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Posted 5/29/2013 2:44 AM (GMT 0)
To day I met with a surgeon concerning my GERD. 10 years ago I had the Bard EndoCinch procedure. It was worthless and did nothing for my reflux. In the past 17 years I have had 5 trips to the ER for nocturnal aspiration of gastric content into the trachea. It's an extremely terrifying and painful experience. You choke, cough and struggle to breathe. Your throat is on fire. The surgeon said that I really should have the Nissen Plication surgery due to the severe nature of my reflux and my previous failed procedure.

I have a few questions for those who have already had this surgery: At what point will I be able to eat a decent, bulky meal? I'm a meat and potatoes person and I really enjoy carbonated drinks-- I know-- not the best foods for somone having a Nissen. But seriously, is there a point where I will be able to eat a substantive dinner?

I'm nervous about this surgery and more concerned about the recovery and complications rather than the actual surgery. Any feedback would be appreciated. PS: I'm a 48 year old active male. Daily excercise. Average weight. No smoking, alcohol or caffeine.

 

Posted 5/29/2013 8:38 AM (GMT 0)
Hi Ian

Had my op nearly 10 years ago.

I was able to eat anything I wanted to after 6 weeks.

Bulky wasn't a problem, however you will have a smaller stomach so will get full quicker than you used to.

You have to chew your food properly and take it slowly with sticky/glutenous foods, but can eat any and as much of these as you like - although you can feel quite bloated if you eat too much.

I have what seems to be a fairly tight wrap and can't vomit or burp. As such, I tend to avoid fizzy drinks but others on the thread have suggested that wraps done now are more "floppy" and can allow some gas to escape so you may not have to completely give up the carbonated drinks.

After the first few months healing you will quite quickly realise how your body heals and reacts to different foods and you'll naturally adapt how you eat.

Hope everything works out.

Cheers.

Les.
Posted 5/29/2013 3:24 PM (GMT 0)
Hi Ian, good luck with your upcoming surgery. I am about 4.5 weeks post-op. I had a Toupet procedure, which is a partial Nissen. My esophagus doesn't work right so my surgeon didn't want to wrap the stomach all the way around it, as he was concerned I wouldn't be able to swallow afterword. The recovery is the same for both procedures, however. I have been able to eat pretty substantial meals of soft foods as of this last weekend (the 4 week mark.) I had salmon, mashed cauliflower, and macaroni and cheese one night, and fall-off-the-bone ribs and a baked sweet potato another night. I have not tried any "solid" meats yet like chicken breasts, steak, etc. nor have I tried raw fruits or vegetables. The hardest things for me to swallow are stuff like bread, toast, crackers, etc. It seems carbs with gluten are the worst. I also had problems with pasta when I tried it during week 3 but those seem a bit better now. My surgeon's nurse warned me that because stuff like bread can expand, it can get stuck in the wrap. Others on this board were able to eat toast and crackers within the first week or two after the surgery, so everyone's recovery is different. You will have to experiment with small bites of different foods to see what goes down easiest for you.

As eLaRef said your stomach will be smaller so you won't be eating as much. Both of those meals I could have easily eaten the whole plate before my surgery, but this weekend I ate half or less. Just meals more leftovers and that food stretches a bit longer, which isn't a bad thing. Since I only had a partial wrap done, I am able to burp quite easily. I haven't had anything carbonated since the surgery, however, nor have I needed to vomit, so I can't comment on either of those yet.

Make sure you ask your surgeon about what he wants your recovery diet to be like. Every surgeon will suggest/require different things. Mine said liquids only for 2 weeks, then soft foods for 4 weeks to follow (I am in the middle of that period now) and after that, we can re-evaluate and see if I can handle normal foods. Others on this board were told differently, everything from liquids only for 4 weeks to "anything you can chew to a liquid" after the first week or two.
Posted 5/29/2013 8:49 PM (GMT 0)
eLaReF and Maggie- Thank you for such a quick reply. I appreciate your encouraging feedback. I admit that not being able to burp is a concern for me. My surgeon is quite skilled and respected. He has performed over 600 Nissens. I'll talk to him about not wrapping too tightly. My guess is that he is probably quite familiar with this complaint and has mastered the wrapping technique-- (at least that's what I hope).

My last trip to the ER was only a couple of weeks ago--yuck! I really wanted to do a less invasive surgery like the Esophx, but my surgeons says my better bet is the Nissen given my history. I am now resigned and have accepted this treatment option.

My surgery probably won't occur until the latter part of the summer-- but it will happen-- most likely August.

I will keep the discussion board active after my surgery, and I look forward to all of your responses. Thank you.

Ian
Posted 5/29/2013 11:32 PM (GMT 0)
Ian

Welcome to Healing Well.

As the others have said, you will get full much quicker and should limit your food intake to 1/4 to 1/2 cup several times a day during recovery.
I have the floppy wrap and I can eat anything I want to, but I can't eat as much as before. Chewing your food to a liquid is important during the first few months. The wrap heals about 80% in 6 months, but still takes a full your or so to heal completely. Expect things to feel good the 1st couple weeks and then get worse due to swelling and adding new foods to your diet. This is very normal, but people tend to question if the surgery worked or not.

Take care,
Bill
Posted 5/30/2013 2:57 AM (GMT 0)
Bill-- But can you burp? Can I still maintain a decent body weight? I know most people are concerned about gaining weight-- not me. I don't want to lose weight. Did you have a problem with weight gain or loss during your recovery period? Also, you quoted a statistic about the wrap being healed 80%. In what way is it not completely healed? Swelling? Over time, have you been able to eat larger meals or are you restricted to smaller meals for the rest of your life? I guess I'm worried about only being able to eat like a small bird. Sorry for all the questions. The decision to have Nissen surgery came with incredible anxiety. I appreciated your reply. Thanks!

Ian

Posted 6/1/2013 8:18 AM (GMT 0)
Hi Ian, I had my wrap, a Nissen Toupet (Partial wrap) the same as Maggie the cat, 16 days ago...I live in Australia and my Specialist explained everything to me beforehand. He said he preffered to do the Toupet as he said he has had no trouble with people eating after surgery when doing the Toupet. As I understand it a Toupet is a 3/4 wrap and the Hiatus Hernia is sewn onto your esophagus. Because it is 3/4 the wrap doesn't become too tight as that seems to be the reason some people can't swallow. I have had no trouble swallowing since my op. I was on vitamised food for a week then went onto mashed food including chicken and fresh atlantic salmon. Today I had some salad, Lettuce, tomato. cucumber and grated carrot and some hot chips ( I think you call them fries) also 3 pieces of battered squid and a small wholemeal bread roll. It was all fine. Mind you I seem to have had a brilliant recovery all round. I am 67 year old female and the surgery was nowhere near as bad as I expected. Because of my age, my surgeon had me sent to ICU straight after surgery, about 1pm and at 10pm the same day they kicked me out of ICU and said I wasn't sick enough to be there, so went down to the ward. Was in hospital 3 nights and then went home. By the way I have been able to burp since the day of the op!! And NO I haven't had any fizzy drink since either. I really hope this helps and I am happy to answer any questions you would like to ask. I have a forum on this sight day by day since my op if you would like to read it. Its Headed "Having Partial wrap 15th May" I suggest you talk to your doctor about having a partial wrap rather than A full wrap if it would be suitable for you....Good Luck!
Posted 6/1/2013 10:20 AM (GMT 0)
yeah  I am a 73 year old retired military and had a full (but floppy) NF 11 weeks ago. I suffered from Hiatal Hernia and silent reflux for years, not GERD.  Post surgery, I was on a full liquid diet for two weeks then soft food for three weeks.  The full liquid diet included anything that could be pureed.  I followed the Washington State University post abdominal Surgery diet that is posted in the files on this site.  Since I went on solid food I have only found one thing that I had problems with--watermelon.  nono Watermelon is deceptive because it has lots of cell membranes that might not get chewed well and can temporarily clog up the wrap.  I can do a modified burp....I have to really focus to do it in order to remove injested air.  I can drink carbonated drinks in moderate quantities if I swish them around in my mouth to reduce the amount of bubbles.  I get large amounts of abdominal gas--far more than I would ever have pre-NF.  But (I claim) I am very fortunate in that mine smell like roses--you can ask my adult children......
Posted 6/1/2013 10:33 AM (GMT 0)
One additional thing I forgot to mention...I am also very active and I was prepared to be physically disabled from my normal activities for six months to a year during recovery. As I pointed out previously I did not suffer from GERD and I do not claim that your recovery will be similar to mine. However, since I have been retired, my normal routine was to play tennis six days a week. Prior to surgery I made every effort to be in the best physical condition I could be in (for a fat old man). I weighed 213 lbs. At my two-week post op checkup I asked the doctor how long I should wait before I began to play tennis again. He said, "when you feel strong enough"! So, I waited another week and then I just hit a few balls with some friends. I didn't play full games but just hit for exercise. At five weeks I began playing games with them and now play every day again. The Doctor cleared me to play in a Senior's tournament next week.
Posted 6/1/2013 12:47 PM (GMT 0)
Hi Ian,

It sounds as if we'll be welcoming you to the Wrapped Club soon!  I'm glad you got so many helpful replies to your question.  We've got great members here at Healing Well!

 I had my full wrap about four and a half years ago.  Believe me, once you're healed fully, you won't have a bit of trouble maintaining a healthy weight. 

The stomach may be a bit smaller, but the main reason your quantities are so low during recovery is that the top of your stomach (where the message of fullness is translated and sent to the brain) is swollen due to the surgery, and the brain interprets this as fullness.

It is true that because of the wrap you'll always need to eat a little more slowly  and chew your food completely.  Just this week I was eating a baked potato skin and all, and it caught at the wrap site. It's not a real problem...it just causes a little discomfort and spasming until it gets through.

If you're a "meat and potatoes guy", be sure to have a crock pot on hand.  You can put a nice piece of beef, potatoes, carrots, and onions in with a package of Lipton onion soup mix and about a cup of water.  Let it all cook for hours and hours.  (about 12 hrs or so)  When it's done, everything will be extremely soft and will be able to be chewed to a liquid.  I thought I'd only be able to eat the meat-flavored veggies, but the meat was so well cooked that I could chew that to liquid as well.

My surgeon set me free to eat "anything that can be chewed to a liquid/creamy consistency" at 5 or 6 days post op.  Some require liquid diets for a while.  It's an individual decision.  My mouth and teeth became my blender, and I never really had a problem with this eating protocol.  It made my recovery much easier and more enjoyable.

I can burp...often quite loudly.  However, I don't really make the decision when.  My stomach burps itself, and I just go along for the ride.  It works, though.  Only very occasionally does the gas get a little ahead of me, and I get some bloating.  It has not been a problem, though.

I stayed away from soda for about a year, then started testing.  I can drink a couple sodas without a problem.  I drank beer much before sodas, and its carbonation doesn't bother me.  Champagne is another story.  I wouldn't recommend drinking much of that.

Here's my early recovery journal, in case you haven't run across it in the Resources section:

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

Glad you've joined the forum!

Best wishes,

Denise

Posted 6/1/2013 1:19 PM (GMT 0)
I had my Nissen about a year and a half ago.  Don't worry about your weight.  I lost 19 pounds at first, but put it plus a bit more on since.  I was a very active person prior to my surgery; Irish dancer from age 12 and still did it twice per week, as well as going to a personal trainer twice a week.  Walks etc.  I was told not to do any of this activity until about 5 months after the surgery.  The surgeon wanted the scar tissue to build up so the wrap would not slip or be compromised.

I returned to Irish Dance 5 months later for a competition.  I went back full force and ended up injuring myself terribly; had to have foot surgery.  So that explains my weight gain.  Had about a year of no activity.  So be careful returning to activity.

I had no problem with liquids, and foods like mashed potatoes until about day 6, then I could not eat any soft foods.  They would get stuck in my esophagus and I would have purging.  That lasted for about 4 to 5 days.  The wrap was tight, but it was caused by delayed swelling, which was frustrating, but normal as I learned.

All in all, I would have the surgery all over again.  Yes, carbonation is hard on the stomach still, so I do not do much of it.  I do have increased gas, but that is worth feeling better.  I am a bit worried as of late.  Feels like the reflux has returned; however, I am thinking it may be a med and allergies that are causing this feeling.  I'll give it a bit before I head to the doctor.

I wish you luck.  Just relax and know there are ups and downs during the recovery, and everything beyond the initial couple months; eating, activity etc. is very individual.  you just have to take it slow and know it takes time to figure out the new anatomy of you body.

Posted 6/1/2013 7:01 PM (GMT 0)
Thanks to all for the comforting and reassuring comments. On Monday I do a Barium swallow test and then on Thursday the surgeon will do an upper endoscopy to see what everything looks like - especially in light of my previously failed Bard Endocinch. I will most likely receive dilations as food already tends to have difficulty going down the esophagus. It's comforting to know that those who are older than me have recovered well and resumed an active life. I do enjoy my daily excercise. I play basketball and use my Nordic Track on days when it's rainy and cold.

Sandy if I ever could afford the flight, I'd fly to Australia tomorrow. My wife has cousins and an aunt who live there. We have always wanted to visit.

I'm assuming that everyone here no longer has reflux or regurgitation. My problem is that I have to go to bed starving-- and even then it is possible for me to have an episode of gastric aspiration that would result in an ER visit. I have to remind myself that the end goal is to eliminate a lifetime of digestive misery. Thanks again. Will keep all posted as the date draws near.
Posted 6/1/2013 7:53 PM (GMT 0)
Hi Ian, Just some more reassuring......Before surgery I was on reflux meds for about 10 years...Was taken off these the day after surgery and no reflux since. Also I had to sleep 30 degrees upright prior to op and now can sleep flat on bed for first time in 6-8 months....its heaven!! I was only getting about 3-4 hours sleep before ( with sleeping tablets...first time in my life having to take them) and am now getting about 7 hours sleep (no sleeping tabs)...What a blessing!! Before surgery I also had asthma and a persistant cough for approx. 12 months left over from a really bad lung infection I had last year. I was coughing up clear stick mucus several times every day. I am pleased to say I no longer have the cough or the asthma since my op....It seems to have cured a multitude of things!! Mind you, I am a Christian and I had a lot of people praying for me at the time. A positive attitude is also great medicine..I believe it is mandatory to your recovery! I sincerely hope all goes well for you and you have a speedy recovery!
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