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GI suggested that I see a surgeon. Now what?

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GERD & Acid Reflux
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Posted 2/23/2016 3:33 PM (GMT 0)
Hello. So here is my situation. I have had GERD for nearly 20 years. I also have Barrett's Esophagus. I have had scopes done every 2 years as recommended, as well as a BRAVO test about 4 years ago. I have been taking PPIs for many years without great success. On my last visit to the GI, he was concerned about the frequency of the reflux I have been having and suggested that I see a surgeon about Nissen Fundoplication. I have made an appointment (scheduled for March 25th) with the surgeon. I guess my main question would be: How long, from initial appointment with surgeon, does it take to get to surgery day? I know there preoperative tests that need done. I am just anxious to get it over with as soon as possible. Any help would be greatly appreciated!!
Posted 2/23/2016 5:58 PM (GMT 0)
I don't have an exact answer to your question. Once they found out that I have LPR an appointment with the surgeon was scheduled and I had the surgery 2 weeks later because my symptoms were so severe. Perhaps your doctor can order some tests ahead of your appointment? That would speed things up a bit.
Posted 2/23/2016 11:52 PM (GMT 0)
It likely depends on the surgeon, the facilities, their capacity to book procedures, etc. I saw the surgeon for the first time in early January. I then had an upper GI with barium contrast within the week to evaluate for both a giant paraesophageal hernia and a persistent history of escalating GERD. I then was scheduled for an endoscopy, manometry and ph probe (Bravo) placement about 2.5 weeks later. I then returned for all of my results the following week. Surgery was discussed necessary, particularly due to the giant hernia, with a couple of possible approaches presented. I opted next to meet with the surgeon from the practice who specializes in giant hernia repair and fundoplication. As he was on vacation, I was scheduled to see him 2 weeks later. We discussed my options and decided on the hernia repair and full Nissan fundoplication. Because I also have severe anemia (likely due to the hernia), he scheduled me for a colonoscopy 2 weeks later (next Wednesday, actually) to rule out any other anemia-causing issues, followed by the surgery 1.5 weeks after that. Overall, it's been about a 2 month process. But if your physicians are readily available for appointments and your testing facilities have capacity to work you in sooner than later for any necessary preliminary assessments, I imagine you could be booked for surgery -- if appropriate -- within a month. That's only my guess, though. I'm sure everyone has a different experience.
Posted 2/24/2016 8:21 PM (GMT 0)
Hi, Stoey. I am new to this particular forum since I had acid reflux surgery 4 weeks ago. My GI doc did 2 tests before referring me to a surgeon...a modified barium swallow and an esophageal motility study that checks out the function (or lack thereof) of the sphincter muscle at the base of the esophagus. Mine was working at all and the walls of my esophagus were not functioning well either, with a hiatal hernia. I have had GERD since 2003 and was tired of fooling with it. The GI doc gave me a choice of dealing with it or surgery. I chose the surgery because of the lack of function. It is a big decision, not to take lightly, because the walls of the esophagus, the sphincter and the diaphragm will all be inflamed afterwards and it just takes a lot of time for that to go away. Plus you have to change your diet totally. I keep reading these forums because they are educating me much more than my doc.
Posted 2/24/2016 8:48 PM (GMT 0)
Hi Stoey,
I was diagnosed about 15 years ago, & it never really bothered me; pretty well controlled by Omeprazole. I noticed last Fall that I was SOB & would have to stop walking to catch it. Also wheezing. I attributed it to the fact I'd put on 10lbs over the past year. I might add that I had open colon resection in 2007, L hip ORIF in 2012, L TKR in 10/ 2014 & R TKR in 5/2015. My point being I thought I was past any surgery for awhile. I was misdiagnosed with Pneumonia at Urgent Care 12/23/15, saw my IM the next week, CT Scan with contrast the same day showed paraesophageal hernia with half of my stomach herniated. I saw Surgeon 2/7/16, Endoscopy 2/15/16 & the hernia surgery one week ago this past Monday. My exacerbation on 12/23 was bad: severe chest pain, could not breathe, coughing, wheezing. Once the docs start to move I think they go pretty fast. I am slowly recovering & still have lots of unknowns. Even tho surgery was Lap, it's not any east recovery...one day at a time! It's best to get it done asap. Good luck!!! I too found this forum when I first knew I had to have surgery & it has been a Godsend

Post Edited (lgse0211) : 2/24/2016 1:51:30 PM (GMT-7)

Posted 2/24/2016 9:25 PM (GMT 0)
Thanks all. This forum has been very helpful! I just wish I could meet with the surgeon and schedule the surgery, without all of the testing. Isn't having Barrett's enough proof of having GERD? I have had so many endoscopes done and also have had a pH test done in the past. I, for the life of me, cannot fathom why my GI has not recommended this YEARS ago. I see people on here with the same problems I have been having for what seems like my whole adult life, and they wound up getting the surgery only after a short time. Sorry for ranting, just wish I could have gotten this surgery like 15 years ago!!!
Posted 2/24/2016 9:35 PM (GMT 0)
Stoey ~ you aren't ranting. My hernia did not show as the problem on the xray ~ they saw it but thought most of it was pneumonia. My IM saw something in the blood work that indicated there might be a blood clot, hence the CT Scan which showed no blood clot, no pneumonia but my HUGE hernia. I wondered why I needed the endoscopy when I'd had the CT Scan. The surgeon & my GE both told me that the surgeon needed to know exactly what he was dealing with before he went in...this included Barrett's, ulcers, adhesions, anything suspicious that might indicate Cancer, or any obstacles. The surgeon didn't want any surprises. I didn't need a biopsy but my GE said he would have taken one if the scope indicated anything of concern. Waiting for the endoscopy & the results (which my GE gave me right after the test) was worse for me than the surgery ~ well, almost anyway. I hope that helps!

Post Edited (lgse0211) : 2/24/2016 2:38:16 PM (GMT-7)

Posted 2/25/2016 12:37 AM (GMT 0)
Stoey, I'm sure the testing, although seemingly redundant and unnecessary, would be required to confirm your exact present state. Like LGSE said, it's best for the pros to know exactly what they're dealing with before they dive in. Maybe the surgeon won't require the tests if yours are relatively current? It's a shame that you've had to wait for this type of approach. I'm sure that some physicians are cautious with surgery -- as they should be. Without a hernia or other complicating issues, maybe he/she felt that the GERD/Barrett's could be handled with non-invasive measures, or that it was best to wait for the surgery option until things progressed to a more challenging state. With your increase in reflux frequency, you've obviously reached that.

There are side effects to this surgery as there are with most. I haven't had my surgery yet so I only know from what I've been told by the surgeon and what I've read here. Still, if the likely results are better than the possible side effects, it may be worthwhile to consider a surgical option. But it's also good to see if there are other options available too. Ask lots of questions, even those that you think are silly. You want to do what's best for you and your long-term health.

Good luck and let us know how things progress. Like many folks here, some of us are still in our initial stages and learning as we go from those who've been there, done that :)
Posted 2/25/2016 12:49 AM (GMT 0)
Amen, CaliGal. I'm just a little over one week post op & although I realize it is a long recovery time, I still have issues but already it's been worth it. At least it's over and I'm on my way to being "my new normal".
Posted 2/25/2016 1:18 AM (GMT 0)
Guess I'm just anxious because when I was 17 (20 yrs ago) I had a laparoscopic appendectomy that had MAJOR complications (i.e. The surgeon severed an artery without knowing) and landed me in the hospital for 2 months. Every time I think about the potential surgery, my adrenalin kicks in and I just want it done NOW!
Posted 2/25/2016 1:21 AM (GMT 0)
Caligal, hope everything goes well!
Lgse, keep up with the positive thoughts and you'll recover in no time!
Posted 2/25/2016 2:08 AM (GMT 0)
I think most of us feel that way -- once we have a plan, we want to just get it done and get on with it. Your previous complication isn't likely a common one. Chances are, you'd have an uneventful surgery -- and any requested tests by the surgeon are likely to help to increase this likelihood. Heck, mine is sending me in for a colonoscopy a week and a half before my surgery. He wants to check things out "thoroughly" as I've already had a an endoscopy. I can't say I was thrilled by that request but if it helps him to do his job better -- and make me better -- then so be it. Bottom's up!

:)
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