Post nissen fundo need some advice and assurance

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Aryana70

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I have ben suffering from LPR and acid reflux for the past 3 years, and finally decided to have the nissen fundoplication surgery. did a lot of research and ensured that I was operated on by one of the top surgeons 5 days ago. I was told that the op went well and I had the 360 wrap. I had quite a bit of pain the second day and whenever I tried to swallow the shoulders really hurt. I have been on soft diet, liquid and pureed, like scrarabled egg, etc and have been fine, ofcourse have to drink and eat slowly but all together feels much better than expected, but I am scared.
I have a funny burning feeling in the throat which makes me think that the reflux is not gone. I feel like the food wants to come up, but it can't feeling dry and burning in the throat, feels like reflux is back!!!maybe?!!!
I have been crying for the past hour, since I was extremely hopefull that this would work for me. I am not sure whether since I am so scared whether I am being too sensitive and it is nothing and I am just feeling the sensation because I have had it for the past 3 years of my life, or is it for real and it is acid making it's way up. I feel like I need to go and have some gaviscon, but don't want to do that. My follow up appointment is in 2 weeks time, and I am really scared.
Any ideas or similar experieces? should I try the gaviscon and see whether it gets better? I keep feeling like I need to drink water.
I am off PPIs , I was on 40mg of nexium twice daily. Just wondering if anyone else who has has nissen ever felt like this?
 
Good to hear everything looks ok. I had my Barium Swallow a couple months ago and despite tons of water had a problem with constipation also. In addition to lots of water, my GI doc had me take a high dose (5x) of Miralax to get things moving along better.

Take care,
MountainReader
 
I do understand the being scared. My acid reflux was irritating my lungs so bad that my asthma flared and treatments weren't helping at all. At one point, I almost stopped breathing and needed emergency treatment. Nothing I did for the reflux was working towarRAB the time before I had my surgery.

I will say that I have extremely severe reflux. I've had 2 scopes that came back fine. My GI doc assured me that the fact I was aggressively trying to treat my afcid reflux helped with the damage. I'm more worried about the damage it caused to my teeth than my esophagus.

Anyway, if you are really concerned something is wrong, call your surgeon or GI doc. They may have some suggestions.

Otherwise, give it some time to heal. I think my healing went as well as it did because I didn't eat any soliRAB at all the first two weeks. It gave my stomach some time to heal. I added in the soft fooRAB for another 2 weeks after that. Again, it gave my stomach more time to heal. After that, I chewed things really well and took small bites.

If you really are worried about damage that may have occurred, talk to your doctor. They may have you take your Nexium for a while longer to help with the healing. There are options.

Think good thoughts,

MountainReader
 
Hi Aryana70,

Can you give me an update on your condition? In your last post you still weren't feeling much better but your doctor said to give it some time. I had a Nissen on Monday and am refluxing today (Friday). I am wondering if I am one of those people who don't benefit from the surgery or if I just have to wait for things to heal. It seems most people see an immediate reflux cure, but I haven't.
 
I had a Nissen in 2008. It takes about 3 months for your stomach to totally heal from the surgery. Right now, your stomach is inflammed and not in its normal state. Give it a couple more weeks before really worrying.

My surgeon had me on a liquid only diet for 2 weeks. I added soft fooRAB in for two weeks after that. Then I added in solid fooRAB, except bread and meat. I added those in at the 3 month mark. You might want to take it easy on what you are eating for a while.

Per my doctor's orders, I stayed on my PPI's post surgery. I would think that some Gaviscon might help as needed. That's my own personal opinion though. Are you still taking painkillers? That may have an affect as well.

Wishing you well.
 
Thanks for your prompt reply. I was on two 40mg nexiums a day and was taking gaviscon regularly, but was bad with the diet, and keep thinking being bad with my diet might have affected me. I have to say though I have had 3 endoscopies all before 15months ago and they were all fine, but since the reflux was really bad over the last 6 months that is what really worries me. Also I am a real worrier. I have to say though that that my symptoms were more stomach related prior to surgery, and I am not having those symptoms, so just wondering if the food that I am consuming is staying there too long before it makes it ways down, and that is what irritates me.
 
I've had Barium Swallows twice. They are actually the tests that showed it was reflux that was irritating my lungs. The test will show how your swallowing process is working and will show if anything is coming back up. It will also show how things are going into your stomach. It is a good test for where you are now. I had my second s couple months ago when I had asthma problems to confirm that my Nissen hadn't come undone and to confirm that it wasn't reflux affecting my asthma.

It is an easy test. Quick and easy with nothing to worry about. Just drink lots of water after your test. There is a possibility that the Barium can cause constipation.
 
Thanks again. Unfortunately have another isue now, my wisdom tooth which neeRAB to be taken out is now infected. I as supposed to have it out but decided to have the nissen first. I have the antibiotics at home, but they are very strong and I am not sure whether I can take them after nissen, don't see why not, but will be calling the surgeon tomorrow and checking with him. Also will mention my symptoms to him. I think after eating the food takes a long time to get through the wrap perhaps, and maybe that is why I feel like I am refluxing, it just feels very heavy an uncomfortable at my osephagus as if the food won't get digested, not sure if this makes sense.
Enjoy your Sunday, and Thanks again.
 
You can always call your surgeons office to ask them.

In my opinion, it really is too soon to know for sure. According to my GI doc, it takes about 8 weeks for swelling to completely subside from the stomach. As he explained it to me, "your stomach is angry at you for the trauma you are putting it through". I took this to mean I need to take it slow.

What are your "reflux" symptoms right now? My surgeon said some of the problems post-surgery are from things not making it all the way down, vs the symptoms of things just coming back up from the stomach.

What kind of diet are you on? I was on a liquid, no lump or seed, diet for the first couple weeks then on a soft diet for a while after that. Personally, I continued to avoid the things I avoided in my anti-reflux diet prior to surgery as well.

My GI doc also had me remain on the PPI's. That is contrary to what most people experience so I don't know if it made a difference in my recovery or not.
 
I have not had a Nissen fundoplication but read through others' posts here. I think it takes weeks for the inflamation of the stomach to go down and for you to start feeling normal. If your goal in having the surgery is to get off PPI's, then I would not continue the dependency on them unless your doctor tells you to get back on them for some reason. Find out if you can take antiaciRAB occassionally for irritation. You probably need a very mild and alkaline diet while your stomach heals. But I agree with the other posters in that the symptoms you feel are not comfortable but likely the ones people experience in the days and weeks post surgery. Hope you feel better soon and I would love to hear how you are healing and getting along as time goes on.
 
Glad to hear your original symptoms are better. Try giving your stomach a bit more time to heal more before you increase your worries. I worried some too and my GI doc told me that my "stomach is angry at you" for the surgery and takes months to calm down. It is inflammed and swollen for a while after surgery and it takes time for the swelling to reduce. That is part of the reason for the diet.

I found that a heating pad or one of those buckwheat things you stick in the microwave and heat up helped me feel better some. I also liked sitting on the sofa with a soft pillow pushed against my stomach. Made me feel better.

I totally relate with things getting worse over time. I was on 2 PPI's for about 5 years until they just stopped working. I was also supplementing with Gaviscon, sleeping on an incline, eating carefully, lost weight, etc... Nothing was totally working. My acid was so bad that Even 1 1/2 years post-surgery I'm still on Kapidex 60mg and sleeping on an incline. Overall I'm doing significantly better. I'd have the surgery again in a heartbeat.

Try to find something relaxing that you enjoy during your recouperation to take your mind off things.
 
Hi Mountainreader, you are very kind and I am very greatefull for the responses, if you don't mind I have couple of other questions.
Is the reason for the diet the healing process or is it because the wrap might become undone. Since I moved on to the soft food quickly I am concerned that it might have undone the wrap, is that possible? Also I have 2 small children and it is not easy to get much rest, I haven't been lifting anything heavy but have been moving around and sleeping on my side. Do these things matter?
It's just that I wasn't given any instructions just the diet sheet. Also how long were you off work, I just don't think mentally or physically I will be well to go back for another couple of weeks at least.
On the positive note had very soft scrarable egg today, which I chewed througly and I am still feeling ok, much better than before when I had the pureed bananas. I know I was hungry and had the bananas more quickly.
Thanks again for the replies.
 
If you are following the diet your doc or surgeon gave you, I wouldn't worry about pulling the stitches. I'd worry more about heavy lifting too soon.

The liquid or soft food allow your esophagus and stomach time to heal and the swelling to go down. You just need to be careful not to get food "stuck" above the wrap. If you ever do get something "stuck" don't worry. It is uncomfortable, but eventually everything goes down. It doesn't affect breathing because it is so low.

You should be able to sleep in comfortable positions. I had tons of left side pain with the surgery so sleeping on my back with a wedge pillow under my knees was my preferance. I don't see a problem with side sleeping.

I took 2 weeks off. I maybe could have gone back after 1, but was happy I took 2. It took me a couple weeks to get back to full speed. I just barely started on the soft food when I went back to work.

Take care,
MountainReader
 
Sorry to hear you are hurting so much. You should be fine to take the antibiotics. I'm sure your surgeon will confirm this.

Are you still taking painkillers for your Nissen? I'd assume that would help some with the tooth pain as well.

If your problems continue long-term, you might want to have the test you to make sure that the wrap isn't too tight.

I had a colonoscopy within a week of my surgery. My GI doc wasn't concerned about one thing affecting the other. (One week on Nexium and I have had IBS now for 2 years. Talk about a horrible side-effect for me.)

Take care,
MountainReader
 
Hi MountainReader,

Thanks for your response. I think I have been pretty good w/ my diet. If there is any problem with it it is maybe that I'm eating too little. Yesterday I had a bottle of ensure, some pureed soup, tapioca pudding and 2 tablespoons of applesauce along with some clear beverages through the day. I used the applesauce to get down two doses of crushed Zantac (my surgeon suggested staying away from pills for a while). I may suggest to my surgeon that I go back on ppi's for a while as you recommend.

I've had an irritated throat for the past couple of days. This didn't bother me as I associated it with the things you mentioned and possibly the tube they put down your throat during surgery. What got to me was a reflux episode last night while sleeping. Don't laugh, but I dreamt that I enjoyed my first belch in a while and then woke up swallowing one swallow after another to push back down what had run up my esophagus. This caught me by surprise and gave me the concern I am now experiencing.

Thanks again for your reply. Are you still on the ppi's?
 
Oh that is good, because I keep wondering what if the wrap has come undone, or I am still refluxing. The problem is that I also suffer from silent relux, and get a lot of weakness in my voice, and a lot of phlegm, and I am experiencing that at the moment and that's why I wonder if I am still refluxing.
Also I am not doing very well emotionally and I know stress doesn't help. I am unfortunately experiencing some gyno mproblems as well, and it all seems to be going on at the same time, and it is causing too much pressure.
I have endometriosis and had 2 ops last year where they burnt them, but I think it is back, and that doesn't help either.
Also where the wrap is is hurting today.
You must be thinking my God this woman is a real mess.

If the wrap has come undone, woukd they redo the op?
 
Thanks for your responses, I guess I am really scared that I might have barretts, They didn't scope me before the surgery. My last scope was 15months ago and the osephagus was fine. The surgeon said that since your scope was fine then and yu have been on 40mg nexium twice daily you couldn't have developed barretts, he said it takes years with no protection.
I am just really emotional and depressed, this dissease has really scared the hell out of me for te past few years, and I hate being so weak and helpless.
 
I'm sorry to hear you are having so many problems. My theory is that when it rains, it pours. When one thing throws the body our of balance, other things go out of balance as well.

I actually ended up with a Colonoscopy one week after my Nissen. That Nexium I took for my reflux gave me chronic "D". I found out that week that I had IBS. It has been almost 2 years since I took that medication and I still have problems.

I had shoulder surgery 6 months before my Nissen as well.

I just found out last week that the intubation they did during my a Nissen was probably what caused my recently diagnosed TMJ. I've had ear and hearing problems and face/neck muscle problems and couldn't figure out why. My ENT's and Audiologists said my ears were fine. It took over a year for me to figure out it was my jaw.

Who knew that the reflux would trigger so many other issues.

On the flip side, in the long term, I'm happy with my fundoplication.

I asked my GI doc about what would happen if the fundoplication stitches pulled or the procedure slipped. He basically said we would re-evaluate my treatment. He indicated it would probably be that I'd add a third dose of PPI's daily. (I'm on a double-dose strength of Kapidex basically for life.) I do stress about that. I had the surgery because the PPI's couldn't get my reflux under control. I've read about a few people who have had revision surgeries, but they appear to be pretty rare.

My reflux was "silent" as well. I never had heartburn (except on Nexium). For me it was about a chronic cough instead of hoarseness though. Major impact on my day-to-day living. Eventually it got bad enough it became life-threatening because I was having bad breathing problems. Reflux can really be a sneaky thing with its symptoms.

Take care,
MountainReader
 
According to my surgeon, belching is common after the surgery. He said it wasn't coming up from the stomach, but it was air not making it past the surgical wrap and coming back up since it wasn't going down. I had a bit of belching while I was healing as well.

I'm an unusual case. My surgery was very successful, but I never went off of PPI's. I'm 2 years post-surgery and tests I've had recently show it is holding nicely. Unfortunately, I'm overproducing stomach acid and have it coming up in a gaseous form and irritating my lungs so I'm on PPI's for life. My doc told me it was the worst case he has ever seen. (Not something I want to be known for.) Despite my continued problems, I'd do the surgery again in a heartbeat because of the major benefits I've had from it.

I found a good water pour-in from Special K that has tons of protein. I supplemented with that as well.

Just remeraber, you are still pretty recent from surgery and it will take some time to heal. Keep up your diet. SounRAB like you are on the right track there. Please don't rush adding the food back in. I was off of solid meats and bread for about 3 months since they don't break down when you chew. I think it was good advice in my healing process.
 
Oh God it sounRAB like you have been through a lot as well. I definitely think stress plays a big part, and unfortunately woth Reflux it is a vicious circle.
just over a year ago I had a really bad toothache they did a root canal and a cap which costed me a fortune but the dull ache was still there, finally I was diagnosed with TMJ, and I was told that chewing too much gum(to help with LPR) isn't helping?!!!
You are definitely right when it rains it pours.
I hope you don't have the need to take another kapidex, and the dosage that you are on now is sufficient.

I move abot a lot, and due to kiRAB I am very active, and keep thinking will this wrap ever last on a person like me.
All the best to you and I will update you once I know the results.
Take Care
 
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