what is up with the large amount of Nissen surgery failures??? Part 1 of 2

I had the surgury 12 yrs ago and recently have developed some problems.Can someone tell me what the mobility problem means? I have not heard of that.I know recently I have had constant burping, everything I eat I get chest pains, heart fluttering, pain between my shoulder blades, and some refux.My surgury when I had it 12 yrs ago was a nightmare.I was told I would be in hospital for 4 day, I was in for 19 days.Dr nicked my liver during surgury, I was hooked up to a machine for about 6 days from my liver.I was so ill I could not hold down anything.Was a terrible experience, when I healed I felt very good for a few years.I recently, last summer the Dr did a scope I was having some problems then.He tole me not bad enough to do a redo, but last few weeks symptons have continually gotten worse.Going to Dr tomorrow for this and some other issues so I'll see what happens

 Jo-Ann

This is Marie.
I have a very sever case of Acid Reflux. When I eat any food or drink, I feel the sour taste of it favor come up to my mouth. I have sour taste -reflux 7/24. It is miserable. I have heartburn almost every day. I also have tight pressure on the left of my rib case area. I also have short of breath. I am on Protronix 40mg in the morning and 40mg in the evening. The med doesn't seem be affective at all. Even though I am taking the PPI med, I am still getting the sour taste reflux and heartburn. I believe my LES is non-functioning. Does anyone know if I am a candidate for Nissen surgery or no....

Thank you.
Marie

Hi Janice,
Thank much for the information. :)
Janice, have you ever have 24 Hour PH test? My doctor would like to have that done, but she told me that I have to stop taking PPI med for 7 days to have the test. I am scare even to stop the PPI med for 1 day.

I was on Prilosec 2x a day while back. Than, it becomes ineffective, I changed over to Prevacid 2x (30mg mornin & 30mg in the evening) a few week and it becomes ineffective. Then, my doctor switch me over to Nexisum (20 morning and 20 evening), it worked only 3 week, and I am beginning to get reflux all days. Now, I have been switch over protonix 40 2x a day. I am still getting reflux - sour-taste all day. At night time, I get soar-throat even my bed is elevated over 8 inch (2 big block under the head side of the bed) with 2 or 3 pillows on top of it too. Every night, I get soar-throat. Now, I have to sleep sitting against the wall. I get sour taste coming up but not as bad as soar-throat when I sit sleep against the wall. It is very difficult to sleep. I am very skinny. I loss almost 40lb over 10 months. Now, I weight only 126lb due to the acid reflux. I ate 4 to 5 time - small meal a day. I eat rice, vegetable, fruite, soup, lean chicken, and anything that have no acid. No junk food, no soda, no pizza, and no to anything that are fat. At this point, I am not sure if any med will be effective for me anymore. I was also on reglan and it didn't help.

Bill and I are on the same page, I agree with him 100% With your symptoms and medication failure rate, the sooner you get the 24 hour ph done, the better.

I have had several of these tests done; it's not the most fun in the world, but it tells them a lot. I've done it both on med and off med. I'm not going to lie to you, off meds was difficult, but living with this disease is even more difficult. You are in a tough situation, no doubt, but you have to have these tests to quantify your symptoms, without them, surgery is not a wise idea.

Bill's suggestion of manometry is also very important, it may reveal an underlying cause that you don't know about. Motility issues can very often mimic GERD and will often cause weight loss; speak to your Dr. about this as well.

Good luck and let us know how you're doing.
Janice

Marie...
Manometry is a test of the pressures and muscle activity of your esophagus and L.E.S. The last one I had done about 3 weeks ago or so was different than the one I had about 3 years ago. It involves a tube being placed in your esophagus through your nose and reading being recorded while you dry swallow and wet swallow. The last one I had to swallow 10 times with water and 10 times with a gel, somewhat like jello. They also measured the pressure of my L.E.S. resting and while swallowing. Mine came out normal.
They tested mine again because I am having issues with food getting stuck at the Nissen wrap area. I didn't have any problems for 1.5 years after surgery and then after a stomach bug got me I developed swallowing issues. I have been told that if food sits in the esophagus it can mimic the feeling of reflux. I don't know that for a fact, it is just what I've been told.
Janice may have some more insight as to motility issues.

Bill

Hi all I was just reading some of the newest entries and have a few comments and questions. I had a nissan done in 2000 and it only worked for a year and then back on meds. The only thing that works for me is Nexium 40mg 2x aday but I am unable to take it 2x a day because of side effects. I won't go into that here. My doctor keeps preaching to me about losing weight and then all will be well. I have lost 25 so far(with the help of TOPS) and when I was first diagnosed with this problem I was thin (ideal weight according to the charts). He wasn't my doctor back then so he doesn't understand. Has any one that had the surgery and been thin have it work long term? Every one else in my family which is extensive that has this is ideal weight or underweight so I think just to keep saying if I "get really thin like Olive Oil and you won't have any more problems" my GI's exact words is just idiotic. I also now have the manometry problem from the surgery. That is not an easy thing to live with. I get stuff stuck all the time and have to drink alot of water to get food down. I have found that sucking on hard candy before bed or after I eat which causes you to swallow alot helps to clear out the esophagus. I was tested for the acid and manometry 2 x before my surgery. The manometry was good before the surgery. 

Recently when my stomach was so bad the Nexium 1x a day and pepcid 20mg. 2x a day and then sucralfate before lunch and before bed did help. My doctor said they all work in a different manor. I am going to try to talk him into the sucralfate every night from now since mine is primarily at night or when I lean back in my recliner. Barb   

Thanks for the information Janice. The doctor that put me on the pepcid and sucralfate was my regular doctor because I had seem my GI doc the week before and he had scheduled a EGD with Bravo. I had such a sore throat from the acid reflux that I wanted to rule out some other reason for the sore throat before I went back to the stomach doc. and my regular doc put me on the pepcid and sucralfate with the Nexium. It did help, but it might not have been the best thing before I had that test done. I'll see what the GI doc has to say tomorrow. He has been suggesting that they loosen my wrap and that's what the surgeon had told me when I started having problems but the thought of having surgery again after having 2 in one year was just too much  back in 2001, so I never went back to see my surgeon and now I am in a different HMO. Right now I am set to have surgery on the 26th for a much needed hysterectomy so there won't be any other surgery this year unless it's an emergency because this will wipe out my sick leave and then some. In the mean time I will continue to lose weight but I still don't think it will help my stomach at all given my history and my family history. Barb 

Marie,
If you are having food getting stuck, also called dysphasia. You doctor should do an endoscopy
(EGD). That can show them if there is a stricture that needs to be dilated or if the LES is open. Or they may have to do a barium study to see these problems also. I've had my LES area dilated about 7 times since Sept. '08 and that should have fixed my problem they tell me. It hasn't and I am awaiting their phone call to tell if they want to surgery or not.

Bill

Well my bravo study came back only showing acid came up 2x. I argued with my doctor about it. He took me off all my stomach meds so this should be real great for my asthma. I wake up with terrible sore throats and burning and pain. Of course when the study was done my stomach was much better since I had been on all those new meds at the time. I hate doctors. He says that he thinks I have a super sensitive esophagus and gave me a pill to try that is for cramping that is taken sublingualy (Hyomax-SL). I took it an hour ago. We'll see if it works tonight. I don't think that it will. He told me if I keep having problems that interfere with my life to call him and he would refer me to UW Madison or Mayo clinic. I said oh like when I'm so exhausted because I can't sleep that I can't function. I have no time left to take off from work for that. He also suggested having my wrap undone half way to help with the swallowing problems. I told him I wasn't having another surgery this year as I am having a hysterectomy on the 26th. Barb

Bo Peep,

How long did it take after your surgery for your athsma to improve?????

Bill,
What type of symptom do you experience when your LES was open too long? Do you experiece acid reflux or sour taste mouth?
Bill, can you drink and eat and burp ok lately?
I was in and out of ER so a few times due to my pain burning throat and sour mouth. The ER Dr. say I might have a leak valve -he say - that is probably why I am experience the reflux all day.

Thanks.
Marie

Thanks for the encouragement Bill. The pill the doc gave me did not work last night. I have quite a few Nexium left because I get 3 monts by mail order at a time. This morning I took the nexium because I can not risk experimenting right now with my health because if my acid reflux gets real bad from taking nothing then my asthma is going to act up and I will not be able to get my hysterectomy and that is one thing I do not want to mess up as I can get rid of those problems forever. I first hand that the PH studies can come back negative if you are really careful about what you eat which I did because I didn't want to have him say that it was because of me eating bad and tell that I would be ok if I just didn't eat bad. When I had my first PH before my surgery it came back negative for that reason and then they did another one 4 months later that came back positive because I ate all the stuff you shouldn't when you have this problem. This doctor has washed his hands of me. He wants to send me to UW Madison or the Mayo clinic just to get rid of me I think. I don't think he was happy about me argueing with him. I am going to see if I can get the information from my last doctor that shows the 2 different tests I had done so I have something to back up what I'm telling them. I'm so sick of doctors I could scream. I have way too many problems and don't need this kind of grief from a doctor. I don't like having all these different doctors. Well I need to go attempt to get some sleep for the night. I'll be up at least 2 times during the night. I am just exhausted which is not going to be good for my health. Barb

That's what every one keeps telling me Bill. I wish I would have pushed them to do some thing about my problems before this. I can't wait to have it done and over with. I wish my stomach problems were that easy to take care of. I thought the Nissan was going to do that and all it did was cause more problems. Right now I can't even go any where else, because I have no sick leave left and I do not have a vehicle that I would drive the 100miles to Madison. My insurance is a HMO so that limits me too. I think UW Madison is allowed though. I have been dealing with this since I was 14 years old. A 14 year shouldn't have to take antacids on a regular basis. By the time I was 23 those didn't work any more. I am just sick of all of it. I have had ulcers in the past and gastritis also. In fact there was mild gastritis detected this last time. If I eat or drink any little thing that I shouldn't it throws me into terrible stomach pain, gas and bloating, so I still don't see his reasoning behind taking nothing. He even told me I could eat any thing now. Yeah real funny. I've seen a number of GI docs in the area when I had my other insurance because every time one of them would do a EGD and or colonoscopy with out giving me enough meds I would switch. That is the one and only thing I can say for this doc is he listened to me in regards to that and the last 2 tests were done under a general anesthesia, which was alright with me. If I start having problems with my asthma that doctor is going to push me to see another GI doctor. I guess I'll deal with that when the time comes.

Bill did you have to have lung surgery because of your acid reflux. Mine caused me to end up with asthma and when it acts up my asthma gets really bad. Barb