Throwing up and not sure what to do

You are not stuck !

Check out this link and then see if your surgeon or PCP can order you this test.There is a lot of really useful links here.

What is achalasia?

www.medicinenet.com/achalasia/article.htm#tocb

Esophageal manometry

Another test, esophageal manometry, can demonstrate specifically the abnormalities of muscle function that are characteristic of achalasia, that is, the failure of the muscle of the esophageal body to contract with swallowing and the failure of the lower esophageal sphincter to relax. For manometry, a thin tube that measures the pressure generated by the contracting esophageal muscle is passed through the nose, down the back of the throat and into the esophagus. In a patient with achalasia, no peristaltic waves are seen in the lower half of the esophagus after swallows, and the pressure within the contracted lower esophageal sphincter does not fall with the swallow. In patients with vigorous achalasia, a strong simultaneous contraction of the muscle may be seen in the lower esophageal body. An advantage of manometry is that it can diagnose achalasia early in its course at a time at which the video-esophagram may be normal.

What is esophageal spasm?

Esophageal spasms are irregular, uncoordinated, and sometimes powerful contractions of the esophagus, the tube that carries food from the mouth to the stomach. Normally, contractions of the esophagus are coordinated, moving the food through the esophagus and into the stomach.

There are two main types of esophageal spasm:

• Diffuse esophageal spasm. This type of spasm is an irregular, uncoordinated squeezing of the muscles of the esophagus. This can prevent food from reaching the stomach, leaving it stuck in the esophagus.
• THIS IS IMPORTANT TO UNDERSTAND because many banded people think that their food is stuck due to not chewing well or they think they ate too fast.
•  
• Nutcracker esophagus. This type of spasm squeezes the esophagus in a coordinated way, the same way food is moved down the esophagus normally. But the squeezing is very strong. These contractions move food through the esophagus but can cause severe pain.
• Again, this is often explained away by band surgeons and banded patients as eating to fast and/or not chewing well enough.

You can have both types of esophageal spasm.

After many ER visits, doctor visits, specialists, procedures and hospital admissions still being wrongly diagnosed. I was finally diagnosed with dysphagia ( difficulty in swallowing ), and esophageal motility disorder ( difficulty in swallowing,regurgitation of food and esophageal spasms ), and erosion of the esophagus.

I had the manometry study done and it was totally normal.  Everything is fine this morning. Back to normal. Just downed a protein shake. A little bit of muscle soreness from the last two days, but it went down without pain. Slept 10 hours last night. No vomiting since about 9 pm last night. Think I will stay on full liquids for today to give more time to heal. 

Glad you're feeling better and sorry it took me so long to get back to you, I was with a friend who was having the DS surgery and managing " The Mother Of All Garage Sales " for my parents, all at the same time . We did very well with the garage sale and made a litttle over 2,800 dollars for my parents.

I was scheduled for the manometry while I was in the hospital, but once they saw that I had an erosion they skipped the test and took my band out. How was the test like for you ? Can you share the details with me so I can get a better understanding of what it feels like to have it done ?

Lisa

  Is that what lead to the Lap Band not working for you??
Jen

I ended up with a slipped band that required surgical repair. That is what ended up being the end to the good of the lapband. After the repair, I have had nothing but troubles. Even before the slipped, I had trouble with restriction, but the weight was coming off. I am extremely sensitive to even 1/4 ml.   After the repair, never found restriction and the weight stopped coming off. 
Steph

Yes, my esophagus stopped " massaging " the food down to my stomach. Everything I ate or drank sat for hours in my esophagus. It would either eventually pass or after an hour or two I would have to bend over the toilet and let it out. Sometimes all I had to do was bend over and it came up very easily and other times I violently threw it up. During the time the food was stuck in my esophagus I would experience back pain and what felt like anxiety/panic attacks and heart attack like symptoms.

Eventually my band caused me to have multiple mucosal tears in my esophagus and I started throwing up bloody mucosa. When this first stared happening. I attributed the bloody mucosa to violently throwing up food that was stuck deep in my esophagus. The food was so far down and stuck that it wasn't going down and it wasn't coming up and there were times I had to bring it up because it was causing me severe pain while it just sat there "stuck".

One night I woke up with my airway fully obstructed and I ran to the toilet and had to do the heimlich maneuver on myself until I  vomited up a bloody mucosa clot. It was quite scary because I couldn't inhale and I thought I was going to choke to death. Luckily I am trained in the heimlich maneuver and was able to dislodge the obstruction from my airway myself.

The vomiting of the bloody mucosa became more frequent and my pain became worse. I was sick and tired of fighting with my HMO and all their denials for my multiple requests to see my band surgeon for over a year. I was very close to a " normal " BMI and they sent me a letter stating that I was a WLS success and therefore didn't need to see my band surgeon for anything. DENIED !

I was denied four times with each appeal taking up to three months a piece and ended up in the ER multiple times. Finally I overheard the office manager at my PCP office talking to someone on the phone saying that they needed to approve a visit for me because I was just going to keep going to the ER which was costing them a lot more then just paying for an office visit to see my band doctor.

My original band surgeon was out of net work now and I even tried going to the hospital that he works out of to see him on an emergency basis, but he told the ER doctor that he couldn't come in to see me because he was no longer contracted with my HMO ( My HMO was low balling him on the contracted rates ). I was screwed beyond belief.

I received the approval a few weeks later. I think you probably know the rest of my story right ?

I know most view the band as " reversible ", but it can be a real ***** to get the approval to actually remove it....Insurance company HMO's can be really underhanded about stuff like this. They finally granted me a band removal because I was throwing up blood. The new band surgeon I was referred to immediately admitted me to the hospital directly from his office where it was later confirmed that I had an erosion and multiple mucosal cracks. My band was removed with a " Surprise you have now been sleeved WLS " upon my awakening in the recovery room.

I think they gave me the sleeve as a consolation prize because they knew that they had royally screwed up with all the denials. They actually assigned me my very own nurse when I was discharged to handle all my appointments, prescriptions, and anything else I needed.I was called everyday at my house by this nurse to see how I was doing and asked daily, " How can I help you ? " and given a direct number to this nurse to call with any questions or concerns that I might have.

That was in May. I now have new insurance and I am getting amazing care and follow up. It truly blows my mind how differently I am being treated by the new ins verses the old ins.

Lisa