Fundoplication in three weeks

Hi all

I have joined today so I can get support from people who have either been through the NLF or who are about to go through it.

First here's the background to me.

about eight years ago I got really bad reflux, so much as one alcoholic drink could cause me agony. I was put on 20mg Omeprazole and have been on it ever since. At the time I had an endoscopy which revealed a small hiatus hernia but not large enough to worry about. Any time off work was going to be an inconvenience so I have controlled this with medication ever since.

Throughout last year I experienced more and more regurgitation - nothing serious, but I could have a coffee and still feel it rising in my throat many minutes later. I went to see my doctor in the September who referred me to a specialist, then I had another endoscopy. The nurse told me I had a wide hernia and wanted me to go for manometry and a pH study.

I went for the manometry (didn't enjoy it one bit, my eyes were watering throughout the whole process) and was told I have around 50% peristalsis when it should be closer to 90%, they asked if I had difficulty swallowing but I said no. The nurse wondered if the reduced peristalsis was caused by the hernia but the consultant who did the surgery would be able to tell. Then the pH test was for 24 hours and it was the worst thing I have experienced - one week with no Omeprazole before the test, then a tube down my nose for 24 hours. When I returned the next day the nurse said I had worn the button out I had to push each time I felt acid - I told them that's because I felt it loads!

So here's the situation now.

I don't get any pain from the hiatus hernia unless I forget to take one Omeprazole or perhaps if I've had a bit too much alcohol to drink, or maybe been a bit erratic with eating. My oesophagus is in good shape, I have told taking the Omeprazole from pretty much the start of the symptoms I have reduced any chance of Barratt's. In three weeks tomorrow I am due to have surgery, I am not sure if it will be a full wrap or partial because of the peristalsis and the surgeon could not tell me that at the time since the manometry was done at another hospital who did not send the results in time for my appointment with the surgeon back in December.

And here's the main bit why I joined this forum.

I'm panicking. I know a NLF is the best thing for me. I know I don't have pain now as it's controlled by medication, but I don't want to be on the medication for life. I know if I don't have the surgery I risk developing Barratt's. I know it all makes sense - but I also know that this is selective surgery so I could pull out at any time.

I have no intention in pulling out of surgery but I'm looking for some reassurance. I know there are nightmare stories out there so please if you know of one of those stories I really am saying 'ignorance is bliss' - I don't need to know. I keep thinking I'll be in hospital - fine, then they'll put a cannula in my hand - okay, bit edgy now knowing what's going to happen, then I'll be wheeled into the operating theatre and it's that bit I'm worried about - the time between the cannula and being knocked out. I don't want a sedative as I want to go home as quickly as I can after the op so I want to be on my feet asap after I come round to start moving some of the gas about they pump into me.

I am fit, not overweight, not a smoker, I cycle to work daily (just under two miles) and today I took an extra two mile diversion on the way home so I've done a block of two miles to work and four miles home. I intend doing this daily up until the day before my op - is this a wise move?

After the op, besides being as mobile as possible without straining myself (since I have been told I won't have nearly as much energy due to reduced intake of food - what are the experiences of this?), are there any particular vitamins I can be taking to improve my recovery?

Thanks for taking the time to read my really lengthy first post, and I appreciate all input you have as I start the beginning of the process to my NLF.

To Stuart2012 and others.
I'm so glad to find this site to share my experience and hear about other people's long term experience after their Nissen Fundoplication procedure. My NF procedure was done May 10th 2011. I suffered for 20 plus years. I never really thought about it. Heartburn was something I lived with. I remember laughing at the early GURD commercials as invented labels for conditions we all live with but now we have a label to sell a medication to treat. My condition evolved into acid reflux which was not as easily treated or ignored. I ate earlier. Six hours wasn't enough. I lifted the end of my bed four inches. Then went on medication for about 6 years. First Prevacid, then a generic version as that became less effective then Nexium. Leg cramps made me investigate Nexium side effects. I'm not sure if the leg cramps were related to the nexium but aggravated arthritis and swollen joints are. I recently heard an ad linking Nexium to osteoporosis. I had broken a toe with a fairly minor bump. I wondered about. I had meniscus surgery and the second knee was going down the same path. I stopped the medication and my knee pain subsided. Not gone but much less. I was first advised by my doctor to change medications but found they all had similar awful side effects. I later saw my Gastroenterologist and another who scolded me and said I must be medicated. The 3rd said you can’t use the medication. You need surgery. I asked about the stories I heard about the surgery. He said that the positive results were diminished by doctors who didn’t know what they were doing. Make sure you have a class A surgeon. Nearly a year later I am happy. I was told I could go back to my old life style. But didn’t need to test the success of the procedure. I was a serious junk food junkie! Lots of cola, chocolate, fast food, pizza. Post surgery during my puréed food period my tastes were recalibrated and those foods were no longer desirable to me. To be honest pizza & chocolate still are tasty but much smaller doses. Part of why we are here is because our food supply is so poisoned. I have grass fed beef now much less acid and a whole different taste then the corn feed we now in our food supply. And I have not had cola since my surgery. I was told that carbonated beverages would make me feel bloated. I probably can but choose not to. I think I am not as tight as I was just after the surgery but still good. I have had heartburn twice in the last month. Three months ago I over ate. Previously I though it wasn’t possible since I felt full so quickly during a meal. I have made dietary changes away from what I suspect were the cause. All and all I am very happy with the results. go ahead with the surgery with confidence. All I have read supports my confidence in long term success but I am still looking ahead with caution.

Hi Stuart,

I had Nissen yesterday and am at home today. I am very surprised by how good I am feeling because I was prepared to be in significant pain today. When I first came out of recovery I had very bad pain in my chest and shoulders. My doctor assured me it was quite normal and was an upshot of the gas during anesthesia. I was on IV pain meds every six hours while at the hospital and came home with a prescription for Hydrocodone elixir. My throat is still a bit sore from the tube down the throat during the operation. I have read about people not being able to burp after Nissen but that has not been an issue for me. I was able to burp immediately. I had five small incisions from the laparascope but they really are not very painful.  I also had a large hiatel hernia repaired. I feel better than I have in years. I realize that everyone's surgery experience is based on their condition, the skill of the surgeon and how well they take care of themselves afterwards. I wish you the best possible outcome and good health in the future!

I did bump up my exercise, concentrating on strengthening my core muscles. However, I was told to discontinue any vitamins, supplements, aspirin and herbs two weeks before surgery.

All the best!

I have had time to properly read the replies as I was rushing out to work earlier but have sat down and looked at them since.

Thanks firstly to everyone who has taken the time to reply. There is some fantastic information, particularly Kitt that is good advice about this surgery being a first. Realistically I didn't get much of a choice on surgeons as I live in the UK and with our NHS system my doc should give me choices but it rarely happens. There was a little bit I missed out - I went to see my doctor back in September who made the referral to the specialist and I was seen in late September, had my endoscopy in October, manometry and pH studies in November and was back for the results on the first day of December.

In the UK we are supposed to have no more than 18 weeks between the initial doctor's appointment and treatment commencing so by January I was annoyed nothing was happening and I kept calling on a weekly basis to be told I was on a waiting list. Eventually I wrote a letter to the specialist's office saying I was concerned about the waiting time and according to NHS guidelines I should be referred to another hospital if they cannot do it, but I made sure I was really nice in the letter saying it's not the specialist I have concerns with as my treatment was great so far (as great as shoving a camera down my throat gets anyway) but the waiting time... then about three weeks after I sent the letter in I get a phone call saying expect a letter with my appointment soon... then the letter lands on my doormat and I suddenly think 'why on earth did I complain, they're going to operate on me now!'

The surgeon seems very busy but this is his area of surgery, and my OH had gallbladder surgery two years ago by the same person as a day surgery case. That solved all of her problems. I spoke to the hospital who say I'm likely to go in during the morning (my time is 8am to arrive on the ward), get ready for surgery, stay in overnight, then stay with them until early evening the next day.

One thing has really eased my mind. I was reading again through the paperwork the hospital gave me, particularly on anaesthetic, and the bit I was dreading was being on the ward, getting on the trolley and they put in the cannula. That time between putting the cannula in and wheeling me into theatre really worried me - I imagine from the size of the hospital it's a five minute journey between the ward and the theatre so I'd be getting anxious knowing what was happening, the cannula would have made it 'real' for me (does that make sense?).

Anyway reading the papers again, I may be able to walk to the theatre or they may insist I am on the trolley. This is the important bit for me - the cannula doesn't go in until I'm at the theatre doors, not on the ward five minutes before. And apparently I will be wheeled into a small room off the theatre where an anaesthetist will do the cannula then inject the anaesthetic in the small room first so I shouldn't even see the theatre.

And tonight on the way home? 4.3 miles in 15 minutes on the bicycle, not bad eh, I want to be fully fighting fit for when the day arrives.

Thanks again for everyone's words, they really mean a lot.

Kewpie1957 said...
Hi Stuart,
I had Nissen yesterday and am at home today. I am very surprised by how good I am feeling because I was prepared to be in significant pain today. When I first came out of recovery I had very bad pain in my chest and shoulders. My doctor assured me it was quite normal and was an upshot of the gas during anesthesia. I was on IV pain meds every six hours while at the hospital and came home with a prescription for Hydrocodone elixir. My throat is still a bit sore from the tube down the throat during the operation. I have read about people not being able to burp after Nissen but that has not been an issue for me. I was able to burp immediately. I had five small incisions from the laparascope but they really are not very painful. I also had a large hiatel hernia repaired. I feel better than I have in years. I realize that everyone's surgery experience is based on their condition, the skill of the surgeon and how well they take care of themselves afterwards. I wish you the best possible outcome and good health in the future!

How are you doing today? Hope you have a great recovery.

Hi Stuart
I too am from the UK and had my surgery on 2 March 2012. Unlike you though I had put off the surgery for many years just going to regular clinic apointments. It eventualy got too much and June 2011 I agreed to surgery. As you can see I have waited an awful long time from June to March for surgery. From September onwards was phoning the Consultants secretary regularly wanting to know when would likely be, to have a bombshell dropped Monday before Christmas that actually they had made a major mess up and not actually put me on the list until 4 August 2011 (in fact this was the date that I had a pre-op done!!!). Well you can imagine the anger and sheer despair I felt.

Fast forward to 2012 and letter arrived mid January telling me surgery was to be Friday 24 February - panic set in!! Week or so later further letter arrived saying I had to have an overnight stay the night before, so arranged to finish work on the Monday before so that I could get the house and things in order. Life loves to through major things in the way and came down with a nasty cold and chest infection that Monday. Came home to a message that the hospital "due to clerical error" had actually given me the wrong date and surgery was to be 2 March with overnight stay on 1 March, God was obviously looking after me as they wouldn't have done surgery that week when I was so unwell.

This on top of other things that happened as you can imagine made me start to seriously question what I was doing! My children, who are my rocks, made me realise that not going through with the surgery would be entirely the wrong decision as I had no quality of life whatsoever.

As for the cannula, I was taken through to the operating ante room on my hospital bed and this is where they put it in whilst talking and trying to distract me. The aneasthetist came to see me on the ward to explain what would happen. Try not to worry too much about when they put the cannula in, I know thats easier said than done but just think that it's the means to bringing an end to the awful symptons you have. I stayed in hospital for two nights and was glad to come home and get into my own bed.

If it wasn't for this forum and the many knowledgeable people on here, then I think that I would have been really worried reading all the horror stories on the internet. Having been following for many months I felt in the right place with th right sort of knowledge of the recovery that the surgeons in the UK do not seem to give us. Also the eating regime was not really explained to me but again the most wonderful people here have given me their help through their posts.

Regards
Eileen

Hi Stuart,

Don't stress too much over the surgery and hospital stay.  I think you're likely to find it much easier that you're expecting.  At least that was my experience.

It's great that you're going into the surgery very fit.  I agree that it will help your recovery.  Honestly, maybe someone around here will remember the name of the member, but when I first started at the forum, there was a member who'd been wrapped fairly recently and was back biking miles at a time at somewhere around two weeks.  I told him he was my hero.

That said, you should run any post-op exercise questions you have by your surgeon.  Don't make any of those decisions without the advice of your doc, since you won't want to do anything to harm your wrap.

Best wishes!

Denise

Good Evening, I have been on Nexium for the past 17-18 years. I have been dealing with the spasms and feeling everything I eat and drink gets stuck in my throat for the past 2 months. I don't sleep well for this reason. I had a EDG & Bravo done and went for the results yesterday. I do not have any tumors or precancer. The Dr suggest I have a manometry done, I informed him that I know that I cannot handle that being done, so I will have a Upper GI in the next few days. I have a trip planned in April, my co-worker will be on vacation the 2nd week of May, therefore I am looking at having it done the middle of May. I am glad that I found this site to read positive and encouraging comments. I am a little scared.
Thanks

alohilani said...
Good Evening, I have been on Nexium for the past 17-18 years. I have been dealing with the spasms and feeling everything I eat and drink gets stuck in my throat for the past 2 months. I don't sleep well for this reason. I had a EDG & Bravo done and went for the results yesterday. I do not have any tumors or precancer. The Dr suggest I have a manometry done, I informed him that I know that I cannot handle that being done, so I will have a Upper GI in the next few days. I have a trip planned in April, my co-worker will be on vacation the 2nd week of May, therefore I am looking at having it done the middle of May. I am glad that I found this site to read positive and encouraging comments. I am a little scared.
Thanks

Hi and welcome, I am very new to this site as well and when the letter came through confirming my hospital date I was really nervous. Work has been going really badly for me recently, lots of changes and it has even brought me to tears this week several times until I told my boss enough is enough and they need to stop messing me about. To cut a long story short, in a funny way that has been very good at keeping my mind off the surgery. I got the phone call earlier this week saying my surgeon has to bring my slot forward to next Tuesday and even that didn't play on my mind because I was stressing about work.

My manometry was not pleasant at all, but no worse than the endoscopy (I assume you have had one of these?) I just zoned out, it made me wretch a little bit but in exactly the same way as the endoscopy did. What do you think is stopping you handling it?

quick note as feeling bit rough, went for surgery 1130 this morning, in a couple of hrs, is now 330 uk time and went well. got toupet. will post more when up to it.

Stuart glad you are able to post a quick note. Hope you are Ok and everything went well. You are now on the road to recovery and a better quality of life. I am now just over 4 weeks post op and other than a couple of episodes not doing too bad. I too had a partial wrap but mine was a 180 anterior wrap due to motility issues

Take care
Eileen

Hi Stuart!

Welcome to the Healing Well Wrapped Club!  Glad your surgery went well, and you're now on the other side and getting ready to heal and go on with your much-improved quality of life.

You are very fortunate to have the NHS.  It breaks my heart when people post their severe GERD issues without insurance. 

I'll look forward to hearing your home and tucked in on the couch, ready to relax and heal.

Happy healing!

Denise