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31 days post surgery

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GERD & Acid Reflux
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Posted 12/13/2013 8:05 AM (GMT 0)
Hi all

It's 31 days since my surgery.

I really thought that by now the internal healing would have settled but it seems to throw up different symptoms all the time.

I'm sure I still have reflux because it affects my mouth. Yesterday evening I started to get a warmth feeling in my chest/ oesophagus/ throat. I can't even tell if this is heartburn.

Could all this be down to swelling ? Should I still have swelling after 5 weeks ?

I'm due to see my surgeon on Tuesday which will be 5 weeks after my surgery. Not sure what he will say. Last time I saw him which was about three weeks after surgery he said to give it time. Even though he assured me that it's not reflux. I don't know how he can say this without tests.

I try to stay hopeful and believe that it's due to swelling but I'm really not sure. If it was swelling then why am I getting something coming up into my mouth. Not even sure what it is but what I can say is my mouth never feels fresh. Is this reflux ?

Did anyone still get these problems 5 weeks after surgery ? I must say that since surgery I've only had odd days here and there where I've felt comfortable.

Should it take this long for things to settle cause I'm getting seriously worried that things are not working out.

I hear of people that have got over this with no problems whatsoever and are back at work after a couple of weeks.

I know I'm going on. I really want a glimmer of hope from others that have gone through this that things can and do turn out ok weeks later even after having lots of problems in the first few weeks.

Concerned and desperate

Maria
Posted 12/13/2013 10:45 AM (GMT 0)
I still have swelling after 4 months. Even with this surgery I have to watch what I eat. Are you taking PPIs? I take Nexium with Carafate and maybe a Pepcid if I need it too.

My work is very stressful and I notice the stitches bother me when I am anxious or stressed. You might take longer to heal than others.

Try to get some rest.

Michelle
Posted 12/13/2013 11:17 AM (GMT 0)
Hi Michelle

Thanks for your reply.

I started taking my ppi's again a few days ago. I will carry on with them for a while to see if they help. I hope everyone is correct in saying that it's early days and everything needs time to settle.

Are you hoping to give up your ppi's eventually?

Mara
Posted 12/13/2013 1:28 PM (GMT 0)
I only started to feel "normal" (aside from some gross bloating) in the last month or so.
It really does take a long time to heal internally.
I had nasty heartburn symptoms (feelings at least) even into month two and three.
You really do have to watch what you eat, take zantac, eat very small meals and walk walk walk to get your strength back.

I know it sounds stupid, but I felt for a long time like my body was just really fragile after surgey, even 3 months after. I felt like I would never be able to physically do some of the things that I used to do.

about 3 weeks ago I started working out again, stretching, walking twice a day, jogging for 1 minute at a time, lifting really really light weights and only now do I feel like I am getting my pre-surgery body and health back.

I guess the point I am trying to get at, is that you would think that things would be a lot better a month out, but most likely they are not going to be. You need another month or two under your belt before you can really start questioning if your surgery was successful or not. My surgeon doesn't even do tests on the wrap until your 6 month mark, although I know all surgeons have different methods.

staying on the PPIs while things heal up is a good idea. In a few months start tapering down and see how you feel.
Posted 12/13/2013 1:53 PM (GMT 0)
Maria - I noticed the most improvement between weeks 6 and 7. You still have better health to look forward to.

Why did your surgeon choose the partial vs. the full wrap? I don't remember your conditions prior to surgery.
Posted 12/13/2013 3:48 PM (GMT 0)
Hi Laurie

My surgeon said he prefers the partial wrap.

Also on my manometry test it said that I had a slight weak swallow but only on liquids and not on bolus. It was only slight and nothing to worry about. I'm not sure that it was very accurate - I don't think that I swallowed normally during the test. I also had a hiatus hernia repair. My demeester score was very high at 33.9.

Hi Stephanie

Thanks for your encouragement. I do keep trying to tell myself that it's still early days. I do know that it's acid reflux cause I can taste it in my mouth. I also get the heartburn.

I do try to convince myself it's down to the swelling and because the wrap site is swollen it can't close tightly enough - I know it's a silly theory. Then I think if the site is swollen then how come I don't find it difficult to swallow food. I've only had problems with food about 3 times.

I know that your correct that the doctors won't do tests yet. I know my surgeon is very genuine and would want to find the reason why it's failed.


Thanks Laurie and Stephanie
Posted 12/13/2013 5:22 PM (GMT 0)
Oh - I wonder if your persistent reflux is because of the partial instead of 360. You will have to ask for testing as soon as allowed. So sorry this is happening to you.
Posted 12/13/2013 6:54 PM (GMT 0)
Hi Laurie

I wondered that too.

I'm not sure how the surgeons decide on which wrap to do. I don't know if the high demeester score means anything in deciding the wrap.

Maria
Posted 12/13/2013 7:52 PM (GMT 0)
Maria,

Sorry you're feeling the way you are. Even moreso, that you don't have a high degree of confidence in the success of your procedure. Did your doctor tell you why he was performing a partial vs a full wrap? From my reading, and in consultation from my surgeon, partial wraps are usually done when the patient has problems with swallowing that are compounded by reflux & regurgitation. Usually, the full Nissen wrap is the gold-standard for reflux and regurgitation issues when there aren't swallowing concerns.

The only way to really know if you are experiencing true reflux (and not just feeling the effects of healing on the esophagus) is to have the 24hr pH study performed again. This will evaluate if you're truly refluxing and to what degree that is happening. Otherwise a barium swallow and/or EGD can show the surgeon if a wrap of any type has failed.

-TonyG-
Posted 12/13/2013 8:04 PM (GMT 0)

Normally the success rates for fundoplication range from 70 to 90 percent depending on the study.  Thus, this is not a fool-proof procedure.  Studies also show that 60 percent of people who undergo fundoplication still needs to be on anti-reflux therapy.  

It may also be possible that it does take a few months for improvement to be felt.  

If there continues to be symptoms, you may want to consider 24-hr pH study to determine whether there continues to be reflux.  If positive, there is a possibility that the surgery may have failed and options to correct this can then be discussed with your surgeon. 

Glad to know you are seeing your Dr. next week.

Kindly,

Kitt

Posted 12/13/2013 9:48 PM (GMT 0)
Hi TonyG

I don't know why the surgeon decided to do a partial wrap he did say it was what he preferred. On my Manometry test they said I had a slight weak swallow to liquids but not weak to bolus swallows.

I didn't regurgitate food. My symptoms started suddenly in April caused by what I believe was a hernia.


Hi Kitt

I'm seeing my surgeon on Tuesday so will discuss that I think this procedure as failed and we need to discuss what to do next. I'm sure that i'll be told to wait and see if it settles before tests are done.


Thanks Tony and Kitt
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