Recovery Problem - Post Fundoplication

Hi, I had a fundoplication 2 weeks ago and was on a full liquid diet for that time.  When I started with more "soft food" yesterday I had a piece of soft chicken that I didn't chew well enough and as it went down is really hurt me.  Since then I have been having constant reflux symptoms and pain.  I hope my fundoplication didn't come undone or that I didn't do permanent damage.  Has anyone ever experienced this in their recovery?  Up to that point everything was fine except for the usual discomfort.  I have a follow-up appointment with the surgeon in a few days. 

Thanks

Keep to very soft foods because you're still swollen. If you have to chew take small bites and chew very well before swallowing.
Keep your portions to 1/2 cup a meal or less right now.

You probably just bruised it a little, it's still very tender in there.

Sounds like your esophagus is just irritated from you eating something it was still too swollen to handle. Guaranteed a little piece of chicken won't break anything :) It just might hurt to swallow! Take it slowly with advancing your diet, you'll be able to eat chicken again soon enough. Totally agree with any pain being interpreted as reflux. Wait till you're 3-6 months out before worrying that the surgery didn't work.

Thank you for your encouragement.  I will decrease the portions I eat for now and hope for the best.  It is just that after the "chicken" episode I feel like something changed in the healing process.  Hopefully it is, as you have indicated below, just irritation.  We'll see with the doctor on Tuesday at my previously booked post-op appointement. 

 

I find that keeping the morale up is the hardest at this time.  This is a first for me.  I will need all the morale boosters you guys can throw my way.  I will also have a good read of your recovery journal dencha.

 

Merci

As Denise points out -- there are LOTS of different suggested diets following fundoplication.

Personally, now on day 5 following third procedure, my doctor has me on clear liquids only until day 15, and then going on full liquid for another 2 weeks. After the first fundoplication, a different surgeon had me eating macaroni and cheese (a food many people will tell you is a nightmare for a while) on day 5.

If you find chewed chicken at week 2 is too much -- cut back. Go back to pureed foods. It isn't a defeat -- your body might just need more time.

Hi Bobbi,

Welcome back!  The recovery takes 6 months to a year for complete healing and upper GI tract adjustment to the changes.  You'll have some ups and downs, it's very normal.  It sounds like you overdid it and your esophagus/wrap is irritated.  Remember that the esophagus is a dumb organ (as my surgeon said), and it interprets all pain as reflux.

Just back off the rough foods for a while.  Take small bites and chew your food completely.  Only swallow things that have been chewed to a liquid (creamy consistency) for a while.  No alcohol, spices, acidic foods for a bit, until things feel better again.

If it keeps up and is bothering you a lot, you could ask for a script of Carafate suspension, which will coat the esophagus and help it heal.

Don't worry for a moment.  This too, will pass, and you'll be back to living it up!

Happy healing!

Denise

 

Hi all,

I had my surgery almost a year ago. Denise, your diary helped me a lot prior and the first month or two after - thanks so much.

Bobbi, Denise is right, trying to relax trough issues like you just had is very important. I had a terrible experience with swelling and thought I damaged the wrap for good. All of the sudden, around day 8 or 9, I stopped being able to eat soft foods. It was like trowing up, but not really because nothing was making it to my stomach. However, it was as if my esophagus would fill up and I would have to wrench to get rid of the build up.

I was eating over cooked noodles in chicken broth. It was the first several bites, and I ate no more, yet I was stuck in this cycle of fluid build up and wrenching the fluid out.

I suffered through a few days of that and called the surgeon because I was certain I damaged the wrap. It did feel like reflux again. So she had me come in and do a barrium swallow test while being x-rayed. They showed the wrap was in place, but even the liquid barium was going in very slow. It was due to swelling. I was scheduled for 4 weeks off work. By the time I saw her I was 2 weeks into that time. She extended it by 2 additional weeks until she was sure I was doing ok. It took what seemed like 6 days to finally calm down. Then I would have a bit of this off and on for the following 2 weeks. I did get anxious when it happened, which I think made it worse. So, even though painful, it is important to try to stay calm and relaxed.

I so wish I would have done a diary like Denise. It would have not only helped me remember the time frames more exact, it would help others because I think no 2 Nissen's are the same.

I have had a very good year after all of that cleared up. Week 5 I had a return of reflux, but I really do think it was like a "phantom" reflux, it cleared up within a week.

Right now I have had 3 weeks of a viral infection, mosty terrible bronchitis. I have been coughing hard and often for weeks now. I am on a couple different meds, which I think are making me feel like I have reflux, when it's probably just irritation to my stomach.

Denise, you had a lot of coughing due to your Asthma right? I have ashtma too. Did you have this same concern, hurting your wrap, with the amount of coughing? I think i rememeber reading that in your diary.

Thanks - Anita

Hi Sharon,

Welcome to the Wrapped Club! You did it, and are on the other side!  Remember that you're in the toughest part of your recovery.  After two or three weeks you'll notice a big improvement. 

 Just rest, eat many, small meals, no iced drinks, no straws, and walk around your house a little whenever you get up to go to the bathroom to help relieve the shoulder pain and get your strength back.

Also, remember that your wrap will become increasingly swollen over the next two weeks or so, so don't be surprised if your swallowing gets worse before it gets better. 

We're here for you whenever you have a question or need support and TLC!

Happy healing!

Denise

Nerves are tricky things. I had an open hysterectomy from hip bone to hip bone a few years ago and it took almost a full year for me to get feeling back around the incision area. So I do think that is pretty normal.

Bill you have been through a lot - an inspiration to those of us that have such concerns over our initial, and hopefully only, Nissen.

Take care,
Anita

Try liquids for a little bit then slowly increase to solids again.

Hi Bobbi,

I'm sorry to hear you're still struggling with your recovery.  What you're experiencing is unusual in its intensity.  During the first year you can have some ups and downs and irritate your wrap/esophagus due to the swelling, healing and adjustments that are going on, but the severity of what you're dealing with seems out of the norm. 

I'm glad to hear that you're going for a follow up with your doctor.  Your description of pain doesn't sound right to me.  If it's strictly from irritation it doesn't seem like it would be lasting as long as this.  I'm no expert, though, so don't hold me to it! 

I'm sure your doctor will have more answers for you.  I know it's hard to wait for your appointment (why do they always have to be such a long way off?).  Until then, you'll need to deal with the reality you're living with, which is pain and irritation.  The rule of thumb is to always listen to your body.  If your wrap/esophagus is giving you problems, then baby them with soft foods that are chewed completely.  Stay away from any irritants like acidic foods, alcohol, and spice.  Don't swallow anything that is not chewed to a smooth consistency.  Otherwise thing will be scratching their way through your lower esophagus and wrap as they make their way into your stomach. 

There is one other thing that comes to mind that might help with the discomfort.  You could see if the doctor would prescribe Carafate suspension.  It has coating qualities that can help protect the esophagus, wrap, and stomach and help with healing.  It's quite expensive, so it's important that you have good prescription insurance, but if you do, be sure to call your doctor's office and request a prescription. 

If you don't have good insurance the next best thing is Sulcrafate tablets, which are generic.  You can put a tablet in a little medicine cup, add a little water/and stir it with a toothpick.  Then throw it back like a shot.  It will coat the esophagus and wrap on the way down in a similar way that Carafate does.  It's the same medication, but the suspension does a better job.  Still, I think you would find some relief.

Good luck with all this.  Glad you posted so you can get some support as you work through this problem.

Best wishes!!

Denise

 

Hi Bobbi123,

As I'm sure your wife has told you, Carafate/Sulcrafate is an old drug. I can tell you this, though. I had a period of time when my wrap/lower esophagus were giving me fits (reason unknown) and the Carafate made a huge difference.  I had been treating it with Maalox which didn't seem to be doing much.  I finally realized that I had some Sulcrafate tablets from my pre-Nissen days and got one out, mixed it with a little water, and threw it back.  IMMEDIATE relief from the pain I was having.  I have a reactive stomach, so I always keep Carafate on hand, just in case.

No guarantees that it will work like that for you, but it can't hurt.  It can only help coat and protect.

This austerity worldwide is becoming more and more of a problem.  I'm so sorry to hear about your cancellation.  Can you go to another hospital to get it done?  Good luck with that whole situation!

Best wishes,

Denise

Hi...the liquid is better, but more expensive. If you can get it, do. Until then, though...put the sulcrafate tablet in a medicine cup or shot glass and add enough water to make a little slurry. the just "throw it back" like a shot. If you take it that way it has a chance to coat your lower esophagus and wrap instead of just your stomach. The suspension is better,but it should provide some relief, though.
Good luck...hope it helps!