Time for the Roto Router Man

Last week I met with the medical oncologist and the GI doctor on Monday and Tuesday. The meeting with the oncologist was fine. We discussed the side effects I am still feeling and I told him about the esophageal dilation procedure. He agreed that it was a good idea and said that they have referred people to the GI doc for that procedure. One potential hang up is the blood thinners that I am on. He said I can go off of those for the week before the procedure. (Yippee!!! Warfarin is definitely not a fun drug.) For now the only drugs I am on regularly is the ear patch and pain patch.

The next day I met with the GI doc to talk to him about the dilation procedure. He reviewed the written report from the swallowing eval and also agreed that this was the direction to go in. Normally they dilate the lower esophagus but he has worked in the upper esophagus area as well. Because it is near my wind pipe and I had radiation treatment to the area they are going to proceed slowly and just try to open the esophagus up a little bit at a time. This means I will most likely have to undergo several procedures. I am OK with that if it works. There is also the potential for the throat to close back up after a period of time and the procedure would need to be repeated. I view it as cleaning out the plumbing. From what I have read in some cases the procedure takes and there isn't much if any follow up treatments required. In other cases it appears that the procedure needs to be repeated every few months to keep things open.

Basically the procedure involves the doctor, with the aid of scope, threading a wire down my throat to find a passageway that is open. Then they slowly inflate a balloon to open up the area that does not open when swallowing. In my case this is most likely due to strictures that formed as a result of the radiation treatment. The radiation treatments will make the esophagus more "fragile" so they will proceed carefully to avoid tearing or puncturing the esophagus. They may also put in an air tube to protect my breathing. Fortunately I will be under sedation during the treatment. For those that are interested here is a link to a video on YouTube that shows the procedure.

All in the procedure takes less than a half hour. I go in early in the morning on Tuesday and should be back home by mid morning. From what I have read they will be able to tell almost immediately if it worked or not. It it does work then I should be able to start to swallow normally and eat some foods like soups that have bits of food in them. Right now I can only consume things that are liquid or readily melt into liquid form.

Also later in the week I head up to the Roswell Park Cancer Institute to have them review my current status and also talk to them about the side effects that are persisting. I did discuss the dilation procedure with the lead doctor on my case and while he couldn't comment on my specific situation he did say that dilation is often done in cases like mine. He also mentioned that he has worked with my ENT Doctor on cases and would trust his opinion.

I will try to post an update on Tuesday about how the procedure went.