may also suffer from low K unless the diuretic is a K

> > > sparing diuretic and then they may have too much K in the

blood.

> > > Diabetes can also influence the K levels (more than one way)

see

> > the

> > > 17th edition Merck Manual Page 2549 Table 296-4 and read about

K

> > and

> > > Na.

> > >

> > > Hyperventilation must be used with caution, just breathe deeply

> and

> > > exhale through pursed lips to avoid over doing. Very rapid

deep

> > > breathing can be dangerous as the brain can get overloaded with

> > > oxygen and will cut off blood flow to the brain and produce a

> mild

> > > stroke. I think it would be very hard for this to occur if one

> > where

> > > to limit oneself to mild hyperventilation to no more than 20

> > minutes

> > > plus eating time. The operative word here is mild. However,

> > > hyperventilation (possibly antacids) is of particular danger to

> > those

> > > subjected to epileptic fits and can cause epileptic convulsive

> > > attacks.

> > >

> > > Other controls

> > >

> > > I usually am able to detect when food is building up in the

> > > esophagus, there is the feeling of fullness plus the beginning

of

> > > hiccups. I must stop eating and continue hyperventilating

until

> > the

> > > cardia valve opens usually accompanied by a burp and the

> esophagus

> > > gradually empties. If I go too far, and fill the esophagus too

> > much,

> > > the cardia valve will not open and I must heave up the contents

> of

> > > the esophagus. Eating slowly and chewing thoroughly gives more

> > time

> > > for the cardia valve to open.

> > >

> > > I control nighttime regurgitation by eating early, cleaning my

> > teeth

> > > and mouth of food particles at the end of dinner and then

> drinking

> > a

> > > glass of water to wash every bit of food down the esophagus.

If,

> > > during the evening I burp and taste any food I have to go

through

> > the

> > > routine again of hyperventilating, two Tums and water to open

up

> > the

> > > cardia valve to flush the food from the esophagus. I count on

4

> to

> > 6

> > > hours after dinner before going to bed and there must be no

food

> or

> > > liquids after dinner. Regurgitation is dangerous since it

places

> > > food near the trachea where it may aspirate into the lungs.

Food

> > > near the trachea will initiate a cough. This is important to

> > > clearing the trachea of food. Aspiration can cause pneumonia

and

> it

> > > can infiltrate the lungs and reduce lung capacity. Anyway to

> > reduce

> > > regurgitation, especially while a sleep, is important. I would

> > never

> > > use a cough medication, or sleeping pill, since the cough

reflex

> is

> > > very important in preventing aspiration into the lungs. I

> believe

> > > sleeping on one's side reduce the risk of aspiration.

> > >

> > > I sleep with a wedge pillow plus a regular pillow and if I wake

> up

> > in

> > > regurgitation than I sleep sitting up in a reclining chair. I

use

> > the

> > > hyperventilation and Tums treatment to open the cardia valve

plus

> a

> > > little bit of water to wash it down. Sometimes the cardia

valve

> > does

> > > not open and if I take too much water the regurgitation is like

a

> > > fountain of water in my mouth (even filling my nose) so I don't

> > like

> > > to take much water at night. This is tempered by the fact that

I

> > may

> > > go to sleep while trying to open the cardia valve thus failing

to

> > > open the valve. Some patients have severe regurgitation

problems

> > > (often throat cancer patient) and they can only sleep sitting

up

> in

> > a

> > > reclining chair. I have noticed that some patients slip into

> > > Achalasia without the MD being aware of it

> > >

> > > Another hint is that I solve the hyperventilation timing

problem

> in

> > > restaurants by using buffets, or fast food restaurants since

> there

> > is

> > > no long wait for the meal to appear. I have the advantage of a

> vast

> > > pick of foods in the buffet so that I can eliminate the acid

> foods

> > > and balance the salt and K foods. I can start hyperventilating

> on

> > > the car journey to these restaurants.

> > >

> > >

> > >

> > > 4

> > >

> > >

> > >

> > >

> > >

> > > 5

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

[Guest guest]

From Eva: I read and reread this information...Did it help any of you? It

seems like a really long time to hyperventilate. I'm often preparing the meal

so sitting there and hyperventilating is not easy.

But it seems like a good method to clear my esophagaus before going to bed --if

it is not empty.

Thanking you in advance for you thoughts...Eva from Chicagoland

>

> 1 Jan 2006

>

> Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> as a nuclear physicist, then many years as a rocket scientist.

> Achalasia is very complex and it has taken me years to understand the

> small amount that I know of the process. It is possible, without

> surgery, to gain good control of Achalasia with this knowledge. It

> will be hard for an medical doctor (MD) to treat a patient since the

> most important blood test is not stable and can change from minute to

> minute. An MD can be very valuable in curing, or controlling, the

> many medical disorders that may contribute to Achalasia. I believe

> the patient needs to observe and experiment, using the information

> that I have uncovered, to further reduce Achalasia. I am afraid the

> complexity will discourage many patients and even MDs.

>

>

> Achalasia

>

> Introduction

>

> I believe that Achalasia relates to nerve transmission pulses. Nerve

> transmission is done electrically and they may be upset by abnormal

> changes in the conductivity of the nerves. The blood feeds the

> nerves and keeps it alive and healthy and the blood itself can affect

> the conductivity of the nerves. The body, and blood, contains

> electrolytes. Electrolytes are atoms, or compounds, that in solution

> can conduct electricity. They do this by dropping or gaining an

> electron (becoming an ion) with a positive or negative charge. The

> major electrolytes are potassium, magnesium, phosphate, sulfate,

> bicarbonate and small amounts of sodium, chlorate and calcium. By

> conductivity I do not mean the same as a metal with a flow of

> electrons, the conductivity in nerves is caused by potassium plus ion

> and sodium plus ions exchanges across the nerve fiber membrane. It

> is a slow flow compared to electron flow and it reinforces along the

> fiber as it proceeds. I will only consider potassium (K) and sodium

> (Na) in this report since there is such a direct link to nerve

> impulses. The cardia valve and the peristaltic action of the

> esophagus can fail under misfiring nerves. The pioneering work in

> this field was done by Dr. Harold Friedman and his work was published

> as " Ionic Solution Theory " in 1962. This text treats solutions in

> the body as well, as general chemistry.

>

> Cause

>

> One major cause of Achalasia is described in this article. There are

> at least two other causes--see Scleroderma and Chagas in the latest

> 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> informative to read the chapter on Esophageal Disorders which

> includes Achalasia. What I have to describe is based on accepted

> medical knowledge concerning nerves and transmission of nerve

> pulses.

>

> Achalasia (medical dictionary explanation) means failure to relax,

> especially of the cardia valve muscle which results in retention of

> food in the esophagus. A medical textbook explanation says the

> defect appears to originate from a loss of motor innervation, by

> fibers originating in the dorsal nucleus of the Vagus nerve. The

> Vagus nerve is a packet of nerves that runs from the brain stem down

> the neck into the body, most nerves run down the spinal column and

> branch out to the body organs. The Vagus nerve (wandering nerve)

> supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> valve, lungs, heart, etc but it is not the sole supply of nerves for

> most of these organs.

>

> As a point of interest, Achalasia was formerly called a Cardiospasm.

> This was misleading since cardia implies the heart but the cardia

> valve (splincter valve at the bottom of the esophagus) is just near

> the heart. A spasm means a contraction of a muscle but in a

> Cardiospasm the muscle does not contract but fails to relax. If the

> failure to relax was because of a cramp on top of the normal

> contraction of the cardia muscle I would think this would produce a

> pain which might be perceive as an Achalasia spasm.

>

> I have had Achalasia for 20 years and very early my body reacted to

> the disorder by hyperventilation which brought me out of Achalasia.

> From this I developed the reasoning why this was important to me but

> I found out later that my technique would make some patients worst.

> From reading letters to the Achalasia Forum I have been able to

> understand some of the complex reasons for Achalasia. I find

> experiencing Achalasia is very helpful in understanding it but I am

> at a loss to understand spasms since I have never had one.

>

> I have found K and Na to be the most controlling electrolytes in

> Achalasia and I have not worked with the other electrolytes. I

> suspect that low calcium may be involved in spasms since low calcium

> is know to excite the nerves to a point that a muscle goes into a

> spasm called Tetany. The low calcium can become even more of a

> problem if the blood goes alkaline since this adds to the excitation

> of the nerve system. Low levels of calcium in a blood test might

> indicate if this is a problem. Possibly ingestion of calcium might

> bring one out of the spasm. There are many reasons for low calcium

> and one should consult an MD to uncover your own problem. Since a

> cramp is a spasm, athletes often get leg cramps from loss of salt

> during exercise. Leg cramps while sleep often arise from too much K

> released into the blood from respiratory acidosis (shallow breathing

> while a sleep).

>

> There are two blood (serum) factors that one should be familiar

> with in order to understand Achalasia. One is the pH of the blood.

> This is a measure of the acidity or alkalinity of the blood.

> Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> acid and 7-14 alkaline. The blood is normally slightly alkaline at

> 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> lower or higher will lead to death within hours. pH is a logarithmic

> scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> not change from 7.4 more that plus or minus 0.2 or one will get

> sick. The body has a quick response to adjusting the pH to safe

> values. Food, liquid, drugs and breathing can change the pH of the

> blood but only by a very small, but important amount. If the blood

> goes acid, a small amount of K falls out of the body cells into the

> blood and if the blood goes alkaline a small amount of K is forced

> into the body cells from the blood. The second factor in the blood is

> the ratio of Na to K.

>

> Blood serum requires a certain ratio of Na to K in the blood and this

> is about 28 to 1. This ratio is the same as the ratio of Na to K in

> sea water which is cited as a reason why man may have originated in

> sea water. This ratio changes with the pH of the blood, because K is

> either dropped out of the blood with acidity or forced back into the

> cells with alkalinity. The ratio is not used in normal medicine but

> I will use it since it provides clues to the patient as to when and

> why he is in Achalasia. This ratio can not deviate very far from

> this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> By misfire I mean that when the blood is alkaline the nerves become

> over excited to, at a maximum, one could go into convulsions. When

> in acidity it decreases its acidity to, at a minimum, one could go

> into a coma. Different nerves and nerve pathways may have a slightly

> different pH, and may also response differently to the same pH so all

> the nerves do not fail at the same time. Nerves close to the gastro

> tract may respond faster to food, drugs, and liquid changes than leg

> and arm nerves because the food is in immediate contact with the

> nerves. Also some of the organs (possibly the cardia valve) may be

> supplied solely by the Vagus nerve.

>

> I think of pH and Na to K as related since if the pH changes the

> ratio of Na to K also changes. Thus if K is high the blood is acid,

> and if K is low the blood is alkaline.

>

> The body stores a large amount of K in the body cells and a much

> smaller amount in the blood. Na stores a large amount in the extra

> cellular fluids and blood and very little in body cells. There is a

> mechanism to keep this in the proper balance called the Na-K pump.

> There are other ways to balance the absolute amount of K in the

> blood, some very fast and others slow, as a change of K by a factor

> of three can kill. Na is not held under as strict a control. There

> are clinical values for absolute values of Na and K and a variation

> from these values can be an indication of something wrong in the body.

>

> The nerves require the proper pH (or ratio of Na to K) for proper

> firing of the nerves. The proper ratio can be changed temporarily by

> foods, liquids, drugs or breathing. Then there are semipermeant

> disorders that bias the ratio for long periods of time. I say

> semipermeant because they may come and go over weeks, months or years

> and the disorder create these biases might possibly be cured. For

> instance, for 17 years I would go in and out hypothyroidism on very

> irregular schedule related to my level of stress. Today, I am out of

> it for many months and I fall into it for a week or two, at the

> most. In my case high stress is apt to bring on hypothyroidism.

> Hypothyroidism can be present without the patient or his MD being

> aware of. My 17 year spell with hypothyroidism was never detected by

> my MD even thought I suspected I was in it but my blood tests never

> reveal it, probably because I drifted in and out of it and it never

> was present when a blood test were taken. Also I tried to control my

> excess of K by eating less K foods while in hypothyroidism to control

> atrail fibrillation (a nerve firing problem). Thus, it is not

> surprising that blood tests did not reveal excess K.

>

> A temporary event can be created by breathing, either hyper, or

> hypoventilation. Hyperventilation (respiratory alkalosis) will push

> K back into the body cell from the blood serum and hypoventilation

> (respiratory acidosis) will drop K out of the body cells into the

> blood. This is very fast acting and I use it to alter the K in my

> blood. Some short term events can last a long time, I normally

> hypoventilate because of a sunken chest, thus a short term event

> becomes a long term, event.

>

> The longer term events come under the class of metabolic acidosis or

> metabolic alkalosis. Metabolic means a chemical event. Respiratory

> acidosis, or respiratory alkalosis, is also a chemical event but I

> think it is separated from metabolic since is is such a quick event.

> Eating acid foods will act the same as respiratory acidosis and drops

> K in the blood but since is a food process it takes longer to work

> (minutes instead of seconds) and last longer. An antacid (Tums or

> milk) will also make the blood alkaline and push K back into the body

> cells from the blood. An acid drink (cola syrup, soft drinks or

> orange juice) will drop K into the blood. Acid foods such as pickle,

> strawberries, tomatoes, and vinegar can drop K into the blood for a

> limited time. Food, liquids, drugs are short term events but they

> can extend into very long events.

>

> Drugs can seriously change the pH. I recently read an ad in the NY

> Times for Topamax (migraine headache) it states one side effect is

> metabolic acidosis which will produce hyperventilation. The

> hyperventilation will shift the blood towards neutral.

> Hyperventilation was a part of my Achalasia.

>

> Some 60% of those with achalasia have an epiphrenic diverticulum.

> This is a pouch at the cardioesophageal junction. The pouch can

> collect food which does not go into the stomach but ferments in the

> pouch and in the fermenting process becomes acid. I have one of

> these pouches and I sense if I swallow a chunk of meat which stays in

> the pouch, that it will take up to a week before the meat passes into

> the stomach and I have much Achalasia during this period. As much as

> I try to chew thoroughly, if I eat a steak, there always seems to be

> a chunk that drops into the throat. I try to avoid beef steaks but I

> seem to be able to eat ham and pork without trouble. Ground beef is

> safe to eat.

>

> Long term events are diseases, such as hypothyroidism which elevates

> K and depress Na in the blood, and hyperthyroidism which elevates Na

> and depresses K. Low adrenal output elevates K and depress Na in the

> blood. High adrenal output elevates Na and depresses K. Diuretics

> can depress K, or K sparing diuretics can elevate K. Dehydration can

> elevate Na in the blood.

>

> The vast majority of the population escapes Achalasia. So what is

> differ about patients of Achalasia. I propose that short and long

> term events do not balance out but add up. I normally

> hypoventilate. I have been in hypothyroidism, of and on, for many

> years, I normally eat too may K foods and avoid salty (Na--sodium

> chloride) foods. They all add up to a low ratio of Na to K or an

> acid blood.

>

> Treatment

>

> One can see the vast complexity of Achalasis. In fact , this

> disorder is so complex that my method of coping with it is very

> difficult for most patients and even more so for MD's who have very

> little to work with, since any blood test are fleeting and reveal

> little. It would be very difficult to handle a case with a child.

> There is one hope and that is to cure the diseases that place the

> ratio out of balance. For instance, my Achalasia is much diminished

> when I am free of hypothyroidism. A patient can try to balance the K

> foods with the Na foods, and by balance I do not mean one for one,

> but your own requirement that minimizes Achalasia. Also try to

> balance acid liquids and foods with alkaline ones. A parent can also

> place a child on the same diet.

>

> There is a table in the 17th Edition Merck Manual that can help you

> see how different disorders affect the Na and K levels it is on Page

> 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> very helpful. One must evaluate what is one's problem whether too

> much, or too little K. Na maybe the problem from too much ingestion

> of Na (salt), which is easily solved.

>

> I have developed a treatment to open up the cardia valve as I eat.

> My problem is too much K and too little salt, this will makes

> Achalasia worse for those who are normally high on Na and low on K.

> If you have Achalasia I believe you probably fall into one or the

> other case, although there must be many who just eat too much salt.

>

> To bring myself into a normal ratio of Na to K, first, during the

> meal I try to determine whether the meal contains enough salt or

> whether I need to add salt. If one must add salt, it takes very

> little salt to add the right amount. Then just before a meal I

> mildly hyperventilated for about 15 minutes and take two Tums

> (regular) antacids and this normally sets me up for a normal meal

> without Achalasia. One must continue to hyperventilate during the

> meal since normally one would hypoventilate while eating. Sometimes

> in a restaurant, the meal comes too late, and I have been

> hyperventilating too long, changing from too high in K to too low.

> If I stop hyperventilating and wait about 10 minutes the ratio will

> approach normal and I can then eat. Sometimes during the meal I will

> eat too many K foods and Achalasia will kick in. If I eat a dill

> pickle, strawberries, tomatoes, orange juice, etc then I will go too

> acid which drops too much K in the blood and I am in Achalasia.

>

> I have no experience with low K and high Na. I would think an acid

> drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> (milk), would start one off correctly and the normal hypoventilation

> while eating would also help. Eating less salty foods and more K

> foods would also help.

>

> If the Na to K ratio causes misfiring of nerves and prevents the

> cardia valve from opening, then other nerves are apt to misfire. I

> can sense that my atrail fibrillation occurs with Achalasia, and the

> actions I take to lower Achalasia, also lower atrail fibrillation.

> The cardia valve, esophagus, larynx, and part of the heart and lungs

> are controlled by nerves in the Vagus nerve. When really bad from

> too much hypothyroidism the nerves in my legs produce peripheral

> neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> can appear when in hypothyroidism I wonder if gastroesophagel reflux

> disease (GERD) might not be a different form of Achalasia in which

> the cardia valve remains open rather that closed.

>

> In addition to those with too much K or too little K, patients may

> suffer from salt (water) retention which leaves too much Na in the

> blood. Salt retention is difficult for an MD to detect, since there

> are no clinical tests for it. I was in heavy salt retention for 9

> months before I understood what was wrong. Salt retention can be

> caused by some medications and also by stress. Those that take

> diuretics may also suffer from low K unless the diuretic is a K

> sparing diuretic and then they may have too much K in the blood.

> Diabetes can also influence the K levels (more than one way) see the

> 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> Na.

>

> Hyperventilation must be used with caution, just breathe deeply and

> exhale through pursed lips to avoid over doing. Very rapid deep

> breathing can be dangerous as the brain can get overloaded with

> oxygen and will cut off blood flow to the brain and produce a mild

> stroke. I think it would be very hard for this to occur if one where

> to limit oneself to mild hyperventilation to no more than 20 minutes

> plus eating time. The operative word here is mild. However,

> hyperventilation (possibly antacids) is of particular danger to those

> subjected to epileptic fits and can cause epileptic convulsive

> attacks.

>

> Other controls

>

> I usually am able to detect when food is building up in the

> esophagus, there is the feeling of fullness plus the beginning of

> hiccups. I must stop eating and continue hyperventilating until the

> cardia valve opens usually accompanied by a burp and the esophagus

> gradually empties. If I go too far, and fill the esophagus too much,

> the cardia valve will not open and I must heave up the contents of

> the esophagus. Eating slowly and chewing thoroughly gives more time

> for the cardia valve to open.

>

> I control nighttime regurgitation by eating early, cleaning my teeth

> and mouth of food particles at the end of dinner and then drinking a

> glass of water to wash every bit of food down the esophagus. If,

> during the evening I burp and taste any food I have to go through the

> routine again of hyperventilating, two Tums and water to open up the

> cardia valve to flush the food from the esophagus. I count on 4 to 6

> hours after dinner before going to bed and there must be no food or

> liquids after dinner. Regurgitation is dangerous since it places

> food near the trachea where it may aspirate into the lungs. Food

> near the trachea will initiate a cough. This is important to

> clearing the trachea of food. Aspiration can cause pneumonia and it

> can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> regurgitation, especially while a sleep, is important. I would never

> use a cough medication, or sleeping pill, since the cough reflex is

> very important in preventing aspiration into the lungs. I believe

> sleeping on one's side reduce the risk of aspiration.

>

> I sleep with a wedge pillow plus a regular pillow and if I wake up in

> regurgitation than I sleep sitting up in a reclining chair. I use the

> hyperventilation and Tums treatment to open the cardia valve plus a

> little bit of water to wash it down. Sometimes the cardia valve does

> not open and if I take too much water the regurgitation is like a

> fountain of water in my mouth (even filling my nose) so I don't like

> to take much water at night. This is tempered by the fact that I may

> go to sleep while trying to open the cardia valve thus failing to

> open the valve. Some patients have severe regurgitation problems

> (often throat cancer patient) and they can only sleep sitting up in a

> reclining chair. I have noticed that some patients slip into

> Achalasia without the MD being aware of it

>

> Another hint is that I solve the hyperventilation timing problem in

> restaurants by using buffets, or fast food restaurants since there is

> no long wait for the meal to appear. I have the advantage of a vast

> pick of foods in the buffet so that I can eliminate the acid foods

> and balance the salt and K foods. I can start hyperventilating on

> the car journey to these restaurants.

>

>

>

> 4

>

>

>

>

>

> 5

>

[Guest guest]

Why would you do all this? It is dangerous, messing with the oxygen your body

gets? Really? I mean really really really. Do you want to go out do dinner

like this? Why why why when you could have surgery and eat. For the vast

majority of us? Why spend all this time and effort? That pouch he talked

about is likely the enlarged esophagus from all that food sitting there.

What do you think happens when that food sits there forever, what chemical

reactions are going on and what is that doing to your blood, it is rotting

food!!!!! Yet this discussion is about tidbits of salt and alkaline and acid.

Seems like rotting food is a bigger problem? Is this a way to live life,

searching for some secret treatment that " someone " is hiding. Some vast

conspiracy is keeping the real treatment from coming forward? Going through all

this, and yes capitalizaion here: WHILE YOUR ESOPHAGUS IS STRETCHING OUT AS BIG

AS A STOMACH. The myotomy is proven over and over and over to alleviate most

all these symptoms. Do you think we are making up the fact we can eat???? Just

guessing, out of the many hundreds here, most, probably 80% have had a myotomy

or a dialation. Some too late, and regret waiting.

So those are my thoughts, you asked, please don't attack, because remember you

asked. Others, please don't attack me, she asked. ly, now I'm a little

crabby. Really are you kidding, you would consider doing this instead of

getting one invasive medical treatment? Assuming you can get such treatment,

and you are medically, financially and mentally ready. Would you not have a

C-section if needed, an appendectomy? Bet you could find people who think an

appendectomy is the wrong thing to do as they lay in the emergency room,

probably the same people that would consider breathing into a bag to help w/

achalasia symptoms.

Really, really, really, there is not a secret cure. We are EATING and DRINKING

almost normally after surgery. It isn't fake eating. Why, why why suffer, when

you don't have to. Why put your family through this, watching you suffer. It

is a miserable thing for your family to have to put up with.

Also notice this man was 84 years old at that time. That is a whole different

proposition. I don't remember you saying you were anywhere near that age.

So those are my thoughts, guess the claws weren't tucked in.

Done for the day.

Sandy

> >

> > 1 Jan 2006

> >

> > Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> > as a nuclear physicist, then many years as a rocket scientist.

> > Achalasia is very complex and it has taken me years to understand the

> > small amount that I know of the process. It is possible, without

> > surgery, to gain good control of Achalasia with this knowledge. It

> > will be hard for an medical doctor (MD) to treat a patient since the

> > most important blood test is not stable and can change from minute to

> > minute. An MD can be very valuable in curing, or controlling, the

> > many medical disorders that may contribute to Achalasia. I believe

> > the patient needs to observe and experiment, using the information

> > that I have uncovered, to further reduce Achalasia. I am afraid the

> > complexity will discourage many patients and even MDs.

> >

> >

> > Achalasia

> >

> > Introduction

> >

> > I believe that Achalasia relates to nerve transmission pulses. Nerve

> > transmission is done electrically and they may be upset by abnormal

> > changes in the conductivity of the nerves. The blood feeds the

> > nerves and keeps it alive and healthy and the blood itself can affect

> > the conductivity of the nerves. The body, and blood, contains

> > electrolytes. Electrolytes are atoms, or compounds, that in solution

> > can conduct electricity. They do this by dropping or gaining an

> > electron (becoming an ion) with a positive or negative charge. The

> > major electrolytes are potassium, magnesium, phosphate, sulfate,

> > bicarbonate and small amounts of sodium, chlorate and calcium. By

> > conductivity I do not mean the same as a metal with a flow of

> > electrons, the conductivity in nerves is caused by potassium plus ion

> > and sodium plus ions exchanges across the nerve fiber membrane. It

> > is a slow flow compared to electron flow and it reinforces along the

> > fiber as it proceeds. I will only consider potassium (K) and sodium

> > (Na) in this report since there is such a direct link to nerve

> > impulses. The cardia valve and the peristaltic action of the

> > esophagus can fail under misfiring nerves. The pioneering work in

> > this field was done by Dr. Harold Friedman and his work was published

> > as " Ionic Solution Theory " in 1962. This text treats solutions in

> > the body as well, as general chemistry.

> >

> > Cause

> >

> > One major cause of Achalasia is described in this article. There are

> > at least two other causes--see Scleroderma and Chagas in the latest

> > 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> > informative to read the chapter on Esophageal Disorders which

> > includes Achalasia. What I have to describe is based on accepted

> > medical knowledge concerning nerves and transmission of nerve

> > pulses.

> >

> > Achalasia (medical dictionary explanation) means failure to relax,

> > especially of the cardia valve muscle which results in retention of

> > food in the esophagus. A medical textbook explanation says the

> > defect appears to originate from a loss of motor innervation, by

> > fibers originating in the dorsal nucleus of the Vagus nerve. The

> > Vagus nerve is a packet of nerves that runs from the brain stem down

> > the neck into the body, most nerves run down the spinal column and

> > branch out to the body organs. The Vagus nerve (wandering nerve)

> > supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> > valve, lungs, heart, etc but it is not the sole supply of nerves for

> > most of these organs.

> >

> > As a point of interest, Achalasia was formerly called a Cardiospasm.

> > This was misleading since cardia implies the heart but the cardia

> > valve (splincter valve at the bottom of the esophagus) is just near

> > the heart. A spasm means a contraction of a muscle but in a

> > Cardiospasm the muscle does not contract but fails to relax. If the

> > failure to relax was because of a cramp on top of the normal

> > contraction of the cardia muscle I would think this would produce a

> > pain which might be perceive as an Achalasia spasm.

> >

> > I have had Achalasia for 20 years and very early my body reacted to

> > the disorder by hyperventilation which brought me out of Achalasia.

> > From this I developed the reasoning why this was important to me but

> > I found out later that my technique would make some patients worst.

> > From reading letters to the Achalasia Forum I have been able to

> > understand some of the complex reasons for Achalasia. I find

> > experiencing Achalasia is very helpful in understanding it but I am

> > at a loss to understand spasms since I have never had one.

> >

> > I have found K and Na to be the most controlling electrolytes in

> > Achalasia and I have not worked with the other electrolytes. I

> > suspect that low calcium may be involved in spasms since low calcium

> > is know to excite the nerves to a point that a muscle goes into a

> > spasm called Tetany. The low calcium can become even more of a

> > problem if the blood goes alkaline since this adds to the excitation

> > of the nerve system. Low levels of calcium in a blood test might

> > indicate if this is a problem. Possibly ingestion of calcium might

> > bring one out of the spasm. There are many reasons for low calcium

> > and one should consult an MD to uncover your own problem. Since a

> > cramp is a spasm, athletes often get leg cramps from loss of salt

> > during exercise. Leg cramps while sleep often arise from too much K

> > released into the blood from respiratory acidosis (shallow breathing

> > while a sleep).

> >

> > There are two blood (serum) factors that one should be familiar

> > with in order to understand Achalasia. One is the pH of the blood.

> > This is a measure of the acidity or alkalinity of the blood.

> > Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> > acid and 7-14 alkaline. The blood is normally slightly alkaline at

> > 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> > lower or higher will lead to death within hours. pH is a logarithmic

> > scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> > not change from 7.4 more that plus or minus 0.2 or one will get

> > sick. The body has a quick response to adjusting the pH to safe

> > values. Food, liquid, drugs and breathing can change the pH of the

> > blood but only by a very small, but important amount. If the blood

> > goes acid, a small amount of K falls out of the body cells into the

> > blood and if the blood goes alkaline a small amount of K is forced

> > into the body cells from the blood. The second factor in the blood is

> > the ratio of Na to K.

> >

> > Blood serum requires a certain ratio of Na to K in the blood and this

> > is about 28 to 1. This ratio is the same as the ratio of Na to K in

> > sea water which is cited as a reason why man may have originated in

> > sea water. This ratio changes with the pH of the blood, because K is

> > either dropped out of the blood with acidity or forced back into the

> > cells with alkalinity. The ratio is not used in normal medicine but

> > I will use it since it provides clues to the patient as to when and

> > why he is in Achalasia. This ratio can not deviate very far from

> > this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> > By misfire I mean that when the blood is alkaline the nerves become

> > over excited to, at a maximum, one could go into convulsions. When

> > in acidity it decreases its acidity to, at a minimum, one could go

> > into a coma. Different nerves and nerve pathways may have a slightly

> > different pH, and may also response differently to the same pH so all

> > the nerves do not fail at the same time. Nerves close to the gastro

> > tract may respond faster to food, drugs, and liquid changes than leg

> > and arm nerves because the food is in immediate contact with the

> > nerves. Also some of the organs (possibly the cardia valve) may be

> > supplied solely by the Vagus nerve.

> >

> > I think of pH and Na to K as related since if the pH changes the

> > ratio of Na to K also changes. Thus if K is high the blood is acid,

> > and if K is low the blood is alkaline.

> >

> > The body stores a large amount of K in the body cells and a much

> > smaller amount in the blood. Na stores a large amount in the extra

> > cellular fluids and blood and very little in body cells. There is a

> > mechanism to keep this in the proper balance called the Na-K pump.

> > There are other ways to balance the absolute amount of K in the

> > blood, some very fast and others slow, as a change of K by a factor

> > of three can kill. Na is not held under as strict a control. There

> > are clinical values for absolute values of Na and K and a variation

> > from these values can be an indication of something wrong in the body.

> >

> > The nerves require the proper pH (or ratio of Na to K) for proper

> > firing of the nerves. The proper ratio can be changed temporarily by

> > foods, liquids, drugs or breathing. Then there are semipermeant

> > disorders that bias the ratio for long periods of time. I say

> > semipermeant because they may come and go over weeks, months or years

> > and the disorder create these biases might possibly be cured. For

> > instance, for 17 years I would go in and out hypothyroidism on very

> > irregular schedule related to my level of stress. Today, I am out of

> > it for many months and I fall into it for a week or two, at the

> > most. In my case high stress is apt to bring on hypothyroidism.

> > Hypothyroidism can be present without the patient or his MD being

> > aware of. My 17 year spell with hypothyroidism was never detected by

> > my MD even thought I suspected I was in it but my blood tests never

> > reveal it, probably because I drifted in and out of it and it never

> > was present when a blood test were taken. Also I tried to control my

> > excess of K by eating less K foods while in hypothyroidism to control

> > atrail fibrillation (a nerve firing problem). Thus, it is not

> > surprising that blood tests did not reveal excess K.

> >

> > A temporary event can be created by breathing, either hyper, or

> > hypoventilation. Hyperventilation (respiratory alkalosis) will push

> > K back into the body cell from the blood serum and hypoventilation

> > (respiratory acidosis) will drop K out of the body cells into the

> > blood. This is very fast acting and I use it to alter the K in my

> > blood. Some short term events can last a long time, I normally

> > hypoventilate because of a sunken chest, thus a short term event

> > becomes a long term, event.

> >

> > The longer term events come under the class of metabolic acidosis or

> > metabolic alkalosis. Metabolic means a chemical event. Respiratory

> > acidosis, or respiratory alkalosis, is also a chemical event but I

> > think it is separated from metabolic since is is such a quick event.

> > Eating acid foods will act the same as respiratory acidosis and drops

> > K in the blood but since is a food process it takes longer to work

> > (minutes instead of seconds) and last longer. An antacid (Tums or

> > milk) will also make the blood alkaline and push K back into the body

> > cells from the blood. An acid drink (cola syrup, soft drinks or

> > orange juice) will drop K into the blood. Acid foods such as pickle,

> > strawberries, tomatoes, and vinegar can drop K into the blood for a

> > limited time. Food, liquids, drugs are short term events but they

> > can extend into very long events.

> >

> > Drugs can seriously change the pH. I recently read an ad in the NY

> > Times for Topamax (migraine headache) it states one side effect is

> > metabolic acidosis which will produce hyperventilation. The

> > hyperventilation will shift the blood towards neutral.

> > Hyperventilation was a part of my Achalasia.

> >

> > Some 60% of those with achalasia have an epiphrenic diverticulum.

> > This is a pouch at the cardioesophageal junction. The pouch can

> > collect food which does not go into the stomach but ferments in the

> > pouch and in the fermenting process becomes acid. I have one of

> > these pouches and I sense if I swallow a chunk of meat which stays in

> > the pouch, that it will take up to a week before the meat passes into

> > the stomach and I have much Achalasia during this period. As much as

> > I try to chew thoroughly, if I eat a steak, there always seems to be

> > a chunk that drops into the throat. I try to avoid beef steaks but I

> > seem to be able to eat ham and pork without trouble. Ground beef is

> > safe to eat.

> >

> > Long term events are diseases, such as hypothyroidism which elevates

> > K and depress Na in the blood, and hyperthyroidism which elevates Na

> > and depresses K. Low adrenal output elevates K and depress Na in the

> > blood. High adrenal output elevates Na and depresses K. Diuretics

> > can depress K, or K sparing diuretics can elevate K. Dehydration can

> > elevate Na in the blood.

> >

> > The vast majority of the population escapes Achalasia. So what is

> > differ about patients of Achalasia. I propose that short and long

> > term events do not balance out but add up. I normally

> > hypoventilate. I have been in hypothyroidism, of and on, for many

> > years, I normally eat too may K foods and avoid salty (Na--sodium

> > chloride) foods. They all add up to a low ratio of Na to K or an

> > acid blood.

> >

> > Treatment

> >

> > One can see the vast complexity of Achalasis. In fact , this

> > disorder is so complex that my method of coping with it is very

> > difficult for most patients and even more so for MD's who have very

> > little to work with, since any blood test are fleeting and reveal

> > little. It would be very difficult to handle a case with a child.

> > There is one hope and that is to cure the diseases that place the

> > ratio out of balance. For instance, my Achalasia is much diminished

> > when I am free of hypothyroidism. A patient can try to balance the K

> > foods with the Na foods, and by balance I do not mean one for one,

> > but your own requirement that minimizes Achalasia. Also try to

> > balance acid liquids and foods with alkaline ones. A parent can also

> > place a child on the same diet.

> >

> > There is a table in the 17th Edition Merck Manual that can help you

> > see how different disorders affect the Na and K levels it is on Page

> > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> > very helpful. One must evaluate what is one's problem whether too

> > much, or too little K. Na maybe the problem from too much ingestion

> > of Na (salt), which is easily solved.

> >

> > I have developed a treatment to open up the cardia valve as I eat.

> > My problem is too much K and too little salt, this will makes

> > Achalasia worse for those who are normally high on Na and low on K.

> > If you have Achalasia I believe you probably fall into one or the

> > other case, although there must be many who just eat too much salt.

> >

> > To bring myself into a normal ratio of Na to K, first, during the

> > meal I try to determine whether the meal contains enough salt or

> > whether I need to add salt. If one must add salt, it takes very

> > little salt to add the right amount. Then just before a meal I

> > mildly hyperventilated for about 15 minutes and take two Tums

> > (regular) antacids and this normally sets me up for a normal meal

> > without Achalasia. One must continue to hyperventilate during the

> > meal since normally one would hypoventilate while eating. Sometimes

> > in a restaurant, the meal comes too late, and I have been

> > hyperventilating too long, changing from too high in K to too low.

> > If I stop hyperventilating and wait about 10 minutes the ratio will

> > approach normal and I can then eat. Sometimes during the meal I will

> > eat too many K foods and Achalasia will kick in. If I eat a dill

> > pickle, strawberries, tomatoes, orange juice, etc then I will go too

> > acid which drops too much K in the blood and I am in Achalasia.

> >

> > I have no experience with low K and high Na. I would think an acid

> > drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> > (milk), would start one off correctly and the normal hypoventilation

> > while eating would also help. Eating less salty foods and more K

> > foods would also help.

> >

> > If the Na to K ratio causes misfiring of nerves and prevents the

> > cardia valve from opening, then other nerves are apt to misfire. I

> > can sense that my atrail fibrillation occurs with Achalasia, and the

> > actions I take to lower Achalasia, also lower atrail fibrillation.

> > The cardia valve, esophagus, larynx, and part of the heart and lungs

> > are controlled by nerves in the Vagus nerve. When really bad from

> > too much hypothyroidism the nerves in my legs produce peripheral

> > neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> > can appear when in hypothyroidism I wonder if gastroesophagel reflux

> > disease (GERD) might not be a different form of Achalasia in which

> > the cardia valve remains open rather that closed.

> >

> > In addition to those with too much K or too little K, patients may

> > suffer from salt (water) retention which leaves too much Na in the

> > blood. Salt retention is difficult for an MD to detect, since there

> > are no clinical tests for it. I was in heavy salt retention for 9

> > months before I understood what was wrong. Salt retention can be

> > caused by some medications and also by stress. Those that take

> > diuretics may also suffer from low K unless the diuretic is a K

> > sparing diuretic and then they may have too much K in the blood.

> > Diabetes can also influence the K levels (more than one way) see the

> > 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> > Na.

> >

> > Hyperventilation must be used with caution, just breathe deeply and

> > exhale through pursed lips to avoid over doing. Very rapid deep

> > breathing can be dangerous as the brain can get overloaded with

> > oxygen and will cut off blood flow to the brain and produce a mild

> > stroke. I think it would be very hard for this to occur if one where

> > to limit oneself to mild hyperventilation to no more than 20 minutes

> > plus eating time. The operative word here is mild. However,

> > hyperventilation (possibly antacids) is of particular danger to those

> > subjected to epileptic fits and can cause epileptic convulsive

> > attacks.

> >

> > Other controls

> >

> > I usually am able to detect when food is building up in the

> > esophagus, there is the feeling of fullness plus the beginning of

> > hiccups. I must stop eating and continue hyperventilating until the

> > cardia valve opens usually accompanied by a burp and the esophagus

> > gradually empties. If I go too far, and fill the esophagus too much,

> > the cardia valve will not open and I must heave up the contents of

> > the esophagus. Eating slowly and chewing thoroughly gives more time

> > for the cardia valve to open.

> >

> > I control nighttime regurgitation by eating early, cleaning my teeth

> > and mouth of food particles at the end of dinner and then drinking a

> > glass of water to wash every bit of food down the esophagus. If,

> > during the evening I burp and taste any food I have to go through the

> > routine again of hyperventilating, two Tums and water to open up the

> > cardia valve to flush the food from the esophagus. I count on 4 to 6

> > hours after dinner before going to bed and there must be no food or

> > liquids after dinner. Regurgitation is dangerous since it places

> > food near the trachea where it may aspirate into the lungs. Food

> > near the trachea will initiate a cough. This is important to

> > clearing the trachea of food. Aspiration can cause pneumonia and it

> > can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> > regurgitation, especially while a sleep, is important. I would never

> > use a cough medication, or sleeping pill, since the cough reflex is

> > very important in preventing aspiration into the lungs. I believe

> > sleeping on one's side reduce the risk of aspiration.

> >

> > I sleep with a wedge pillow plus a regular pillow and if I wake up in

> > regurgitation than I sleep sitting up in a reclining chair. I use the

> > hyperventilation and Tums treatment to open the cardia valve plus a

> > little bit of water to wash it down. Sometimes the cardia valve does

> > not open and if I take too much water the regurgitation is like a

> > fountain of water in my mouth (even filling my nose) so I don't like

> > to take much water at night. This is tempered by the fact that I may

> > go to sleep while trying to open the cardia valve thus failing to

> > open the valve. Some patients have severe regurgitation problems

> > (often throat cancer patient) and they can only sleep sitting up in a

> > reclining chair. I have noticed that some patients slip into

> > Achalasia without the MD being aware of it

> >

> > Another hint is that I solve the hyperventilation timing problem in

> > restaurants by using buffets, or fast food restaurants since there is

> > no long wait for the meal to appear. I have the advantage of a vast

> > pick of foods in the buffet so that I can eliminate the acid foods

> > and balance the salt and K foods. I can start hyperventilating on

> > the car journey to these restaurants.

> >

> >

> >

> > 4

> >

> >

> >

> >

> >

> > 5

> >

>

[Guest guest]

Sandy, thanks for your straightforwardness on this issue. I was only thinking

of trying this as a temporary measure.

I still have not had the motility study done...that's next for me, but in the

meantime to help get the food down -- especially at night which is the big

problem for me. Luckily for me I'm at the beginning stages and I don't have

pain.

This process was posted three years ago, so I just wondered about it.

Loved your comment about the bag, but he does not use bag to hyperventilate.

Granted, I'm not crazy about surgery - partly because I know people who still

had problems afterwards, but I do understand that there are many successes.

Thanks again and enjoy your holiday....

Eva from Chicagoland...

-- In achalasia , " toomuchclutter " <sandycarroll@...> wrote:

>

> Why would you do all this? It is dangerous, messing with the oxygen your body

gets? Really? I mean really really really. Do you want to go out do dinner

like this? Why why why when you could have surgery and eat. For the vast

majority of us? Why spend all this time and effort? That pouch he talked

about is likely the enlarged esophagus from all that food sitting there.

>

> What do you think happens when that food sits there forever, what chemical

reactions are going on and what is that doing to your blood, it is rotting

food!!!!! Yet this discussion is about tidbits of salt and alkaline and acid.

Seems like rotting food is a bigger problem? Is this a way to live life,

searching for some secret treatment that " someone " is hiding. Some vast

conspiracy is keeping the real treatment from coming forward? Going through all

this, and yes capitalizaion here: WHILE YOUR ESOPHAGUS IS STRETCHING OUT AS BIG

AS A STOMACH. The myotomy is proven over and over and over to alleviate most

all these symptoms. Do you think we are making up the fact we can eat???? Just

guessing, out of the many hundreds here, most, probably 80% have had a myotomy

or a dialation. Some too late, and regret waiting.

>

> So those are my thoughts, you asked, please don't attack, because remember you

asked. Others, please don't attack me, she asked. ly, now I'm a little

crabby. Really are you kidding, you would consider doing this instead of

getting one invasive medical treatment? Assuming you can get such treatment,

and you are medically, financially and mentally ready. Would you not have a

C-section if needed, an appendectomy? Bet you could find people who think an

appendectomy is the wrong thing to do as they lay in the emergency room,

probably the same people that would consider breathing into a bag to help w/

achalasia symptoms.

>

> Really, really, really, there is not a secret cure. We are EATING and

DRINKING almost normally after surgery. It isn't fake eating. Why, why why

suffer, when you don't have to. Why put your family through this, watching you

suffer. It is a miserable thing for your family to have to put up with.

>

> Also notice this man was 84 years old at that time. That is a whole different

proposition. I don't remember you saying you were anywhere near that age.

>

> So those are my thoughts, guess the claws weren't tucked in.

>

> Done for the day.

>

> Sandy

>

>

>

> > >

> > > 1 Jan 2006

> > >

> > > Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> > > as a nuclear physicist, then many years as a rocket scientist.

> > > Achalasia is very complex and it has taken me years to understand the

> > > small amount that I know of the process. It is possible, without

> > > surgery, to gain good control of Achalasia with this knowledge. It

> > > will be hard for an medical doctor (MD) to treat a patient since the

> > > most important blood test is not stable and can change from minute to

> > > minute. An MD can be very valuable in curing, or controlling, the

> > > many medical disorders that may contribute to Achalasia. I believe

> > > the patient needs to observe and experiment, using the information

> > > that I have uncovered, to further reduce Achalasia. I am afraid the

> > > complexity will discourage many patients and even MDs.

> > >

> > >

> > > Achalasia

> > >

> > > Introduction

> > >

> > > I believe that Achalasia relates to nerve transmission pulses. Nerve

> > > transmission is done electrically and they may be upset by abnormal

> > > changes in the conductivity of the nerves. The blood feeds the

> > > nerves and keeps it alive and healthy and the blood itself can affect

> > > the conductivity of the nerves. The body, and blood, contains

> > > electrolytes. Electrolytes are atoms, or compounds, that in solution

> > > can conduct electricity. They do this by dropping or gaining an

> > > electron (becoming an ion) with a positive or negative charge. The

> > > major electrolytes are potassium, magnesium, phosphate, sulfate,

> > > bicarbonate and small amounts of sodium, chlorate and calcium. By

> > > conductivity I do not mean the same as a metal with a flow of

> > > electrons, the conductivity in nerves is caused by potassium plus ion

> > > and sodium plus ions exchanges across the nerve fiber membrane. It

> > > is a slow flow compared to electron flow and it reinforces along the

> > > fiber as it proceeds. I will only consider potassium (K) and sodium

> > > (Na) in this report since there is such a direct link to nerve

> > > impulses. The cardia valve and the peristaltic action of the

> > > esophagus can fail under misfiring nerves. The pioneering work in

> > > this field was done by Dr. Harold Friedman and his work was published

> > > as " Ionic Solution Theory " in 1962. This text treats solutions in

> > > the body as well, as general chemistry.

> > >

> > > Cause

> > >

> > > One major cause of Achalasia is described in this article. There are

> > > at least two other causes--see Scleroderma and Chagas in the latest

> > > 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> > > informative to read the chapter on Esophageal Disorders which

> > > includes Achalasia. What I have to describe is based on accepted

> > > medical knowledge concerning nerves and transmission of nerve

> > > pulses.

> > >

> > > Achalasia (medical dictionary explanation) means failure to relax,

> > > especially of the cardia valve muscle which results in retention of

> > > food in the esophagus. A medical textbook explanation says the

> > > defect appears to originate from a loss of motor innervation, by

> > > fibers originating in the dorsal nucleus of the Vagus nerve. The

> > > Vagus nerve is a packet of nerves that runs from the brain stem down

> > > the neck into the body, most nerves run down the spinal column and

> > > branch out to the body organs. The Vagus nerve (wandering nerve)

> > > supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> > > valve, lungs, heart, etc but it is not the sole supply of nerves for

> > > most of these organs.

> > >

> > > As a point of interest, Achalasia was formerly called a Cardiospasm.

> > > This was misleading since cardia implies the heart but the cardia

> > > valve (splincter valve at the bottom of the esophagus) is just near

> > > the heart. A spasm means a contraction of a muscle but in a

> > > Cardiospasm the muscle does not contract but fails to relax. If the

> > > failure to relax was because of a cramp on top of the normal

> > > contraction of the cardia muscle I would think this would produce a

> > > pain which might be perceive as an Achalasia spasm.

> > >

> > > I have had Achalasia for 20 years and very early my body reacted to

> > > the disorder by hyperventilation which brought me out of Achalasia.

> > > From this I developed the reasoning why this was important to me but

> > > I found out later that my technique would make some patients worst.

> > > From reading letters to the Achalasia Forum I have been able to

> > > understand some of the complex reasons for Achalasia. I find

> > > experiencing Achalasia is very helpful in understanding it but I am

> > > at a loss to understand spasms since I have never had one.

> > >

> > > I have found K and Na to be the most controlling electrolytes in

> > > Achalasia and I have not worked with the other electrolytes. I

> > > suspect that low calcium may be involved in spasms since low calcium

> > > is know to excite the nerves to a point that a muscle goes into a

> > > spasm called Tetany. The low calcium can become even more of a

> > > problem if the blood goes alkaline since this adds to the excitation

> > > of the nerve system. Low levels of calcium in a blood test might

> > > indicate if this is a problem. Possibly ingestion of calcium might

> > > bring one out of the spasm. There are many reasons for low calcium

> > > and one should consult an MD to uncover your own problem. Since a

> > > cramp is a spasm, athletes often get leg cramps from loss of salt

> > > during exercise. Leg cramps while sleep often arise from too much K

> > > released into the blood from respiratory acidosis (shallow breathing

> > > while a sleep).

> > >

> > > There are two blood (serum) factors that one should be familiar

> > > with in order to understand Achalasia. One is the pH of the blood.

> > > This is a measure of the acidity or alkalinity of the blood.

> > > Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> > > acid and 7-14 alkaline. The blood is normally slightly alkaline at

> > > 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> > > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> > > lower or higher will lead to death within hours. pH is a logarithmic

> > > scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> > > not change from 7.4 more that plus or minus 0.2 or one will get

> > > sick. The body has a quick response to adjusting the pH to safe

> > > values. Food, liquid, drugs and breathing can change the pH of the

> > > blood but only by a very small, but important amount. If the blood

> > > goes acid, a small amount of K falls out of the body cells into the

> > > blood and if the blood goes alkaline a small amount of K is forced

> > > into the body cells from the blood. The second factor in the blood is

> > > the ratio of Na to K.

> > >

> > > Blood serum requires a certain ratio of Na to K in the blood and this

> > > is about 28 to 1. This ratio is the same as the ratio of Na to K in

> > > sea water which is cited as a reason why man may have originated in

> > > sea water. This ratio changes with the pH of the blood, because K is

> > > either dropped out of the blood with acidity or forced back into the

> > > cells with alkalinity. The ratio is not used in normal medicine but

> > > I will use it since it provides clues to the patient as to when and

> > > why he is in Achalasia. This ratio can not deviate very far from

> > > this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> > > By misfire I mean that when the blood is alkaline the nerves become

> > > over excited to, at a maximum, one could go into convulsions. When

> > > in acidity it decreases its acidity to, at a minimum, one could go

> > > into a coma. Different nerves and nerve pathways may have a slightly

> > > different pH, and may also response differently to the same pH so all

> > > the nerves do not fail at the same time. Nerves close to the gastro

> > > tract may respond faster to food, drugs, and liquid changes than leg

> > > and arm nerves because the food is in immediate contact with the

> > > nerves. Also some of the organs (possibly the cardia valve) may be

> > > supplied solely by the Vagus nerve.

> > >

> > > I think of pH and Na to K as related since if the pH changes the

> > > ratio of Na to K also changes. Thus if K is high the blood is acid,

> > > and if K is low the blood is alkaline.

> > >

> > > The body stores a large amount of K in the body cells and a much

> > > smaller amount in the blood. Na stores a large amount in the extra

> > > cellular fluids and blood and very little in body cells. There is a

> > > mechanism to keep this in the proper balance called the Na-K pump.

> > > There are other ways to balance the absolute amount of K in the

> > > blood, some very fast and others slow, as a change of K by a factor

> > > of three can kill. Na is not held under as strict a control. There

> > > are clinical values for absolute values of Na and K and a variation

> > > from these values can be an indication of something wrong in the body.

> > >

> > > The nerves require the proper pH (or ratio of Na to K) for proper

> > > firing of the nerves. The proper ratio can be changed temporarily by

> > > foods, liquids, drugs or breathing. Then there are semipermeant

> > > disorders that bias the ratio for long periods of time. I say

> > > semipermeant because they may come and go over weeks, months or years

> > > and the disorder create these biases might possibly be cured. For

> > > instance, for 17 years I would go in and out hypothyroidism on very

> > > irregular schedule related to my level of stress. Today, I am out of

> > > it for many months and I fall into it for a week or two, at the

> > > most. In my case high stress is apt to bring on hypothyroidism.

> > > Hypothyroidism can be present without the patient or his MD being

> > > aware of. My 17 year spell with hypothyroidism was never detected by

> > > my MD even thought I suspected I was in it but my blood tests never

> > > reveal it, probably because I drifted in and out of it and it never

> > > was present when a blood test were taken. Also I tried to control my

> > > excess of K by eating less K foods while in hypothyroidism to control

> > > atrail fibrillation (a nerve firing problem). Thus, it is not

> > > surprising that blood tests did not reveal excess K.

> > >

> > > A temporary event can be created by breathing, either hyper, or

> > > hypoventilation. Hyperventilation (respiratory alkalosis) will push

> > > K back into the body cell from the blood serum and hypoventilation

> > > (respiratory acidosis) will drop K out of the body cells into the

> > > blood. This is very fast acting and I use it to alter the K in my

> > > blood. Some short term events can last a long time, I normally

> > > hypoventilate because of a sunken chest, thus a short term event

> > > becomes a long term, event.

> > >

> > > The longer term events come under the class of metabolic acidosis or

> > > metabolic alkalosis. Metabolic means a chemical event. Respiratory

> > > acidosis, or respiratory alkalosis, is also a chemical event but I

> > > think it is separated from metabolic since is is such a quick event.

> > > Eating acid foods will act the same as respiratory acidosis and drops

> > > K in the blood but since is a food process it takes longer to work

> > > (minutes instead of seconds) and last longer. An antacid (Tums or

> > > milk) will also make the blood alkaline and push K back into the body

> > > cells from the blood. An acid drink (cola syrup, soft drinks or

> > > orange juice) will drop K into the blood. Acid foods such as pickle,

> > > strawberries, tomatoes, and vinegar can drop K into the blood for a

> > > limited time. Food, liquids, drugs are short term events but they

> > > can extend into very long events.

> > >

> > > Drugs can seriously change the pH. I recently read an ad in the NY

> > > Times for Topamax (migraine headache) it states one side effect is

> > > metabolic acidosis which will produce hyperventilation. The

> > > hyperventilation will shift the blood towards neutral.

> > > Hyperventilation was a part of my Achalasia.

> > >

> > > Some 60% of those with achalasia have an epiphrenic diverticulum.

> > > This is a pouch at the cardioesophageal junction. The pouch can

> > > collect food which does not go into the stomach but ferments in the

> > > pouch and in the fermenting process becomes acid. I have one of

> > > these pouches and I sense if I swallow a chunk of meat which stays in

> > > the pouch, that it will take up to a week before the meat passes into

> > > the stomach and I have much Achalasia during this period. As much as

> > > I try to chew thoroughly, if I eat a steak, there always seems to be

> > > a chunk that drops into the throat. I try to avoid beef steaks but I

> > > seem to be able to eat ham and pork without trouble. Ground beef is

> > > safe to eat.

> > >

> > > Long term events are diseases, such as hypothyroidism which elevates

> > > K and depress Na in the blood, and hyperthyroidism which elevates Na

> > > and depresses K. Low adrenal output elevates K and depress Na in the

> > > blood. High adrenal output elevates Na and depresses K. Diuretics

> > > can depress K, or K sparing diuretics can elevate K. Dehydration can

> > > elevate Na in the blood.

> > >

> > > The vast majority of the population escapes Achalasia. So what is

> > > differ about patients of Achalasia. I propose that short and long

> > > term events do not balance out but add up. I normally

> > > hypoventilate. I have been in hypothyroidism, of and on, for many

> > > years, I normally eat too may K foods and avoid salty (Na--sodium

> > > chloride) foods. They all add up to a low ratio of Na to K or an

> > > acid blood.

> > >

> > > Treatment

> > >

> > > One can see the vast complexity of Achalasis. In fact , this

> > > disorder is so complex that my method of coping with it is very

> > > difficult for most patients and even more so for MD's who have very

> > > little to work with, since any blood test are fleeting and reveal

> > > little. It would be very difficult to handle a case with a child.

> > > There is one hope and that is to cure the diseases that place the

> > > ratio out of balance. For instance, my Achalasia is much diminished

> > > when I am free of hypothyroidism. A patient can try to balance the K

> > > foods with the Na foods, and by balance I do not mean one for one,

> > > but your own requirement that minimizes Achalasia. Also try to

> > > balance acid liquids and foods with alkaline ones. A parent can also

> > > place a child on the same diet.

> > >

> > > There is a table in the 17th Edition Merck Manual that can help you

> > > see how different disorders affect the Na and K levels it is on Page

> > > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> > > very helpful. One must evaluate what is one's problem whether too

> > > much, or too little K. Na maybe the problem from too much ingestion

> > > of Na (salt), which is easily solved.

> > >

> > > I have developed a treatment to open up the cardia valve as I eat.

> > > My problem is too much K and too little salt, this will makes

> > > Achalasia worse for those who are normally high on Na and low on K.

> > > If you have Achalasia I believe you probably fall into one or the

> > > other case, although there must be many who just eat too much salt.

> > >

> > > To bring myself into a normal ratio of Na to K, first, during the

> > > meal I try to determine whether the meal contains enough salt or

> > > whether I need to add salt. If one must add salt, it takes very

> > > little salt to add the right amount. Then just before a meal I

> > > mildly hyperventilated for about 15 minutes and take two Tums

> > > (regular) antacids and this normally sets me up for a normal meal

> > > without Achalasia. One must continue to hyperventilate during the

> > > meal since normally one would hypoventilate while eating. Sometimes

> > > in a restaurant, the meal comes too late, and I have been

> > > hyperventilating too long, changing from too high in K to too low.

> > > If I stop hyperventilating and wait about 10 minutes the ratio will

> > > approach normal and I can then eat. Sometimes during the meal I will

> > > eat too many K foods and Achalasia will kick in. If I eat a dill

> > > pickle, strawberries, tomatoes, orange juice, etc then I will go too

> > > acid which drops too much K in the blood and I am in Achalasia.

> > >

> > > I have no experience with low K and high Na. I would think an acid

> > > drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> > > (milk), would start one off correctly and the normal hypoventilation

> > > while eating would also help. Eating less salty foods and more K

> > > foods would also help.

> > >

> > > If the Na to K ratio causes misfiring of nerves and prevents the

> > > cardia valve from opening, then other nerves are apt to misfire. I

> > > can sense that my atrail fibrillation occurs with Achalasia, and the

> > > actions I take to lower Achalasia, also lower atrail fibrillation.

> > > The cardia valve, esophagus, larynx, and part of the heart and lungs

> > > are controlled by nerves in the Vagus nerve. When really bad from

> > > too much hypothyroidism the nerves in my legs produce peripheral

> > > neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> > > can appear when in hypothyroidism I wonder if gastroesophagel reflux

> > > disease (GERD) might not be a different form of Achalasia in which

> > > the cardia valve remains open rather that closed.

> > >

> > > In addition to those with too much K or too little K, patients may

> > > suffer from salt (water) retention which leaves too much Na in the

> > > blood. Salt retention is difficult for an MD to detect, since there

> > > are no clinical tests for it. I was in heavy salt retention for 9

> > > months before I understood what was wrong. Salt retention can be

> > > caused by some medications and also by stress. Those that take

> > > diuretics may also suffer from low K unless the diuretic is a K

> > > sparing diuretic and then they may have too much K in the blood.

> > > Diabetes can also influence the K levels (more than one way) see the

> > > 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> > > Na.

> > >

> > > Hyperventilation must be used with caution, just breathe deeply and

> > > exhale through pursed lips to avoid over doing. Very rapid deep

> > > breathing can be dangerous as the brain can get overloaded with

> > > oxygen and will cut off blood flow to the brain and produce a mild

> > > stroke. I think it would be very hard for this to occur if one where

> > > to limit oneself to mild hyperventilation to no more than 20 minutes

> > > plus eating time. The operative word here is mild. However,

> > > hyperventilation (possibly antacids) is of particular danger to those

> > > subjected to epileptic fits and can cause epileptic convulsive

> > > attacks.

> > >

> > > Other controls

> > >

> > > I usually am able to detect when food is building up in the

> > > esophagus, there is the feeling of fullness plus the beginning of

> > > hiccups. I must stop eating and continue hyperventilating until the

> > > cardia valve opens usually accompanied by a burp and the esophagus

> > > gradually empties. If I go too far, and fill the esophagus too much,

> > > the cardia valve will not open and I must heave up the contents of

> > > the esophagus. Eating slowly and chewing thoroughly gives more time

> > > for the cardia valve to open.

> > >

> > > I control nighttime regurgitation by eating early, cleaning my teeth

> > > and mouth of food particles at the end of dinner and then drinking a

> > > glass of water to wash every bit of food down the esophagus. If,

> > > during the evening I burp and taste any food I have to go through the

> > > routine again of hyperventilating, two Tums and water to open up the

> > > cardia valve to flush the food from the esophagus. I count on 4 to 6

> > > hours after dinner before going to bed and there must be no food or

> > > liquids after dinner. Regurgitation is dangerous since it places

> > > food near the trachea where it may aspirate into the lungs. Food

> > > near the trachea will initiate a cough. This is important to

> > > clearing the trachea of food. Aspiration can cause pneumonia and it

> > > can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> > > regurgitation, especially while a sleep, is important. I would never

> > > use a cough medication, or sleeping pill, since the cough reflex is

> > > very important in preventing aspiration into the lungs. I believe

> > > sleeping on one's side reduce the risk of aspiration.

> > >

> > > I sleep with a wedge pillow plus a regular pillow and if I wake up in

> > > regurgitation than I sleep sitting up in a reclining chair. I use the

> > > hyperventilation and Tums treatment to open the cardia valve plus a

> > > little bit of water to wash it down. Sometimes the cardia valve does

> > > not open and if I take too much water the regurgitation is like a

> > > fountain of water in my mouth (even filling my nose) so I don't like

> > > to take much water at night. This is tempered by the fact that I may

> > > go to sleep while trying to open the cardia valve thus failing to

> > > open the valve. Some patients have severe regurgitation problems

> > > (often throat cancer patient) and they can only sleep sitting up in a

> > > reclining chair. I have noticed that some patients slip into

> > > Achalasia without the MD being aware of it

> > >

> > > Another hint is that I solve the hyperventilation timing problem in

> > > restaurants by using buffets, or fast food restaurants since there is

> > > no long wait for the meal to appear. I have the advantage of a vast

> > > pick of foods in the buffet so that I can eliminate the acid foods

> > > and balance the salt and K foods. I can start hyperventilating on

> > > the car journey to these restaurants.

> > >

> > >

> > >

> > > 4

> > >

> > >

> > >

> > >

> > >

> > > 5

> > >

> >

>

[Guest guest]

Eva,

 

I read for the first time today, the explanation of how to balace Na and K is a

bit cumbersome i believe. Never tried hyperventilation with that purpose but i

think can be done just to see if gives any good or no indication.

Hyperventilation is commonly used by apnea divers and by the way i never heard

of anybody dying of too much breathing.

 

There was (is?) a group called Alternative treatment for achalasia that was run

by Quincia where we used to share our experiences on alternative treatments.

 

cheers

 

mauro

From: goldenmtgoat <egaira@...>

Subject: Re: achalasia process

achalasia

Date: Sunday, April 12, 2009, 7:38 PM

From Eva: I read and reread this information. ..Did it help any of you? It seems

like a really long time to hyperventilate. I'm often preparing the meal so

sitting there and hyperventilating is not easy.

But it seems like a good method to clear my esophagaus before going to bed --if

it is not empty.

Thanking you in advance for you thoughts...Eva from Chicagoland

>

> 1 Jan 2006

>

> Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> as a nuclear physicist, then many years as a rocket scientist.

> Achalasia is very complex and it has taken me years to understand the

> small amount that I know of the process. It is possible, without

> surgery, to gain good control of Achalasia with this knowledge. It

> will be hard for an medical doctor (MD) to treat a patient since the

> most important blood test is not stable and can change from minute to

> minute. An MD can be very valuable in curing, or controlling, the

> many medical disorders that may contribute to Achalasia. I believe

> the patient needs to observe and experiment, using the information

> that I have uncovered, to further reduce Achalasia. I am afraid the

> complexity will discourage many patients and even MDs.

>

>

> Achalasia

>

> Introduction

>

> I believe that Achalasia relates to nerve transmission pulses. Nerve

> transmission is done electrically and they may be upset by abnormal

> changes in the conductivity of the nerves. The blood feeds the

> nerves and keeps it alive and healthy and the blood itself can affect

> the conductivity of the nerves. The body, and blood, contains

> electrolytes. Electrolytes are atoms, or compounds, that in solution

> can conduct electricity. They do this by dropping or gaining an

> electron (becoming an ion) with a positive or negative charge. The

> major electrolytes are potassium, magnesium, phosphate, sulfate,

> bicarbonate and small amounts of sodium, chlorate and calcium. By

> conductivity I do not mean the same as a metal with a flow of

> electrons, the conductivity in nerves is caused by potassium plus ion

> and sodium plus ions exchanges across the nerve fiber membrane. It

> is a slow flow compared to electron flow and it reinforces along the

> fiber as it proceeds. I will only consider potassium (K) and sodium

> (Na) in this report since there is such a direct link to nerve

> impulses. The cardia valve and the peristaltic action of the

> esophagus can fail under misfiring nerves. The pioneering work in

> this field was done by Dr. Harold Friedman and his work was published

> as " Ionic Solution Theory " in 1962. This text treats solutions in

> the body as well, as general chemistry.

>

> Cause

>

> One major cause of Achalasia is described in this article. There are

> at least two other causes--see Scleroderma and Chagas in the latest

> 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> informative to read the chapter on Esophageal Disorders which

> includes Achalasia. What I have to describe is based on accepted

> medical knowledge concerning nerves and transmission of nerve

> pulses.

>

> Achalasia (medical dictionary explanation) means failure to relax,

> especially of the cardia valve muscle which results in retention of

> food in the esophagus. A medical textbook explanation says the

> defect appears to originate from a loss of motor innervation, by

> fibers originating in the dorsal nucleus of the Vagus nerve. The

> Vagus nerve is a packet of nerves that runs from the brain stem down

> the neck into the body, most nerves run down the spinal column and

> branch out to the body organs. The Vagus nerve (wandering nerve)

> supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> valve, lungs, heart, etc but it is not the sole supply of nerves for

> most of these organs.

>

> As a point of interest, Achalasia was formerly called a Cardiospasm.

> This was misleading since cardia implies the heart but the cardia

> valve (splincter valve at the bottom of the esophagus) is just near

> the heart. A spasm means a contraction of a muscle but in a

> Cardiospasm the muscle does not contract but fails to relax. If the

> failure to relax was because of a cramp on top of the normal

> contraction of the cardia muscle I would think this would produce a

> pain which might be perceive as an Achalasia spasm.

>

> I have had Achalasia for 20 years and very early my body reacted to

> the disorder by hyperventilation which brought me out of Achalasia.

> From this I developed the reasoning why this was important to me but

> I found out later that my technique would make some patients worst.

> From reading letters to the Achalasia Forum I have been able to

> understand some of the complex reasons for Achalasia. I find

> experiencing Achalasia is very helpful in understanding it but I am

> at a loss to understand spasms since I have never had one.

>

> I have found K and Na to be the most controlling electrolytes in

> Achalasia and I have not worked with the other electrolytes. I

> suspect that low calcium may be involved in spasms since low calcium

> is know to excite the nerves to a point that a muscle goes into a

> spasm called Tetany. The low calcium can become even more of a

> problem if the blood goes alkaline since this adds to the excitation

> of the nerve system. Low levels of calcium in a blood test might

> indicate if this is a problem. Possibly ingestion of calcium might

> bring one out of the spasm. There are many reasons for low calcium

> and one should consult an MD to uncover your own problem. Since a

> cramp is a spasm, athletes often get leg cramps from loss of salt

> during exercise. Leg cramps while sleep often arise from too much K

> released into the blood from respiratory acidosis (shallow breathing

> while a sleep).

>

> There are two blood (serum) factors that one should be familiar

> with in order to understand Achalasia. One is the pH of the blood.

> This is a measure of the acidity or alkalinity of the blood.

> Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> acid and 7-14 alkaline. The blood is normally slightly alkaline at

> 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> lower or higher will lead to death within hours. pH is a logarithmic

> scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> not change from 7.4 more that plus or minus 0.2 or one will get

> sick. The body has a quick response to adjusting the pH to safe

> values. Food, liquid, drugs and breathing can change the pH of the

> blood but only by a very small, but important amount. If the blood

> goes acid, a small amount of K falls out of the body cells into the

> blood and if the blood goes alkaline a small amount of K is forced

> into the body cells from the blood. The second factor in the blood is

> the ratio of Na to K.

>

> Blood serum requires a certain ratio of Na to K in the blood and this

> is about 28 to 1. This ratio is the same as the ratio of Na to K in

> sea water which is cited as a reason why man may have originated in

> sea water. This ratio changes with the pH of the blood, because K is

> either dropped out of the blood with acidity or forced back into the

> cells with alkalinity. The ratio is not used in normal medicine but

> I will use it since it provides clues to the patient as to when and

> why he is in Achalasia. This ratio can not deviate very far from

> this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> By misfire I mean that when the blood is alkaline the nerves become

> over excited to, at a maximum, one could go into convulsions. When

> in acidity it decreases its acidity to, at a minimum, one could go

> into a coma. Different nerves and nerve pathways may have a slightly

> different pH, and may also response differently to the same pH so all

> the nerves do not fail at the same time. Nerves close to the gastro

> tract may respond faster to food, drugs, and liquid changes than leg

> and arm nerves because the food is in immediate contact with the

> nerves. Also some of the organs (possibly the cardia valve) may be

> supplied solely by the Vagus nerve.

>

> I think of pH and Na to K as related since if the pH changes the

> ratio of Na to K also changes. Thus if K is high the blood is acid,

> and if K is low the blood is alkaline.

>

> The body stores a large amount of K in the body cells and a much

> smaller amount in the blood. Na stores a large amount in the extra

> cellular fluids and blood and very little in body cells. There is a

> mechanism to keep this in the proper balance called the Na-K pump.

> There are other ways to balance the absolute amount of K in the

> blood, some very fast and others slow, as a change of K by a factor

> of three can kill. Na is not held under as strict a control. There

> are clinical values for absolute values of Na and K and a variation

> from these values can be an indication of something wrong in the body.

>

> The nerves require the proper pH (or ratio of Na to K) for proper

> firing of the nerves. The proper ratio can be changed temporarily by

> foods, liquids, drugs or breathing. Then there are semipermeant

> disorders that bias the ratio for long periods of time. I say

> semipermeant because they may come and go over weeks, months or years

> and the disorder create these biases might possibly be cured. For

> instance, for 17 years I would go in and out hypothyroidism on very

> irregular schedule related to my level of stress. Today, I am out of

> it for many months and I fall into it for a week or two, at the

> most. In my case high stress is apt to bring on hypothyroidism.

> Hypothyroidism can be present without the patient or his MD being

> aware of. My 17 year spell with hypothyroidism was never detected by

> my MD even thought I suspected I was in it but my blood tests never

> reveal it, probably because I drifted in and out of it and it never

> was present when a blood test were taken. Also I tried to control my

> excess of K by eating less K foods while in hypothyroidism to control

> atrail fibrillation (a nerve firing problem). Thus, it is not

> surprising that blood tests did not reveal excess K.

>

> A temporary event can be created by breathing, either hyper, or

> hypoventilation. Hyperventilation (respiratory alkalosis) will push

> K back into the body cell from the blood serum and hypoventilation

> (respiratory acidosis) will drop K out of the body cells into the

> blood. This is very fast acting and I use it to alter the K in my

> blood. Some short term events can last a long time, I normally

> hypoventilate because of a sunken chest, thus a short term event

> becomes a long term, event.

>

> The longer term events come under the class of metabolic acidosis or

> metabolic alkalosis. Metabolic means a chemical event. Respiratory

> acidosis, or respiratory alkalosis, is also a chemical event but I

> think it is separated from metabolic since is is such a quick event.

> Eating acid foods will act the same as respiratory acidosis and drops

> K in the blood but since is a food process it takes longer to work

> (minutes instead of seconds) and last longer. An antacid (Tums or

> milk) will also make the blood alkaline and push K back into the body

> cells from the blood. An acid drink (cola syrup, soft drinks or

> orange juice) will drop K into the blood. Acid foods such as pickle,

> strawberries, tomatoes, and vinegar can drop K into the blood for a

> limited time. Food, liquids, drugs are short term events but they

> can extend into very long events.

>

> Drugs can seriously change the pH. I recently read an ad in the NY

> Times for Topamax (migraine headache) it states one side effect is

> metabolic acidosis which will produce hyperventilation. The

> hyperventilation will shift the blood towards neutral.

> Hyperventilation was a part of my Achalasia.

>

> Some 60% of those with achalasia have an epiphrenic diverticulum.

> This is a pouch at the cardioesophageal junction. The pouch can

> collect food which does not go into the stomach but ferments in the

> pouch and in the fermenting process becomes acid. I have one of

> these pouches and I sense if I swallow a chunk of meat which stays in

> the pouch, that it will take up to a week before the meat passes into

> the stomach and I have much Achalasia during this period. As much as

> I try to chew thoroughly, if I eat a steak, there always seems to be

> a chunk that drops into the throat. I try to avoid beef steaks but I

> seem to be able to eat ham and pork without trouble. Ground beef is

> safe to eat.

>

> Long term events are diseases, such as hypothyroidism which elevates

> K and depress Na in the blood, and hyperthyroidism which elevates Na

> and depresses K. Low adrenal output elevates K and depress Na in the

> blood. High adrenal output elevates Na and depresses K. Diuretics

> can depress K, or K sparing diuretics can elevate K. Dehydration can

> elevate Na in the blood.

>

> The vast majority of the population escapes Achalasia. So what is

> differ about patients of Achalasia. I propose that short and long

> term events do not balance out but add up. I normally

> hypoventilate. I have been in hypothyroidism, of and on, for many

> years, I normally eat too may K foods and avoid salty (Na--sodium

> chloride) foods. They all add up to a low ratio of Na to K or an

> acid blood.

>

> Treatment

>

> One can see the vast complexity of Achalasis. In fact , this

> disorder is so complex that my method of coping with it is very

> difficult for most patients and even more so for MD's who have very

> little to work with, since any blood test are fleeting and reveal

> little. It would be very difficult to handle a case with a child.

> There is one hope and that is to cure the diseases that place the

> ratio out of balance. For instance, my Achalasia is much diminished

> when I am free of hypothyroidism. A patient can try to balance the K

> foods with the Na foods, and by balance I do not mean one for one,

> but your own requirement that minimizes Achalasia. Also try to

> balance acid liquids and foods with alkaline ones. A parent can also

> place a child on the same diet.

>

> There is a table in the 17th Edition Merck Manual that can help you

> see how different disorders affect the Na and K levels it is on Page

> 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> very helpful. One must evaluate what is one's problem whether too

> much, or too little K. Na maybe the problem from too much ingestion

> of Na (salt), which is easily solved.

>

> I have developed a treatment to open up the cardia valve as I eat.

> My problem is too much K and too little salt, this will makes

> Achalasia worse for those who are normally high on Na and low on K.

> If you have Achalasia I believe you probably fall into one or the

> other case, although there must be many who just eat too much salt.

>

> To bring myself into a normal ratio of Na to K, first, during the

> meal I try to determine whether the meal contains enough salt or

> whether I need to add salt. If one must add salt, it takes very

> little salt to add the right amount. Then just before a meal I

> mildly hyperventilated for about 15 minutes and take two Tums

> (regular) antacids and this normally sets me up for a normal meal

> without Achalasia. One must continue to hyperventilate during the

> meal since normally one would hypoventilate while eating. Sometimes

> in a restaurant, the meal comes too late, and I have been

> hyperventilating too long, changing from too high in K to too low.

> If I stop hyperventilating and wait about 10 minutes the ratio will

> approach normal and I can then eat. Sometimes during the meal I will

> eat too many K foods and Achalasia will kick in. If I eat a dill

> pickle, strawberries, tomatoes, orange juice, etc then I will go too

> acid which drops too much K in the blood and I am in Achalasia.

>

> I have no experience with low K and high Na. I would think an acid

> drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> (milk), would start one off correctly and the normal hypoventilation

> while eating would also help. Eating less salty foods and more K

> foods would also help.

>

> If the Na to K ratio causes misfiring of nerves and prevents the

> cardia valve from opening, then other nerves are apt to misfire. I

> can sense that my atrail fibrillation occurs with Achalasia, and the

> actions I take to lower Achalasia, also lower atrail fibrillation.

> The cardia valve, esophagus, larynx, and part of the heart and lungs

> are controlled by nerves in the Vagus nerve. When really bad from

> too much hypothyroidism the nerves in my legs produce peripheral

> neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> can appear when in hypothyroidism I wonder if gastroesophagel reflux

> disease (GERD) might not be a different form of Achalasia in which

> the cardia valve remains open rather that closed.

>

> In addition to those with too much K or too little K, patients may

> suffer from salt (water) retention which leaves too much Na in the

> blood. Salt retention is difficult for an MD to detect, since there

> are no clinical tests for it. I was in heavy salt retention for 9

> months before I understood what was wrong. Salt retention can be

> caused by some medications and also by stress. Those that take

> diuretics may also suffer from low K unless the diuretic is a K

> sparing diuretic and then they may have too much K in the blood.

> Diabetes can also influence the K levels (more than one way) see the

> 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> Na.

>

> Hyperventilation must be used with caution, just breathe deeply and

> exhale through pursed lips to avoid over doing. Very rapid deep

> breathing can be dangerous as the brain can get overloaded with

> oxygen and will cut off blood flow to the brain and produce a mild

> stroke. I think it would be very hard for this to occur if one where

> to limit oneself to mild hyperventilation to no more than 20 minutes

> plus eating time. The operative word here is mild. However,

> hyperventilation (possibly antacids) is of particular danger to those

> subjected to epileptic fits and can cause epileptic convulsive

> attacks.

>

> Other controls

>

> I usually am able to detect when food is building up in the

> esophagus, there is the feeling of fullness plus the beginning of

> hiccups. I must stop eating and continue hyperventilating until the

> cardia valve opens usually accompanied by a burp and the esophagus

> gradually empties. If I go too far, and fill the esophagus too much,

> the cardia valve will not open and I must heave up the contents of

> the esophagus. Eating slowly and chewing thoroughly gives more time

> for the cardia valve to open.

>

> I control nighttime regurgitation by eating early, cleaning my teeth

> and mouth of food particles at the end of dinner and then drinking a

> glass of water to wash every bit of food down the esophagus. If,

> during the evening I burp and taste any food I have to go through the

> routine again of hyperventilating, two Tums and water to open up the

> cardia valve to flush the food from the esophagus. I count on 4 to 6

> hours after dinner before going to bed and there must be no food or

> liquids after dinner. Regurgitation is dangerous since it places

> food near the trachea where it may aspirate into the lungs. Food

> near the trachea will initiate a cough. This is important to

> clearing the trachea of food. Aspiration can cause pneumonia and it

> can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> regurgitation, especially while a sleep, is important. I would never

> use a cough medication, or sleeping pill, since the cough reflex is

> very important in preventing aspiration into the lungs. I believe

> sleeping on one's side reduce the risk of aspiration.

>

> I sleep with a wedge pillow plus a regular pillow and if I wake up in

> regurgitation than I sleep sitting up in a reclining chair. I use the

> hyperventilation and Tums treatment to open the cardia valve plus a

> little bit of water to wash it down. Sometimes the cardia valve does

> not open and if I take too much water the regurgitation is like a

> fountain of water in my mouth (even filling my nose) so I don't like

> to take much water at night. This is tempered by the fact that I may

> go to sleep while trying to open the cardia valve thus failing to

> open the valve. Some patients have severe regurgitation problems

> (often throat cancer patient) and they can only sleep sitting up in a

> reclining chair. I have noticed that some patients slip into

> Achalasia without the MD being aware of it

>

> Another hint is that I solve the hyperventilation timing problem in

> restaurants by using buffets, or fast food restaurants since there is

> no long wait for the meal to appear. I have the advantage of a vast

> pick of foods in the buffet so that I can eliminate the acid foods

> and balance the salt and K foods. I can start hyperventilating on

> the car journey to these restaurants.

>

>

>

> 4

>

>

>

>

>

> 5

>

[Guest guest]

Mauro,the website I found does not seem to be active. I can't get on it. Which

one are you referring to:

Eva

> >

> > 1 Jan 2006

> >

> > Wallace H. Allan ---I am a retired physicist, age 84, I worked first

> > as a nuclear physicist, then many years as a rocket scientist.

> > Achalasia is very complex and it has taken me years to understand the

> > small amount that I know of the process. It is possible, without

> > surgery, to gain good control of Achalasia with this knowledge. It

> > will be hard for an medical doctor (MD) to treat a patient since the

> > most important blood test is not stable and can change from minute to

> > minute. An MD can be very valuable in curing, or controlling, the

> > many medical disorders that may contribute to Achalasia. I believe

> > the patient needs to observe and experiment, using the information

> > that I have uncovered, to further reduce Achalasia. I am afraid the

> > complexity will discourage many patients and even MDs.

> >

> >

> > Achalasia

> >

> > Introduction

> >

> > I believe that Achalasia relates to nerve transmission pulses. Nerve

> > transmission is done electrically and they may be upset by abnormal

> > changes in the conductivity of the nerves. The blood feeds the

> > nerves and keeps it alive and healthy and the blood itself can affect

> > the conductivity of the nerves. The body, and blood, contains

> > electrolytes. Electrolytes are atoms, or compounds, that in solution

> > can conduct electricity. They do this by dropping or gaining an

> > electron (becoming an ion) with a positive or negative charge. The

> > major electrolytes are potassium, magnesium, phosphate, sulfate,

> > bicarbonate and small amounts of sodium, chlorate and calcium. By

> > conductivity I do not mean the same as a metal with a flow of

> > electrons, the conductivity in nerves is caused by potassium plus ion

> > and sodium plus ions exchanges across the nerve fiber membrane. It

> > is a slow flow compared to electron flow and it reinforces along the

> > fiber as it proceeds. I will only consider potassium (K) and sodium

> > (Na) in this report since there is such a direct link to nerve

> > impulses. The cardia valve and the peristaltic action of the

> > esophagus can fail under misfiring nerves. The pioneering work in

> > this field was done by Dr. Harold Friedman and his work was published

> > as " Ionic Solution Theory " in 1962. This text treats solutions in

> > the body as well, as general chemistry.

> >

> > Cause

> >

> > One major cause of Achalasia is described in this article. There are

> > at least two other causes--see Scleroderma and Chagas in the latest

> > 17th Edition " Merck Manual of Diagnosis and Therapy " . It will be

> > informative to read the chapter on Esophageal Disorders which

> > includes Achalasia. What I have to describe is based on accepted

> > medical knowledge concerning nerves and transmission of nerve

> > pulses.

> >

> > Achalasia (medical dictionary explanation) means failure to relax,

> > especially of the cardia valve muscle which results in retention of

> > food in the esophagus. A medical textbook explanation says the

> > defect appears to originate from a loss of motor innervation, by

> > fibers originating in the dorsal nucleus of the Vagus nerve. The

> > Vagus nerve is a packet of nerves that runs from the brain stem down

> > the neck into the body, most nerves run down the spinal column and

> > branch out to the body organs. The Vagus nerve (wandering nerve)

> > supplies some nerves to the ear, tongue, larynx, esophagus, cardia

> > valve, lungs, heart, etc but it is not the sole supply of nerves for

> > most of these organs.

> >

> > As a point of interest, Achalasia was formerly called a Cardiospasm.

> > This was misleading since cardia implies the heart but the cardia

> > valve (splincter valve at the bottom of the esophagus) is just near

> > the heart. A spasm means a contraction of a muscle but in a

> > Cardiospasm the muscle does not contract but fails to relax. If the

> > failure to relax was because of a cramp on top of the normal

> > contraction of the cardia muscle I would think this would produce a

> > pain which might be perceive as an Achalasia spasm.

> >

> > I have had Achalasia for 20 years and very early my body reacted to

> > the disorder by hyperventilation which brought me out of Achalasia.

> > From this I developed the reasoning why this was important to me but

> > I found out later that my technique would make some patients worst.

> > From reading letters to the Achalasia Forum I have been able to

> > understand some of the complex reasons for Achalasia. I find

> > experiencing Achalasia is very helpful in understanding it but I am

> > at a loss to understand spasms since I have never had one.

> >

> > I have found K and Na to be the most controlling electrolytes in

> > Achalasia and I have not worked with the other electrolytes. I

> > suspect that low calcium may be involved in spasms since low calcium

> > is know to excite the nerves to a point that a muscle goes into a

> > spasm called Tetany. The low calcium can become even more of a

> > problem if the blood goes alkaline since this adds to the excitation

> > of the nerve system. Low levels of calcium in a blood test might

> > indicate if this is a problem. Possibly ingestion of calcium might

> > bring one out of the spasm. There are many reasons for low calcium

> > and one should consult an MD to uncover your own problem. Since a

> > cramp is a spasm, athletes often get leg cramps from loss of salt

> > during exercise. Leg cramps while sleep often arise from too much K

> > released into the blood from respiratory acidosis (shallow breathing

> > while a sleep).

> >

> > There are two blood (serum) factors that one should be familiar

> > with in order to understand Achalasia. One is the pH of the blood.

> > This is a measure of the acidity or alkalinity of the blood.

> > Chemically pH ranges from 0 to 14 with 7.0 the neutral point. 0-7 is

> > acid and 7-14 alkaline. The blood is normally slightly alkaline at

> > 7.40. Thus 7.40 is considered neutral and anything lower is acid and

> > higher as alkaline. The blood pH ranges from 7.0 to 7.7 and anything

> > lower or higher will lead to death within hours. pH is a logarithmic

> > scale so .7 is a change of 5X in acidity, or alkalinity. The pH will

> > not change from 7.4 more that plus or minus 0.2 or one will get

> > sick. The body has a quick response to adjusting the pH to safe

> > values. Food, liquid, drugs and breathing can change the pH of the

> > blood but only by a very small, but important amount. If the blood

> > goes acid, a small amount of K falls out of the body cells into the

> > blood and if the blood goes alkaline a small amount of K is forced

> > into the body cells from the blood. The second factor in the blood is

> > the ratio of Na to K.

> >

> > Blood serum requires a certain ratio of Na to K in the blood and this

> > is about 28 to 1. This ratio is the same as the ratio of Na to K in

> > sea water which is cited as a reason why man may have originated in

> > sea water. This ratio changes with the pH of the blood, because K is

> > either dropped out of the blood with acidity or forced back into the

> > cells with alkalinity. The ratio is not used in normal medicine but

> > I will use it since it provides clues to the patient as to when and

> > why he is in Achalasia. This ratio can not deviate very far from

> > this 28 to 1 or the nerves (the pH changes the ratio) will misfire.

> > By misfire I mean that when the blood is alkaline the nerves become

> > over excited to, at a maximum, one could go into convulsions. When

> > in acidity it decreases its acidity to, at a minimum, one could go

> > into a coma. Different nerves and nerve pathways may have a slightly

> > different pH, and may also response differently to the same pH so all

> > the nerves do not fail at the same time. Nerves close to the gastro

> > tract may respond faster to food, drugs, and liquid changes than leg

> > and arm nerves because the food is in immediate contact with the

> > nerves. Also some of the organs (possibly the cardia valve) may be

> > supplied solely by the Vagus nerve.

> >

> > I think of pH and Na to K as related since if the pH changes the

> > ratio of Na to K also changes. Thus if K is high the blood is acid,

> > and if K is low the blood is alkaline.

> >

> > The body stores a large amount of K in the body cells and a much

> > smaller amount in the blood. Na stores a large amount in the extra

> > cellular fluids and blood and very little in body cells. There is a

> > mechanism to keep this in the proper balance called the Na-K pump.

> > There are other ways to balance the absolute amount of K in the

> > blood, some very fast and others slow, as a change of K by a factor

> > of three can kill. Na is not held under as strict a control. There

> > are clinical values for absolute values of Na and K and a variation

> > from these values can be an indication of something wrong in the body.

> >

> > The nerves require the proper pH (or ratio of Na to K) for proper

> > firing of the nerves. The proper ratio can be changed temporarily by

> > foods, liquids, drugs or breathing. Then there are semipermeant

> > disorders that bias the ratio for long periods of time. I say

> > semipermeant because they may come and go over weeks, months or years

> > and the disorder create these biases might possibly be cured. For

> > instance, for 17 years I would go in and out hypothyroidism on very

> > irregular schedule related to my level of stress. Today, I am out of

> > it for many months and I fall into it for a week or two, at the

> > most. In my case high stress is apt to bring on hypothyroidism.

> > Hypothyroidism can be present without the patient or his MD being

> > aware of. My 17 year spell with hypothyroidism was never detected by

> > my MD even thought I suspected I was in it but my blood tests never

> > reveal it, probably because I drifted in and out of it and it never

> > was present when a blood test were taken. Also I tried to control my

> > excess of K by eating less K foods while in hypothyroidism to control

> > atrail fibrillation (a nerve firing problem). Thus, it is not

> > surprising that blood tests did not reveal excess K.

> >

> > A temporary event can be created by breathing, either hyper, or

> > hypoventilation. Hyperventilation (respiratory alkalosis) will push

> > K back into the body cell from the blood serum and hypoventilation

> > (respiratory acidosis) will drop K out of the body cells into the

> > blood. This is very fast acting and I use it to alter the K in my

> > blood. Some short term events can last a long time, I normally

> > hypoventilate because of a sunken chest, thus a short term event

> > becomes a long term, event.

> >

> > The longer term events come under the class of metabolic acidosis or

> > metabolic alkalosis. Metabolic means a chemical event. Respiratory

> > acidosis, or respiratory alkalosis, is also a chemical event but I

> > think it is separated from metabolic since is is such a quick event.

> > Eating acid foods will act the same as respiratory acidosis and drops

> > K in the blood but since is a food process it takes longer to work

> > (minutes instead of seconds) and last longer. An antacid (Tums or

> > milk) will also make the blood alkaline and push K back into the body

> > cells from the blood. An acid drink (cola syrup, soft drinks or

> > orange juice) will drop K into the blood. Acid foods such as pickle,

> > strawberries, tomatoes, and vinegar can drop K into the blood for a

> > limited time. Food, liquids, drugs are short term events but they

> > can extend into very long events.

> >

> > Drugs can seriously change the pH. I recently read an ad in the NY

> > Times for Topamax (migraine headache) it states one side effect is

> > metabolic acidosis which will produce hyperventilation. The

> > hyperventilation will shift the blood towards neutral.

> > Hyperventilation was a part of my Achalasia.

> >

> > Some 60% of those with achalasia have an epiphrenic diverticulum.

> > This is a pouch at the cardioesophageal junction. The pouch can

> > collect food which does not go into the stomach but ferments in the

> > pouch and in the fermenting process becomes acid. I have one of

> > these pouches and I sense if I swallow a chunk of meat which stays in

> > the pouch, that it will take up to a week before the meat passes into

> > the stomach and I have much Achalasia during this period. As much as

> > I try to chew thoroughly, if I eat a steak, there always seems to be

> > a chunk that drops into the throat. I try to avoid beef steaks but I

> > seem to be able to eat ham and pork without trouble. Ground beef is

> > safe to eat.

> >

> > Long term events are diseases, such as hypothyroidism which elevates

> > K and depress Na in the blood, and hyperthyroidism which elevates Na

> > and depresses K. Low adrenal output elevates K and depress Na in the

> > blood. High adrenal output elevates Na and depresses K. Diuretics

> > can depress K, or K sparing diuretics can elevate K. Dehydration can

> > elevate Na in the blood.

> >

> > The vast majority of the population escapes Achalasia. So what is

> > differ about patients of Achalasia. I propose that short and long

> > term events do not balance out but add up. I normally

> > hypoventilate. I have been in hypothyroidism, of and on, for many

> > years, I normally eat too may K foods and avoid salty (Na--sodium

> > chloride) foods. They all add up to a low ratio of Na to K or an

> > acid blood.

> >

> > Treatment

> >

> > One can see the vast complexity of Achalasis. In fact , this

> > disorder is so complex that my method of coping with it is very

> > difficult for most patients and even more so for MD's who have very

> > little to work with, since any blood test are fleeting and reveal

> > little. It would be very difficult to handle a case with a child.

> > There is one hope and that is to cure the diseases that place the

> > ratio out of balance. For instance, my Achalasia is much diminished

> > when I am free of hypothyroidism. A patient can try to balance the K

> > foods with the Na foods, and by balance I do not mean one for one,

> > but your own requirement that minimizes Achalasia. Also try to

> > balance acid liquids and foods with alkaline ones. A parent can also

> > place a child on the same diet.

> >

> > There is a table in the 17th Edition Merck Manual that can help you

> > see how different disorders affect the Na and K levels it is on Page

> > 2551 Table 296-5. The Table 296-4 with Na and K on Page 2549 is also

> > very helpful. One must evaluate what is one's problem whether too

> > much, or too little K. Na maybe the problem from too much ingestion

> > of Na (salt), which is easily solved.

> >

> > I have developed a treatment to open up the cardia valve as I eat.

> > My problem is too much K and too little salt, this will makes

> > Achalasia worse for those who are normally high on Na and low on K.

> > If you have Achalasia I believe you probably fall into one or the

> > other case, although there must be many who just eat too much salt.

> >

> > To bring myself into a normal ratio of Na to K, first, during the

> > meal I try to determine whether the meal contains enough salt or

> > whether I need to add salt. If one must add salt, it takes very

> > little salt to add the right amount. Then just before a meal I

> > mildly hyperventilated for about 15 minutes and take two Tums

> > (regular) antacids and this normally sets me up for a normal meal

> > without Achalasia. One must continue to hyperventilate during the

> > meal since normally one would hypoventilate while eating. Sometimes

> > in a restaurant, the meal comes too late, and I have been

> > hyperventilating too long, changing from too high in K to too low.

> > If I stop hyperventilating and wait about 10 minutes the ratio will

> > approach normal and I can then eat. Sometimes during the meal I will

> > eat too many K foods and Achalasia will kick in. If I eat a dill

> > pickle, strawberries, tomatoes, orange juice, etc then I will go too

> > acid which drops too much K in the blood and I am in Achalasia.

> >

> > I have no experience with low K and high Na. I would think an acid

> > drink (cola syrup, soft drink, orange juice) and no alkaline drinks

> > (milk), would start one off correctly and the normal hypoventilation

> > while eating would also help. Eating less salty foods and more K

> > foods would also help.

> >

> > If the Na to K ratio causes misfiring of nerves and prevents the

> > cardia valve from opening, then other nerves are apt to misfire. I

> > can sense that my atrail fibrillation occurs with Achalasia, and the

> > actions I take to lower Achalasia, also lower atrail fibrillation.

> > The cardia valve, esophagus, larynx, and part of the heart and lungs

> > are controlled by nerves in the Vagus nerve. When really bad from

> > too much hypothyroidism the nerves in my legs produce peripheral

> > neuropathy. Carpal tunnel syndrome, which is a nerve disorder, also

> > can appear when in hypothyroidism I wonder if gastroesophagel reflux

> > disease (GERD) might not be a different form of Achalasia in which

> > the cardia valve remains open rather that closed.

> >

> > In addition to those with too much K or too little K, patients may

> > suffer from salt (water) retention which leaves too much Na in the

> > blood. Salt retention is difficult for an MD to detect, since there

> > are no clinical tests for it. I was in heavy salt retention for 9

> > months before I understood what was wrong. Salt retention can be

> > caused by some medications and also by stress. Those that take

> > diuretics may also suffer from low K unless the diuretic is a K

> > sparing diuretic and then they may have too much K in the blood.

> > Diabetes can also influence the K levels (more than one way) see the

> > 17th edition Merck Manual Page 2549 Table 296-4 and read about K and

> > Na.

> >

> > Hyperventilation must be used with caution, just breathe deeply and

> > exhale through pursed lips to avoid over doing. Very rapid deep

> > breathing can be dangerous as the brain can get overloaded with

> > oxygen and will cut off blood flow to the brain and produce a mild

> > stroke. I think it would be very hard for this to occur if one where

> > to limit oneself to mild hyperventilation to no more than 20 minutes

> > plus eating time. The operative word here is mild. However,

> > hyperventilation (possibly antacids) is of particular danger to those

> > subjected to epileptic fits and can cause epileptic convulsive

> > attacks.

> >

> > Other controls

> >

> > I usually am able to detect when food is building up in the

> > esophagus, there is the feeling of fullness plus the beginning of

> > hiccups. I must stop eating and continue hyperventilating until the

> > cardia valve opens usually accompanied by a burp and the esophagus

> > gradually empties. If I go too far, and fill the esophagus too much,

> > the cardia valve will not open and I must heave up the contents of

> > the esophagus. Eating slowly and chewing thoroughly gives more time

> > for the cardia valve to open.

> >

> > I control nighttime regurgitation by eating early, cleaning my teeth

> > and mouth of food particles at the end of dinner and then drinking a

> > glass of water to wash every bit of food down the esophagus. If,

> > during the evening I burp and taste any food I have to go through the

> > routine again of hyperventilating, two Tums and water to open up the

> > cardia valve to flush the food from the esophagus. I count on 4 to 6

> > hours after dinner before going to bed and there must be no food or

> > liquids after dinner. Regurgitation is dangerous since it places

> > food near the trachea where it may aspirate into the lungs. Food

> > near the trachea will initiate a cough. This is important to

> > clearing the trachea of food. Aspiration can cause pneumonia and it

> > can infiltrate the lungs and reduce lung capacity. Anyway to reduce

> > regurgitation, especially while a sleep, is important. I would never

> > use a cough medication, or sleeping pill, since the cough reflex is

> > very important in preventing aspiration into the lungs. I believe

> > sleeping on one's side reduce the risk of aspiration.

> >

> > I sleep with a wedge pillow plus a regular pillow and if I wake up in

> > regurgitation than I sleep sitting up in a reclining chair. I use the

> > hyperventilation and Tums treatment to open the cardia valve plus a

> > little bit of water to wash it down. Sometimes the cardia valve does

> > not open and if I take too much water the regurgitation is like a

> > fountain of water in my mouth (even filling my nose) so I don't like

> > to take much water at night. This is tempered by the fact that I may

> > go to sleep while trying to open the cardia valve thus failing to

> > open the valve. Some patients have severe regurgitation problems

> > (often throat cancer patient) and they can only sleep sitting up in a

> > reclining chair. I have noticed that some patients slip into

> > Achalasia without the MD being aware of it

> >

> > Another hint is that I solve the hyperventilation timing problem in

> > restaurants by using buffets, or fast food restaurants since there is

> > no long wait for the meal to appear. I have the advantage of a vast

> > pick of foods in the buffet so that I can eliminate the acid foods

> > and balance the salt and K foods. I can start hyperventilating on

> > the car journey to these restaurants.

> >

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> > 4

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> > 5

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