Six Days of Expert Esophageal Care Ends Months of Embarrassment and Pain Caused by Achalasia

Ciaran Simon always discounted his heartburn as sensitivity to spicy food. It was not until his symptoms became debilitating that he sought medical attention.

“After eating three or four bites of food, I’d hiccup and burp uncontrollably, and have difficulty swallowing,” explained Ciaran. “Then I’d get a really sharp pain between my breastbone and throat. It was so bad I was reluctant to eat in public. Even my girlfriend shielded her eyes at the dinner table.”

After seeing his primary care physician in June 2016, and then two gastroenterologists, Ciaran was diagnosed with achalasia. Often mistaken for acid reflux, achalasia is an uncommon condition which prevents the esophagus from pushing food toward the stomach and from opening the valve located between the esophagus and stomach so food can pass into the stomach.

As Ciaran regurgitated both solids and liquids, including water, his 6-feet-4-inch body dropped from 240 to 170 pounds. His chronic cough lingered. At least once or twice a week, he would awaken from his sleep aspirating on bile (a digestive fluid) and food. Clients at Ciaran’s two Houston-area pubs thought the 58-year-old had cancer.

By now, it was September and Simon needed surgery. Special circumstances required he wait until 2017.

“My gastroenterologist gave me a Botox injection to provide temporary relief from my symptoms so I could get through 2016,” said Ciaran. “Right after Christmas, my symptoms returned.”

A New Year, a New Lease on Life

As 2017 began, Ciaran called Farzaneh Banki, MD, director of the Esophageal Disease Center at Memorial Hermann Southeast Hospital and professor of surgery at the McGovern Medical School in Houston. Ciaran was scheduled for a barium imaging swallow test the next day, January 4, 2017, at Memorial Hermann Southeast. This test would reveal abnormalities in the esophagus and stomach.

“I was told to come to Dr. Banki’s office right after the test and to bring the disk with the test results that was given to me in the radiology department,” said Ciaran.

Going into the consultation with Dr. Banki, Ciaran had few questions since he had extensively researched achalasia.

“Dr. Banki was very thorough in laying out everything that would occur,” said Ciaran. “When she asked me when I wanted to undergo surgery, I jokingly said ‘tomorrow.’ Immediately, she and her assistants sprang into action to make that happen.”

In the middle of working out the details, Ciaran said Dr. Banki stopped, put her hand on his shoulder and asked if he really wanted the surgery this quickly. She explained that many people say they want it quickly, but when confronted with a fast turnaround, they decide to wait.

“It was touching that she took the time to reaffirm my decision,” said Ciaran. “I told her I was thrilled with the urgency.”

Pre-operative tests were scheduled for the next day, Thursday, and surgery was scheduled for the following Monday. The pre-operative tests confirmed achalasia and showed aspiration of food and salvia.

The following Monday, January 9, 2017, Ciaran underwent a laparoscopic Heller myotomy and a Dor fundoplication, a minimally invasive surgical procedure in which the muscle between the lower esophagus and the top of the stomach is cut. The stomach is then used to make a loose valve around the esophagus that allows food to get into the stomach, but prevents reflux disease. The surgery involves five laparoscopic incisions.

Ciaran went home the day of surgery and ate a liquid diet for two weeks. Within a week, he was walking one mile a day. He graduated to soft foods, then solids. By February, Ciaran was happily dining out again, free of embarrassment.

After he was released from Dr. Banki’s care in late April, Ciaran resumed his active lifestyle that includes regular workouts and playing golf. He says, he now must behave himself to keep his weight between 195 and 200 pounds.

“In six days under Dr. Banki’s care, I went from A-Z,” said Ciaran “The pace was breathtaking, but the professionalism, competence and human touch even more impressive. It was by far, the best medical experience of my life.”

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