Fundoplication has me apprehensive

Believe me, you're not alone in fearing this surgery after reading the scary posts online.  I waited far too long, and as a result have some permanent health issues.  Oh well...better late than never!  I join the chorus of those who are thrilled with the results of their surgery.  My symptoms were more atypical...mainly lung involvement.  Because of the surgery, I one again have healthy lungs!

Here is an exerpt from my recovery journal that is posted in the Resources on the GERD forum main page.  Hopefully it helps as you journey toward your decision.

Best wishes,

Denise

Nissen Surgery Failures: My Thoughts:
Yes, there are many very disturbing stories all over the internet--enough to scare anyone away from this procedure. I spent four years searching the web, looking for information to help me make an informed decision. The internet sources I searched out provided me with an overabundance of reasons not to go ahead with a surgical fix.

It is clear that pre-testing is crucial to ensuring that a patient will be helped by this surgery. Motility tests (manometry--tests the strength and effectiveness of your swallowing muscles, as well as the strength of the LES valve.), 24hr PH Monitor, Barium Swallow, and perhaps a stomach emptying study, are all tests that can spot problems that could complicate this surgery.

Choosing a skilled and experienced surgeon is also critical. A surgeon who does an overly tight wrap can create swallowing problems--especially in someone who has slipped through the testing cracks, and has a swallowing problem to begin with. Careful selection of a good candidate is most important. Don't rush your way towards surgery. Go to a good GI doc, and thoroughly explore all your options. Once you have a trusted specialist, it's likely that he/she will be able to recommend a surgeon who is skilled in the procedure. Then check that surgeon's credentials further.

Make an appointment with one or more surgeons...ask lots of questions. Just because you meet with someone doesn't mean you have to go through with surgery. My family doctor recommend a surgeon, and I met with him/had tests done/was told I was a good candidate for the surgery. I was not ready to make that decision, so I went back to my GI doc, who looked at the results of the tests the other surgeon did, and ordered an additional test. After testing was done and we discussed the results, he suggested that I just go and talk to the surgeon...no rush...just discuss the procedure, and start to think about what I wanted to do. I ended up meeting with his recommended surgeon twice, and made the decision to go through with the surgery.

Keep in mind that many, many people have a Nissen Fundoplication and never enter any comments in a forum online. It's more likely that people who had bad outcomes will search the web for reasons for their suffering. Many, many successful surgeries happen, and you just don't hear about them. The more problems a person has with the outcome, the more likely you'll hear about his/her poor results.

It is too early for me to know if I'll be in the ranks of the successful, or unsuccessful procedures. I understand that I can not speak with any authority in that regard. [Note:  I wrote this within 3 weeks of my surgery...I can tell you now that I am among the ranks of success procedures.]

I do know that as an open procedure, this is a 50 year old surgical method, so it must have helped many people for it to have lasted this long.

Laproscopic Nissen Fundoplication has been around a much shorter time (approx. 15 years, I believe, but I may be off on that number). From what I've read, the move to laproscopic Nissens has been beneficial, in that fewer surgeons are qualified for to do non-invasive procedures, and it creates a situation where a few surgeons get lots more Nissen surgeries--which provides ample opportunites for developing skills necessary for successful outcomes.

So yes...it seems that there is a disproportionally large number of Nissen failure when you read forums such as these. If you go to surgical sites, though...read medical journal entries, you will find that the success rate is quite high. That doesn't solve the problem for people who have had poor outcomes, but it should create more confidence in someone making the decision to have this life-changing surgery.

Don't let scary stories make up your mind for you. Do the work to find out if this procedure is right for you. Then make an informed decision and go with it. Best wishes to anyone trying to make this difficult decision.
Also...good luck to those who are struggling with surgeries that didn't work out the way you had hoped. I hope you all find solutions to your medical problems.

Thanks again to everyone who shares their experience and hope on this forum. It has made a big difference to a lot of people.

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Good luck with your appointment and testing! Let us know how it goes.

 Glad you've joined us!

Denise

That's great to hear!  Just remember that it takes a full 6 months for most of the healing and a year for the rest.  I continued to fine-tune and improve into the second year, believe it or not.  Don't forget to continue to take small bites, and chew carefully always.  Sometimes when people start adding a more normal diet they forget to continue with the careful chewing and start getting some discomfort.

Glad you've joined us!

Denise

Glad to hear that your surgery has been a success and that you are making good progress!  If I haven't already welcomed you to the Healing Well Wrapped Club, my apologies!  Consider yourself welcomed.

My surgeon told me that I could eat anything that could be chewed to a liquid/creamy consistency on Day 6.  If you take small bites and chew, chew, chew what you're eating completely, you'll do just fine.  If whatever you're chewing doesn't chew to a liquid, deposit it into a handy napkin.

Stay away from bread unless it's toasted.  No steak...I think my surgeon said don't try it until the 8 week mark.  I'm three and a half years post op, and still am careful to chew things thoroughly. The wrap that was created to form a barrier that doesn't allow acid to escape the stomach.  That barrier works both ways, though, and it creates more resistence when food enters the stomach as well.

Eat many small meals throughout the day, rather than one large one.  That way your stomach is more likely to be able to release excess air/gas through the wrap.  The fuller the stomach gets, the tighter the wrap/flap is.

You need to listen to your body.  It will tell you if you're overdoing it.  If you take small bites and only swallow things that can be chewed to a liquid, you'll do just fine.  If something seems to be "stuck" don't worry.  You'll get a little spasming and discomfort, but with continued sipping of room temperature water or tea, it'll eventually make its way through and into the stomach.

Happy eating!

Denise

It's not going to hurt your wrap, but will create discomfort for you.  I'd stay away from steak for a few more weeks.  I would suggest using a crock pot to cook beef to slow-cook beef to a very tender and soft consistency.  You could put some carrots, onion, potatoes, and beef, with a package of Lipton's Onion Soup Mix and a cup of water into the crock pot, and let it cook for hours and hours.  Everything will be flavored with the beef and will satisfy your urge.  I was able to eat beef very early using this technique.

Don't worry for a moment that you've injured your wrap.  If something feels stuck, be patient and relaxed, and take sips of water or tea.  You can irritate your wrap, but it won't cause permanent damage.  It just might cause some discomfort for a few days.

Best wishes!

Denise