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Dysphasia, sliding hiatal hernia with schatzki ring and anastomotic stricture



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I have chronic illness that always tends to complete things, if there is a side effect to be had from a medication- I get it. Same for surgery. But it was either take the risk to fight to lose weight against metabolic disorders amongst other things, or give up. I had RNY April 29th and I haven’t progressed to soft foods without getting sick. I’m not ver good at tracking time passing. 2 weeks liquids got extended, and I’m probably supposed to be getting past purée.

I was in hospital 3 days post op. I finally got home and ended up in the ER and in hospital another 3 days due to aspiration pneumonia (plus acute uti, and critically low potassium) they did a swallow study and said I have Dysphasia and can’t drink Water without it trying to go down the wrong way. When I try to drink it’s painful. My chest ends up in pain for awhile. It takes well over an hour to drink my morning Protein Drink. I can’t use the thick it water thickener additive because it’s food starch aka corn starch and maltodextrin, which is basically like sugar in the body.

I tried some purée, later than I should have. Had a few episodes of throwing up. Though the one time I just had a few sips of Protein drink while doing laundry and got violently sick. A thick mucus, a lot of foam, and the little bit of shake. I had another follow up with my surgeon. And he ordered a upper gi fluoroscopy. And a endoscopy. I was told previously to see an ent about the dysphasia who then told me to see a neurologist.

the upper gi fluoroscopy Showed:

1. Sliding hiatal hernia

2. Schatzki ring of distal thoracic esophagus

3. Luminal channel at the gastrojujenostomy appears narrow measuring 3mm (I’m assuming this means anastomic stricture)

i have too many things confusing me. The endoscopy couldn’t be scheduled until July. I got the test results on a Cleveland Clinic App (my chart) so I didn’t hear from the doctor about it yet. It seems too thin of liquids don’t go down well, but neither does purée. I had to drink water to flush out the oral contrast and ended up in a lot of pain. It took days for it to move out of my system.

I had a ct when I was in hospital for pneumonia that showed a pelvic mass. My gp ordered a ultrasound but I couldn’t properly fill my bladder, the tech said nothing. I went to see my doctor (uro/gyn) only to find the appointment was with a nurse practitioner instead and the only date to see him weeks away. I got a call from the testing place to schedule a repeat ultrasound. I explained to the technician what happened last time and she agreed it made no sense if it was on the ct to order a test that didn’t work to visualize the mass let alone order a repeat. So I’m waiting to know what to do. Given my history and my lower abdomen still abnormally swollen... I’m not worried but I know my history of inaccuracies in tests that they only see how bad something is when they end up doing surgery.

i have a brain mri early tomorrow that the ent ordered for the neurologist. I have had loss of taste and smell prior to RNY surgery. Worsening tinnitus, pain, dizziness, vision problems, etc. I’m concerned I won’t get answers about anything.

I’m not worried but other stressors are compounding the problems. I know that

A. Proton pump inhibitors never worked for me and always caused more problems than they are worth

b. I had ulcers in my stomach prior to surgery so I’m confused how they can visualize the sectioned off stomach for ulcers since the contrast doesn’t go into that portion of stomach

c. I’m feeling the same ulcer symptoms again

d. I know anastomic stricture is treated with a dilation procedure but 3mm seems extremely narrow.

e. Schatzki ring seems to go hand in hand with hiatal hernia but doesn’t seem that common. I can’t imagine what the doctor would suggest there. But with my chronic illness even small things aren’t minor. If that makes any sense. I can never get across the risks even so called conservative approaches have (ie, medications)

also my Vitamin B12 levels came up well over normal limits, before taking any supplements yet no doctor has said anything. B12 is water soluble and shouldn’t build to that level in the blood. I’m also needing a colonoscopy because of possible colitis.

Im not really expecting answers, but perhaps someone might have had similar issues. I’m just trying to process some things. My energy level gets eaten away very quickly. I deal with things moment to moment. But some things are overwhelming my system. (Not even the medical issues) but that exhaust me so I can’t process anything. So maybe some perspective might help. What scares me most is my medical conditions will block me from losing weight. I’m in a stall. I’m getting at least 50 grams of protein. I can only be so active. I lost about 29lbs since surgery. I’m sorry this is long and maybe even pointless.

~ Christine

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I have chronic illness that always tends to complete things, if there is a side effect to be had from a medication- I get it. Same for surgery. But it was either take the risk to fight to lose weight against metabolic disorders amongst other things, or give up. I had RNY April 29th and I haven’t progressed to soft foods without getting sick. I’m not ver good at tracking time passing. 2 weeks liquids got extended, and I’m probably supposed to be getting past purée.
I was in hospital 3 days post op. I finally got home and ended up in the ER and in hospital another 3 days due to aspiration pneumonia (plus acute uti, and critically low potassium) they did a swallow study and said I have Dysphasia and can’t drink Water without it trying to go down the wrong way. When I try to drink it’s painful. My chest ends up in pain for awhile. It takes well over an hour to drink my morning Protein Drink. I can’t use the thick it Water thickener additive because it’s food starch aka corn starch and maltodextrin, which is basically like sugar in the body.
I tried some purée, later than I should have. Had a few episodes of throwing up. Though the one time I just had a few sips of Protein drink while doing laundry and got violently sick. A thick mucus, a lot of foam, and the little bit of shake. I had another follow up with my surgeon. And he ordered a upper gi fluoroscopy. And a endoscopy. I was told previously to see an ent about the dysphasia who then told me to see a neurologist.
the upper gi fluoroscopy Showed:
1. Sliding hiatal hernia
2. Schatzki ring of distal thoracic esophagus
3. Luminal channel at the gastrojujenostomy appears narrow measuring 3mm (I’m assuming this means anastomic stricture)
i have too many things confusing me. The endoscopy couldn’t be scheduled until July. I got the test results on a Cleveland Clinic App (my chart) so I didn’t hear from the doctor about it yet. It seems too thin of liquids don’t go down well, but neither does purée. I had to drink water to flush out the oral contrast and ended up in a lot of pain. It took days for it to move out of my system.
I had a ct when I was in hospital for pneumonia that showed a pelvic mass. My gp ordered a ultrasound but I couldn’t properly fill my bladder, the tech said nothing. I went to see my doctor (uro/gyn) only to find the appointment was with a nurse practitioner instead and the only date to see him weeks away. I got a call from the testing place to schedule a repeat ultrasound. I explained to the technician what happened last time and she agreed it made no sense if it was on the ct to order a test that didn’t work to visualize the mass let alone order a repeat. So I’m waiting to know what to do. Given my history and my lower abdomen still abnormally swollen... I’m not worried but I know my history of inaccuracies in tests that they only see how bad something is when they end up doing surgery.
i have a brain mri early tomorrow that the ent ordered for the neurologist. I have had loss of taste and smell prior to RNY surgery. Worsening tinnitus, pain, dizziness, vision problems, etc. I’m concerned I won’t get answers about anything.
I’m not worried but other stressors are compounding the problems. I know that
A. Proton pump inhibitors never worked for me and always caused more problems than they are worth
b. I had ulcers in my stomach prior to surgery so I’m confused how they can visualize the sectioned off stomach for ulcers since the contrast doesn’t go into that portion of stomach
c. I’m feeling the same ulcer symptoms again
d. I know anastomic stricture is treated with a dilation procedure but 3mm seems extremely narrow.
e. Schatzki ring seems to go hand in hand with hiatal hernia but doesn’t seem that common. I can’t imagine what the doctor would suggest there. But with my chronic illness even small things aren’t minor. If that makes any sense. I can never get across the risks even so called conservative approaches have (ie, medications)
also my Vitamin B12 levels came up well over normal limits, before taking any supplements yet no doctor has said anything. B12 is water soluble and shouldn’t build to that level in the blood. I’m also needing a colonoscopy because of possible colitis.
Im not really expecting answers, but perhaps someone might have had similar issues. I’m just trying to process some things. My energy level gets eaten away very quickly. I deal with things moment to moment. But some things are overwhelming my system. (Not even the medical issues) but that exhaust me so I can’t process anything. So maybe some perspective might help. What scares me most is my medical conditions will block me from losing weight. I’m in a stall. I’m getting at least 50 grams of Protein. I can only be so active. I lost about 29lbs since surgery. I’m sorry this is long and maybe even pointless.

~ Christine
My heart is breaking for you. I pray they find answers and you get soon. I have no advice for you. I haven't had my surgery yet. Don't worry about the weight right now. Keep on to them all till you get answers. Bless you!

Sent from my LM-Q710(FGN) using BariatricPal mobile app

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Sorry for all you're going through. Just wanted to say I am 3 months post gastric bypass and at 3 weeks out we discovered I have an anastomatic stricture and marginal ulcers. I understand how it feels to not be able to tolerate even liquids. I have had 4 endoscopies with dilation, with a 5th one next week. I'm still on liquids but feel better. Take care, and I hope you get better soon.

Sent from my SM-N960U using BariatricPal mobile app

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Thank you for your responses. I am in a kind of holding pattern. My doctor seems I should wait another two months to recheck the pelvic mass. I’d rather not. I at least wanted a clearer idea what it could be. Clarification. No one said it was just a cyst. It seems big enough to question it at the least. But that’s separate from my RNY.

I have not heard from my surgeon about the upper gi fluoroscopy. My endoscopy isn’t until July 11th. I like at least knowing what I’m going into with the endoscopy. Some part of me just doesn’t want to do it.

i think the 26th I’m supposed to progress to the next phase. But I know it won’t happen. I’m trying to take it in stride and make sure to get 50 grams of Protein. It’s hard to get Water without pain. Let alone enough. I’m taking Vitamins (I bought mostly Whole food gummies)

all the physical things aside. It kind of hurts that I had to go this far just to lose weight.

I fought so hard to lose weight before and didn’t think I ate unhealthy at all. Low carb, low calories, etc. it’s hard when simple carbs are easier to stomach when you feel sick. But I looked for low carb alternatives. I didn’t give in for so many years to my sugar addiction or cravings for things like fried chicken. I followed strict low carb. It wasn’t until my weight jumped literally 30lbs out of nowhere that I loosened up on the carbs.

My worst cheat most times was sweet kale salad with gardein crab less crab cakes or tuna salad. I’d make low carb grilled cheese sandwich or low carb pizza. But not very often. I ate cauliflower mash, cauliflower rice, shiritaki rice, and mostly vegetarian foods occasionally meat , and more veggies. I mean how can veggies make me fat.

I can’t even think about food now. Though I do miss sushi. I admit I cheated once before surgery to have sushi that I hadn’t had in many years. Prior to surgery I’d already lost my ability to properly taste food or smell. For some time. I tried to find texture and taste in food. Like salty or sweet or crunchy. I know food isn’t everything but does it need to disgust us in order to lose weight?

I know I’m totally off topic. I can’t get back on track. With my health. Was I ever on track? I knew the risks but it was RNY or give up. I just have no one that understands Myalgic Encephalomyelitis, and metabolic disorders, and having Gastric bypass surgery.

I don’t expect much if anything, and I never ask for help. But right now I appreciate the response to this. I’m not very good at this.

Thank you.

christine

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