My Nissen Fundoplication-Pre and Post Op Journey

July 15th-

I am having the Nissen Fundoplication on July 18th (Thursday) and I wanted to document my recovery. I am 45 yo, male, and have been living with excruciating GERD for years. I requested this surgery years ago and was told that I should just use medication. I've been on medication for years and have now developed Barrett's Esophagus. So, NOW my Gastroenterologist has referred me to a surgeon.

I have read so many great stories and tips on these forums that I feel very prepared for the surgery and the recovery.

I know everyone recovers differently, but during this Pre-Op period of a few days, I wanted to mention my impressions of how my surgeon has prepared me for the RECOVERY.

I have had a number of surgeries in the past and the main take away that I have is that neither the surgeon nor the hospital staff (nursing, dietitian, PT, social work)prepare you for recover the way I think they should.

I should also mention that I am single, live alone and because I live in a large city, do not keep a car.


After reading the forums on HW about recovery, I make a 2 page list of questions mainly about food choices, medications and possible symptoms.

My surgeon dismissed all of them, saying that I can eat anything that I can chew small enough to swallow. This is not the case with most people on this forums and I certainly don't want to use trial and ERROR to decide what agrees with me. I will stick to the approved Nissen Diet.

I also asked about needing a pill crusher (as I take some daily medication) because many people spoke of not being able to swallow anything but liquids for some days after the surgery. He told me that wasn't an issue. I bought one anyway just in case (I can always use it for the dog's pills when he has them!)

The biggest issue that I have about not being fully prepared is prescriptions and groceries.

I asked for my prescriptions to be sent to the pharmacy in advance of my discharge so I would not have to wait at the CVS after just leaving the hospital (this happened after my spinal fusion and was intolerable). I also requested a scrip for anti nausea medication and was told NO. I was told that If I needed it after I was discharged I should call for a script. This is exactly what I wanted to avoid and anti nausea meds are not a controlled substance that is in demand on the street so why not err on the side of caution and send me home with it?

The groceries part is what flabbergasts me. I was told that I would get a consultation with a dietitian at the hospital AFTER my surgery to discuss my diet, Post-Op! I am speechless. Why would you not provide that information PRIOR to the surgery o you can be stocked up on the items you need? It's not as if most people are normal prepared for a liquid diet at all times, and who wants to grocery shop after being discharged from the hospital?!

Thankfully, because of these forums and other sites I am prepared food-wise and in over the counter items such as Gas-X.

I know this was a bit of a rant but this is what my experiences with surgery have told me. There is an assumption that everyone has; Transportation, Caregivers, and Capacity to tackle all of these necessary things Post-Op and on pain meds. It doesn't make sense to leave these things until after surgery, when you could be VERY prepared at home for the recovery, which is the hard part for the patient, not the surgery.

So that's my Pre-Op statement/rant. I will post next after my surgery (Unless something interesting happened between now and then!).

Best of luck Sheila!

Bill,

Thanks for the recommendations. It's interesting that you mention things getting worse after 2-3 weeks (wrap swelling), my surgeon dismissed that as well
I will DEMAND the nausea medication. I think it doesn't hurt to have it anyway and there's a better than average chance I WILL need it.

Out of curiosity, what anti-nausea medication did you get, and was it helpful? Also, aside from Gas-X, is there any other over the counter OR prescription I should consider having available?

Thanks for the tip Tara!

Hi Ben,

Good luck with your surgery!  You're right about this forum...it's a lifesaver for providing answers and important things to know.  Yes, DEMAND anti-nausea drugs.  You don't just need them for possible post-op nausea, but should always have them on hand.  Once wrapped, you won't want to vomit or retch severely with a stomach bug, as it can damage the wrap.  I can't believe how obtuse surgeons can be about that. 

My surgeon happily provided me with a script for Zofran (great for run-of-the-mill nausea) and my PCP gave me Compazine suppositories for those all out stomach bugs.  I didn't know if I'd be able to vomit post-op, but since my surgery 4+years ago I had 3 stomach bugs and each time I vomited once before taking the Compazine to stop the nausea.

Interesting that your surgeon doesn't buy the "wrap swelling" fact.  My surgeon actually told me that my swallowing would get worse before it got better because of swelling, and that peak swelling would be on or about the two week mark.

I took my own medications to the hospital, so I wouldn't have to pay the big bucks for the hospital's version.  They took the meds to the hospital pharmacy to get them approved and then I could take them no problem.

As Bill said, when you eat solids you need to chew them until they become a liquid/creamy consistency.  My surgeon was unique in that I was on liquids in the hospital (don't use straws--they will most likely give them to you) and went home with a soft diet.  Then when I saw him at Day 6 I was set free to eat "whatever can be chewed to a liquid".  My teeth/mouth became my blender.  It was trial and error, and I kept a handy paper napkin available in which to deposit anything that didn't chew completely.  It worked great for me.  Toasted bread chews fine, but stay away from untoasted bread and steak. Don't swallow anything that doesn't chew to nothing.

Good luck with your surgery!

We'll soon be welcoming you to the Wrapped Club!

Take care,

Denise

Ben-

I use Phenergan for nausea and it works well for me, but others use Zophran, etc.

I have found OTC Pepsid to work well for any lingering heartburn while healing. I never really had any issues with gas, so I can't comment on that.

Now for the uninformed doctors. Since most have never had to go through this recovery they have no idea!

When I was at the University of Iowa for an esophagus tear I met lots of GIs and GI surgeons. They were all very interested in what my recoveries were like with my past 2 nissens. One of the GIs training there moved to my area and became my new GI. He remembered me because I was such a difficult case. Anyway, he told me I should write a book or a blog about my experiences because the doctors don't really understand what we go through. I told him I was a mod for this site and explained to him about this site and he thought what we do here is very valuable.
Mt PCP has been thinking of this surgery and even he wasn't properly informed. He asked me what to expect if he went through with the surgery. Now that was a strange appointment.

In my experience there are 2 types of doctors, 1) willing to listen and learn from what there patients go through and 2) those that have a severe complex and won't believe anything that doesn't come from another doctor or research. I am lucky to have had mostly the 1st type.

I have had a nissen since 6/06 and I carry anti nausea meds with me everyday.

Take care,
Bill

July 19th-

Well I'm home 29 hours after my surgery.

My surgeon sent me home with out pain and anti nausea meds. He knows that I have Percocet for occasional use for my spinal fusion, I asked for Oxycodone (w/o the Tylenol) because that little pill would be tiny and easier to swallow. He told me to just crush my Percocet, which I did and I throw it up every time.

He told me that Zofran has terrible side effects and he wouldn't prescribe it or anything else, despite the fact that I had been on it intravenously every six hours since the surgery.

So that is my Dr experience.

I can not seem to even get water down. Water and anything else just accumulates in my throat until it comes up.

It's going to be interesting without the IV saline. Hopefully it will be better tomorrow.

I am burping like crazy and that worries me, on the other hand I'm so glad I can, even though it hurts. So that's it for today!

Thanks Denise.

I am seeing how this goes today. I seem to be able to get down some juice, but not enough to keep hydrated. I'll contact him if it doesn't get better by this afternoon.

I did find that I can get a pain pill down with a small sip of liquid antacid, so that has helped.

Hi Ben,

Sorry to hear you required an ER visit, but happy that your doc was there to take care of you.  It is amazing how dense some surgeons are regarding these things.  Did your surgeon have lots of Nissen experience?  It's unbelievable that you were sent home with gallbladder surgery instructions.  That was a big "oops"!

Occasionally someone's wrap swells more than the average amount, which causes lots of problems with getting nutrition and liquids down.  In that case, medical intervention is required.  I'm glad you're seeing your surgeon on Monday.  He really dropped the ball.  Maybe it will be a learning experience for him and someone else will benefit from your problems.  Too bad you had to deal with it, though.

The problem is, the wrap generally gets more swollen before it goes down and things straighten around.  I will say this.  Even now, if I chug water, it backs up and drains down.  It's not a problem, but I can feel it.  I chug water all the time...it's just an interesting experience!

Hang in there.  You're in the roughest part of your recovery.  It'll gradually get better and better.  Let us know what the surgeon says!

Happy healing,

Denise

My husband had Nissen surgery May 1st along with fixing a massive hiatal hernia and opening the lower part of his stomach for quicker discharge. There was no options other than this surgery for him because he had a double lung transplant 8 months ago and was starting to have chronic rejection because of Gerd. It's been very slow recovery for him and at 2 1/2 months post he still struggled with bloating and difficulty eating certain foods. Because of his anti rejection meds for his transplant he has slower healing results. But the good news is that all rejection of his new lungs have stopped. For some reason he finds it easier to get food down if he lays down right after eating.

Thanks for the support Bill!

I am meeting with my surgeon tomorrow. He wan'ts to see me.

I am interested to see if he is conciliatory or berates me for not calling him first. :) I detest these sorts too.

The saving grace is that this should be our last appointment. I will go to my GI for the rest of my recuperation.

July 23-Day 5

I have been wondering about burping. I am burping after drinking and eating anything. I am sure that this is better than NOT burping, but I guess it worries me that I am able to do this SO much. Could the wrap be to loose? As of this morning I feel like I cold eat or drink anything (not that I will) because everything is going down easily and with the burping (releasing gas) I am not uncomfortable.

Any thoughts?

Ben, thanks for doing the diary, I like to read successful outcome stories.

Your surgeon sounds rubbish, hopefully he did well on the actual procedure though. Its always a bit of a roll of the dice with doctors some are good others aren't, I've found that out the hard way after seeing many doctors.