Giant Paraesophageal Hernia Surgery End of This Month

cuicui

Been there, done that - same place, same surgeon, same diagnosis. 3 1/2 years ago and SO glad I got it fixed!

I had a little reflux for years, then was in a bad wreck that pushed my stomach into my chest. It took me 4 months of jumping through the hoops of testing. I was really scared of the surgery, but knew I couldn't live without horrible symptoms unless it was done.

I was already in 60's but in good shape. I was in hospital for 4 days, left on liquids. Don't worry about bringing in anything unless you have food intolerances. I don't tolerate sulfites, so couldn't eat gelatin, popsicles, their broths and juices. I froze my own clear liquids and had a relative bring some the day after surgery.

I hated the pain button. They kept putting it in my right hand and I couldn't feel it or use it and dropped it. The cause was getting 4 sticks for a radial arterial line - sloppy. I used to do arterial sticks when I worked at that hospital. I couldn't swallow at all with the NG tube, but that was pulled the 2nd day, so not really much of an issue. You really don't want anything in your stomach, so don't sweat it. A relative could help you with finding the pain button. I had nobody with me, which was part of the problem.

You'll probably be on full liquids in a matter of days - clear liquids plus milk. Look up UPMC's post Nissen diet. It's online. When I went home I had to get my own food. I had things stocked up - Boost, mainly. I could only tolerate one a day because of my "allergies," but most people can consume it just fine. There aren't many places to shop in Oakland, but you have someone who can drive. They'll have to get your liquid pain scripts too, so locate the nearest pharmacy! They've got lots better stuff than morphine. If you've had experience with pain meds, make sure you take a list of your reactions with you to the hospital. I have two typed pages, including otc meds.

You'll be allowed coffee soon enough. Coffee and tea are clear liquids, without cream. I need my 2 cups of coffee!

Long-standing issues: only inability to vomit. Not really much of an issue. I quick chew up a Zofran if I am sure I am going to heave. I had a flu a couple of weeks ago - one that's not in the shot. I had dry heaves, but Zofran controlled it.

Hubby can look for the usual complications: bleading, breathing problems. Not much to worry about. This group of surgeons has a success rate higher than any I've read about. Recovery is a bed of roses, including some thorns. I wouldn't go back to having my GPEH on a bet!

Sloppy only meant that the artery should have been hit the first time. You won't wake up with this tube. It's only for immediate blood pressure during surgery.

I didn't have morphine. I was on Dilaudid immediately post-op, changed to Roxicet until I left the hospital. They must have changed policy if they aren't prescribing liquid pain meds now. Make sure to take at least a stool softener, probably even something stronger if you are on narcotic pain med at home. You don't want to get constipated! It puts pressure on the wrap. At home I was on a liquid narcotic a few days, then crushed Vicodins. It's easier to just chew them. You get used to the bitter taste. I know I need Zofran when I take most opioids. If you have ANY nausea post-op tell them immediately. They will normally put it in your IV during surgery, but you'll only get it when you ask for it later. Your home doc can prescribe it for you. I insist on keeping a little on hand for emergencies - like the flu.

They won't tell you about the NG tube. It's to drain the stomach during and immediatley after surgery. They'll pull it when they see there's no blood draining. It doesn't hurt. Maybe a moment when they pull it, not bad. Just don't try to swallow. It's NOT a feeding tube, just a drain.

Just go with what they do. They can't be absolutely sure pre-op. They have to get in there and see how much esophagus they have to deal with, because with the stomach in the chest it is hard to measure esophagus beforehand. It also depends on how well you swallow. I had polio as a kid, so my swallow is "wimpy." Therefore the Toupet. I did vomit once, but only a little and my stomach was full that time. I didn't even get any fluid up at all when I had the flu a few days ago.

Oh yes, I did read my notes. I was really embarrassed about the fat in my mediastinum. Worried too because if you've got fat there you have it around your heart. I was only maybe 25 pounds heavy too. I doubt they bother to comment about fat. They probably see it every day, and 30 lbs is nothing to them. The good thing about me reading it was I got serious about losing it. My cardiologist says I'm the poster child for dropping my cholesterol. I stopped eating bread, not hard since you don't want to eat that after this op. It's too hard to swallow unless it's toasted.

The mediastinum is the area in the chest where your stomach is now, up next to your heart. They have to go up in there and dissect the stomach, colon, and esophagus down before they can close the hole in the diaphragm. This why you want to have these thoracic surgeons, not just a general surgeon. These docs do thousands of these operations. It's not just a simple wrap. My surgery took something like 4 1/2 hours, not counting at least 3 hours in recovery. Tell the relatives to go get lunch. No use sitting around worrying.

You won't really want to see anyone after surgery for more than a couple of minutes, and limit it to no more than 2 persons, one at a time. You just want to sleep. They may be able to help you with the pain button or getting Zofran if you have nausea. Don't rush out of the hospital. Your condition is much worse than the usual simple Nissen. It takes lots more time to recover. It's life-threatening though, so necessary.

Hi all,

I am so glad to be reading your stories because after reading some other posts how this surgery ruined their life, etc.....I was ready to back out of surgery.

My surgery is being done in July. My surgeon is actually an esophageal transplant surgeon and has done more of these in the Phoenix area so I am pretty confident in his skills. He wanted to do surgery in March but because of my schedule was busy I am doing it in July. More than 2/3 of my stomach is in my chest and as long as I eat very small frequent meals I am pretty miserable.

I work a lot and have a demanding (desk) job and run a very large medical practice so I am trying to get a sense of how long others were in the hospital, how long before you were able to work, sit for hours, did you have issues with flatulence (if so, how much and how long did that go on?), how long before you were able to go on a (30-45 minute) walk?

In previous surgeries I bounced back very well. I am of regular weight and only have 5-10 lbs max that I can lose. Did you all lose weight? Did everyone have nausea? Are there any preventative treatments that you would suggest? I saw one person mentioned to make sure that you are eating small meals and chewing well. If you had an NG tube, was it put in after you were put to sleep?

Did everyone do a bowel prep prior to surgery? Did anyone have a pain pump that you administered yourself? I had one in a prior surgery (not related) and it was great. As a result I was never in pain.

Okay, finally when did you feel comfortable not having anyone around to help with your post op recovery needs? Like getting up and preparing your own meals, doing laundry, and that kind of thing. I am a very type A personality and like doing things on my own.

Thank you in advance to anyone that can give me your honest feedback about your experience. I realize we all heal at different rates but this forum definitely seems to be informed!

Kind regards,
Trixie

I wanted to add a few things regarding my own recovery experiences here. For reference, I had a toupet & hiatal hernia repair done 16 days ago. My hernia was about 4cm.

I did not have an NG tube. I specifically asked the nurse about it before the surgery as I was paranoid about it and she said the doctor only uses them in extreme cases or if something goes wrong. Maybe a larger hernia is considered an "extreme case", I didn't ask. I did have a catheter in during the surgery itself, but it was put in place and removed while I was under so I have no memory of it.

I was not told to do any kind of "gut prep" (laxatives, enema, etc) and ate a normal dinner (sandwich and chips from Jersey Mike's) at 5pm the night before the surgery and had water right up until midnight. I had no bowel problems post-op and had my first post-op bowel movement about 15 hours after getting out of surgery.

Didn't have a pain pump so can't comment on that. I did get both morphine and hydrocodone in the hospital. Both make you sleepy/woozy, the morphine will start working almost immediately since it is injected thru the IV. The hydrocodone they gave me in tablet form. It was a very large tablet and the first time I took one I didn't think to break it in half and it did get a little stuck. Had to drink a lot of water to get it to pass the wrap. After that I broke the tablets in half and they went down easier. Doc did say that they could crush them or give me liquid medicine if I really had trouble swallowing, but I didn't.

I have lost about 10-15lbs so far and expect to continue losing as I am overweight and only eat very small amounts at a time.

My surgery was on a Friday so I had the weekend to recover (went home the day after surgery), and my husband took Monday and Tuesday off work as well to be with me. After that I was able to stay home by myself no problems, could get up to make "meals" (heat up broth, scoop ice cream, etc.) I was doing laundry on Thursday. Could bend over fine, no pain or problems at all. I made dinner for my husband (not myself since I was still on the restricted diet) the following Wednesday.

I can burp (not belch) just fine and while I have been nauseous a few times since the surgery (they gave me a script for nausea meds when I was discharged), have not had to vomit so not sure if I can or not.

I have had a very excellent and easy recovery so perhaps I have just been lucky and am not the "norm" for this surgery. If you'd like to read more about my experience, see my thread " My Partial Nissen Fundoplication (Toupet) Experience -- A positive story"