By Kadesha Thomas
Photo by David Christopher
Left to right: Angela Willis, RN, APN; Loretta Kasparas, RN; Marco Patti, MD; and Anne Forsythe, RN, team up to care for esophageal disease patients.
Bill McQuillan had an upbeat bop in his walk after he left his final check-up with Marco Patti, MD, director of the Center for Esophageal Diseases. There was no need for more appointments or medications. “He said I’m perfectly fine,” McQuillan shrugged — an abrupt change from what he had been facing last year.
In February, McQuillan, 58, a concrete contractor who lives in Niles, Illinois, was diagnosed with esophageal achalasia, a rare condition in which the esophagus muscles no longer perform peristalsis, the squeezing motion to push food down. The condition also does not allow the esophageal sphincter muscle to relax and let food pass into the stomach. So, the food jams in the esophagus “like a big, stuffed sausage,” Patti said. Without treatment, the condition progressively worsens to the point where only intense vomiting clears the blockage.
“Look at my legs,” McQuillan said as he wrapped the leg of his blue jeans tightly around his lower thigh. The bone near his knee was about as thin as a soda can. Because he could not keep food down, the weight on his 5-foot-11-inch frame had dropped from 235 pounds to 162 pounds in the past year.
McQuillan first noticed the problem a year before being diagnosed when he would become slightly nauseous after eating. “I’m one of those guys who doesn’t go to the doctor,” admitted McQuillan, whose slick dark hair accentuates his tough-guy persona. He dismissed the symptoms as a stomach bug and made adjustments by taking smaller bites, chewing longer and drinking more fluids with each meal. But after several months, he could even feel soup backing up in his chest.
This condition destroyed his ability to eat as much as his social life. Because he could anticipate becoming nauseous after every meal, he had to limit eating out with friends and family. “It was even painful to watch TV,” McQuillan said. “When you are hungry but can’t eat, all of the food commercials are magnified. I would get jealous and try to eat anyway. But I would still throw up.” He also had to time his customer calls at work around when he planned to eat. Too many calls had been cut short because he felt nauseous mid-conversation.
It wasn’t until family members commented on his drastic weight loss that he decided to see his physician in Park Ridge, who diagnosed him with esophageal achalasia. When McQuillan researched the condition on the Internet, the findings were not good: cause — unknown; cure — nonexistent. Then, he read about the laparoscopic Heller myotomy, a two-hour, minimally invasive operation that opens the sphincter at the end of the esophagus and allows food to pass into the stomach. His physician immediately referred him to the University of Chicago Medical Center, where Patti is an internationally known expert in the treatment of this disease.
“We moved fast,” said Loretta Kasparas, RN, nurse associate. “As soon as he called, I ordered the additional testing he needed and made his appointment with Dr. Patti.”
When McQuillan came to the Medical Center to meet Patti in April, he had lost more than 15 pounds in three weeks. “He was very distressed, frustrated, depressed,” Patti recalled. “But he had done his research, and he was very optimistic about the outcome of the operation.”
Having done more than 400 myotomies throughout his career, Patti was just as confident. Even though the procedure doesn’t cure achalasia, it allows patients to eat normally in more than 90 percent of cases. Patti made five small incisions in McQuillan’s abdomen to access the esophagus. Then, with the inner esophageal layer (mucosa) kept intact, the muscle layers around the esophagus were severed and sewn open, allowing food to pass easily into the stomach. To prevent acid reflux, Patti folded and secured a portion of the upper stomach over the lower esophagus.
The very next day, McQuillan could swallow small portions of soft foods; the day after that — an entire bowl of cream of chicken soup. After two days at the Medical Center and two weeks of recovery at home, he was at his favorite barbecue shack eating a beef sandwich.
“I felt like a human again,” McQuillan said. The incisions from the surgery now look like mere mosquito bites, and McQuillan’s weight is at 180 pounds.
The chance of the condition recurring is minimal. So, when McQuillan walked out of his follow-up appointment with Patti, the only thing Patti asked was that McQuillan e-mail an update every six months.
“All right,” McQuillan said, heading out of the appointment. “I’m going to Portillo’s.”