Nissen Fundoplication - failure

Some may remember my posts from a few short months ago. My original thread can be found here: https://www.healingwell.com/community/default.aspx?f=45&m=2847294

I received some bad news today - my NF failed. Like Dencha, I had lung problems pre-op, that included inhaling acid. Acid showed up on a lung bronchoscopy last July - which lead me to the NF.

I saw my pulmonologist a couple of weeks ago for my 6 month post-op follow up. I can say for certain that my lungs, throat clearing, hacking up crud are as bad as they were before the NF. He was very surprised and not sure what was causing the continuation of the issues. He ordered a CTScan with contrast. After a hassle from the insurance company, I had it done on Friday. I personally went to the hospital, today - to pick up the disc and report, on my way to another doctor appointment. I see the pulmonologist on Wednesday to discuss the CT results.

The CTScan report stated: Moderately large hiatal hernia with gastric fundus in the lower thoracic cavity.

I read the results at a stop light - the horror! I'm very upset. Now, I know there was that risk of the NF failing, but my recovery went so well. Who knows when it failed - I have no idea. All I know is I have a lot of trouble breathing, my cough is constant, my sinus problems persist, etc.

I have a message in to the pulmonologist - asking him to contact my NF surgeon directly. I don't see a reason to have to go through any type of endocsopy, barium swallow, manometry, etc.

For those that have had a redo - is it done via lap or open?

I underwent Nissen Fundo surgery in February 2012. Prior to surgery I coughed, gagged, and threw up many times a day. I also had post nasal drip something crazy. I was treated for upper respiratory infection, and sinus issues with many different medications. I was put on prednisone over and over and nothing helped me. My doctor referred me to ENT and I had many tests done there also. Nothing showed up. ENT sent me to allergy doctor. My coughing was so severe the allergy doctor prescribed me lidocain  through a breathing machine to relieve the cough. No allergies either. Was sent back to GP and he said he thought it might be acid reflux. He sent me for ph bravo and the results were off the chart for GERD. The acid was aspirating into my lungs yet the GI doc told me the coughing was in my head. I was then sent to another GI surgeon and he said he had never seen such off the chart numbers and I needed surgery. I had the surgery and had a great recovery. For two years I have not coughed or had post nasal drip. Unfortunately,  at the end of January 2014 I started off with the cough again and now it is out of control. I was sent back to my surgeon who did the bravo ph test and it was negative for GERD but positive SAP for correlation of coughs and reflux. He told me it was due to chronic constipation and hypersensitive esophagus. I was then sent to the Mayo Clinic in Jacksonville, FL for a second opinion. This GI doc told me he does believe it is GI related and suspects a disease of the esophagus or that the wrap was too lose in the beginning and that it could be any kind of reflux not just acid that is causing the problem. He agreed that the pictures of the wrap from the endoscopy looked fine.  I am scheduled to go back next week for the manometry study and the 24 hour impedance and ph study.  Your symptoms sound identical to mine. How was it determined that your wrap failed? Do you have acid or any other type of reflux? Any suggestions?

I am so very sorry to hear this. I am one who has followed you and appreciated your insights.

I wish you all the best going forward.

J.

Thanks J. and Michelle.

My immunologist contacted the radiologist to confirm. My pulmonologist apologized several times when I saw him on Wednesday. So, along with the radiologist, that makes 3 doctors.

I see my surgeon next Friday 4/25. I will bring the report and CD with me to the appointment. I could have gone in today - they made time, but I had a surgical procedure scheduled on my back yesterday that I did not want to delay. I spent most of today in bed, but I'm up now feeling better.

I got past the feeling sorry for myself part, I feel like I'm in an angry stage, maybe accepting of it, though. I wish I knew what was going to happen next Friday, I have to be patient.

Thanks, again - for all the support.

I can't tell you how much I feel for you and how sorry I am you're going through this.

This all worries me for my future and that I'll never be well. I had no idea all these things could happen.

Laurie,

Thanks for explaining the difference. Take care of yourself. I hope you get better.

Michelle

I feel for you as well. Having to redo the surgery is not an optimal choice but sometimes has to be done. Like Bill has said, his recoveries were easier with redos. You can be more prepared as you've been through it now. Hope they can do it as a lap procedure again for you.

I plan to look I to the procedure you had in your back. I have degenerative disk disease as does my twin and older brother. It runs in our family. We all have herniated disks. My husband is a chiropractor so would never allow me to have a fusion done but the radio frequency ablation sounds promising. Backs get somewhat better but never great again. Therapeutic yoga has been a God send for my pain. Have you ever tried it? I was very limited initially but it got better. Only thing that's ever controlled my pain.

Best wishes to you. I hope you can get these issues resolved. Back issues increase my reflux and symptoms as well. Not sure if it does for you.

Debra

The therapeutic yoga is basically stretching. It won't affect your breathing. If anything it will help your breathing b/c they teach you how to breath. It also helps strengthen core strength but not as much as Pilates. It can help you keep some mobility and decrease pain. Maybe your doc will let you do that. Good to know about the range of pain the ablation can help. Wonder if it would help me. I think mine is more pinched nerves b/c of the herniations. I def will look into it. Thanks

Debra

Sorry to hear of the failure. A positive is you have a diagnosis! After mine nothing showed up on swallow even though I knew something wasn't right. YES a redo is feasible and the most important thing is to have an EXPERIENCED operator someone who has done multiple redos with good results . ihave had a redo and to be honest was way easier than the first recovery! . good luck you will get sorted