Post Nissen Tongue Dry/Burn and Throat Burn

Hi Mike,

Welcome to the Healing Well Wrapped Club! Were those symptoms you had before the surgery, or are they new ones?  At two weeks out, you're in the thick of healing, and can have many discomforts in your upper GI tract. 

Keep in mind that your wrap has become increasingly swollen over these past two weeks, and is nearing peak swelling.  It's very possible that what you're experiencing is related to that.  You could be having food and/or medications held up at the wrap site that is irritating your esophagus.  It can mimic reflux, and cause irritation.

Once the swelling begins to go down you'll find things begin to get easier and more comfortable. 

Also, if you have symptoms that led you to the surgery, you'll have to wait longer than two weeks to experience relief.  Your upper GI tract has been put through a lot.  It has been revised, and accosted by surgical tools.  It takes time to heal those inflamed tissues, but give them time.  I had lung problems that were brought on by reflux, and it took a full two and a half months for them to begin to show improvement.  I've heard of people taking even longer than that to heal problems created by reflux.

Hang in there...try to surrender to your recovery and follow it where it takes you.  If you can go with the flow and relax into your healing, it will be much easier for you.  You can't rush it, so don' try.

I don't know if you've seen it already, but if not, here is my early recovery journal:

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

Again, glad you've joined us!

I'm sure others will be by to weigh in on the subject. 

Happy healing!

Denise

Hi Mike,

I don't think I've heard of it after surgery, but certainly before surgery.  Still, everyone is different, and everyone's recovery is different.

Don't jump to any conclusions this soon after your surgery.  This recovery takes at least 6 months for the majority of the healing, and a full year for the rest.  I found improvements even into the second year.

The hoarseness I had prior to surgery (that is exacerbated by allergy issues) has taken over 3 years to improve.  This is a long-term process.

Just take it a day at at time.  Try to follow your recovery's lead, and go with the flow.  If you're worried about your tongue issue, why not find a top-notch ENT in your area and see if you can get an appointment.  See if your PCP can recommend someone.  That way you might be able to get enough information to allow you to relax into your recovery. 

I know how hard it is to have bothersome symptoms that don't resolve right away after surgery.  There's always the fear that you had the procedure for nothing, or as you said, have created new symptoms.

Still, at your stage of recovery, I can GUARANTEE that you've created new symptoms.  This is a challenging time in a challeging recovery, and I'm certain you've got lots of discomforts and pains.  It's natural in the early weeks.  Many at your stage of recovery think that they've made a mistake and should never have gotten the surgery.

This too, will pass.  Relax, and let your body do its work.  You'll get better, but it'll take time and patience.

Very best wishes,

Denise

Mike,

Of course, I'll do whatever I can to answer questions.  This forum has many very experienced members, so I'm sure if you continue to post, you'll receive lots of support and information.

I'll be interested in hearing what you find out from your ENT visit.

Happy healing!  Hang in there...you're in the roughest part of recovery. 

It gets better from here!

Best wishes,

Denise

Hi Mike,

At your stage of recovery, you're not in a position to declare your surgery a failure.  Odds are that your wrap is swollen, and therefore tighter than it was meant to be.  Food is being held back and is irritating your esophagus and mimicing reflux.  Keep in mind that your esophagus is a "dumb organ", and interprets all pain as reflux.

Things will improve as you heal...patience.

Give the Diflucan a little more time.  It may take more than a few days to clear things up,if fungus is the culpret.  I've had thrush (fungal infection) and took a liquid mouth rinse version of Diflucan. 

Glad to hear you're getting some testing and will see your surgeon.  There is no reason you should be worrying without getting information about what's going on from your medical providers.

Be sure to post how the tests and appointments go.

Good luck!

Denise

Hi Mike,

At Day 18, pretty much anything is possible.  When we say that the peak swelling is on or about Day 14, that's with the idea that an individual could peak before or after that time.  It's just a rule of thumb.

My guess is that swelling is still a factor in what's going on.  As you know, I'm not a doctor, and don't pretend to be.  Still, having experienced the recovery myself as well as working here on the forum for the past 3 and a half years, I've learned a lot.  It's very common for swelling to create swallowing problems.

Also, you are very right in your assumption that food, medication, and liquid that is held back by the swollen wrap can mimic reflux perfectly.  I'd guess that you've got quite a lot of irritation going on right now, and yes, I think it could create the symptoms you're experiencing.

Everyone's recovery shares certain similarities, but there are also unique reactions that aren't shared by all post-Nissen patients.   Keep in mind that surgeons don't generally recommend introducing bread and steak into the diet until about 8 weeks.  This is precicely because of the swelling that is to be expected.

Swelling is also the culprit that creates most bloating issues.  That's why it resolves over time as the swelling reduces.

Hang in there...this will improve over time.  There is always a chance that the wrap is too tight, but at Day 18 it's way too soon to determine that fact.  The odds are in favor that the swelling is the problem.

Be sure to take your medications carefully...crush and mix with food, and follow with lots of sips of water.  Medications can be especially irritating.  If you're still on liquids and soft foods take smaller sips and bites, and try sipping some water in between meals to keep the swallowing motion going.

Try not to panic.  This should start subsiding soon.  Just be thankful that what you're experiencing isn't that nasty reflux you had the surgery to prevent!  A tight wrap can be a very good thing.  Here's hoping you feel better very soon!

Best wishes,

Denise

Denise,

As always, thanks for the reply and info. I see my surgeon today to discuss the results of the Upper GI. I know I'm being impatient with this process; it's just very difficult right now, as you are well aware. Not too mention the thrush I'm dealing with. I hope that goes away too. I talked to my Primary Care and she said it could take some time for the thrush to go away. I just took pill number 6 and really don't see much improvement yet. That said, still 8 more pills to go . I'm on the 100mg of diflucan for 14 days...sound about right?

Drtinsac,

Thanks for the info. re: the diflucan and yeast. I'm impatient when it comes to medicine and expect results within a few days of taking it. Sounds like this thrush stuff just takes some time to get rid of. If I may ask, what dose of diflucan did your ENT put you on? Is the 100mg? That seems to be the standard.

Thanks,

Mike

Denise,

Thanks for the reply. I will definitely let you know what the surgeon has to say regarding the Upper GI test. If I can help others here that's great and is why I continue to post .

By the way, it just dawned on me last night that it could be my 12 year old retainer that caused the thrush; especially in my weakened state post surgery. To that end, I have stopped wearing it while I am on the diflucan.

I'll post later today on the results of my surgeon appointment!!

Thanks Denise!!

Mike

Denise,

So here is what my surgeon said:

According to the results of the Upper GI, he considers it a "perfect" Nissen
He said the tightness, at this juncture, is a good thing and he would actually be worried if everything was passing straight through
The report showed no reflux

He also prescribed Nystatin (swish and swallow anti-fungal), which I will take in combination with the Diflucan, to rid the thrush.

I feel tremendously better. He said the swelling will subside as will the difficulty swallowing.

He also stated that the esophagus is a "dumb" organ. To that end, now that it feels something "tight" restricting it (i.e. the wrap), it's not sure how to proceed, thus the difficulty swallowing. He also stated that he could provide me with something to "assist" the esophagus with swallowing, thought, at this juncture, doesn't think that is necessary. He said he typically only uses that option if someone literally can't swallow or is regurgitating the majority of things they try to swallow.

The only thing now is to rid my mouth of this thrush and I can continue on the road to recovery.

As always, thank you for all of your responses and information. Greatly appreciated and tremendously helpful.

I will continue to post as I progress and receive feedback from my Dr.'s.

Thanks,

Mike

Denise,

Just wanted to let you know, and hopefully we can share with others too, the barium liquid that I swallowed got "stuck" in the esophagus asa well; it's not just food that gets stuck due to swelling, it can be liquids as well, which, as you know, can cause irritation.

I'm guessing that's why I still have similar symptoms as I did pre-op. I still have the cool menthol feeling in my throat/mouth. Did you ever have that? If so, did that eventually get better for you? If not, have you heard of it. Often times when I breathe in still I feel like I have a shortness of breath. Kind of feels like when your throat/lungs feel when you run outside in the cold weather. Make sense?

Let me know if you've heard of or had the above symptoms and if the barium/liquids getting stuck is common due to the tight wrap. I literally watched the barium linger in my esophagus and very slowly go into my stomach.

Mike

Hi Denise,

So, an update, I went to an ENT today to get his opinion on my throat. He said, it's not thrush and is just part of life. I thought what on earth? how did two other doctors tell me it was thrush and you just dismiss it as normal and "part of life". Anyhow, rather discouraging to say the least. I'm going to continue my course of diflucan and nystatin as my tongue is still dry, burning, and white. He said, if it were thrush the diflucan would have worked within 3 days. That's contrary to the research I've done and what my GI doc told me; both said it could be 7-14 days to cure thrush.

Also, I'm getting chest pain, behind the breast bone, right in the middle. Is that common?

Also, and a bigger question, I'm now wondering if my symptoms prior to the surgery were really acid reflux? My GI doc told me that the endoscopy he performed pre-op suggested reflux and I definitely had the hiatal hernia. I just wish I would have done the upper GI test prior to surgery; that's the only test that wasn't suggested. I did everything else (i.e., the endoscopy, the swallow test, and the 24 hour ambulatory test).

I'm just really concerned that maybe I should have only had the hernia repair or maybe nothing at all considering I have the exact same symptoms as pre-op. On the other hand, maybe the symptoms are due to the food/liquid lingering in the esophagus. I truly appreciate all your encouragement, info, etc. I really helps!!

Looking forward to hearing your thoughts!!

Mike

Denise,

Thank you so much for your email. You're absolutely right, I've done everything I can at this point. All of your information and encouragement have been extremely helpful. I will do my best to let the recovery take its course; multiple doctors have told me everything is okay. I guess I just have to understand that my body has had a MAJOR revision and I need to let it heal accordingly. I will continue to post my recovery experiences as I hope I can be as helpful to others as you have been to me.

And, I promise, I won't stop asking questions .

Thanks Denise!!!!

Mike

Hi Denise,

Just a quick update. So my original GI doc was confused/upset at the primary care physicians for not performing a culture on my tongue. He didn't understand how they could 100% diagnose me with thrush without testing. Anyhow, he agreed to see me next week to perform and endoscopy. He assured me that he will culture my throat and tongue to see if what I have is in fact thrush. I also asked him if I really had GERD prior to surgery and his response was "definitely". All the tests showed it.

Based on previous posts, I'm guessing, given my LPR issues, some of the white burning tongue could be from the food getting stuck at the wrap site, and just lingering there. It probably causes quite a mess down there and as a result the white burning tongue. If that's the case, so be it and, in time, i'm sure my swelling will go down.

Any thoughts/comments. Always nice to get your perspective on things.

Thanks Denise!!

Mike