Patient experiences - Gerry Smith

It is difficult to remember the exact chronology of this story but it goes back many years to my young days.

I seem to have inherited this disorder as my father who was a market gardener always suffered from 'indigestion' and constantly took a milky white medicine. From the ages of 15 until 18 in the late 1940's and early 1950's I worked with him, and although it made me very fit physically, I recall that the many hours bent double doing hand-weeding and similar tasks, caused me some discomfort.

In 1952 I joined the Royal Navy where I spent the next 12 years. Although I continued to have minor digestive problems, I was young and fit and enjoying life. It is possible that the old tradition of supplying all serving ratings with a daily ration of one eighth of a pint of very strong rum did little to help my slowly deteriorating oesophagus. As a Chief Petty Officer I received it supplied neat and not watered down and it had to be consumed immediately and not saved.

In 1964 I left the Navy and joined a fledgling electronics company, which was just taking off and in my 30 years with them the turnover went from £3 million to £2 billion. It was an exciting ride and we lived a fairly racy life with a great deal of eating and drinking, with worldwide travel and extensive entertaining. In my defence I do not believe I ate or drank more than any of my colleagues. Over the years I began to have more and more discomfort and the consumption of Rennies, and later Bisodol became an essential part of my life.

One sensible thing I did at the age of 50 was to finally stop smoking after a lifetime of serious dedication to this stupid addiction.

Around 1990/91 I was forced to seek medical help and was referred to a marvellous consultant and experienced my first gastroscopy examination. This I believe showed I had ulcers and confirmed that the root cause was a serious hiatus hernia. It was also discovered that I was producing stomach acid at a high rate and so I was placed on daily medication to help control this. I started with Zantac, which was later replaced by Losec.

Now followed a pattern of regular gastroscopy examinations, which were normally every 18 months, but if more ulceration occurred then the frequency was changed. The usual pattern if ulcers were present was to increase the daily medication dosage and look again in say six month's time.

Over the years I developed a wonderful relationship with my consultant and we agreed from the start that he would always keep me fully informed of the risks and possible outcome of this condition. In the early 1990's I was diagnosed with Barrett's oesophagus, which is a condition where the excess acid from the stomach burns the bottom section of the oesophagus. This now required even more careful monitoring as it shows that the acid reflux, which is the escape of acid through the hiatus hernia, was finally doing some serious damage. I was fully aware that this was the start of a path that could possibly ultimately lead to cancer of the oesophagus and the regular monitoring continued.

Although I carried on with a relatively normal life, I found that increasingly the consumption of alcohol was causing me considerable pain and discomfort, and so in 1997 I stopped drinking. To my surprise, this proved to be incredibly easy and caused much more distress to my friends than it did to me.

Early in 2001 I went for my usual gastroscopy, which was a relaxed, jokey exchange with the consultant and theatre staff, as I was by now an experienced trouper at this routine. The usual biopsy samples were taken as always and off I went. This time the regular pattern was altered when I received a call from the consultant saying we should meet for a chat. With a more serious face than normal he informed me that the biopsy had shown that I was suffering from High Grade Dysplasia. This is a cell abnormality in the oesophagus, which can be a precursor to cancer, and decisions had to be made. Essentially there were three options, the first was do nothing and look again in a few month's time. This was immediately discarded as too risky. The second was to have laser or similar treatment to 'burn off' the affected area. This was discussed at length, and the risk was that if one rogue cell was left untouched then the danger was still there. There was also the fact of my age, although I was 67 the consultant felt that I still had some mileage left in me and said that if I had been 77 then this treatment may have been the best option. The third option was the most radical, but ultimately the safest, which was to have surgery to remove the part of the oesophagus affected by Barrett's. I was left in no doubt that this was a major operation and was referred to a marvellous young surgeon by my consultant.

My wife and I went to see him and were impressed by his confident manner and he was totally frank and open about the risks involved. My final decision was made after I had asked both my consultant and the surgeon that if they were in my position, what would they do? Without hesitation both of them replied that they would have the operation.

Before undertaking the operation the surgeon did his own lengthy gastroscopy examination during which he took no less than 21 samples for biopsy. He confirmed the High Grade Dysplasia was present but found no evidence of cancer. It was not easy to take the decision to undergo major surgery when in fact there was actually nothing wrong with me, only some danger signals.

However, I made the decision and on the 21 st of June 2001 entered the King Edward VII Hospital in Midhurst for the operation. The procedure was to remove the lower portion of my oesophagus and the top part of my stomach and join the two together and at the same time include a repair to the hiatus hernia. Everyone is different and in my case there was a complicated blood supply arrangement to my stomach and the surgeon had to remove more of that organ than first envisaged. One third of my oesophagus and half of my stomach were removed. The operation was a complete success and I remained in the care of the excellent nursing staff for thirteen days. The highlight was after several days when they carry out the 'watertight' test where you drink a foul liquid and they watch it go past the join on the X-ray machine and everyone heaves a sigh of relief when it does not leak. On returning to the ward, my lovely named nurse then said those unbelievably wonderful words, "Would you like a cup of tea?"

On Saturday 30 th of June 2001 I was in my room with my wife and two children when the surgeon came in, sat on the bed and stated that I was a very lucky man indeed. He had just had the result of the tests that were carried out on the bits of me they took away and they found a 'minuscule' cancer on the site of the ulcer and Barrett's. He assured me that it was not present anywhere else and that it had been caught so early that he was sure they had removed the entire problem. He added that my decision to go for the operation was without doubt the best one I had made in my whole life!

I am now revising this on the 7th October 2004, well over 3 years down the line. I am literally back to normal, having learned new eating habits. I am leaner, which was predicted, am active, fit and healthy and doing all of the things I did before, including plenty of cycling which I enjoy very much.

I shall be eternally grateful to my consultant for without his diligent monitoring of my insides the problem would have developed into the deadly serious cancer of the oesophagus without my knowledge. He proved without doubt the incalculable value of regularly monitoring a potentially dangerous situation. I shall also be ever indebted to my fantastic surgeon and the wonderful team of dedicated staff at the hospital.

If anyone in a similar situation would like to talk to me I shall be more than happy to do so.

Gerry Smith (01264 359648)

October 2004

Update - January 2006

I saw my surgeon in September 2005 and he is pleased with my progress and does not want to see me again for 2 years.

It is now more than 5 years since my operation and I am absolutely fine and enjoying life.

Update - September 2008

My surgeon has given me the all clear again, and I am fit and well.

Patient experiences - Gerry Smith

Update - January 2006

Update - September 2008

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