Nissen Fundoplication Recovery

 Denise

Please hang around as we all really need your encouragement!!!!

Thank you again

CO Grandma or my name is Carol

 Hi Denise

I will for sure let you know what goes on.

Again thank you for the encouragement. I know it will be good in the long run.

Thanks

Carol

I'm entering my 19th month of post-op. I'm eating very normal now (since the third month), too normal...gained weight. :(

The burping and gas issues will fade with time. As for vomiting, I've vomited on three separate times with no trouble. Although is is unadvisable to do this I'm okay. It's best to ask your surgeon or GI to give you an antinausea medicine to carry around.

Your stomach is smaller, but it can expand in time.

Hi Jannygirl,
Welcome to Healing Well! You're definitely in the right place. I understand your worry and concern, as I shared it as I considered moving forward with surgery. This forum was great, because it was both encouraging and realistic.

I had my surgery in February 1009. During the first 3 months or so, I could not eat much at all...the swelling of my stomach mimicked fullness, so I ate very small amounts at a time. As the weeks passed over those months my stomach's ability to accept more and more food increased. By 4 months I was eating normally.

Don't worry...you'll be able to eat as much food as you want once you're completely healed. You'll loose weight initially, but will gain it back unless you're very careful.

My wrap was loose, so I was able to burp. That ensured that I didn't get gas buildup. Occasionally I'll get some bloating, but it is rare. Gas? During the bloating times I have more.

Those of us who have had the surgery are careful to always carry anti-nausea meds, as it's not good for the wrap to vomit. I did come down with a stomach bug and was able to vomit. My surgeon told me that I would not be able to burp or vomit, and I could do both. I can't burp at will, but my stomach seems to burp itself.

If I hadn't it would have ended up going out the other end, instead. I've been told that if you can't vomit, if you suspect food poisoning you should head to the ER. I haven't heard anyone having to do that, though.

The antinausea drugs I've heard of here are phenegrin, zofran, and compazine supposatories. I found the compazine supposatories to be most effective when I had the stomach bug.

The main thing you need to know is the importance of finding a very skilled surgeon who has done 300+ to 1000+ Nissen fundoplications. It's the type of surgery that requires lots of skill, as it's kind of an art form...

Again, welcome to the Healing Well GERD forum! Be sure to ask any other questions or express other concerns or worries you have. We'll do the best we can to answer you questions and share our own experience.

Good luck with your decision!
Denise

 Hello Jannygirl,

I am new to this site, However, I had Nissen Fondoplication Surgery( Reflux Surgery) and my hiatal hernia was repaired in May of 2010. Because I had some swallowing issues (dysphagia) my cardiothoracic surgeon recommended that I have the "Hill wrap" which is a 270 degree wrap of your esophagus around the upper part of your stomach (fundus). With this procedure, the patient should be able to vomit and belch although they may still experience some episodes of reflux. The full wrap is a 360 degree wrap (nissen wrap) which is a tighter wrap, but may prevent the patient from vomitting or belching.

Unfortuately my results are not good. Immediately following the surgery, I began to experiece diarrhea, belching, flatuence(gas) excessively! The burps would smell and taste like rotten eggs! May 25, 2011 will be one year since the surgery. The symptoms are still present! The diarrhea is the worst post-op symptom! I have as many as 0-3 episodes of diarrhea everyday.  It has even progressed to episodes of fecal incontinence(most humiliating problem anyone could have). I have had so many diagnostic test to determine the cause of  my symptoms and thus far all have not receive any definitive answers. I have research and found through an American Medical Journal (a reliable resource) that a study was done on patients who have underwent Nissen Fondoplication surgery. Several patients reported bowel dysfunction which included constipation, diarrhea and fecal incontinence for more than a year following the initial surgery. I have lost 20 pounds thus far. My surgeon had advised me that most patients will lose approximately 10 pounds following surgery due to the post-op diet (your stomach can only hold very littel food following the surgery. i.e. you may be only able to drink 2 ounces of liquids with each meal) You wil feel extremly full for several weeks. For me this was frustrating because I was very thirsty!  In additon to the diarrhea, I have developed diverticulosis. This is a disorder of the colon which is very common in about 5o% of people over age 60. Basically your colon has diverticula (small sacs that line the colon) it is recommended that people with this disorder should increase the fiber in their diet. However, (I am not close to 60 years of age)I did not have this condition before surgery. As I am a a research queen, I embarked on another American Medical Journal in which there was a case study where patients were given colonsocopies (examination of the colon under general anesthesia) and did not have diverticulosis, but under went the nissen fondoplication surgery, had a second colonoscopy and infact found that they now have diverticulosis! Researchers believe that because there is so much gas introduced in the stomach during the surgery, the pressure of the gas on the organs, especially the colon can cause this problem.(trust me, your surgeon will never admit to this). Diverticulois is generally harmeless despite some episodes of  colicky cramping in the lower abdomen. HOWEVEVR, if these pouches become inflamed they can leak posionous fluid into the colon which is life threatening! Last, but by far least about this surgery is the probability of damage to the vagus nerve ( this is the main nerve that regulates digestion it is located inc the cranial nerve (the brain) and runs through the abdomen. There is a risk with any abdominal surgery that this nerve can be injured. The results can be devastating and permanent. It is believed that my vagus nerve was damaged which resulted in me developing "Gastroparesis" this is commonly considered a diabetic condition. Basically as in diabetics due to uncontrolled sugar levels they developed nerve (neuropothies) that eventually diminished the nerve sensations in the stomach or they stomach functioning completly and you will develop gastroparesis (I am not diabetic; however it is belived that people with tyroid problems are at risk of developing this disorder) My diagnosis is considered idiopathic (meaning, doctors don't know why patients who are not diabetic or have tyroid disorders developed this condition, other than damage to the vagus nerve during abdominal surgery). Gastroparesis is when the stomach will slowly empty foods or no longer empty foods from your belly. You will develop chronic bloating, gas, nausea and vomiting and extreme abdominal discomfort. There is no cure for this disorder. You will have to follow a restricted diet for the remainder of your life. Some patients have it so severe that they are placed on tube feeds. At this time I am surviving off of a Full-liquid diet (Boost/ Ensure shakes) and soft foods. Unfortunately a recent EGD( when camera is placed in your stomach under general anesthesia) showed that even full liquids are not emptying from my stomach in a normal manner. Normally four hours following a solid meal less than10% of the meal would remain in your stomach. Anything more indicates slow gastric emptying (termed gastroparesis) once again "NO CURE." There is a diagnostic test which can confirm if you infact have this condition. My test results indicated that I had 33% of my meal still in my stomach after 4 hours. This is considered severe. The risk is that the longer the food stays in your stomach the more your at risk for bacteria overgrowth which can reap havoc on your body. I do not intend to scare you or anyone in this fourm. However, think hard about this decision, look at the risks compared to any advantage. I understand every patient is different, but even with odds of " one-in-a-million" there is still that risk. (ps. please excuse any spelling errors) LOL.

I am so glad to finally find other people on the planet that are going through the same thing I am right now. Today I am one week out from a nissen fundoplication that was done on April 25th. Spent an extra day in the hospital, they were beginning to lean at keeping me another night but my veins felt they had been cleaned out with Drano so in my desperation I begged to one of my docs to please let me go home. Thankfully I got to go home!!

My docs prepared me for the before surgery, but I wish they had taken some time to let me know about the after surgery recovery and diet. On my discharge paper the nurse only wrote that I am supposed to eat a Full Liquid Diet for 3 weeks (this will be my first post-op check up with the doctor) with no information or diet plan on what that really entails. As I was being discharged the doctor's dietitian came into my room and told me that a good way to gauge if something was okay for me to eat was to make sure it could go through a strainer.

I was also completely unaware of how severe gas bloating would be and how painful it really is, especially when one cannot burp (at least for the time being). Hopefully burping will be something that I will be able to do eventually. I am just not very hungry, tired of broth and I am frustrated at the lack of knowing what I can and cannot eat. I notice if I do not eat or drink often enough that is when my stomach pain and bloating really get their worst :(

The pain in my back and shoulder blades has been excruciating. I haven't seen my belly this big since I was pregnant 13 years ago. This past weekend the only way I found that helped my stomach pain and bloating was to begin slowly introducing small amounts of soft foods into my diet. I started out with some very watery mashed potatoes, mashed up bananas, and mashed up avocados. On Monday when the docs office opened again I called and spoke to the dietitian to make sure adding these soft foods was okay, to my complete surprise she was upset that I had started soft foods back into my diet. I was completely taken aback by this since she was the one who said to gauge the things I ate by making sure they went through a strainer first.

Is this really something I should worry about? I had no problems with any of those 3 items going down. So far I have had no heartburn and the only burning sensation I believe is from the wrap itself and that mainly happens if I have a lot of gas pressing against it or when I am laying down.

The discharge nurse told me that the doctor wanted me to call their office if I was ever in any extreme pain or had any bloating or swelling that concerned me. Well I did that too and was basically treated as if I was a bother for even asking. I asked if everything I was feeling was normal and questioned why they didn't tell me these things in their office before the surgery took place. I even asked before the surgery what to expect from recovery and was told that since I was having a robot assisted laproscopic nissen that my recovery should be easy with little to no pain. Au contrare - thanks to your thread and others I have read recently I am experiencing what I guess should be considered the norm.

My prayers to all here and hope that we all feel better sooner rather than later :)

Hi scottikat,
Welcome to Healing Well! I'm so glad you've found us...and welcome to our Wrapped Club! You are definitely not alone on the planet! There are many of us who hang around this forum to share our experience and support. We've all been where you are, and that's the beauty of this forum. As you said, your surgeon can do the procedure and release you on a "liquid diet", but with all their medical expertise, they haven't lived the recovery the way we have.

Any, any, any time you wonder or worry about a pain or symptom that concerns you, your surgeon should be your first resource. For everything else, your friends here can help you out!

I first found this site when I was trying to get the courage to have the surgery. My lungs were in horrible condition and my asthma and family docs both were certain that my reflux was causing the problem. My GI doc wasn't so sure, but after four years of struggling, he finally said that I might want to go talk to the surgeon (or I could continue on medication, which wasn't doing the job). Long story short, in February 2009 I had a Nissen and by mid-May my lungs were 100% better. Hooray!

I do not think that surgeons or GI docs prepare patients for what to expect post surgery. It is amazing to read posts here and see just how unprepared people are for what to expect during the recovery. I found out so much from other members here that helped me through.

Let's start with shoulder pain. I always thought it was so strange that one of the worst post-surgical pains you get is in the shoulder. Really? What does the shoulder have to do with anything? From what I've read it is caused by the gas that is pumped into your abdomen to create a field of view for the surgeon, as well as sutures in the diaphram muscle. This will diminish over time. I found that walk, walk, walking helped it a lot. The more I walked, the better it felt. It's worth a try...I walked around my house in February, but I did have a treadmill, which I hopped on and walked, slowly at first, increasing time and speed as I recovered. I can vouch for it helping tremendously. Now that it's springtime, you can get outside and walk, so you're lucky!

Another important thing...your wrap site will become increasingly swollen over the first two weeks, peaking at 14 days and then begins to resolve. Therefore, don't be at all surprised if you have more difficulty swallowing--it will likely get worse before it gets better. That's totally normal. I suspect that's why your surgeon has you on a full liquid diet.

Post-surgery diet protocols vary widely. Some surgeons, like yours, require full liquid for several weeks, others switch to plain liquids, while mine allowed solids that could be chewed to a liquid (after I saw him on Day 5).

I suspect that my surgeon simply has more trust in his patients and their ability to choose food carefully and follow his directions to chew thoroughly and eat only what chews to a liquid. Rather than blending the food, I took small bites and chewed very carefully.

I never had a moment's problem with that eating protocol. I once asked my surgeon if anyone has made mistakes in eating, and he replied that he had a couple problems in all his years of doing the surgery, but the vast majority do great. Hence, his adherence to his very liberal (and wonderful, from my perspective) eating protocol.

Look, I'm not one to go against a surgeon's recommendations, but I can tell you that I had the same surgery and don't see a thing wrong with what you're doing. Just remember...small bites and chew completely. If you're not having problems, go for it. Just remember you might have to back off a bit (or not) when the swelling increases. As I said, I was eating solid foods starting at Day 5. My surgeon said that just because food was soft didn't mean it wouldn't cause a problem..."a bolus of mashed potato could get stuck"...that's one reason he opened the eating up sooner than many.

I was told anything except steak and bread. I was very careful, took small bites, and chew, chew, chewed. If something didn't chew to a liquid, I didn't eat it.

The bloating will subside as time goes on. Don't drink with a straw...it introduces more air into your stomach. Stay away from carbonated beverages as well...alll those bubbles add up!

Stick around and ask questions as they arise. I found this forum to be such a godsend when I had my surgery. People helped me so much that I decided to stick around and help others as I was helped.

I suggest that you start your own thread on the main page. Then it'll be easier for other members to find you.

Again, glad you've joined us! Hang in there...it'll get better!
Take care,
Denise

Post Edited (dencha) : 5/3/2011 7:41:48 PM (GMT-6)

 Denise

Had my doctors appointment and we all agreed that the surgery looks find. I had a barium test. But my surgeon said when he does a surgery he does not consider it a success until his patient

feels good. Unusual for a doctor to say. He put me on a medication that will relax my stomach

muscles so I will be able to eat better. He thinks when I try something new I tense up because

I am afraid it will bother me. So I will do this for 2 weeks and go back in to see him. He did not

even charge me. So we are thinking positive!!!!

Thank you again for sticking around.

Carol

Hi Carol,

I'm so glad to hear that your doctor appointment and your barium swallow went well. It can be scary to swallow in the early weeks, and you could, indeed be stressing unconsciously. I hope the medication helps. It's a good idea to give it some time. I'll be interested in hearing how it works for you.

Good luck!
Denise

Hi Jorgito,
I'm sorry you're sad, but I can assure you that in the early weeks reflux or other reflux symptoms are quite common. The wrap is still swollen and has not settled into place. Some people experience absolutely no reflux after the surgery, while others (who in the end have a successful outcome) do experience it. Those people are often put on some amount of PPI to make them more comfortable during the recovery.

I understand your fear. I also experienced it when I was recovering from my surgery in 2009. I was so worried that my surgery was done for nothing, and that it was a failure. That was not the case, though. I'm very happy with the result, as I no longer have very unhealthy lungs caused by reflux.

It's difficult to trust that things will be okay in the long run, but try to relax and let things happen as they happen. Take whatever you need to make you comfortable, but don't assume the worst. You're not alone in the experience you're having. Many of us have "been there".

Hang in there, and things will get better!
Denise

Hi Laura,
Sorry to hear you're still having problems. It's a good thing that you're going to have a barium swallow...it will be able to observe the repair and see if there is obvious reflux.

I trust your doctor knows the realm of possibilities while recovering from this surgery, but keep in mind that everyone is different. My lung issues that i had the surgery to resolve took two and a half months to resolve, and seemed to get better overnight at that time.

The healing takes longer than two months to be complete. It took longer than 2 months to cause the burning you're still experiencing. It's possible that it is still healing. Hopefully the barium swallow will answer your questions.

Try not to worry. See what the doc says after the barium, and let us know.
Good Luck!
Denise

Hi Jorgito,
I am glad to hear that your barium swallow results were normal. Did you read my post to you yesterday on this thread?
Denise

hi everyone,

i will be going for LNF in three weeks, i had TIF done in March which failed and post surgery all symptoms has worsen, meds don't work despite i am taking more than allowed. my only worry after surgery is hiccups, because when i had TIF done after i woke up, i was given soup to drink and as soon as i drank a little hiccups started and that lasted for more than 24 hours, anyone have a solution for hiccups, i told my doc but he said hiccup won't damage the valve and for me it did. Right now i am having issues to swallow food, when i swallow it feel like fire in my throat. any help will be much appreciated.