Patient Leaves Death Plans Behind, Embraces Long Life
By Rudi Williams
American Forces Press Service
BETHESDA, Md., April 19, 2005 Myron Ricketts believed his doctor was telling him to get his will in order because his days on Earth were short.
He had just been diagnosed with a precancerous condition called Barrett's esophagus and low-grade dysplasia, which is caused by gastroesophageal reflux disease, or GERD.
Ricketts, a retired Navy rear admiral, said he's generally not a worrier, but thoughts of mortality crept in with the diagnosis. "So I brought wills up to date and got things settled as to how things should happen if I went," he said. "I made plans as to what to do, because it's not like today you got it and tomorrow you're dead."
Ricketts' condition is also known as acid reflux disease, acid regurgitation, acid indigestion or sour belching. Untreated GERD can result in Barrett's esophagus and can eventually progress to esophageal cancer.
Ricketts didn't get any relief from his suffering until he met Navy Capt. (Dr.) Mark Johnston at the National Naval Medical Center in Bethesda, Md., in the early 1990s.
For years, Ricketts, a 72-year-old Vietnam War veteran, suffered from frequent symptoms including almost unbearable burning sensations in the throat and chest and acid regurgitation. Over the years, the GERD caused the chronic irritation from acid-bile reflux that causes the normal esophageal lining cells to be replaced by precancerous cells, or dysplasia. For most of his younger years, Ricketts didn't know what was causing the severe pain in his chest and burning sensation in his throat whenever he drank certain fluids or when he bent over or lay down. And he didn't know what was causing frequent regurgitation of a nasty, acid-tasting fluid.
He told his doctor about the problem, but the treatments never solved the problem. "Long before Barrett's was recognized for what it is, I was an engineer on an aircraft carrier and I was literally throwing up everyday," he said. "It didn't slow me down. I'd just say, 'Uh, oh,' and go to the head and throw it up and go back to work."
He was frustrated when, in the 1970s, a flight surgeon aboard the USS Independence told him his condition was caused by stress.
Years later, Ricketts experienced a burning sensation while driving that was so bad it forced him to pull off the road. "I was afraid I was having a heart attack and would crash and kill a bunch of people," he said. "But the pain went away as it normally did and I drove to my doctor's office and told him about it. He said it was one of three things: your heart, your gall bladder or your esophagus."
After an exhaustive diagnostic process, he finally got his verdict. That's when he met Johnston, the man who eventually solved his problem and probably saved his life. A few years later, when Johnston was discussing the results of an examination with Ricketts, he told the admiral about a new concept he was working on to treat esophagus diseases. "He said, 'I'm starting to work on something that could turn out pretty well,'" Ricketts recalled. "It turned out to be 'cryotherapy.' He said he'd be looking for some patients, and I said sign me up."
Johnston told Ricketts about his concept of using a new procedure called cryotherapy, the application of extreme cold for the treatment of serious esophageal diseases. His technique called for freezing the esophagus in a 15- to 20-minute pain-free outpatient procedure instead of performing a gruesome esophagectomy operation.
In an esophagectomy, the patient's esophagus and top part of the stomach are removed. A portion of the stomach is then pulled up into the chest and connected to the remaining normal portion of the esophagus.
To date, the National Naval Medical Center is the only facility that performs cryotherapy in the treatment of esophageal diseases.
Ricketts said he'd been diagnosed with a mixture of low-grade dysplasia and Barrett's in a relatively long -- 8 centimeters -- segment of his esophagus. "I had the most 'acreage' of anybody in Dr. Johnston's first group of patients," he said.
On March 28, 2003, Ricketts became the third patient to be treated with cryo for this type of disease. "From a patient's perspective, it was a non-event," he said. "You go in, get your (intravenous line) and pain medication. It doesn't knock you out, but you don't remember a thing about what's going on. There was no pain, no hurt, no nothing afterwards."
So far he's had the procedure performed eight times.
"I was (Johnston's) most challenging patient because my Barrett's was probably the most resistant to treatment and I had the most healing complications," Ricketts said. "It would ulcerate and it would heal, but slower than the other patients."
Ricketts said he's the only patient from the original group that's still being treated. The rest of the patients are in the monitoring phase.
However, 95 percent of his Barrett's has disappeared. "Now I just have little islands of it that have been resistant," Ricketts said. "The odds of my contracting something worse are greatly diminished. I couldn't be more pleased with the way things have gone. I'm just delighted."
Whenever he boasts to someone about how pleased he is with Johnston's technique, Ricketts emphasizes that the program is still in the research-and-development stage. "It's not only treatment and initial observations, but it's follow-up in the longer term," he noted. "Will this stuff come back? I am, along with every other cryo patient, coming in every six months to see if there have been any reoccurrences."
The admiral has gone from thoughts of an early departure from Earth to thoughts of a long life. "Now I'm looking at it from a much more optimistic point of view," he said. "And I plan on living to really a ripe old age."