Advice 18 months post op

Hi there

Ive had 18 wonderful reflux free months. All has been well until I have had a chest infection. I have been coughing badly for 3 weeks and now I have terrible bloating in my diapraghm. Its high up and I havent had this type of bloating since pre op.

No reflux of any kind and Im hoping the constant coughing has just inflamed the area and no damage has been done.

Any tips on if this is nothing to worry about and it will subside eventually or if the bloating is a bad sign.

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Coll-

Sorry to hear you are having problems after so long with good results. My best advice is to get a hold of your GI or surgeon and let them know what is going on. It's probably just very irritated, but there is a chance the coughing could have damaged the wrap. So please let the doctors know what you are feeling.

When ever I have questioned mine my surgeon does a barium swallow and that is very good at seeing if there is something going on or not.
Also you may want to try eating some easier foods on your stomach to ease up on the wrap a bit. Maybe even go with smaller more frequent meals if you don't already.

Take care,
Bill

Hi Coll,

I'm the resident expert on coughing.  I had my Nissen because reflux had made my asthma uncontrollable.  I coughed nonstop throughout my recovery and feared I'd tear out the newly placed stitches.  Guess what?  They held and I did fine.

When I discussed my fears with my surgeon on my final follow-up, he said that "even water can erode stone". He said that there is a cumulative effect of coughing, straining, etc., that will eventually weaken the repair. These things are unavoidable. 

I've always figured I'm even at more risk of needing a redo at some point because even though the surgery solved the problem of dangerously sick lungs, I still have allergies and asthma, and have times when I cough a lot.

I very seriously doubt that a lung infection/coughing is enough to damage your wrap.  Yes, it can be irritated by severe coughing, but if my wrap held during the first weeks of recovery, at 18 months, the healing/scar tissue will protect it during coughing fits.  Try coughing while lying over a bed.  Lying down when coughing seems to put less strain on the area.

If you still have mucous stuck in your lungs, have someone use cupped hands and hit your back while lying on the bed.  Have them cover the entire lung area.  After they've been doing it for a while, try coughing.  It definitely makes it easier to raise mucous.  This is called postural drainage/or lung PT.  Here's a link with information.  The Percussion or Vibration section is what I'm talking about:

http://pennstatehershey.adam.com/content.aspx?productId=117&pid=60&gid=000051

If you have a hand held vibrating massager (I have one called a "Thumper") That works great, too, and you can do it yourself, if it has a long handle.  The thing is, this percussion makes it easier to cough things out, so you don't have to put so much pressure on the diaphram and wrap.

I had been on high doses of steroids for my lungs, and my internal tissue was very fragile at the time of the surgery.  The surgeon did take a couple extra stitches because of that, but if mine held with as much coughing as I did during recovery, I have a hard time believing yours has failed.

Still, if you don't feel better after you've had a chance to recover and give your wrap a break from coughing for a decent amount of time you can always call your surgeon.  They generally will order a barium swallow to see what's going on. 

Good luck!

Denise