Thursday, July 2, 2009

Update

Cricopharyngeal Paralysis is what my primary diagnosis is, limiting my ability to swallow. Nice to know they actually have a name for it.

Today was another follow up with my surgeon, and this time I had him write it down for me. Trying to remember a term like "Cricopharyngeal Paralysis" is not among my stronger abilities.

Briefly: the cricopharyngeus is a muscle in the lower throat; the doorway between the larynx and the esophagus through which all things must pass if they are to make it into the stomach.

The larygeal paralysis has been mostly dealt with. It's likely about as good as it's going to get without the right vagul nerve (which controls the right side)present and functioning. Therapy, so far, has taken me to the point where the left side has strengthened enough to make swallowing possible.
It will never be as it once was, but I've already accepted that certain things will be altered forever, so any further improvement is just additional blessings to be grateful for. And things could have turned out much worse, so you'll hear no complaining from me.

Also, forever gone, is usage of my right vocal cord. This will remain permanantly paralyzed, and leads to most of my aspiration problems as the passageway into my lungs remains slightly ajar. The doctor has a remaining trick up his sleeve to help solve the aspiration issues and improve the speech abilities, but that's another posting.

There is a solution for the cricopharyngeus that we are currently discussing. We could continue with the therapy, hoping to strengthen the muscle further. Basically, this means strengthening the left side to overcompensate for the non-functioning right side. (All issues are on the right side, due to the missing vagul nerve.)
OR
A dialation procedure. This would consist of shoving progressively larger tubes down my throat, past the cricopharyngeus, in order to stretch the muscle. This would allow me to swallow bites of food larger than a teaspoon, or drink more than a sip of water at time.

I've tend to take the view that the body is designed in a certain way for very specific reasons. The dialation would leave my throat open, causing potential concerns later on. Also, with the muscle weakened/stretched, stomach contents may not be so likely to stay in their proper place while bending over or doing physical activity. I've dealt enough with that for three months after the surgery when I had to make sure not to move around too often.
Back then, it didn't take much for something to pour out, triggering the gag reflex, and emptying everything I had in me. I was throwing up every day,leaving me sick inside and unable to keep anything down for several hours afterward.
(and further explains why I didn't post much for two months).
It was the big contributing factor to the malnutrition that caused my body to whither away, the infections, and a couple bouts of pneumonia.

I told the doctor I was in no hurry to try the dialation. I wanted to give things a chance to function properly before we start making further alterations. He agreed, and wants to see me again in three months.
In the meantime, he's released me to return to work the first week of August. He wants me to stay out as long as possible due the nutritional and hydration requirements of my line of work.
Considering the progress made just in the past month, I think I should be good to go by then. Besides, the disability benefits will run out at that time, and I got bills to pay and a mortgage to make.

Here are a couple of links that can illustrate better, and briefly, that of which I am speaking.
Link
Video

3 comments:

RW said...

Go get 'em gino, you're doing fine!

Robi1 said...

You're a better man than I, dealing with that. I'm willing to bet that you've survived something that a slew of people haven't, or more to the point, couldn't.

Seriously - get well.

Robi1 - out.

Gino said...

RW: i plan on it!

Robi: thanks,robi, but if you were in the same situation, i dont doubt you would have done the same.
lots of folks out there deal with all kinds of maladies. i consider myself lucky in that it wasnt worse, and was something that, given time and rest, i could eventually come out of.

and i had a lot prayers on my side. i knew that. its impossible to fully express how grateful i am for what others have asked for on my behalf, and how much those intentions kept me in a positive attitude.

there is a lot of comfort to found through doing all you can, and then trusting in the Lord to take your efforts and do with them whatever He wills.

and besides, a positive attitude not only aides in the healing process, but helps to strengthen those loved ones who are losing sleep over you.