Laparoscopic Hill Hiatal Hernia Repair??

I recently had a Lap Hill Hiatal Hernia Repair on Dec. 2nd for complications with GERD leading to Barrett's Esophagus.  The surgery was pretty rough for me and I'm still a pretty young guy (32).  Even though this is my first surgery ever, I typically like to think that I have a high pain tolerance.  Not so much with this surgery.  I definitely don't have reflux any more but in the first week or so I lost around 15 pounds or so and am now 25+ pounds lighter.  I was sent home after almost a 2 day stay in the hospital post op.  I pretty much stayed in the theatre seating for about four to five days after getting home and was in a vicodin coma.  After the Vicodin ran out I got up and realized that it was very hard to swallow, actually it wasn't hard to swallow but after swallowing everything just seemed to pool in my esophagus.  I called my surgeon a few times and he just said that it was normal post op recovery but he was not aware that everything I drank was just pooling in the esophagus, either was I.  Finally I became sooo weak that my wife finally called my surgeon and told him that she was taking me to the ER, so he called and they actually admitted me for a few days with an NG feeding tube.  During the stay I had a Barium Swallow study done and it showed that I was having some sort of esophageal spasm.  They sent me home with the NG feeding tube thinking that it was going to help things travel to my stomach...Wrong!  It made it worse it seems, Everything I drank pooled and caused excrutiating pain and caused me to vomit.  I even vomited the feeding tube.  I was sent back into the ER and was given another NG feeding tube and sent home with the same results.  After becoming very weak and about 25 pounds lighter within two weeks of surgery I was agian admitted and was given a PIKK line with TPN feedings.  I was sent to have another motility study done with the results showing that my mid and lower esophagus had limited motility.  After a week in the hospital they sent me home for the holidays, the 22nd.  I did not have a good Christmas at all!  I just became weeker and weeker and on the 26th my wife calld my surgeon and I was sent back to Radiology to have another PIKK line put in.  I'm now waiting until my Insurance company approves my home TPN feedings.  I am getting even weeker and was only given fluids on the 26th which has not really helped.

My wife has been a trooper being that we have Twin 7 month old babies at home and she has basically been a single parent for this whole month of December.  I feel the worst for her.

My question is has anyone dealt with any kind of esophageal spasm, dysphagia or achalasia post op after any kind of Hiatal Hernia repair whether it was a nissen or Hill?  The surgeon called a few collegues who are very familiar with this type of repair and were surprised that he has not run into this before.  The surgeons in Seattle say they see this in about 1% of their repairs and that they just send their patients home with the PIKK line and TPN feedings and that it works itself out.  My surgeon is one of the most experienced in my state and does 2-4 of these procedures a day for the last 20 years but has never seen this before.  Just my luck!  Any help would be appreciated.

Post Edited (hp) : 12/28/2008 10:21:02 PM (GMT-7)

Thanks Bill. The worst part about it is that I haven't had any nutrients or anything for the last seven days other than two fluid bags three days ago and my insurance company doesn't have any information requesting the home care so now i have to have the surgeons office start all this paperwork again and have a feeling that i'm going to have to be admitted again. This is a nightmare! All I need to hear is that someone has had this issue after their repair and that everything was fine after time. I'm pretty week right now so if anyone replies, I'm sure I will view the reply but might not respond for a day or two until I can get some nutrients in me.

Thanks in Advance to anyone who replies.

Hello HP and Trica........welcome to GERD and Heartburn foru.  We are so glad to have you with us.

HP I am so sorry you have been through a tough ordeal and I know the members will empathize with you as I do.

We have a forum for new members I will bring to the top if you would like to share a bit about yourself and Trica, you too.

We love new members...........so welcome again.

Kitt

Tricia,

Sorry to respond soo late, been going through alot and haven't really felt like going online. Anyways, I actually had a dilation done back around the middle to end of Dec., can't really remember what day. I'm sure I have the paperwork somewhere. I've been on the TPN through the PICC line since the 29th of Dec. and have actually gained a little bit of weight back and seem to be feeling fairly decent compared to where I started after surgery. My surgeon is definitely one of the ones you mentioned and I go back to see him on the 28th of January. I can't wait and I am hoping he has some answers. You had mentioned that swallowing is more of an issue with the Hill procedure and know of a few people who have had several dilations to correct the problem. Do you know what the problem was? Was the hernia repair too tight or was there too much traction on the stomach/esophagus? I have to admit that I am doing better with swallowing/pooling of foods and liquids but not even close to where I was before the surgury. They said my motility was not that strong before the surgery but contributed it to the GERD. I never had any issues with it befoe, EVER. I never had to think twice about swallowing and I certainly never had to worry about chewing my food into nothing and slicing my food to the size of my biggest pill let alone drinking water with every swallow, which seems to make things worse. Feb 2nd will be two months of dealing with all of this which has been very stressful especially with twin eight month olds who need my attention, pump or no pump. I think the worst part about the whole thing is that I CANNOT sleep!! I normally take pills for narcolepsy but haven't taken any for two months, actually I haven't taken ANY pills for anything. Actually I'm not sure if the sleep is the worst part about it, the diarreha is pretty bad but it's because I get more liquids than solids but knowing why doesn't help much. Enough sobbing.... I'll update with any progress or plan of attack. I would love to hear how long the people that you spoke of had to deal with the dysphagia and if they ever found out what the ultimate cause was.

I will say that the best thing about all of this is that I DO NOT have GERD any more which means I probably can stop worrying about Barrett's. Or maybe I'm jumping the gun and really won't know if the GERD is completely gone until I can actually eat normally. Thanks to all who replied. Oh! I almost forgot that on the 1st of Jan. I had this shift around my LES/stomach area and it was definitely painful. It felt like someone was standing on my chest while they were slowly bouncing up and down. Ever since then though is when I started to see improvements. Also, I had quite a few episodes with tremendous pain in my chest which felt like my ribs were being pushed out. It's hard to explain but know that it was extremely painful and each episode lasted for a minimum of 30 minutes and up to 60 or more minutes. At first I contributed it to gas but I got to thinking that if it was gas then I would probably still be having the same issues but I haven't for at least a week. It reminded me of when I had a few kidney stone episodes but instead of in the side and back it was in my chest, back and rib cage. Anyways, I'm rambling and will go. Not like I'm able to sleep or anything and this darn TPN pump doesn't help with all the racket it makes! One night around 4 am I was trying to sleep and felt two gushes which seemed like my esophagus was flushing like a toilet into my stomach, weird.

Kitt,
Thank you for your response and compassion. I'm on the TPN for 16 hours a day. My mother is recently retired and has been watching the twins Mon, Wed & Fri. for us but there's alot of work to get them ready and my wife has to get up an extra hour and a half early so that she can drop them off and be to work on time. So that equates to the alarm going off at 3:30 in the morning which I'm normally still up. Like last night or actually this morning I tried to go to sleep after I posted here but was not able to, so I just got the babies up and ready to go then I took some tylenol PM which took about three hours to kick in. Thanks again KITT!

Maggiemae

Welcome to HealingWell and the GERD/Heartburn Forum.

Maggie, I am so sorry your having so much trouble.  Your right you are not getting the nutrition you need.

I have friends that have TPB that they use at home.  They hook it up at night and let it run over  12 hours or whatever the physician orders.  Some have port-a-caths where others have the picc line.

Get back to that physician of yours, sweetie, and tell him you cannot make it through 5 more months of going without nutrition.  Be your own best advocate.

I am sure others will have some advice for you and know we all support you.

Gentl Hugs,

Kitt

 

HP,  Did you, by chance, have your surgery in Puyallup?  I am scheduled to have the Lap Hill on 3 March and was surprised to see so many patients with post-op complications.  I have to admit, I’m a little more nervous now than I was before I read the posts.  Stupid me, how does that saying go, “If you don’t want to hear the answer, don’t ask the question”?  Anyway, I hope you are feeling better and any words of wisdom would be much appreciated.  Hope you’re recovery is going better. 

Hey everyone I'm new to healing well just had a few questions if someone could please answer with the same surgery/experience?! I'm 20 yrs old and have had problems with acid reflex since I was 17. Around a year and a half ago I had my gallbladder removed (which was producing 97% acid) helping with acid problems. Throwing up for 2 years stretched my diaphragm and valve, plus made 1/3 of my stomach push into my stomach (super painful). This was hell for me especially at such a young age and going through high school and all. Now I have had a endoscopy which was clear of barrettes and just about 2 weeks ago had my hill repair on the hernia. I don't have any symptoms of acid reflex but just like hp in these two weeks i did lose 10 to 15 lbs. I know my diet is supposed to be a liquid diet. Let me tell you its a nightmare eating soups and broths all day. The question I have is: HOW LONG DID IT TAKE TO EAT THICKER MORE SOLID FOODS? IS THERE CERTAIN FOODS THAT GO DOWN EASIER THEN OTHERS? IS THERE ANY STEPS I SHOULD TAKE BEFORE MOVING TO THE NEXT FOOD STAGE? Please, any help would be very appreciated!!! Don't want to keep losing weight.....

-John C.