Paraesophageal Hernia Repair Journal

Hi everyone figured I'd jot down my experience as I went a different direction than many here. To make a long story short I had a paraesphageal hernia repair without a nissen fundoplication.

I'll start with doctor recommendations that I got.

I was here before but lost my account login information, so if my story sounds familiar thats why. I have a paraesophageal hernia (PEH). I have had well controlled gerd for the last 20 years. I've seen 4 different surgeons now about my repair and have had 4 different opinions. My symptoms are chest pain, a constant dull ache under my sternum, back pain and sometimes pain in my neck and throat. Here are the opinions I got

Surgeon one - large university - thoracic surgeon. Surgery is not emergency but should be done because it's only going to get worse. It probably will not resolve any of my symptoms as they are atypical of PEH. He would do a robotic laparoscopic procedure with the PEH repair and Nissen fundoplication. He said I will no longer be able to burp or throw up.

Surgeon two - bigger large university - thoracic surgeon with specialty in esophagus disorders. Because I do not have any of 3 major symptoms (reflux that comes up, food sticking, problems swallowing) he would not recommend surgery as he does not believe pain is due to PEH. Refers me to a gastro doctor.

Surgeon three - general surgeon specializing in GI issues local hospital - Recommends laparoscopic repair with Nissen. Downplays all side effects, I will be able to burp throw up etc and will be out of hospital quickly with very little lifestyle change.

Surgeon four - thoracic surgeon different local hospital. Takes time to show me barium swallow and test results. Says because my esophagus has remained in place under the diaphragm this is why I'm not having the GERD issues most people with PEH have. Suggests pulling down the hernia, repairing the diaphragm and leaving it at that.

Day 2 - struggled with pain control. I am sensitive to many drugs. Because I had excessive bleeding during the surgery they rule out all Ibuprofen type drugs. After trying 3 lower class drugs they find low dose dilaudid is what is helping with the pain. Once they get pain under control I sleep a lot. They only allow me liquid diet. I get up and walk throughout the hospital several times.

Day 3 - struggled with pain while coughing. My lungs have developed crackling sound and I either start coughing or stay another day. I suck it up and start coughing. Oh the horrible horrible pain. I'm coughing up so much junk though I understand why they made me do it. They increase my diets to soft food. I order oatmeal and cream of wheat. At this point I'm just happy to eat and hospital food tastes good. I have no trouble swallowing except my mouth is so dry and my throat so full of phlegm it makes it hard to swallow. Swallowing does not hurt though and no food gets stuck. Middle of the day I get sent home even though I still am having trouble staying on top of pain and nausea keeps returning. Get home take pain medication and sleep a lot.

With how far in you are you actually sound like you are progressing nicely. As you have probably been told time and time again walking can help with the shoulder pain if its related to the gas they fill you with for the surgery, otherwise it could be referred pain from your diaphragm, either way gentle exercise should help with that.

I hope the rest of your recovery goes well :)

Sounds like you're recovering fine.

I tried a few scar formulations but was not impressed. Not worth the money!

I was closed with dissolving stitches under the skin and a few steri-strips. My scars disappeared mostly by themselves, with a little massaging to keep them from sticking to tissue below and forming a deep depression. But I didn't do anything until the strips all came off and I had no pain. 5 years later I can't even find 4 of the scars and the 5th is not noticeable to anyone but me.

A couple of the dissolving stitches worked their way back up through the incisions. One I snipped off at the surface. Another I pulled gently and snipped when it wouldn't go any further without causing pain.

If you need the pain med take it. You don't have to be one of those battlefield guys who sew themselves up in the movies.

Hi Sylvie!

The large university hospitals mostly told me they let a lot of people go after one day. My surgeon told me for sure 2 days up to 4. I will tell you I was in no shape to go home after one. I barely was after 2 and honestly was a bit anxious to go home. My biggest worry was throwing up. I felt very nauseous after my procedure and they don't want me throwing up because it could damage the repair. Getting in a car with all those drugs in my system was hard but once I got home it was much easier to sleep and heal, with the help of family taking care of me of course.

With that large of a repair I would try talk to your surgeon or even his office staff and see if they will be flexible on how many nights you stay. I know a lot of it depends on insurance, and what the office gets approved before hand.

sylvie, don't let them kick you out of the hospital until you feel comfortable about managing yourself. I know here its about 2 nights for LNF and about a week for open, but everyone is different and has different reactions to anesthesia, medication, eating and moving around.

Michiganmom, glad to hear your recovery is going well. That itching can be a real pain! I've found that cold compresses or some calamine lotion (the stuff they use on chickenpox) seem to do the trick there. I use a calamine lotion which is mixed into aqueous cream so it doesn't go all flakey like straight calamine lotion does.

Scar reduction preparations are pretty hit or miss, the only ones I have heard (but haven't yet tried) are good are silicon scar sheets, but they only work well on new scars apparently but yours are new so they might be worth a try. Lapro scars do seem to disappear quite well though, I only have one scar still visible from a lapro appendectomy I had a few years ago and my step-dad has 0 visible scars from his PEH repair, though his was done with the carbon fibre mesh, not with a wrap