Post-op lap nissen fundo/hiatal hernia repair

Doghouse:

Antibiotics are a regular part of any surgery. They will give you a pre-op dose and then you will have more after surgery to ensure you don't get a staph infection. Antibiotics for prevening staph is good. It's just how it affects each individual person that makes the after-effects "interesting".

No bowel prep for me, just no eating after midnight the evening before.

I did not have a CT scan before I left the hospital. My hospital stay was limited to pain management, rest, and ensuring I could intake liquid and pee.

I cannot lift anything heavier than a gallon of milk for 6 weeks.

As to running and lifting weights - that's up to your physician. But keep in mind you'll have had 5 incisions with instruments leading up towards your chest - that's going to affect your abdominal muscles. Plus if you have a hiatal hernia repair, your diaphragm will need time to heal and your diaphram is involved with breathing.

I'm 3 weeks post-op and even working just at my desk I cannot handle an 8-hour day. My co-workers tell me to go home after about 4 hours because I look physically drained to them. I am scheduled to go back to work full time this Monday, but fortunately have the flexibility of being able to leave when I feel tired without being docked salary.

Post Edited (HappilyWrapped) : 11/10/2007 9:55:43 AM (GMT-7)

Doghouse,

My surgery was in 2005, but I did not have any bowel prep or a CT before leaving the hospital.  I think the gallon of milk is pretty much the standard that they go by as far as lifting.  As for down the road on lifting, I can't really help you there.  I have severe asthma and do not have the lung capacity to lift too much any way.  To my knowledge, when a patient is fully healed, they are able to do whatever they did before.  I just don't know what that time frame is. 

 I also had a hiatal hernia repair at the same time and I guess before it had time to heal, I got a serious case of bronchitis and tore it.  So, I now have a sliding hiatal hernia.  I don't think this is likely to happen to the average person, it's just because my asthma is severe.

As for time off work, I would plan on three weeks with the option to take more time off if you need to.  As you can see, everyone heals differently, has different side effects.  It is not a pleasant surgery to recover from, but if you need it, it is definitely worth going through.  I am glad I had it done.

Take care!

Carla

Welcome, nocough. Glad you're feeling fine right now. Reading our previous posts should give you some really good information as to what to expect over the next few weeks.

If you have someone at home with you, ask them to rub your back. It will help move those gas pockets around so they can dissipate. I got quite a bit of relief after this surgery and a previous one when my spouse rubbed my back - it sort of broke up the gas and relieved some of the pressure/pain.

How are you able to take Vicodin? I thought it only came in a pill form - do you have a liquid version or are you crushing the pill?

Barbara:
Question: How's that chest pain/pressure you were experiencing? I've got to say I'm not as thrilled as I was about going to work tomorrow. I've got more discomfort (pain and pressure) in the wrap site this weekend than ever before. Maybe it's due to the internal healing. I know the wrap is fine as shown by a CT scan this past Friday. Just can't seem to shake the new chest pain that radiates into my back. The MD I saw Friday evening mentioned it could be a possible gallbladder issue due to the results of blood tests - but the results could have been due to the recent surgery and not the gallbladder. It's also not cardiac-related pain. It's either part of the surgical procedure or gallbladder. Just wondered if your discomfort has subsided as you are a week further along than I am.

Alycarr00:
At 3 weeks post op, traveling on a plane with a 2-year-old will be interesting. If you are on your own, contact the airline and explain that you've had recent surgery and require assistance. Also tell them you are on a special diet and ask if you can bring your food onto the plane. You may need a doctor's note for that. If you are traveling with someone, let the other person do all carrying of heavy items. Remember - nothing heavier than a gallon of milk. I could not lift a toddler, walk and hold them right now and I am exactly 3 weeks post op. I also feel worse now than I did a week ago - I am back on a liquid diet because the swelling inside has cropped up again.

Not everyone gets thrush nor does everyone acquire c.diff. Each person reacts differently to the antiobiotics given during and after surgery. Watch the diarrhea - it is normal to have some, but if it is "explosive" make sure you check with your physician to give you the time to get treatment before you travel - it's a 7-10 day course of an antibiotic. Had I not caught it quickly, I'd be in a bad way for a plane trip right now. You will most likely have gas, so be prepared to be aromatic while on the plane.

I can't believe your surgeon has OK'd a plane trip 3 weeks post op - unless you didn't mention it. If you have not mentioned it, then make sure you talk to the surgeon. That will be your best source of information. You said your trip can't be rescheduled; can you reschedule the surgery for after the trip?

If you go through our previous posts, you'll notice that there are several mentions of no pills as well as good information about how we felt 3 weeks post op. You will not be swallowing pills for a while - yes they will go down your throat, but they will not pass into your stomach and may get stuck thus causing pain and the inability for anything else to get past them. Make sure you check to see if your current meds can be crushed or if they come in a liquid. The opening into your stomach from your esophagus will be swollen after surgery - hence the need for liquid diet. As it heals and the swelling goes down, it allows soft foods to go through. You don't want to ingest anything that might get stuck.

Soft diet means nothing more than the consistency of pudding. It sounds like for you that will be an issue so you will have to go more liquid. You'll be eating a lot of soup - just blend it so you don't have any chunks - and no tomato products like tomato soup as that's too acidic after surgery. Meal replacement drinks will be another option as will smoothies and shakes as well as very loose scrambled egg. There's not much in an airport, at a restaurant or on the plane that you should be consuming at 3 weeks post op. Remember that this soft diet is not permanent - it is meant to allow your stomach and the wrap to heal which will allow you to eat normally later. You'll get good ideas if you "google" a search for "post nissen fundoplication diet". You'll find several doctors and hospitals have posted good diet instructions for patients who have had the procedure.

Good luck with your surgery and your trip.

Oh I wish the time schedule could be different!! If I reschedule it will have to be the end of January. I guess I will be calling my surgeon tomorrow!!! Thanks.

Okay..you guys can just call me queen of the impatient.... my appointment with my gastro is in dec. I called their office to see if there is any testing I could get done between now and then so when I meet with him in december, he can tell me whether or not I'm a candidate for this surgery. Instead of meeting with him in december and THEN starting the testing process... YES, I am impatient!!!! I admit it!! Freely and openly!!! :D

Here is a question....I've read several times that if your doctor has confirmed that your have esophagitis via endoscopy that you don't need to have the 24hour ph study done because obviously, the esophagitis is going to be caused by reflux. Think I'll have to do it? Of course I know the doc has the final say.

Also, I had a manomentry done a couple of years ago with normal results, think that will be good enough or do you guys think they will want a more current one? Once again, I know my doc has the final say.

A heads up too, if I'm not a candidate for this procedure, I'm going to come crying back to this board for mental help!!!!! :)

Sorry guys I sure am getting behind on posting.  Believe it or not I am still having a little bit of brain fog and I really have to concentrate/focus to write my posts.  I am just hoping that this a temporary setback.  Another thing is that I am still a little nervous/jittery whenever I hear a sudden loud noise.  I have two examples of this.  I live in a rather large city and not far from a business zone and exactly two blocks from a night club and these idiots around 11:00 p.m. kept reving up their motorcycle engines for about 15 minutes and everytime they did this I literally wanted to jump out of my skin.  Also, yesterday in my bedroom I had a problem with the cable box twice and the cable just stopped like if it had been unplugged and the t.v. made a loud noise (granted the t.v. wasn't even that loud to begin with) and when this occured my heart just wanted to go crazy because it startled me like if someone had put a gun to my head.  I just hope this goes away.  Also, because of this I know it will be a while until I can go back to work. Imagine me dealing with those teenagers and me in this fine mess?   

Doghouse:  I too had no bowel prep or a CT scan/gastrografin before I left the hospital.  I can't remember if you had another question?

HappilyWrapped:  I am so sorry to hear you had a setback and you were doing so good.  How scarry it must of been for you.  Yes, I still have that dull chest pain and it doesn't go away, sometimes I feel it more than other times, even at night time.  In fact, I always wake up every morning and say to myself "today is the day it isn't going to hurt anymore," but unfortunately that isn't the case.  I have had two sort of bad episodes and this is what happened:  I always give exact details because I know people who are anticipating this surgery really want to know what to expect in great detail.  The other day around 3:30-4:00 I made myself a smoothie with ice cream, a banana, strawberries, and milk and drank about 5 oz, then it was time for dinner around 6:00 I fried my usual small piece of liver and a runny mashed potato (what I experienced next was horrible) I think that the smoothie I drank was still partially in my stomach and when I ate it was too much food and let me tell you it feels terrible.  I was starting to panic and didn't know if I wanted to vomit, nausea, poop or what.  I walked and walked as much as I could and finally after about two hours it subsided.  It also happened again Friday with a small portion of spagetti so now I am being very very careful not to let my stomach get too full at one sitting.  Be very careful once you start eating a little more because what I experienced was horrible.  HappilyWrapped, did they want you to take the painkillers after you had the problem?  I also have been meaning to ask you if you can belch like before you had your surgery?  I can't belch like I used to (you know how you can pull up some air thru your diaphram and let out a belch).  I can burp but a tiny burp and I mean tiny and only while I am drinking.  Is this the same with you?  I just hope you get better because I know how a setback can feel.....

Carla:  I haven't had a choking incident but I have been very careful and take tiny bites.  I am very thankful for the advice you gave me and have been careful because I would be so scared to choke.  I eat very slow and it can be very stressful.  Does food still get stuck and you have to be careful still after 2 years post op? Before the surgery I used to drink lots of water but can't now.  The nausea seems to be getting a little better and haven't taken a pill in two days (knock on wood) and thank God diarrhea wasn't a problem for me.  I have had some constipation but I think is due to the fact that I am not drinking that much water.  I had to give myself an enema (I know too much info) because I am so scared to strain and tear my hernia or wrap.  Carla, did they ever fix your hernia?  The left arm still hurts but not as bad as it used to.  I still sleep elevated because of my gerd I had purchased an adjustable bed, so I am careful not to sleep on that side. 

Alycarr00:  I am sorry to say but this surgery isn't a walk in the park.  This Wednesday will be 4 weeks post op for me and I am still struggling with a bunch of issues as I am sure you have already read via my posts.  Honestly, you will not be able to lift your toddler because your wrap will be compromised.  The surgeon stressed to me the importance of not lifting or not eating bread/steak until he approved me to do so because of the possibility of choking.  You will definately need help with your two year old.  With what I know now, there is no way I could of gone on a trip 3 weeks post-op.  You will be weak because you will not be getting adequate nourishment.  Unfortunately, your choices are limited as you will be on liquids for about 2 weeks and then progress to soft foods.  You will have to experiment just remember not to let your stomach get too full at one sitting (eat smaller meals throughout the day) and take very small bites, you won't be able to gulp your food like you used to.  I agree with HappilyWrapped and would cancel the trip because this surgery is too important and what you have to go thru is tough only to fail because you were lifting or not ready because to travel because of the surgery.  I hope you aren't disappointed with what we are telling you but there is no way I could have handled a trip along with being alone with my two year old.  Good luck and let us know what you decide.  Barbara...... 

Barbara:
No, they did not offer pain killers after Friday's episode. The only thing I can take is Tylenol and that doesn't help at all. So, they said if the pain returned to head for the ER and another shot of morphine. As the hospital is less than a mile from my home, it's an option if I need it. Just as a bit of humor - when I got the morphine shot in the ER Friday, the Wizard of Oz was on TV in the room I was in. I must say that Munchkin voices are amusing when "high" and I'm so glad I knew that the horse changed colors and I wasn't seeing things.

No, I can't bring up a belch from my toes like a guy can. However, I never could pull up a really big long one, so I'm not experiencing anything different than before. I can burp without drinking. As a matter of fact, the first thing I do when I sit up to get out of bed in the morning is belch. Yes, I can make myself burp when I feel the need to.

You may be right. I didn't think I ate a lot quantity wise, but looking back maybe I did and that may have caused the pain. I do know it was awful and did not subside after 2 hours. I was told by the doctor that walking was best to relieve the pain and the next thing to do for relief was to lie on the right side because that helped the stomach empty faster. Neither item worked - but the medication did give instant relief.

Alycarr00:
Smart choice to postpone!

doghouse:
The 24 hour ph study measures the amount of acid in your esophagus, that is not something you can tell by an endoscopy. The endoscopy shows the damage, the ph study shows how much acid you are exposing your esophagus to in order to get that damage.

You had the manometry done a couple of years ago, no it's not good enough. You need the tests to be current - the way your body is right now

I had 2 ph studies and 2 manometry tests one set done in May and another done in September - both were totally different in their results. The first ph study showed off-the chart acid. The second showed normal readings. The first manometry showed I was not a good candidate - not enough motility to propell food into my stomach. The second one confirmed that I was a good candidate - there was plenty of ability to propel food through the wrap. The difference was one set of tests was done with a period of no PPI's to show what my body is like normally and the other was after a period of Nexium twice a day which showed what my esophagus was like with no acid in it.

You're right, the doc has the final say. However, there's several shoulders on this board for you to cry on if you aren't a good candidate. And if that doesn't make you feel better, you can surf the internet and find all the stories of the people who weren't good candidates, but their doctor did the surgery anyway, and now they wish they hadn't done it.

Good luck - I hope all tests lead to a wrap and relief.

nocough:
Glad the gas pockets have subsided. You'll have ups and downs as you can see from our previous posts. But at least we've provided enough info so you know a bit more about what to expect than you did before. Hopefully others will find this board before surgery and it will help them not be so scared.

Has anyone noticed that this thread is getting a lot of hits? Barbara, you must have named this thread well for all the people surfing for post-nissen information. I know that's how I found it.

To All,
I can't tell you enough how much that I appreciate your candidness concerning the fundo surgery. I met with my surgeon on Friday and am having a hiatal hernia repair and a fundo wrap on Monday, Nov. 19th before Thanksgiving. Can't wait to eat that turkey! JUST KIDDING! I am staying 2 nights providing all goes well. He told me that this is kind of his niche and he does 40 - 50 per year, with a surgeon normally doing maybe 3-4 a year. He was extremely encouraging about improving my quality of life and recovery process. I was so glad that I had become a reader of this forum since it provided me with so much information to ask at my appointment. He thinks that I should be able to go back to school in 2 weeks with light duty. Being a library media specialist, I do a lot of teaching but my principal was said that I didn't have to do anything until I was ready and that I could just sit at my computer and check out books if I feel like it. I also have a private office in my library and keep a pillow and blanket in there for lunch naps. He said that I could rest at anytime and that basically I could do whatever I want. He also said that I didn't need to come back until ready. I am not one to want to lay around the house and I know that I will have to really pace myself not to over do it. Thanks so much for the honest candor about rest, pain, and above all - EATING ( or lack of!) I have slow motility at the end of my esphogus and he is doing a 270 degree wrap instead of the full 360. He feels that this will be of the most benefit. He said that he also puts a few stitches in the diaphragm. One thing that I will be curious to see is how it affects my IBS. I am hoping that maybe the small amounts of food and in being so very careful in what I eat will help. The IBS is really a great deal of more discomfort to me than my hiatal hernia and reflux. He told me that after my PH study (which was one of my better 24 hour periods) that I had 146 periods of reflux in that time with 3 that were a constant 40 minutes a piece. He said that I had 5 times the normal relux. He explained how damaging it is to your esphogus to keep it bathed in acid for that long. Anyway, I will post my progress as soon as I feel like it next week. I will do anything not to cook for Thanksgiving! Not really, I enjoy cooking but my sister is having our families at her house. Happy Thanksgiving to All!

Tammy,

You have done an outstanding job with the way you have broken this site down.  Kudos to Tammy!

Thanks for doing a great job for us!

Carla