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Nissen Fundoplication Reccomended

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Posted 10/23/2012 7:36 PM (GMT 0)
Hey all! I'm new to the forum and my GI doc says I should have an NF. I'm 59 and have been dealing with GERD and on meds for 10-12 years. Due to Barrets signs and an ulcer he wants me to do this procedure. Other than sleep issues due to regergatation Nexium has been handleing it ok. At what point should I go through this sort of procedure?? A little nervous about coming out worse than I went in! All my doc says is to find a surgeon with a lot of expierience. Question: Live with it or fix it??

Any input would be appreciated!

John

Posted 10/23/2012 11:21 PM (GMT 0)
I fixed mine because it was messing with my lungs. It is well worth the procedure and recovery. I love sleeping flat and not choking during the night. I got a good night's sleep and got more energy.
Posted 10/24/2012 11:19 PM (GMT 0)
Read about Barrets in the locked post at the top of the forum. Your doctor has a good reason to recommend surgery.

You can also read more posts on this subject by putting the keyword into the search box at the top of the page.
Posted 10/25/2012 1:21 AM (GMT 0)
Hi John,

I'd say go for it!  I had the surgery in February 2009, and only wish I'd had the courage and the cooperation of my GI doc to have had it sooner. Your GI doc's recommendation that you find a highly experienced Nissen surgeon is extremely important.

Here's my early recovery link so you can get an idea of one person's recovery experience:

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

I found this forum shortly before my surgery and it was a wonderful resource.  I was provided with great information and support from others who'd been through recovery.  This is a great place!

Good luck with your decision. 

Glad you've joined us!

Denise

Posted 10/25/2012 3:34 PM (GMT 0)
Hi John,
Reflux can sure make your life miserable that's for certain. You say you are managing your reflux symptoms with PPI's except for episodes of regurgitation/reflux during the time when you are laying down or sleeping. Have you elevated the head of your bed, ensured that you haven't eaten too close to the time of you retiring for bed, had anything that may irritate your stomach that might lead to your symtoms being exacerbated or lost weight (if applicable)? It is also wise to entertain adjusting your medication in the evenings to cater to your problems nocte. It is a good idea I feel to exhaust every avenue before resorting to surgery, as I am sure you know that it can, in some instances render you either worse off or indeed leave you burdened with some ailments that you didn't have initially. If you continue to suffer beyond management with medication and lifestyle changes or continue to show signs of Barrets, then that is worrisome due to what can occur due to that type of gastric/esophageal errosion. A fundoplication I believe is big and can, more often than not be a successful procedure that should be undertaken only as a last resort. Good luck John with what ever you decide but ensure that your surgeon is very experienced with this procedure and you have the essential testing before you undergo this particular surgery.
Redards
Buzz
Posted 10/25/2012 6:13 PM (GMT 0)
Well it's tough decision, but I am very glad I went through with it. So glad in fact I have done it 3 times and would hesitate to have it done again. I am the exception to the norm though as for having 3 nissens. My first wasn't done correctly, I blame myself for not researching my surgeon better. The last redo was caused from what had to be done to repair a tear in my esophagus other wise I'd still only have had 2 nissens.

I had such good results I had to beg to have it redone 6 months after my esophagus repair because they wanted to wait 9 months to be sure everything was healed before they redid it again.

I am a year and 2 months post 3rd nissen as of yesterday!

Take care,
Bill
Posted Yesterday 4:44 PM (GMT 0)
Thanks for the input!! I'm just concerned about the fix ending up worse than the problem. I've been living with this for 10+ years and since I see the errosion to the esophagus, and having a brother inlaw die of esphogeal cancer this year, I feel I need to pursue it. Does anyone have a source for finding the right surgeon for the job? I live in the Orlando Florida area. My GI doc reccomended one in another city but I don't know how to qualify there expierience.

PS: Any guess on out of work time for a desk job??

Thanks again!

John

Posted Yesterday 5:07 PM (GMT 0)
John,

I worried about that, too.  There are so many scary posts on the internet that anyone would.  Unfortunately, that fear led to me waiting far too long for my surgery and as a result I have permanent damage from the steroids I took to keep my lungs in operation while my GI doc and I put off my surgery (I didn't push hard enough because of my own fears, that matched yours).

I strongly believe that the majority of those people either wrote those scary posts during the early recovery stage (when it is a bit rough, and most surgeons don't adequately prepare you for), or had inexperienced surgeons who did the surgery improperly. 

It takes more than a great all-around surgeon for this procedure...it requires experience and expertise gained from practice.  It's important to choose someone who does many, many Nissens.

Good luck!

Denise

Posted Yesterday 6:27 PM (GMT 0)
Thanks Denise! What is considered "many" nissens?
Posted Yesterday 11:19 PM (GMT 0)
Johnnnnn-

100's, the more the better. If you have a good teaching hospital near you that is a good place to look as well.

Take care,
Bill
Posted Today 2:02 AM (GMT 0)
Hi John,

The rule of thumb I heard here at the forum when I was choosing a surgeon, it was 300+ in a smaller city and 1000+ in a large city.  Now that the surgery is done laproscopically, it has limited the surgeons who do it to those who do non-invasive procedures.  Therefore it has had a postive impact on the surgical learning curve. 

In the city where I live, when asking about where to go for testing to see if my wrap was holding I was told about "the surgeon who does all the Nissens".  (I had mine done by a surgeon who'd done 300+, and did 2 on the day I had mine.  Since then I've moved to a bigger city--maybe twice the size of the one I lived near before.)

The more the better.  Plain and simple.  And if I were to need a redo, I'd find the surgeon who regularly does redos and surgeries to improve problem Nissens.  That may mean I need to travel to a larger medical center like Cleveland Clinic.  I'll cross that bridge when I come to it, though!

Good luck!

Denise 

Posted 12/27/2012 3:52 PM (GMT 0)
OK, Getting ready for visit to first surgeon under consideration. Recommended by a Doctor friend and I'm working on a list of questions for him at our first meet. Number of Lap. Surgeries, success rate. One of his nurses "thought" it was in excess of 300 done in his career. Would anyone suggest any telling or worthwhile questions to help make this decision?
I also am interested in timing for this. As I have annual get together with a group at the end of May, I hope to be some what less restricted by then. I can't get it done before mid February either. Is 3 months too short a period to resolve primary post surgery issues? AH! I suspect I'm over thinking this but that's how I roll, :)
Thanks for any insight to this process.
Posted 12/27/2012 4:16 PM (GMT 0)
Just had my NF with a big hiatal hernia repair on 12/4. I have a desk job. Going back on 1/7. I have not had any gerd. Stopped all my gerd meds. I have even had orange juice which was a real trigger for me. Fabulous. No real problems eating as long as I limit amounts and chew, chew. I even had thin crust pizza yesterday. My physician has done about 300 procedures. I live in a smallish city, so that is a good number here. I have had absolutely no problems. I am very happy I had this done. I did ask dr about numbers, complications, surgical team, etc. Good luck.
Posted 12/27/2012 4:33 PM (GMT 0)
Thanks IlliniFan! Was the month off enough time off? More than needed from the surgery/vacation related?? I'm trying to figure out my expected back to work timing?

Thanks Again!

Posted 12/27/2012 7:16 PM (GMT 0)
I think I will be tired when I go back, but I think it will be okay. Was doing well until Christmas, but way over did it and am pretty wiped out now. it has also been too cold and nasty to walk outside so haven't regained strength as well as I should of. Bending over frequently gives me pain, and it is hard to stick with a lifting weight limit. Some people have gone back in as little as 2 weeks. I could not have done that. For me, I think 4-5 weeks is fine. My surgeon actually said 4-6 weeks.
Posted 1/18/2013 4:48 PM (GMT 0)
Met with a surgeon! He said he quit counting how many he has done in 1997 when he hit 300. He is telling me 2-3 weeks for a back to work time. Go for the barium swallow test next week to make sure I can do a full nissen then off to the races I guess! Does age, weight have a bearing on recovery time? I'm 59,6' 1" & 230lbs. Hietal (sp) Hernia will be fixed at the same time. Yahoo!
Posted 1/18/2013 5:35 PM (GMT 0)
Hi Johnnnnn,

Yay!  Glad to hear you found an experienced Nissen surgeon.  What pre-op testing have you had already?  Generally surgeons either do the testing themselves, or want records of a barium swallow, endoscopy, manometry, and 24 hr PH monitoring.  I'd also had a stomach emptying test some time before.  Which tests have you already had?

The only real bearing weight has (I believe) is that fat makes it difficult to see what they're doing in a laproscopic procedure.  I know that at times it can make the surgery revert to open.  I used to worry about the possibility of an open procedure, but Bill, a moderator here, had one and said in some ways it was easier to heal from.

Good luck!

Denise

Posted 1/18/2013 6:12 PM (GMT 0)
The test done already are Endoscopy(many over the years) and Bravo- a 24 hour ph and now doing the barium swallow.

Many years ago I had a procedure done, Stretta Procedure, http://en.wikipedia.org/wiki/Stretta_procedure

Worked pretty good for about 5-6 years but here I am. Thanks for the insite!!

Posted 2/12/2013 3:44 PM (GMT 0)
D Day around the corner- the 22nd. Pre op test on the 20th. He said I'd be back to work in 1-2 weeks. Planning on 2-3. Small Hiatel hernia and full nissen. No beer for 6 months, bummer 
Posted 2/12/2013 4:04 PM (GMT 0)
Hi Johnnnnn,

Good luck on the 22nd!  If you have any questions, ask away!  I suspect you'll be enjoying a little beer before 6 months.  I enjoy beer, and am certain I had some before the 6 month mark.  You won't drink glass after glass, but you can have enough to satisfy your taste for it.  The one caviat is if you have severe bloating issues...then you'll have to wait the full 6 months.  My surgeon told me I wouldn't be able to burp, but my stomach started burping itself right away, so I never had many bloating issues.

Before my surgery I spoke to someone who'd had the surgery two years earlier.  I was bemoaning the fact that I wouldn't be able to drink beer, and she said that was incorrect--beer carbonation isn't as aggressive as soda.  I did stay away from soda the full 6 months or more.  I'm 4 yrs post op, and can drink it now.  I'm not a huge soda drinker, but can drink a couple glasses without trouble.

Champagne is another story.  I had two glasses when celebrating my son's engagement, and was really bloated.  The carbonation got ahead of my stomach's ablity to release gas, so it blew up like a balloon, because it pushed the wrap tightly against the opening of my stomach.  I've found that the case.  When the gas gets ahead of the release of gas, it makes the wrap unable to open.  That's how it works.  The fuller your stomach gets, the tigher he wrap gets.

Best wishes!

Denise

 

Posted 4/16/2014 7:21 PM (GMT 0)
Hi JOhn - just wanted to check how everything went, also who did your Stretta by the way?
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