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questions about GERD and fundoplication

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Posted 1/9/2013 7:18 AM (GMT 0)
hi guys, i am new here. i was searching online for information about fundoplication and came across this website.

i am 20 years old now and I was diagnosed with GERD and reflux laryngitis about 2-3 years back. But about 4-5 years back, i already had reflux symptoms. these times were the worst i had ever experienced in my life so far. Since being diagnosed with this illness, i have never fully recovered even when i was on PPI, antacid, gavscon and made many lifestyle changes. I could never speak properly for these 2-3 years and had reflux almost everyday.

i was fed up with this, so i decided to go for the nissen fundoplication surgery. I had it done about 5 weeks ago. My surgeon was one of the best and was one of the few who had experimented and perfected laparoscopic fundoplication in the 90s. Things actually went pretty well and i do feel much better now. i can sleep and wake up fresh unlike in the past. The doctor also told me that he found a small hiatus hernia in me, something endoscopy did not found out in the past. I just had my throat checked and the doctor said that the vocals are still swollen due to the seriousness of the reflux in the past. But thankfully, he said that the burnt marks in my throat are not recent, meaning the surgery was a success.

However, i have a slight regret in me after doing this surgery. i feel like a handicap now having to live with the wrap in my body for the rest of my life. And i too have to bear the burden of worrying whether the wrap will stay in place for the next 50-60 years in life. I had actually wondered if the hiatus hernia was the cause of the reflux. if it was, there were actually simple exercises that could push the stomach back in place.

Anyway, i shall not talk about what i feel and will be moving on to my question. The doctor told me that i should never carry heavy weights in future even if i had fully recovered. Is that true? as i had lost a lot of weight after this operation, i wanted to go to the gym and work out a little. He did told me that i could start light training though, therefore, i was wondering if 3kg or 5kg of weights will be okay? its a little embarrassing carrying 3kg weights as i am a guy though.

Also, i didnt had the chance to ask him, but could the wrap be reversed in future if i want to be normal again? I just read up about linx operation and it seems like a very simple but brilliant idea. I was thinking i might want to switch to that if it becomes successful in about 5-10 years time.

Lastly, i read up that after fundoplication, people can go back eating things that they can't when they have GERD. Is that true? I didn't have the time to ask my surgeon all these as i had too many questions to ask him.

Sorry for the long post guys. I hope someone does help me out. thank you.

Post Edited (ris3r) : 1/9/2013 12:22:32 AM (GMT-7)

Posted 1/9/2013 3:27 PM (GMT 0)
Hi ris3r,

Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah    I had my Nissen in February 2009, so I know exactly what you're going through.  You were very wise to find a highly experienced surgeon to do your wrap.  It increases the success rate and ensures that you will do just fine!

During the first 5 weeks you experience the worst of what the wrap recovery has in store.  It takes time, but you'll gradually add more and more of the foods you ate prior to surgery, and yes, you will be able to eat those things that were triggers in the past.

While the LINX sounds great, it is still a new method, and hasn't been time tested the way the Nissen has.  Nissen fundoplications have been done for over 50 years, and the procedure is considered the "gold standard" for stopping reflux.  You couldn't have had a better procedure.

The thing at risk when you lift very heavy weights is your repaired hiatal hernia.  The hernia repair is what is keeping the wrap in place.  When the hernia repair goes, so goes the wrap.  I do think, especially at the stage you're in, you should be very careful about lifting.

I have heard of people who've blown out their hernia repair and therefore their wrap by very heavy lifting.  There are some here on the forum, though, who are weight lifters, and you could probably look for their threads by using the google window at the top right of the page.

I have an experience with discomfort caused by lifting a very heavy box of books that really scared me.  I was fearful that I'd damaged my wrap, since I experienced a sharp pain, but fortunately, after a few days it started feeling find again, and is working perfectly.

This is the thing.  The HH is certainly not the only thing causing your reflux.  Your surgeon wouldn't have done the wrap if it were.  Think about it.  The HH didn't show up during endoscopy or any testing.  Therefore, it wasn't the reason the surgery was recommended.  I'm certain you had all the prerequisite testing, and those things indicated that your LES was insufficient.

If you were to take down your wrap, you would be right back to the condition that sent you to surgery. Keep in mind that the type of reflux you were experiencing was not only uncomfortable, but also risky.  At age 20, you have a lifetime of reflux exposure ahead of you, which is not a good thing.

Once you're fully healed (6 months to a year) you will be back to eating completely normally.  Well...you'll actually have to eat more slowly and chew more fully, but you'll be eating anything you want to eat.  I have nothing I can't eat, and I am able to drink beer without any problem as well.  Yes, once wrapped you'll be able to enjoy those trigger foods you had to avoid!  Yay!

It's tough at 5 weeks to see how great the surgery is going to be for you.  Try not to project a lifetime of "handicap"...think instead of how it will free you to enjoy life (and sleep)!  You'll even be able to talk and sing again!

Glad you've joined the forum! I'm sure others will be by to share their own experiences and offer their support.

Stick around...it's a great place to ask questions and be around others who understand!

Happy Healing!

Denise

Posted 1/11/2013 4:08 PM (GMT 0)
Hey there! Thanks for the welcome and the answers! It's really horrifying to find out how many people are having GERD. Just makes me realize how stressful this society has become. If only we can be less competitive and be more caring, things will certainly be much different.

It is also worrying to hear that so many people who had done fundoplication has so many problems. Thankfully, I had gotten an experienced surgeon to do it for me. He claimed that he has never had a failure before( so I do hope I won't be the 1st! Haha)

Now that you had mentioned singing, I do hope to share a little story about myself. Probably none of you out that would even care about it, but i will feel better saying it out. I do love singing and I have a silly dream of being a singer one day.

So, about 8 months back, my reflux condition was actually improving and sort of under control. After years of not being able to talk or sing, and although my vocal cords had not fully recovered, I could finally sing! Just then, I came across news that a local recording company was going to organize a competition to find the next rising star. I registered without hesitation! Even if I hadn't had the chance to practice any songs or vocal technique, I certainly would not give this opportunity up!

I didn't had much expectation, but to my surprise, I got through the first 2 rounds of audition smoothly and got into the top 100! My friends even made a small fan group for me! I began feeling confident. Something I did not feel for years. I thought that things were finally going my way and the dark days had finally gone.

But to my horror, I was wrong. My reflux came about just 1 month before my final audition. Why did it come back? I had continue the lifestyle changes and my medication! I was desperate and tried many things to recover on time, but to no avail. Just one week before the audition, I lost my voice completely. I couldn't even sing a note out without my voice cracking. However, on the day of the audition, my voice returned slightly and I praised The Lord for it.

I went up the stage nervously as I didn't prepare for it, but I used these emotions and sang the best song I had even sung. I thought I was going through, but they told me sorry. I was surprised, so I ask why. they told me my voice was good, but I was too nervous, and was shaking. I begged for a chance but they didn't gave it. My dreams were shattered before me and I slumped into a depression. Nobody knew how depressed i was. I really felt like giving up. Life was too tough to carry on. I was stressed out with my studies and my family didn't know the pain I went through.

Even till now, there is still this scar in me. I feel so worthless and am so disappointed with myself. That's probably why I feel like a handicap now.

Anyway, I just want to say that GERD didn't just hurt me physically. It had hurt me mentally and spiritually. I do hope and pray for better days ahead now that I had my fundoplication done.

I do admire those that suffered more than me yet are still able to be happy. Stay strong and continue fighting!
Posted 1/11/2013 4:41 PM (GMT 0)
Hi ris3r,

Thanks for sharing your story.  Try not to project negative things into your future.  They aren't real, and are created in your mind.  Why waste time imagining horrible things when you can enjoy the present moment and live your life day by day.  Grab every moment (like you did when you had the opportunity to audition), and live it in the fullest.  The future will come to you, and when it does you will deal with whatever it has to offer. 

Use your faith, and stop worrying about what will be.  Embrace the now of your life.  You can do this!  Good luck with your recovery.  Be sure to ask any questions that come up, and request support when you need it! Thanks again for sharing!

Happy healing,

Denise

Posted 1/11/2013 5:46 PM (GMT 0)
Just out of curiousity, what makes you not a good candidate for this surgery?
Posted 1/11/2013 5:57 PM (GMT 0)
I understand what you went through...i love to sing as well. For years it was a dream. I have a daughter now and want to read and to sing to her..its very hard though because my voice gets very tired and raspy. I just got put on new meds so im hoping it works. Im trying to stay positive after being soo negative for months. Good luck to you:)
Posted 1/11/2013 6:03 PM (GMT 0)
Hi gigglesalc,

There are a few things...I'm no doc, but these are the ones I've learned of over the years:

Your reflux levels are low, so the GI doc doesn't think a Nissen will help you.  (I was one of these, and thus I had to wait a long time for my surgery.  It doesn't mean it won't help you--it certainly helped me--but it does mean it'll be a struggle to get someone to do it.)

Your swallowing test shows real problems with swallowing reflexes.  In this case you would have difficulty getting food through the new wrap barrier.  There are still some Nissen choices (a partial wrap, for example), but the full wrap would be unavailable to you.

You might have some physiological or physical differences that might create problems should you have the Nissen surgery.

Some GI docs aren't well-informed on LPR and other atypical (lung involvement) issues that can result with even small amounts of reflux.

These are a few things that can keep you from getting referred to a surgeon.  The testing that is done can identify most of these.  Barium swallow, 24hr PH monitor, manometry, endoscopy, and often a stomach emptying test, are prerequisites. 

Wish I knew more about this, but it's a start.

Good luck!

Denise

Posted 1/12/2013 4:18 PM (GMT 0)
Hey dencha, thanks for those encouraging words. I will certainly try to be more positive from today onwards. Anyway, out of curiosity, may I ask why did you go for the surgery if your reflux level were low? Also, how's life after the operation? Are things much better?

And sracey77, I am so sorry to hear about not being able to pursue your dream and not being able to read/sing to your daughter. I do wish you all the best and may you recover soon.

If both of you won't mind, I want to pray for the both of you to have a speedy recovery and a better life. God bless.
Posted 1/12/2013 8:03 PM (GMT 0)
Hi ris3r,

The reflux I got (which at times may have been more than the 24hr PH test showed) was creating havoc with my lungs.  I have asthma, but as my reflux increased, it became impossible to control.

After a couple months of healing post-op, my lungs have been great.  Yay!

Life post Nissen is like it was before my Nissen minus horribly unhealthy lungs and constant coughing!

Take care,

Denise

Posted 1/28/2013 3:41 AM (GMT 0)
hi, sorry for the late late reply. I just caught a flu 2-3 weeks ago and it just recovered now. I think that it took so long to recover because i am weak after the surgery? This 2 weeks was really miserable. I had to deal with flu, fever, cough on top of the post surgery really is tiring.

Anyway, it sounds like your reflux was worse than mine. I agree with you too. The 24hr PH test might not be accurate. During my 24hr PH test, I had what I counted as a good reflux day. Yet the results came back that I still had extensive reflux. I just wonder how serious the results will be if it was a bad day.

Anyway, I am about 7-8 weeks post ops and for the past 1 week, it seems that i have reflux again. I know its normal, but its really frustrating. I would wake up with a slight burning sensation and a hoarse and sore voice. I am suddenly feeling full and bloated easily and a little nausea. I did not really feel that since I had the ops. Is this normal? The reflux is not as serious as it used to be, but I just want to be healthy again, and to be able to sing again too.

Also, I dont really have any difficulty eating food now, I could eat rice or some soft meat without it getting stuck. However, the next day I can feel some pain on the chest. I would presume that is the esophagus? Anyone else experienced that?

Lastly, why do I feel so tired all the time and like get out of energy so easily? Is that what we are supposed to feel after a surgery? I just don't seem to have the strength to do anything. I used to spend lots of time playing with my dog, but since the ops, I didn't have much energy to do it.

Hope to receive a reply soon. thank you.
Posted 1/31/2013 2:51 AM (GMT 0)
bumppzz.. anybody who can answer me?? I am desperate to get my voice back to go back into singing again.. It is really frustrating that after almost 2 months post ops that I still have not recovered my voice. Anybody who has acid laryngitis and had done the fundoplication here? How long does it take to fully recover?
Posted 2/4/2013 2:31 AM (GMT 0)
HELLO?! Anybody there? Can't some guy reply... or is this forum so dead??
Posted 2/4/2013 3:28 AM (GMT 0)
Hi Ris3r,

I wrote you a long post a couple days ago, and when I went to submit it, there was a problem with the site and I lost it all.  I didn't have the energy to write it all again right away, and do you think I could remember who I was writing to the next day or two?  No.

Anyway, better late than never.  Hopefully, this time it will not be lost upon submission.

There is a lot to cover in your post.  I'll do my best!  First the tiredness.  You've had major surgery, which is enough to make you exhausted. Your insides have been through a lot, even though you wouldn't know it by looking at your outsides.  On top of all that, you had the flu!  No wonder you're beat!  Listen to your body, rest, relax, and work on getting your strength back.  Your body needs the rest in order to heal. 

Being able to eat all kinds of food at your stage is normal.  You're likely not eating slowly enough and chewing your food completely, which is irritating your wrap and causing the chest discomfort.

As far as the "reflux" it's likely it's esophageal pain caused by your surgery/recovery.  As my surgeon said, you can get reflux during the early recovery weeks and months, because the wrap can be swollen and not settled into place.  The surgery does not take reflux to zero, or you wouldn't be able to swallow and eat.  It just takes it down to normal levels--like your friends who don't have reflux, but might pop a Tum after eating really badly.

The hoarseness will heal over time, but it will take time.  Are you still taking PPIs?  If not, you might want to start just while you're recovering. It might protect you better from any errant bit of reflux that gets past your healing wrap and creates problems with your healing voice.  It won't be forever...just while you're healing. Rebound won't be a problem because you've got the wrap to protect you. 

The flu has certainly set your recovery back, so don't be surprised if it takes a little longer to progress to the next stage of recovery.  It'll get better...try to be patient and surrender to your recovery.  If you can go with the flow and relax into your recovery, it will be much easier.  Your body will heal in its own sweet time.

Good luck!

Denise

Posted 2/5/2013 2:40 AM (GMT 0)
oh, i am sorry. i did not know that someone did reply. it is just that i am so tired and frustrated with life so far and when nobody replied it just got worse. anyway, thanks for the reply now and it does seem assuring. I didnt really have anytime to rest at the moment as i am working some temporary job to earn some money for my mom after the ops. but i suppose i should quit soon and take some rest, since my mom told me she can manage.
Posted 2/5/2013 11:11 AM (GMT 0)
I was told after I'm recovered I can lift weights and do whatever I did before the operation this op doesn't make you a handicap you gotta weigh up whether the reflux is worse surely you feel better after having this op it just takes time to
Recover my doc said a full recovery is 6 week the general consesnsus round here is 6 months I guess everyone is different I however feel like another couple of months and I'll
Be pretty much healed
Posted 2/5/2013 3:02 PM (GMT 0)
Hi ris3r,

Oh, my goodness!  You're back to work, too!  So, lets get this straight.  You've had major surgery that revised your upper GI tract, then the flu, and you're already back to work.  No wonder you're struggling.

I hear frustration in your voice.  Please remember that this recovery can't be rushed.  If you can surrender to it, listen to your body, and understand that no matter how hard you struggle against it, you can't make the recovery a moment quicker.

Relax into it and accept what is.  You have a good long recovery ahead.  It take 6 months for the majority of healing and a year for the rest (which is mainly your body adjusting to the changes.

If you can surrender into your recovery and accept it, you'll have a much easier time.  People who fight it and struggle against it, wanting it to go faster, resenting that it doesn't, have a terrible recovery.  Acceptance is the key.  Your body will heal in its own sweet time, and you can't make it go any faster than it will.

It will get better...promise!

Hang in there!

Denise

Posted 2/6/2013 2:34 AM (GMT 0)
hi dencha,

yeah, i believe i need the rest. i had handed in my resignation letter and will be quitting in 2 weeks time. Shall take the time to rest and relax. Hopefully things will get better soon.

btw, sammy said that healing takes 6 weeks? i am already 9 weeks post ops and still feeling pretty bad. Anyway, all the best to all of you out there.
Posted 2/6/2013 4:01 AM (GMT 0)
Hi ris3r,

The recovery takes much longer than 6 weeks.  It takes 6 months to a year.  Everyone's recovery is unique, and your situation (flu, going back to work) will slow your recovery. 

 Anybody who sets a time certain when recovery is achieved is not realistic.  Each of us is different, and we all heal in our own unique way.  I can tell you I wasn't completely healed at 6 weeks.

Sure, things begin to improve gradually.  6 weeks is much better than 1 or 2 weeks.  But to be considered totally healed?  No way.  There will be ups and downs in any recovery.  A few steps forward and a step backward. 

Hang in there,

Denise

 

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