Figuring out post nissen pain causes

Hi GerdyGirl,

From my experience, I'd guess you injured your esophagus and wrap, but didn't blow them out.  Because of that, you are experiencing some pain that likely has little to do with what you're eating, but rather that you're eating at all. 

I wouldn't worry too much at this point.  You are likely to have some additional swelling which is creating some discomfort as well.  This should all resolve as your upper GI tract has time to heal.  It's adjusting to BIG changes, and your vomiting episode interfered with it's positive progress. 

You've hit the proverbial bump in the road.  That doesn't mean that it will be forever.  You've had a little setback and are experiencing some new pains.  I'd be willing to bet that given a few more weeks of healing and babying it, you'll be back to "normal", which still isn't normal, because you've got more healing and adjusting to do.

I agree that lifting could exacerbate the problem.  It's very common to have discomfort in certain sleep positions after this surgery.  My stomach/wrap still doesn't like me to lay in my side.  I can do it, but after some period of time I'm awakened by pain that subsides as soon as i change positions.  I'm three and a half years post op.  Sorry to tell you, but it's possible that you may have some little quirks that continue after full healing.

Of course, as you know, if you are ever concerned and are experiencing pain that is bothersome and worrying, the best option is to contact your surgeon's office and discuss the symptoms with your doctor.

My biggest and longest lasting severe quirk was dumping.  It continued sporatically (usually after eating a large salad or something else that irritated my wrap) throughout the first year.  I'd decided that I'd be living with the loud gurgling and diarrhea forever.  Since it wasn't a daily event, I was not that disturbed over that.  Lo and behold, sometime in the second year it all stopped.

Hang in there. Baby your esophagus for a while.  Crush those pills, or see if you can get scripts for lower dosages and take 2.  Personally, I still can't take large pills without discomfort.  I take liquid calcium and flaxseed oil.

Good luck...hope you're back to your old self very soon.

Best wishes,

Denise

Post Edited (dencha) : 7/24/2012 6:28:10 PM (GMT-6)

^^I hope so! I had a little meltdown on the phone with my boyfriend today over feeling like I may never be able to do anything but "light" exercise. It does feel like my esophagus is just irritated and I don't know what a slip feels like, but I think it's less likely. I'm seeing my surgeon either Thursday or Friday and am on liquids + crushed pills + no exercise until then. I may just end up sending my meds to a compounding pharmacy in the future so I can get them as liquids instead of tablets. Not sure how much that costs though.

I know this is probably just a minor setback but I am just so mad! When I had GERD at least I knew what I had been doing to piss off my stomach (drinking, ibuprofen, etc) and had some control over it. This is have no control over and didn't do anything to cause it.

Buying the liquid diet stuff in the grocery store tonight I was in between steam coming out my ears and bursting into tears. I think it's partly because I am taking care of myself and still having problems, and partly because I'm scared that I will have future complications and re-operations. The re-operations really scare me because I've assisted a few of them on people who have had multiple stomach surgeries and sometimes their stomachs are just a huge mangled mess of scar tissue and you can barely recognize any of the anatomy. In those cases is it just so easy to cut through the wrong thing and have the surgery turn into a big mess. Each time you do surgery, the anatomy gets further from normal and harder to repair. I don't want to end up like that :(

I am worrying to much. Most likely, I just have a persistent case of esophagitis. I'm done dwelling on it until my appointment. Also going to block from my mind the fact that my insurance expires next month and I am still looking for a job...

Thanks for the encouragement. I'm doing better today on liquids, but still having some pain. I don't think it's something serious. And I'll find a job sooooon!

Saw the doctor and he agreed with my concerns, so I did a barium swallow. It looked pretty standard, no pooling above the wrap! Yay :) Still waiting for the official results.
The surgeon is so frustrating. Every appointment I've had, he's been late by 2 hours. Yesterday that super sucked because they asked me to fast for the swallow, so my 1pm appointment was pushed to 3pm and I thought I might faint. At 4 I finally got to eat some barium burger, yummm. I always leave feeling like my questions weren't answered, so I wrote them down. He spied them when he walked in and grabbed the list, read it over and said we would answer every question. But he never did! Argghhhh! He also said he might know of a job for me though, so I won't complain. I will ask again when they call with the results.

Well it's almost 4 weeks later and I'm still having the pain. Annoyingly, my doctor is out of the office for another week so I can't get a hold of him. He wanted to hold off on giving me any plan or treatment until the results of the barium swallow were done (the next day) and conveniently forgot to tell me that he was taking leave for a week and a half. Despite my telling him my insurance was about to expire.

I've been on liquids for a week and a half, which pretty much fixes the irritation, but every time I try solids it comes back no matter how much I chew. It feels like I ate something too big, but the pain doesn't start till 20 minutes after eating and lasts a few hours. It's not getting any better. The radiology interpretation of my barium study was pretty normal, but the surgeon still needs to review it. Frustrated. I wish there was something I could do to help my poor esophagus.

Yep, was thinking of carafate but I don't have any. I called the doctor's office and they told me he's actually out till the 13th & my insurance expires on the 19th, so they called him at home and now I'm getting an endoscopy next week. I'm also talking to a surgeon friend, so somehow this is going to get figured out!

I'm a little upset right now because I had some applesauce and that felt irritating. Throat issues scare me because it is such a vital thing, it's unnerving.

Thanks for your support.

Hi Gerdygirl, when you had your barium did they move you into various positions in order to coat your stomach so they could get a good view of the wrap, or did you remain in an erect postion?
Regards
Buzz

GerdyGirl,

I'll be glad when this is all figured out and you're back on the road to recovery.  Hopefully that will be very soon.  Hang in there!

Denise

Gerdygirl, did you have a hiatus repair as well, or just the fundoplication for reflux? I had problems swallowing after surgery from the get go that worsened at 8 weeks post op. I have pain between my shoulder blades most times when I eat and feel that things go down better if I stand up when eating. Also there is pressure in my back/sternum. I am now over 4 months post op and just want to function like a normal human being again. I would like to have a drink of booze but when I tried some red, I just had this sensation of hotness sitting in my esophagus. Not enjoyable at all.
When you say barium burger, what do you mean? All I got in the way of solid was a marshmellow that I was told to chew up and 2 medium mouthfulls of barium to drink. I stood up for the entire exam, which took mere minutes before I was literally dismissed and was told everything was fine with a couple of contradictions. I am furious as I know that it was not a thorough examination and it cost me a fortune. I am so upset by the whole thing and I am seeing the surgeon tomorrow for his assessment. My biggest problem besides having my swallowing stuffed up, is the lack of interest that my surgeon is showing and my dwindling funds.

Buzzmoz, di we have the same surgeon? Today I have had a 1/2 of a egg sandwich and a small bowl of green beans 1/4 of a potato. Mine feels like it gets stuck or there is phlegm trying to come out around my Adama Apple. The inflammation goes through my right shoulder and down into my bicep. Setting here with a ice pak on my shoulder to try and calm it down. Has not been fun driving my wife crazy!!!

Hi GerdyGirl,

It's a real surprise to me that a dilation was considered the cure for your problem.  Live and learn!  I would have thought that it was temporary swelling and irritation that caused your problem.  That's why I love this forum...I'm always learning something new!

Here's hoping you heal and feel better very, very soon!

Denise

Hi GerdyGirl,

You had your surgery 2/21/12, which puts you at 6 months post-op.  I remember when we first talked, you were planning on going back to work very soon after your surgery.  Were there things you were doing then that might have created injury, such as heavy lifting?

Does your surgeon think your wrap is intact?  Does he/she think that it's too tight? 

You had an episode of dry heaves, which, no doubt irritated your wrap and created some swelling.  Then you had a dilation, which is an additional potential irritant. 

What does this mean?  I would assume that your recovery will be set back, and it will take longer for you to reach the typical 6-month recovery improvements.  Babying your wrap/stomach with soft foods, small bites and chew, chew, chew, staying away from acidic, spicy foods...will give you the best chance of getting things back on track.  I know it's not what you want to hear, but it's likely your best chance to get things better.

As soon as you get a job and health insurance, if things aren't better for you, I suggest you find a different surgeon to provide you with a second opinion.  You'll probably need to go through some of the same testing you did prior to your Nissen, but it will be the only way to determine what is going on.

Things may very well respond to your careful eating, but if it doesn't, it is imperative that you find a highly skilled Nissen surgeon and get a second opinion.  I (and many here) am a strong believer in not going back to the surgeon who may have created a problem for you.  Obviously if you're sure that your initial surgeon is the best in the business and you feel confident that he/she will provide the very best care, go for it.  I always like to get a different pair of eyes on the problem.

So sorry you're still struggling!  Hopefully you'll be feeling better soon.  It'll be a slow slog, but with time and care, you'll hopefully be on your way to feeling better.

Best of luck,

Denise