Mary-
Howdy. As Denise said I had a nissen done wrong the first time and it was almostt 3 years before it was figured out what was wrong.
I have a question...Have you gotten a 2nd opinion on how to go about
this redo? Also how long had it been since the redo was done until it came undone? Did the surgeon tell you why the nissen came undone besides just telling you "you ripped out the sutures"? The last 2 surgeons I had redo mine do all 3 types, lap,
open, and thoracic.
My first redo was done lap and my last redo was done
open by a surgeon who prefers to do them thoracic since he is mainly a thoracic surgeon. He was dealing with a "blown" apart nissen and did it as an
open surgery vs. a thoracic. I am going to post my story, please read it.
www.healingwell.com/community/default.aspx?f=45&m=2337138 this is from our resources thread at the top of the GERD foum. Denise has a very good recovery journal there also.
Now for the thoracic part. I have had 2 thoracic surgeries. 1 by the surgeon who did my last redo
open and 1 by a surgeon at the University of Iowa hospital for my esophagus tear from a scope. My 1st thoracic was done as a lap thoracic doe a lung surgery and the 2nd was an
open thoracic for the tear.
Please forgive me if I bounce around a bit here, as I have so much info I want to tell you but my thought process is a bit off right now because of lack of sleep due to pain from my SCS surgery. That's a whole othe matter.
Anyhow...I hope you took the time to read my story before finishing reading this because it can explain a lot of what I have been through.
2 things come to mind as to why your nissen came undone. 1 is because you may have very damaged tissue from either the GERD or meds, issues from the 1st surgery being undone, or like me way too many EGDs and dilations, or Heaven forbid a bad job by your surgeon. I know he is one of the best in your area, but things do happen. That is why I ask you get a 2nd opinion from another surgeon who does these. Preferably one who specializes in redoes.
My 1st redo I asked the surgeon who did my last redo to do it, but he referred me to the surgeon who ended up doing it because the local GIs couldn't say for sure what was wrong with mine. He had worked with the other surgeon before and knew he specialized in nissen redoes and swallowing issues. He works at Loyola Medical Center near Chicago. It even took him about
4 months to get an idea of what was wrong. HE really is a great surgeon and I am sure I would still be with his redo had it not been for the esophagus tear.
Now for the thoracic experience. 1st off I prefer the
open surgery and if I ever need another redo I will ask for that.
My
open thoracic was an emergency and I had no choice but to have it that way. I have a feeling your surgeon might also be a thoracic surgeon as well as a general surgeon as mine is. There is no way around this but to be blunt and give you my real experience. Having a thoracotomy is no fun at all, but it goes allow the surgeon a different look at the area and may allow for a better nissen in your case. They basically do things the same way just from the other side. It allows them to see the esophagus better and they can see if there is a problem such as a too short esophagus and then they can loosen the attachments easier to let the esophagus drop some so there is less tension on the wrap, this is very important as a wrap with tension will most likely fail.
With my thoracic surgery I had some very bad pain from them spreading my ribs, this wasn't done on my lung surgery. You will have a chest tube because they have to be sure your lungs can stay reinflated since they will have to deflate one lung for room to work. Of course this will be put in while you are asleep, not like you may have seen or heard of in emergency cases where they do it awake.
Doing it thoracic does make your acute recovery longer because they have to do so much to gain access to the area. The rest of the recovery should be normal. But remember this surgery no matter which way it's done is a long recovery. Think in months not days or weeks. Be patient with the recovery, I can't stress this enough. I know there are a lot of people with complaints and feeling it didn't work, but if you look at where they are in recovery they are usually between 2 weeks to about
2 to 3 months. This is the point at which their body is really just beginning to really heal and adjust to the new design of the digestive system. A lot of those same people feel much better later on. Also remember most sits about
this surgery where people are complaining do not have people who are happy with their nissen because they never go online and post about
it. They have no reason to, they are happy. This forum has both people who are struggling with the wrap and people who have gotten through the recovery and are very happy.
If you had relief from you 2nd nissen that was working then it makes sense to have it fixed to get that relief again. I will have mine redone as soon as possible if mine ever fails. In fact I was begging them to redo mine 3 months after my thoracic surgery, but they made me wait 6 months to let the other surgery have time to be mostly healed before doing the nissen again. After all was said and done I realize this was best, but at the time all I could think about
was I hate having this reflux and it's going to make my Barretts worse.
Sorry if I am rambling on here, like I said I am sleep deprived right now. Please email me if you would like some more specifics and any answers to long tough questions.
My email is on my profile and under my user name, just click on the envelope. I am more than happy to discuss your situation with you.
Take care,
Bill
