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Any tell-tale signs that my wrap is still in place?

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Posted 6/6/2012 3:10 PM (GMT 0)
I lifted weights for the first time in almost a year.  I used to lift regularly and could lift quite a lot.  This time I lifted 10 lbs per dumbbell and went through my whole routine.  It felt awesome. 

I was also eating very poorly for a few days, and biking a lot.

But now I feel that the lung-Suffocating reflux is back.  There is also slight pain at the surgery site.   Worried that I pulled something over a week ago (or possibly when lifting weights?) I would like to know if there is a tell-tale sign that the surgery is still holding, like that feeling in the throat when you drink water (you know the one....that *rrrrrrrRRR* sound/feeling)

I also feel a bit nauseous.

Please let me know.

Posted 6/6/2012 4:34 PM (GMT 0)
The weird feeling/sound in the throat is definitely not a tell-tale sign of a wrap problem. I get that regularly and my wrap seems to be doing just fine. Reflux could be, but remember, our wraps were not made to prevent ALL reflux, that's impossible. If the surgeon made it that tight, we wouldn't be able to eat. The wrap is designed to just make you like a normal person. My surgeon told me, if you overeat garbage food, you definitely could get some reflux, just like anyone else.
Posted 6/8/2012 11:02 AM (GMT 0)
If you are gettin the gurgling after drinking something it sounds to me like it's still intact. It may be irritated though. I would go slow introducing weights back in. Maybe do half a normal routine for a while, kind of like starting out with PT. Then gradually add more reps and slowly add more weight. Might have to lessen the reps and such as you add weight just to be safe and let your body re-adjust to your old routine slowly.
Remember the scar tissue will need to be stretched and worked slowly to avoid any unnecessary pains. I believe if you go slow and methodical you should be able to get back to where you were in the past.

Take care,
Bill
Posted 6/11/2012 2:25 PM (GMT 0)
Well, I just had an Upper GI series (barium swallow x-ray). Right when I laid down, there was what appeared to be a small amount of reflux in my esophagus, however the doctor said it may have been some of the barium that hadn't made it into my stomach before I was laid flat.

We did it again after I drank some water, and waited for it to go down my stomach, and then there was nothing. The doctor said that it looked like the wrap was intact. He had me bear down for an extended period of time and everything, and nothing came back up.

He also said there was a chance that I just felt reflux very strongly even when there was a little. I am really hoping that what we saw in my esophagus on the x-ray screen was just stuff that hadn't made it down into my stomach.

Thoughts? I'm 7 months out from surgery.
Posted 6/11/2012 5:29 PM (GMT 0)
Also, could sinus congestion mimic reflux? I get that lung-suffocating what-feels-like-reflux, but I'm wondering if this feeling could be very exacerbated by my nasal congestion.
Posted 6/11/2012 5:46 PM (GMT 0)
Hi Dave,

When I had my barium swallow post-Nissen I had a small amount of barium that didn't make it past the wrap.  Apparently it traveled up and down the esophagus driven by escaping air from the stomach.  My GI doc said that result was a first for him.  Bottom line, my wrap was tight...so tight that not everything gets through immediately. I find liquids are most likely to be held up and take some time to drain through.

Some of us have very sensitive upper GI tracts, and you could be very sensitive to any little reflux (and there will be some post-Nissen...the wrap can't be so tight as to not allow swallowing) that might get by, or food/liquid/medication that is help up at the wrap site.

Try to relax.  You're still healing. 

I'm not a weight lifter, but I understand the pull toward getting back to your routines.  I know surgeons tell people that they can get back at it right away, but I wonder if it would be better to go slow on that until the year mark.  Just back it off a few notches until everything gets a chance to adjust to its new configuration. 

I don't know.  It just seems that lifters around here seem to get into trouble when they go all out too soon.  I hate to even mention this, but it might be prudent to avoid ever lifting extremely heavy weights once a person has gotten wrapped. 

That said, I'm just speaking from an observer's point of view, and since my younger son lives and breathes weight lifting, I do understand what a sacrifice that would be.

You're still healing.  You're going to get discomfort sometimes.  It's likely that everything is fine.

Hang in there,

Denise

Posted 6/11/2012 5:56 PM (GMT 0)
Denise, thank you very much for responding. By "extremely heavy", do you mean like 300 lbs? Or like 100 lbs? I highly doubt I would lift more than 250 lbs ever again. Does that sound less than the "extremely heavy" lifting you're referring to?

What do you think about for the next six months me lifting about 20 - 40 lbs? Does that sound like way too much?

The reason I ask is because I highly value your thoughts.
Posted 6/12/2012 7:45 PM (GMT 0)
Anyone want to "weigh" in?
Posted 6/12/2012 8:20 PM (GMT 0)
Hi Dave,

I can see why you're looking for guidance here.  There's not much at all online except for forums like these.  I did find one source that followed the success and failure of Nissens and this was a quote that stands out:

"Other diaphragmatic stressors occurring later after surgery are more difficult to predict and prevent, and are subject to recall bias. In one patient, the sport of weight-lifting was temporally related to the occurrence of two episodes of intrathoracic migration of the fundoplication. At the time of the first reoperation, one of the 0-gauge braided polyester sutures had broken, allowing herniation of the wrap through the hiatus. It is difficult to predict the type of stress placed on the diaphragm with heavy weight-lifting, and it may be wise to advise patients who have undergone LARS to avoid these types of activities. In a second patient, wrap herniation and disruption developed after a high-speed motor vehicle accident that also caused a pulmonary contusion and shoulder separation."

 

Here's a link to the full text of the study:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420811/

Look, this doesn't really answer your question regarding amount of weight.  What consttutes "heavy"?  I don't really have an answer for you.  I guess you could research which types of weigh-lifting activities put the most pressure on the diaphram. 

Wish I was more help!

Good luck,

Denise

Posted 6/12/2012 8:29 PM (GMT 0)
Denise, yes I've read this article a few times. It seems to be one of the very few studies available online regarding weightlifting after the Nissen.

This quote stands out for me:

"The other patient in whom laparoscopic re-repair ultimately failed was a young male weight-lifter in whom acute intrathoracic migration of the wrap developed while he was bench-pressing >300 lb."

He was bench pressing a huge amount of weight. I would only probably get up to 200 lbs, and that would probably be in like a year from now or more. Adding some mass to myself with just lifting 30-40 lbs for the time being I don't think would be a problem for my surgery....... Do you agree?
Posted 6/12/2012 9:56 PM (GMT 0)
Hi Dave,

I agree that reasonable amounts (and 30-40 pounds sound reasonable) of weight should be fine.  As I've said, I have a son who LOVES to lift, and if he were to need this surgery it would be devastating if it meant he couldn't lift.  So believe me, I'm fully aware of what's at stake here.

That said, these were the cards that were dealt you, and if keeping your wrap intact and functioning means that you have to give up the level of weight lifting you've aspired to prior to surgery, then it's a decision you'll have to think long and hard about. 

What I don't understand is the lack of information and support from surgeons.  They seem quite happy to send people back to the gym with little concern over what problems it might cause.  I mean, really, if you just listen to what surgeons have told their patients who post here, it's okay to go back to lifting whatever you like.

I guess it comes down to weighing the alternatives and deciding what works for you and your own lifestyle choices.  It's a risk-benefit ratio that you'll have to consider.

Wish I could be of more help!

Good luck with your decision making and quest for information,

Denise

Posted 6/13/2012 3:37 AM (GMT 0)
The risk-benefit ratio is a big thing I think about all the time.

With anything, there are risks. There are risks when I get in the car in the morning to drive to work. There are risks when I get on a plane. There were risks during my surgery. There are risks everywhere in life, most usually extremely small, but they still exist. Its up to us to weigh these risks to the benefits and make a decision.

This surgery definitely places some restrictions on you for life. We've read the stories here, there will definitely be SOME level of risk when lifting weights or doing any other type of strenuous activity. No one can ever say 100% that any amount of weight lifting will never damage the wrap. The risk does seem to be very small, but it still exists. Those of us that have the surgery will have to decide if the benefit of these activities outweigh these possible risks. If its something you love and not doing it would significantly decrease your quality of life, maybe the risk is worth it.

I am only six months out from surgery, so I'm still deciding exactly where I stand on this risk/benefit balance. And it may take me a while. I don't want to live a life always in fear of undoing my wrap, but also, I want to ensure the wrap holds for decades to come.
Posted 6/13/2012 1:23 PM (GMT 0)
I plan to work my way up to about 200 lbs, possibly 250 lbs in the distant future.

I will work my way up from 30-40 lbs.

I don't lift weights all herky-jerky; I do smooth, controlled movements with plenty of breathing.

And I absolutely won't lift weights on a full stomach.

Like bowecho said, "I don't want to live a life always in fear of undoing my wrap." Absolutely right.

I have my own little "gym" (a mat, a Bowflex Revolution, and many dumbbells which I use way more than the Bowflex Revolution) set up in my home, just waiting for me to use it again.
Posted 6/13/2012 8:58 PM (GMT 0)
Good luck and let us know how you get on as I plan to keep lifting if I get a redo. At present I have dropped the amount I lift by more than 50% and less regular sessions with fewer sets. I do more cardio now than resistance but still enjoy it.
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