Giant PEH, Anemia, GERD... Soon Gone?

New to this forum. Thrilled to see so many people with similar experiences and stories to share. I was recently diagnosed with a giant paraesophageal hernia, with most of my stomach in my chest. I'm also severely anemic (but didn't know it until recently), asthmatic and have years of GERD experience as well. I should have taken out stock in Pepcid and omeprazole years ago.

For the past couple of years, I've been plagued by exhaustion, shortness of breath, racing heartbeat upon exertion, headaches and the feeling that I simply couldn't keep up like before. In my early 40's and, although slightly overweight, not obese, I was baffled by my inability to do the things I love to do. I've always been active outdoors and a super on-the-go kind of gal. And, of course, the more I limited by activities, the more weight I gained. I thought that everything I was feeling was due to my increased weight and, perhaps, asthma issues. But it didn't make sense as friends who were also asthmatic and far heavier than I could do ten times more and not be winded and exhausted.

During a chest X-ray for a bout of bronchitis, my results showed a "large hernia." Thankfully, my doctor sent me for a surgery consult. Turns out, after an upper GI, endoscopy, manometry and ph probe, that I had more going on in my body than I thought. My surgeon links all of my difficulties to the giant hernia. He believes:
- The anemia is caused by the hernia. The anemia causes the exhaustion, heart racing and shortness of breath. The hernia, too, can cause these issues as the stomach is taking up space in the chest.
- The GERD is at least strongly exacerbated, if not caused by, the hernia. With my stomach in the wrong spot and upside down, reflux is common and frequent. Reflux can also exacerbate breathing issues, particularly for asthmatics whose lungs can be irritated by the aspiration of stomach acid.

Who knew that all of these things -- these annoying, life-altering things -- could be connected? After years of feeling a sense of unexplainable physical deterioration, I now have hope. I am scheduled for surgery in a couple of weeks to repair the giant PEH along with a full Nissan fundoplication wrap. I'm nervous about the procedure and the possible side effects (post-op pain, swallowing issues, inability to burp/belch, inability to vomit, if needed, etc.) but excited by the possibility of having my physically active life back. I'd love to be able to walk, hike and more without feeling horrible.

Would love to hear from any of you with similar experiences, particularly your post-op successes and challenges. I'm sure I'll be posting more soon as questions pop into my head. Thanks to you all for being here!

It is possible to only repair the hernia without the fundoplication (full or partial). I asked my surgeon about this and he said that he nearly always does fundoplication while repairing the hernia. He said that, particularly with giant PEHs, the majority of patients have GERD too, which is resolved by the fundoplication. I'm guessing that the fundoplication also serves to help prevent a recurrence of the hernia. If the top part of the stomach is wrapped and stitched, it might be less likely to herniate again. My surgeon is very experienced with these procedures so I trust his judgement on this. He swears that, once healed, I'll feel better than I have in years -- that I haven't known how badly I've been feeling, but will once I feel good. I can't wait for that day! I'd love to hear if others have had this type of "feel good" success, ultimately, after healing.

Thanks, Aero. Now that time has passed, do you feel noticeably better? Do you notice differences in your comfort or energy, etc. now that thIngs are repaired?

CaliGal,
I have a similar experience to yours. I have suffered with GERD since 2007 and have been on Omeprazole. In December of 2015 I developed a cold which went to a sinus infection then another cold. After 8 weeks of feeling bad I finally went back to see my doctor on January 25th. She immediately put me in the hospital as I had very low blood pressure and a racing heart rate (140 beats per minute). Once in the hospital it was discovered that I had severe anemia (Hgb was 7.3) caused by blood loss. After two blood transfusions and an endoscopy procedure it was discovered that I had a hiatal hernia. Over half of my stomach was in my chest which was causing my shortness of breath and an irritation of the lining of my stomach which caused the internal bleeding. I was sent to a bariatric surgeon (Feb 4) who recommended the Nissen Fundoplication surgery. On February 16th I had the surgery.
I stayed in the hospital for two days before being released. I think the worse part was lack of sleep in the hospital. Between a snoring roommate and nurses in and out I was happy to be home.
So here I am a week out and I am doing okay. I am glad I found this site and wished I had seen it before. I feel like I was rushed into the whole procedure though without any prep at all. Make sure you ask questions of your surgeon. Am I glad I did it? I hope so. My wish is to be rid of the heartburn and the shortness of breath I had been experiencing.
Since the surgery, I have had pain off and on in my shoulders which is helped by walking. I also have difficulty at times with food being stuck in my esophagus even though it is liquid at this time. I am sure that will subside as the swelling goes down. My surgeon has me on a full liquid diet soon to be followed by pureed food. He wants me to remain on liquid and mushy food for awhile before moving on to solids. Doesn't seem to be much of a problem as I don't have much of an appetite to begin with. In fact since surgery I am down 11 pounds. Not really a recommended way to lose weight. My incisions (I have 5) seem to be healing okay. I am still taking Omeprazole but only for the next 4 weeks to keep the acid down while my esophagus heals then I should be able to stop. I have liquid Tylenol with codeine for pain which I rarely take. I only took it for the first few days then felt I didn't really need it anymore. I also have medication for nausea. Although I still have bouts with nauesa I have only taken it a couple of times.
I have been given 4 weeks off from work and at first thought I would be back after two. After this first week though, and after reading many posts on this site, I have decided that I will probably take the entire time off. I am still a little wobbly and weak. I didn't realize how major this surgery is. I tend to underestimate the time it takes my body to heal fully. The hardest part for me is sleeping. I slept on my side last night and woke up with a terrible pain in my chest. I think I was compressing the chest area too much. I did take the Tylenol which helped with the pain.
Good luck with your surgery. Time will tell if it worked for me. As for my recovery, I will remain positive and optimistic.

Who would have thought as you said that all these symptoms would add up to this? I had no idea and wouldn't have know had it not been for the anemia diagnosis.

Taking it easy is the way to go especially when introducing food back into your system. I am going to stick with the liquid diet a little longer than my surgeon said to. I had a bad reaction tonight when I tried to eat some very mushy mashed potatoes. I didn't eat much but apparently it was too much as I had a hard time getting them to go down. It won't hurt to stick it out on liquids for awhile longer. Keep in mind when you do try to eat/drink that you need to keep it to little bites and sips. Not thinking I took three good swallows of juice and paid for it a few minutes later. I had momentarily forgotten about everything and just knew that I was thirsty. As far as what I drink/eat, I stick to juices, carnation instant breakfast (vitamins, protein from milk), Popsicles, puddings (I just keep them in my mouth until they dissolve), tea, water, broth and jello. Also cream soups are good as long as I strain out the vegetables and water it down with a bit more milk than is required. I really like the Campbell's cream of broccoli. If you have other liquids I haven't listed please share. I am afraid I may get pretty tired of it soon.It hasn't been a problem so far but then I haven't had much of an appetite.

Other than the initial consultation with the surgeon I didn't have the opportunity to ask more questions. Everything happened so fast with me. My doctors felt that I should have the surgery sooner than later as I was bleeding from irritation around the hernia. So I don't know if the surgeon used anything to repair the hernia with. I know the upper part of my stomach is now wrapped around my esophagus but that is about the extent of my information. I go see the surgeon next week for a follow up and will definitely asked what more was done if anything. As far as restrictions i have been told no lifting more than 10 pounds for the first 4 weeks then after that no more than 20lbs for 6 months. I work with small children so that will be a challenge for me. I am suppose to walk a minimum of 6 times per day which usually consists of walking around my house. I have lately started walking up the block a few houses and back while holding my husbands arm. It's nice to get out of the house but I still need to be careful as I get dizzy at times. I can resume regular exercise in 4 weeks if I am up to it. I can also return to work before my 4 week recovery time if I feel like it. I will have to wait and see on that one.

I wish I would have know more before surgery but all I can do now is be patient (something I am not when it comes to myself) and do the best I can. I am grateful for these forums as it is a great way to get the information from others that have gone through the same thing.