 The Clarinet BBoard
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Author: martin
Date: 2005-06-28 22:53
About three years ago I asked a question about reflux and clarinet playing.
One respondee mentioned the plicator procedure for combatting reflux. Has anyone had this procedure and what were the reults?
Martin Shapiro
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Author: Synonymous Botch
Date: 2005-06-29 01:35
I also suffer from this, and the first time it happened - I thought it was a heart attack. My doc got me to drop 10 pounds (on the way to 25) and it abated.
I also reduced the resitance in my reed setups and that put an end to the burble in my belly while playing.
Have you fully explored dietary changes and weight loss?
My GP explained acid reflux as a feedback system - if I eat too much, it hurts!
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Author: martin
Date: 2005-06-29 01:56
Thanks but I've already tried your advise... dropped twenty pounds... softer reed..... that's why I'm considering the procedure.
Martin
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Author: hans
Date: 2005-06-29 02:02
martin,
I had the plicator procedure nearly 2 1/2 years ago. It was performed by Dr. Gregory Haber, who left Toronto about a year later (so I was told) and moved to New York City to practise.
The procedure was highly successful in stopping my reflux immediately and I have had no negative effects whatsoever. I would have it again without reservation.
The procedure takes only about 20 minutes under "conscious sedation" and it is performed completely by going down the patient's throat with a surgical apparatus. I was completely unaware and remember nothing of the operation. A few hours later I was allowed to go home. Tylenol 3 was the only medication needed for several days for moderate pain. Ice cream helped too.
Write me if there is anything else you would like to know and I will try to answer your questions.
Regards,
Hans
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Author: DavidBlumberg
Date: 2005-06-29 10:50
Martin, have you tried Prilosec? It's over the counter now and for me (and my wife who had temporarily lost her voice due to AR) works really well. I have a Hiatial Hernia as well as acid reflux, and it prevents both from acting up.
What used to get mine was stress and/or tomato products.
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Author: Alseg
Date: 2005-06-29 13:40
It does indeed work. It cinches up the inlet to the stomach around the esophagus.
The "Gold Standard" is still the Nissen Fundoplication (laparoscopic or open).
If you are having a problem, the first order of business is an upper endoscopy, then esophageal manometrics and ph monitoring.
Proton pump inhibitors are efficacious.
Weight loss and dietary management is part of the process.
Disclaimer...The above is a general statement not to be construed as a patient relationship (legal stuff).
Oh yeah, and this is my day job.
Former creator of CUSTOM CLARINET TUNING BARRELS by DR. ALLAN SEGAL
-Where the Sound Matters Most(tm)-
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Author: martin
Date: 2005-06-29 15:23
Thank you all for the information. Taking acid reducing medicine helps me
but once I start playing, if it is at a time when I am predisposed to reflux, clarinet playing makes it worse. I could, of course, stop playing and that would virtually eliminate the problem. This is an option I would hate to choose.
Hans, I work in Manhattan and have actually been able to locate Dr. Haber.
Thanks again,
Martin Shapiro
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Author: hans
Date: 2005-06-29 20:32
martin,
I understand that Losec and other acid production inhibitors (I tried them all) can interfere with B vitamin production leading to deficiency, something my MD neglected to tell me. In addition, they may have other unwanted side effects such as headache (severe in my case) so that it would certainly be prudent to do some research before taking them (as with any prescription) for the rest of your life. There are reputable web sites that can help with this research; e.g., <www.mayoclinic.com>
My acquaintance who had laparoscopic fundoplication performed by Dr. Mehran Anvari (in Hamilton, Ontario) was unable to vomit afterwards (a potentially serious problem?) and cold drinks close up her oesophagus until it regains normal temperature, then trickle down slowly into her stomach. She is envious of my endoscopic plication's success. The fundoplication procedure also had a longer recovery period, beginning with a hospital stay.
Endoscopic plication created none of the above problems for me. I suspect that, when Dr. Haber has trained more surgeons, it, or enteryx, or some other more elegant procedure will become the new "gold standard".
Regards,
Hans
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Author: Alseg
Date: 2005-06-29 21:23
Hans
You friend has a "gas bloat syndrome" or tightness that does not allow for the egress of air from the stomach (the esophagus is also a vent). This is an uncommon but known complication of many antireflux procedures.
Your friend represents a "series of one" as does your own experience, neither of which is statistically significant
We have not even mentioned propulsive medications (Reglan etc) nor have we excluded gastroparesis or outlet problems.
In other words....no formal evaluation has been done.
I do not subscribe to the school of "one size fits all."
Intervention should be tailored to the patient.
Hell, we can not even agree on the best reed or horn, let alone a procedure that few of us can perform.
We have given a member of this group some important info and things he can ask his physicians about.
I just got out of an O.R. trying to fix a guy with peritonitis. Tomorrow I will attempt to eradicate an esophageal cancer for another person.
Tonight.....Baermann's Adagio.
That is all from me on the subject.
Martin....good luck.
AS
Former creator of CUSTOM CLARINET TUNING BARRELS by DR. ALLAN SEGAL
-Where the Sound Matters Most(tm)-
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