Re: 2nd dilation

[Guest guest]

I had a heller myotomty w/ dor fundo in april 2005 and had to have my first

dialation about a year later. I have had 4 total so, I think. Each time it the

swallowing seems worse for a week or so, then improves greatly. It has been

about 6 months since the last one and things are basically OK. I have to drink

about a quart of water wach time I have a meal, but at least it goes down

eventually.

I think the wrap is too tight, but that is another story.

But overall, I consider the surgery to be a sucess.

Dave

>

> Hi Everyone,

>

> I had my second dilation, yesterday.  Very sore last night; many spasms.  But

> amazing relief, today.  For the first time in years, I took a drink by

> swallowing a few times in a row...not just the small sips of recent days.  For

> me... personal magic!  I know the chances are that relief is temporary, but I

am

> banking on forever.  Sooooo glad I did it!

>

> Thank you all for helping me decide to give dilation a second shot.

>

> Best regards.

> Bonnie

>

>

[Guest guest]

I've had A for 21 yrs. Dilation when diagnosed w/good success.

Heller/part myo in '02. Been having trouble again for a good year now, was on

liquids since June, ulceration/inflammation, etc. in lower 1/3 of E and was

constricted to 3mm in lower 1/3 also.

Saw different dr. specializing in motility disorders. Dilation to 12mm via

fluroscopy on 10/28 resulted in ulcer bleeding and I left w/3 endoclips in my

throat and a second one scheduled (and done) on 11/23. W/in a week and a half

or so after 10/28 I could tell I was pretty much back to where I was before that

and the (therapeutic) dr. (same one as before) doing dilation on 11/23 confirmed

it - couldn't get the scope thru again but dilated to 15mm this time w/no

bleeding. He wanted to schedule a third for 2 weeks later but I have not done

so. There has to be a reason I constricted again so rapidly and completely and

I want to pursue the reason instead of just doing dilations. He took no

biopsies either time.

Will be a week tomorrow since second one and things are still pretty good w/lots

of water, of course. (even got to have a little turkey!!)

Anybody ever have the stricture return so fast and furious or have any ideas as

to why/what? I've made an appt w/the motility specialist for the 7th and will

see what she says but wanted to ask you all, too.

Thanks,

[Guest guest]

Hi ,

Sorry to hear about your situation.  This group can be very helpful.  Where

are

you from and who are you seeing for all of this?  Please share.  You had the

Heller in '02, with a wrap, was it a Dor?  Also, are you saying that you have

developed a stricture?  Is that like a thickening ring in the esophagus? 

Please

give more detail if possible.  I would think that if that is the case you may

want to consider surgery...something more than just dilation?  I've also had

Achalasia for 22yrs now.  I just had first surgery which was a hellers/Dor in

August.  The relief has been successful for me so far. 

One thing this group will tell you is to make sure you have the very best

doctors that you can find that are experts with achalasia and the esophagus.  I

know you are in distress and I hope that we can support you!!!! 

Julee So Calif.

________________________________

From: <muthjennifer@...>

achalasia

Sent: Mon, November 29, 2010 9:44:19 AM

Subject: Re: 2nd dilation

 

I've had A for 21 yrs. Dilation when diagnosed w/good success.

Heller/part myo in '02. Been having trouble again for a good year now, was on

liquids since June, ulceration/inflammation, etc. in lower 1/3 of E and was

constricted to 3mm in lower 1/3 also.

Saw different dr. specializing in motility disorders. Dilation to 12mm via

fluroscopy on 10/28 resulted in ulcer bleeding and I left w/3 endoclips in my

throat and a second one scheduled (and done) on 11/23. W/in a week and a half or

so after 10/28 I could tell I was pretty much back to where I was before that

and the (therapeutic) dr. (same one as before) doing dilation on 11/23 confirmed

it - couldn't get the scope thru again but dilated to 15mm this time w/no

bleeding. He wanted to schedule a third for 2 weeks later but I have not done

so. There has to be a reason I constricted again so rapidly and completely and I

want to pursue the reason instead of just doing dilations. He took no biopsies

either time.

Will be a week tomorrow since second one and things are still pretty good w/lots

of water, of course. (even got to have a little turkey!!)

Anybody ever have the stricture return so fast and furious or have any ideas as

to why/what? I've made an appt w/the motility specialist for the 7th and will

see what she says but wanted to ask you all, too.

Thanks,

[Guest guest]

Hi Julee,

I've actually been a member of the group for over a year now except I

accidentally unsubscribed for a couple weeks a couple months ago.

I'm in PA and am seeing Dr. Bethards at Hershey Medical Center.

Like I said she specializes in motility disorders and I really like her. I

switched from a gastroenteroligist who was good and had referred me to an

excellent surgeon for my myo but I now wanted someone who specializes in our

problem. Things were GREAT for 7 1/2 years after the myo. No reflux, nothing

but good swallowing until last year when I could tell things were starting to

close up again.

If I'm understanding them according to the GI and the therapeutic dr. doing

these dilations (not Dr. Bethards) it's the lower 1/3 of my E, not my LES that's

constricting. Not just a band of tissue, the whole lower 1/3 was down to 3mm

wide and then again, 3 wks (less) after the first dilation in Oct. Things are

still good right now, a week after the second one.

Having had such good success w/the very first dilation 21 yrs ago and w/the

surgery much later I am just really wondering what's happening this time around

and if anyone else has experienced this.

[Guest guest]

,

I just wanted to get your time line straight. You had your 1st dilatation 21

years ago and then 14 years later had a myotomy? Do you know what your esophagus

looked like when you had the myotomy?

Was it all stretched out and turned (sigmoid) or did it maintain its shape for

those 14 years?

I ask because I have heard about sigmoid esophagi folding in on themselves and

not allowing any food to go through.

This is probably not your situation since you said a dilatation is helping you

swallow temporarily. I personally have not heard of anything like this happening

but I am sure there are people in this group that can chime in.

It is very important to get checked out by the experts especially since this

sounds a little out of the ordinary. So if you aren't getting answers from your

current team of doctors, I would look at other options.

Good luck to you and keep us posted,

Cara

>

>

> Hi Julee,

> I've actually been a member of the group for over a year now except I

accidentally unsubscribed for a couple weeks a couple months ago.

> I'm in PA and am seeing Dr. Bethards at Hershey Medical Center.

> Like I said she specializes in motility disorders and I really like her. I

switched from a gastroenteroligist who was good and had referred me to an

excellent surgeon for my myo but I now wanted someone who specializes in our

problem. Things were GREAT for 7 1/2 years after the myo. No reflux, nothing

but good swallowing until last year when I could tell things were starting to

close up again.

> If I'm understanding them according to the GI and the therapeutic dr. doing

these dilations (not Dr. Bethards) it's the lower 1/3 of my E, not my LES that's

constricting. Not just a band of tissue, the whole lower 1/3 was down to 3mm

wide and then again, 3 wks (less) after the first dilation in Oct. Things are

still good right now, a week after the second one.

> Having had such good success w/the very first dilation 21 yrs ago and w/the

surgery much later I am just really wondering what's happening this time around

and if anyone else has experienced this.

>

>

>

>

>

>

>

>

>

>

[Guest guest]

wrote:

> If I'm understanding them according to the GI and the therapeutic dr. doing

these dilations (not Dr. Bethards) it's the lower 1/3 of my E, not my LES that's

constricting. Not just a band of tissue, the whole lower 1/3 was down to 3mm

wide and then again, 3 wks (less) after the first dilation in Oct. ...

From what you have said before, you have spasms, painful spasms. They

can be in the esophageal body not just a problem of the LES. Typically

they would be in the lower 1/3. It sounds like a spasm was described.

notan

[Guest guest]

Cara,

It was stretched out some 21 yrs. ago but apparently has maintained it's shape

thru-out time.

I'm aware of sigmoid E and none of the doctors have said mine is so one would

think not but I've put it on my list of questions just in case.

Thanks.

Notan:

I did have frequent and pretty severe spasms starting the day after the second

one a week ago but not after the one in Oct., which was when I re-constricted

(is that a word?) so rapidly. I'm hoping this is a good sign for this one to

last. Haven't had one since Monday nite, thankfully. They felt just like A

spasms I've had in the past. I've added another question to my list from your

comment. Now I'm wondering exactly what is being dilated? Can they dilate the E

and not the LES or is it a package deal? Everyone just keeps talking about my

E.

I am also taking 40mg of Prevacid solutab 2x/day and Carafate slurry 4x/day for

the inflammation/ulceration.

Dr. Bethards prescribed this which my former GI hadn't, so I feel really good

about the change.

I love this group!

[Guest guest]

wrote:

> ... Can they dilate the E and not the LES or is it a package deal? ...

They can do dilatation on the E too. I don't know if they would but they

could.

Here is a thought for you, peppermint oil, reports suggest that it calms

esophageal spasms.

Peppermint oil improves the manometric findings in diffuse esophageal spasm.

http://www.ncbi.nlm.nih.gov/pubmed/11418786

Peppermint oil reduces gastric spasm during upper endoscopy: a

randomized, double-blind, double-dummy controlled trial.

http://www.ncbi.nlm.nih.gov/pubmed/12665756

(This study is really too small to mean much but it is interesting.)

notan