Re: Re: Update/Notan reply

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Dear Notan, I am unable to offer constructive advice or personal experience as Pippa and can, but I do want to offer my support to you. You help others so much and deserve as much help from all of us that we are able to offer. I hope that things turn out well for you, or at least as well as possible. My thoughts are with you, Lots of love from Ann (England) XXXXXXXXXXXXPippa <kevin.brown150@...> wrote: Hi NotanI was told that my hernia was very excessive in fact the doctor who took the x ray pictures had never seen anything like it and ask if he could publish the pictures for medcial teaching. He had never seen anyone with achalsia before I did see the pictures in fact he showed me the film of the thick liquid going down and as he tilted me on the table you could see the barium coming back up which he mistook it going into what he thought was the stomach that had gone through the haitus wall. My stomach was so tiny he thought that the rest of it must be alongside my oesophagus, in fact what he could see was a diltated oesophagus food stuck in it and the baruim trying to makes it way back up into my throat.When I

discussed the operation with my surgeon he did say that the barium pictures showed that the hernia was as high as T2 which is the second rib down from your collar bone (after the CT scan which he requested it acutally showed that it was food that was back up to T2 and and not a part of my stomach and it was the LES that was the problem and no hernia was present at all) The surgeon said the same as you because it was so high up there was a fear that the blood supply to the stomach could be cut off or that the hernia itself could wrap itself around major organs causing a life and death situation because of my weight and lack of keeping anything down its was agreed that surgery was my only option. Mr did say that its only about 1 in 10 hernia's that end up being this type and it can involve open surgery lasting anything for 4 to 5 hours as it is fairly complex as you can imagine. They need to pull the

stomach back down again and repair the hiatus wall to stop the stomach going back through the wall again, I am not sure if it can be done by keyhole probably it could be that my surgeon was happier to do by open rather than keyhole.I am glad that you oesophagus is not dilated any more it gives me hope that next year when I have my endoscopy I might be told the same which will be a great relief to me as you can imagine.Please keep us posted on your progress with your GI doctor I for one will be very interested to hear what he has to say. take care NotanPippa x> > > That's really encouraging news for the members who have had their HM > > surgery to know that your barium swallow showed a big improvement

> > in your swallowing and the condition of you esophagus. You must have > > been very happy to hear that news.> > Yes, my esophagus was clearly dilated in the last barium swallow before > surgery. I had some concern that even with the surgery it could get > worse and then when I heard the CT report of a large hernia I actually > thought of you and that this wall also probably a mistake and so > expected a lot of dilation. I was very glad it was not dilation.> > > ...you must wonder what on earth is going to be thrown at you next.> > I have had a strange medical history all my life. It is tiresome.> > > my surgeon said they only perform surgery on this type of hernia if > > it is causing major health problems, so you may be lucky and be told > > that they are going to leave well alone.> > Often people do

not have any reason to know they have one until it is > found when doing x-rays for other reasons. A paraesophageal hernia > causes greater risks than the typical hernia. It also has a small chance > of becoming an emergency life and death situation. That happens when its > blood supply is cut off. Generally people will go for years without that > happening. If a person is old enough the odds are you would live out > your life without a problem from it, so surgery may not be recommended. > Aside from the elderly, it is controversial to have surgery or not. Some > doctors say it is best to have it, others say wait and see. One thing > that can make a difference is the size of the hernia. In my case it is > described as large. Although I have not noticed it, such a hernia can > have an impact on other organs, like the lungs and the esophagus. >

Sometimes they are found because people have problems swallowing. In my > case I have heartburn. I don't know if surgery will be recommended but I > suspect the GI will at least want to discuss it.> > notan> Send instant messages to your online friends http://uk.messenger.

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Mal wrote:

> ... yesterday my general

> practitioner told me that drugs like Nexium block proper absorption of

> Vitamin B12 - I will double check with my surgeon about that.

>

It is more complicated than yes or no about whether it blocks

absorption. In a way it can. If you reach a point where you have no acid

production (not everybody on Nexium does) then you can not absorb B12

from protein sources. You can still absorb it from some supplements.

Your body stores enough B12 for a very long time so if it can absorb it

some times you can get by times where you don't. However, it is good to

monitor B12 levels if you are on Nexium long-term. This is also true for

other PPIs and to a lesser degree H2 blockers. The body can develop

other problems absorbing B12 not related to Nexium. This can be more of

a problem as we age. Also, vegetarians need to be more cautious about it.

notan