Discussions By Condition: Medical Errors

Achalasia or not?

Posted In: Medical Errors 0 Replies
  • Posted By: Halfnote39
  • November 23, 2010
  • 05:26 PM

My wife has been dealing with her esophageal problems for around 5 years or so now. We saw a specialist here locally in Columbus, GA and he had my wife undergo both an esophageal manometry test and an EGD. The EGD results were normal other than the tightness of the LES both when the scope was pushed throught and then brought back through during the EGD. We met with that same doctor for the results of the esophageal manometry test in early September of this year and he told us the results were weird. He had initially thought after my wife's first consultation with him that it was probably Achalasia, but the results had thrown him for a loop as some aspects seemed to support that, but the fact that there was a fair amount of peristaltic activity shown in the first results was not consistent with Achalasia. He told us he was not certain enough to make a definite diagnosis and referred us the The Emory Clinic in Atlanta, GA.

We went there for the initial consultation in late September and met with the doctor who been assigned to my wife there. She looked at the results from the two prior tests and told us , as the first doctor had, that were aspects of those results both inconsistent and consistent with Achalasia. She told us, however, that in the 12 swallows done in the first test, that there had actually been one swallow that had resulted in a normal peristaltic contraction(normal swallowing motion) and that there is a doctor at the University of South Carolina that is considered the leading authority in the country for esophogeal motility disorders. He is actually referred to as the "Guru" of esophageal motility disorders and that he has a rule of thumb when diagnosing Achalasia that she said she tends to follow which is, that if there is even one normal peristaltic contraction shown in the manometry test results that it is not Achalasia. So even though she didn't come out and say it directly, by the guru's rule of thumb, the results of the first test indicated that it was not Achalasia. The doctor wanted my wife to do a second manometry test there at Emory to see what it would show. The second test was done last Tuesday morning and just yesterday afternoon we got a call from the doctor saying she had seen enough on the second test that she was diagnosing it as Achalasia and recommended the Laparoscopic Myotomy surgery and gave my wife the name of a good Thorasic surgeon at Emory The problem is that I am troubled by this as we have the first results basically ruling out Achalasia and now a second test allegedly confirming it. My wife and I aren't entirely sure what to do. We are going ask the doctor at Emory about the first results, but when my wife asked her on the phone about the first results , the doctor became mildly defensive and said that test results vary sometimes. These results are not just varied, they're night and day of each other. So we are in a tough spot now and trying to figure out where to go from here. I don't want to stand in the way of my wife getting the treatment and relief she has long been desperate for, but I also don't feel safe in proceeding without a valid explanation as to why the two test results are so different either and why we should ignore the first results which at present contradict what she just diagnosed. I do trust the doctor, but I don't think we can just ignore the first test results. Am I crazy? :)

Any advice or suggestions out there?

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