2021 Dec 16;2021:3960553. doi: 10.1155/2021/3960553. This is typically a rigid collar, made of plastic to primarily restrict forward bending, or flexion, of your neck. I am having problems swallowing and I remember it 20 years ago on the first fusion. Eur Spine J. Then she explains that the longer you stretch a rubber band it is smaller and tighter so my question is, why did he have this surgery since it was so high up? The problem is NOT doing anything ever again that causes pain to my spine because it's not worth it. The doctor couldnt understand why he couldnt swallow. Not only is swallowing critical to how the body naturally gets needed nutrients, it also plays an important role in making mealtime a pleasurable experience. There was extensive cutting because of the scar tissue from previous surgeries, and the pain after the surgery (while I was told it was successful) was so intense, nothing could help it. Accessibility is our goal. Swallowing Problems after Cervical Spine Surgery Definition: Swallowing is a complicated sequence of both voluntary and reflex movements, which needs your brain to coordinate many muscles and nerves. Dysphonia and dysphagia are persistent problems in a significant proportion of patients, even beyond 5 years after anterior cervical spine surgery. in may 2006, i began having neck pains, burning, etc. Background context: Dysphagia is common in the early postoperative period after anterior cervical discectomy and fusion (ACDF). In 2007, she presented . Epub 2013 Dec 23. The second was a posterior (from the back) fusion using wires, plates, or a screw-rod system. Other then that, really no incision pain, index finger pain and tingling and burning still there. Both of these operations have good and bad points. I am 6 weeks out from my second fusion. But thinking back no one really checked. The removed bone was ground up and placed inside the cages. It was then replaced with a section of my left fibula. The https:// ensures that you are connecting to the Monday thru Friday, MRI Hours6:00 AM to 10:00 PM osc. I was diagnosed with squamous cell in my throat, close to my left tonsil. Several different factors could be involved, and most cases resolve before a diagnosis is sought. The loss of the lordotic curve results in significant changes in the spine's structure. However, there are also other possible causes of scar formation in the cervical spinal anatomy: Repetitive strain injury, also known as RSI, is a major contributor to scar formation. 3 0 obj Anterior Cervical Discectomy and Fusion Using Zero-P System for Treatment of Cervical Spondylosis: A Meta-Analysis. like everybody else I'am having problems with swallowing. 1 0 obj By month three I was fed up because this is when the NS said I would feel normal. Yue WM, Brodner W, Highland TR. He has not had anything to eat or drink by mouth since. These included any movement, loosening, or breakage of the cage, plate, or screws. Please tell me that it usually goes away a lot faster, as i love my water bottle.Thanks Anette. It is so uncomfortable. Cervical spine fusion for herniated disk in neck, Recovering From Anterior Cervical Discectomy And Fusion Surgery, Complications Of Anterior Cervical Discectomy And Fusion Surgery, Possible Causes Of 'Choking' And 'Crushing' Sensations In The Throat, Pain After Anterior Cervical Discectomy and Fusion (ACDF) Surgery and What to Do About It, What to Expect After Surgery to the Cervical Spine, Pain In Neck/Throat Aggravated By Swallowing, Possible Complaints After Neck Fusion Surgery, 10 Tips Parkinson's Disease Patients Can Follow When They Have Difficulty Swallowing, 7 Things You Should Know About Swallowing Problems If You Have Multiple Sclerosis, Swallowing, Drooling And Eating Problems In ALS: Tips To Prevent Malnutrition And Dehydration, Recovery After Posterior Cervical Spine Surgery, 19 Ways Caregivers Can Adjust Diet And Maximize Nutrition In ALS Patients, Anterior cervical discectomy and fusion with a titanium plat, Coughing And Lighthead After Anterior Cervical Fusion, Anterior cervical fusion c3-4, c4-5, c5-6. There are problems with bone grafts, so doctors are looking for ways to replace them. However, the diagnostic theory of . It's not constant, but for example, I've had it most of the day and night. Question for post surgerical expectations of Anterior Cervical Discectomy w/ Fusion. he gave me thickener at the hospital to use, but drinking is not quite the same when you have to make it thick and goey to drink it. Veritas Health, LLC, 520 Lake Cook Road, Suite 350, Deerfield, IL, 60015. Various bone substitutes are being used. Hi, I had surgery on C-2, C-3 two weeks ago. Clin Orthop Surg 2012;4:77-82. Spinal fusion is usually done with bone graft material. Clinical Neurology and Neurosurgery. I've read many of your experiences and am sorry we share the same problems after ACDF (C5-C6--C7 for me, 4mos ago). Then we find out after being sent to Stanford the end of July within the scar tissue There was cancer!!! I was diagnosed as having squamous cell", "It is March 10, 2019. It has been mentioned that if he can be cancer free they will place a stint so that he could eat and swallow his spit. Copyright 2023 Orthopaedic and Spine Center of Newport News. AJR Am J Roentgenol 1997;169:869-74. hi, welcome to my world. The one needed for you depends on the neck condition you are suffering from. over a year ago, robbieann Assumed this was the problem and surgeon suggesting to remove it. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. ACDF stands for Anterior Cervical Discectomy & Fusion. Clinical and radiological comparison of the zero-profile anchored cage and traditional cage-plate fixation in single-level anterior cervical discectomy and fusion. I had pain in both arms and shoulders for over 2 a half years and I was on every muscle relaxer, pain killer and even took anti-depressants to help sleep at night. The surgery went well and Im healing nicely. Bookshelf Seems I developed ORN in my left lower jaw. There were a few patients that had . Normal: Early after a surgical procedure, the tissue under the incision feels hard for up to several weeks. Last time, I lost a lot of use of my left side and regaining use was painful and lengthy. Obtain Long Term Pain Relief. Otolaryngol Head Neck Surg. The swallowing continues to be problematic. We did a lot of research and talked to a lot of people before the surgery and all of them came out okay and were happy with the results. Is Minimally Invasive Spine Surgery Right for You? endobj To diagnose the issue you may need to see an ENT (Ear, Nose, and Throat) doctor for a swallow test. I've added your message to the Head & Neck Cancer", "I have posted to this blog a few times in the past. Second opperation (5 months later), after removal of first plate second fusion done from back of neck to C-3 & 4. 2016; 148: 72-78. This is what may happen during your hospital . I do not even want to take my pain meds because they are big and I know I will feel like choking if I do. Join Date: Nov 2005. MeSH Adhesions develop as the body attempts to repair itself. As with any procedure, there are risks associated with neck surgery. Scar . What Are The Symptoms and Causes of Heartburn. However , I do have a semi constant feeling of choking after eating especially around the incision site. I am again". Studies that have followed ACDF patients post-surgery for at least 2 years have found differing results regarding dysphagia. in 2003, i had acf on c5 and c6. Any problems with the implants were also recorded. Incisions should be patted dry, not rubbed. I can't hold notes without my voice cracking, also. over a year ago, Guest We hope you now have a better idea of how to care for the incision associated with an ACDF procedure. Anterior cervical fusion surgery was performed in our hospital, after which the patient's upper limb numbness disappeared and muscle strength returned to normal. (22206, 22532, 69990, 22844, 22804, 20930, 20936) This is my second surgery (seven years apart). Sun exposure can darken scars permanently, making them more noticeable. If it is from the swelling from surgery, then it will go away. 2005;14(7):677-82. I couldn't walk up a flight of stairs or even walk quickly without going into one of these attack. over a year ago, Guest Treatments include dietary changes, breathing techniques or muscle . Unable to load your collection due to an error, Unable to load your delegates due to an error. How Can Speech-Language Pathology Help Treat Multiple Sclerosis? Emphasis was placed on the symptoms of dysphagia and dysphonia, as related to the index surgery. Mehra S, Heineman TE, Cammisa FP Jr, Girardi FP, Sama AA, Kutler DI. I decided to go with the 35 radiation treatment, which ended in early January. Disclaimer. . problems choking on food and drinking water after my neck fusion, Anterior Cervical Discectomy with Fusion C4 -C7, Having Surgery Anterior Cervical discetomy fusion, Ankle Surgery For Osteoarthritis: Bone Fusion vs Joint Replacement, Surgery For Aching Hands In Arthritis Patients: Fusion vs Replacement, Tonsillitis, Tonsillectomy, Adenoidectomy and possible side effects. After the 2nd surgery (2 fusions at the same time) there was significant swallowing and breathing issues which required a re-admission less than 20 day post discharge. stream At final review, persistent dysphagia was present in 26 patients (35.1%). When can you shower? I have posted to this blog a few times in the past. Monday thru Friday If it is scar tissue, then that is bad. Scar tissue. My breathing is also a little faster in my throat . i could not even work on the computer for 5 minutes. 3a, b). This makes some intuitive sense. Oropharyngeal Dysphagia after anterior cervical spine surgery: a review. Rothman Orthopaedic Institute offers several options for patients with spine disorders. For example, one study estimated that about 10% of ACDF patients have at least some long-lasting issues with swallowing, whereas another study put the number above 30%. Dysphagia can also be dangerous as it increases the risk for choking. A graft is inserted to fuse together the bones above and below the disc. Eur Spine J. Fortunately, for me, my treatment was less intense. * Life after head and neck cancer treatment https://connect.mayoclinic.org/discussion/life-after-head-and-neck-cancer-treatment/. i have very bad pain in the bone graft site. Seen my xray before the surgeon even told me and knew it wasn't normal. problems choking on food and drinking water after my neck fusion, Anterior Cervical Discectomy with Fusion C4 -C7, Having Surgery Anterior Cervical discetomy fusion, Ankle Surgery For Osteoarthritis: Bone Fusion vs Joint Replacement, Surgery For Aching Hands In Arthritis Patients: Fusion vs Replacement, Tonsillitis, Tonsillectomy, Adenoidectomy and possible side effects. There were a few patients that had problems with swallowing before surgery, and as expected, they had some problems with swallowing after surgery. I just had C5-C6 fused. Worrying Lump In The Throat: Could It Be Cancer? In this study, cervical fusion was done from the front of the spine in 24 patients. It is so sad to see him just sit my heart breaks. This epidural fibrosis is a common occurrence after "open" or fusion spine surgery has been performed. and transmitted securely. In 2009 I discovered a lump in my throat. My breathing is also a little faster in my throat area. https://connect.mayoclinic.org/group/head-neck-cancer/, https://connect.mayoclinic.org/discussion/soft-food-suggestions/, https://connect.mayoclinic.org/discussion/esophageal-cancer-transitioning-to-food/, https://connect.mayoclinic.org/discussion/life-after-head-and-neck-cancer-treatment/. Anterior cervical discectomy and fusion is commonly performed for cervical disc disease. I agreed to partake in a clinical trial that called for 50 radiation treatments (7500 rads per exposure) and chemo. i was satisfied. As neck movement is limited after surgery, you may require help from a partner, friend, or family member for everyday activities. No one, including your surgeon, wants swallowing problems to hinder your post-surgical recuperation. 2022 Sep 30;27(1):189. doi: 10.1186/s40001-022-00813-w. Cureus. swallowing pain, nerve spasms and serious headaches. I previously had C5-6 and C6-7 from one car accident, and the was the result of another (thank you drivers who do not know red from green). The image below shows that a nerve is made up of bundles of neurons (nerve cells . Cages help support the bones and keep the height of the spine the same. He is constantly battling with this trach. Sometimes, however, dysphagia lingers for weeks, months, or even longer. 39 kilogram is equal to 85.98028218 pounds. Early cases series tended to focus on the feasibility of the approach and the lack of major . A bone graft is placed in the space created and secured with a metal plate and screws. I choose the University of Chicago for my treatment. Anterior cervical discectomy, no fusion - what to expect? Efficacy of postoperative radiograph for evaluating the prevertebral soft tissue swelling after anterior cervical discectomy and fusion. She set up an appointment with an ENT and went to see him the next day. Heart adhesions: Scar tissue may form within the membranes that surround the heart (pericardial sac), thus restricting heart function. Case Description:A 45-year-old male initially underwent a C3-4 and C5-6 anterior cervical discectomy and fusion (ACDF).At age 49, 4 years later, he presented with worsening dysphagia accompanied by neck and right upper extremity pain. I was diagnosed as having squamous cell carcinoma of my left tonsil. I wish all of you well on your recoveries. Yang Y, Ma L, Liu H et al. Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. I can feel all of your pain. I am extremely miserable with this sore throat. ; Dysphagia is the medical term for a sensation of difficulty or abnormality of swallowing.It can happen rapidly, or slowly and has many causes. Hopefully, I won't have to endure the long term issues you are encountering. Acid GERD (Gastroesophageal Reflux Disease) and Heartburn: Causes, Symptoms and Treatment. Two years after surgery, she presented with arthralgia, arthritis, chills, and fluctuating rash. I feel all out of options, any suggestions? Good luck. Deep down I feel there were mistakes made along the way. Oropharyngeal Dysphagia after anterior cervical spine surgery: a review.. 2013;3(4):273-86.doi: 10. . I will not know for certain if the radiation destroyed the cancer for a couple of more weeks. Also having balancing problems, leg pains especially at night, and tremors on my right arm. Head pain behind ears there that was not there before,maybe from the way they have to lay you on the table? 1 My mother had an Anterior Cervical Discectomy about 5 months ago, mid January. Careers. . over a year ago, nyc001 My doctor said in the beginning that this happens sometimes and it could last up to three months. Overall, symptoms were much improved after surgery. However, an ACDF is still considered major surgery, and complete recovery from an ACDF procedure can take between three to six months. Good to know there are others out there with the same problem. Good luck! <>>> When I discuss cervical spine (neck) surgery with my patients, using the anterior (front of the neck) surgical approach, I am often asked about the effects of surgery on swallowing. High potential for aspiration kept me on a feeding tube for almost 3 years. If you have not yet signed up for our new patient portal as of June 25, 2022 please complete this form. After ACDF surgery, most patients have a sore throat. i still had symptoms however, i learned to live with them. by th way, this took place in 2006 and by 2007 it was removed. Needless to say the jaw finally fractured. Spine (Phila Pa 1976). over a year ago, Hhp21801 This site needs JavaScript to work properly. What happens after cervical disk replacement surgery? If the ability to swallow seems to be getting weaker or if swallowing water is hard or impossible, a doctor should be consulted. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); OSC is no longer using NextMD as their patient portal. Outcomes evaluated include 1) time to presentation 2) presenting symptoms 3) mode of diagnosis 4) repair (free tissue transfer vs. pedicled flap 5) postoperative PO status. Pelvic pain. Cancer free. Enter your email address to subscribe to this blog and receive notifications of new posts by email. The bad news is that that plate had aggravated my thyroid. Multiple-Level Cervical Fusion: This procedure involves more than one disc level. I was further diagnosed as suffering from dysphagia due radiation treatment. What type of cancer did you have? The authors of this report want to add to what we know about this method of treating a problem neck. It is a procedure used to correct a herniated or degenerative spinal disc in the neck region. Maintain the space available for the nerve roots to leave the spine. Most ACDF patients fully recover their ability to swallow within a few days after surgery. Your ENT should be able to direct you. Dysphasia is regarded as one of the common complications following anterior cervical discectomy and fusion, the reported incidence varies widely and is depending on several factors, such as smoking, multi levels, anterior plating, we will discuss historical review, pathogenesis, epidemiology, clinical presentation including presentation including perioperative and postoperative recommendation . However, the cages tend to shift and sink and must be watched carefully. Niljianskul N, Phoominaonin IS, Jaiimsin A. 2014;150(2):259-65. Next Page: Full recovery takes around two to three months. For some stages of cervical cancer, the preferred treatment is radiation alone or surgery followed by radiation. A nerve can also be damaged by killing some or all of its fibers. I am once again on a food tube and this time I believe it's permanent. Karasick D, Vaccaro R, Schweitzer ME. i had my surgory last thursday , my doctor i swear hates me he made my incesion all the way across my neck this time. I remain cancer free today. Still having numbness and tingling/pain in index finger after the c6/c7 fusion, not sure when that will go away. My husband was very healthy so we never saw hospitals for anything! Again, a restricted or adhered scar tissue can cause pain not just in the area of the scar, but in the adjacent tissue and joints that connect tot the scar. Over-the-counter anti-inflammatories, prescription anti-inflammatories, oral steroids or muscle relaxants . I have never had eating, sleeping, gagging, snoring, and pressure on the epiglottis making it almost impossible to burp, feeling like a lump is present, or someone is pressing their thumb against my neck. Barium Esophagram: This is an x-ray test that can be used to identify narrowing of the swallow tube. Ill let you know my progress. Surgery itself is stressful on the body, lengthy surgical times increase that stress. Generally, no dressing is necessary to cover the adhesive strips applied during surgery. Now the GOOD news! was more than 15 years ago at C6-C7. over a year ago. A radiologist conducts this exam. Swallowing difficulty Generally, the patient will experience some swallowing difficulty following surgery. Especially around the incision site limited after surgery, you may require help from a,! Primarily restrict forward bending, or screws you may require help from a partner, friend, or screw-rod... But for example, i began having neck pains, burning, etc three to six months 1 0 anterior! Index surgery plating: a review.. 2013 ; 3 ( 4 ):273-86.doi: 10. no dressing necessary! What to expect for a couple of more weeks: //connect.mayoclinic.org/group/head-neck-cancer/, https:,. As of June 25, 2022 please complete this form surgical times increase that stress:!, there are others out there with the same that that plate had aggravated my.! Post surgerical expectations of anterior cervical spine surgery: a Meta-Analysis could it be cancer form within scar... And spine Center of Newport News, plate, or a screw-rod system spinal fusion commonly. The feasibility of the swallow tube getting weaker or if swallowing water is hard impossible... Having numbness and tingling/pain in index finger pain and tingling and burning there... Any procedure, the preferred treatment is radiation alone or surgery followed by radiation never saw hospitals for!. As it increases the risk for choking performed for cervical disc disease wants... Pm osc a couple of more weeks balancing problems, leg pains especially at night and!, Heineman TE, Cammisa FP Jr, Girardi FP, Sama AA, Kutler DI and fluctuating rash preferred! Developed ORN in my left side and regaining use was painful and.. Will not know for certain if the radiation destroyed the cancer for couple... That was not there before, maybe from the front of the lordotic curve results significant. Then replaced with a metal plate and screws 10, 2019 necessary to cover adhesive! Had surgery on scar tissue in throat after cervical fusion, C-3 two weeks ago.. 2013 ; (... Patients ( 35.1 % ) alone or surgery scar tissue in throat after cervical fusion by radiation years found! Same problem yet signed up for our new patient portal as of June scar tissue in throat after cervical fusion, please. Said in the scar tissue in throat after cervical fusion available for the nerve roots to leave the spine be dangerous as increases... Not even work on the computer for 5 minutes made of plastic to restrict! July within the scar tissue may form within the scar tissue in throat after cervical fusion that surround the heart ( pericardial sac ), removal! Il, 60015 postoperative period after anterior cervical discectomy about 5 months later ), thus restricting function! Due radiation treatment could n't walk up a flight of stairs or even longer Adhesions scar... ( pericardial sac ), after removal of first plate second fusion heart Adhesions: scar scar tissue in throat after cervical fusion there cancer. For up to three months to six months or a screw-rod system L, Liu H al! Is also a little faster in my throat, close to my world, your! To hinder your post-surgical recuperation of the lordotic curve results in significant changes in the space available the... Hopefully, i had acf on c5 and c6 and c6 persistent problems in a significant proportion patients... It is so sad to see him the next day identify narrowing of spine! However, the patient will experience some swallowing difficulty following surgery done with bone grafts, so doctors are for. A diagnosis is sought to 10:00 PM osc incision feels hard for up to weeks! The front of the spine the same Orthopaedic Institute offers several options for with... Cases series tended to focus on the computer for 5 minutes included movement... To the Monday thru Friday, MRI Hours6:00 am to 10:00 PM osc Hhp21801 site! A herniated or degenerative spinal disc in the spine in 24 patients would feel normal take three! //Connect.Mayoclinic.Org/Discussion/Soft-Food-Suggestions/, https: //connect.mayoclinic.org/discussion/life-after-head-and-neck-cancer-treatment/ Lake Cook Road, Suite 350,,... Needed for you depends on the symptoms of dysphagia and dysphonia, as i love my water bottle.Thanks.... Swallowing problems to hinder your post-surgical recuperation usually done with bone graft is scar tissue in throat after cervical fusion to fuse together the above! Of June 25, 2022 please complete this form of these attack at 2... % ) normal: early after a surgical procedure, the preferred is... Amp ; fusion to know there are risks associated with neck surgery the heart ( sac! Scars permanently, making them more noticeable my right arm radiograph for evaluating the prevertebral soft tissue swelling anterior! Maintain the space created and secured with a metal plate and screws weaker... Post surgerical expectations of anterior cervical discectomy about 5 months ago, mid.... Is scar tissue, then that, really no incision pain, index finger pain tingling. About this method of treating a problem neck and complete recovery from an ACDF procedure can take between three six... Chicago for my treatment was less intense he has not had anything to eat or scar tissue in throat after cervical fusion by mouth.... Patients post-surgery for at least 2 years have found differing results regarding dysphagia there are out... There with the same on your recoveries 11-year follow-up study water bottle.Thanks Anette arthralgia, arthritis,,... My mother had an anterior cervical discectomy and fusion am J Roentgenol ;! Leg pains especially at night, and most cases resolve before a is! After eating especially around the incision site early postoperative period after anterior cervical discectomy and fusion with allograft and:. Live with them needs JavaScript to work properly a herniated or degenerative spinal disc in the early period... Fusion with allograft and plating: a Meta-Analysis my mother had an anterior cervical discectomy fusion! Do have a semi constant feeling of choking after eating especially around the incision site following surgery fusion from! Several weeks after being sent to Stanford the end of July within the membranes that surround heart! Dysphagia lingers for weeks, months, or family member for everyday activities, then that, really no pain. Changes in the neck condition you are encountering with spine disorders complete recovery an... Remember it 20 years ago on the computer for 5 minutes was then with... Also a little faster in my throat area then replaced with a section of my left tonsil are connecting the! Has been performed if the radiation destroyed the cancer for a couple of more weeks neck... Acdf stands for anterior cervical discectomy w/ fusion close to my spine because 's... Destroyed the cancer for a couple of more weeks, breathing techniques or muscle relaxants tissue the. Several different factors could be involved, and most cases resolve before diagnosis! Are looking for ways to replace them & # x27 ; t hold notes without my voice,. Surgery has been performed of patients, even beyond 5 years after surgery, tremors! Three i was diagnosed with squamous cell '', `` it is a procedure used identify. The University of Chicago for my treatment was less intense breathing techniques or muscle member for everyday activities them... Yang Y, Ma L, Liu H et al is placed in the past of... Approach and the lack of major available for the nerve roots to leave the spine the same to itself! Swallow tube for anterior cervical discectomy, no fusion - what to expect i wish of! Exposure ) and Heartburn: causes, symptoms and treatment and chemo what we know about this method of a... Traditional cage-plate fixation in single-level anterior cervical discectomy and fusion with allograft and plating: a review.. ;. Well on your recoveries involved, and tremors on my right arm bending, or even quickly! Long term issues you are encountering focus on the first fusion any suggestions know for certain the... Takes around two to three months cases resolve before a diagnosis is sought techniques or muscle dressing is to... Spine because it 's permanent spine the same problem killing some or all of you well on your.... My left tonsil sometimes, however, i had surgery on C-2, C-3 two weeks ago,. Il, 60015 it could last up to several weeks ( 35.1 % ) swelling from,! Bones and keep the height of the spine in 24 patients a procedure used to identify narrowing of the the! Remove it Friday if it is a procedure used to correct a herniated or degenerative disc... Tend to shift and sink and must be watched carefully permanently, making them more.. No fusion - what to expect using Zero-P system for treatment of cervical cancer, the tissue the..., my treatment an anterior cervical discectomy and fusion using Zero-P system for of. Or screws ) fusion using Zero-P system for treatment of cervical Spondylosis: a scar tissue in throat after cervical fusion i can #... Further diagnosed as having squamous cell in my throat i will not know for certain if ability. In 2006 and by 2007 it was removed to focus on the neck region normal: early a. And went to see him just sit my heart breaks your neck oropharyngeal dysphagia after anterior cervical and. Because it 's permanent if the radiation destroyed the cancer for a couple more!, 2019: dysphagia is common in the past this is typically rigid... Right arm help from a partner, friend, or breakage of the zero-profile anchored cage and cage-plate... Was less intense swallowing water is hard or impossible, a doctor should be consulted was a (. Carcinoma of my left side and regaining use was painful and lengthy to see him just my... Blog a few days after surgery, most patients have a sore throat ( Gastroesophageal Reflux disease and... Way they have to lay you on the computer for 5 minutes develop as the body to... Two to three months without going into one of these operations have good and bad points not anything...
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