A few posts ago I wrote about finding out that I have Barrett's Esophagus, here: A Day In My Life: Barretts Esophagus Go to the post and read the definition and such if you would like.
The short story is I recieved the diagnosis (in the mail) on July 1 and finally had an appointment with the surgeon yesterday!
He asked why I had come, what questions I had and I said " well given the fact that my Dad died of esophageal cancer, and I received a paper in the mail saying I had Barrett's esophagus, we are wondering where do we go from here" (my husband was with me).
Dr Harmon was awesome...he broke down the definition of Barrett's esophagitis, explained that the statistics are inconclusive as to how often someone with Barrett's ends up with esophageal cancer. He said the suggested recheck would be in three years, but after talking with me he felt comfortable saying he would do it again next year at this time, and if insurance was a problem he would "fight" to explain to them why I should have it rechecked in a year. (due to the history I have).
So I will have another biopsy next year at this time.
He said the key is to get rid of the reflux...medicine, diet, raising the bed head higher than the feet...were all important.
Dr Harmon said often times medicine does not do the trick and then surgery is suggested. It is called :
Nissen Fundoplication
In a fundoplication, the gastric fundus (upper part) of the stomachis wrapped, or plicated, around the lower end of the esophagusand stitched in place, reinforcing the closing function of the lower esophageal sphincter. The esophageal hiatus is also narrowed down by sutures to prevent or treat concurrent hiatal hernia, in which the fundus slides up through the enlarged esophageal hiatus of the diaphragm.
In a Nissen fundoplication, also called a complete fundoplication, the fundus is wrapped all the way 360 degrees around the esophagus. In contrast, surgery for achalasia is generally accompanied by either a Dor or Toupetpartial fundoplication, which is less likely than a Nissen wrap to aggravate the dysphagiathat characterizes achalasia. In a Dor (anterior) fundoplication, the fundus is laid over the top of the esophagus; while in a Toupet (posterior) fundoplication, the fundus is wrapped around the back of the esophagus.
The procedure is now routinely performed laparoscopically. When used to alleviate gastroesophageal reflux symptoms in patients with delayed gastric emptying, it is frequently combined with modification of the pylorus via pyloromyotomy or pyloroplasty.
He suggested that, although he wouldn't want to rule out surgery, he would like me to try all the other things first. I told him that the medicine I am taking does not seem to be taking care of the symptoms. He suggested two things: switching the med from morning to taking it at night, and adding an over the counter product in the morning for awhile. He did say that the medicines are proving to cause problems with osteoporosis and that it is important to keep that in mind.
Scott asked him about my intake of DIET COKE (creep) and he did suggest that any type of carbonated beverage...and caffiene were no nos, although he said "anything in moderation" is acceptable. More on the diet coke issue in a later post.
All and all it was a very enlightening meeting. He said he wished more people would call him and set up appointments to talk about results like these, but that so many don't. He did say that although in the two biopsies he took there was no dysplasia, that you can never be quite sure as there is so much surface to cover. He felt that checking again in a year, would help to rule out dysplasia all together.
I showed him a book I had ordered and just recieved about eating with acid reflux problems. he did have some thoughts about that too, which I will share later, along with the book.
In the meantime, I hope sharing this helps someone else, I never think going and looking for problems is a good thing BUT if you have severe acid reflux, wake up in the mornings with a sore dry throat, feel like there is something stuck in your throat all the time and have asthma and a relative who has has esophageal cancer...well it is probably time to ask your Dr. about being checked..."just sayin'"
Another thing about that...he said he would be interested to know what "type" of esophageal cancer Dad had, as there are two types and possibly he didn't have the type that we are concerned about. DAD was a heavy smoker and an alcoholic up until the last 30 years of his life, and he complained of acid reflux problems. I am pretty sure I can get that info from my very organized step mom:)
Thanks for reading!
Dancingly, Denise
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