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What Pre-op Questions to Ask Surgeon?

Posted , 8 users are following.

maya2452
maya2452

I'm new to this forum. Live in Texas and have had achalasia for 16 years. It is now so bad that I need surgery. I'm desperate!!! I wrote up a few questions to ask my surgeon at our consultation on June 5 and wonder if some of you with more experience having had a Heller Myotomy with fundoplication could add other questions. These are mine:

1. What type of fundoplication do oyou perform with HM?

2. How many HMs have you performed?

3. What is the success rate of your patients?

4. What are possible post-surgery side effects?

5. How long does the surgery take?

Many thanks for your input.

1 like, 36 replies

36 Replies

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  • AlanJM
    AlanJM maya2452

    Posted

    I think I would start with asking for an explanation of exactly where the problems are occurring in your oesophagus (this should be clarified with high resolution manometry) and the length of the muscles that the surgeon intends to cut.

    ​What condition is your oesophagus in generally, or has it become baggy and lost its natural tone and resilience?

    ​Then it is a matter of how far the fundoplication will be wrapped around to deal with reflux.

    • DJ-RN
      DJ-RN AlanJM

      Posted

      When your talking esophageal Alchalasia, it's already understood that the esophagus has lost its tone and has an excessive amount of turgor. Rather it be a partial wrap, or a full wrap (which is usually not done,) most likely the patient is going to experience GERD. Often though after healing, the GERD subsides. But you can almost be guaranteed some acid reflux on any Fundoplication that they do.

      Good Luck!

      DWRN

    • maya2452
      maya2452 AlanJM

      Posted

      Thanks for the info, Alan. I think my esophagus is dilated but not horribly so. I believe that the reason I"m still having such a problem eating after a balloon procedure and several dilations over the years is that the muscle spasms and doesn't stay open. That's why I want the HM surgery.

    • AlanJM
      AlanJM maya2452

      Posted

      I think it is very logical to go for the Heller's myotomy if the dilatations do not really work long term.   The manometry test should show exactly where the problems are occurring in the muscles up the length of your oesophagus and the surgeon should have this information so as to know what length of muscles to cut in order to relax the clamping shut of (presumably - and normally) the lower oesophageal sphincter.

      ?Cutting these muscles does allow the food to transit through much better, but the side effect is that the valve effect is lost to prevent the reflux.   Hence the fundoplication to re-create this valve effect.

      ?The spasms are normally caused either by this sphincter muscle system being clamped shut, or by reflux, or by something else.   This sounds a bit vague I know.   But the myotomy should enable food to pass through very much better so as to ensure you can retain good nutrition.   It does not guarantee freedom from spasm pain in the future, however, but in many cases it does.

      ?As the years go by, it is possible for the oesophagus to get baggier and baggier under the weight of the coagulating food until it drops below the entrance into the stomach, and then the food can become stagnant as it has no route to escape except upwards.   So it is a good thing to have the procedure done at an early enough stage to avoid this.

  • Pepita933
    Pepita933 maya2452

    Posted

    I live in the Houston area and had an awesome surgeon.  He used a DiVinci machine--it is robotic surgery, and is minimally invasive.  For me this surgery was easier than many of the surgeries I have had.  I think I had liquids then soft foods before I got out of the hospital.  I think my time in the hospital was tops 3 days.  I had not been able to eat much but liquid things before the surgery, and after was so much better.

    i think surgery can be scary.  Try to focus on how much better your life will be after the surgery.  Overwhelming fear is not good for you or your family.  Go on walks, start giving thanks for the good things in your life, your little one, a drop in the temp., a beautiful sunset.  Yes, you can plan your questions, but try and get a grip on your fear.  Check out the hospital, if you trust your primary care doctor ask who he would see.  If you believe in a higher power, give your troubles to him, just put all these worries metaphorically into a big laundry basket, and hand it to him to handle.  If you find yourself worrying again, do it again, and again.

    Remember this is just a temporary thing, just a moment in your life.  It gets better.

    • DJ-RN
      DJ-RN Pepita933

      Posted

      Such great advice. Sometimes we can literally make ourselves sicker.

      DJRN

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