KME,
I'm new to this site but have picked up some good info, so far, by reading the posts. I think I can answer your question about the shoulder pain. And,I'd like to give you a little of my GERD/Hiatel Hernia experiences, too, to see if they're similar to yours.
I had suffered from severe GERD and Hiatel Hernia for the last 25 yrs. and took the Pepcid, Zantac, Prilosec and ended up with 2 40mg of Nexium a day for the last 3.5 yrs. Over the last 6 yrs. I developed a sphincter, too. I've had to have the esophagus dilated every year for the last 6 years, the last one was on 4/24 and it didn't help. I've been choking on food, water and air. Can't get more basic than that! Finally, that dr. told me there was nothing else he could do for me. I had 4 ulcers in the esophagus (with a lot of scarring) and 2 in the stomach; he referred me to a surgeon.
The surgeon I was referred to was great - took his time to fully explain the procedure and listened to my concerns. (A co-worker of mine had this done about 5 yrs ago & it was disastrous! The first one, they did a full wrap - way too tight - no food could get down. The 2nd one, to repair the first, they poked a hole in her esophagus and stomach and she was in the hospital for a month and went home with a feeding tube. She had the added complication of Barrett's.) When I'd told my dr. about my co-worker's experience, he explained that he puts a tube down the throat and dilates it so, when he's stitching the Fundus (stomach) to the back of the esophagus, he knows how tight to make it. When he explained that process to me, I was convinced he was the surgeon for me!
Because of my co-worker's experience, I was really apprehensive about this surgery but felt I didn't have much choice. I've been sleeping on a 10" foam wedge plus 2 pillows for the last 3 months. I would cough all night long and only got about 2 hrs of sleep a night. You can't function on that. My surgeon put me on a liquid diet (criteria was: anything you can get through a straw) for 10 days before the surgery.
Seven days before the surgery, I had to stop taking aspirin (heart trouble), my arthritis med, and one of my blood pressure pills because they thin the blood too much. My surgeon STRESSED that I would be on a total liquid diet (clear liquids only) until I came back for a post-surgery checkup. My surgeon did ask me if I had a tendency to vomit a lot. Fortunately, I rarely get the flu and that wasn't a problem. He said, several times, how important it was to follow the pre- and post-surgical diet or I'd have problems after the surgery. I lost 10 lbs before I had the surgery. (And, I'm sure that was one of the reasons he had me on liquids, since I was at 226 lbs when he operated and it probably helped with the surgery.)
I had the surgery on 6/26/09. The anesthesiologist gave me 5 little pills before surgery that was to help the nausea and keep me from vomiting; thankfully, they pills worked! (I would really suggest that you ask about this at every step of the way.) When I woke up after the surgery, I had some severe pain across my sholder (left to right). The nurse told me that was caused by the gas (bubble gas) they put into your abdominal area to create a space for the surgeon to work with the laproscopic tools and that the bubble gas rose to the shoulders (after the surgery) on it's way out of the body and that was the pain I was feeling. They gave me morphine for it and that helped. The next morning the pain had moved to the right shoulder and I could hardly move the shoulder - it felt like someone was poking a sharp knife in the joint. Again, more morphine for the pain. The pain returned while I was waiting to be checked out and they gave me Vicoden. That night, the shoulder pain was bad again so I used one of those pain patches you can buy at the drugstore for back/arthritis pain and stuck it on the shoulder (fortunately, I keep them on hand because of my arthritis). It worked and I slept through the night (with only a little coughing). The 2nd day after the surgery, I swear the pain moved to the head, because I had a huge headache. The shoulder/headache was completely gone by Noon of the 2nd day.
I had to see a dietician before the dr. would release me from the hospital. She gave me a Nissen-Fundoplication diet put out by the University of Penn (you can find it online). When I went home, I was eating only clear chicken/beef broth, tea (decaff), non-citric juice and jellow for my 3 "meals" a day. Plus, I'd have tea or jello as "snacks". I didn't try to figure out the calories; I figured they were miniscule. But, I've been losing about 1.5 lbs a day (to date, I've lost 22 1/2 lbs since 6/16 when I started on liquids). I've been very weak and have no energy but, I haven't had any pain - only a little discomfort when I try to sleep on my left side (but that was only the first couple of nights). I do get the hiccups and it sometmes feels like I have acid reflux in my throat (maybe that's what the esophagus is "remembering"?). My coughing is still going on but it's no longer the deep, hacking coughs I had before the surgery (the coughing would wake me up & I'd be, physically, bouncing up & down in bed from it). The coughs are now a short, raspy cough. And, they've lessened with each day. That could be a left-over from the surgery. I have a prescription for Vicoden for pain, but haven't taken it (I really don't like the side-effects) and haven't really needed it. I've taken Acetomeniphen when I've had pain and that's been handling it (just taking 2 500mg a day). So, I think I've been lucky with the pain.
The only problem I've had, that was mostly my fault, was that I "crashed" on 7/1/09 - the 6th day of the clear liquid diet. I was so weak I could hardly stand. And, I hadn't been drinking enough water or getting my 5 meals in (you're supposed to have 5 small "meals" a day on the clear liquid diet) because I didn't really feel hungry to bother. Well, the world went a spinning and I almost passed out while taking my meds. I had to sit down for 10 min. (5 of those with my head between my knees), trying to keep from passing out. So, make sure you eat those 5 mini-meals a day. The clear liquid isn't much but you don't want to mess up your electolytes. Also, since the clear broth is so bland, and I figured I wasn't getting enough salt, I shake a little salt into the liquid to give it a little taste. That's helped the lightheadedness. I'm sure the dr. won't approve, but I couldn't deal with almost fainting again. I'm hoping to advance to the full liquid when I see my surgeon next Wed.
But, the important thing is that I no longer have the acid reflux pain/discomfort! And, that makes the surgery worthwhile to me. The important thing is to get a surgeon who knows what he's doing and is upfront with you when you ask questions. If he desn't want to answer your questions, in detail, find another! Would I do it again? Yes.
If you have any other questions, I'd be happy to answer them. GOOD LUCK!!!