Stefan: Another Question?????

[Guest guest]

Hi Sally,

We can all crunch numbers and come up with what the capacity of the esophagus would be. 1 inch diameter, pi r squared X the length, but then one thinks that with peristalsis (that we don't have), its relatively little that actually goes thru the esophagus at one time (what they call the bolis) traveling down. Then you get to the A patients where its like a cesspool filling up, and slowly "leaking out" the bottom.

Perhaps my answer is going to be a cop out, but the correct answer just might be. The answer is that it depends upon the person. How much the elasticity of the E has suffered; how sensitive the person is to the stress of a stretched E while eating. The answer can be different for each person.

Its not so much what you eat and drink, its how you eat and drink it. Do you do all your eating first, then chug down 2 cartons of Orange Juice, or have you learned to be patient and take more time to eat, while alternating with drinking. In the end, the A patient, who is systematically patient with their eating will probably finish eating first, even by being the slowest (as defined by me as the person who clears their E from their current meal first).

Stefan, by chucking his food in (being young and human and all) is probably doing himself a disservice in the long run. Our E's are only a pipeline, not a transportation system, no longer equipped for piling it in, or pigging out. We will suffer from doing other than we are capable. We all have to learn what we can tolerate, and try to stick with the regimen.

He needs to compare notes with others sharing his circumstance.

In a message dated 5/27/2006 6:14:23 A.M. Eastern Standard Time, sallyavory@... writes:

>> Thanks for the info! And now another Question????ON YOUR MARKS & & Anyone else.'Does anyone know the capacity of food and drink the E can take before it would be under strain?'GET SET...........GO!Regarding the drinking,a few on the site have answered, and in reply to you all:Stefan has a tendency to 'chuck food in' and drink 2 cartons of orange juice to wash it down, his theory is that he needs weighty food and heavy drinks. I have not questioned this up to now, but the Dr says that there was liquid coming out of the E prior to his dilatation, and this was after having no liquid for 15 hours before! There was food too (after 18hrs fasting)So it seems that when we thought the food was being forced into the stomach by the weight and liquid, we were wrong, and the E was just stretching out. So the idea now is to eat less at a sitting, try to limit the sheer volume of food and drink the E has to deal with at one time, maybe walk around/flap the arms etc. It's just something to try really, but of course, when the boy needs to drink a lot there would be no stopping him anyway.The main thing now is that he has to take the responsibility as he is off out and about all the time, and Mum can't walk behind him nagging!So we told it like it is and he seemed to take it in ok. But he is 17 and it won't be uppermost in his thoughts most of the time. I suppose he is one of those with Achalasia that is not desperately restricting to lifestyle, but deep inside it's quietly messing him up. So hard to convince him to take charge of it! I have gone on too long now............Cheers,Sally, Stefan > Hi Sally,> > According to one article, the normal E when swallowing has a diameter of > 1 inch.> > _MUSC DDC - Esophagus_ > (http://www.ddc.musc.edu/ddc_pub/digestiveOrgans/esophagus.htm) > > I just have a comment to make. (Actually 2 comments now)> > First one is that I see that beat me to the punch again.> > Second one is that, while I agree with your husband's thought of a portion > regime, I don't agree with his thought about less liquid, if possible.> > Achalasians need liquids to survive. There is no such thing as drinking too > much liquids (unless those liquids have a certain alcohol content).> > The main thing to do, whether or not one has had surgeries, balloon > dilatations, stretchings, or nothing at all, is to eat slowly, drink plenty, and have > the E cleared before going to sleep.> > > > In a message dated 5/26/2006 3:09:29 P.M. Eastern Daylight Time, > sallyavory@... writes:> > Question?? What is 'normal size' for the E?> We had a chat with Dr Rawat today and he said Stefan's E is two or > three times normal size-a bit vague I thought, but very worrying.> > So my husband has suggested a small portion regime and less liquid > if possible. I told Stef to stop fighting the regurging, and let it > come back up sometimes-he was not impressed!> > We also explained about the bagginess, and tried to get him to take > the responsibility for eating less upon his teenage crazy self. Not > easy!! Strange that none of his doctors has ever suggested a diet > for Esophagus preservation. I was quite suprised yesterday evening > when I returned from a quick phone call, back to the ward, to find > Stefan being escorted to the food trolley for heavy food. After what > I've read here, it makes sense to take it slow.....> Anyway he wheezed through the night, so I put him on the Asthma > inhaler, just to be safe.> He's not bad today, had little meals and careful with the drinks!> > , Stef is on the proton pump inhibitors already.> Hope it goes well today for Mark> Best wishes,> Sally, Stefan> > > > >> > Sally, I'm sorry to hear that Stefan had ulcers in his esophagus. > > Is the doctor going to put him back on steroids to protect his > > esophagus from inflammation? I read that the tissue is thin and > > fragile in eosinophilic esophagitis. Or a proton pump inhibitor > > to protect it from reflux, since he doesn't have the > > fundoplication? I hope he's feeling better soon and that future > > dilations are less stressful for both of you.> > > > I downloaded the Achalasia song from > > www.myspace.com/icarusburning. Mark quite likes it, as well as > > the other songs by Stefan's band.> > > > Carolyn, yes, I forgot to figure in your time difference, so your > > 3 AM posts must actually be midnight. Mark doesn't think it > > helps him to drink huge amounts of water because the water will > > get stuck behind the food, and anyway Isordil helps quite well > > whenever things are sticking. As a result he has only lost four > > or five pounds. But he has been off that for three days in > > preparation for today's endoscopy.> > > > Yesterday when he was on clear and full liquids, he didn't notice > > any sticking at all, even without Isordil. It's very unusual for > > him to have no sticking. Perhaps it means that whenever liquids > > are sticking, they're actually backed up behind solids.> > > > Maggie, I don't think Mark's esophagus is so dilated that very > > much food is hanging around in there--at least it wasn't too > > dilated when he had the barium swallow--but I will ask the doctor > > about that.> > > > I'm letting Mark sleep as late as possible today before his 12:30 > > endoscopy so he doesn't mind the lack of food and drink so much. > > Now I must go run on the treadmill for my own emotional health.> > > > > > > > Stefan's dilatation> > > > > > > Hi all,> > > Stef had the dilatation today at Chelsea & Westminster > > > Hospital. Dr> > > Rawat said there was still food in the E after 17 hrs fasting, > > > and> > > when he put him on his side liquid came out of Stefan's mouth, > > > even> > > though he had not had a drink for 15 hrs.> > > The E looks baggy apparently and some ulcers too. They took a > > > biopsy,> > > and dilated with 3 ballons up to 12mm. They will do the same > > > in a> > > month and maybe then again a month later.> > > It's all quite traumatic as he has to have full anaesthetic, > > > and all> > > that goes with it, and as any parent knows that is very > > > stressful!> > > He came out of surgery with chest pain and a 'stuck feeling', > > > and> > > wanted to drink a lot. We have him home now, and he ate soft > > > food (no> > > improvement yet), so we will wait and see.> > > All the best to you who have to go through it all,> > > and the mums who go through it too........> > > Love> > > Sally in London (bit of Sun, lots of rain)> > >> >> > > > > > > >

[Guest guest]

>

> Thanks for the info! And now another Question????

ON YOUR MARKS & & Anyone else.

'Does anyone know the capacity of food and drink the E can take

before it would be under strain?'

GET SET...........GO!

Regarding the drinking,a few on the site have answered, and in reply

to you all:

Stefan has a tendency to 'chuck food in' and drink 2 cartons of

orange juice to wash it down, his theory is that he needs weighty

food and heavy drinks. I have not questioned this up to now, but the

Dr says that there was liquid coming out of the E prior to his

dilatation, and this was after having no liquid for 15 hours before!

There was food too (after 18hrs fasting)

So it seems that when we thought the food was being forced into the

stomach by the weight and liquid, we were wrong, and the E was just

stretching out. So the idea now is to eat less at a sitting, try to

limit the sheer volume of food and drink the E has to deal with at

one time, maybe walk around/flap the arms etc.

It's just something to try really, but of course, when the boy needs

to drink a lot there would be no stopping him anyway.

The main thing now is that he has to take the responsibility as he

is off out and about all the time, and Mum can't walk behind him

nagging!

So we told it like it is and he seemed to take it in ok.

But he is 17 and it won't be uppermost in his thoughts most of the

time. I suppose he is one of those with Achalasia that is not

desperately restricting to lifestyle, but deep inside it's quietly

messing him up. So hard to convince him to take charge of it! I have

gone on too long now............

Cheers,

Sally, Stefan

> Hi Sally,

>

> According to one article, the normal E when swallowing has a

diameter of

> 1 inch.

>

> _MUSC DDC - Esophagus_

> (http://www.ddc.musc.edu/ddc_pub/digestiveOrgans/esophagus.htm)

>

> I just have a comment to make. (Actually 2 comments now)

>

> First one is that I see that beat me to the punch again.

>

> Second one is that, while I agree with your husband's thought of

a portion

> regime, I don't agree with his thought about less liquid, if

possible.

>

> Achalasians need liquids to survive. There is no such thing as

drinking too

> much liquids (unless those liquids have a certain alcohol

content).

>

> The main thing to do, whether or not one has had surgeries,

balloon

> dilatations, stretchings, or nothing at all, is to eat slowly,

drink plenty, and have

> the E cleared before going to sleep.

>

>

>

> In a message dated 5/26/2006 3:09:29 P.M. Eastern Daylight Time,

> sallyavory@... writes:

>

> Question?? What is 'normal size' for the E?

> We had a chat with Dr Rawat today and he said Stefan's E is two

or

> three times normal size-a bit vague I thought, but very worrying.

>

> So my husband has suggested a small portion regime and less

liquid

> if possible. I told Stef to stop fighting the regurging, and let

it

> come back up sometimes-he was not impressed!

>

> We also explained about the bagginess, and tried to get him to

take

> the responsibility for eating less upon his teenage crazy self.

Not

> easy!! Strange that none of his doctors has ever suggested a diet

> for Esophagus preservation. I was quite suprised yesterday

evening

> when I returned from a quick phone call, back to the ward, to

find

> Stefan being escorted to the food trolley for heavy food. After

what

> I've read here, it makes sense to take it slow.....

> Anyway he wheezed through the night, so I put him on the Asthma

> inhaler, just to be safe.

> He's not bad today, had little meals and careful with the drinks!

>

> , Stef is on the proton pump inhibitors already.

> Hope it goes well today for Mark

> Best wishes,

> Sally, Stefan

>

>

>

> >

> > Sally, I'm sorry to hear that Stefan had ulcers in his

esophagus.

> > Is the doctor going to put him back on steroids to protect his

> > esophagus from inflammation? I read that the tissue is thin

and

> > fragile in eosinophilic esophagitis. Or a proton pump

inhibitor

> > to protect it from reflux, since he doesn't have the

> > fundoplication? I hope he's feeling better soon and that

future

> > dilations are less stressful for both of you.

> >

> > I downloaded the Achalasia song from

> > www.myspace.com/icarusburning. Mark quite likes it, as well as

> > the other songs by Stefan's band.

> >

> > Carolyn, yes, I forgot to figure in your time difference, so

your

> > 3 AM posts must actually be midnight. Mark doesn't think it

> > helps him to drink huge amounts of water because the water will

> > get stuck behind the food, and anyway Isordil helps quite well

> > whenever things are sticking. As a result he has only lost

four

> > or five pounds. But he has been off that for three days in

> > preparation for today's endoscopy.

> >

> > Yesterday when he was on clear and full liquids, he didn't

notice

> > any sticking at all, even without Isordil. It's very unusual

for

> > him to have no sticking. Perhaps it means that whenever

liquids

> > are sticking, they're actually backed up behind solids.

> >

> > Maggie, I don't think Mark's esophagus is so dilated that very

> > much food is hanging around in there--at least it wasn't too

> > dilated when he had the barium swallow--but I will ask the

doctor

> > about that.

> >

> > I'm letting Mark sleep as late as possible today before his

12:30

> > endoscopy so he doesn't mind the lack of food and drink so

much.

> > Now I must go run on the treadmill for my own emotional health.

> >

> >

> >

> > Stefan's dilatation

> >

> >

> > > Hi all,

> > > Stef had the dilatation today at Chelsea & Westminster

> > > Hospital. Dr

> > > Rawat said there was still food in the E after 17 hrs

fasting,

> > > and

> > > when he put him on his side liquid came out of Stefan's

mouth,

> > > even

> > > though he had not had a drink for 15 hrs.

> > > The E looks baggy apparently and some ulcers too. They took a

> > > biopsy,

> > > and dilated with 3 ballons up to 12mm. They will do the

same

> > > in a

> > > month and maybe then again a month later.

> > > It's all quite traumatic as he has to have full anaesthetic,

> > > and all

> > > that goes with it, and as any parent knows that is very

> > > stressful!

> > > He came out of surgery with chest pain and a 'stuck feeling',

> > > and

> > > wanted to drink a lot. We have him home now, and he ate soft

> > > food (no

> > > improvement yet), so we will wait and see.

> > > All the best to you who have to go through it all,

> > > and the mums who go through it too........

> > > Love

> > > Sally in London (bit of Sun, lots of rain)

> > >

> >

>

>

>

>

>

>

>

>