Guest guest Posted September 12, 2006 Report Share Posted September 12, 2006 I finally got insurance through the state. Talk about hoops to go through. I met yesterday with my GI doc who does the dilations himself. He said he doesn't promote one over the other. He just talks more about dilations because he does them and sees the results more than the surgery side. He gave me stats and numbers, etc. comparing the two. Everything seemed to fit with everything I've read here and other places throughout the net. Except one. He said that the proper balloon size needs to be used. If it is too big a perforation may occur which requires surgery to repair the esophagus. So he errs on the side of caution with the largest balloon he thinks he can safely use. So 30-40% of the people need to come back and have it done again with a larger balloon. Once the correct balloon size is figured out he said, " it should be good for the rest of your life. Maybe one more in 5-10 years but that should be it. If the balloon doesn't work and surgery is required the surgeons usually don't do much cutting because the balloon does a great job " . I was under the understanding that balloon dilations only last 10 years at best and usually closer to 5. Real life experiences would be appreciated as I'm scheduled for a month from now for dilation. Thanks, Nate Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 Elasticity of the LES might be reduced by stretches(which happened in my case) versus going w/straight out incisions in tight resilent muscle tissue fom the get go to get the full moon. IMHO humbly.\ > > Nate, > It differs from case to case, in my case,it > lasted for 12 years... > It is worth going for a couple of dilatations before going for surgery..many people get a lot of relief from dilatations.normally , > 30 mm baloon is safe.. > Let's see what others advise... > Mukesh > > Dilation compared to H/M > > I finally got insurance through the state. Talk about hoops to go > through. > I met yesterday with my GI doc who does the dilations himself. He > said he doesn't promote one over the other. He just talks more about > dilations because he does them and sees the results more than the > surgery side. > He gave me stats and numbers, etc. comparing the two. Everything > seemed to fit with everything I've read here and other places > throughout the net. Except one. He said that the proper balloon > size needs to be used. If it is too big a perforation may occur > which requires surgery to repair the esophagus. So he errs on the > side of caution with the largest balloon he thinks he can safely > use. So 30-40% of the people need to come back and have it done > again with a larger balloon. Once the correct balloon size is > figured out he said, " it should be good for the rest of your life. > Maybe one more in 5-10 years but that should be it. If the balloon > doesn't work and surgery is required the surgeons usually don't do > much cutting because the balloon does a great job " . > I was under the understanding that balloon dilations only last 10 > years at best and usually closer to 5. > Real life experiences would be appreciated as I'm scheduled for a > month from now for dilation. > > Thanks, > Nate > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 Hello empirelimo@..., In reference to your comment: Mukesh,you're going out on a limb...with your 30 mm. recommend.Is that independent of bodysize/weight ?--- I have had two dilations with 35mm balloon both times. Both were held for 3 minutes. I am female and when the first one was done I was 70 years old and weighted approx 160. The second one was 3.5 years later...again with 35mm and held for 3 minutes. I would think the size depends more on the experience of the doctor and what they feel feel comfortable using. Maggie Alabama Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 Nate -- I had a dilation in December '96 and it didn't do much good. In May '98 I had a second one, and the doc told me that he used a " bigger " balloon (I'm assuming it was a 40mm) and that he held the dilations for longer periods of time before deflating. (They do several inflations of the balloon per session, not just one.) Two weeks later I got my tonsils removed. Six months later I got married. Five months after that I got pregnant. In January 2000 I gave birth to the cutest little boy you ever did see. (Slightly biased, sorry!) A few years ago I went to see Dr. Richter (when he was still in Cleveland, which is only 3-4 hours away from where I live in Michigan). I was " certain " that he was going to tell me that he was sending me to Dr. Rice for a myotomy. But lo and behold, my LES was letting food go through pretty well... the problems I was having were related to getting the food down to the LES in the first place. My esophagus was already " tortuous " (that's the term doctors use to describe a stretched-out, twisted esophagus... why they can't just say " stretched out and twisty " is beyond me!), and with the lack of proper peristaltic contractions, stuff would " get stuck " rather easily. At that point, a myotomy wouldn't have done me a bit of good, because all a myotomy does is open the LES -- you're still responsible for getting the food down that far in the first place. At this point, I'm overdue for a " maintenance " barium swallow. I had one a couple years ago, but the radiologist who did it (and to my surprise it really was a radiologist who took the films, rather than an x-ray tech) was a complete moron. I told him specifically that I wanted to know the diameter of my esophagus, so that I could track any changes over time, but he didn't take the films in such a way that we could actually measure it. Then last year I was dealing with my injured knee and the specialists for that and MRIs and all that stuff, so I just ignored my esophagus. I'd better call the doc and get that scheduled before hockey season gets going any more (the 6yo's hockey season started in August, but the pros don't start until October). Some days I'm eating things that go down well, I'm chewing well, I'm remembering to drink water every few bites, and nobody would ever know there was anything wrong with me. But when I'm lazy about it, I'll get food blocked up in my esophagus (not because of the LES, but because of the esophagus itself) and I have that eyes-watering, choking, " OMG I'm gonna spew " feeling. Ninety-nine percent of the time, I'm able to stay calm, keep my mouth closed, take " Lamaze " style breaths, and add sips of water to eventually push the blockage through. After dealing with this for well over a decade, I've gotten pretty good at preventing spews; I know for a fact that when this first started, I just " let the chips fall where they may " whenever a blockage tried to come back up. Now, I can head 'em off at the pass because I feel them coming on, I stop adding food to make them worse, I relax my body, and I push them through with more water. Debbi in Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 Mukesh, you're going out on a limb... with your 30 mm. recommend. Is that independent of body size/weight ? > > Nate, > It differs from case to case, in my case,it > lasted for 12 years... > It is worth going for a couple of dilatations before going for surgery..many people get a lot of relief from dilatations.normally , > 30 mm baloon is safe.. > Let's see what others advise... > Mukesh > > Dilation compared to H/M > > I finally got insurance through the state. Talk about hoops to go > through. > I met yesterday with my GI doc who does the dilations himself. He > said he doesn't promote one over the other. He just talks more about > dilations because he does them and sees the results more than the > surgery side. > He gave me stats and numbers, etc. comparing the two. Everything > seemed to fit with everything I've read here and other places > throughout the net. Except one. He said that the proper balloon > size needs to be used. If it is too big a perforation may occur > which requires surgery to repair the esophagus. So he errs on the > side of caution with the largest balloon he thinks he can safely > use. So 30-40% of the people need to come back and have it done > again with a larger balloon. Once the correct balloon size is > figured out he said, " it should be good for the rest of your life. > Maybe one more in 5-10 years but that should be it. If the balloon > doesn't work and surgery is required the surgeons usually don't do > much cutting because the balloon does a great job " . > I was under the understanding that balloon dilations only last 10 > years at best and usually closer to 5. > Real life experiences would be appreciated as I'm scheduled for a > month from now for dilation. > > Thanks, > Nate > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 All I can do is share my experience. I've had two balloon dialations, but with only 20 mm balloons. Both occurred before I was officially diagnosised with A in June. The first 20mm lasted six weeks before I couldn't get anything down again. The second was about ten weeks ago and I'm just now starting to have more problems keeping things down. Since I'm not responding well, my GI recommends surgery for me. Good luck to you! -Kathleen > > I finally got insurance through the state. Talk about hoops to go > through. > I met yesterday with my GI doc who does the dilations himself. He > said he doesn't promote one over the other. He just talks more about > dilations because he does them and sees the results more than the > surgery side. > He gave me stats and numbers, etc. comparing the two. Everything > seemed to fit with everything I've read here and other places > throughout the net. Except one. He said that the proper balloon > size needs to be used. If it is too big a perforation may occur > which requires surgery to repair the esophagus. So he errs on the > side of caution with the largest balloon he thinks he can safely > use. So 30-40% of the people need to come back and have it done > again with a larger balloon. Once the correct balloon size is > figured out he said, " it should be good for the rest of your life. > Maybe one more in 5-10 years but that should be it. If the balloon > doesn't work and surgery is required the surgeons usually don't do > much cutting because the balloon does a great job " . > I was under the understanding that balloon dilations only last 10 > years at best and usually closer to 5. > Real life experiences would be appreciated as I'm scheduled for a > month from now for dilation. > > Thanks, > Nate > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 Maggie , Yes..u are right.. It depends on the age n body of the patient n also experience of dr. My son was 14 when first 2 dilatations were done..n last one when he was 26. It varies from case to case... Mukesh Re: Re: Dilation compared to H/M Hello empirelimo@..., In reference to your comment: Mukesh, you're going out on a limb... with your 30 mm. recommend. Is that independent of body size/weight ?--- I have had two dilations with 35mm balloon both times. Both were held for 3 minutes. I am female and when the first one was done I was 70 years old and weighted approx 160. The second one was 3.5 years later...again with 35mm and held for 3 minutes. I would think the size depends more on the experience of the doctor and what they feel feel comfortable using. Maggie Alabama Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 Hi Nate: I posed the same question myself back in June. If this link I've created works, you can read my post & responses here: achalasia/message/35176. Or you can just look up message #35176 & go from there. To me, the dilation is almost a no-brainer, looking back. I don't mean to sound flip - as there is a real, but small, risk of perforation - but the whole process went smoothly for me. The greatest discomfort was from the prick of the needle for the IV I was given and a bit of chest pain for 2 days post-procedure. That's it! The doc who performed the dilatation had been doing them for 15 years, hasn't had a perf yet (I asked him) and is conservative. He uses 30mm & 35mm balloons but never the 40mm. He feels 40mm is too risky. (I visited another doc who was very comfortable with 40mm - especially in a male.) This was done about 7 weeks ago and while I'd like to say that I am totally free from any eating discomfort, the truth is that I do experience some mild discomfort when eating. I have been told that my esophagus appears " tortuous " . My discomfort is manageable via drinking water, etc. as reported by others. I have re-gained lost weight (my weight loss was becoming a major issue), can now sleep comfortably, experience NO regurgitation, can eat whatever I want, etc. My quality of life has improved tremendously - without surgery and without recovery from surgery(!). The way I look at it - and you may want to check this out - is that surgery is still an option for me. Having a dilatation does not rule it out. My thinking was to try the least invasive therapies first & escalate until symptom relief was achieved. Good luck, Nate. Rich (Chicago USA) > > I finally got insurance through the state. Talk about hoops to go > through. > I met yesterday with my GI doc who does the dilations himself. He > said he doesn't promote one over the other. He just talks more about > dilations because he does them and sees the results more than the > surgery side. > He gave me stats and numbers, etc. comparing the two. Everything > seemed to fit with everything I've read here and other places > throughout the net. Except one. He said that the proper balloon > size needs to be used. If it is too big a perforation may occur > which requires surgery to repair the esophagus. So he errs on the > side of caution with the largest balloon he thinks he can safely > use. So 30-40% of the people need to come back and have it done > again with a larger balloon. Once the correct balloon size is > figured out he said, " it should be good for the rest of your life. > Maybe one more in 5-10 years but that should be it. If the balloon > doesn't work and surgery is required the surgeons usually don't do > much cutting because the balloon does a great job " . > I was under the understanding that balloon dilations only last 10 > years at best and usually closer to 5. > Real life experiences would be appreciated as I'm scheduled for a > month from now for dilation. > > Thanks, > Nate > Quote Link to comment Share on other sites More sharing options...
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