bravo results & pre-surgeon questions

I just got my bravo test results back and sure enough (i was in pain thru out the whole thing) I have way too much acid coming through, and apparently my esophagus is very weak valve wise.  So i have to call to make an appointment with the surgeon and he's going to go over the surgery and such.  I need help...What should i ask?  What can i expect?

My gi doc told me i pretty much have to have the surgery because 3 times i ended up in the ER due to the PPI meds.  Three days ago i started achipex and ended up having a near heart attack 2 days later.  For a 22 year old i was scared!  And they hope that this will clear up the shooting pains and all the acid i constantly have.  So if anyone could help i would appreciate it.  Especially any of the wrapped club, which it looks like i'm soon to be a part of it:).

thanks!

g

I have one I feel is very important, Which "style" Nissen do you perform? There is thd update version where it is a NONO to attach the freed up fundus to lower anterior stomach, This was th way the surgery was first designed in the 50s and 60s. It doesn't givre the patient a usable valve. They must loosen enough of the fundus from the spleen to have anough fundus to fully wrap around the LES. If the fundus is attached to lower interior stomach, bad things will happen This is what I dealt with for 3 years, Food getting stuck, medicines getting stuck for 20 minutes at a time. I found out after many not so fun tests that they would have to do surgery to see what the ptoblem is and then see if it van be fixed, Mine was able to be fixed it took 4 .5 hours of surgery to get it done right though, Then came the2 plus week of hospital stay because of complications trying to remove the old unfunctional wrap. What this long drawn out post is saying.....,make sure your surgeon know the latest techniques out there. Don't believe that just because he says he has or can do it no problem, doesn't mean he has been trained in the latest and greatest technique. Run away!
I did no home work the first time and got a messed up wrap. The second time I did my homework and asked other surgeon about someone I was looking to use. After many positive stories and the nursing staff there telling me they would take their kids to him, I Felt better, Then I bugged him every month to get to the bottom of my problem and he told me he would and fix it.

Well thats my rambling on the subject for now,
Bill

Hi Griffdawg,
Here's the huge list of questions I asked my surgeon:

How many of your Fundo patients have persistent swallowing difficulty after the surgery?
How long before eating becomes “normal”?

What size “intraesophageal sond” (bougie)? Why do you use that size? How does it affect patient swallowing issues after surgery? How long do your patients experience swallowing problems? (Your surgeon may not use a bougie...some don't)

How many “successes” have you had?
Heartburn free
Normal swallowing
Minimal changes in digestive system

What are the possible immediate or long term complications?

How long do you expect a repair to last?

What type of diet do you prescribe post surgery?
How long on liquids/soft foods/regular foods

How long after surgery are most of your patients able to eat regular food?
What foods will I not be able to eat after the surgery?
How about taking pills?

How often do you have to switch from lap to open procedure?
What might cause my fundo to fail? What are the chances that this will happen?
How often has it happened to other patients you’ve operated on?
How many times have you had to redo or stretch valve?

You told me that I wouldn’t be able to burp after the surgery. I assume then that I won’t be able to vomit either. How do I cope with a stomach virus?

How long do your patients generally stay out of work after surgery?
How much pain will I expect to have after surgery?
Does the repair of a hiatus hernia create special problems?
Are there activity limitations?
When could I resume normal activity?

How long before the sutures heal and the repair is strong?
How long before repair swelling subsides?

What kind of anesthesia will I have?
What drugs will I receive? Do I have to be on an antibiotic postoperatively?
Do I need any other tests before the operation? (Often you'll need a chest x-ray and blood test right before.)
Who else will be in the OR? CAN I HAVE YOUR ASSURANCE THAT YOU WILL BE THE ONLY ONE PERFORMING THE SURGERY?
How long does the surgery take, and how long will I be in the recovery room?
Will I be able to sleep on a level bed after the surgery?
What medications will I need to stop taking after the surgery?

Will I stop the PPI’s immediately after surgery?
When will I need to be seen after the surgery for follow up?
If I have more questions before the surgery how can I get them answered?
Is there anything else I should know that I haven’t asked?
I have a hiatal hernia. How does this complicate the procedure? Can you tell from the barium swallow results how severe it is and whether or not it will impede the chances for a successful outcome?
How about my manometry? Is my swallowing sufficiently strong for the procedure to be successful?
Is there anything else I should know that I haven’t asked?

I know it's a crazy long list, but I actually did discuss these issues with my surgeon. He was fine with it. Maybe you won't want to ask all of them, but you should be able to use it to establish your own list.
Good luck!
Denise

bill hows ur recovery since been? i just started reading into them, and im glad things are working out now.

Griffdawg -
Thanks for asking. Things are getting much better now. If you have been reading the posts from my hospital ordeal please remember that is not the norm. I had a screwed up first Nissen and the complications were from what HAD to be done in order for me to have a normal life again. I highly recommend reading Denise's post op notes. I believe Bea has a fairly detailed one also. Denise's list of questions is also great. I wish I had that list 3 years ago. If you find a good surgeon who believes you are a good candidate for this surgery everything will be great.

Take care,
Bill

thanks denise!  i looked up your older posts and they will help big time!  especially with what to expect.  Especially if the surgery keeps me out of the ER (they know my face and name already lol).  and the questions are a big help, infact i changed over the surgeon was meeting with from a new guy to the guy who normally does it.  That helped settle me down a lot too:)

thanks kitt! it makes me feel welcome, reassured and certaintly not alone!

thank you for all the help! I have two tests to take before my surgoen officially schedules surgery... the barium test, which sent me to the er because i kept vomitting, and this stomach emptying test i have next week. Than im on the road to surgery! yipe!

Griffdawg-
Good luck with tests and keep us updated about the surgery.

Take care,
Bill

griffdawg

I am glad you are getting closer to a date for your surgery. Please do keep us updated as we will be here to support you throughout your surgery and we make a great cheer leading squad.

I wish you peace,

Kitt

G, have you scheduled your operation yet?
Have you considered the Esophyx? If it fails you can have it done again or fall back on a nissen, but you only have a sore throat after instead of a sore stomach. The liquid diet lasts only a week, and soft foods for a month. You feel well enough to go back to work after a few days on light duty. My doctor says weight does not matter, just the size of the HH. You can find information on the internet by typing in "Esophyx Procedure". I've found videos and information from the company from that. I even found my doctor that way.
There should be at least one experienced doctor in your area even if you have to drive awhile. You don't have to worry about a "tight wrap". The nurse who I talked to, her daughter had the surgery, says she gets no gas build up and can burp easy. She has had no side affects from the surgery and doesn't need her meds anymore. I'm going to go see this doctor in October and schedule my operation over Thanksgiving Holidays break so I can be able to get back to work on Monday following.

Good luck in whichever procedure you chose.

Joy

thanks bea! hello joy!
i jsut looked up all that stuff on Esophyx, and i'm now wondering about it. Are there any websites that have that information on it to find doctors in the area that do it? my operation will be scheduled by the surgeon starting on wednesday, and than i hope sooner than later'. I just started gettin muscle spasms, and they think it's the ppi im taking ugh. as for the Esophyx, everyone i talk to online is still sketchy about it working and for sum it only decreases the meds. With all my bad luck i need to stay off them forever! Anyone had Esophyx done?