Nissen Fundoplication - Before & After

I believe my problems began about 9 years ago shortly after I started a new job. Working in the prep room of a microbiology laboratory I was responsible for sterilising all the equipment & bottles etc used in the laboratory.This involved long periods of standing, bending & very heavy lifting.
I started to experience random episodes of heartburn. Not bad at first just enough to be annoying. This went on for a number of years, didn’t bother me much, the symptoms would come & go until I started to experience chest pain & shortness of breath as well.

I decided that it was time to visit my GP for a check-up. She sent me to a cardiologist who performed a barrage of tests but could find nothing wrong. She concluded that I had a mild chest infection & prescribed a course of antibiotics.

Eventually everything settled down & I had no symptoms until September 2009 when the familiar heartburn & chest pains returned together with acid reflux. Each time I went to see my GP (& believe me there were many times) she would give me more antibiotics thinking the chest pain was another chest infection & eventually giving me inhalers because it was believed I had adult onset asthma which would account for the shortness of breath. Each visit would leave me more depressed because I was feeling worse & worse & my doctor was treating me as if it was all in my head.

By November 2010 I was totally fed up. As well as the heartburn/reflux, chest pain & shortness of breath I started getting back pain under my left shoulder blade & the feeling of fullness like “something” was pressing under my left side ribcage. This made me even more breathless as I was unable to take a deep breath without it causing pain. The reflux got worse & I was unable to get relief no matter what I tried. Over the counter antacids didn’t help neither did raising the bed. There was constant burning & regurgitation after every meal & I would wake most nights vomiting because of it.

One morning noticed blood in my urine. Thinking the worst I went back to my GP, this time I was adament that I was not leaving her office until some action was taken. I was referred to a Urologist to investigate. This involved taking urine samples over several days & looking inside my bladder with a cystoscope. Nothing unusual was found so I was sent for an ultrasound scan to look at my kidneys.
This scan showed normal kidneys but did reveal a dilated common bile duct.

Finally I thought we were getting somewhere but my GP was unconcerned & said it was quite normal after having a gall bladder removed (mine was removed in 1985) & it was totally unreated to my symptoms. I was unconvinced & asked for a second opinion. On 7th March 2011 I was seen by a gastroenterologist. He was a wonderful man & for the first time in nearly 10 years here was a medical profession who was actually willing to listen. He sent me for an MRI scan, performed a gastroscopy & colonoscopy & tested for liver function. These tests revealed grade 1+ reflux esophogitis & hiatus hernia. (No explanation why the common bile duct was dilated. Totally random & yes unrelated to my symptoms). I was prescribed a course of PPI (pantoprazole 40 mg daily) to see how things went. I perservered for about six weeks but had no effect. The pressure under my left ridcage increased along with constant pain & I was so breathless that I couldn’t even walk up a flight of stairs without puffing.
I was using my inhalers more & more but they were having little effect. The vomiting from reflux got so bad it was happening after every meal & effecting my work.

After discussing this with my GI doctor he agreed to refer me to a surgeon who specialised in hernia surgery. On 20th June 2011 I was seen by the surgeon who agreed I was a suitable condidate for a laproscopic Nissen Fundoplication. After explaining what the surgery involved, the benefits & risks I agreed. It was a no brainer & I was booked for surgery the next week.

The thought of major surgery didn’t worry me to much. It was a relief just knowing that there was going to be an end to this nightmare.

On Wednesday 29th June 2011 I reported to the hospital at 11.00am, was shown to my room & went through the usual admitting process. Had a visit from the surgeon & anaethestist who checked this & that & asked many questions. The nurse gave me the standard issue glamorous blue gown & lovely white stockings to change into, gave me some pre-med & I was taken up to the operating theatre.

The last thing I remember was looking at the clock in the theatre, it was 3.00pm. I awoke in the recovery room in incredible pain & knew straight away that this was not how I should be feeling after a laproscopic procedure & it was now 7.00pm. Things were a bit of a blur & I drifted in & out for a while not sure what was going on. At 8.30pm I was returned to my room. Once I was settle into bed & pain meds given I was able to think more clearly & started asking questions. The nurse said there had been complications & the surgery had taken longer than originally thought.

The next morning the surgeon came in & told me what had happened.
When the first incision was made they found too much scar tissue from my gall bladder operation 26 years ago & the laproscope had grazed my liver. It was decided to convert to an open Nissen because of the adhesions & the liver laceration needed to be stitched as well. At this point my surgeon also discovered a small piece of bowel was twisted up & trapped under my spleen. This needed to be pulled down & stitched back into position. He said this was the cause of the pressure & pain under my left side ribcage & that it had been crowding my lung space making it difficult to breathe. So mystery solved.

I stayed in hospital 5 days & returned home feeling so much better than I had in years despite the usual aches & pains associated with surgery but without all the horrid symptoms I had before surgery. No acid reflux, no heartburn & I can breathe properly- deeply & effortlessly.

Fast forward to today I am now 3 weeks post-op & doing well. My incision is looking good & my tummy still feels very tender but I know inside will take a long, long time to heal completely.

Food is an issue at this point. A semi-liquid diet with everything being soft & mushy is very challenging but I think it is just my impatience that is causing the most concern right now. Tried some minced chicken last night & maybe I didn’t add enough gravy or chew it properly but a piece got stuck at the wrap. Was so painful. I need to slow down & listen to my body. Eat small amounts of soft mushy food when Im hungary & remember the mantra ‘Chew, Chew, Chew‘. If things go wrong I will just revert back to liquids for a couple of days then try again.

Still experiencing gas & bleching & my bowel is having a wee sulk. Some days I seem to live on the loo. Have lost about 6kg which is not such a bad thing, have still got some to spare.

I know each day I am getting stronger & my insides are healing better so need to continue to take things quietly & rest as much as I can.

See the surgeon again next week & will look at the possibility of returning to work. Mentally Im ready but physically I know I still have a long way to go. Maybe light duties, will need to be chained to a desk for a while.

Good luck to anyone who has had this surgery or contemplating having it.I know it is early days in my recovery but the benefits definitely outweigh the
risks.

Will keep you posted.

Lynda

Thanks Joy.

I am so glad I found this forum to express how I was feeling. It started out as a few thoughts put into words in the hope that it would help others going through this experience but ended up a bit like a novel LOL.
Anyway I do feel as if I'm among friends & the support & encouragement I have received has been amazing.

Lynda

Hi elsiem

Welcome and thanks for sharing your story. It is always helpful to read others experiences with the NF. Glad to hear at 3 weeks you are doing well. Please do keep us updated on your progress.

Hi halloweenbaby. Thank you for your wonderful words of encouragement.
It is 10.30am Friday here in New Zealand & like you I'm just out of bed. Its the first thing I do every morning too. check into this forum & read everything recently posted while enjoying my brekkie.

You are so right about "filling in the blanks". I have read so many threads here & thought this is my life. I went downhill so quickly in the last 7 months that every day was a struggle & I dont care how qualified or experienced a doctor is, it is still our bodies & we are the best judge of what we are feeling & how things affect us.

Hang in there & good luck with your surgeon visit next week. I will be praying for a positive outcome for you. The light at the end of the tunnel is getting brighter.

Lynda

So sorry to hear that you have had to give up your writing career because of GERD. It is indeed a cruel & heartless illness.

Please stay strong. Your surgery day is fast approaching & you will not believe the difference that your life will take after it is all over.
Will be thinking of you each day wondering how you are feeling & coping.

I see my surgeon tomorrow for my 4 weeks follow up. Cant believe how fast the time has gone. Am so glad I had the surgery & would recommend it to anyone.

take care

Lynda

Had an appointment with my surgeon today for 4 weeks post-op check but because there was to much snow in Christchurch & the driving was treacherous he rang & cancelled. Now he is away for a month overseas so I dont see him again till 29th August. Went to my GP instead. First time I've seen her in 8 months since she referred me to the specialists. What a change in her attitude. She was very sympathetic about my ordeal. (so she should be after mucking me around for years). She even apologized for not picking up on my problems sooner.

Anyway am healing well. Not allowed back at work for another 2 weeks yet but I guess I can cope that. Can start to add a bit more texture to my food as long as I continue to chew it well.

So Im happy to report a very positive outcome.

I hope you are all doing well.

Lynda

Lynda

I am glad to hear you are doing so well and also to know it does snow somewhere else other than in Minnesota. 

Thank you  for posting your progress as I know it will be of great comfort to members who may be facing surgery and are worried about post op recovery.  It is nice to know that you have perservered and advocated for yourself. I admire your courage and determination.

Gentle Healing Hugs,

Kitt

I'm one month s/p Nissen Fundoplication, hernia repair, and inserted 2 inch esophagus tube. I get so sick when I try to eat anything, pudding applesauce, ice cream, water, ect. my doctor wants me to wait a little longer before he scopes me. I should add that I had my chest tube/drain removed one week ago today. I just need some help, can anyone help me with some ideas. My doctor has give meds to help with nausia but not doing much. Is all this normal? Has anyone else had this problem. I'm worried I'm going to dehydrate.

Thanks for your quick response Bill. The tube was inserted for length. I'm told the procedure went well, but couldn't prove it by me. Guess I'm just a little discouraged with the eating problems. It almost feels like spasms, then I start to gag. Maybe I should just keep pushing myself a little more, and wait it out.

Thanks MessieBessie

Aw, did you eat too much? Feel better soon.

Joy - Thank you. Took some pain meds & slept for 4 hours. Pain was scary because it wasn't like anything I've felt before. It wasn't at the wrap site but along the left side where they repaired the twisted bowel. Feeling better now but still a bit queasy. Have eaten a popsicle & will try some soup a little later.

Thinking back I remember it took a long time before I was able to tolerate eggs after I had my gallbladder removed 26 years ago so maybe it is the case this time as well. Will just have to put eggs on the 'not yet' foods list along with steak & bread.

messiebessie - welcome. Im sorry, didnt mean to ignore your post, was just a little pre-occupied with my own drama this morning.

Im not familiar with having your esophagus extended so cant offer any advice but would agree with Bill. Avoid ice cold/hot drinks. Eat small amounts often & try not to stress about it. Your insides have a lot of healing to do & unfortunately its something that can't be rushed.

Maybe if you would like to start your own thread you will find that there are many knowledgeable, caring, supportive people in this forum who may have the answers you are looking for.

Bill - I hope you are doing ok. I've been following your story & it seems that you certainly are having a rough time of it. I wish you well & hope it's not too long before you find relief.

Take care everyone

Lynda

I just had nissen fundoplication on July 29th.  I have had surgery before, but must say I have never experienced what I went through with this surgery.  From the moment I woke up in surgery, my shoulders/back/neck were in severe spasms.  I have a pretty high pain threshhold, but this was unbelievable.  I got no relief for the spasms other than an occasional pain shot, which did absolutely nothing.  I kept asking the nurses to please help me, and they kept saying that the position I was in most likely aggravated a pre-existing muscle problem.  I suffered through this for over 18 hours before the spasms finally began to subside.  I was then released.  The tenderness from the actually surgery really not a big deal compared to the tenderness of all of my muscles due to the constant spasms.  The Dr. prescribed hydrocodone for me to take, and of course nothing but clear liquids until my first follow-up appt., which is still several days ahead.  I called the Dr.s office yesterday, because the hydrocodone was making me have severe pain in my stomach with only being able to have clear liquids.  Plus, the medication was also giving me the side effect of a horrible headache.  The Dr.s medical nurse called me back to say "not to worry because the Dr. said the muscle spasms are very common after this surgery and to just keep taking your medication".  I was furious!  Why weren't the muscle spasms explained to me prior to surgery so I would at least know that it was not uncommon?  Why didn't the nurses in the hospital seem to know that was what was going on instead of telling me I needed to go see an orthopedic after I was well enough to make an appointment?  And why for God's sake would the Dr. tell me to keep taking the medication that I had specifically called in to say was a problem?  I'm at home on my 5th day from surgery and enduring the spasms on occassion, but NOT taking the medication for the reasons I've previously explained.  My follow-up is next Monday, August 8th.  Can anyone recommend any help for the spasms?  I've done icy/hot, ice/heating pads, but nothing is touching it.  I'm so dissappointed in the way this surgery has gone and what I've been put through with no warning ahead of time.  I do of course have the severe gas, which the Dr. explained would go away soon after surgery.  From what I'm reading on this site, I may now always be enduring the severe gas issue.   I'm not one for a lot of crying, but I can tell you I'm just about in tears.  I'm sorry for the downer of a post, but I'm really in a bad place right now.  To think, this surgeon has one of the top reputations in this city (Houston).  He may have done a excellent surgery, but he could definatly improve in the education of his patience.  The only thing I got before surgery from him was a pamphlet explaining how the surgery is done.  None of the after effects.  And I stupidly thought there was nothing more I needed to know.   

Hello. Hope you are all recovering well.

A quick update. Saw my Doc today & she has cleared me to return to work on Monday. Just for half days to start with on light duties. No lifting, bending or repetitive movements & she will get my surgeon to review it in 2 weeks when he returns from overseas.

Mental I'm ready. Have become a little brain dead over the past 5 1/2 weeks but unsure how the body will handle things. Time will tell. Anyway I have the weekend to prepare.

Wish me luck.........

Lynda