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My Nissen Fundoplication-Pre and Post Op Journey

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GERD & Acid Reflux
Do you feel you were prepared sufficiently for your recovery by your physician?
Yes-Absolutly - 7.7% - 1 votes
Yes-Somewhat - 23.1% - 3 votes
Didn't effect me - 0.0% - 0 votes
No-There were gaps - 30.8% - 4 votes
No-Not at all - 38.5% - 5 votes
If it hadn't been for friends and family I would have been unprepared. - 0.0% - 0 votes
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Posted 7/24/2013 3:01 PM (GMT 0)
July 24-Day 6

Well It's been one week since the surgery and I am a bit concerned.

Along with my full ability to belch (and I appreciate that that means less pain for me!), I have been aspirating in my sleep for the past 5 days like clockwork and last night I was woken up with a heart attack of pain from GERD. I haven't had that since the surgery. I am no longer on Omeperozol, although I will start taking it before bed for a while.

I guess with all the surgeon issues, I am starting to wonder if his lack of concern about my dietary and meds concerns, is because he does such a loose wrap it doesn't restrict or accomplish the goals it should. I hope not, but I am not feeling confident. The aspiration is the worst part of GERD and the scariest and I certainly hopes that was over.
Posted 7/24/2013 6:10 PM (GMT 0)
I had my surgery on June 17th. I have trust in my surgeon but he did not communicate very much about the healing process. I found this blog before my surgery and am so thankful! At least I had some information to start with and then I have followed the progress of others.

Thanks to all of you for your candid comments!!! It has been a wealth of information for others.
Posted 7/25/2013 4:54 PM (GMT 0)
July 25-Day 7

Thanks Andy for the nice note!

Well It's been a week and What a week! I guess aside for the medical part I have to say that my biggest take away is this; No amount of research and planning will get you when you need for recovery if your Dr. is, to quote Andy, RUBBISH.

If I could do this all over again, I would have gone to another surgeon immediately after running my legitimate questions, gleaned from these forums, past my surgeon only to have him dismiss them as irrelevant. Since the key to this entire surgery is an understanding of the reality of recovery and long term diet change, a surgeon that doesn't seem to be in touch with that isn't worth having.

I am starting to add some FOOD into my diet today. Baby steps. I see now that REMEMBERING to chew thoroughly is a hard thing to keep in mind. It takes concentration and re-training! I get full VERY quickly.

I've lost 10 lbs and look forward to loosing more. I am waiting for the glue to drop off because all I want right now is a long soak in the tub. :)
Posted 7/27/2013 1:45 PM (GMT 0)
July 27-Day 9

Well things have gotten better in the food dept. Eating SOME soft food, mostly mashed potatoes and chicken noodle soup.

I am still throwing up (really esophageal spasms) if I eat to fast or to much. Temperature is a big issue, cold and hot don't agree with me. I am DYING for a BIG long drink of ice cold water!

I am having one BIG problem though. I use to wake up with aspiration choking once every week or two. Now it's every night and multiple times. I am not getting much sleep and I am coughing up things that should not be in my lungs. I am sleeping almost sitting up after the first one of the night and still am getting it.

Part of it MAY be my fault. I find it hard not to drink something before bed (and maybe eat a little something). This may be part of the issue, but I think it's more than that.

I am hoping this will subside when the swelling subsides more. Is this common or should I be talking to my Dr. about this?
Posted 7/27/2013 5:17 PM (GMT 0)
Ben-

You are reaching the peak swelling part and the wrap will not function properly while it is swollen. Until this goes down it may be necessary to return to the pre surgery lifestyle things such as not eating a few hours before bed and such.
Stay away from cold or over hot drinks. They aren't good for an irritated GI system right now. Warm is okay, but hot and cold isn't. Both can start spasms and cause things to get stuck.

Hang in there, it will get better.

Take care,
Bill
Posted 7/27/2013 6:26 PM (GMT 0)
I had my surgery this week on 22nd July after cancelling it a year ago. I was complaining this morning about the pain in my back and ribs whenever I eat/drink. It's actually a pain for me to have to eat. At the moment I am still on a liquid diet/Ensure milkshakes/jelly/yogurt(double cream)/strained soup/watery mash potato made with lots of full cream milk and butter.
My surgeon has instructed that I follow this diet until next week Friday. Then once I have seen him, I change to a diet where everything is pureed for a month (BABY FOOD) and thereafter for a month to a diet where i can eat anything as long as it can be mashed with a fork. That seems a lot longer that all the threads I have read through.
Although I probably feel this intense pain at least 5- 6 times a day, it is so much better than the last 2 years of having a constant sore throat/cough/running nose and asthma as well as having to sleep propped up every night. I never really experienced heartburn, just severe flu like symptoms non-stop.
However, can anyone help me with ideas on what to eat so that i don't lose any more weight. I went on diet prior to the op, for 5 months and lost 17 kgs (which i needed to lose.)
I am 51 years old, and before i went for the op, my grandchild (3 years old) was with me while i was getting dressed and told me "you have granny legs."
When i asked her mom what that meant she said that when my grandchild is in the bath for too long and her fingers look like prunes, they tell her she "has granny fingers!!!!"
Posted 7/28/2013 9:46 PM (GMT 0)
July 28-Day 10

Thanks Bill for the advice. It has helped.

I'm eating SOME soft foods in moderation. Mashed potatoes are my friend!

NATLER-I am not expert, but I saw this tip in another thread and it was the highest calorie food I could eat at first. HONEY! It went down easily and I ate a ton of it the first few days.You can also add it to your Ensure shakes (although I found that BOOST shakes are MUCH tastier. Best of luck maintaining your weight! (I myself am enjoying the weight loss!) :)
Posted 7/29/2013 6:05 PM (GMT 0)
July 29th -Day 11

Yesterday I ate well for the first time (soft foods). Today was another matter.

Well you weren't kidding about the wrap swelling peaking! I am back to all liquids. I am so grateful that I was warned about this from the forum, otherwise I would have been worried.

This gives me a good reason to use my Boost supply!

I am going to meet with the hospital administration tomorrow to discuss the bungling of my recovery. I am not hoping for anything more than POSSIBLE better treatment for future wrap patients.

Other than this, I am doing OK and waiting for my glue o fall off so I can take a bath!!
Posted 7/31/2013 3:22 AM (GMT 0)
July 30 - Day 12

Wrap swelling is in full gear, but I feel fine. I am still concerned about the nightly aspirating. I am basically sleeping siting up to avoid it, but It is still happening to some degree, so a bit tired from all the getting up to cough.

I met with the hospital administration and the representative was truly appalled by my discharge and treatment from my surgeon. I presented her with an 13 page letter and a copy of the Nissen Diet.

She will be turning it over to the VP of Physician Services, so we'll see what happens. I hope they address this so others are treated more appropriately.
Posted 7/31/2013 1:17 PM (GMT 0)
Ben,

Thanks for taking the time to discuss what happened to you in the hospital in an effort to improve the situation for the next person!  It will definitely make a difference for another Nissen patient.

If you're having a lot of wrap swell, it's likely that whatever is left in your esophagus when you go to bed is migrating into your lungs to some extent.  Also, with esophageal irritation that might be happening at the wrap site, your esophagus is making lots of mucous to protect itself.

If the problem continues or gets worse, discuss it with your GI doc or surgeon.  See what they have to say about the whole thing!  In the meantime, continue to sleep with the head of your bed elevated/or wedge/or recliner, so you don't have as much trouble when you're trying to sleep.

Happy healing!

Denise

Posted 8/1/2013 3:55 PM (GMT 0)
Hello everyone,

I just had my annual upper endoscopy (EGD) a few days ago, after being on Dexilant 60Mg, once daily for a year.

To my surprise, my Gastro MD said that all was normal. No inflammation. No Gastric Polyps. Yet I have reflux.

Biopsies were taken and I will have the results next week.

He asked if I would strongly consider the NF previously suggested and I told him "not at this time." I mentioned the Torax Linx and the yet unapproved EndoStim and he looked like he never heard of them before.

Blank expression on his face.

Ben, I understand your feelings about the hospital and doctor. I have had similar experiences.

Actually, it would be great if you could tell us or email me (in my profile) about your Hospital and/or MD.

I would like to avoid that person if in the NYC area.

I don't want to be on PPI's, but I don't think that these newer procedures are ready (and approved) to give me the lifestyle which I am seeking. The NF makes me shiver, even though it is highy promoted. The surgeon who would like to operate on me to do the NF robotically said that "I will" be able to vomit, but mentioned nothing like the risk of ruining the wrap or having to eat pureed foods. Then again, he wanted me back for a second visit to discuss more about the NF surgery and I didn't take the next step. Guess I'm too scared.

All comments welcome.

GM :)

Posted 8/1/2013 4:03 PM (GMT 0)
GM,

My surgeon was not in New York, so you dodged that bullet!

MY feeling, and this is only MY feeling, is that the NF was the best choice for me. My issues have not been with the surgery, but the surgeon and the follow up care. That can be avoided and I should have run when he dismissed my questions.

Be that as it may, as far as I know on my 2 week anniversary today, the surgery went fine. I am optimistic and from everyone else on the forum, the food part gets better and better.

Now I can't say how I'll feel about it in 3-6 months, but I seem to be progressing at the usual rate and it had dramatically reduced my acid reflux.

My advice is to do more research, check out ALL the threads on NF on HealingWell.com and anywhere else you find forums. The surgery is the easy part, the recovery is really a matter of being prepared and knowing what is coming.

I hope that helps somewhat!
Posted 8/1/2013 4:10 PM (GMT 0)
July 31 - Day 14

Well it's been two weeks. I've lost 10 lbs (was and am hoping for more). I am still on the liquid diet with some soft food thrown in (but not much at one time!). I would kill people for a slice of pizza and a Diet Coke! My reflux is SO much better, although I started taking my Omeprozole again, just until I am out because I did have 2 episodes and I know that it will happen occasionally, especially right after surgery. I have found that the liquid pain meds make swallowing MUCH easier, so I am still taking a small amount in the morning. Eggs that are not scrambled are not your friend. I tried a poached egg and that was an experience! Also noodles from Chicken noodle soup get stuck all the time.

My biggest issue is that I am still coping with the nightly aspiration. That part is hard to manage (and I am doing everything I should to avoid that), I am hoping that improved before I get pneumonia!

We'll see what week 3 brings!
Posted 8/1/2013 4:11 PM (GMT 0)
Hi Ben,

Thanks for your prompt reply!

I strongly feel that preparing a patient for the after care of each particular surgery is a specialty onto itself.

Please keep us posted on your progress.

Best,

GM :)

Posted 8/2/2013 2:44 AM (GMT 0)
Ben-

I am very impressed with your attitude toward all this. It really will help you get through this recovery, please do loose that.
As for the non scrambled eggs, here's what I have notice with foods early on and I mean the 1st 3 months or so. Any things that doesn't have some "body" to it can pile up at the wrap as the muscles can't force it past the wrap. I hope this makes sense to you. If not I can try to explain it better. Anyway, that's why even mashed potatoes that aren't somewhat runny can pile up too. It's strange because you would think those soft foods would be alright. but they aren't.
I am very happy to hear you got in tough with the right person at the hospital and I pray they do follow through with your complaint. As we discussed before you got one of the surgeons I detest as well as you do.

I am thinking Denise may be right about some food still sitting at the wrap area and that may be causing some of your night time reflux issues. I had this very bad with my 1st wrap and also had it some with the other 2. I found that if I drank some water a few times an hour or so before going to sleep it helped with this. The food basically ferments and that's as bad as acid.
Keep up the great journal, it will help others here.

GM-
It's good to hear switching to the newer PPI has helped your polyps! I can understand your wanting to wait and see what is in the future for the surgical options. YES, many GIs don't stay up on the new techniques that are out there. I have had this several times. I was lucky to have had a new GI here that was training at the University of Iowa hospital when I was there for the tear and he was on my case there. So he was up to date on the newer approaches and knew what had happened to me 1st hand.
I agree with preparing the patient before surgery and after care are so very important. It can make the difference between a success and possible failure just due to the mental aspect of the recovery process.

Take care,
Bill
Posted 8/2/2013 3:25 AM (GMT 0)
As always, Thanks for the advice Bill. I really appreciate it!
Posted 8/4/2013 7:06 PM (GMT 0)
Aug 4 - Day 18

I believe the swelling has subsided (for the most part). I am happy to say that the aspiration in the night has calmed down. I still do it about once a night, usually right before I wake up. I think it's because I have settled into the bed and am lying flat!

Food is getting a bit more varied, but I am taking it slowly. I tried some thin sliced deli meat (the crappy pre-sliced, but full of water kind) with some soft/light cheese spread as "roll-ups", not bad. There are so many sweet soft things to eat and not enough savory that I am drinking broth and eating mashed potatoes just for some non-sweet flavor! I found that chocolate Kisses don't bother me, if I let it melt in my mouth (that "sweet" I can enjoy!). I really want bread and pizza! :)

I am still waiting for the glue on my incisions to fall off. I am giving it until Thu (3 weeks), before I take a bath and let them come off as they will.

I am disappointed with the weight loss. I have lost 10 lbs, but was hoping for 20+. I lost the first 10 in the first week and since then have been stuck. I am going to start the exercise bike this week and see if that jump starts me again.

I am still belching A LOT! I am going to stop the twice a day Omeprozole this week and SEE if this operation has been successful. I have been taking Gas X gel caps twice a day as well, as a precaution and am going to ease off that as well so i can see what I feel like w/o any drugs!

The hospital is suppose to find me another surgeon to follow up with, so I will make an appointment when I get a name this week. I am wondering about the incision sites. It feels like there are hard knots below the skin, is that normal?

Other than that I'm doing fine. Bored but keeping busy around the house with things and taking long walks with the dog.
Posted 8/5/2013 10:51 PM (GMT 0)
Aug 5 -Day 19

So I learned something that has had an impact on my loosing weight, or rather not loosing weight, as well as general health. I spoke to a nurse friend who wanted to discuss my diet and pointed out that I was getting almost no protein.

When I added protein enriched BOOST and deli turkey, I started loosing weight again AND had more energy. Just goes to show you can be so concentrated on the "diet" and what you CAN eat, you can forget to be aware of the total picture.

I was contacted by the hospital to discuss the surgeon and my issues with him. It was interesting. Some of my issues seemed to be taken seriously. Some were casually blamed on the hospital. I emailed the person from the hospital to discuss that part. It would be nice if there was less finger pointing and more apologizing and correction for the future.
Posted 8/6/2013 12:40 AM (GMT 0)
Ben-

The hard area at the incision is normal. It's the area healing and the sutures. That will go away after a while when they dissolve. I had that with my 2 lap nissens and other lap surgeries.

If you were getting mostly carbs I can see that as being a cause for not loosing any weight.

Keep up the great journal!

Take care,
Bill
Posted 8/7/2013 4:24 AM (GMT 0)
Aug 6 - Day 20

Today I spoke with a supervising Dr. about my surgeon and he asked me what I wanted as an outcome. I told him I simply wanted another surgeon to follow up with and whom I can contact if I have any issues, as I am not ever 3 weeks out and don't really know where the surgery stands yet. He said he would make some calls.

Today I started having pain in my gut, not exactly associated with an incision. It's not sharp and it's localized, so I am giving it another day to see if it changes. I am not running a temp, so i am not worried about infection at this point. Is this normal at all?

I got out for the first time since the surgery to go to the State Fair. I ignored all the food as it was inedible even w/o the surgery with the exception of one favorite thing. Now I know why melted cheese is a no no. 1/4th of the best mozzarella sticks in the world and I was running for the rest room to cough it up! Well it tasted great, but was the absolute wrong choice, so live and learn. On the plus side, I know better for the future!
Posted 8/7/2013 5:44 AM (GMT 0)
Ben-
you keep that up and we will have to rename this thread "Things not to do after a nissen" nono smilewinkgrin
Don't worry, you aren't the 1st to gave to learn the hard way. I still did it a few times after my 3rd nissen and I know that I know better. Just bringing up food that is stopped by the wrap won't damage anything, but isn't fun.
I don't think there is anything better than the smell of food at the fair! yeah yeah yeah

I had all kinds of weird pains in my belly after my nissens. Sometimes it was like a nerve pain then a muscle pain and then just pain. It's quite normal to have some weird pains for a couple months or so. As long as they aren't severe, won't stop, or you are running a fever. If these were to happen I would at the very least contact your doctor or go to the ER.
Can you pinpoint where the pain is?

Take care,
Bill devil
Posted 8/7/2013 2:20 PM (GMT 0)
Bill,

you said in one of your replies to expect anything during the two week mark, from feeling you are refluxing to strange pain. I am 8 wks out and I feel like I am refluxing.but it is different feelng from reflux feeling before surgery.

The doc said because  my lower esophagus spincther was loose for so long and plus I had a hital hernia for so long, now that everything is fixed and  tight it's just food that is waiting to get in the stomach. He said it is not to tight because food is going down. and once my esophagus get use to the new valve and coordination gets going things will get better so to give it time. have anyone ever experienced this problem. please help me to understand. I know from reading all the experiences everybody is different when it comes to healing and I just have to be patience and let nature take its course.

But if anyone have experienced this problem or know anyone who has, pls let me know. I want to know if things will get bettr as time goes by.

If so about how much time am I looking at.

pennie shocked

Post Edited (pennie) : 8/7/2013 8:26:08 AM (GMT-6)

Posted 8/7/2013 7:36 PM (GMT 0)
pennie-

Food sitting at the wrap is a common complaint. Try drinking something warm before you eat and afterwards. It helps relax the wrap area to let everything go through. Food or meds sitting there will cause reflux like feeling.

The wrap will settle in once you have healed all the way. 80% of the healing takes place in the 1st 6 months and the rest will take about another 6 months. Some people loose this sensation in the 1st 3 or 4 months and some have it for a while past the 6 month mark. It does get better, but the changes can be slow.

Take care,
Bill
Posted 8/9/2013 5:25 PM (GMT 0)
Aug 9 - Day 22

Well yesterday was 3 weeks since my surgery. I am eating soft food (still not that a lot), supplemented by liquids (although Jello is off my list for life-I forgot how much I detest it!).

I have not had any significant aspiration for about a week. A little every night, but not anything major and nothing like it was which sent me straight to the bathroom like before.

I'm having some trouble explaining (over and over) that I am not "all better" and can't go out for steak!! It's interesting how badly others either want you to be better because the care about you and others want you to be better so they don't have to think about it or be concerned any longer. (I think they ALL "care", it's just the difference between how some people deal with others medical issues.)

I received a call today telling me that the assisting surgeon would be taking over my case, so I will not be seeing my surgeon again. This is a relief as I have not had anyone related to my surgery to contact for the past 18 days. Again Thank God for the forum.

So, all in all things are looking up and I am getting bored around the house and am looking forward to getting back to work, part time anyway!
Posted 8/10/2013 12:18 AM (GMT 0)
Ben-

I know what you mean. People think that this is like some other lap surgeries where after a couple weeks things are all better. They just don't know that this is a major over haul of your system and requires a slow recovery. Kind of like rehabbing your GI system.

Take care,
Bill
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