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Posted 6/10/2013 2:18 PM (GMT 0)
Hi everyone!

I'm very glad to have found this website and these forums.  I'm going to be having a Nissen Fundoplication on June 20th after ten years of suffering g.e.r.d and being on medication for all those years with the head of my bed propped up ten inches.  Even with thoses measures, I have still been suffering large volume reflux, mostly at night, but also other times when I bend over etc so, after four years of dithering, have finally decided to go ahead with the Nissen.

I have looked at some Youtube clips, both animation and actual procedures so I understand it.  I've also looked at lots of websites about post-Nissen diet and I plan to stick to liquids for some time, and very gradually build up to mushy solids later on. I know what to avoid, such as carbonated fluids, drinking with straws, anything that introduces extra wind.

I have some questions that I hope other members can perhaps answer:

Have other members found it helpful to take an antispasmodic such as Buscopan or similar for the bloating/gas?

I know I have to avoid chocolate but does that include white chocolate?

At this stage my plan is to return to work 11 days after surgery - is this too soon?  I work at a desk job.

I'm worried about future illness such as gastro during which I may feel like throwing up - is this even possible after a Nissen procedure?

I'll keep reading through the other forums, they are a great source of information and have allayed some of my fears about this procedure.  I'm very much looking forward to being able to have my bed horizontal again - not having to carry thick books in luggage when I travel so I can prop up hotel beds!  I'm hoping to eventually get off the Nexium also but mostly it will be nice not to wake up choking in the night.  Hope to hear from other members with any tips.

Jen   blush

Posted 6/10/2013 4:41 PM (GMT 0)
Hiya Jen!

I had my NF done back on April 30th and let me tell ya, it was the best decision I've ever made. I was tired of the PPI's 4xs a day, sleeping sitting up, not being able to eat anything without feeling sick and just the general cruddiness that comes along with GERD.

All the research you're doing is fantastic. Your post-op diet will be the key to your recovery. There are a TON of diets out there on the internet that will cross your eyes. However, keep it simple and stick to your surgeons advice. Likely while you're in the hospital, you'll be on clear liquids for the first day or so. If you can keep that down and it doesn't bother you, then you'll get moved up to full liquids, which means you'll get applesauce and oatmeal and the like introduced (smoothies, not-chunky soups, etc). My surgeon asked that I stay on that diet until I saw him for my post-op follow-up appointment on May 16th, which I did. Towards the end of that time period, I added soft scrambled eggs and small bites of bread (no crust!). Once your doctor clears you, start introducing other foods slowly. Avoid soft sticky food (peanut butter, marshmallows, etc) and really hard, crunchy things. Meats and tougher vegetables should be taken in small bites and chewed thoroughly. The key to avoiding all the bloating is avoiding gassy vegetables (broccoli, cabbage, etc.), chewing slowly, taking small bites, and sitting up straight when you're eating. As a complication to our disorder, us GERD'ers tend to swallow lots of air involuntarily when we eat/drink. That will take some time for it to go away and you'll find that you may be slightly uncomfortable after your first few real meals. Go for walks and sit up as straight as you can. I also found that sitting and pushing my shoulder blades back into the couch or chair helped expand my chest and opened up my esophagus a bit. I have never taken anything for the gas and haven't had much of a problem. Your diet and activity level will help manage any excess gas concerns you might have. As for chocolate, I've started eating it and haven't had a problem. While I was on my liquid diet, I had chocolate-flavored Boost and even a chocolate milkshake and didn't have any problems with that either. White Chocolate isn't really chocolate, so you shouldn't have any problems if you can handle dairy.

As Denise would say...surrender to your recovery. Best advice ever. Don't rush things. Your body will tell you when it's okay to start getting back to normal life. I went back to work the day after my post-op appointment. I also have a desk job. I just found that I would get tired quickly and found it helpful to take an afternoon walk around the building to refresh myself and finish the day but was exhausted when I got home.

Best of luck to you! I hope your procedure goes great and that you feel the same relief as I have. It's a fantastic feeling to be able to sleep horizontally and to be able to eat anything you'd like without the trouble associated with it that came with having GERD. Keep us posted on your progress!

-TonyG-
Posted 6/10/2013 7:58 PM (GMT 0)
Hi Tony,

Thank you so much for your reply - everything you say makes perfect sense, especially the sitting up while eating.  I have found myself practising chewing my food throroughly then breathing out before I swallow each mouthful and I'm hoping this technique will help avoid swallowing air.  I'm glad to hear you're feeling so much better, I hope to also have a similar improvement in my daily life, especially going to sleep wtihout lying there worrying I'm going to be woken up being choked to death by my dinner.  I'll keep you up to date with my 'wrap' journey and hopefully I can be of help to others in the future via this forum.  Thanks you again!

Jen

Posted 6/10/2013 8:15 PM (GMT 0)
Jen-

Welcome to Healing Well.

Please remember that things will get worse sometime around the 2 to 4 week mark, but will gradually get better from there. The surgeons never seem to tell anyone this. The wrap will swell and feel as if your are having reflux again. This is because the swollen wrap isn't as effective as it will be once everything settles in.
Along with surrendering to your recovery remember this recovery is a marathon not a sprint. It takes a good 6 moths for about 80 % healing and 6 months to finish healing.


I also found it easier to sleep in a recliner the first couple weeks or so. If you are going to lay in bed be sure to roll to your side and use your arms to push you up to get out of bed vs just sitting up. Your abs are going to be quite sore if you just sit up in bed.


Take care,
Bill
Posted 6/10/2013 8:35 PM (GMT 0)
Tony, great to hear you are doing well. Are you off PPIs now?

MMM
Posted 6/10/2013 9:26 PM (GMT 0)
MMM,

Yup, one of the first things my surgeon told me as I was about to be discharged after surgery was to stop taking the Protonix I had been taking 4x's a day for the last 5 years. I haven't had a single flare of reflux or heartburn since the morning of my surgery. It's been fabulous.
Posted 6/11/2013 6:11 AM (GMT 0)
Hi Bill,

Thanks for your reply also - I didn't know about the 2-4 week thing, I'll have to keep that in mind regarding going back to work.  I plan to keep my bed propped up as it is for at least a couple of months - what's two more months after ten years, eh?  Just went out and bought stuff like Buscopan, Degas and liquid paracetamol and vitamins, assuming I may have trouble with tablets for a while.  I will take this very steadily and not try to rush anything, that's for sure.  Did you find you lost any weight afterwards?

Jen

Posted 6/11/2013 10:20 AM (GMT 0)
That's great to hear Tony.

MMM
Posted 6/11/2013 1:37 PM (GMT 0)
I am NF + 13 weeks and received great encourgement from this forum and a Facebook group called Nissen Fundoplication.  I found a link to that group here in HealingWell.  That encouragement was due to the research I was able to do from the archives.  I read hundreds of threads related to the operation and got personal encouragement from the moderators and members.  However some of it was discouraging also--especially about diet.

I went into the operation with the understanding that I would never be able to eat certain foods, drink certain drinks, etc.!  Grains, breads, raw veggies, fruits with skins, chocolate, sugar or other carbohydrates, and certain meats would always be troublesome.  In some respects I would be a future Vegan and a limited one at that!  Not that that would be necessarily bad, but it was just not me.  Some of that was a misunderstanding on my part.  This might sound like I am a barbarian at the gate, but not everything your read on any site is necessarily true or if it is true, that it will universally apply to everybody who has an NF.

nono  I followed my doctors instructions exactly.  During pre-surgical office visits he told me I would be on clear liquids for two weeks then full liquids for several more weeks.  In particular he cited pasta.  He said the reason was that his Brother-in Law had the NF and had tried to cheat on the diet with pasta and he had problems.  I was prepared to do that.  I spent a lot of money buying things that would fit that diet.  However, what he told me post-surgery, the first night in hospital surprised me.   He said that when I was released I could eat anything that could be pureed.   That left a lot of room for interpretation.  I did not push the limits, but I pureed a lot of things including some soups that contained meat and/or some of the other "forbidden" items--such as creamed soups, vegetable beef and chicken vegetable.  I thinned all of those soups 50% with beef or chicken broth and pureed all the lumps of "stuff".  Some of those soups may also have contained pasta, rice, potatoes, or may have been thickened with unknown ingredients but once they were pureed they didn't cause me any trouble.  I continued with the pureed diet for six weeks.  nono While that may have been successful for me, that may not be true for you.  Everyone will respond differently.

At 13 weeks, I can eat anything including everything I listed above.  I may be unique but don't think I am. You have to listen to your own Surgeon, your own body, etc.  As in the diet that I followed, try small amounts of foods that you like.  If they cause you problems take a step back and return to the liquids.  Later try again.  I wish you every success in your recovery and a bright future without GERD.

The barbarian

Posted 6/11/2013 8:23 PM (GMT 0)
Hi all. I am only 4 weeks post surgery and I can eat almost anything now. The only things I haven't had is steak , chops etc. But pasta, salad, potato, sausages etc I can eat with no trouble. I had a "TOUPET" partial wrap so I think this is the reason I have had a great recovery. My surgeon said he prefers to do the partial wrap than the full wrap as you are able to swallow much better after surgery.....Yes everyone is different!! Good luck with your recovery!
Posted 6/12/2013 3:52 AM (GMT 0)
Jen-

Yes I did lose weight, but I had quite a bit to loose. I lost about 30lbs the 1st time, but had eating issues. I lost about 20 lbs the second time, but gained most back over about 18 months. I had lost about 60lbs when my esophagus tore and had my 2nd redo 2 years ago, but have gained back about 20lbs. Those are mostly muscle mass though since I couldn't eat for something like 6 months and lost a lot of muscle.

I would say about 15 to 20 lbs is somewhat normal, but some or all can come back when your diet returns to normal.

Take care,
Bill
Posted 6/12/2013 3:56 AM (GMT 0)
Jen,

I lost 20 pounds almost immediately and have gained about 6 of those back and am holding right about there. I find that I get fuller faster so I'm not eating as much as I used to so I believe that's helping me keep the weight off. I, however, definitely had the 20 pounds to lose. I'd agree with Bill that the 15-20 pound weight loss is normal after the fundoplication.

-TonyG-
Posted 6/12/2013 5:32 AM (GMT 0)

Thanks Bill and Tony,

It probably wont kill me to lose a few pounds so that shouldn't be a problem.  I've been reading through some other member's posts about their whole recovery etc and still have a couple of worries - it's a yucky question but did anyone else have issues with sudden diarrhoea that caught them out before they made it to a bathroom shocked ?

I'm trying to be prepared for any eventuality - possibly I'm overpreparing but would rather that than be caught out. 

And are there others out there who live alone and how well did you cope once you got home?

Thanks again, everyone, sorry to be a worry-wort. shakehead

Jen

Posted 6/12/2013 6:20 AM (GMT 0)
Hello All!! Im new here and was reluctant to discuss my Fundoplication surgery Im not doing as well as I would hope to. I had my surgery on the 15th of last month, which will be 1 month in. The first couple weeks I did rather well but I ended up having to go back to fluids again and now I am on soft foods. I have to see my surgeon next week because for some reason I am getting these horrible spasms, they start off in my stomach and end up in my throat. I had this right before my surgery and wound up in the Emerg room in so much pain they had to give me morphine. I cant even explain what this is but I cant feel them coming on. Im careful about what I eat and focus on eating slow but these things I have are very painful. Do any of you have something similar? Im a nurse and trust me, I dont have all the answers. Any help would be appreciated. I just dont like speaking neg especially for the people who are doing so well or havent had their surgery yet. Thanks so much for taking the time to listen. By the way, the only pos thing for me is this awesome weight loss! : )
Posted 6/12/2013 1:25 PM (GMT 0)
Hi CTMEDZ,

Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah It seems to me that if you were getting spasms prior to your surgery it's not all that surprising that you're having them at the one month mark.  It takes time for things to heal.   I had terrible lung issues prior to my surgery, and the problem persisted for about two and a half months.  It takes a full 6 months for most of the healing and a year for the rest.  You've got lots more healing to do.

You mentioned that you did pretty well for the first two weeks. Did your surgeon tell you that your wrap would become increasingly more swollen during the first two weeks, peaking on or about Day 14.  My surgeon told me that my swallowing would get worse before it got better, and that's what happens.  A few here have avoided the swelling issues, but most have the problems you're describing.  I think that many surgeons keep their patients on liquids for several weeks just because of this issue. 

If you take small bites and chew, chew, chew until whatever you're eating is a creamy liquid consistency, you'll do fine.  If something doesn't chew completely, don't swallowing.  It's perfectly appropriate for you to be on a soft diet at this point. 

I was turned loose at Day 6 to eat "anything that could be chewed to a liquid/creamy consistency."  I always kept a paper napkin handy to deposit inappropriate foods.  It's a trial and error project.  Take small bites and chew, chew,  chew, chew.  If it doesn't chew to a liquid, don't swallow it.  It'll open up a world of choices.  If you overdo it and your wrap gets irritated, take it easy and back off.  Soup is always a good choice at those times.

Don't assume that if you're still having spasms that you always will.  Healing takes time and a lot of patience.  Just relax into your recovery.  If you can surrender to what is, and listen to your body, you'll do just fine. I appreciate your concern for others and the fact that you don't want to scare people away from getting a Nissen that will help them.  We all have seen those scary posts online.  In fact, that's why I stuck around the forum.  I wanted to "pay forward" the positive help and information I received here when I had my surgery 4+ years ago.

I'm glad you've joined the forum!  Why not start your own thread on the main page?  Then you can share your recovery, ask questions, and get support.  Here's the link to the main page:GERD - Heartburn

Just click the "Post New Topic" button, add a topic and write your introductory post.  You could even copy and paste what you've written on this thread.

Glad you've joined the forum!

Take care,

Denise

Posted 6/12/2013 7:26 PM (GMT 0)
Hi Jen,

Glad you've found the forum.  You've already gotten some great advice from our wrapped members! Soon we'll be welcoming you the Wrapped Club as well!  I got a full wrap in February 2009, and have never looked back.  My issue was asthma/lung problems made much, much worse because of reflux.   Here is a link to my early recovery journal, in case you haven't seen it:

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

I'll try to answer some of your questions:

Have other members found it helpful to take an antispasmodic such as Buscopan or similar for the bloating/gas?

I didn't have much trouble with bloating, so the only thing I took was Gas-X to help with getting the burps started. This only works if your stomach is in the mood to burp, which it sometimes is.  Also, I took BEANO before eating gassy veggies, and it helped keep gas from even starting.

I know I have to avoid chocolate but does that include white chocolate?

Some people drink coffee right away, and don't have any problems.  I put chocolate in that category.  I have a sensitive/reactive stomach, and certain things bother me.  They did both before and after the surgery.  It's not a reflux issue...just a stomach problem.  I think you could eat a small amount of chocolate post-op and see how it goes.  Everything in moderation.  If you're a chocoholic, just tastes will be enough to keep you going through recovery.  I don't see any problem with white chocolate. 

 

At this stage my plan is to return to work 11 days after surgery - is this too soon?  I work at a desk job.

I'm a second grade teacher (retired) and planned to go back to teaching half days in two weeks.  My lungs weren't in good shape (an infection) and my classroom was filled with illness.  My PCP, principal, and teaching assistant all said NO!  So even though I'd planned to go back sooner, I ended up taking 6 weeks, and it was a blessing.  By the time I went back I was feeling great.

If you go back to a desk job at 11 days, you'll still be very weak and tired from the surgery.  Even though it's laproscopic and doesn't look like much was done, inside you've had major surgery.  If  you can possibly take more days, do so.  You'll be glad you did.

If you end up going in to work earlier, remember to limit bending and lifting.  Get others to do that kind of work for you.  Don't be a hero!

 

I'm worried about future illness such as gastro during which I may feel like throwing up - is this even possible after a Nissen procedure?

I was told by my surgeon that I wouldn't be able to vomit after my surgery, but in the past 4 years post-op I've had three stomach bugs and each time I vomited once.  I have anti-nausea drugs (Comapzine suppositories) and took them as soon as I realized I was sick.  Because of that I never vomited more than once, and thus protected my wrap.

It is very bad for your wrap to vomit--especially during the recovery period, but always. Be sure to get your surgeon, PCP, or GI doc to give you scripts for anti-nausea drugs, and carry them wherever you go.  You never know when you're going to get sick.  I like Compazine suppositories for stomach bugs.  Once my stomach is sick, no pills are going to stay down.  Zofran works well for mild nausea.

Good luck with your upcoming surgery!  Keep asking questions.  We'll be here to answer any questions we can and to support you through your surgery!

Best wishes,

Denise

 

Posted 6/13/2013 5:37 AM (GMT 0)
Jen- My wrap is schduled for August-- but I'm in the same boat. I'm reading everything I can about the surgery. I'll be following your story as it looks like you'll being getting wrapped before me.
Posted 6/13/2013 3:38 PM (GMT 0)
Hi Jen,

"Those" kinds of issues are directly related to how fast you advance your diet. Yes, some people have other underlying conditions that might aggravate the problem, but if you're generally in good health and don't get too ambitious on advancing your diet then you shouldn't run in to too many problems. That said, will you have moments of diarrhea? Probably. I think it's part of the healing process. Will it be of the explosive-can't-make-it-to-the-bathroom type? Probably not unless your body absolutely did not like what you were eating. Likely your doctor will send you home with some sort of narcotic pain medicine (make sure to ask for liquid and not pills!). If you take it at the regular intervals, then you will probably be constipated for a bit in the beginning. As you taper off of it (I was only on it for about a week after I got home) things will get "easier" and it'll be tempting to try to eat more because you'll feel better. DON'T. Stick to the diet.

More questions? Just ask!
-Tony-
Posted 6/13/2013 7:06 PM (GMT 0)
Jen-

I never had any accidents, but I do know just about every bathroom in the area pretty well. It's caused more from your body adjusting to it's new configuration and the gas they use puts pressure on your guts and causes trauma. While it heals from this trauma you will get bouts of dumping. Sugary foods and certain greasy foods are the worse offenders.
I could eat a raw apple and be fine, but eat canned fruit and dump.

If you get the chance please read Denise's recovery thread a couple times and a few others that are on here. Denise's is on the resources page at the top of the forum. If you want to know what the worst can be read mine there also. I am that 1 in 10,000 problem child.

As for nausea be sure to not leave the hospital without an anti nausea med script. This is just as important as pain meds. You will get nauseous some time and dry heaves HURT! Not to mention bad for a healing wrap. You will most likely be able to burp if they do a floppy wrap, don't panic thinking it didn't work. You won't be able to blow out the windows anymore, but eventually you will be able to release enough to feel comfy. This may take several weeks though.

Please, Please, PLEASE remember this recovery is a marathon not a sprint race. Slow and steady is how you win this battle. And sometimes you have to take a few steps back. We all get anxious and see our incisions healed and push our diets. I've done this 3 times and I did it with my third one too, but I knew what happened and backed off my diet. Believe me your body can survive a LONG time with fluids and small amounts of food. I couldn't eat or drink from 2/28/11 until 7/20/11, well I was able to squish the little sponge thingy soaked in water 6 times an hour the last 2 weeks.
So be sure to stay hydrated and eat 1/4 1/2 cup meals 6 to 8 times a day, if possible. Don't wait til you feel full. Your part of the stomach that tells you you are full is what they use for the wrap and it will give all kinds of crazy signals for several weeks to months.
Sorry I went of an a tangent, but we have a lot of people heading into this surgery and the surgeons never seem to know what it really is like to recover from this. My email is available 24 hours a day and I check it often if you have questions feel free.

Take care,
Bill
Posted 6/15/2013 11:13 PM (GMT 0)

Hi Denis and Bill,

Thank you both so much for your comprehensive answers and I'm sorry for not replying sooner.  Your advice is so helpful in allaying a lot of my worries.  My main thing will be to make sure I have anti-nausea drugs.  I spoke with my pharmacist last week about the surgery and what is available in liquid form for nausea and he was also really helpful.  He lives locally to me and knows I live alone so has given me his phone number to call if I need anything delivered, or even a bottle of milk or other groceries, bless him.  I'm 46 and in fairly good shape so I hope to be able to cope well with my recovery.

I will definitely not be pushing too fast, though, I promise and I think I will advise my boss tomorrow that I will be taking more than 11 days off from work.  I work 12 hour shifts in a high-stress job and if I'm going to be tired, then I'm going to make mistakes and in an emergency services job, I can't risk that.

I will absolutely stick to the diet, too, I will not risk damaging my wrap for anything.  I'll admit that yesterday I went with my best friend and her kids to Sizzler and we celebrated my last all-you-can-eat experience probably ever.  I just had to have one last hurrah and I did it at lunch time not dinner time, so no reflux last night (didn't east any dinner!).

Four more days to go and almost looking forward to it... I'll go and read your recovery story now, Denise, and will stay in touch with my own.  Thank you again, to everyone.

Jen

Posted 6/16/2013 12:34 AM (GMT 0)
Thanks, also, Tony.
Posted 6/16/2013 11:46 AM (GMT 0)
Jen,

You are very welcome!  That's what we're here for.  Bill and I got lots of help and support when we were going through the surgery and recovery, and that's why we stuck around to help others who need it. There aren't that many places online where you can get positive, supportive, and helpful tips from others who've been there/done that!  Be sure to ask any other questions that come to mind!

Best wishes,

Denise

Posted 6/16/2013 11:14 PM (GMT 0)
Jen, I would only add to the very good advice you've already gotten by saying I wouldn't take any medications or herbs or over-the-counter meds without asking my doctor first. Take a list with you to the hospital if you can't see the doctor before then.

I had no trouble with diarrhea, just constipation from my pain meds. I keep Miralax on hand still. I also didn't lose any weight, probably because I ate what I could, at first only 1/4 cup, every hour or 2. I have no problem with applesauce, eat it on my oatmeal every day.

For gas and bloating, avoid any "gassy foods," sodas, straws, eating while lying down or reclining. Don't let the surgeon "dilate" your esophagus if you have trouble swallowing, at least not right away, unless it's really severe like liquids not going down. Read some more about this from other sources. Your esophagus and stomach will relax and the swelling will go away after a couple of months. I can burp partly now, but happily do not have reflux - despite a young resident who insisted he wanted to dilate me. I wanted to agree to an endoscopy, but he said he'd dilate my esophagus even though I told him I refused that.

Some people can vomit after surgery, but mostly we can't. I had flu and went to ER with dry? heaves, nothing coming up. My antinausea med was not enough. I couldn't swallow water, was dehydrated after 3 days of it. They thought I was a drug seeker, didn't even get the right diagnosis. At least I got an IV for a few hours, although 500cc wasn't really enough for rehydration.

Post Edited (Alcie) : 6/16/2013 5:19:15 PM (GMT-6)

Posted 6/18/2013 8:34 AM (GMT 0)
Thanks Alcie, more good advice.  I'll admit I'm starting to freak out just a little bit, the surgery is day after tomorrow.  However, re-reading your posts and Denice, Bill and Tony's and all the others is helping me to stay calm.

Fortunately, I'm in the health profession myself (paramedic) so if I get dehydrated, there are any number of friends I can call who will come to my house and give me i.v fluids.  I will ask the doctor to write me a script for some really good anti nausea meds before I leave hospital.

less than two days to go - crossing my fingers for a straightforward procedure and recovery.  I've organised an extra week off work on top of what I was going to have so will hopefully be ok.  Thank you again, everyone, for your encouragement and reassurance.

Jen  blush

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