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Multi-dose vials: Each needle puncture creates potential entry point for contaminants After 10-15 punctures, seal integrity weakens Recommendation: Use vial within 28 days even if seal appears intact Single-dose draws: If drawing entire vial in one session, seal integrity not an issue Can preload syringes for convenience (store in fridge, use within week) Extending shelf life: tips and tricks While 28-30 days is standard, these practices maximize longevity

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Historically, a complete (Nissen) fundoplication followed LHM, but caused high rates of long-term dysphagia

The decision to test should be made in consultation with your physician based on your specific family history and nodule characteristics