Nissen Fundo recovery/nausea

My name is Sean, im new this but I had no other option but to have nissen op as I was suffering badly for 18mths from acid reflux, had an awful pain at bottom of my throat and my voice was going from the acid, well I had op 2 weeks ago now and I have an very upset stomach, cant eat much at moment very bloated and suffering badly with nausea, only have had a little acid attack nothing major, but im so scared at moment with this nausea its like a battle  for me now to get yoghurt down, not to do with been able to swallow but from nausea, feel very sick is this normal, need help please if any1 is out there or has experienced the same thing as me this liquid diet is killing me

Regards

Sean

Welcome to Healing Well!  Actually, I should welcome you to our Wrapped Club! There are quite a few wrapped members here, so you should be getting lots of helpful posts soon.

First, I want to tell you that at your stage of recovery, you have reached peak swelling of your new wrap and hernia repair.  Remember, while you only have little incisions on the outside, your inside has undergone major surgery, and will take much longer to heal.

Just think...that poor stomach of yours has been stretched and wrapped, and stitched.  No wonder it's nauseous!  At this point, the swelling is at its most extreme, and will soon begin to resolve.

My surgeon told me early on that my swallowing would get worse before it got better, and warned me of the two week mark peak swelling.  It always amazes me (as seen on posts here at the forum) how little surgeons prepare their patients for what to expect.

Did you get a prescription for anti-nausea drugs?  If not, you should call tomorrow and get a script.  While your nausea isn't likely to cause you to vomit, you may pick up a bug (I recently had one that went through everyone--and I mean everyone--in my family), and won't want to vomit.  It could damage your wrap.  If your nausea is bad enough, call whoever is on call today and get them to call in a script for you.  Most here use these three:  Compazine (suppositories are best as they bypass the stomach), Zofran, and Phenegran.

The esophagus is a "dumb organ" and interprets all pain as reflux.  I'm sure it's feeling plenty of pain at this point, so it's likely that your reflux sensation is just post-surgical pain.

Also, my surgeon assured me that "anything is possible" during the healing period, and I could, indeed have a bit of acid refluxing into my esophagus.  The wrap is swollen and misshapen, and could allow a bit through.  That's why many stay on PPIs until the healing has had a head start.  Acid is hard on the healing wrap, so they prefer that their patients don't challenge it in that way.

If you're having trouble with yogurt, stick with a liquid diet for a couple of days.  You can manage the yogurt if you just take tiny amounts over a long time.  Follow with some sips of water, so that your esophagus continues to push it through.  No ice water, though.  Cold beverages can cause spasms.  Try some warm weak tea, or even warm water.  It'll work better.

Stick around and ask questions.  Here is a link to the posts I wrote during my first 19 days post-op.  They might at least give you an idea of how your recovery compares.  That said, everyone is different, so don't expect things to be just the same.

https://www.healingwell.com/community/default.aspx?f=45&m=2183443

Best wishes!  Hang in there...things will improve over time.  If you can surrender to your recovery, and follow it where it takes you, you will have a much easier recovery.  Those who struggle against what is, have a lot more trouble dealing with the recovery process. 

Go with the flow...you can't change it, so if you can accept what comes, you'll do much better.  There are many here who can help you understand the process and give you hope that things will improve over time.  Don't worry!  What you're going through is very normal.

Denise

PS...Kitt, how funny!  We must have been posting at the same time!

I responded to your other post regarding post-op diet suggestions.  I posted a couple more good resources you should be able to link to.

As far as the bra issue goes, you'll likely need to find some sort of bra-top that doesn't have the strong elastic pulling on your incisions.  I guess I can only suggest that you wear clothes that don't make your braless condition obvious!  Most find a need to wear pants with elastic as well, during the early recovery. 

As you progress, your incisions will heal, your bloating will subside, and you'll be able to go back to your old clothing.

Weight loss is always an issue with this surgery.  I lost 14 pounds post-op, but have gained it back.  Some drink liquid supplements like Ensure to help supplement the reduced amount of food that the stomach can tolerate.  If you sip on it throughout the day, you should be able to get quite a few more calories into you.

Good luck!

Denise

Sorry to hear you're still struggling with nausea.  Did you mean that your stomach felt better over Christmas and you ate a lot more?  If so, that would explain why your stomach is rebelling right now.  12 weeks is still in the early stages of recovery, and when you overdo it even a bit, you can pay with some nausea or pain. 

This recovery takes 6 months for the the majority of the healing and a full year for the rest.  At three months you're getting there, but since you had such a difficult start, you were probably set back a bit with your healing.

Be sure to baby your stomach right now.  You may have to go backward a bit with your eating until it calms down.  As far as diarrhea goes...you may be reacting to the duphalac.  Also, when your stomach is irritated you could get diarrhea from that as well...there is something called dumping.  You would know that's your issue if you hear gurgling in your stomach after you eat and at some point after have diarrhea.  It's hard to say since you're on medication to loosen your stools.

Look, don't give the diarrhea a thought. It'll settle down once you're off the duphlac.  The nausea is your stomach saying it's irritated and not happy with things.  It's not something to be worried about...just something to be lived with until you heal further.

Take it easy with what you put in your stomach for a while.  Keep thngs smooth and bland, until your stomach feels better.  Good job with the chewing meat!  Your wrap is obviously ready to handle regular foods when chewed well.  Now you just have to baby your stomach into being more comfortable.

Did your doctor ever mention Carafate Suspension?  It's a medication that coats your stomach.  I'm not sure whether it would help with nausea, but it coats your wrap and stomach and protects it from acid.  The coating lasts up to 6 hours. It's very expensive, so you'd only want to get it if you have good insurance.  There's a generic pill version that is called Sucrafate, but if you can get the suspension it's the best.  I'm sure the Sucrafate might work as well, especially since your main problem is within your stomach.  You'd probably have to melt it in a little medicine cup of water and drink it down to get it past the wrap.  It's pretty big.Are you still on PPIs?  They might calm your stomach down as well.

Hang in there...everyone is different, and there are definitely those who struggle with nausea during the recovery.

Glad you stopped by.  Stick around!

Denise

Post Edited (dencha) : 12/28/2011 7:17:20 AM (GMT-7)

You'll  have some ups and downs as you go through your recovery.  Hang in there...in time your stomach will adjust to the changes, healing will occur, and you'll be in business again!

I'm concerned about your "trying to vomit" comment.  I want to reiterate that retching can be very harmful to your healing wrap.  Do you have any anti-nausea medication?

You should do everything you can to avoid vomiting or retching.  Nausea is one thing...you'll just need to baby your stomach and (as you are doing) try to identify triggers.  (Just remember what your stomach has gone through!  Poor little stomach!) Just don't retch and vomit.

I'm glad to hear that there are lots of good things going on with your recovery.  In time the nausea will resolve.

Best wishes!

Denise

Appreciate your reply. Not doing very well at all. 

For six weeks, you sound like you might be pushing the food.  Two yogurts is quite a large quantity of food for one sitting.  Curried rice is pretty spicy, when you're having stomach issues.  A waffle and a half is a lot for one sitting at your stage of recovery.

I suggest you try to keep your food pretty bland at this point.  If your stomach is reacting to what you're eating, you need to slow it down.  While everyone is different, I think you're probably pushing quantities, considering you are having nausea issues.  Try smaller amounts and more frequent meals.  Stay away from curry for a while.

Check out the document at this URL for food ideas:

http://surgery.med.umich.edu/thoracic/clinical/procedures/MushyDiet-Nissen.pdf

Hang in there.  As healing continues, things will improve.

Denise

I'm glad to hear you had a good visit with your surgeon.  That said, you're having far too much of a struggle with your constipation issue. 

Wow.  I'm curious.  Did you tend to have these problems before surgery?  I know when you're taking narcotic pain meds it slows the bowels down, but generally once you're off them, things improve.

I do know that you can become dependent on laxatives.  Have you discussed this issue thoroughly with your GI doctor?  I expect you have--especially after your hospitalization.

It is true that when you reduce your intake of food and beverages constipation will follow until your body adjusts to the change.  It happens to me whenever I slow way down on eating.

Liquids are a critical part of getting things moving...I'm sure you've heard that. I'll bet while you were in the hospital they were pumping you full of them.

Your dad may be on to something.  If the oral meds have really given you problems, it might make sense to take another route.  I wouldn't do it without discussing it with your doctor, though.  You might also want to ask about the risk or laxative dependency and how that resolves.

Hopefully things will settle down for you soon.  Push those fluids!

Best wishes,

Denise

First, the 12 week number isn't really correct.  It takes a full 6 months for most of the healing and a year for the rest.  I found certain issues resolved sometime in the second year. 

 Your recovery requires patience and surrendering to the process.  You can't hurry the healing...it'll happen in its own sweet time.  It takes time for your upper GI tract to adjust to the changes that have been made. 

Think about that poor stomach of yours...stretched, wrapped, and stitched.  It's not an easy adjustment.  You'll heal on the outside long before your insides are healed. 

Hang in there, it will get better.  Gradually things will improve.  You won't have to wait until 6 months for ALL the healing...as you move toward that point things will improve month to month.

Take care,

Denise