blockage in esophagus?

Question
Hi, I'm 58 yrs. old, had lap band surgery in Mexico in September, 2008.  I lost 20 lbs in the month after surgery, then no more.  I thought that the band was too loose, so I got a fill on Thanksgiving, 2008.  Nothing but trouble since.  Food started to get stuck. As time passed, it got stuck more frequently, and began to get painful.  I've had it stuck for five hours, during which I was in terrible pain. It feels like I'm having multiple heart attacks. The blockages and the pain has become worse to the point now that I can't eat anything solid.  Sometimes when there is a blockage, my breathing is restricted.  I can still breath, but I feel a restriction in my throat (probably trachea).  Sometimes it feels like liquid seeps down my trachea, like overflow from my esophagus.  Is that possible? I live in the desert, and work outside in the heat.  My main goal is to keep hydrated, but sometimes even water feels like it's stuck, and causes pain.  But it clears up in a reasonable time.  I can't do protein powder. I've tried about five different brands and they all upset my stomach, with horrendous gas. One thing I can eat is ice cream, but lately that also feels like it gets stuck. But it does have some protein.  I have lost another ten pounds this month because I can't eat anything, but I'm concerned about my health.  I take liquid vitamins, and try to drink stuff that has some nutritional value, but I'm at a loss as to where I can get the protein I need.  Since I stopped eating, I am much happier because I'm not in pain.  I check my blood pressure every day.  It's usually within the normal range.  Lately it has been low 95/56 and around there.  I'm not athletic, and this concerns me. I walk transects through the desert in my work (biologist), but I don't work out other than a little yoga. I'm also having pain in my shoulder and between my shoulder blades.  It's possible that is from an old injury, but I wanted to mention it in case it's some sort of symptom. I have also been waking up in the morning to painful ribs.  It takes a few minutes of moving around before I can walk up straight, and breath properly. I don't have any health insurance. My job is dependent on the economy, and I'm lucky to pay the rent each month. I need to find the most economic way to fix this other than not eating.  I'm taking Prilosec OTC, half a pill in the morning and half a pill at night.  Those are hard to swallow, and they don't seem to be helping. Is there something I can take that is in liquid form? I'm a mess and I need help.  Please share your wisdom with me.

Answer
Patti,
You are in urgent need of experienced attention for you and your Band.  You should contact the nearest Center of Excellence bariatric surgery program and get engaged with their program.  You can find Center of Excellence sites at www.asmbs.org - this is the website for our national organization.

Be aware that you may have trouble getting enrolled in a local program, since physicians are hesitant to take over responsibility for surgery done elsewhere, especially outside the US.  You should get the assistance of your primary MD to get you in with the surgeons if you need to.

Please spread the word to your friends and contacts - bariatric surgery should be viewed as part of a long term plan to combat obesity.  It works best if it is managed by a Center of Excellence close to your home.

Best of luck,
Dr JP

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