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what questions should I ask the surgeon at nissen consultation

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Posted 9/22/2011 3:28 PM (GMT 0)
Hello all!

I bumped into this forum yesterday and it was so helpful to me that I decided to sign up and post.

A little bit about me: I am a 25-year-old female. I've been dealing with acid reflux for about six years now, though I was just officially diagnoed by a gastroenterologist this May. I've been on five different medications and nothing has helped me; the symptoms keep getting worse, and I feel like my quality of life has really been affected.

When the last PPI didn't work, my gastroenterologist referred me to a surgeon for nissen fundoplication. I will see the surgeon next week, and I just wanted to know, does anyone have any recommendations for what I should ask him? The most important questions? Maybe what you wished you would have asked, or what you were really glad you asked, before you had the surgery?

I'm feeling good about the prospect of surgery because I feel like it's the only thing that can really improve my life, but I'm just worried mostly about the aftercare, making sure I take care of myself and mend the best way possible so that I can resume a (semi) "normal" life.

Any advice would be most appreciated! Thank you!

Alison

Posted 9/23/2011 1:04 AM (GMT 0)
alison-
I would ask how many he has done and how many were successful and didn't need a redo. Also I would ask what kind if diet he recommends and for how long. Sounds weird, but I would also ask which way he does the surgery. Through the belly or through the chest. Also if he expects to just use the scopes or an open procedure.
i just had an open redo and 'the recovery hasn't been to bad.

Take care,
Bill
Posted 9/23/2011 2:07 AM (GMT 0)
Hi Alison,

I'm glad you've joined us!  Welcome to the Healing Well forum!  I would add to Bill's fine list, what tests the surgeon intends to do on you.  He should want you to have a recent 24hr PH, manometry, endoscopy, and possibly stomach emptying.  These tests will ensure that he knows what type of wrap to do, and even if a wrap is the right solution for your problems.

In my experience it doesn't seem that surgeons really know what to expect with recovery to any significant degree.  Most people come to the forum with no idea how long or difficult a recovery to expect.  Some don't even realize they won't go back to normal eating in a couple weeks.

I would think it would be valuable to ask your surgeon what you should expect your recovery to be like.  How long will you be out of work, when you will begin to eat "normal" foods (my surgeon had me choosing my own foods by 5 days...I could eat anything that could be chewed to a liquid).  What are the lifting restrictions?  Does he do a tight or loose wrap...how does he decide?  Will you be able to burp and vomit after surgery?  Will you be able to take pills?  When?  How long will you be in the hospital? 

There's a start...

I'm sure others will be by to add to the list!

Good luck!

Denise

 

Posted 9/26/2011 2:03 PM (GMT 0)
Hey Alison,

I'm really interested to hear what your surgeon has/had to say about your situation. I'm 25 and just got the results of my EGD back stating I have Barrett's Esophagus. The GI doctor mentioned a Nissen as a possibility, but wants me to wait a year for my next EGD before going that route and just keep taking my Dexilant every day. My life has taken a turn for the worse and constant throat pain/reflux and being on this medication that alters my mood is reaching near-unbearable levels.

Anyways, just wanted to let you know you're not the only person your age dealing with this stuff :)

Matt
Posted 9/26/2011 2:49 PM (GMT 0)
Hey Allison,

My doctor is totally against this procedure. He mentioned it to me about 30 years ago and again, just recently. He says that the majority of patients he's seen that have had this surgery (performed by another gastro doc), had to have it redone in a few years..... and then another surgery to correct the first surgery. I too have been dealing with this for years and am tired of taking meds on top of meds, etc. I wish you all the luck.
Posted 9/26/2011 3:14 PM (GMT 0)
Cassie-
Welcome to Healingwell!
The success of this surgery depends on several factors. Not everyone is a good candidate for the Nissen. If the tests show the person is a good candidate you then need a very good surgeon who has many successful nissens already done. By many I mean at least 100 or so with no issues. I made the mistake of not asking how many successful nissens my first surgeon had done and ended up with an incorrectly done nissen. Had it redone almost 3 years later by a surgeon who pretty much only does nissens or esophagus surgeries and had what I would call a perfect wrap. It was unfortunately destroyed when they fixed a tear from and EGD in my esophagus on March 1st '11. I had my 3rd done on Aug. 24th and am doing quite well as far as the wrap goes. Have more pain than the first 2, but this one was done open vs. Lap. Also had tons of scar tissue he had to deal with this time.

I've heard of some people having their nissens last 16 to 20 years. Sure they may be the exception, but on average I believe it's about 10 years and may be better now that they have figured out that most can be done lap.

I think I read your statement right that your GI doc is basing his advice from one surgeon only? If so maybe this surgery just isn't his cup of tea?

Take care,
Bill
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