3 wks Post Op Lap Nissen-- Problems!

Hi,

 I had my Lap Nissen 3 weeks ago. I did not read this board until after the surgery (didn't want to scare myself!) and once I did, I thought that I had been really lucky. Of course I had the severe pain, especially in my chest, for about 1.5 weeks, then I was just extremely sore. Now I would just say that my abdomen is just a tiny bit uncomfortable.  I never had nausea, diarrhea or bloating and I was able to burp almost immediatley-- thank God for burps! My surgeon is the chief of gastric surgery at The Mayo Clinic and has done over two thousand Nissen Fundoplications. The only surgeries he performs is the Nissen and the Gastric Bypass, so I was very confident with his ability and experience.

For the first week or so, I really never felt hunger and got by just fine on tiny bits of applesauce and Ensure. By 2 weeks, I had lost 12 lbs and it was time for me to start back to school (I'm in nursing school) so I decided that I needed to increase my food intake. But that has been easier said than done.

Swallowing is not a problem, as long as I chew very well. My problem is the amount of food that I can actually get down. I want to eat and think that I'm hungry, but as soon as I take 3, maybe 4 tiny spoonfuls of food I feel as though I have just eaten my own weight in food! My stomach also becomes very distended.  It's the same story with fluids-- I'm struggling to even get down 32oz of fluid/day. I also have this constant, painful gnawing in my stomach that is almost like extreme hunger pains, it gets a bit better after a few bites of food, but returns after 10 minutes or so.

Yesterday I became very nauseated, weak and sweaty. I went to the ER and they gave me 2 liters of fluids b/c I was so dehydrated. The ER docs told me to see my surgeon, which I will be doing next Friday (8/29). They also told me that my body is in serious starvation mode and that I should try to eat things that are very high in calories and fat, but low in volume, like heavy cream or pureed potato salad. I've done this and it gives me a bit more energy, but just makes the discomfort worse!

I'm really weak and tired all the time, which I know is to be expected, but it's really difficult being in nursing school while dealing with this. In two more weeks I return to clinicals, where 2 days a week I'll be on the hospital floor for 12 hours-- that is mandatory, so I really need to figure out what's going on before them

I do have realistic expectations regarding the healing process, I just expected it to be more related to pain, difficulty swallowing and fatigue. But my problems seem to be more related to the volume of food than the swallowing problems that everyone else seems to be having. I've jokingly said that my Dr. must have accidently done a gastric bypass instead of the Nissen!

Sorry to write so much, I'm just at my wits end and wondering if anyone else had problems like this??

Thank you in advance for any replies!!

Kelly

Hi Kelly and welcome! When they perform this op your stomach ends up smaller than before so you won't be able to eat as much straight away. I keep eating little and often. My day went something like this:

A small pot of smooth yoghurt for breakfast

Ensure/Complan (hot chocolate flavour with cream and a flake) for elevenses

Pureed veg about the size of a pot of stage 1 baby food for lunch

A small pot of custard mid afternoon

Pureed veg or porridge for tea same size as above

And try and fit some icecream with cream and sauce in somewhere!

And have drinks in between.

I eat it all very slowly and sometimes I carry it around with me just taking a spoonful now and again.

I can't help with the gnawing stomach pains. Maybe it is just hunger.

I still have to be careful not to eat too big a portion as my stomach gets distended.

It's a very slow process!

Thank you for the replies! Part of me realized that my problems were just part of the healing process, but the other part was a bit panicky. I think I just needed confirmation that others have this same experience. I am going to go back to my Dr. on Friday just to make sure all is well. Also, since I posted I figured out that dairy was the cause of all the gnawing pains, it wasn't gas, just a intense gnawing. Anyhow, I've felt a bit better now that dairy is out of the picture. I know some people say that pasta is not a good thing to eat, but oddly, whole wheat macaroni (i use water instead of milk), popcicles, canned diced peaches and applesauce seem to be the least aggravating to my tummy. I'm taking a multi-vitamin too because that diet doesn't contain too much nutrition. I do want to be able to eat more, but part of me kind of hopes that I'll always have a tiny appetite from now on-- my boyfriend is an Executive Chef and that is tough on your figure!!

I do know not to push myself physically. I've already had my Dr. write a note to my clinical instructors that I am not to lift or ambulate any patients.

I had my surgery at the Mayo clinic in Jacksonville (I live in Atlanta). I have a rare genetic disorder that makes my blood pressure sky high and my team of Nephrologists are there (yes, it takes a TEAM of Dr's to control my BP!!) . None of the doctors here in Atlanta would do the surgery without one of my Nephrologists present, so I just went back down to Jax.

God forbid, if you ever have a significant or rare health problem, Mayo is the place to go (they're in Minnesota, Forida, or Arizona). I had seen 12 doctors here in Atlanta w/ no diagnosis, but Mayo diagnosed the genetic disorder in 3 months. Only 168 people are known to have this disorder, so it's a miracle that they figured it out so quickly.


Okay, I'm rambling on because my only alternative is studying!!

Thanks again for the advice!