HealingWell
Search Close Search
☰

Post NF worries

Support Forums
>
GERD & Acid Reflux
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/16/2012 2:21 PM (GMT 0)
Hi all. I am new to this forum and wanted to ask a few questions that are worrying me, following my recent surgery.
I am today, 6 days post Op (LAP Nissen Fundo) and am experiencing a few discomforts which I would welome some reassurance on.

Firstly, I am getting chronic neck pain, like someone is running a sword across the back of my neck. It is intermittent, but when it kicks in, it really knocks me about. Also, I am still experiencing occasional oesophagus spasms, identical to what I was having prior to the surgery - a very sharp sudden spasm that takes your breath away and then its gone. Is this normal after only 6 days? I am worried the surgery has failed. I have no other pains. The chest and shoulder pain is slowly going as the gas works its way out of me. I cant get Gas X in the UK so am letting nature take its course. I have zero pain when swallowing.

The next question is diet. My surgeon has me on a fluid diet this week (first week post op) then 2 weeks of semi fluids for 2 weeks (puddings, ice cream, and milkshakes etc). I have been taking a thing called "complan" this week (bit like an energy drink with vits and minerals) and soups. I have nibbled on a biscuit once but other than that I am not eating anything else. I just wonder if the complan is too early, i dont know. I am so tired and exhausted, is there anything else someone could recommend that would qualify as a fluid option which wouldn't damage me but give me some energy and calories?
I have been reading posts on this forum for weeks, even when in the hospital bed and it has given much strength. I hope you can help me with these queries.


Thanks, Carl
Posted 11/17/2012 3:01 AM (GMT 0)
Hi Carl,

Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah Neck and specifically shoulder pain are extremely common post Nissen surgery.  Actually, for most people, that pain is worse than the surgical pain from incisions.  From what I understand it's caused by a combination of the gas pumped into you to open the field of vision for the surgeon, and the irritation of the diaphram/nerves.  If you can get up and walk as much as possible, you may find it helpful.  Even walking around the house can work.  I had a treadmil and started walking on that, as it was winter and I couldn't get out.  If you can get out to take a walk, and walk around the house in between, I think you'll likely find some improvement.

As far as the spasms continuing, I wouldn't worry.  First, the irritation that created those spasms will not disappear after just 6 days of relief from reflux.  Also, the esophagus is a dumb organ that interprets all pain as reflux.  Your lower esophagus and stomach have been through a lot, and it will take time for everything to calm down and get feeling better.  You've undergone major surgery, and it is going to take time to get feeling better.  The pains are to be expected.  Your esophagus didn't get that irritated in a few days, and it won't heal in a few either.

Be sure to stay away from iced or very cold drinks, as they can create spasms, which will only make your problem worse. Also, stay away from straws, as they can create even more bloating.

It's totally normal to worry about whether or not your surgery was a success or failure.  We've all done that.  During the early weeks of recovery it can be very difficult, and many question whether or not they made the right decision to go forward with their surgery.  Given a few more months, though, they're posting glowing reports and are very happy wit the results.

Keep in mind that your wrap will become increasingly more swollen during the first two weeks post-op, so don't be surprised if your swallowing gets worse before it gets better.  After your swelling peaks on or about the 14 day mark, it'll begin subsiding and your swallowing will improve again. 

As far as your exhaustion goes, keep in mind that although you only have five little incisions, on the inside your body has undergone major surgery, and being tired is to be expected.  Your internal organs were moved around, and your upper GI tract has been completely revised.

Every surgeon is different regarding eating protocols.  Mine had me eating "anything that could be chewed to a liquid (creamy consistency)" from the fifth or sixth day post op.  I did this, and had no problem at all.  If you're anything like me, your stomach fills up very quickly.  I could only eat a quarter to a half cup of food at one sitting.  It's better to eat many small meals all day than to overstuff your stomach.  If you take very small bites and chew, chew, chew, your mouth will act as your blender, and you'll do fine.  If something doesn't chew completely, don't swallow it...deposit the offending food in a handy paper napkin.

Here are some eating recommendation links:

http://www.upmc.com/patients-visitors/education/nutrition/Pages/diet-after-nissen-fundoplication-surgery.aspx

http://www.nissenfundoplication.com/nissen-fundoplication-diet

https://healthonline.washington.edu/document/health_online/pdf/Esophageal_Diet_After_Surgery_3_11.pdf

You'll find some recipes for blenderized drinks that are high in nutrition.

I don't know if you've run across my early recovery journal, but just in case you didn't see it, I'll include it here:

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

It'll give you an idea of what another person's experiece was like during the early recovery process.

Again, glad you've joined us!  From what you've described, it sounds as if you are recovering just fine.  You're in the toughest part of recovery, so hang in there! It gets better.  If you can surrender to your recovery and follow it where it leads you, you'll do much better.  You can't rush this.  Your healing will take its own sweet time.  Listen to you body and let it tell you what to do.  If you can go with the flow, you'll find your recovery much easier.

Happy Healing!

Denise 

Posted 11/17/2012 8:42 AM (GMT 0)
Thanks Denise for your wonderful and inspiring reply.
I have been worried and to be honest you do read such scare stories on the internet that at the first sign of pain I have been over-reacting and thinking its a major problem.

I will keep you updated on my progress and will definitely take a look at the diet link you have sent. Bit of back and lower stomach pain this morning but only nature making me better.

Thanks again for the support. Carl
Posted 11/17/2012 8:46 PM (GMT 0)
Carl-

I too want to welcome you to the forum and the wrapped club!

Denise has given you some great advice as usual. As for getting more calories you can make smoothies and add protein powder to it. I was told to eat ice cream when I could handle to cold. It has lots of calories and your body needs all it can get, whether good or bad ones doesn't matter right now.

You could also drink some warm tes or something before you eat the ice cream to relax things abit in there.

Did you nave a manometry done before surgery to see exactly how your esophagus works when swallowing? The spasms may be some thing that will have to be treated seperately, but you won't know until you are healed.

Take care,
Bill
Posted 11/18/2012 8:33 PM (GMT 0)
Hi Bill, thanks for the welcome.
Yes, I did have a manometry prior to the surgery, together with a 24hour ph test, which came back as 57.9 whatever that means, lol.
Had a bad night last night. Didn't sleep much and had chest pain all night. Today (8th day post Op) has been up and down. Took your advise and had some ice cream early on. Also a cup of cheesy pasta which certainly gave me more energy.

I did, however suffer another severe "spasm/hernia pain" which lasted around a second and then it went. I call it a spasm but I dont know if it is. It is like a squeezing, sliding sensation which I always believed was the hernia itself moving around. I thought I could feel stomach moving through the sphincter but I sincerely hope it wasn't. I still worry that complications have arisen.
Thanks again, Carl
Posted 11/18/2012 9:11 PM (GMT 0)
Hi I'm in the Uk and I had my Nissen on Friday the 16th. Yesterday before I was let out of hospital I had some mash and gravy and today I had some complan which went down well. I've also had porridge and yogurt.

I've also taken today gripe water for the trapped wind which seems to have helped. I know I'm very early days but so far so good.
Posted 11/19/2012 1:40 PM (GMT 0)
I had my Nissen on 3rd October (redo) and in the early weeks I ate the following

Custard
Baked apple(scrape out the apple from the flesh)
Rice pudding inc muller rice
Mashed potatoe with cheese
Puréed veg
Soup of every imaginable variety
Digestive biscuits
Fa.gg.otts and gravy
Quiche (except the pastry)
Corned beef hash (wk 4 onwards)

Bear in mind that at about 10 days your wrap will tighten, this is actually swelling, and you may be able to eat less and find that what you could eat before you can no longer. This is only a temporary set back and soon over, the main thing I would say is to just eat little amounts and take it easy.
Posted 11/19/2012 3:24 PM (GMT 0)
Can I ask, when were you taken off your PPI's? I have been told to keep with the lansoprazole for another week or so at 15mg. Part if the reason for the NF in the first place was to finish with the drugs and their nasty side effects. Do most people come off them a week or so after the surgery? Thanks Carl
Posted 11/19/2012 3:49 PM (GMT 0)
Carl-

I was off PPIs the day after surgery with all 3. Remember the first 2 to 3 weeks the swelling will be at the worst and things will seem as if the surgery didn't work. As the swelling gradually goes down things will improve. Please be patient.

Take care,
Bill
Posted 11/19/2012 4:35 PM (GMT 0)
I was told to come of nexium straight away and I haven't had any reflux since.
Posted 11/19/2012 5:08 PM (GMT 0)
Hi Carl,

I have a very reactive stomach and asthma, so I've stayed on Protonix 40mg before dinner to ensure that any errant reflux is not going to get my lungs going.  It takes just the tiniest amount of reflux to create issues for an asthmatic.  Since my surgery I've done great, except for allergy issues that still plague me.

Many go right off PPIs.  My surgeon and PCP wanted me to continue for a while to protect my healing wrap and deal with typical reflux issues caused by wrap swelling and a poor seal.  I went off it intially, but because of my asthma and the fact that I was taking steroids (hard on the stomach) was put back on during the recovery.

I went off them after a couple months, but my asthma doc required its addition to my regimen later, for the reasons already expressed.  I still sleep with an elevated bed for the same reason.  I'm thrilled with the results of my surgery anyway.  I had some very unhealthy lungs on very high PPI and steroid dosages prior to my surgery.  Today I have healthy lungs with a tiny fraction of the medication I was taking then.

 

If the PPIs bother you, I can't see any reason why you should still be taking them.  I stopped at 2+ years to have testing done (requested by my asthma doc) and didn't have the typical rebound while I was getting my 24hr PH done.  Showed me that the wrap was working...keeping the reflux in my stomach.

Good luck!

Denise

Posted 11/20/2012 2:57 AM (GMT 0)
Welcome Carl,
I am just shy of 8 weeks post op. I was really fatigue too for the 2 weeks. then I spoke to my doctor and he suggested protien water because it gives you energy any keeps you full longer. Adding alittle sugar to warm water helped too. But as someone already mentioned make sure you walk regularly so can build up your stamina. For chest pain I placed a cold pack along my sternum that worked well.
I only experienced spasms 3xs since surgery: 1 when I tried to eat ice cream a week ago. 2nd day of surgery when I was trying to brush my teeth. 3rd I'm not sure what set it off. Most importantly try not to panic that just intensifies then tightness. Try to take deep breaths in through your nose and slowly breath out 3xs that is what helped me.
I wish you a speedy recovery with minimal medical concerns!
Take care,
Kaye
Posted 11/20/2012 1:34 PM (GMT 0)
Thanks Kate. I've been to see my doc this morning ands I'm seeing my surgeon this afternoon. I had a really bad episode this morning. Woke up and couldnt find any energy to even raise my arms above my head. My legs were jelly and felt like they weighted a million lbs. My head was a couple of seconds out of sync with my eyes and I was wobbling all over the place. My doc won't give me a diagnosis until I see my consultant tonight but says the liquid diet is having an impact. He says it may be an infection too. Think I had a panic attack when I woke up which didn't help. The lack of energy is 100 times worse than the surgery. They should guide you more on post op diet than they do. I felt like I was dying this morning. On a lighter note the surgery is healing well and stitches have gone with no pain
Posted 11/20/2012 3:33 PM (GMT 0)
Hi Carl

I'm in the UK too, the active ingredient in Gas-X is Simethicone which is the same as in Wind-Eze and some of the Rennie Deflatine products which you can get here.

I've personally forund a couple of normal Rennie anti-acids to be effective if I've over-eaten and am feeling bloated, but Wind-eze is fine too - I'm just not as keen on the taste.

As for food, try the Dunns River "Nourishment" drinks - they come in a can and are like thick milkshakes but they have the equivalent calories of a small meal. You can get them in most supermarkets here - usually by the milkshakes/UHT milk

Hang in there.

Les.
Posted 11/21/2012 2:36 PM (GMT 0)
Just an update. Second week is definately worse than the first. I haven't slept in 3 nights. Still not getting enough nutrition. Taking complan and sugar water and loads of soups but still very wobbly on my legs and head feels detached. Having some back pain today. Ate a mushed up pancake last night. Very small mins but it didn't go down well. Very painful indeed. Trying to catch up on my sleep but I just can't drop off. I will keep you informed. Thanks
Posted 11/21/2012 2:46 PM (GMT 0)
Hey, Carl...

Sorry to hear you're struggling. What you're describing isn't typical post-op.  Have you discussed this with your GP, GI, or surgeon?  Unless your nutritional needs are much higher than the average, you shouldn't be feeling this way just because of not being able to eat normally.

I suggest you contact your doctor and see if you can get more help.

So sorry you're not feeling well!

Denise

Posted 11/21/2012 3:01 PM (GMT 0)
Hi Denise. I went to see my surgeon yesterday and he is adamant it is nutrition. I had an ultrasound scan yesterday too which was fine, no bleeding or anything. I do live alone and am useless at looking after myself so nutrition sounds about right to me. I am a bit concerned about dumping syndrome. I may have a bowel movement perhaps once every 2days and when I do, it seems to be a complete evacuation, ie big. I think I just need more time to settler. Going back to work on Monday so hopefully the activity with that will get me moving on the right track. Thanks
Posted 11/21/2012 3:42 PM (GMT 0)
Hi Carl,

Aha...dumping syndrome comes complete with some dizziness symptoms, so that makes some sense.  I had dumping (I could always tell it was on its way when my stomach would gurgle loudly) occasionally during the first year and into the second.  I thought I would always have it, but sometime during the second year I suddenly realized it wasn't happening any more.

Take a look at this anti-dumping resource.  Take note of the fact that sugary foods can actually cause a dumping onset:

http://uvahealth.com/services/digestive-health-1/images-and-docs/dumping-syndrome.pdf/view

Click on the PDF link below the title on the webpage.

Good luck!

Denise

Posted 11/21/2012 5:49 PM (GMT 0)
Just had some pureed Swede potato carrot onion and leak. Got to be honest, I'm feeling better. Gonna try steamed cid loin with the same and some mash tomorrow with some parsley sauce. Let's hope it does the trick
Posted 11/21/2012 5:50 PM (GMT 0)
Of course I meant cod loin, doh
Posted 11/21/2012 6:40 PM (GMT 0)
Hi Carl,

After my surgery, I had a surgeon with a very lenient eating protcol.  I could eat absolutely anything except untoasted bread or steak.  The rule of thumb was to eat anything that could be chewed to a liquid, and if you eat slowly and chew, chew, chew, many things are in that category.  If you have a slow cooker, try cooking some meat and veggies for hours and hours, and you'l find them very chewable.

Good luck!

Denise

Posted 11/22/2012 7:48 PM (GMT 0)
Hi,
Update at 12 days post-op

Just thought i'd let you know that i have started on the pureed vegetables yesterday and I feel better, not a lot, but better. I also managed to get some sleep last night which eased much of my wobbliness this morning. I am still suffering from jelly legs however and think that maybe its still effects from the anaesthetic...maybe.

My back is also weak and painful today, right between my shoulder blades, like knives being twisted and similar to pre-op acid pain. I hope this is common and a temporary effect before the swelling eventually goes down. Had a couple of left rib cage area twinges too which is new.

I boiled a pot full of swede, carrots, potatoes, onions and leek, which i then blended into a paste and had a steamed cod fillet with parsley sauce with it. It went down well and I feel better nourished.

Lets hope I can get to sleep again tonight and see if tomorrows brings improvement.

Thanks, Carl
Posted 11/22/2012 8:07 PM (GMT 0)
I'm a week out from my surgery and I am doing well. I am just now transitioning to mashed potatoes and apple sauce. I'm still tiring easily but working on short walks to.get my strength back. Still for the first time in 20 years I have no Acid in my throat! I've been having a lot of diarrhea though, weird because I don't eat but soup and liquids....any one else have this?
Posted 11/22/2012 8:21 PM (GMT 0)
Hi there, glad your doing well and welcome to the forum. Diarrhea is normal. Watch having too much sugar though as it may induce dumping syndrome, as I have mentioned above. Make sure your getting fibre and don't rush the transition from liquids to purees. Are you still getting spasms in your lower throat? I am on a daily basis but again is all part of the healing. Second week I found was worse than first as the surgery swells more and peaks around say 14 so take next week easy and don't push it.
Posted 11/23/2012 5:16 PM (GMT 0)
Carl-

I think your weakness in the legs and such very well could be nutrition and lack of rest. You had major surgery and your body needs LOTS of rest.

It's good to hear you have advanced your diet a bit. If things start to feel worse just go back a bit with the types of food for a day or two. The pain you described sounds just like what happens when the swelling hits. The swelling may take a while to go down, so please don't get worried if things don't improve quickly. This is a slow recovery, but so worth it in the end.

I also wanted to warn you about chicken and potatoes. Some people can have issues with them getting stuck for a while too. It's kind of a trial and error thing.

Take care,
Bill
✚ New Topic ✚ Reply
12