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My EsophyX procedure..9 days post-op

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  • #76
    I second this--I'm grateful for your progress reports. I've been rooting for you, and I hope sincerely that this procedure will be perfected. I am simply bothered that the company and the physicians do not seem to be on the same wavelength about the consequences of this procedure. I certainly did not mean to imply that you were in any way gullible for pursuing this procedure or offend in any way--my 'guinea pig' allusion was simply meant as a warning to all others out there that, despite the company's good intentions, this procedure is a work in progress, not a harmless, simple, reversible, walk in the park solution to GERD. Maybe it will become that, but it doesn't sound like it's there yet.

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    • #77
      Thanks a lot for the well wishes from both --rato and Kevin...I sincerely mean that. If I came off a bit defensive...I am sorry about that. To be quite honest, I am probably a lot more frustrated than I have even realized. I just returned from my last doctor's visit and will update tomorrow. This whole process has been a total grind, and I am glad that it can hopefully shed some light on a few things. My next post will be kinda long...so I'm waiting until tomorrow...outta energy. Thanks again very much for the well wishes.

      @Jurgen - Just wondering if you had that appointment and how it went?

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      • #78
        And you have a right to be frustrated. I am frustrated too, as I was really hoping that this procedure would work out for you. Everyone here understands how tough this disease is to deal with, and we're just grateful that you've been willing to share your experiences with us.

        In the worst case scenario, if you have to get a fundo, that is what you would have needed to get anyways. On the bright side, it is a more established procedure with a much better track record of success, so you won't have to worry as much about whether there will be results.

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        • #79
          Just remember that you are supported here and that your reports are very valuable. It's likely that everything will work out eventually. I'm very sorry this is turning into a medical odyssey for you. It can be exhausting, especially if your daily responsibilities weigh on you at he same time. Best of luck

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          • #80
            Sorry this has taken so long, but it has been such a busy time lately. And again..thanks for the well wishes..means a lot. Frankly...I don't have time to deal with this dang disease any longer right now! Just after the holidays last year I was 6'3" and 202 lbs. Obviously I am still the same height but now around 180 lbs. I am HUNGRY. Enough of the crybaby stuff...here's where I stand.

            So I spoke with my Doc and had a big list of questions. Some I had general knowledge of before hand, and some he clarified for me a lot. As of now..from doing the last scope..it is assumed that the esophyx did not effectively work. It is still possible that this is not the case. There is still a possibility that I am not passing food through the LES valve normally and that is causing my issues. Even if this is not my sole problem, I think it is one of them. I feel much worse after solid foods..can taste what I have eaten in my mouth for hours after a meal..and had a poor motility result before I ever had surgery. All of this leads me to think that food isn't passing into my stomach normally. So it is possible, that even though the surgical site looked flawed, that the procedure may be doing it's job. I have been back on PPI's for awhile now so there is no way to tell now. So...as luck would have it...I get to do the bravo test and manometry (dreading this) again to find out. I really wanted to avoid the manometry again, but it is necessary at this point. I am having it done by a GI specialist recommended to me in my home town instead of traveling to get it done again. The reason for this is twofold..one is to avoid the drive..two is for a second opinion. Why not at this point, right??

            Rato...I have been trying to talk myself into exactly what you said about the nissen...so it is reassuring to hear you say it as well. I got some definitive answers about how a nissen would go down after having the esophyx. I had a good idea of where I stood before having this done, but got clarification on a few things. First, a redo is entirely possible..and it's not that big of a deal. At this point though..my Doc feels that I am never going to stop cycling, I am never going to stop going to the gym, I am never going to quit golfing so he wants me to have what is most durable...he feels that is the nissen. I am not going to make any proclamations...but read into that what you want when comparing the two

            So here is the deal with the reversible issue after my conversations...plural because i spoke with several surgeons. It is true that if you think an easy reversal is possible with the esophyx device...you are mistaken. I think that has been the general understanding on this board for awhile now. There is no way that it can be undone endoscopically...and yes, I feel that is how it is represented on the company website. Here is what can be done however...if you are getting a nissen done after the esophyx...it does not have to be done over top of what is already there. The esophyx procedure can be "taken down" which essentially returns you back to your original state first. Most, if not all, of the fasteners are taken out. If there are some that are deeply embedded, then they are left. The most important part though is that the esophyx procedure is taken down before a nissen is done, and it is all taken care of during the same surgery. Although, the reason this can be done is because you are already having a laparoscopic procedure (the nissen) performed. If someone tried to just have the esophyx taken down, for no other reason than to just get rid of it, I don't believe you could ever find a doctor to do it. So does this jive with a claim of the esophyx being reversible...absolutely not in my opinion. This was good to find out however, because I did not want one procedure done over another.

            Another question that I had dealt with the life expectancy of a nissen. From my research, it is typically 7-10 years. I also read that no more than one redo is recommended. Me being in my mid-thirties, made me worry that the esophyx..and then a nissen..would already count as two. I was glad to find out that it would not. The reason for the limit on having a nissen redone..as i was told..is because of the trauma caused to the esophagus from the dissection done during the surgery. Since this is never done with an esophyx, it would not effect future nissen redos.

            I think that is all for now. I have to schedule the two tests with the new GI doc and then go from there. Who knows...maybe this thing is actually working and my poor motility is causing the issue. One good thing..I was terrified to have the nissen done before. Now, I could care less. I just want to be on the other side of all this and get back to moving forward in life. I will certainly update after my next round of tests are complete, and I have a second opinion. Again...thanks for the well wishes. I hope the very best for everyone dealing with this mess too.

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            • #81
              Very interesting. Thanks for the update!

              Perhaps Tricia could jump in here with her assessment. I have always read that a Nissen with a case of poor motility is risky. Might not the same be true of an Esophyx procedure? One does read about partial wraps used in motility dysfunction with success, but I have never seen a definitive answer on this.

              Best wishes! I grew up in the Charlotte area--always a lot of traffic! I hear that Bank of America might leave....

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              • #82
                My original doctor in Raleigh recommended a toupet (270 degrees) fundo instead of the standard 360 degree wrap because of the motility. An esophyx is also 270 degrees.

                The traffic does leave a lot to be desired, but I will take the weather-for-traffic trade any day. Now, if I could just get back on the golf course....

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                • #83
                  Kevin

                  Originally posted by Kevin View Post
                  Very interesting. Thanks for the update!

                  Perhaps Tricia could jump in here with her assessment. I have always read that a Nissen with a case of poor motility is risky. Might not the same be true of an Esophyx procedure? One does read about partial wraps used in motility dysfunction with success, but I have never seen a definitive answer on this.

                  Best wishes! I grew up in the Charlotte area--always a lot of traffic! I hear that Bank of America might leave....
                  Hi Kevin All of the esophyx studies, exclude people with esophageal motility disorders . My understanding is they don't touch people with motility disorders . Here's a trial by Blair Jobe [url]http://clinicaltrials.gov/ct2/show/NCT00857597[/url] You see under exclusion criteria - esophageal motility disorders .

                  There are two classifications of esophageal motility disorders though , there are primary motility disorders that are not caused by GERD -- and there are secondary motility disorders caused by GERD . That's where proper assessment comes in. If someone has bad peralistis or failure of relaxation for example , it is up to the surgeon to decide if a carefully constructed full fundo would improve motility or cause problems . You probably have seen studies saying fundos improve peralistis , sometimes they do - sometimes they make things much worse . The decision would be based on the total clinical picture ( is the motility issue primarily GERD caused or not ? ) the specific test results ( how bad motility is ) and the surgeons clinical experience.

                  We've had people with bad motility in the forum get multiple opinions and one surgeon will say he can only do a partial..... and then they will go to another surgeon who will say no problem with a full----- the wraps are pretty floppy these days they say , or they can make it looser if need be . Of course it depends on the nature of motility problem . A lot of motility problems are misdiagnosed on manometry so proper diagnosis is imperative prior to any op . People with nutcracker esophagus or diffuse spasm would have to have a partial . A full fundo is disaster in those people. I don't remember very many partial successes in this forum in people with primary motility disorders.

                  Often people with motility issues have a very sensitive esophagus too, so any stimuli provokes symptoms.

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                  • #84
                    Hi, all!

                    It`s been one week since I had the Esophyx procedure. I went to the doctor recommended by NEVERMIND and so far I am very happy with the results. The pain is slowly fading away and my throat is vey clean. I pray this lasts..

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                    • #85
                      Good news for you Iva!! I hope you continue to have a great result and keep feeling better. Do you think as highly of the doctor as Nevermind did? She was a big fan of his.

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                      • #86
                        Thank u, DTanna

                        I wish u could feel the same..
                        The doctor..I didn`t actually meet him, because he was in a rush, he had many operations planned in different hospitals, but I had contacted him by e-mail and spoken with him on the phone. I hope the reslults of his work will speak for themselves.

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                        • #87
                          Iva,
                          I am so very happy to hear that you are doing well. I really hope that you will continue to leave updates on your results...I am extremely interested to hear how the rest of your recovery goes. It sounds like you and Never have a very good surgeon, and I am very interested to hear how things continue to go for you. The biggest thing though...is just that you are doing well, and feeling well, and no longer have to deal with horrible reflux! Please let us know how your progress continues. I am thinking of getting in touch with your doctor...so any updates would be very appreciated. Continued good luck and continued good health!!

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                          • #88
                            You are so nice, DTanna,thax

                            It`s been 14 days since I had the Esophyx procedure. I am feeling fine, some slight pain (I suspect it`s when reflux tries to escape trhough the valve but is stopped), still taking Nexium (doctors told me to take it for 2 weeks but I am planning to take it a bit longer though not daily).
                            DTanna the doctor is based in Paris and you may contact him by e-mail (when you google the name Adrian Lobontiu you will find the address).
                            How are you doing, having pain, reflux?

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                            • #89
                              Hey Iva. I am doing pretty well. Some things are much better than before the surgery, and some things are worse. I still think that my motility problems are what is troubling me the most right now. It is hard to say what is wrong with me right now because no matter what I eat...some days are great and others are not so good. I am going to a local gastro to have the 2 tests done that my surgeon is requesting. I am having all of my records sent to him for a second opinion before I move forward with anything else.

                              It's great that you're feeling well. I had some pain early on that I could tell were from things trying to move past the valve. Hang in there...it gets better!

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                              • #90
                                Hi,DTanna!

                                What test are going to do? What do u mean by "some things are worse"?
                                Wish u luck anyway..

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