Eat Happy!

Eat Happy!

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Tuesday, February 18, 2014

Upper GI and Hernia Update

Ian's upper GI series (swallow study) went very well. They started with him drinking the liquid through a straw. His swallowing looked great, and it passed the fundoplication well. (This was liquid only) Then they inserted barium in through the G-tube in order to check the integrity of the fundo. There was no reflux. The liquid passes put of his stomach very well.

Tom and I have seen eight of these Upper GIs now and are pretty familiar with what we are seeing. There is a hernia, the same one from last May. It does not appear to be any larger. The Dr. will review it later today. I'm not sure if we will hear from him.

If it is decided the hernia is the problem, I'm not sure what our options are. Ian has already had one slipped-twisted-herniated fundoplication. There was probable vagus nerve damage with the initial fundo. When it was repaired last July, there was the possibility of more vagus nerve irritation. It is impossible to know unless major damage is present (which here was not). Each fundo has a higher risk of failure. This would be the third one. It isn't as simple as a "fix" like undoing and then redoing. There is tons of scar tissue, making the nerves hard to see and navigate. Surgeons avoid continual repairs as frequently as they can.

I don't know what our options will be if the herniated fundo is causing the problems. Even if it has not gotten worse, it could be causing problems. Last time, Ian dealt with his hernia for six months before it caused enough problems for repair. (Remember, they absolutely want to avoid repairs whenever possible.)

Assuming we don't get a call canceling the test tomorrow, we will do the gastric emptying scan tomorrow at 11:30. That will check his stomach motility and see if he is hanging on to food too long in his belly, causing him to fill quickly, and keeping his stomach from accommodating the amount of food normally needed.

Ian will need to eat as much of one scrambled egg, bread, and juice as possible in ten minutes. Three-quarters of the egg is our major goal. We are going to make him *really* hungry and hopefully be able to use some ketchup for the egg if they will let us. Ian still loves the novelty of dipping things in juices / ketchup / gravy / sauces.

Here are the comparison upper GIs.



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