Re: Continued problems swallowing a year after surgery - ques re: manometry

[Guest guest]

Thanks Notan. My son had the manometry test that led to his diagnosis, and he

had a very difficult time with it. This was the single worst thing for me to see

him go through in the whole business (and I imagine he'd say the same). I would

hate to put him through that again unless absolutely necessary. When I read

about the test, it claims there is a " thin tube " put down the nose (or throat).

The tube they put down 's nose was not very thin. I'm wondering if there is

a thinner tube, better procedure, etc. - maybe my son didn't have the latest,

greatest technology for the test. Can anyone tell me their experiences with

manometry? Is it always just awful? Part of the problem could be his age when he

got it (17), so I'm wondering how bad it really is.

Thanks,

Phyllis

> > " For some spasms above the LES will still cause

> > trouble swallowing even if the LES is no longer a problem. "

> > seems to describe my son.

>

> The best way to find out if that is the case is probably manometry. It

> can determine if there are still problems of pressure at the LES or if

> spasms are causing pressure problems. If the problem is not consistent

> then it could be possible for the test to miss it though, if it were

> from a spasm and none happened during the test.

>

[Guest guest]

My son had the test done and only gagged once. It was not as bad as we thought.

Must have been the small tube and someone that knew what they were doing. I

prayed about it alot and put it in Gods hands and really it was fine. Not a bad

experience.

,

Cullen's mom

Sent from my iPhone

On Jan 18, 2011, at 1:38 PM, " phidgeit " <pmarlino@...> wrote:

> Thanks Notan. My son had the manometry test that led to his diagnosis, and he

had a very difficult time with it. This was the single worst thing for me to see

him go through in the whole business (and I imagine he'd say the same). I would

hate to put him through that again unless absolutely necessary. When I read

about the test, it claims there is a " thin tube " put down the nose (or throat).

The tube they put down 's nose was not very thin. I'm wondering if there is

a thinner tube, better procedure, etc. - maybe my son didn't have the latest,

greatest technology for the test. Can anyone tell me their experiences with

manometry? Is it always just awful? Part of the problem could be his age when he

got it (17), so I'm wondering how bad it really is.

>

> Thanks,

> Phyllis

>

>

> > > " For some spasms above the LES will still cause

> > > trouble swallowing even if the LES is no longer a problem. "

> > > seems to describe my son.

> >

> > The best way to find out if that is the case is probably manometry. It

> > can determine if there are still problems of pressure at the LES or if

> > spasms are causing pressure problems. If the problem is not consistent

> > then it could be possible for the test to miss it though, if it were

> > from a spasm and none happened during the test.

> >

>

>

[Guest guest]

Phyllis wrote:

> ... I'm wondering if there is a thinner tube, better procedure, etc. - ...

They do come in various diameters. This is interesting because there are

studies that suggest that the diameter of the probe effects the

findings. Larger probes produce greater pressure. Perhaps this is one of

the reasons every GI or surgeon seems to want them done over by their

preferred, or in house, test center. The person doing the test can make

a big difference on how nice, or not, the test is. I had it done at two

different centers. One was at Mayo in AZ. That one was much easier than

the other and while both were uncomfortable neither was a big deal for

me. I tolerate a lot though. I did throw up on the fist doctor, but I

saw that as more of problem for him than me.

A barium swallow can also show some things but I did not have much luck

with radiologists recognizing my achalasia before I was diagnosed by

manometry. They seemed to think everything looked good, even

peristalsis, though the barium didn't move while I was lying on the

table. Not a mention of achalasia or anything related to it.

notan

[Guest guest]

I had a manometry back in 2008 prior to my heller. It was pure torture. The

tube was not small. I was sick through the whole thing and my throat was sore

for days. The worst of it all was that when the doctor saw it he said the

results were inconclusive. I ended up going to another specialist who diagnosed

me without a manometry. I have vowed that I will never go through that test

again.

> > > " For some spasms above the LES will still cause

> > > trouble swallowing even if the LES is no longer a problem. "

> > > seems to describe my son.

> >

> > The best way to find out if that is the case is probably manometry. It

> > can determine if there are still problems of pressure at the LES or if

> > spasms are causing pressure problems. If the problem is not consistent

> > then it could be possible for the test to miss it though, if it were

> > from a spasm and none happened during the test.

> >

>

[Guest guest]

Sorry I don't post much, but is that the test that you actually swallow stuff

during the procedure? I think I had this test and yes I never want to do it

again, the tube isn't very small, mine was put down my throat and then I had to

swallow water at different intervals as she would lower and raise the tube.

Terrible test....

________________________________

From: Redwoodsy <redwoodsy@...>

achalasia

Sent: Wed, January 19, 2011 6:04:33 PM

Subject: Re: Continued problems swallowing a year after surgery -

ques re: manometry

I had a manometry back in 2008 prior to my heller. It was pure torture. The

tube was not small. I was sick through the whole thing and my throat was sore

for days. The worst of it all was that when the doctor saw it he said the

results were inconclusive. I ended up going to another specialist who diagnosed

me without a manometry. I have vowed that I will never go through that test

again.

> > > " For some spasms above the LES will still cause

> > > trouble swallowing even if the LES is no longer a problem. "

> > > seems to describe my son.

> >

> > The best way to find out if that is the case is probably manometry. It

> > can determine if there are still problems of pressure at the LES or if

> > spasms are causing pressure problems. If the problem is not consistent

> > then it could be possible for the test to miss it though, if it were

> > from a spasm and none happened during the test.

> >

>

[Guest guest]

wrote:

> ... at different intervals as she would lower and raise the tube.

> Terrible test....

One of the benefits of High Resolution Manometry (HRM) is that after the

probe is placed it does not need to be raised and lower during the test.

They just place it and leave it until the end. The placement is not

critical like it is in standard manometry. That makes it easier on the

tech too who doesn't have to torture the patient and the test can be

done quicker. All good news for us.

notan

[Guest guest]

I've never posted before, but I had to reply on this. My 85 year old father

had this test done a couple months ago and his was inconclusive also. He

said, " I'm 85 and I'll NEVER have that done again. " He had surgery for a

deviated septum about 40 years ago and they said that made it harder for the

tube to go through his nose.

_____

From: achalasia [mailto:achalasia ] On Behalf

Of Crouch

Sent: Wednesday, January 19, 2011 9:04 PM

achalasia

Subject: Re: Re: Continued problems swallowing a year after

surgery - ques re: manometry

Sorry I don't post much, but is that the test that you actually swallow

stuff

during the procedure? I think I had this test and yes I never want to do it

again, the tube isn't very small, mine was put down my throat and then I had

to

swallow water at different intervals as she would lower and raise the tube.

Terrible test....

________________________________

From: Redwoodsy <redwoodsy@...

<mailto:redwoodsy%40embarqmail.com> >

achalasia <mailto:achalasia%40>

Sent: Wed, January 19, 2011 6:04:33 PM

Subject: Re: Continued problems swallowing a year after surgery

-

ques re: manometry

I had a manometry back in 2008 prior to my heller. It was pure torture. The

tube was not small. I was sick through the whole thing and my throat was

sore

for days. The worst of it all was that when the doctor saw it he said the

results were inconclusive. I ended up going to another specialist who

diagnosed

me without a manometry. I have vowed that I will never go through that test

again.

> > > " For some spasms above the LES will still cause

> > > trouble swallowing even if the LES is no longer a problem. "

> > > seems to describe my son.

> >

> > The best way to find out if that is the case is probably manometry. It

> > can determine if there are still problems of pressure at the LES or if

> > spasms are causing pressure problems. If the problem is not consistent

> > then it could be possible for the test to miss it though, if it were

> > from a spasm and none happened during the test.

> >

>

[Guest guest]

Too bad for people with sigmoid esophagi's the HRM isn't usually an option. Its

very difficult to place with all the twists and turns in the E. Therefore we are

subjected to the primal torture of the standard manometry. I am hoping never to

have to have it again.

> > ... at different intervals as she would lower and raise the tube.

> > Terrible test....

>

> One of the benefits of High Resolution Manometry (HRM) is that after the

> probe is placed it does not need to be raised and lower during the test.

> They just place it and leave it until the end. The placement is not

> critical like it is in standard manometry. That makes it easier on the

> tech too who doesn't have to torture the patient and the test can be

> done quicker. All good news for us.

>

> notan

>

[Guest guest]

spotoca wrote:

> Too bad for people with sigmoid esophagi's the HRM isn't usually an option.

Its very difficult to place with all the twists and turns in the E. Therefore we

are subjected to the primal torture of the standard manometry.

That is surprising. They are similar and placed the same way. The

difference is the number of sensors in the tube, far apart in standard

and close in HR. They both appear to coil easily. If I had to guess I

would guess that HR may not coil as tightly or go around as sharp of

turns. Hard to tell from photos. Do you know why this is? Why is one

easier than the other?

notan

[Guest guest]

I too thought the manomotry test was dreadful. The tube is horrible and stung

so much. Not helped by the fact that even though i would have thought my

nostrils were the same they are apparently not....after trying to get it down

one she had to swap to the other. She probbaly didnt like me much as i vomited

all over her several times through out...opps!

Definately won;t be first in the queue for that again...although at least it

confirmed everything so i could have the surgerty which was the best choice i

have ever made!

Nicola

> > > > " For some spasms above the LES will still cause

> > > > trouble swallowing even if the LES is no longer a problem. "

> > > > seems to describe my son.

> > >

> > > The best way to find out if that is the case is probably manometry. It

> > > can determine if there are still problems of pressure at the LES or if

> > > spasms are causing pressure problems. If the problem is not consistent

> > > then it could be possible for the test to miss it though, if it were

> > > from a spasm and none happened during the test.

> > >

> >

>

>

[Guest guest]

From what Rice told me, he was only able to place the standard wire through the

endoscopy. For some reason the HR wire needs to go through the nose and down the

throat. I realize this does not make logical sense but the only way they were

able to place my wire was during the endoscopy (because of my sigmoid turn).

It came out the first time and they tried to do the HR through my nose but it

coiled. So they sent me back for a 2nd endoscopy where they replaced the

standard wire.

i am sure there is a better explanation for it. I will try to find out.

> > Too bad for people with sigmoid esophagi's the HRM isn't usually an option.

Its very difficult to place with all the twists and turns in the E. Therefore we

are subjected to the primal torture of the standard manometry.

>

> That is surprising. They are similar and placed the same way. The

> difference is the number of sensors in the tube, far apart in standard

> and close in HR. They both appear to coil easily. If I had to guess I

> would guess that HR may not coil as tightly or go around as sharp of

> turns. Hard to tell from photos. Do you know why this is? Why is one

> easier than the other?

>

> notan

>

[Guest guest]

I agree Nicola.  I hated it both times I had it done (the " old " torturous way,

where I threw up all over the technician) and most recently last year with HRM.

 Both were dreadful, but without them, who knows where I'd be today.  As

horrible as they are, the short term discomfort/embarrassment/pain was worth the

diagnosis, and I wouldn't do it differently.

kim

From: Nicola <nicola_uk10@...>

Subject: Re: Continued problems swallowing a year after surgery -

ques re: manometry

achalasia

Date: Thursday, January 20, 2011, 4:04 PM

 

I too thought the manomotry test was dreadful. The tube is horrible and

stung so much. Not helped by the fact that even though i would have thought my

nostrils were the same they are apparently not....after trying to get it down

one she had to swap to the other. She probbaly didnt like me much as i vomited

all over her several times through out...opps!

Definately won;t be first in the queue for that again...although at least it

confirmed everything so i could have the surgerty which was the best choice i

have ever made!

Nicola

> > > > " For some spasms above the LES will still cause

> > > > trouble swallowing even if the LES is no longer a problem. "

> > > > seems to describe my son.

> > >

> > > The best way to find out if that is the case is probably manometry. It

> > > can determine if there are still problems of pressure at the LES or if

> > > spasms are causing pressure problems. If the problem is not consistent

> > > then it could be possible for the test to miss it though, if it were

> > > from a spasm and none happened during the test.

> > >

> >

>

>

[Guest guest]

I don't get accused of being normal much but you guys are really making

me feel like the odd one in the group.

My nose burned some as it went through. Not a big deal. I have had worse

with food coming out my nose while I slept. Jalapenos are a bummer. I

gagged some as it went down and hit the gag reflex. Not a big deal. I

can do that while brushing my teeth and tongue. I even threw up on the

fist guy that did it. Not a big deal. He should be used to it. It wasn't

painful. It wasn't scary. It went like I expected it to. Where is the

problem?

notan

[Guest guest]

you're the most awesome kind of odd notan  

Maybe it's different for guys... I know when I puked all over the first tech,

the embarrassment was the worst and made the rest of the test so much worse

because of it.  Painful?  Not exactly, just wicked uncomfortable.  HRM was

much easier, even though I still didn't much enjoy it... I would have rather

been anywhere else, actually.  But at least that time I wasn't throwing up,

therefore decreasing the embarrassment factor.

kim

From: notan ostrich <notan_ostrich@...>

Subject: Re: Continued problems swallowing a year after surgery -

ques re: manometry

achalasia

Date: Thursday, January 20, 2011, 4:37 PM

 

I don't get accused of being normal much but you guys are really making

me feel like the odd one in the group.

My nose burned some as it went through. Not a big deal. I have had worse

with food coming out my nose while I slept. Jalapenos are a bummer. I

gagged some as it went down and hit the gag reflex. Not a big deal. I

can do that while brushing my teeth and tongue. I even threw up on the

fist guy that did it. Not a big deal. He should be used to it. It wasn't

painful. It wasn't scary. It went like I expected it to. Where is the

problem?

notan

[Guest guest]

Kim wrote:

> ... I hated it both times I had it done (the " old " torturous way, where I

threw up all over the technician) and most recently last year with HRM. Both

were dreadful, ...

Was the HRM any better? In the old system they have to keep moving the

sensor at the LES because the LES keeps moving and they need it at just

the right place and that place can be hard to find. In HRM there is no

one sensor that has to be at that location and as long as some of the

probe is in the stomach there will be sensors at the LES so they don't

need to keep moving it. That should also have made the HRM test faster

if they were doing the same tests otherwise (same number of swallows and

such). I saw an ad for an HRM catheter that was under 3mm in size. Many

of the old style were 4 to 5mm, but I don't know what size most HRM ones

are that are being used.

notan

[Guest guest]

I was actually shocked by how much quicker the HRM was.  I was expecting the

same thing, when I went in, and I don't think I was in there much more than

10-15 mins.  The first one, back in 1998, was closer to an hour, if not more.

 Every time they moved that tube, I threw up  I feel badly for people that

have to have it done the old way.  HRM was a breeze, comparatively, even though

having a tube shoved down your nose isn't the most relaxing way to spend your

time.

kim

> ... I hated it both times I had it done (the " old " torturous way, where I

threw up all over the technician) and most recently last year with HRM. Both

were dreadful, ...

Was the HRM any better? In the old system they have to keep moving the

sensor at the LES because the LES keeps moving and they need it at just

the right place and that place can be hard to find. In HRM there is no

one sensor that has to be at that location and as long as some of the

probe is in the stomach there will be sensors at the LES so they don't

need to keep moving it. That should also have made the HRM test faster

if they were doing the same tests otherwise (same number of swallows and

such). I saw an ad for an HRM catheter that was under 3mm in size. Many

of the old style were 4 to 5mm, but I don't know what size most HRM ones

are that are being used.

notan

[Guest guest]

Kim wrote:

> I was actually shocked by how much quicker the HRM was. ... HRM was a breeze,

comparatively, even though having a tube shoved down your nose isn't the most

relaxing way to spend your time.

Maybe that is the best it can be put. Neither is a fun way to spend the

time but the HRM is better. I hate to think that some people are still

getting the old manometry. It isn't as accurate and it is much less

comfortable and takes longer. Thanks for giving us your comparison from

having had both.

notan

[Guest guest]

My very first manometry test was done in the mid 90's ( as I recall).  It seems

I remember that it was about the size of a straw, they inserted it up my nose

and down my throat, the results were on what looked like a polograph....it was

recording on long sheets of paper???  That must of been how they did it back

then?  Last year, I had the HRM done and the tube seemed bigger to me???  

Also,

I recall with the first test, that after they inserted the tube past the gag

reflex, I was fine.  This time, I gaged through most of the test, it was worse

for some reason.  I had to take 10 sips of water, approx 30 sec apart.  I

wanted

to do well through the test, but at one point, I got frustrated and wanted to

yank the tube OUT. 

Julee So Calif.

________________________________

From: Nicola <nicola_uk10@...>

achalasia

Sent: Thu, January 20, 2011 12:04:34 PM

Subject: Re: Continued problems swallowing a year after surgery -

ques re: manometry

 

I too thought the manomotry test was dreadful. The tube is horrible and stung so

much. Not helped by the fact that even though i would have thought my nostrils

were the same they are apparently not....after trying to get it down one she had

to swap to the other. She probbaly didnt like me much as i vomited all over her

several times through out...opps!

Definately won;t be first in the queue for that again...although at least it

confirmed everything so i could have the surgerty which was the best choice i

have ever made!

Nicola

> > > > " For some spasms above the LES will still cause

> > > > trouble swallowing even if the LES is no longer a problem. "

> > > > seems to describe my son.

> > >

> > > The best way to find out if that is the case is probably manometry. It

> > > can determine if there are still problems of pressure at the LES or if

> > > spasms are causing pressure problems. If the problem is not consistent

> > > then it could be possible for the test to miss it though, if it were

> > > from a spasm and none happened during the test.

> > >

> >

>

>

[Guest guest]

I thought the manometry test was a walk in the park.My only problem was my

blood pressure was sky high the day of the test and they said they couldn't do

it.I told them I would go to the emergency room immediately after the test if

they did it, so they agreed to proceed.I never did go get checked out.

> > > > > " For some spasms above the LES will still cause

> > > > > trouble swallowing even if the LES is no longer a problem. "

> > > > > seems to describe my son.

> > > >

> > > > The best way to find out if that is the case is probably manometry. It

> > > > can determine if there are still problems of pressure at the LES or if

> > > > spasms are causing pressure problems. If the problem is not consistent

> > > > then it could be possible for the test to miss it though, if it were

> > > > from a spasm and none happened during the test.

> > > >

> > >

> >

> >