Discover illness after two decades
Diagnosed after two decades of suffering
Ever since he was eight years old, Christopher Howe's mother Valda knew something was wrong with her son. She took him to numerous doctors for severe chest pains, but was told, "stop wasting your money, your son is healthy," or " he only has worms." Eighteen years later he has a name for his illness - achalasia.
Howe's symptoms were regurgitation after almost every meal, difficulty swallowing, loss of weight and severe pain. "It felt like something was squeezing against my heart and, in order for me to get some relief, I would have to hold a pillow against my chest and squeeze it for about 10-15 minutes," Howe explained to Outlook as he outlined his very uncommon illness.
According to gastrologist Naydene Williams, who has been treating Howe since his first surgery in 2009, achalasia is a condition that affects the lower oesophagus, in which there is a failure of the muscular band at the end of the oesophagus to relax. "This is due to an abnormality of the plexus of nerve fibres in this band - the lower oesophageal sphincter. Failure of this muscular sphincter to relax results in an interference of the smooth movement of food from the oesophagus into the stomach. This may result in an accumulation of food and fluid in the oesophagus," explains Dr Williams.
She notes that the medical community is yet to find the main cause of the illness, and although there are various treatments available, there is no cure for the condition.
"There are treatments such as botox which may be used in some cases, but the most permanent relief is through surgery - oesophageal dilatation and surgical cleaving of the muscle," Williams added.
In 2008, the illness that has plagued Howe his entire life, escalated to the point where he couldn't even take liquids without them coming back up. An X-ray (barium study), revealed that the muscle that releases the food into the stomach, had been entirely closed up.
Howe developed a hernia, and bacteria from the backup of undigested food which was found in his oesophagus. His oesophagus was dilated.
He was recommended to a nutritionist who told him to adjust his diet to more liquid foods, including smoothies, but that caused more damage. "They later found that the liquid does more damage than solid foods," Howe explained.
He told Outlook that it was like a double 'whammy' for him to deal with - the tightening of the muscles plus the absence of the paralysis to push the food through.
Howe did his first surgery in Florida in 2009. "They attempted to cut the rims of the muscle to free up the area to allow the food to pass through, and took a part of the outer walls of the stomach and wrapped the area to prevent the acid from coming back up," Howe explained.
Soon after returning home from his surgery, he had to be rushed to the emergency room. "I had to be rushed to the University Hospital because I had something that had in vitamin C and I was not aware that it did," he told Outlook.
Today, his symptoms have returned, but not as severe as they have been in the past. But, as time goes by, he feels them becoming more unbearable.
Now almost five years after his first surgery, Howe is preparing for his second one, this time in Jamaica.
In an interview with Outlook just a day before his observation began, he noted that he has a positive attitude about the surgery. His concern, though, is not so much the actual procedure, but the recovery process. He fears what happened the last time could repeat itself. "I would have to learn how to walk, talk and function again. That was not a good experience for me the first time and so that is my main concern," Howe emphasised.
The 32-year-old from Clarendon, who was raised in Allman Town, Kingston, by his mother, recalls her encouraging him to "always strive for the highest and never quit".
Despite his suffering, Howe never allowed his physical discomfort to stop him from achieving his goals. "I was always seen as a leader. I was head boy at Excelsior High School," he told Outlook with a smile.
He explained that he did everything like a normal student, except when it was time to eat. "When I felt it coming up, I always went to be by myself so no one would know what was happening," he shared.
After completing high school, he moved on to Vector Technology where he achieved a diploma in computer technology, and is now pursuing his information technology degree at the University College of the Caribbean. Howe is currently an IT operations supervisor at the Jamaica National Building Society.
After decades of misdiagnosis, Howe advises others who are experiencing similar symptoms with doctors not able to give them a diagnosis to never give up.
He notes that others who are diagnosed with achalasia should not feel amputated by it. "Although it took a while for doctors to find the problem, there are doctors who care and will go the extra mile to ensure that you get the medical attention you need," Howe adds.
"Dr Deborah O'Connor and Dr Prosper-Chen stand out to me because they suspected that my condition was not normal and immediately determined that an X-ray is the best way to determine what's going on inside. Every chance they got, they followed up and even after referring me to the specialists (gastroenterologist), they still checked in. For this, I am grateful."
Dr Lindberg Simpson, one of Howe's current doctors, noted that achalasia is prevalent in adults between the ages of 30 and 60 years old, and less likely to affect young children. The fact that Howe was afflicted at such a young age is very unusual. He also advises individuals who might be experiencing some of these symptoms and are not being diagnosed to ask their doctor to have them do an X-ray.