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barret's esophagus and fundoplication

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Posted 11/25/2010 12:46 AM (GMT 0)
Recently diagnosed with Barrett's and a hiatal hernia.  Surgeon, who does 70 nissen fundoplications a year for the past seventeen years, says that the surgery is what I need.  No dysplasia yet with Barrett's, but he recommends surgery because of my age--55--since the chance for esophageal cancer is more likely for me.  He said, "If you were 75, we'd treat you with medicine, but this is nothing to play around with."  I take Prevacid each day and have for many years and I don't suffer real badly from reflux though it is there.  I've been reading these boards, and frankly, you all have scared the heck out of me with complications, etc.  Nobody can make my decision for me, but I would be interested in your advice.  The surgeon is a good man with a good rep.  But this seems to be a life-changing operation and I am troubled.  I could get a second opinion, but if the next opinion is just take meds, what about the cancer risk?  Hard to make a right decision when there are so many opinions.  open to suggestions and for anyone who responds, thanks so much for taking the time to make things a little clearer.
Posted 11/25/2010 12:52 AM (GMT 0)
If you suffer from Barrett's you do need the surgery. It sounds like a good surgeon.

I've had no complications and no complaints. I had a very smooth recovery.
Posted 11/25/2010 2:06 AM (GMT 0)
Hi Seamus,
I'm sorry to hear that our forum has scared you. That's funny, because when I found this forum before I had made the decision to have the surgery, it was the one place where I found a balanced attitude. It's a surgery that does change things and create some quirks, but it also is a lifesaver, and has been a very positive influence on the quality of life that many here experience.

Keep in mind that most people have this surgery and never post or discuss their outcome online. People who seek out forums like this are often those who have had problems. There are no guarantees that you will not have inconveniences because of the surgery. However, if you need it to insure your general health, then it is worthwhile. My attitude has always been that any of the inconveniences are far better than the alternative. In my case, it was uncontrolled lung issues/asthma due to reflux.

I many have damaged my wrap (coughing during recovery) and I'm looking into the possibility that I need a redo/revision. I will, however, have the revision surgery if tests indicate I need one, and I will do it happily. Before the surgery, my lungs were horrible. After the surgery (once my lungs healed), for the first time in about 5 years, I had healthy lungs again.

You are the only one to make the decision regarding this surgery. You need to really want it. You need to accept and welcome the changes as a worthwhile trade for the alternative, should you not choose the surgical option. If you go into the surgery with a negative attitude of nonacceptance, you will find it to be a terrible experience. If you look at the surgery as a positive option, you will cope with any changes with grace.

Remember, many, many people have this surgery and go one with their lives without every posting a single word online.
This forum and all others online, are a skewed view of the surgical outcomes.
Discuss it further with your surgeon, and only go forward when you're totally sure it's the right thing for you.
Good luck!
Denise
Posted 11/25/2010 6:37 AM (GMT 0)
I too have Barrets, and have been going to Mayo Clinic in Scottsdale AZ to cure it. After they clear up the Barrets I probably will have the surgery. I had a friend who had it done 8 years ago and says it is the best thing he every did. These forums are kinda scary, but helpful. My friend no longer has take any PPI's and eats what ever he wants.
Posted 11/25/2010 6:42 AM (GMT 0)
I had the same diagnosis, after having pneumonia four times in one year from asperating reflux my GI Doc recomended the surgery. I was 37 at the time, I just turned 50 a few days ago. The procedure started ia a laproscopic until they found a hole in my esopogus. The procedure then went full open, I was cut down the midline from just below the breastbone to the naval. I went from vomiting 3-4 times a week from the reflux to no reflux at all.

Thirteen years latter the barrets is still in check, Not even one incident of reflux and med free for any type of heartburn.

If I had to due it again today I would in a split second! best decision I ever made to solve the problem.

One note, I weighed about 320 at the time, after the surgery I lost 80 pounds. ( new diet helped also)

If you are tired of the GERD I recomend you have the surgery. It will save your life!
Posted 11/25/2010 10:47 PM (GMT 0)
Sure the idea of surgery is scarey. This is major surgery and not to be taken lightly. But I'd be lots more scared of cancer! A lot of us have had complications. That's why we're talking here. But by and large, even with complications, we're much better of than we were. I'd do it again without any of the anxiety I had about the first operation.

I had a bad hernia - stomach stuck halfway into my chest from a bad accident. My operation was a long one and being older, I took longer to heal. It took me about 3 months to get my diet figured out. But I feel so much better now! I have trouble with gas, but am learning to not eat the foods that cause that.

Life changing? Yes, for the better!
Posted 11/26/2010 12:55 AM (GMT 0)
You folks are great and I so appreciate the insight and the advice. I have not had terrible symptoms. I can easily live with how I am feeling right now. The doctor feels that the surgery is necessary because of Barrett's which oftentimes has no symptoms. Yet, it seems that getting cancer is relatively rare. Hope you see my dilemma. I am heavily leaning toward surgery, but I have people who jabber in my ear that I'll be taking a step I can't come back from and that the "cure" will be worse then the perceived threat to my future health. In all honesty, I know that esophogeal cancer is really on the upswing, particularly in men. Terrible way to go. My Barrett's will never get better, only worse. Not getting surgery is like playing Russian roulette with my body. Of course, I'm pretty confused. I've never had major surgery before, don't know what it is like and frankly am concerned. But if I need it, I need it. Thanks so much for helping me and for making me think. Any other thoughts and ideas will be much appreciated.
Posted 11/26/2010 2:18 AM (GMT 0)
My surgery day...My first surgery ever!
1. put on breezy gown and climb into bed.
2. million questions
3. IV in wrist. Hurt some, but tolarable.
4. more questions
5. rolled to pre-op for more questions and two anti-nausea shots in the IV.
6. rolled into OR (who are those masked people?) :))
7. Slide onto table and stretch out arms
8. Night-night
9. Wake up slightly in post-op, very thirsty and sore.
10 fall back to sleep
11. wake up again
12. fall back to sleep
13. wake up as they roll you to the room and put you in bed. Asleep again! (I had a hard time waking up fully)
14. wake up fully and get ice chips and pain killer in IV (That woke me up a lot!)
15. spend rest of the day resting and going to the bathroom.
16. doctors and nurses come in checking in on you, some look at your cuts (5 small ones)
17. dismissed next morning to go home to recooperated
18. for at least a week you want to rest and sleep
Posted 11/26/2010 4:07 AM (GMT 0)
Joy, didn't you have to take a road trip for your surgery?
Posted 11/26/2010 3:04 PM (GMT 0)
drgrcr-
I took a 2.5 hour plus road trip for my redo. And the another road trip back there on day 4 , but that was because of the horrid job the first surgeon did. I should have stayed there a couple more days like my surgeon wanted, but I wanted to go home. Next time I'll listen to the doctor! LOL!

Take care,
Bill
Posted 11/26/2010 6:01 PM (GMT 0)
How are you today Bill? was it worth it? Supposedly the surgeons at the Mayo are the best. I sure hope so.
Posted 11/26/2010 7:43 PM (GMT 0)
drcrgr, Yes, I went across state to the premier surgeon in Georgia. He was the first in the state to do a lap Nissen and he had developed his own method for the Tourpet. He's a great surgeon! Great bedside manners.

It was a five hour drive one way.

Posted 11/26/2010 9:00 PM (GMT 0)
Tourpet is what I am suppose to get.

What gets me is the doctors wont, and suppose do to all the law suits and such. they wont guarantee that the surgery will cure any of my problems....I wake up in the morning with a gnawing pain just under my breast bone, it will move to the left or the right. My gastro says it could be paraesophogeal......what ever that is. He says I have a motility problem that is the reason for the tourpet, works for me, I just want to get rid of the annoying pain that I never had until a year and half ago.

But the wont to the surgery until they have got rid of the problem spots in my esophogus. I feel like I am in the canadian medical system.......hurry up and wait. I won't my old life back. Fat, dumb and happy!

What gets me is my wife is starting to have some of the same symptons, she says her food feels like it is getting stuck in her throat, and she having some pain under her breastbone. Is there anything else that mimicks hiatal hernias? My wife also has been diagnosed with RA.
Posted 11/26/2010 11:34 PM (GMT 0)
I don't know any except heart problems.
Mine started out food getting stuck and just kept getting worse.
It's best to get rid of the barrett's before the wrap you don't want the barrett's getting wrapped up inside the wrap do you?
It took three years before I got my surgery and I live in USA! They wanted to make sure it was gerd and that medicine wouldn't help it.
Posted 11/26/2010 11:46 PM (GMT 0)
Medicine like PPI's? don't work on me. still get the pain. If it wasn't for tramodal I would be a mess. Yep I want to get rid of the Barret. Just getting tired of living like this. I knew of another lady who had the wrap after many years of suffering, she is a different girl now, says she feels 100% better.
Posted 11/28/2010 3:43 PM (GMT 0)
Hi drgrcr,
On Mintie's thread you asked the question, "Does anyone have a good result with this surgery? I wrote this response there, but I don't think you saw it. I'll post it again here. Hope it's helpful!

Hi drgrcr,
There are two parts of the puzzle that together create a successful Nissen surgery. First, choosing an outstanding, very experienced surgeon (experienced in this particular procedure), then being the right person to have the surgery. It is not a surgery to consider unless you're having very problematic symptoms. It changes your upper GI tract, and no matter how great the surgery goes, there will be some lasting changes that you have to embrace and accept.

The recovery is not without challenges, although I personally thought it was much easier than I'd expected. It is not a surgery to go forward with unless you fully embrace the challenges it presents.

I had the surgery to improve my lungs. I had uncontrollable asthma as a result of reflux. I actually was not a typical Nissen patient. Most who have Nissen fundoplications have extreme reflux and regurgitation. Food and acid reflux into the mouth. That was not my case. My reflux was quite minor. Because of that my GI doc didn't recommend the surgery for many years, although I badly needed it. My asthma and family docs were insistent that my reflux was causing my uncontrolled asthma. Finally I was referred to a surgeon.

After they had time to recover, my lungs were healthy for the first time in over four years. Yes, my surgery was a success. I have very "livable" quirks that I gladly accept in return for healthier lungs.

In fact, I fear that my extreme coughing after the surgery may have compromised the wrap, so I'm going for testing to see if I need revision surgery. I'm having some asthma (nothing like it was before surgery) and I want to make sure I'm not having any leakage. I'm getting some testing the beginning of December. I already had a Barium Swallow, which showed no reflux.

Keep in mind that the majority of Nissen recipients never post on a forum. They have the surgery, and are happy with the results, and go on with their lives without going online to complain or ask questions. When you look online for your information, you get a skewed picture, as many people go online searching for answers after experiencing problems. Some of these people did not have experienced surgeons, and have had problems as a result. Did your friend who was happy with his Nissen post online before and after? I doubt it. Case in point.

Do not have the surgery unless you're ready to embrace the experience.
It sounds like you are not ready. If you expect problems, if you aren't willing to accept the changes and quirks that can be inconvenient, then you're not ready. You have to be at a point where the challenges of surgery are worth it because of the positive changes that come with it. You have to be ready to take a chance.
Many of us have found that it was the best decision we could have made!
Good luck with your struggle to decide. Believe me--I was exactly where you are before I decided to have the surgery. It is not an easy decision to make.
Best wishes!
Denise
Posted 11/28/2010 5:31 PM (GMT 0)
Thanks Denise, I needed that. I have never had many medical problems until the last year and half, and after 35 years of working in a business where I could solve problems it is hard for me to wrap my mind around something that is not a yes or no, fix and go deal. I had my gall bladder removed because the doctors where I live couldn't figure out what the problem was. So a couple of more EGD's here and one found some Barrets. But said "we can check once a year and make sure it doesn't progress... I then decided to go to the Mayo Clinic in Scottsdale, they checked and found some dsplaygia which they are fixing.

That is something that is curable. One the many test that I had done was a motility test which showed I don't have a strong swallow. That is the reason they want to do a partial wrap. My question to them is "will the wrap get rid of this pain I have for a year and half?" They don't know. That is why I am following this forum very close, to see if there are other people like me who have had the same symptoms, Like I said, I have a friend that I worked for 30 years who had the surgery, he said it was the best thing he ever did. He keeps encouraging me to do it and so I am, cuz I am really tired of living like this.....just got to hurry and wait.
Posted Yesterday 12:17 AM (GMT 0)
Hi drgrcr,
This forum is a perfect place for you to search for answers, and wrap your head around the pros and cons of the surgery. It's definitely not your "fix and go deal"--there are many variables to consider (including the type of wrap you should have considering swallowing strength). It sounds like you're taking all the right steps and educating yourself. When you finally make the decision one way or another, embrace the decision and have no regrets.
Good luck!
Denise turn
Posted Yesterday 12:42 AM (GMT 0)
I had the Toupet. It was chosen by my surgeon because I have a very weak swallow due to polio. I wouldn't be able to swalow past a full Nissen. If you do not have some swalowing problem the surgeon should be doing a full Nissen. Do you know why he doesn't want to do it?
Posted Yesterday 4:37 PM (GMT 0)
Because my motility test showed a weak swallow
Posted Yesterday 5:47 PM (GMT 0)
drgrcr-
I had the full wrap done and things are going well with that. If i have to do it a third time, I'd do it without hesitation. Sure beats living with all the other problems. I am able to eat and drink basically anything I want to. Once in a while I get a little feed back from my stomach, but a couple antacids take care of that and all is well again. I didn't have any issues this year after Thanksgiving for the first time in about 20 years. Well, almost any how, but that's a different problem. LOL! Any how, I had my redo done at Loyola because the surgeon who did my lung surgery recommended a surgeon there. Besides the complications from trying to undo the first surgeons nightmare all was good. I can't blame the second surgeon for the first ones botched job.

God luck to both of you......I'd do it again in a second.

Take care,
Bill devil
Posted Yesterday 6:27 PM (GMT 0)
Just so you know, some of us do get a wonderful result from the surgery. I did. : )
I woke up without any of the reflux, chest pain, etc that I'd been living with and now that I'm on day 27 post surgery - I feel great!
I don't have any of the complications you read about in other posts.
I'd do it again - even though I'm not fully healed- just to feel as good as I do now.
Good luck!!!!

Cat
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