UPDATE: Reporting Back on My Hernia & Fundoplication Surgery

I'll continue to add updates to this thread for anyone interested in current my experiences with post hernia repair and fundoplication recovery. I'm always happy to answer questions and am very thankful for those of you who take the time to answer mine!

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Hi All,

You've all provided so much support in the weeks leading up to my surgery this past Friday that I wanted to report back. Here's the scoop for anyone intrested:

- Surgery Date: Friday, 3/11
- Duration of Surgery: about 3 hours
- Condition Prior to Surgery: Giant Paraesophageal Hernia (3/4 of my stomach residing in my chest by my left lung, pushed through a large hole in by diaphragm, along with a history of persistent GERD, heartburn, severe anemia, shortness of breath, etc.
- Hospital Stay: 3 nights

Day Of Surgery
Nerves, nerves, nerves! We arrived for registration at 6am and then the care team started with their pre-op routines. Vitals check, IV placement, discussion with the anesthesia team, etc. Nice folks, all very routine. I am a difficult stick when it comes to IVs -- my veins are very small and spidery. i'm also a total baby about them and often faint. The nurse ended up placing it in the inside crook of my left arm, which is fine for a small procedure but not good for long-term placement during recovery. instead of poking me again, the anesthesia team said that they'd put me under first and, while in surgery, would place a new IV in my hand so that I wouldn't need to feel it. I was very thankful for this option. Also, I was nervous about being sick upon awakening from anesthesia as that's been the case with my other two procedures. The anesthesiologist placed a fantastic anti-nausea patch behind my ear, called Scopolamine, in preop and assured me that they'd also give me several doses of anti-nausea meds after surgery.

By 7:45 am, they wheeled me into the OR and introduced me to the whole medical team. There were so many people in there! They quickly moved me to the ER table, made some cute small talk and, before I knew it, I was asleep. I was finished with surgery by about 10:45 and then wheeled into recovery. My honey was told by the surgeon that the surgery went perfectly -- no issues or complication at that time. I'm also thrilled to report that there was no nausea and no vomiting (or even those feelings) post-op. The Scopolamine patch works up to 72 hours too, so it remained in place during initial recovery.

I don't recall post-op recovery at all. I believe I was in there for a couple of hours. I vaguely recall being wheeled into my room. The rest of that day was a blur with sleep being my primary focus. I was on a number of medications -- Dilaudid (hydromorphone, a opioid narcotic), extra-strength Tylenol liquid, and some other painkiller that I don't recall. They also had my legs in pressure wraps that inflated/deflated every minute or so to help prevent blood clots. They were akin to a nice leg massage, really!

The first night, as a result of all of the fluids I was given, I needed to use the bathroom. A nurse helped me up, but I wasn't prepared for the discomfort and challenges that came next. Long story short, my anemia levels had dropped even further during surgery (hemoglobin 5.1) making me very weak and making my breathing labored. Also, as happens sometimes post-surgery, particularly those involving the area around or touching the lung, I'd developed atelectasis, a partial collapse of my left lung. Some of the air sacs in one or more lobes became deflated, making breathing painful and difficult. I stayed in the hospital that night with nurses to help with my efforts and actions, and also ensuring that I stayed ahead of my pain. While lying down, for the most part, I was relatively comfortable. But moving, sitting up, standing for the bathroom, coughing, etc. were all beyond painful. The night brought some sleep but very jarring pain whenever the bathroom beckoned. Still I knew that to help my healing, and help my lung, I needed to do it. So, with the assistance of nurses and heavy painkillers, I did.

Post-Op Days 2-3: Painkillers are My Friend
I remained at the hospital from post-surgery through yesterday (Monday) night. During this time, the medical team worked with me to determine the best medication for my pain, assisted me with breathing exercises to ever-so-slightly push my lung capacity, and also closely watched my anemia. By Sunday afternoon, they decided to give me a blood transfusion -- 2 units, one slightly larger than standard -- to help give my blood a boost. After reviewing the possible side effects, I opted for this painless, uncomplicated transfusion procedure. After all was said and done, by Monday, my blood levels were still abnormal and low, but certainly elevated. And I felt as though I had a bit more energy. After some trial and error and many doses of Zofran (anti-nausea meds), we found the med type and dosage that worked best for me. Between this and the transfusion my upward mobility improved, although still sluggish, labored and painful. Things went from a 10 on the pain scale originally to about a 7/8 when I was mobile. They gave me the option to come home last night, which I took.

Post-Op Day 4: Home at Last
I moved from bed to couch today, where I remained except for bathroom trips and a few slow, very slow, walks up and down the hallway. Breathing is still labored, but the pain in my chest and back have decreased to a solid 7 while up and walking. Lying down, there is very little pain or discomfort. I'm on a liquid diet and am taking my meds on schedule so as to keep ahead of the pain. There's no med-free hero talk here... I have a low pain threshold and will do what I need to in the beginning to keep the pain at bay during my initial recovery. We'll see how the rest of this week goes.

A Few Thoughts & Items of Note

• If you are afraid of the IV part of things, speak up. Let the medical team know. My folks were understanding and had a member of the IV specialist team come to my room when another IV was needed. They actually used a very small needle prick of lidocaine atop the area where they planned to place the IV. It stung mildly for literally a single second and then the area was numb. I never felt the IV placement when lidocaine was used. I will now ask for it anytime I need an IV for sure!
  
• Hydrate, hydrate, hydrate. I munched on ice chips and sips of water constantly while in the hospital. When it came time for my liquid meals, I drank apple juice and chicken broth, and even sucked on jello and italian ice. Flavor was something to look forward to, even though water and ice were fine as well. I thought I'd miss "real" food by now, but I'm just not hungry. Still, I drink to sustain energy which is important. You won't want much -- just a few sips of this and that here and there. Your stomach won't tolerate very much volume. I have also had zero GERD or heartburn incidents. None.
  
• When it comes to clear liquids, such as broths, I've learned that actual soup that is strained well -- cans of soup or homemade -- are FAR better than broth. My honey has been opening up cans of soup, straining out the solids and heating the broth that remains. This broth is SO much more tasty and filling than simple chicken broth or stock. So far, chicken noodle and french onion (each strained very well) are my favorite. The french onion is incredibly flavorful with a hearty beef base, which is a nice swap-out for chicken. I tried plain broth too and, BLECH, it was watery, nasty stuff by comparison.
  
• I heard that I wouldn't be able to burp post-surgery. I can burp little burps from my throat, particularly if I drink a bit too large of gulp and it just sits there in my throat. Not painful, just strange.
  
• Fart. Yes, I said it, fart, fart and fart. The release of gas is important to the healing process, particularly as it can cause discomfort post-surgery. No one in the hospital cares. In fact some of the nurses on my floor would cheer when someone would let out a good one. It's natural and nothing to be modest about in this setting. Consider it a badge of courage and strength.
  
• Stay ahead of your pain. Even if you're feeling OK while lying down, keep in mind your pain level when you are up and walking. Take enough medication to keep this pain at bay, at least in the beginning.
  
• Sleep a lot. It will help you to heal faster.
  
• Accept a sponge bath if offered. You'll feel more human. The nursing staff knows what they are doing and have seen it all. They will quickly give you a bit of freshening up and this will help you to feel better. Promise.
  
• If you need to cough post-surgery, use a pillow held tightly against your chest to support your sore chest/belly. And try to cough gently. I'm a hacker, for sure, and tend to cough hard and deep. But I try to go easy when coughing feels necessary and the pillow is welcome support.
  
• Your chest/stomach will begin to feel worse before they feel better. Currently, it feels as though I am carrying several lead weights inside my chest and belly. When I sit up or stand to walk, I support my tummy and chest with my arms/hands. This seems to help as gravity is trying to move things around in there. And, having had some of your guts reorganized, it is uncomfortable when you apply the pressure of gravity. If you can sit sometimes, on the edge of the bed or couch, for just a few minutes before/after you walk to allow your body to settle a bit. And keep on your meds!

I hope this information is helpful. I'm VERY early in my recovery at only day 4 and know I have a long, slow road ahead. But I have a feeling that the outcome will be well worth it.

To all of you who've posted here in the past few weeks, thank you for your insight and support. I am happy to answer questions to the best of my ability, based on my experience, and will also continue to seek advice and guidance here from all of you.

Onward and upward!

Post Edited (CaliGal) : 3/30/2017 11:41:52 AM (GMT-6)

Glad you are on the road to recovery. Take it slow and easy. Today I celebrate my one month milestone and returned to work briefly yesterday. Very tired when I got home. Tomorrow will be my first full day. No rush to work. Take all the time you can and need to heal!

Congratulations! I think you have some really good thoughts/notes listed. The key will be for you to also follow your own advice, lol. Best wishes on your recovery!!!
Marty

Day 6: Post-Op Poo is Icky
Today I'm feeling much more human. The meds provided to me yesterday for the oral thrush are working; bumps in my mouth are slowly subsiding. Pain in my chest and upper abdomen is slowly decreasing. It's still there, particularly if I push myself too hard or too fast, try to lean over, twist my body, cough, hiccup, sneeze, etc. Otherwise, while getting up from a laying-in-bed position, I feel immense pressure and some discomfort but it's bearable and much better than a couple of days post-op. It feels like I have several large lead weights in my chest and upper abdomen that weigh on my innards. It's an odd feeling, one I'm sure is caused by the tremendous amount of movement, pulling, stitching, patching, etc. of having one's guts rearranged. I'd say that when my pain is high, without meds, it's a 6 on a scale of 1-10. When lying down, I notice my insides but the pain is minimal -- a 1 or 2. In between, when I move slowly and take care of my body, the pain sits around a 3. Not too shabby for 6 days post-op.

I'm getting up to walk up and down the hall as often as I can muster. I sleep on my back on the couch with my upper body elevated a bit. This is most comfortable and prevents me from trying to roll on my side in my sleep, which would be terribly painful. Getting up from sleep in the morning is most difficult as the body is stiff and my insides need to then feel gravity for the first time in hours. It's uncomfortable, but manageable. I'm taking a very slow approach to anything I put in my mouth. I'm still doing clear liquids, which are boring but seem to be allowing me to heal comfortably without much stomach discomfort. Tomorrow, at one week, I may try to increase to a full liquid diet, adding in some dairy (ice cream, pudding, blended and strained cream soups, rice pudding, thin milkshakes, etc.) I'll do this slowly though as my stomach has been pretty deprived lately. Also, dairy tends to increase phlegm for me, which can lead to coughing. I definitely want to prevent this.

Everything is progressing slowly, which is great. Except for the one thing that hit me quite quickly today -- my first post-op poo. Yep, this was a not so fun, but necessary, part of the healing process. I hadn't had a BM since my surgery, but wasn't worried as I'd been on a liquid diet. Nothing in, nothing out, right? Wrong. I'd had plenty of gas -- it was applauded in the hospital and praised as a wonderful thing. Thankfully, I'm not a terribly modest gal, so gas was fine by me. The lower abdominal gas continued once home these past few days with plenty of noisy bum rumbles. Until earlier today when one of these noisy rumbles brought with is a not so pleasant slurry surprise. I jumped up (got up as quickly as I could) and shuffled as fast as I could to the toilet. Once I landed, I was in there for a while. A long, noisy, smelly while. Mainly bile bi-product, the "end result" reminded me of what's produced by your body during a colonoscopy prep -- nowhere near solid and seemingly never-ending for a while. Thankfully, it eventually subsided.

Sorry for the somewhat graphic nature of this but I thought it important to share for those of you along or approaching a similar path. Don't disregard your glorious gas for just that -- at some point post op, it may surprise you as something of a bit more substance than you're expecting.

:)

Cali and Ringer, thanks for that tip. I'm at 7 days post op and am a normal side sleeper. I'm also trying to use my CPAP which is not going well (I think related to my SOB). I'm going to try a wedge and sleep on my back for a while and see how that goes.
Cali, congrats on the BM, lol...... As my friends say, better out than in. Isn't it funny what we thing is success these days!
Anyway, I ate a small bowl of runny grits today (sorry, I'm from the South) and 1/3 of a scrambled egg for breakfast.

You are doing way better than me at measuring and tracking your intake. I finally realized yesterday that I was becoming dehydrated. When I would stand up, I'd become dizzy. I made it a point to take in more liquids and feel much better. I think your structure for tracking and almost forcing liquids in is a best practice and we could learn from that.

Anyway, I hope both of you (and others) continue healing swiftly, thanks so much for the great detailed information and suggestions.

MartyW

Day 7 & 8: Baby Spoons Rock
I'm quite surprised but am starting to feel a bit more like myself a week after surgery. I'm down to taking 1,000mg of extra strength Tylonal during the day for pain and inflammation and only taking my painkiller at night to ensure quality sleep. I stayed on a strict clear liquid diet the first week and just started to add a bit of dairy to my diet yesterday. Nonfat, sugar-free yogurt is working well. I also made a very small milkshake with some added instant breakfast powder and that worked fine. Rice pudding was a nice treat with some cinnamon. But my quantity for each serving of anything is very small -- approximately one-quarter cup at most. Surprisingly, this is quite filling.

I'm still having some irritated bowel issues -- tons of noisy gas and lots of very loose (and yellow) bathroom "runs" (pun intended) -- but I'm sure this is partly due to the week-long liquid diet. I'm going to start adding in a bit of substance and tomorrow, very slowly, starting with some mashed potatoes and maybe some very, very soft pasta. Hopefully this will help to bulk me up a bit.

The one thing that has been incredibly helpful for me is a tip that Ringer recommended to me in another post and it's BRILLIANT. Here's the tip: for immediate post-op eating, BUY AND USE A BABY SPOON! This simple trick has been an absolute lifesaver. It helps to limit my intake, control the size of my bites and swallows, and slow me down. I really think that this is making a huge difference in my recovery -- keeping my new esophagus wrap as comfortable as possible post-op. I'll probably post about the baby spoon as a separate thread because, honestly, it's something everyone who has this surgery should try.

That's it for now. I expect that although things seem "up" right now, there are bound to be some "downs." I've heard about the dreaded "day 14" swelling and discomfort. But I'll take it as it comes.

Hope you all are doing well!

Day 9 - 11: Slowly Soft Foods Beckon

Well, so far so good. I'm very thankful and happy to report that, after some initial post-surgery issues that kept me in the hospital for several days, I'm on the road to recovery. So much progress in such a short time! No reflux or GERD incidents, so far, which is awesome, and pain has significantly reduced.

I maintained a strict clear liquid diet for the first week and now have started to slowly add in not-clear liquids and some very, very soft foods. Cream soups (still strained), yogurt (blended, no chunks), ice cream (smooth, not chunky), even some thinned out instant mashed potatoes. Rice pudding has also worked, but I've been sure to chew and chew and chew, despite it being a bunch of mush, really. I have to watch the dairy and sweets, as I'm finding that they can cause the dreaded dumping syndrome. This of course, sends me scurrying (and clenching) as QUICKLY as possible to the bathroom. Not a fun time, folks. For this reason, I've started to lean toward non-sugar versions of yogurt and have kept the ice cream and rice pudding to a minimum. A few bathroom "runs" like that and you'll tend to want to avoid your triggers. The mashed potatoes have been awesome though as they tend to provide some bulk. My new favorite today is egg salad, prepared as you would deviled eggs and well pureed. I'm not an egg fan but like deviled eggs and wanted some protein in my diet. This puree is tasty and packed with protein, so yay!

Bloating and abdominal "heaviness" is definitely here, particularly whenever I eat anything. I expected it, based on all I've read here, and am coping with it. I have some Gas-X dissolve strips for when it becomes bothersome. The gas seems to be in fits and spurts -- sometimes, I'm quite noisy while, other times, all's quiet. I imagine that someday, once my digestive system has settled into a routine, the bloating and heaviness will subside.

Pain is minimal and typically isolated to my physical movements. I've learned that leaning over or down in a manner that crunches my abdomen and twisting at the waist is not yet possible as it's quite painful. I can feel the areas in my chest and abdomen where the hernia repair and fundoplication were done. Not a good feeling. So tying my shoes, bending down to do anything, reaching around, etc. are still off limits. My honey helps me with washing any parts I can't reach, tying my shoes, getting things from the floor and low places, etc. He's been a lifesaver through all this.

Same goes for sitting. I prefer to recline, but when I sit, I choose to sit on the edge of a chair, very erect and upright. When I try to relax and sit back, my chest and abdomen compresses and my innards hurt where the work was done. Anyone else experience this? For how long??? Does this feeling ever go away? I sure hope so...

That's it for now. I'm waiting for a few "downs" since things have been "up" lately and will take them in stride when they come. Fingers crossed for the best. Hope you all are well!

Hi caliGal

your so nicely detailed..Your information has really helped me.
am 2 weeks since .

are you able to feed wel now?
Have you lost a lot of KG?

Wishing you luck

keep us informed..it's great help