Esophagus woes

On March 11th I went in for an Upper Endoscopy with Ultrasound and Biopsy for a cyst that was found at the end of last year. The plan was to scan it, poke it, and if benign leave it be.

The first procedure seemed to go smoothly enough, as an aside, I am allergic to the general anesthesia Propofol, getting a different concoction made for a much more comfortable experience. I got sent home with some antibiotics and would hear back later in the week for biopsy results. The cyst was determined to be non-cancerous!

First Procedure

The day following the procedure was good. However, Wednesday things went sideways. Slight fever, night sweats, chills, and a creeping pain in my esophagus, I was hoping things would improve, but by Friday I was in tremendous pain and could not speak without going into a coughing fit. I spoke with my doctor. He had me go to the Common Spirit St. Anthony Hospital Emergency Room. I was admitted and underwent a series of tests.

Things were in bad shape. The cyst doubled in size from 2.5cm to 5cm. They were concerned that it was a duplicating cyst, and that there was an infection. I was admitted to the hospital for treatment and monitoring. I stayed from March 15-19th. I was on a rotation of three IV anti-biotics and an antifungal to reduce any infection; with the hope and expectation the cyst would decrease in size and my body would be ready for removal the following week.

I went home Tuesday the 19th and continued to take oral antibiotics until the procedure to remove the cyst Tuesday March 26th. The procedure was called "XI Robot-Assisted Mediastinal and Esophageal Mass Excision". They went in with five incisions on my right side. They collapsed my right lung to get enough room and clearance to poke around in there and extract the cyst. 

Chest Catheter

The whole procedure took about 4 hours and was successful! I woke up with two chest catheters, two IVs, and a few other cords.

Good news was that the cyst was out. The official test results identified the mass as a duplication cyst, which makes me feel as if I should be playing the lottery at this point.

Esophageal duplication cysts are rare congenital anomalies that constitute between 0.5% and 2.5% of all esophageal masses. It is estimated that the incidence of esophageal duplication cysts is one in 8,200 ... (source)

Bad news was that I had two small tears in my esophagus which had to be patched. I was on IV feeding until March 29th. They did many x-rays and scans to ensure I was recovering well. This included an echo scan of my heart to make sure it was still working!

Pick Line

Because I couldn't have anything by mouth they had to give me a pick-line, which was pretty intense. It takes about 20 minutes to prep to put the line in, and about 5 minutes to install it. They ran 42cm long tube from my arm up to my heart. There is a high risk of infection, but it supports three lines at once and allows heavier nutrients to be used. 

On Friday they did a barium swallow test to see how well my esophagus had healed. The test is is an x-ray
while you drink liquid with a contrast, so they could ensure nothing was leaking from my esophagus to the rest of my body.

The test was a success, which allowed me to advance my diet to liquid only. After s few days it advanced again to full liquid (smoothies, peanut butter, and oil). On March 31st they were able to remove one of the two chest catheters. The relief was almost immediate. Thankfully drainage stayed low and they removed the final tube on April 1st. That evening they sent me home. 

Getting home was great, but with its own challenges. The first few nights sleep felt impossible. Sorting out the timing of medication was a feat by itself.

Food was another challenge as I remained on a full liquid diet for two weeks. The nutrition team was worried I would not be able to get enough nutrients or calories because of my soy allergy and keto diet. While the food at the hospital was pretty good, my allergies limited the selection severely. I was able to get enough calories thanks to Elle, who brought me amazing protein smoothies every day, which were very calorically dense and full of fats and protein! With her help, I was able to move to a mechanical soft diet after that and finally to a regular diet a week after. 

I followed up with my surgeon to have my stitches removed Friday April 12th. My doctor let me know it will be 6 weeks until I can go back to anything active. Until then no twisting (no DDR or dancing), stretching (no yoga or PT), or lifting more than 10lbs). I'm not excited about the physical limitations, I know it's part of the recovery process. I'm looking forward to dancing, gaming, and lifting heavy things again.

 Overall, I'm improving a bit each day. Everything is exhausting, the right side of my chest is still numb, and pain comes and goes in waves. I can drive as long as I'm not taking narcotics and most activity is followed by a nap or a long rest. I'm feeling good about the recovery and look forward to getting back to regular activity again.

Here are a few images that are bit more graphic. Mainly a better look at all the wires post operation and holes from the procedure.