Note (Mar 5th): This is an update of “Going under the knife tomorrow”

For the last 8 or 9 years I’ve been suffering from a rare condition called achalasia, which makes it difficult to swallow food and liquids because my lower esophageal sphincter, a trap door at the entrance to my stomach, fails to open to let stuff through when its supposed to.

The sensation feels like you have something trapped in your throat after swallowing anything substantial, which is pretty-much exactly what is happening. Its not pleasant, and means that I need to eat slowly, and drink a lot of liquids while I eat to “flush” it all down. Even worse, sometimes it just doesn’t go down at all, in which case… well, you can imagine.

They don’t know what causes achalasia, but they do know that its not something that goes away naturally. Eight years ago I had a simple procedure called a balloon dilation, where they deliberately stretch the misbehaving sphincter so that it doesn’t close properly, and lets food through. That provides a few months of relief, but its not a permanent solution. Of course, there is a reason that sphincter is there in the first place, and so if it doesn’t close properly it can cause heartburn because acid from your stomach gets up into your esophagus where it doesn’t belong. Anyway, since I had that procedure back in 2000 in London I’ve just learned to live with the problem.

But a few months ago I decided that I would go see a doctor about it again, and learned about a newish treatment called a Laproscopic Heller myotomy, which is performed through keyhole surgery, making it less of a big deal than it otherwise would be. It involves cutting the muscles that keep the problematic sphincter closed, thus addressing the problem of food not getting through for the long term, and often permanently.

Of course, like the balloon dilation, leaving the trap door open can allow stomach acid to get where it doesn’t belong, causing heartburn – therefore they do another procedure called a fundoplication, which involves wrapping the top part of your stomach around the esophagus, effectively creating a new artificial sphincter of sorts, which should help prevent heartburn.

So Thursday was the big day, my surgery was at 8am, by early that afternoon I was surfing the net on my iTouch with morphine pumping through my veins – feeling pretty good. Surgeon said that it went extremely well, and I was able to drink clear liquids by mid-afternoon, by which time my mother and girlfriend had arrived with my laptop.

Here is Ian on drugs, around 10pm 28th Feb

I stayed in for observation that night, but even immediately after the op I wasn’t experiencing any discomfort, although I suspect I’ve got the morphine to thank for that. Still, even without the drugs, I don’t think I would have been in agony.

As I write this its been 4 days since the surgery, and while I’m still being cautious about what I eat and how quickly I eat it, the difference is obvious. [warning: TMI alert!] So far I haven’t thrown up once, whereas before the surgery I would have thrown-up many times a day.

That may seem awful, but after 8 years throwing-up was really no more unpleasant or unusual than sneezing. It was only inconvenient because you need to run to the nearest bathroom to do it, which can make people thing that either you have the world’s smallest bladder, or that you are bulimic (achalasia is a physical disorder, not a psychological one – it has nothing to do with bulimia).

I’m still walking around like an old man, and my chest is full of aches and pains when I’m not on the painkillers, but really its not so bad and its improving rapidly. I expect to be 100% within a week.

Oh, one last thing – the Seton hospital is absolutely wonderful. I felt like I’m was being pampered as if on an international first class flight. The staff were even very nice to my mother and girlfriend, who were also made to feel like they were an important part of the process. Truth be told, I almost feel nostalgic for my stay there.

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