Good news, Bad news

[cajun 46]

The good news is that all of my 3 month labs are NORMAL. I was very surprised and thrilled. It surprised me because although I do eat some fruit 2-3 times a week, I'm not really getting in any veggies...no room for them after getting in the required protein! I think that the Vitamin Water I'm sipping on all day helps a lot.

The bad news is, the upper GI xray showed that I now have a small traction epiphrenic diverticulum. Bummed. I never knew that the esophagus could have a diverticulum so have been reading research online to learn about it. Luckily I'm not having any symptoms so it's probably going to be just "watch it" scenario. I'll see my gastroenterologist after the holidays to see what he recommends.

Dr Aceves thinks it's from "overeating". He's recommended I go back on mushies and liquids for now and reduce the volume I ingest at any one time, to prevent pressure on the diverticulum. I'm going to see a local gastroenterologist after the holidays. Wish I lived closer to Mexicali so I could get to Dr Aceves' office but it's not in the cards for me.

At three months out, how much of a Protein Shake can other folks drink over a 30 minute period? I've been doing one cup, which is one shake. Now I'll have to cut it back to 1/2 cup. It's going to take me longer to get in everything, but I guess no one every promised that this would be easy. No solids means no Christmas dinner with my family! Double Bummer for Christmas!

Today will be the first time some of them see the new me, 68 lbs lighter! I've not told them so they will be very surprised!

Does anyone have experience with this, or know someone who had it? I'm looking for all the information I can get. Apparently it's rare.

[Lee 19]

Cajun, I don't know anything about your situation, but wanted to say congratulations on the 68 pounds. What a success that is! Your family is going to be blown away by your achievements! I'll hold a good thought for you that the doctors will find a good solution to your problem.

[cajun 46]

Thanks Lee!

Have a happy holiday!

[Tiffykins 673]

Great news on the labwork, I haven't a clue about the other situation, but I hope you get some answers.

Keep up the great work, and happy holidays.

[Oregondaisy 2,020]

Cajun what is this? I have never heard of this. If you have no symptoms, how did you figure it out? I haven't had any tests, as I havn't had any problems. I suppose I should have had an upper Gi by now, but I thought if I was not having problems, I really didn't need one!

[cajun 46]

Cajun what is this? I have never heard of this. If you have no symptoms, how did you figure it out? I haven't had any tests, as I havn't had any problems. I suppose I should have had an upper Gi by now, but I thought if I was not having problems, I really didn't need one!

Dr Aceves recommends certain labs plus an upper GI 3 months post surgery. I think it's a good idea, and was actually expecting to have some low labs due to the skimpy food intake...but was not expecting an abnormal UGI. I recommend everyone follow their surgeon's recommendations on getting these done. I would not have known if I had not done those tests.

Dr Aceves has never seen this either. It's rare. I've been doing a lot of reading online about this type of diverticulum. It's usually caused by a motility disorder of the esophagus. Here's the basic description: "Cross et al (1961) stated that "pulsion diverticula suggest increased intraluminal pressure to which has been added a weak area in the musculature of the esophageal wall for out-pouching of the mucosa". The motility disorders they found included diffuse increase in lower esophageal tone, hyperactive and incoordinate peristalsis, esophageal spasm, delayed opening of the esophageal sphincter, and reflux esophagitis. Whatever the case, the common underlying problem is basically the same: normal or hyperactive peristalsis acting against a functional obstruction, with resulting increase in intraluminal pressure being dissipated by formation of a diverticulum through an esophageal wall that cannot withstand the high pressure."

members.tripod.com/famona/ent/cummings/cumm130.pdf

I did have a lot of esophageal spasm in the first month or so, and probably a very tight esophageal sphincter post hiatal hernia repair. I would guess that at times what I was swallowing could not get through the sphincter but the esophagus was still trying to "pump it through". At times I'd have back pain after eating, especially once I started solids. White meat chicken was a common cause of this until I just swore off it. Maybe that was the pressure, I don't know. Anyway, that pressure could have cause the diverticulum to form.

I did not have "foaming" or vomiting after eating, so I don't really think it's from over eating. More likely due to the esophagus just trying to do its' job and meeting some resistance.

More than likely my local gastroenterologist will recommend manometry to assess the pressure gradient in the esophagus. Treating the cause is most important. I don't want this thing to get bigger, that's for sure. Meanwhile I'm back to liquids and mushies, in very small amounts, to try to keep the pressure down.

As hard as I've worked to be successful in this, I am really bummed out to have this complication. The only bright side if there is one, is that I'll probably lose weight faster because I'm going to be eating less until this gets fixed.

[LAN2k 18]

CAJUN while your weight loss at 3 months out is huge and congrats is in order, I am more concerned with your overall health and this complication which has manifested. I am extraordinarily impressed with your knowledge and ability to convey what you know and are progressively learning. I'm equally impressed with your ability to keep your cool regarding this complication. It seems all too easy to dismiss minor to sometimes major/temporary discomfort as par for the course from maybe eating a little too much etc. I too am 3 months out and at my last visit a couple of weeks ago my surgeon made no mention whatsoever of having upper GI testing. His attitude is so cavalier in assuming that anything and everything I am concerned about is "normal" and advises just to "give it time". Can you tell me what is involved in having Upper GI testing and advise as to how I might approach this matter with my surgeon? Or would I be better off having my PCP (who is very responsive) refer me to a gastroenterologist to have this test? I am also curious to know if you are on any PPI and if so which one and the frequency in which you take it? Thanks for this important post.

[cajun 46]

Lan2K

Your PCP can order an upper GI. It is simple. You just drink some white chalky stuff and they take pictures. Done in 5 minutes or so.

My PCP ordered mine, as recommended by Dr Aceves, he recommends this for all his pts at 3 months.

He also recommends nexium which I take.

[Oregondaisy 2,020]

Cajun, I have an appt. with my pcp this week as a follow up for my pancreatitis and gall bladder surgery. Dr. Aceves never told me or gave me any kind of print out on which lab work to have. What should I ask for?

[LAN2k 18]

Lan2K

Your PCP can order an upper GI. It is simple. You just drink some white chalky stuff and they take pictures. Done in 5 minutes or so.

My PCP ordered mine, as recommended by Dr Aceves, he recommends this for all his pts at 3 months.

He also recommends nexium which I take.

Thank you. I will ask her at my next appointment and let her know why. Please keep us updated on this condition.

[cajun 46]

Cajun, I have an appt. with my pcp this week as a follow up for my pancreatitis and gall bladder surgery. Dr. Aceves never told me or gave me any kind of print out on which lab work to have. What should I ask for?

Daisy: See PM.

I read a lot of research this weekend, on epiphrenic diverticuli. Small and asymptomatic diverticuli often do not progress and can be "watched". Since mine's small and asymptomatic, it seems it is not necessary to operate...that's a relief. It will need watching though. Dr Aceves thinks another UGI may be needed in the near future...will know more about the plan soon. I'm relieved to know that no knife will be involved. WHEW!

[cajun 46]

Great news on the labwork, I haven't a clue about the other situation, but I hope you get some answers.

Keep up the great work, and happy holidays.

Thanks Tiff. So far, answers are reassuring.

[Oregondaisy 2,020]

that is so strange, Cajun, especially since you didn't really have any symptoms. I am glad to hear there will be no need for any kind of surgery. whew is right!