Yesterday, after my repeat esophagoscopy, Dr Lewis came to the conclusion that I do not really have an esophageal stricture, but a form of achalasia. This is a condition where the esophagus does not contract and the sphincter at the distal end does not relax. In layman's terms, the esophagus does not propel food towards the stomach, and the muscle of the lower esophagus does not relax to allow the food to advance from the esophagus to the stomach. The result is accumulation of food and saliva in the esophagus that needs to go somewhere. When upright, it can eventually trickle into the stomach by gravity. When lying down, it can go back into the throat and even possibly get aspirated into the lungs.
My search of the internet does not reveal much about this condition acquired as a result of radiation.
Dr. Lewis will consult with a colleague at UCSF and get back to me on Monday.
Possible treatments are:
1. Drugs which relax smooth muscle. These may not be right for me as my blood pressure is already low and this might make it worse.
2. BOTOX! This can be injected through the endoscope and might paralyze the sphincter.
3. Some form of myotomy in which the sphincter is cut, probably also done endoscopically.
4. Major surgery to remove the involved segment of esophagus and pull the stomach into the chest or replace the segment with colon. This would be a last resort. However, it might be best if there is no Merkel Cell Carcinoma lurking in my body.
Last night, I did get some sleep, but today, the second bottle of Boost+ does not want to go down easily.
Most people, when depressed, complain they can't eat and can't sleep. I am becoming depressed because I can't eat and can't sleep.
It is amazing that this has all come on within less than a month.
No comments:
Post a Comment