Laproscopic Nissen Fundoplication!

Hi Carol.

Have you had your surgery yet?  I was wondering how you were doing. 

I wish you luck on your surgery.  It changed my life in such a good way.  I am no longer sick every morning, or all day every day.  I can eat so many things that seemingly would have killed me before, like tomatoes and orange juice without getting heartburn.

To be relieved of daily heartburn is a miracle if you ask me.  I hope you have selected a good doctor, and do take it very easy after the surgery to ensure you heal properly.  There will be pain after surgery, but that WILL go away, and hopefully if your surgery is successful, you'll be free of the pain of heartburn.    

Hi Melba.  Just checking to see how you're doing now, a few weeks after your surgery. 

I've had a few episodes of esophageal spasms and some cramping, and discovered I was eating a little too much, and a little too fast, and probably not drinking enough water. 

Hope you're doing well.

I have felt great for the most part since my surgery.  I have had a few spasms, once in the center of my chest, so it was most likely my esophagus.  I followed up with my doctor... they did a barium swallow which showed everything was okay.  He suggested I slow down a little when eating, and make absolutely sure to chew my food well.  Last week I had another episode sort of like a severe cramp in my lower right side.  These episodes have been very painful, however I'm still very happy to be heartburn free!  I'm finding that it's very important to drink a lot of water these days, but I can eat just about anything without getting heartburn. 

Well, yes, I was sort of heavy.  I am 5' 3" and weighed about 180 at the time of my surgery.  When I had reflux it seemed impossible to eat a healthy diet, because a lot of things that are healthy affected my reflux worse. 

I was on a liquid diet for 2 solid weeks after my surgery, so of course that in itself will lead to a little weight loss.  Once I was able to eat solid food again, I could only eat small portions before feeling very full.  I increased my portions for awhile, but then when I had the esophageal spasms I metioned, I started eating smaller portions again. 

I decided to weigh myself last night, and to my surprise I have lost about 7 more pounds, so now I'm down to 163 lbs.  That's 17 lbs!

I attribute the weight loss to being able to eat better, and also having a little more energy because I'm not sick every day anymore. 

Your lifestyle will definately change after you have this surgery.  When you're sick all the time having reflux, you are forced to do things just to deal day to day.  Imagine not having reflux anymore, at all... it's pretty amazing.  I am finding that I can deal with stressful situations much easier now, instead of having to run from any sort of conflict like I used to have to do because it made me physically sick.  That in itself is such a relief! 

So did you already have the surgery, or are you preparing to do so?  Best of luck to you!

i see the doctor on 01-16-08.  my G.I. doctor wants me to have the surgery after having  a series of test.  but right now my mother is ill, i have three children and a husband.  it does not feel like the right time.

iam depressed and can not eat. i fear the after affects!!!!

I'm truly sorry things are difficult for you.  I can totally relate.  My family had a trip planned to go camping for a week, the same week my surgery ended up being scheduled.  I also had tickets to see Heart the same night, but had to give them up.  : (  I needed the surgery so bad that I had to cancel our camping trip, and my children were very disappointed.  Thank God my boyfriend had vacation time and still took off work for the week to care for me through my surgery and after.

Trust me, you will feel so much better after you have the surgery, and you will be able to eat again without having fear of it making you sick.  Hang in there and best of luck to you.   

karla,

how long did you stay out of work? so let me see if i understand you correctly.  for the first three weeks, you had to eat in small portions?  my doctor said, that for the first five years, my eating habits will be different.  can you relate?

I wasn't working at the time of my surgery at the end of August.  I started a new job at the end of October.  They usually say you can go back to work in a week or 2 if you don't do anything very strenuous for work.  I do administrative work. 

They had me on a strict liquid only diet for 2 weeks following surgery.  A nutritionist met with me in my hospital room to go over what I could and couldn't have.  I stuck to that liquid diet the whole 2 weeks, then gradually started introducing soft, easy to swallow foods. 

It's been almost 5 months since my surgery, and I still find it best for me to eat smaller portions than I used to, but my doctor didn't say anything about five years of that. 

I would think some of these issues would vary a little between patients.  You will be able to discover what works for you. 

I feel very fortunate that my boyfriend of 5 years had also had this surgery about 10 years ago.  He has been there to help me through it so much, and has been very patient. 

You will find that you will be able to tolerate foods that you can't now, like orange juice and pizza. 

One thing is that you won't be able to throw up so if you drink alcohol, DON'T over drink.  You will have the heaves, but nothing will come up.  I don't drink very often at all, but I had a migraine this week that made me very nauseated, but I couldn't throw up.  That part hurts, and I wished at the time I could have just done it and gotten it over with, but it doesn't happen.

karla,

i was told by the doctor that, i would not beable to burp, is that the same with you?  how is your boyfriend doing after 10 years?

karla,

thanks for your patience and time!! sharing your information with me, gives me hope, that one day i will be back to normal!!! happy new year!

I am glad that my experience can be helpful to you.  I do hope you can get your surgery done soon.  Maybe you could get some help from family or friends to get it done.  I can assure you, the sooner you get it done, the sooner you can be on your way to recovery. 

Keep me informed. 

I finally contacted a surgeon myself and asked for the surgery.  At that point I cannot even recall how many times I had ended up in the ER with severe pain, and had seen several different doctors who all just wanted to give me medication. 

The medication is designed to lower the amount of acid your body produces.  BUT, if your lower esophageal sphincter does not function properly, the medication is not going to help you. 

I had Barrett's Esophagus, a Hiatal hernia, and GERD.  The endoscopies I had showed that my sphincter was open all the time, which is what allowed the acid to reflux up into my esophagus and cause Barrett's. 

I would use the internet to search the hospitals in your area for a surgeon who specializes in Thoracic surgery.  If you can get an appointment with a surgeon they may order additional testing of their own to see if you are truly a candidate for the surgery.  There are some factors that indicate whether the surgery will actually help you depending on the test results.  I'm not sure where you live, but if it's in the Seattle area, I'd gladly refer you to my surgeon who was absolutely wonderful.  Good luck to you and let me know how it goes.

Thank you for your reply. I am in Illinois.

The main problem is that my doctors do not want to be bothered. I just want to be fixed. Do you know what the PH score means? I cannot find info on it.

Thanks again.

It seemed to me that my doctors didn't want to be bothered either.  I assume that's because I didn't have health insurance, and Nissen Fundoplication is an expensive ($30-$40K) procedure. 

I found some info regarding pH scores by searching Johnson-Demeester scores.  I see that scores below 22.4 are normal, so I would assume that if yours was 60+ you definately have severe acid.

If you haven't had it yet, you will probably need to have a Manometry test done, which measures the pressure within the esophagus when you swallow.  It's very uncomfortable, yet necessary to determine whether you are a candidate for the surgery.

Thanks again. I am looking up Thoracic surgeons now. I will go back to my doctor for a referral when I find one.

I go back every two weeks to my doctor. It has been so frustrating. But, this last visit he said that he was going to refer me to a gastroenterologist (my doctor is a family physician). The main thing is that I do not want to go thru another endoscopy or PH test or anything. The last GI doctor I saw just kept shoving carafate (increased dosages at a time) down my throat.

I am releived to see that someone has been through similar to me.

Yes, medical doctors (including gastroenterologists) practice medicine, hence they prescribe medicine.  If the medicine is not working for you, chances are the surgery could help.  However, you will not get a surgeon to agree that you are a candidate for the surgery until you have undergone all of the proper testing to assure the surgery will benefit you.  This normally includes an endoscopy, pH testing, and manometry or pressure testing, and possibly even a barium swallow.  Although I had already had both an endoscopy and pH testing once I was finally able to meet with my surgeon, he wanted to perform the testing again himself to assure it was done properly, etc.  The results from these tests when performed by my surgeon varied slightly from the results of them when the gastroenterologist did the tests and proved beyond a shadow of doubt that I was a candidate for the surgery. 

The surgery has improved my life tremendously.  I have not had heartburn one time in 5 months.  I had heartburn every day for at least 20 years and now it's miraculously gone.  I like to say "I left my heartburn at Swedish Hospital."  I even had heartburn the morning of my surgery, but once I woke up from surgery it was gone, and has been gone ever since. 

Thanks to your suggestions, this morning, I had contacted a renowned thoratic surgeon in my area (he is the head of Thoratic surgury unit at University of Chicago hospital. I had e-mailed him and he responded!

I only have one obstacle to go through - I have to change insurance plans with my employer. I can do this and it will be effective April 1st. After I change insurance plans I can make an appointment and see Dr. Ferguson. Hopefully it will be resolved then.

Thank you again for your suggestions.

I'm sorry your experience has been so horrible.  I do knew that the surgery doesn't work for everyone, and feel very blessed that I have had such a good experience with it.  Also, they fixed my hernia at the same time as the fundo, so that probably saved me some grief as well, versus having to have a 2nd surgery for it.

Thank you for sharing your experience.

I am able to burp, but from what I know, that depends on how tight the surgeon makes the wrap.  I am however, very happy that I don't burp 182 times a day like I did before the surgery. 

You get gas because the gas that is naturally produced by your body has to escape from somewhere.  I feel better to have a little gas than be burping all day long.

There is pain after the surgery, just like any surgery, but it does ease up after a few weeks.  I'd say at 5 months post surgery I am fully recovered from it. 

I have had no trouble swallowing.  I would say it's a good idea to eat small bites of food and chew it very well, and take your time eating, even say 3-4 months after the surgery.  I had a few episodes of spasms, which my doctor said could have been the result of eating too much, too fast.  I cut my portions back a little and haven't had any more trouble.

Are you having the surgery soon?  Best of luck to you.  Please feel free to ask more questions if you have them.  I'd be glad to share my experience.

Take care!

I did stay on a completely liquid then soft diet for the first 2 weeks.  I didn't really have any trouble swallowing, and I believe that is because I did completely stick to that diet.  I drank protein shakes that I make myself, I can tell you how if you'd like.  I ate a lot of Gerber Rice Cereal, the kind with the banana.  I mixed in milk to a thin consistancy and added some sugar.  That was great.  I ate a lot of yogurt, other baby foods like the fruits.  I also ate mashed potatoes, and found it was very easy to just micowave a potatoe and mash it with milk and butter.  You can get pretty creative when your diet is limited, but I survived and it wasn't that bad.  It never hurt for me to swallow.

Another thing I would suggest is to make sure you have plenty of help around your house for at least a week after your surgery.  You shouldn't lift much of anything, I'd say even a gallon of milk.  Have someone pour a few portions of beverages so you don't have to lift any containers that may be too heavy.  Try to have help with normal day-to-day housework because you don't really want to be bending over and being up and down a lot like doing laundry.  I'd suggest really taking it easy if you can, as hard as that may be for some, and really helping yourself recover.  Know that in just a short time you'll be back up and better than ever if your surgery goes well. 

Looking back on the episodes of spasms that I did have, at about 4 months after my surgery, I feel I probably could have prevented them by eating slower, taking smaller bites, and drinking more water.  I was so happy that I could eat such a larger variety of food since I didn't get heartburn anymore that I was no doubt over-eating.  That along with not drinking enough water is what I whole-heartedly believe is what caused my spasms.  The pain WAS severe, and it really scared me.  I went back to my surgeon just to make sure that what I had was spasms.  They did some tests to make sure that my wrap had not slipped or come undone.  All was in place and my surgeon told me to slow down a little on the eating.  I haven't had any trouble since then.  I've been eating smaller portions and slower, and have even lost about 7 more lbs. 

Good luck to you!  I hope your experience is as good as mine has been with this.  I know it's scary, but if you have an experienced surgeon I think you'll do fine. 

Hi, I wonder if anyone will see this post.  I'm scheduled on July 16th at Cleveland Clinic; I think I know what to expect, but at the same time I don't think I know a thing!  Your posts have given me great insight as well as some apprehension.

My reflux has been on-going for maybe 15 years, probably more; it now impacts my breathing, my vocal cords and (they're hoping) that it may be a contributing factor in my daily migraine..althought the Dr.s' at CC said nonsense to that. I'm on protonix twice a day plus tagamet with days where the rolaids come out too.  I've developed a stricture in my esophagus too.

They told me that I was "no slam dunk" that I have a 90% chance of this being successful, that I need to expect to have gas bloat and (now I find out) dysphagia..but for how long?, I don't know.  I haven't received my packet of info from them yet, so I have only a vague understanding of the pre-op appointments, and, until I found this and another post, not much understanding about the post op situation...oh they're removing my gallbladder at the same time.

I hope I hear from someone!, I find myself in the surprising position of becoming nervous about this.  I say surprising, because I am not normally like this and I think it's  due to a few things, not enough knowledge; not being at my "home" hospital, concern about the post op things and I have 10 more pounds to get to my surgical weight, they're sticklers about you being as close to your ideal weight as possible..I've hit a plateau and I'm worried about that!

Thanks,

Janice

Hi Janice,

What are you scheduled for, pre-op tests or the actual procedure? 

From my experience, I have had more gas since I had my surgery 10 months ago, but it has not really been unbearable.  I have noticed that certain foods that I eat make this worse, so I just try to avoid those foods.  I only had a little trouble swallowing for a week or two.  For the first 2 weeks after the surgery I was on a liquid diet, and I absolutely stuck to that.  Once I could eat solid foods again, I just focused on eating very small bites and chewing well before I swallowed.  I think it's also a good idea to eat smaller portions, more frequently so you don't overeat.   I think that if you do those things you should be fine. 

I am a firm believer that the success of this surgery is largely based on how a patient takes care of themselves afterwards.  My boyfriend who has also had the surgery convinced me that you sort of have to "protect" your surgery, meaning just take really good care of yourself so it can heal properly. 

One thing for certain is you should ask your surgeon how many of these procedures they have performed.  100 or more would prove they're probably pretty good at it.  My surgeon and his staff did an excellent job of giving me all of the information I needed.  Surely I was still scared too, as everyone going under the knive would be.

I would guess that the reason the doctor is focused on being close to your ideal weight would be because if there is extra fatty tissue surrounding the area they need to access, it makes it much more difficult for them.  I ended up with a 6th little incision due to this because they just couldn't get around the extra fatty tissue. 

I am aware that not all of these procedures work well for everyone, but it has surely improved the quality of my life.  I've lost about 30 pounds and I'm not sick everyday of my life anymore.  In fact I can't remember when the last time I was absolutely nauseated to the point I couldn't stand up, but I know for certain that it was at least 10 months ago.  I don't have to rely on taking a pill, that may or may not work for me.  I can sleep comfortably without waking up in the middle of the night with that fire that just won't go out in my chest. 

Keep in touch and let me know how it goes for you, and good luck!

Karla

Janice, I just had my surgery on May 29th.  I am so happy with the outcome.  I've had absolutely no heartburn at all.  It was so amazing to be able to drink a glass of orange juice with no problem.  As well as all the other weird trigger foods; ketchup and bananas...no problem!  Due to insurance issues I had to fly to the Boston area to have my surgery.  I stayed overnight in the hospital and then drove to relatives in New Hampshire where I layed on their couch for a week.  My surgeon insisted that he see me in person in one week.  (I'm glad he insisted)  I flew home to DC and followed up with a direct phone call to the surgeon a week later.  The only issue I had at first was the pain across my upper chest when I ate.  It was weird how the incisions didn't hurt, but the chest was painful.  The surgeon said that was normal due to the CO2 gas used during the surgery.  He told me to take advil at meals and by now the pain is non-existent.  I get full very fast and only eat small amounts at a time being very careful to chew completely.  Dr. Val said you must not make your stomach do the work of your teeth...chew chew chew.  I've lost 11 pounds since May 29th and love it!!