USC medical center, here I come...(maybe)

[innerSpaceman]

Originally Posted by scaeagles

The last option is a surgery called a heller myotomy, which is basically removing the sphincter at the bottom of the esophagus and cutting away portions of the muscles from around the lower esophagus. This is what I had done in April. Was great for about 4 months, then symptoms returned.

WTF?!?! You have one aggressive esophagus there, bud!

Ok, so how does that surgical procedure differ from the one(s) being proposed now? I can understand not wanting to have surgery that results in a measly 4 months of respite, but - even accounting for you being on the uber-low end of the symptom-abatement scale - how long are abatement rates predicted for either of the two new surgical proposals?

My point is that you can always go the feeding tube route ... (without making too light of the risks and recovery surgery entails) why not try all other options?

[SacTown Chronic]

Originally Posted by innerSpaceman

WTF?!?! You have one aggressive esophagus there, bud!

I swear, ya read things on the LoT that you'll never see anywhere else. Ever.

[scaeagles]

Originally Posted by innerSpaceman

Ok, so how does that surgical procedure differ from the one(s) being proposed now? I can understand not wanting to have surgery that results in a measly 4 months of respite, but - even accounting for you being on the uber-low end of the symptom-abatement scale - how long are abatement rates predicted for either of the two new surgical proposals?

My point is that you can always go the feeding tube route ... (without making too light of the risks and recovery surgery entails) why not try all other options?

The surgery I had (a heller myotomy) is a modification of an existing organ, being the esophagus. What's being proposed is a replacement of the esophagus with part of my intestine, basically a transplant within myself. The original was a 3 hour surgery (and it included an anti-reflux procedure as as well). What's being proposed, so i was told, it a 12-14 hour ordeal, and messes with stuff that currently works just fine. The original was done laparoscopically (6 small holes in my abdomen), the second will require a full opening of my abdominal cavity and chest (this is my presumption, not what I was told - how the hell else could they move part of my intestine to my chest, including under my sternum?). The recovery time will be immense, as opposed to basically a week for the first.

Yes, I can always go the feeding tube route. So it's a cost/benefit analysis for me. Or better stated a risk assessment analysis.

Truthfully, I'd go through my first surgery every 4 months for the rest of my life if it were possible. I'd take a week of recovery for 4 pain free months and the ability to eat what I want (after a couple weeks of restrictions for internal healing) without the pain associated with what I deal with now.

I was told that the esophageal replacement was basically the "last chance" for relief. That tells me it is either a permanent solution or....I don't know. If it doesn't work, I really don't know what that means. How screwed up would I be then?

During the progression of my disease, I have had all sorts of opportunities to read up on therapies and treatments and surgeries and became very comfortable with what was proscribed. This, however, has come at me completely from left field and I have had no time to research it or think much about ramifications.

But, hopefully, this is an exercise in futility. There will be other opinions. And in fact, this morning, my case manager from my insurance company called and has a surgeon who works out of a hopital less than a mile from my home who was trained at the Mayo facility here in Phoenix. She spoke with the surgeon and the surgeon believes that she can help me. This is encouraging. I am hoping there is a surgery much less radical. My appointment is next Tuesday afternoon. This is the surgeon who was recommended to me by the surgeon who did my first (he had to retire for medical reasons of his own). The insurance at first did not want to approve out of network, but they have run out of options.

So, I am hoping to have a different solution in a few days.

Steve, thanks for your interest.

[scaeagles]

If anyone is interested, here is a web page that has the most concise explanations of therapies for achalasia.

http://patients.uptodate.com/topic.a...=digestiv/4384

[innerSpaceman]

Let us know what the new surgeon with encouraging style has to say. Hang in there!

[scaeagles]

One other note - I finally found a study on esophageal resection (the proposed radical surgery). 37 operations over a 16 year period. 2 died in surgery. 34 had no further problems. Don't know if I like a mortality rate of over 5%.

[alphabassettgrrl]

Wow- that's a lot going on. Let's hope your insurance just approves the stuff you need, that the surgeon can find a good procedure that will fix your problem, and recovery times that go well.

[scaeagles]

Crap - what is it with surgeons and surgery? I've again been bumped. I was supposed to meet with this other surgeon today at 3:00, but got a call telling me she had to go into surgery. I'm important, dammit! Let the other guy bleed out and meet my needs now!

Well....maybe not. I'll have to wait until tomorrow at 8:30am.

[Not Afraid]

That happened to me when I had cancer. What? I have cancer and I got bumped???? Well, somehad it worse than me, I guess.

[scaeagles]

Cancer....yikes....my problem is so small. Non-fatal has such a nice ring to it in the grand scheme of things.