laproscopic fundoplication coming up in 4 weeks

I had lung issues prior to my fundoplication 3/16/16. I had a partial wrap due to esophagus motility issues. My lung issues have improved most days, but not enough for me to be very pleased.

I'm still working with my surgeon and next month a pulmonologist to figure this all out. My surgeon feels it's esophageal issues, since I cannot burp well, but who knows. He is trying some medications for esophageal issues and said if that does not help he will do another barium swallow and Bravo probe.

I have read those with atypical issues sometimes do not get full relief from fundoplication, but of course many do get full or partial relief.

I hope your surgery and recovery go well. Keep us updated!

Hi Nicky,

I'm a long-time, but absent member of this forum. I now babysit our 4 grandkids during the week, (ages 5,3, 8 months and 6 months) and have so little time I can't get on the forum much at all. I try to stop by from time to time to see if I can be of any help.

Like you, I had terrible lung issues as a result of GERD. My reflux was milder than yours (no Barretts), but I have asthma, so my lungs were extremely reactive. After a long and drawn out battle between my primary care doc (and my asthma doc) with my GI specialist, I finally was referred to a surgeon and had a laproscopic Nissen in February of 2009. (I was on high doses of steroids and my lungs were infected at the time of surgery.) It took about 3 months to begin seeing improvements, but it is absolutely amazing how well the surgery worked for me. I just wish I'd had it much sooner. The steroids have caused permanent skin damage. My skin is thin and it tears and bruises extremely easily. I'm 64 and have the skin of a 90 year old. I can tear my skin on the edge of a paper bag. I always have alcohol wipes, steri strips, and bandaids with me wherever I go!

Here is a link to my early recovery journal. It'll give you some idea of what the recovery will look like. Since you've got lung involvement, it might be even more interesting to you. I hope you find it helpful!

www.healingwell.com/community/default.aspx?f=45&m=52985

There is something funky about the linking within this website. Although I can copy the links onto a Word document and they work properly, when I put them into the body of a post here at HW it doesn't work.

Go to the main page and look at the top. Click on the GERD Resources and Treatment Options thread in the blue shaded section, then scroll down to my journal.

Don't worry about the surgery. I expected it to be much worse than it was. Attitude is everything. Go with the flow, give your body permission to heal in its own sweet time, and don't worry. You will heal and get back to normal. It takes six months for most of the healing and a year for the rest. Patience is a virtue with this recovery. I've found that surgeons don't really know the true challenges faced after surgery. It definitely has its challenges, especially during the first few weeks. But this too, will pass, and you'll get back to your old self.

You'll always have to chew your food more carefully, and should avoid vomiting even if you can. I suggest you ask your doctor to prescribe an oral medication like Zofran (generic is fine) for milder nausea, and a Compazine suppository in case you (heaven forbid) come down with a vomiting/stomach virus. You won't be able to keep a pill down, and the Compazine will work like a charm to keep you from vomiting. I've had 3 stomach bugs that each surprised me with one vomiting episode (yes, I could vomit...I could feel the wrap holding back, but after several pushes by my spasming stomach, the wrap let go and I was able to vomit.) I took Compazine immediately after, and was able to stop any further challenge to the integrity of my wrap. Vomiting and retching can be very hard on it--most especially during your healing phase.

I hope I haven't overwhelmed you with information. I've always liked knowing everything possible. I'll be happy to answer any specific questions you might have. Just ask away!

Best wishes,
Denise

Hi Nicky,

I recommend that you check out my early recovery journal if you haven't done so yet. It's better to know what to expect, which is why this forum is the best! I think you could enjoy a cruise at 10 weeks post op. You will have to take small bites and chew, chew, chew, but you'll have a pretty wide range of foods you can eat. Here's a post I shared about my experience at 4 weeks, as well as the information I learned from my post-op visit to the surgeon. Hope it's helpful.

4 Weeks+ Post Op Thoughts

Just posting for all those people who are cruising the internet to learn more about the surgery as they try to make a decision:

As I've said in previous posts. If you have all the tests (I think manometry is especially important, because as you'll see in posts here and other places, swallowing problems can be a result of the surgery) and select a very experienced and competent surgeon (if you live in a reasonably large city with a good hospital system (my city is not that big--about 250,000--but has 4 hospitals, with a complex of 3 in close proximity, and a medical university) you won't have to go looking in a big medical center--you will do just fine.) In a smaller city your surgeon should have done several hundred Nissen surgeries, and in a large city 1000+ surgeries.

It seems as if a tight wrap (especially if coupled with swallowing problems) is the biggest issue. Perhaps with people who have had severe GERD for a long time, and have suffered esophageal strictures in the past this is an issue as well--I'm not sure. That was not the case with me.

Anyway, as of about week 4, I've been able to eat virtually anything. (I do find I still have trouble with melted mozzarella. It's not the bread of the pizza, it's the cheese. If I eat a pasta dish (crepe manicotti/eggplant roulettes, with melted mozzarella, for example, I have to remove the melted cheese first. I am not great with pasta or noodles, either. Bread is fine, though. Everything needs to be chewed to liquid...don't get me wrong. You have to be aware of your healing and be a responsible eater!)

That said, I never in a million years, thought the recovery from this surgery would be this comfortable and easy. Honestly, the many gastritis/GERD bouts I've had were FAR worse to recover from than this surgery.

I visited my surgeon at week 5, and asked him several questions:

1. I asked him how much weight I could lift…he was a comedian...
"How much could you lift before surgery?" So I guess I'm okay to use my own judgment.

2. Any activity limitations?
None

3. Eating?
He said that I can eat anything that I chew thoroughly. Even steak, he said, can be chewed to a liquid. On the other hand, mashed potatoes can be swallowed in a big "bolus", and cause problems.

4. Alcohol?
No problem...

5. Why do I feel full so quickly after eating just a small amount?
He said it's because the swelling causes a stiffness, and that stiffness makes you feel more full than you actually are. The resident I spoke to after surgery, said you lose about 15-20% of your stomach capacity with the surgery. (Actually at week seven, I am able to eat more than even last week.)

6. I asked him about the effect of coughing on the hernia repair. (I have asthma. Although it has responded amazingly to the surgery, and is MUCH better than it was before the Nissen, I had a lung infection that hadn't resolved, then last week got the flu...To make it even more fun, the tree pollen is giving me fits.)
He said that "even water can erode stone". He said that there is a cumulative effect of coughing, straining, etc., that will eventually weaken the repair. These things are unavoidable.

7. What size bougie did he use? 56 French (He uses the bougie to ensure that wrap is not too tight.)

So...all in all, I would recommend this surgery. If you have a real problem, the tests indicate that you're a good candidate, and you can find an excellent surgeon, go for it. By the way...when I asked my surgeon how many procedures like this he has done, he estimated about 300. He did two on the day he did mine. I didn't know if 300 was enough, but apparently so, because his skill has resulted in an excellent outcome.

SO STOP READING THOSE HORRIBLE POSTS that blame every problem that occurs after the surgery on the Nissen. I have grown to believe that most of the people who write panicked posts online are in the midst of the difficult early recovery period and think it will go on forever. Of course a too tight wrap on someone who has swallowing issues can create real problems, but this isn't typical.

Keep in mind that most people have the surgery and go on with their lives without ever posting online. If someone has problems, they're more likely to seek out the internet for answers. Those types of posts kept me from pushing for this surgery, and as a result I suffered for years with uncontrollably sick lungs and took so many strong steroids I now have a permanent disability. My skin tears at the slightest bump, and I'm always covered with bruises. Don't let what you read scare you away from a surgery that can improve your quality of life.

You can do this!
It's worth it!
Denise

Thanks I have read all the info and I have spoken to the Nurse of the Dr doing the surgery. She says he has done at least 1000 fundoplicaions over the 26 years experience in Surgery so I am in the right hands. The nurse herself has had the surgery and I feel more confident in the recovery and am still going on the cruise.
Chew your food well and keep it moist seems to be the message.