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18 months after Ivor Lewis op my husband has started feeling very ill
18 months after Ivor Lewis my husband has started feeling very nauseous in the mornings. He can’t eat breakfast until he has vomited awful amounts of mucus like saliva, and undigested food. He has had Botox injections into the pyloric valve to help relax it and let the food through. He is booked in to have another Botox injection in 2 weeks time. It did help last time. Is anyone else having this issue after 18 months ? He is on a Jtube for 12 hours overnight which has helped him gain 12 kilos. As soon as he has vomited, he feels a lot better and can manage his breakfast. Any answers would be appreciated,
Thankyou,
Deb
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Ok... cancer recurrence? Doesn't seem likely since this is a morning ritual... although at only 18 months post-op, he is certainly in the danger zone for seeing a recurrence. Get past 3 years post-op with no signs of recurrence and the odds swing more heavily in our favor.
Ok... why on J tube feeds at 18 months post-op (installed during esophagectomy)? The obvious answer is that he's still not taking in enough calories and hydration by mouth. This is a bit unusual in that both patients and doctors want this tool removed as soon as is feasible post-op. How old is he? And I'll assume his anastomosis is ok and he can physically swallow ok, but space below is still quite limited, and dumping syndrome (both early and late) is still seen. I'll also assume he has experimented with reducing J tube feeds and increasing calories by mouth to see if he can come off it.
Ok... I'll assume pylorus function and slow motility is the main culprit here. Add to that his mucous plug that forms on top of his stomaphagus overnight that is also exacerbated by his motility issues in that he can't digest the mucous down thru his intestines in a timely fashion.
Taking Mucinex? J tube feeding at night? At what rate? Maybe pop on our EC and Esophagectomy Zoom calls (Sundays and Wednesdays) to discuss. Too much to go into here. I'll leave you a pm inside this Mayo site, as well as my cell phone.
Oops... for some reason I cannot leave you a pm... not sure why. You must leave me a pm, if possible. Here's the Zoom link... next call is this Sunday morning (9am Eastern, 6am for me in California), and we're having a cardiothoracic surgeon pop in who does many surgeries including esophagectomies, etc.
https://us06web.zoom.us/j/4550284795
If a passcode is asked for it is tuiBE5
Gary
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2 ReactionsThank you Gary, yes we have seen his surgeon last week and he thinks it is slow motility and pyloris function causing the problem. He had Botox around 4 months ago which helped and surgeon is repeating this in 2 weeks time. He finds sometimes in the mornings, the saliva/ mucus is a problem and he feels unwell until he vomits it up. Feels fine after that and can then handle breakfast. He hasn’t tried mucinex…do you think that would help ??
Thanks
Deb
Hi Deb. Sorry to read that Kerry isn't doing so well. Has Rukshan tried him on domperidone? I have 4 a day for motility.
@suensteve17
Hi sue, yes hes on domperidone just 2 a day. We’re going to see Rukshan on the 10th to have another Botox injection which hopefully will help. It made quite a difference last time.
I’ll let you know if it improves in 3 weeks or so.
Thanks for emailing, hope you’re doing well
Deb
Hi Deb,
From your remarks it sounds like this is something relatively new? Could he be getting over feed through his Jtube? What happens if he skips a feeding?
Hi,
We’ve looked into that…his rate is 70 which is pretty low and it runs for 12 hours overnight. We don’t think that’s the problem…we think it’s the slow motility so hoping the Botox will help 🙂
Thanks
Deb
@brianpj12
Also, hes never skipped a feeding overnight but will be soon as prepping for a colonoscopy..his tube is helping him to gain/ maintain his weight and is needed. 🙂
Thanks
Deb