surgery soon

Hey there,
I am scheduled for the lap nissen on april 8, and am just looking for the answers to a couple questions.
has anyone had the surgery mainly for regurgitation, not acid?
how long until you can return to normal activities? i am a high school student and am worried about how much class i will miss. the office claimed i could return to school four days after the surgery but this sounds unrealistic to me.
has anyone else proceeded with the surgery WITHOUT manometry or pH testing? my surgeon didnt think i needed either. i have had the barium swallow xray, endoscopy, and gastric emptying study, but none of them turned up much of anything except a small hiatal hernia.
thanks for any info you can provide!

Yes I had the nissen for regurgitation which worked a treat untill i broke the rules and did some physical work!!!!   now a redo is in order BUT i would get all the testing you can done BEFORE surgery if doc syas you dont need them sack him and find a gi doc who will.   gd luk......

Hello and welcome to HealingWell and the GERD/Heartburn Forum.

I am glad to see you have met some of our awesome members.


Looking at the threads I see we have several members headed into surgery for various reasons.



I wish you the best with your surgery, tirali! You may want to take the time to read through some of our threads by members who have had the lap nissen.



You may find answers to the concerns you are having. Also be sure to talk with your surgeon re your questions.



Again a warm welcome,



Kitt

I agree with Joy about getting a motility test,. You might consider a scope, maybe a Ph, a Barium Swallow and stomach emptying test. They will tell you some important things. Does the Carafate help with the regurg? My surgeon put me on Carafate and Erythromycin for the regurg. He explained that the two taken together helps some (about 30%) not only coat the esophagus and stomach but helps the stomach empty in a more timely manner, which reduces food to regurg.

I've been "working with" my esophagus (primarily LES...lower esophagus sphincter) for over 25 years. In the beginning, I'm not sure I could have differentiated reflux, regurg, spasm, constriction, etc. with the knowledge that I now have. Tests eliminate guessing. There is likely a diagnosable reason for why you have regurgitated your whole life. Did no doctor seek to figure out why you were doing this?

I have had some reduction in symptoms from Kapadix 60 mg. It also facilitates healing damaged linings. Depending on your insurance, it can be expensive. Often, having the surgery reduces or eliminates the need for medication. With my past esophageal surgeries I haven't needed medication following the surgery.

I again stress...follow the post surgery rules...don't lift, bend, small amounts of liquids...then soft food...chew until food is liquid. Just because you can do something...doesn't mean it is wise to do so. The consequences of weakening the surgical area being repaired can lead to long term misery or added surgery, as some of our member have written about!

Please keep us posted

Good wishes and blessings,


Please keep us posted.

Post Edited (my7pinecones) : 3/21/2010 2:43:23 PM (GMT-6)

Tirali
Your surgeon is wrong in not getting manometry. Has he eliminated nutcracker esophagus and other swallowing problems? How can he tell how tight the wrap needs to be?

More importantly, have you exhausted all the other causes for regurgitation? The squeezing and jumping the stomach does when it's irritated will not go away just because they do a wrap. It only means it won't go up into the esophagus.

You need to take time to find out if you have food intolerances that are causing the irration. That means starting with a food log and then doing challenge testing. My allergist got me doing this and I eliminated the refluxing, although I still had a bad LES and eventually needed surgery.

Surgery is a last resort and is not to be taken lightly.

Thank you all for your good wishes and advice.
my7pinecones- the Carafate has not seemed to be effective. I have had the scope-normal, barium swallow-hernia detected, and gastric emptying study-normal. My gastroenterologist considered Ertyromycin but said it was not appropriate as my stomach empties normally, and offered Reglan but I had read enough to stay away from that! The surgeon told me we couldn't really know what causes the reflux.

StaceyA- Glad to hear someone else hasn't had the manometry, though I know it does seem important... what was your surgical recovery like? One of the reasons I'm not pushing the issue is due to where I am in life right now. I'm having surgery over my spring break so my body has lots of time to recover before being subjected to the stress of a new, far-from-home college environment.

Another question- when was the earliest anyone traveled after having surgery? With college acceptances coming in, I have to look at the possibility of traveling by plane to review choices before making a decision only three weeks after the surgery. Obviously I may not be fit for travel, just wondering if anyone could comment on that.

tirali -
I believe you are going to undergo the operation, but realize that this is not necessarily a complete cure. Your surgeon should have informed you that a lot of patients end up back on acid reducers at some time. I'm only saying that the reflux action of the stomach is not caused by acid.
Even after getting the fundoplication (mine was a Toupet) I have reactions to my food intolerances. I get jumping around stomach (trying to reflux) and sometimes tachycardia.
Being a vegetarian doesn't exclude you from food allergies/intolerances, and you can be lactose intolerant and also have a problem with the milk proteins. I have a problem with most yogurts, which are often considered safe for lactose intolerant, because they often add powdered milk - which may contain sulfite.
Vitamin D needs to be corrected with the formula: for every 1ng/mL deficient you add 100 units of D. I had a level of 18, needed to add 3000 units to get to 48 in the new recommendation of 50 to 80 from Mayo.
My personal list of intolerances (from sulfite), which does not contain much meat:

Bagels, commercial Bread
Bottled Juices – especially containing grape, lemon or lime juice
Brown Sugar, White Beet Sugar (all brands not labeled cane)
Cashews
Canned Soup, except Progresso Light Chicken Noodle or Beef
Catsup, Mustard
Cereals, boxed
Cheese, especially hard cheeses
Cherries
Chocolate, especially dark
cookies, especially chocolate chip
Corn Starch (fillers in gravy, pie filling, some medications)
Corn Syrup, dextrose, maltodextrin
Dried Fruits – except prunes
Eggs, if more than 1
French Fries, packaged mashed potatoes – no reflux with fresh potatoes
Gelatin
Ice cream, Sherbet
Icing
Jams and Jellies (pectin) – no reflux with the raw fruits
Maple Syrup
Milk, powdered – used as filler in “all milk” yogurt and some skim milk
Mixed Spices, especially with pepper
Packaged, Cooked Meats
Peanut Butter
Pepper
Pizza (crust, cheese, sauce, toppings)
Pork, Sausage
Puddings, Pumpkin Pie
Sodas (more than 1 cup)
Tea and Herbal Tea (few brands)
Tomato Sauce
Tuna, some brands, canned – containing soy
Yogurt (more than 1 cup) especially low fat varieties (powdered milk added)
Wine, Beer

Hey Alcie, I appreciate your concern and cautions. My surgeon informed me that the surgery does not work, or only partially works, for many patients, and the the wrap will inevitably fail in all patients, though hopefully it will last many years! After weighing the risks and benefits with my surgeon and parents, I have decided to get the surgery, partly because in my case I think it would be worth it just to stop the regurgitation into my mouth.
I'm sorry to hear about all the foods you cannot tolerate, it must be a trial for you and I hope you are being well cared for by your medical team. Don't worry, I'm aware that my diet does not preclude any number of intolerances and other issues, but mentioned it simply to give more personal history and an awareness of my personal situation. Like you, I had my Vita D level taken and I take 2000-3000 units a day for this.

Lisa, thanks for your perspective! I am hoping for an outcome as good as yours. Are you experiencing any reflux now?

Thank you so much Joy. Gosh I am getting nervous as the date approaches, I am always looking up information online- being informed is good, but this is getting unhealthy!

The surgery was nothing really.
That morning they gave me a pill to keep me from feeling sick after surgery.
I came in that morning, put on the breezy gown (Brrr!), climbed into the bed and covered up.
Answered a bunch of questions, got my IV (hurt just a little). My parents came in and sat with me for about 10 minutes. Then they rolled me out of the room down the hall to the recovery room for prep. They asked me a hundred more questions, gave me a couple of shots in my IV, put and anti-nausea patch on me. They then rolled me into the OR. I saw some huge round lights overhead a couple of doctors and nurses standing around. They had me slide over onto the table, told me to stretch out my arms and it was night-night.

I woke up some later in the recovery room. I was very thirsty and had some pain (the only time I hurt bad). They said they couldn't give me anything until I fully woke up. I drifted in and out there awhile.

The next time I woke up I was being wheeled to my room. They had me wake up again to have me help them get me into bed. They settled me in and I fell back asleep. I woke up somewhat and asked again for water and pain meds. My parents were in the room and got the nurse to come. I got a shot which helped very quickly. My parents rubbed ice on my lips to stop the dryness. After an hour I was fully awake and the pain was down to a dull ache which was very tolerable. I got an extra pillow to rest my IV arm, it was still a little uncomfortable. I ate lunch around 3 that day. It was broth, tea, apple juice, jello, and a popsicle. I loved the cool popsicle.

The hardest part was getting up out of bed to go to the bathroom. It didn't really hurt that much just very cumbersome. My belly was swollen and if I moved too fast I felt weak. My mother had to help me move my legs on and off the bed. I had large compression boots on my legs which stayed on the whole time I was there. It was so hard to walk in those things.

I didn't need any pain medication after that shot while I was in the hospital. When I got home I only need pain medication to sleep at night for four days. After that I felt fine.

This was my first hospital experience since I was born. I was scared at first, but I was surprise all my "what ifs" were all for nothing..

Hang in there. It's not that bad.

Joy

Tirali

Good luck to you! I hope the surgery is a success. I feel bad that you have to go through all of this your senior of high school. Hopefully surgery will give you a better life.

Just wondering if your doctors ever discussed the EsophyX procedure with you? It is a new procedure that is done endoscopically. 

Take care and good luck!

Steve

 

Tirali-
Not all people have the NG tube. I had it the first time, but not for the redo. Guess it really depends on the surgeon. I stayed 2 night both times, again that's a surgeons preference and depends on how you are doing. after surgery both times I had to have a barium swallow to make sure nothing was leaking before I was allowed to eat or drink. Both times this was done the next morning for me. It's not a real big deal except having to roll around was a bit tough with the incisions being sore.
Before my redo they gave me versed and I barely remember anything until I woke up in recovery 4 1/2 hours later.

Take care,
Bill

I am sure they will give you something to help you relax before going to the OR. If not, If you ask they will. They gave me something for every surgery I have had, wow that's been quite a few, anyhow....sometimes it's been versed and sometimes something else. If you don't want to remember much ask for versed, but if you do want to ask for them not to give you versed.
The first time the barium swallow wasn't so bad, but after my redo it was horrible. I am sure that was because I was in surgery so long. My redo took 4 1/2 hours and my original only took 2 hours. Things were a lot more sore after my redo. As for a cath., I did have one with both surgeries, but they removed it in recovery.

Take care,
Bill