Why Mary will love her Christmas food
Mary Townsend’s throat has seen electric, fire-breathing knives and botox in the past few months but she could not be happier.
Earlier this year the 61-year-old lost the ability to keep food, and eventually even water, down thanks to a rare digestive disorder known as achalasia.
The mystery, degenerative condition happens when the muscles of the lower part of the oesophagus fail to relax, preventing food from dropping into the stomach.
Over a matter of months, the high-end retail expert’s already small frame shrank to 48 kilograms and she knew people could notice the bones she felt poking through her clothes.
‘‘You get to that stage and say: is there somebody out there who’s able to help me?’’
It began as phlegm and discomfort in her throat at night.
‘‘You’d be laying down in bed and next minute you would get this pain,’’ Townsend said.
The chest pain made her wonder if she would have a heart attack.
Wellington gastroenterologist Rees Cameron said: ‘‘If you don’t treat it, the oesophagus starts to dilate up and you end up with this sort of bag situation.
‘‘When you lie down at night, what’s sitting in your oesophagus will reflux up and potentially go into your lungs.’’
That means pneumonia, he said. There was also the risk of choking on vomit.
‘‘Untreated it’s a nasty, nasty condition.’’
Experts can’t work out what causes achalasia, or even the major risk factors for having the condition.
Townsend was the second patient in Wellington on whom Cameron has performed a minimally invasive surgery known as per-oral endoscopic myotomy (Poem), which saw her up and out of hospital the next day.
Poem involves an electric knife, which doubles as a burning tool, being fed down the throat to cut through the muscle and to cauterise – clot – any areas of bleeding.
The procedure was first performed in Japan in 2008 and Cameron has brought it to Capital & Coast District Health Board, following a sabbatical in Shanghai where he learnt how to perform the surgery.
Footage of the procedure, in which fire can be seen burning throat tissue, is not for the faint hearted. But Cameron assures: ‘‘It’s quite fun’’.
It works by relieving the tightness and allowing the oesophagus to empty as normal.
Cameron expects to do up to 10 of the operations each year, but said getting theatre time was always a struggle.
In Townsend’s case, botox was done in her oesophagus two months before the procedure, as she had other frailties, Cameron said.
By the time Townsend had surgery, her weight had plummeted to 45kg.
Cameron sees up to 10 patients each year with the condition.
Waikato Hospital also uses the new procedure.
Elsewhere though, the main treatment traditionally involves a laparoscopy through the chest, where surgeons cut the muscles inside the throat, allowing them to stay open.
That usually meant about four cuts in the chest, took about two hours of theatre time, and meant patients would be in hospital for up to three nights.
Cameron has now done the new procedure three times, and has got the surgery time down to 48 minutes, with patients generally staying in one night to recover.
At $6500, it also costs much less than the $10,500 older laparoscopic treatment.
Although Townsend is still recovering, she has been able to eat solid food again, gain some weight, and is looking forward to being able to enjoy a Christmas meal.