hi, dear all,The lowest Sphincter of my esophagus is not functioning well so my doctor advised me to do a poem. I want to know how long do I have to stay in the hospital after a poem operation? If I am in NHS track how long do I have to wait?
Hi, after my POEM surgery I went home the following day. I think the hard part is your restriction on your diet before the surgery and worse after but all worth it in the end.
I forgot to ask you. Do you have acid reflux issues now? If so they might get worse after surgery because there is nothing to stop the acid from coming up. I had to have a fundoplication to correct that issues after POEM.
thank you for your comment. yes, i have acid reflux but at this moment , difficulty in swallowing is the priority. Did you do it in NHS? how long did you wait?
fwiw was diagnosed with achalasia 11 years ago, couldn't swallow and it was very very tough for a while...
I had a balloon op to widen the oesophagus and it was brilliant for a few months but then settled down to be better than before but still far from ideal. I've learned to live with it now and to just make sure I've water nearby when eating + other techniques.
i only mention this as to query if the poem is really necessary or not. My spincter was also not working as it should do also. i hope you make the right decision and that this condition settles so you can live normally again.
All the best Tom
Hi Cherryflower, Have you tried other measures? I tried Botox and it worked well for almost a year. My doctor also advised the POEM, but "she" decided to try Botox one more time. She told me I would stay in the hospital for one night depending on how well I did if "we" and we did the POEM.
Unfortunately, I am still having spasms and she cut the Schatzki ring? I don't know why she did that. I only found out about it on the patient portal. The Botox is wearing off a little so at least I am not regurgitating every single thing which slides down my throat.
Even though I have been traveling to a major medical facility to see my current doctor I am going for a 2nd opinion. I think doctor's should be more informative about what they are doing and what they have done.
I sincerely wish you the best of luck! Donna
Hi Cherry,
I would advise seeking further help with your potential treatment options. There is a new charity for Achalasia - just google 'achalasia-action charity' . There is a great leaflet on there; and one to one support should you require it... I would first look into your diagnosis and take it from there. Find out if it is Achalasia, or related to something else...
Warmest,
Neil
Hi, Neil: thank you very much for the information. Is this charity in the UK or not? I find the NHS in UK is very slow. Therefore, if I can expedite the process of treating my problem, that will be great. I have the results of all the important tests ,if I can find a free consultant and appointment, I will go for it. best CF
Hi, Neil: I did find a wonderful leaflet " patient guide " from the website achalasia-action charity. But where can find the one to one support from medically trained staff? and is it possible to book an NHS operation POEM fast through this site?
Hi, Neil, I read your profile and you are waiting for a Heller’s Myotomy. What is the difference between a Heller's myotomy and a POEM, why do you have to do this one? and how long does the doctor say that you have to wait ?
Hi Cherry,
On the achalasia-action website you can request a call via an email on the Support Page. I help with the Charity website, and my colleague Amanda would pick up your email and fix something up. We often arrange one to one chats with one of our volunteers... We are not medically trained but can advise on centres for treatment...I actually just had the Hellers Myotomy on Friday!! :) The Hellers differs from POEM in that it is key hole surgery from the stomach working upwards from the sphincter. The procedure also involves a 'wrap'; this wrap is essentially a flap made from existing stomachy tissue; its intention is to stop potential for acid reflux. It is a 2 or 3 day trip to hospital. The POEM is an Endoscopic procedure via the Oesophagus; the instrument breaks into the Oesophagus lining and then cuts downwards towards the Sphincter. It is considered less invasive from a Hellers as patients can mostly go home on the same day; the procedure does not involve a wrap which is often considered a down side. Acid reflux is manged solely by tablets and diet. There are so many factors to help you decide. Age, fitness for surgery, shape and condition of your Oesophagus - I think POEM is limited to straight tissue sections so can be difficult for a distorted oesophagus. Only an experianced consultant can help you answer these questions wholly to your case... If you feel you have time, then why not take on more opinions...You can ask to talk to me via the achalasia-action website if you like..:)
Hope your symptoms are manageable for the moment!!
Warmest, N
Hi, Neil: thank you very much for your comment. Do you feel OK now after the operation? I will try to communicate with you through the site. take care !
I have another question, does Heller Myotomy solves two problems, 1. the tension at the sphincter 2. the acid reflux. However , POEM can only solve the 1st problem, is my understanding right? Recently I also saw another doctor, who offers to do a 270 degree Fundoplication. I am not sure this a 270 degree Fundoplication can solve the 2 problems, may be just the 2nd. If your Heller Myotomy can solve all two problems, then that is what I am looking for. How long do people have to wait for that in the NHS track?
no, I had it done in New York City. Really didn't have to wait at all. I would caution to make sure your Doctor has done many of these procedures. This is not something you want to trust to a novice. Good Luck
Hi Cherry,
Yes your understanding of POEM and HM seem about right. Both simply cut through the sphincter muscle to losen it; but the HM involves an anti acid wrap too. The POEM is very unique that it cuts inside the Oesophagus wall - there are some very interesting vids on youtube about POEM; it is very novel. The Fundopulation that you refer to is basically another term for the HM wrap; so your Dr will be talking about HM. Re NHS, it all depends on your urgency. If your weight etc is within BMI measurements, then you will get a standard referral. Should that change you may be expedited. It will differ from place to place; I would expect between 2 - 6 months. Where are you in the country? Warmest, N
There are many different ° of a fundoplication. Mine was like you stated 270° and called a toupee fundoplication. Ask a lot of questions. Interview your Dr. You don't want any mistakes.
Yes, one private doctor offers me that , but I am not sure if that can solve the swallowing problem. He did not mention this when he made the proposal. So I am a bit concerned. I am not sure if the fundoplication is just Heller M
please, above all else be very sure of everything your dr is going to do before you sign the dotted line.
I had the POEM surgery done in 2016 at the Univ. of Iowa Hospitals. I was told I might have to stay the next day but it they didnt expect more than that. I ended up being the rare patient that had complications and was hospitalized for 3 weeks. I later found out the culprit of my infection was that I have a type of Leukemia. My compromised immune system allowed an infection to take over post op. Had we known that going into the surgery, I would have been prepared ahead of time and throughout with antibiotics. I've read several cases where most all had success and short stays. All said and done, even though I had complications, I would recommend it to anyone with Achalasia. I have enjoyed a good outcome and can now eat foods I couldn't before. I also enjoy a much better quality of life than I did prior to the procedure. God's Speed!
I had HM in 2014 had swallowing issues and severe chest pain. The swallowing issues were better but the chest pain remained. in 2016 I returned to the Univ of Iowa because swallowing issues had returned and the. hest pain was still very high. They discovered through manometry that I had high pressures throughout the length of the esophagus. He called it "jack hammer esophagus".
I had the POEM surgery and for awhile experienced a bit of reflux until I developed new eating habits and times.
Now I eat more in the morning, tapering off as the day goes along and nothing to eat or drink after 7pm (other than the water I take my night time pills with).
The diet changes were mostly that I avoided or limited rough foods/raw veggies & heavy breads, carbonated drinks, caffeine and alcoholic beverages.
In 2019 my chest pain is much reduced and swallowing issues have improved. I am very happy that I had the surgeries. Achalasia is miserable.
Hope this helps. Be well. ♡