INSANITY

   Someone had said that the definition of Insanity is to doing the same thing over and again and expect different results. Certainly I am not talking about  learning or trying to be successful. There one can improve and achieve the goal . There was a Royal Air Force pilot and he had successful mission bombing Germany. But then in one of the missions his plane was shot and he lost his leg. He was POW and Germans made a prosthesis for the leg . They never expected but he got the leg and he escaped . He was back on missions to bomb the Enemy . He was again caught and lost second leg  and he had new prosthesis and he escaped again .In spite of losing both legs, one day he was trying to ride a horse and he fell off 30 or so times before he could ride. This type of repeated efforts is worth appreciating. But I was talking about some other reputations, where doing same thing over and again is not going to change outcome. 

   I have known this patient for many years . Had some low oxygen and then had pneumonia. He also had chronic pain pain and was on pain medicines - narcotics and so her carbon dioxide was high and so oxygen was low . I did work up and found out that he was having aspiration and that means water or food was going wrong way in the lungs causing injury and inflammation and pneumonia. He had further work up and he had very poor function of the food pipe. The contraction of the muscles of the esophagus are not there. She was sent to a surgeon and she had a surgery and that did not work. Unfortunately I have seen this too often . In this condition food stays in  food pipe and it comes up and then trickles down the lungs. Unfortunately patient has difficulty of swallowing . He went from one GI specialist to other . Every one did the same thing - endoscopy . Every time different medications were tried - not much different from one other and she gets pneumonia and then gets admitted . HE has no change in medicines or symptoms , and he has changed GI specialist 10 times locally and out of the our place .He gets endoscopies every time he has seen ne doctor. I have told him that only 100 % almost -100% will be to not eat through mouth but have a feeding tube put in for nutritional support. He does not want it and we are doing same thing over and over again ,expecting different results. 

( This is esophageal motility disorder called Achalasia )