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hernia into esosphagus

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Posted 3/15/2016 5:57 PM (GMT 0)
Hi everybody
I have been having a hard time eating for the last 3 months and the condition is getting worse and worse. Here are the symptoms-I can swallow okay but then have intense chest pain and pain in the diaphragm. Then slowly the food or thicker liquid comes back up. I sleep sitting up but if I really fall asleep for a number of hours I have my whole throat area full of slime etc. Some of it runs into my lung and I have to use a breathing treatment several times a day to remove it.
Had a 90 minute gastric emptying study done yesterday where a photos is taking every minute. It seemed the food was not moving out of the esophagus or very slowly. At 30 minutes it was still there. Upon my urging the technician consulted with the radiologist, send him the pictures and I was told that what we thought was a full esophagus was really my stomach pushed into the esophagus. I have an emergency appointment with a different GI because mine is not available. I have barely eaten anything in a month and I think I weigh less than 90 pounds. I have been to the GI 3 times and so far he ignored that I cant eat and suggested smaller meals etc. I have been to 4 ER ( 2 diffferent hospitals) and they always said they can do no tests or xrays in the ER.-Im getting pretty frantic. I will ask the GI today to admit me to hospital where they have good GI surgeons because something got to be done so can get some sort of nutrition.
Has this type of hernia happened to anybody else? I had a Nissen done in May 2015, don't know if that has anything to do with it.
Posted 3/15/2016 11:35 PM (GMT 0)
I come back from my office visit with another doctor at the clinic. He absolutely refused to look at the reports and xrays I brought in. He was absolutely furious that I saw him an dnot my usual doctor. He kept asking me and my daughter what the purpose of it was . I had a nerve asking so many questions etc. I explained to him that my regular gastro cancelled the appointment I had with him and that he can't see me until Mid April. And since I have not been able to eat anything I did not want to wait that long . I told him that I was hoping that he was able to put me in the hospital. He said that there is no reason to put me in the hospital because not being to eat is not an emergency and no insurance company would pay for it. My daughter asked how is not being able to eat not an emergency and he got really ticked and said we have no right to ask all those questions. I then said , well since you are refusing to look at the xray results I guess this visit is over. My daughter went to car and cried because she is so frustrated that nobody is helping me. Then he ran out and ranted to the assistant about me. She then ask me what happened and I told her. I was told to wait in the waiting room and the office manager came out and also inquired about what happened. She is supposed to try to get a hold of my regular gastro and then call me back later this afternoon.
Is it true that not being able to eat is not an emergency and an admission to the hospital would ot be covered? I'm from Germany and I know for a fact that in my home country they would think otherwise and I would have been admitted immediately. I stepped on the scale and lost 5 pounds this week alone.
Please respond because I don't know how to go from here.
Posted 3/16/2016 12:10 AM (GMT 0)
Who gave you the prescription for the swallow study?

I can't understand why the doctor wouldn't look at the x-rays. Did you tell him first that you had a study that showed the stomach herniated into the esophagus and that food just sits in the esophagus because the esophagus is blocked?

I'd try to get in to see a gastro from a different group. I assume the second doc was in the same group.. Tell the person making the new appointment you couldn't get an appointment with your regular doc and don't mention the second guy. Also say you have lost a lot of weight and are now under 90 lbs.

If that doesn't work you can ask the radiologist to refer you to someone, maybe some sort of surgeon, and to call to help you get seen fast.

Or - you can go to an emergency room. But that will incur an ER fee. Take your pictures with you! Just make sure you don't get admitted to the group giving you trouble. I would say I don't have a group now.

If what you said is correct this is beyond a gastro doc. They don't do surgery. Is there a thoracic surgical group? It's not really just general surgery.
Posted 3/16/2016 3:36 AM (GMT 0)
Hi Alcie,
I have an appointment with a gastric surgeon at a local university next week. I made the appointment 2 months ago. I'm now trying to just wait it out for that appointment.
and guess what: the office manager of the office I went to today called me shortly after got home and she wants me to come in this thursday and meet with the regular gastroenterologist I see and who supposedly could not fit me in his schedule until mid April.
When I see the surgeon I will ask him for recommendation for a different gastroenterology clinic. Once that is established I will stop seeing the group of doctors I see now altogether.
Posted 3/17/2016 1:36 AM (GMT 0)
It sounds like you are getting somewhere. I'm glad the office manager seems to be on your side and you have an appointment with a surgeon.

Can you get liquids down? Maybe a little at a time? If you can't swallow anything at all you have to get care somewhere.
Posted 4/3/2016 5:43 PM (GMT 0)
HI all,
Well the herniated esophagus was a wrong diagnoses. The radiologist simply did not know how a Nissen looks on xrays etc >:( Ended up in the ER , I was admitted and stayed for 12 whole days during which all types of tests were done.
During the barium swallow half of the first swallow went into my windpipe and I had a coughing fit which wrote it back up. Second swallow went down okay. Third swallow was too slow moving through the esophagus.
Swallowing study with a speech therapist did not show aspiration but it did show that a small amount of barium did not leave my throat.
Gastric emptying study result-stomach emptied only 19 % at 90 minutes. Since I don't vomit I was not diagnosed with gastroperesis???
I also had a manometry which showed a lot of weakness in the middle of my esophagus. Doctor looked at it and thought food may be pushed back up from the bottom of my esophagus but it was otherwise insignificant.
Every morning I had breathing problems and needed a breathing treatment to get me back on track. The respiratory therapists I encountered during this time all said that the wheezing was in the upper airway and not in my lung which is usually caused by aspiration. I asked them to document that. Nurses documented when a coughed up jello etc after eating.
A burger study was cancelled because the readiologist did not deem it safe after I aspirated during barium study.
Basically I'm back to square one. I was told that my case is complicated and I need further outpatient sudies done . They can't keep me forever.
I still think that I'm aspirating but they refuse to acknowledge it because swallowing study came out negative for aspiration. Aspiration on barium study is not good enough to get dianoses of aspiration.
Any ideas about any of this?? Emptying study? I'm still waking up every morning with food stuff in my mouth and I'm down to 89 pounds.
Posted 4/5/2016 6:37 PM (GMT 0)
Nobody?
Perhaps someone can tell me if a gastric emptying result of 19 % emptying at 90 min is still normal.
I called the hospital to check on the status of my request of records and I should have them in another 10 days or so. I have an appointment that the hospital made for me this afternoon.
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