Toupet fundoplication - Recovery Journal

Hi all,

After 3 cancellations, I finally had my fundoplication (toupet)! It was last Thursday, so today is my 6th day post surgery. It's also my first day not taking any pain medication, so hooray for that as well!

I arrived at the hospital around 7:00, and was in surgery by 8:00 after a brief meeting with the doctors involved to review everything once again. I had my pre-assessment a week earlier, and that was all clear. I was in surgery around 8:00 and was finished around 12:30. After spending a day in the recovery ward, I was able to go home around 18:00. I have 5 small incisions as they were able to do the whole thing laparoscopically and thankfully didn't have to convert to open surgery. They have dissolvable stitches and waterproof dressings; I was told it was safe to remove the dressings after a week if they don't come off naturally on their own before then. I'm on clear liquids for the 1st week, non-clear liquids the 2nd week, mushy food the 3rd week, and soft food (and hard food) 4th and 5th weeks as I feel up to it. And fizzy carbonated drinks once I've mastered harder solids.

From what I understand the surgeon telling me... I had a toupet fundoplication, large hiatal hernia repair/stitching up the diaphragm, and since there was apparently substantial damage to the lower end of the esophagus, the damaged section was resected (and presumably re-formed) before the fundoplication itself.

The pain hasn't been too bad. Before today, I was on paracetamol and codeine every 4-6 hours which was helpful. And today, I haven't taken anything and been okay. Unfortunately, they were pills and I was never a good pill taker to begin with, so taking the pills after the surgery was very difficult. I had to have them cut into 1/8ths to be able to swallow them. Initially, it was the incisions that hurt the most, as well as a very bad sore throat and my right shoulder was incredibly achy. Now, those things are much better, and instead, it is deep inside my upper abdomen that feels tender and bruised. Leaning over is painful, taking a really deep breath is tender/sore, and I've got strict instructions to not lift anything for 8 weeks.

My stomach is making all kinds of wonderful noises - rumbling, grumbling, growling, moaning... and I can sometimes feel painless little spasms (best I can describe it) in the abdominal area. I've been burping a LOT; mostly after drinking anything. (though apparently at night I burp in my sleep too) Sometimes I feel like the liquid gets stuck halfway down my chest for a second or so before finally going all the way down. Sometimes I feel quite nauseated and heartburn-y (for the technical term), but that usually passes after a few minutes and feels a bit better with a few burps. Sometimes there's chest pain and tightness, but again that usually lasts for a few moments and is usually relieved by a burp or two. I'm guessing (hoping!) that the heartburn feelings and chest sensations are still from the healing/recovery process and not indicative that the wrap has failed in some way - especially so early on.

The skin under my dressings is becoming very itchy; I suspect the skin healing has commenced!

I'm very tired, and sleeping a lot with many small naps during the day. I suspect this is due to a combination of recovering from the operation, and essentially being on a very low calorie diet. I'm hoping in a few days I will feel able enough to take a small walk down the street to a local cafe, sit for a while, and walk back home - for some light exercise to prevent adhesions and to get out for a little while. I have initially 2 weeks signed for being off work; I'll wait and see how I feel at the end of this week, but I suspect I will be requesting a renewal of the sick leave paperwork. The fatigue level has surprised me... I knew I would be healing and not eating much, but I feel really wiped out all the time. Much more than I imagined.

All in all, I think not going too bad so far. I will have a follow up appointment in a few weeks, and hopefully, will be told the wrap is fine and settling well. I'll keep my recovery thread updated; hopefully it can be informative to people looking for a recount of personal experience.

Post Edited (Altair) : 4/11/2014 7:44:47 AM (GMT-6)

Thank you for the well wishes. :)

I have (had?) a motility problem as well with gastric emptying, but I was told it wasn't severe.

The consultant and myself didn't previously discuss a resection. I was originally only going to have the fundoplication and hiatal hernia repair. When I was in recovery and he was discussing the outcome with me, he said that there appeared to be a lot of damaged tissue when he went in and had a look. The extent of the damage was apparently very pronounced, and he was having a hard time working with it.

---

Today has been the first hiccup with my recovery. (sorry, graphic bodily function details to follow... advance warning!)

Yesterday I had a small walk to a local cafe, had a sit down, and eventually had a gentle waddle back home. A little sore and tender, but okay.

Today I tried non-clear soup and had a little splash of milk in my tea. Plus the usual clear liquids for drinking and sipping throughout the day. Still liquid, and everything felt okay going down. But then I had my first bowel movement post surgery. It was immensely painful. :( Constipated at the beginning with some straining (and I know you're not supposed to strain so soon after surgery!), and then exceptionally foul smelling diarrhea. Then a few minutes of a small respite, then more diarrhea. And my stomach was very very vocal about the whole process, emitting loud gurgling rumbling noises.

I hope everything's okay... how do you know when something's gone wrong with a fundoplication? Do you get symptoms? Is it only discovered (perhaps incidentally) at a follow up?

The only thing I may have gone a bit awry with is perhaps lifting? I've been feeling a bit better, so I've been around the house helping with odd things here and there as I don't want to feel like a useless wet rag. I've carried some slightly weighty things, but nothing I would normally consider "heavy." I hope I haven't accidentally overdone it.

The good thing today: my bandages came off, and the wounds are healing like a charm. Very small, very neat, slightly slightly bruised and looking like they'll fade in no time.

Thanks for the reassurance. Today was a better today. :) Still having exceptionally loose bowel movements, and usually a lot of them at the same time, but no more pain with them - which I can imagine is a good thing and step in the right direction.

It's now 3 weeks post surgery, and I thought time for an update.

I recall reading somewhere (I believe it was this forum) that recovery is more of a marathon than a sprint, and this is proving to be very accurate.

The shoulder pain has completely subsided now, and taking a small walk each day has definitely helped with that.

I'm still feeling tender and bruised in the abdominal-wide area, but nothing too severe that I've needed anything stronger than the occasional paracetamol. I went to the pharmacy and got dissolvable tablets; best thing I ever did!

I have had a few attempts with soft food, and it's been rocky. I've thrown up 3 times, and have since throttled back and will be going back to baby food for a few days before trying again. I contacted the surgeon, and he said that occasional vomiting with my wrap is okay and expected during this transition. I only need to worry if I am so nauseated I cannot keep anything down (constant vomiting) and/or if the vomiting is particularly violent and painful. I was very reassured to hear that; I've been worrying like mad about the integrity of my wrap. It's like my little baby!

I've found that colder things irritate more than warm/hot things. Also, swallowing is a bit harder in the morning... almost as if my esophagus has, overnight, forgotten a bit how to swallow. But once I get going, I'm normally okay. Chew, chew, chew... and chew some more. Making sure things are mushy and lubricated, and small bites. These have been key for me.

Heinz baby food has been a lifesaver! I was very skeptical; however, after the liquid diet I was desperate for more flavour and was very pleasantly surprised at how much I'm tolerating/liking the baby foods. The sweet and sour chicken and rice blend has been a hit. And Farley's Rusks... mmm!

I'm still feeling quite tired and need a nap in the afternoon after I've had a walk in the morning.

I've gotten my sick leave extended from an initial 2 weeks, to another month on top. The doctor said that although it was done lap and on the outside doesn't look too involved, a LOT happened to my insides and for most people, more than 2 weeks is needed for a full recovery. At least, he said, no working until I'm back to a semi-normal diet and getting the appropriate calories and nutrition.

So, overall okay, but it's definitely slowly but surely, and a bit of one step forward, two steps back.

I'm having a hard time right now.

I've caught a cold, and despite trying to remain topped up on as much liquid cold medicine as permitted, I'm still sneezing and coughing a LOT. My abdominal area is really sore - too much irritation with the coughing, I suspect. Generally speaking, I'm feeling really crummy and terrible from the waist up, all the way to my head.

I'm terrified the wrap will get damaged with all the coughing, if it hasn't been already!

:(

The transition from total puree to soft food is a nightmare.

I'm feeling very depressed about it all. Whenever I try something with any texture - vomit!

Liquids are fine, and anything so blended that it is practically liquid slop is okay too... but anything with any kind of texture or the slightest bits or lumps... bam! Not so good.

I've been trying going back a step for a few days to baby the wrap, but whenever I attempt to take that step forwards after a period of babying, I vomit the food back up after one or two spoonfuls. Been doing this for maybe three cycles now, and I can't seem to progress past slop without throwing up.

I'm supposed to go back to work in two weeks, and I cannot even tolerate soft food. I'm feeling very helpless and frustrated.

hELLO FELLOW GERDERS i THINKi AM LOST .....BUT ANY AYW my problems are lessening I think due to not eating as much as I was in my former gluttonous madness but still maybe a little too much vino ....at the moment . I hope I can navigate my back the other threaders where I was before ....Hello hello for now and anon ....

Hi Lindylou,
This is an old post, and you will be more likely to get a response if you start a new post on the main page.
https://www.healingwell.com/community/default.aspx?f=45
I haven’t experienced either, but had a Nissen fundoplication in 2009. I hope you get a helpful response to your questions soon.
Also, you can search posts in this forum via the search box above. There will be many posts by others who have had the procedure.just click on the search icon in the upper right corner of this page.
Best wishes,
Denise