Guest guest Posted June 22, 2008 Report Share Posted June 22, 2008 > > His this is sanjiv from india. Got diagnosed with achalasia Gr III, a > year back. Went pneumatic dialatation in Dec 07 and second one in May > 08. The main problem is in the non relaxation of the LES. Can anyone > of you may friends help me out in finding a relief to this problem. As > i could see that this problem does not have a perfect cure and many > people have already undergone high quality treatment, i wuld be > xtremely thankful to those who help me out. > Thanx, > > Regards, > Sanjiv > Hi Sanjiv, I had the same problem with the LES not relaxing. I had the dilitation done in December 07, botox injection in February of 08 and found no relief with either of those. I had a Myotomy with a partial wrap done in May of 08 and finally found relief. Hope this helps you. ~Steph from WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2008 Report Share Posted June 22, 2008 Sanjiv, My LES pressure was really high and myotomy was my fix too. good luck dawn Re: Case Achalasia Gr III >> His this is sanjiv from india. Got diagnosed with achalasia Gr III, a > year back. Went pneumatic dialatation in Dec 07 and second one in May > 08. The main problem is in the non relaxation of the LES. Can anyone > of you may friends help me out in finding a relief to this problem. As > i could see that this problem does not have a perfect cure and many > people have already undergone high quality treatment, i wuld be > xtremely thankful to those who help me out. > Thanx,> > Regards, > Sanjiv>Hi Sanjiv, I had the same problem with the LES not relaxing. I had the dilitation done in December 07, botox injection in February of 08 and found no relief with either of those. I had a Myotomy with a partial wrap done in May of 08 and finally found relief. Hope this helps you.~Steph from WI Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2008 Report Share Posted June 23, 2008 Hi steph... Thanx for the reply... Whatever i have read and with the little info i have gathered from the net, i suppose hellers myotomy and pneumatic dialatation are similar type of treatment. i.e. both are involved only in the increasing the dia of the constricted part... Does myotomy has something to do with the rectification of the LES. Further, whether myotomy can ensure that no further constriction shall occur...And can you explain about the " Partial Wrap " . Sanjiv --- <stilen_22@...> wrote: > > > > > His this is sanjiv from india. Got diagnosed with > achalasia Gr III, > a > > year back. Went pneumatic dialatation in Dec 07 > and second one in May > > 08. The main problem is in the non relaxation of > the LES. Can > anyone > > of you may friends help me out in finding a relief > to this problem. > As > > i could see that this problem does not have a > perfect cure and many > > people have already undergone high quality > treatment, i wuld be > > xtremely thankful to those who help me out. > > Thanx, > > > > Regards, > > Sanjiv > > > > > Hi Sanjiv, > > I had the same problem with the LES not relaxing. I > had the dilitation > done in December 07, botox injection in February of > 08 and found no > relief with either of those. I had a Myotomy with a > partial wrap done > in May of 08 and finally found relief. Hope this > helps you. > > ~Steph from WI > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2008 Report Share Posted June 23, 2008 Sanjiv, I don't know if you are located anywhere near Coimbatore or if you can travel there for treatment, but Dr. C. Palanivelu is very experienced with achalasia patients. Someone else on this mailing list had surgery with Dr. Palanivelu and was very pleased with the results. (To find their story, you could search for " Palanivelu " at achalasia/messages ) Dr. C. Palanivelu GEM Hospital 45-A, Pankaja Mill Road, Ramnathapuram, Coimbatore, 641045, India Tel.: (0422) 2324100 Fax: (0422) 2320879 Email: drcp@... -- in PA Case Achalasia Gr III > His this is sanjiv from india. Got diagnosed with achalasia Gr > III, a > year back. Went pneumatic dialatation in Dec 07 and second one > in May > 08. The main problem is in the non relaxation of the LES. Can > anyone > of you may friends help me out in finding a relief to this > problem. As > i could see that this problem does not have a perfect cure and > many > people have already undergone high quality treatment, i wuld be > xtremely thankful to those who help me out. > Thanx, > > Regards, > Sanjiv > > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2008 Report Share Posted June 23, 2008 Hi Sanjiv - I'll try to answer a few of your questions. The dilation is done as an outpatient procedure and under sedation. The dilator stretches and tears the muscles in an effort to open up the LES. They can sometimes work well for many years but most often, if you are younger - they don't last well. A heller myotomy is surgery done under general anesthesia where they cut the muscles of the lower portion of the E and into the stomach, they then 'wrap' some of where they have cut and suture it into place in the muscles of your E. This helps to control reflux and to help keep the LES from closing again. There is much debate about doing a wrap with pros and cons to both sides. Our general consensus is to do what your surgeon thinks is best and is most comfortable with. It is absolutely VITAL that you find a surgeon with the best possible experience in this surgery (at least performed it 50-100 times) The surgery is not a cure although it is the best long term solution. Your results do tend to be better with experienced surgeons. How old are you? I can't tell you anything about the skill level of your surgeon, just find the best one you can. I hope this helps to explain. If you look in the database and files sections up on the top left of this page, you'll find all kinds of information, including questions to ask your doctor, recovery experiences, food lists, etc. Keep reading and ask any questions you may have, we're here for you. Keep us posted. - in NC USA > > > > > > His this is sanjiv from india. Got diagnosed with > > achalasia Gr III, > > a > > > year back. Went pneumatic dialatation in Dec 07 > > and second one in May > > > 08. The main problem is in the non relaxation of > > the LES. Can > > anyone > > > of you may friends help me out in finding a relief > > to this problem. > > As > > > i could see that this problem does not have a > > perfect cure and many > > > people have already undergone high quality > > treatment, i wuld be > > > xtremely thankful to those who help me out. > > > Thanx, > > > > > > Regards, > > > Sanjiv > > > > > > > > > Hi Sanjiv, > > > > I had the same problem with the LES not relaxing. I > > had the dilitation > > done in December 07, botox injection in February of > > 08 and found no > > relief with either of those. I had a Myotomy with a > > partial wrap done > > in May of 08 and finally found relief. Hope this > > helps you. > > > > ~Steph from WI > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2008 Report Share Posted June 23, 2008 Hi buddies... I am thankful to you all for it is the first time someone other than my family members got to understand the gravity of the bloody achalasia... The dialation was performed for first time to 35mm for 90 secs. No mention of pressure in the report. 2nd Dialatation performed by " Rigiflex " baloon at 6psi and 5 psi for one minute each respectively. Though i feel that only a fraction of the trouble has been rectified with respect to first dialatation the main problem is the heavy residue. Well, my age is 32, and the doc is of opinion that at this age treatment for achalasia wont yield better results... I suppose one of you suggested the name of GEM Hospital, Coimbatore. Well i can definately reach there but would really appreciate if someone could suggest a place either at Mumbai / Pune / Nagpur (Remember Oranges - My hometown) / New Delhi. Needless to mention these are all in India. What must be the time gap to be provided between a dailatation and mytomy? Will myotomy solve my problem for entire life.... Bye... Sanjiv > > > > His this is sanjiv from india. Got diagnosed with achalasia Gr III, > a > > year back. Went pneumatic dialatation in Dec 07 and second one in May > > 08. The main problem is in the non relaxation of the LES. Can > anyone > > of you may friends help me out in finding a relief to this problem. > As > > i could see that this problem does not have a perfect cure and many > > people have already undergone high quality treatment, i wuld be > > xtremely thankful to those who help me out. > > Thanx, > > > > Regards, > > Sanjiv > > > > Hi Sanjiv, > > I had the same problem with the LES not relaxing. I had the dilitation > done in December 07, botox injection in February of 08 and found no > relief with either of those. I had a Myotomy with a partial wrap done > in May of 08 and finally found relief. Hope this helps you. > > ~Steph from WI > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2008 Report Share Posted June 24, 2008 Hi Sanjiv, I would also recommend GEM Hospital. I actually don’t know of any place else, the only reason I know of GEM is because my surgeon in the US, Horacio Asbun, has taught laparoscopic surgeries there along with Barry Salky. Looking at the website, they claim to be the most advanced laparoscopic surgery center in Asia and are recognized as a training centre by the National Board of Examination (NBE), Medical council of India (MCI) & Society of the American Gastroenterology Surgeons (SAGES). We always try to refer members in the group to the most specialized doctors in Achalasia, but there aren’t too many members from India. Here are some links for GEM Hospital, maybe you could contact the department head and find out if they know of anyone closer to you who is highly skilled in performing myotomies. http://www.gemhospitalindia.com/page3/page3.html http://www.gemhospitalindia.com/page9/page9.html http://www.gemhospitalindia.com/page24/page13/page13.html Good luck to you! Sandi in No CA From: achalasia [mailto:achalasia ] On Behalf Of inferno_22442 Sent: Monday, June 23, 2008 10:47 PM achalasia Subject: Re: Case Achalasia Gr III Hi buddies... I am thankful to you all for it is the first time someone other than my family members got to understand the gravity of the bloody achalasia... The dialation was performed for first time to 35mm for 90 secs. No mention of pressure in the report. 2nd Dialatation performed by " Rigiflex " baloon at 6psi and 5 psi for one minute each respectively. Though i feel that only a fraction of the trouble has been rectified with respect to first dialatation the main problem is the heavy residue. Well, my age is 32, and the doc is of opinion that at this age treatment for achalasia wont yield better results... I suppose one of you suggested the name of GEM Hospital, Coimbatore. Well i can definately reach there but would really appreciate if someone could suggest a place either at Mumbai / Pune / Nagpur (Remember Oranges - My hometown) / New Delhi. Needless to mention these are all in India. What must be the time gap to be provided between a dailatation and mytomy? Will myotomy solve my problem for entire life.... Bye... Sanjiv > > > > His this is sanjiv from india. Got diagnosed with achalasia Gr III, > a > > year back. Went pneumatic dialatation in Dec 07 and second one in May > > 08. The main problem is in the non relaxation of the LES. Can > anyone > > of you may friends help me out in finding a relief to this problem. > As > > i could see that this problem does not have a perfect cure and many > > people have already undergone high quality treatment, i wuld be > > xtremely thankful to those who help me out. > > Thanx, > > > > Regards, > > Sanjiv > > > > Hi Sanjiv, > > I had the same problem with the LES not relaxing. I had the dilitation > done in December 07, botox injection in February of 08 and found no > relief with either of those. I had a Myotomy with a partial wrap done > in May of 08 and finally found relief. Hope this helps you. > > ~Steph from WI > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2008 Report Share Posted June 24, 2008 > > > > > > His this is sanjiv from india. Got diagnosed with > > achalasia Gr III, > > a > > > year back. Went pneumatic dialatation in Dec 07 > > and second one in May > > > 08. The main problem is in the non relaxation of > > the LES. Can > > anyone > > > of you may friends help me out in finding a relief > > to this problem. > > As > > > i could see that this problem does not have a > > perfect cure and many > > > people have already undergone high quality > > treatment, i wuld be > > > xtremely thankful to those who help me out. > > > Thanx, > > > > > > Regards, > > > Sanjiv > > > > > > > > > Hi Sanjiv, > > > > I had the same problem with the LES not relaxing. I > > had the dilitation > > done in December 07, botox injection in February of > > 08 and found no > > relief with either of those. I had a Myotomy with a > > partial wrap done > > in May of 08 and finally found relief. Hope this > > helps you. > > > > ~Steph from WI > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2008 Report Share Posted June 24, 2008 http://www.ncbi.nlm.nih.gov/sites/entrez This is a website to summaries of medical articles written all over the world. I would suggest putting in the names of the major teaching hospitals that are possibilities for you in the search space in this website along w/ achalasia. In general the best surgeons are found at the biggest and best teaching hospitals. Look in their websites/directories for the heads of the departments in thoracic surgery, chest diseases, esophageal diseases. Contact them via email or phone or both. They will call you BACK!!!!! They will email you back!!!!!!!!!!! You are a highly desirable patient because you have a rare disease. Start of assuming cost or insurance isn't an issue, even if it is. You may have to do the research yourself, and you will learn a lot along the way. You will learn what questions to ask and will be ablt to question the surgeons or gi doctors. Honestly it is hard for us to tell you exactly who to go to, this is your disease, and for the rest of your life you may have to make decisions and research to the best of your ability. I watched on the National Geographic Channel a story about a girl w/ 8 limbs in India. The hospital and surgery costs were totally covered because it is so rare to have a parasitic twin. I did find the publicity push and the surgeon's desire for publicity slightly disgusting, but that is the way it is for surgeons. Beware of that, achalasia isn't anything like that, but the surgeons will desire your business because it adds prestige. Yes, a myotomy may last life long, provided you take care of yourself, chose a good surgeon and have no complications. No guarantees though. Many of us are long term w/o any problems, many leave this group and never look back. But most important is the experience level w/ myotomies in predicting success. Not the overall surgeon's experience, but how many myotomies has he/she done. Again... look through the best teaching hospitals websites at all possible for you and contact the heads of the departments. Almost always our doctors are heads of these departments. Good luck Sandy > > >> > > His this is sanjiv from india. Got diagnosed with achalasia Gr > III, > > a > > > year back. Went pneumatic dialatation in Dec 07 and second one > in May > > > 08. The main problem is in the non relaxation of the LES. Can > > anyone > > > of you may friends help me out in finding a relief to this > problem. > > As > > > i could see that this problem does not have a perfect cure and > many > > > people have already undergone high quality treatment, i wuld be > > > xtremely thankful to those who help me out. > > > Thanx,> > > > > > Regards, > > > Sanjiv> > >> > > > Hi Sanjiv, > > > > I had the same problem with the LES not relaxing. I had the > dilitation > > done in December 07, botox injection in February of 08 and found > no > > relief with either of those. I had a Myotomy with a partial wrap > done > > in May of 08 and finally found relief. Hope this helps you.> > > > ~Steph from WI> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2008 Report Share Posted June 25, 2008 Holt- wrote: > > Here are some links for GEM Hospital, > Also take a look at: mms://ms.rcsed.ac.uk/education/450/wm109.wmv Video of a heller myotomy with partial wrap. notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2008 Report Share Posted July 1, 2008 Hi there.... Thanx for all the inputs you guys have given... I had a talk with my doc. He has suggested me to get a 3rd dialation before i have a surgery...Will repeated dialations create complications in lap surgery???...Has any research made on this...I definately feel some comfort after 2nd dialatation...Still the problem of residue remains... > > > > > > > > His this is sanjiv from india. Got diagnosed with achalasia Gr > > III, > > > a > > > > year back. Went pneumatic dialatation in Dec 07 and second one > > in May > > > > 08. The main problem is in the non relaxation of the LES. Can > > > anyone > > > > of you may friends help me out in finding a relief to this > > problem. > > > As > > > > i could see that this problem does not have a perfect cure and > > many > > > > people have already undergone high quality treatment, i wuld be > > > > xtremely thankful to those who help me out. > > > > Thanx, > > > > > > > > Regards, > > > > Sanjiv > > > > > > > > > > Hi Sanjiv, > > > > > > I had the same problem with the LES not relaxing. I had the > > dilitation > > > done in December 07, botox injection in February of 08 and found > > no > > > relief with either of those. I had a Myotomy with a partial wrap > > done > > > in May of 08 and finally found relief. Hope this helps you. > > > > > > ~Steph from WI > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2008 Report Share Posted July 1, 2008 My last post could apply to you also. Get to the heads of departments. In summary... (yea!) I think having a 3rd dialation is crazy. He/she may be recommending that because that is all he/she can do. Follow the money trail. Bluntly.... move on. Either this doctor isn't doing them correctly and/or they aren't helping. Get to a surgeon and if you aren't at a huge major medical teaching hospital go there and get the surgical head of the esophageal disease department or chest diseases or something to contact you. Through the years here, repeated dialation generally aren't beneficial if the first ones don't work, cause scarring, and make future surgery more difficult. In the meantime your esophagus may be stretching, possibly narrowing the chances for a successful myotomy in the future. That is just my opinion. If you have financial or physical limitations take those into consideration and let us know, achalasia teaches you to research and stretch to get to the best doctors. All doctors are confident in their skills and have great senses of themselves and their abilities. Don't make a mistake relying on their own confidence. You have to know the experts and go to those w/ the most successful experience. Sandy > > > > > > > > > > His this is sanjiv from india. Got diagnosed with achalasia Gr > > > III, > > > > a > > > > > year back. Went pneumatic dialatation in Dec 07 and second one > > > in May > > > > > 08. The main problem is in the non relaxation of the LES. Can > > > > anyone > > > > > of you may friends help me out in finding a relief to this > > > problem. > > > > As > > > > > i could see that this problem does not have a perfect cure and > > > many > > > > > people have already undergone high quality treatment, i wuld > be > > > > > xtremely thankful to those who help me out. > > > > > Thanx, > > > > > > > > > > Regards, > > > > > Sanjiv > > > > > > > > > > > > > Hi Sanjiv, > > > > > > > > I had the same problem with the LES not relaxing. I had the > > > dilitation > > > > done in December 07, botox injection in February of 08 and found > > > no > > > > relief with either of those. I had a Myotomy with a partial wrap > > > done > > > > in May of 08 and finally found relief. Hope this helps you. > > > > > > > > ~Steph from WI > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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