‘Stumbling across LINX’ – the final LINX in the chain

Fast forward to August 2013, by which point mental fortitude was my sole driver. All other systems had been extinguished; hope, ambition and motivation had come and gone. I had pretty much tried every recommended holistic formulary, lifestyle change and medication possible. I was still taking relatively high dose acid suppression tablets, but they were becoming less and less effective. Chronic shortness of breath had engulfed me, for which I was using a steroid inhaler to control the airway reflux. I also had relentless belching which could be embarrassing to say the least! By this stage I had climbed the ophthalmology career ladder and with that came more and more responsibility with higher expectations to perform, but my acid reflux was holding me back. Again, in search of answers I began to trawl the Internet. A new wave of intensity had hit me.

It was one day through sheer coincidence that I stumbled across an acid reflux discussion forum stating how a few of the users had undergone a LINX procedure  – a small titanium band, made of magnets that fits around and augments the lower oesophageal sphincter. The moment I started to read about it, I thought that this could be the best thing for me! I started reading quicker and delving deeper into the possibility that this may help. I felt my medical background helped me in understanding my condition better, but at times the more I read the more worried I would get about things. Sometimes in life, ignorance is bliss. However the LINX seemed to good to be true. The fact that this simple device restored/augmented physiological function with much fewer complication risks than a fundoplication was the major selling point for me. My grandpa once told me ‘Simplicity is the best form of sophistication’. He may very well have been right. At this time there were a limited number of medical publications on the device, all of which I read. My gut feeling was that I had to take a ‘chance’ and see if this would work for me despite the surgery being in its infancy. I had exhausted all other options.

After some more homework, it appeared there were a limited number of centres performing this surgery in the UK and the surgery was only available privately. This did not deter me, after 5 years of suffering I could not put a price on my health. As an eye doctor, I had seen some terrible cases of patients having LASER eye surgery by surgeons without any NHS history and working in private ‘pop-up clinics’. With this in mind I wanted to see a surgeon with an established, robust NHS and private practice. I came across Mr Boyle as one of the UK pioneers of this surgery, and with one of the largest series of patients that had undergone the surgery. His website and video were very clear and my gut feeling was to see him.

In November 2013 I got the ball rolling and made an appointment to see Mr Boyle through his secretary. The appointment was made quickly and the consultation was clear and very positive. Finally some hope, I thought. I required a repeat endoscopy and 24-hour pH manometry, to see if I was eligible. By this stage I was very familiar with these tests!  The endoscopy is a day-case procedure, which is performed by Mr Boyle himself. It involves putting a camera down the oesophagus and into the stomach. The main objectives are to look for any physical cause for the reflux, like a hernia, as well as any tissue damage caused by the reflux. The below picture shows my lower oesophagus with the volvano-like appearance in the centre thought to be a small hernia.  The 24-hour manometry is performed on a separate day and involves placing a small tube through the nostril and down to the junction of the stomach and oesophagus (see picture). The tube is connected to a monitor, which you wear and press every time you feel you’re experiencing reflux. During these 24 hours, you throw the rulebook out the window and engorge on all the foods and drinks that aggravate your reflux. For me these were alcohol, breads, pizza, spicy food, just to name a few! I was relieving my youth

.endoscopypH manometry

There are certain inclusion criteria patients must fulfill on the tests to be given the green light. The tests were performed very efficiently and I fitted all the criteria. I was trying to keep a calm head and after a long discussion with Mr Boyle we both agreed that LINX would potentially benefit me. I had no hesitation, It was now or never. It had only been 2 months since seeing Mr Boyle, that now I was being lined-up for the LINX. I couldn’t believe it, I felt my world had spun 180 degrees. In my head I had set clear success criteria, which I would have been happy for. These were a 50% improvement in symptoms with no shortness of breath.  These criteria were very personal to me, as I felt at this level my quality of life would be sufficient to live relatively normally. My main objective in all this was not perfection. I wasn’t expecting some sort of miraculous paradigm shift in my symptoms. All I wanted was to gain control of my symptoms, that’s all, simply control.

The last 5 years had been turbulent with a lot of dark moments. Finally I could see light at the end of the tunnel and begin to lick the lid of life, reflux free……

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