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3 weeks pre-Nissen

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GERD & Acid Reflux
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Posted 10/16/2011 12:07 PM (GMT 0)
Hi,

I came across these forums after looking for advice on what to expect of the surgery, and have been very helpful so far. I thought I'd share my current situation and doubts I'm having regarding the procedure.

A bit of history: The past 3 years have been a drag. I'm not even 30 and on 160mg PPI daily. This makes the reflux in itself reasonable. Even to a point where it's non existent. This strengthens my doubts. Symptoms that persist though are phlegm, lack of sleep, which causes problems enough in itself, ears/nose/throat clogging up and shortness of breath. I get tired very quickly. As far as I know these are clear LPR symptoms. Stress or anxiety can sicken me to a point where my body shuts down completely.

My Nissen is scheduled in 3 weeks. I'm having serious doubts with all the negativity surrounding this procedure. My main concern is not being able to eat properly, or certain problems I'm having now getting worse, like excessive phlegm/saliva. Not being able to eat bread even up to 6 months after the surgery is something I'm not looking forward to. It really feels like I will be stuck with many problems I currently don't even have. And for a long time.

I've had multiple pH monitor tests. With as much as 58 episodes of reflux. I've had this for 12 years, with a long period being untreated, mainly because the symptoms were not directly related to reflux. I've tried different diets, like low-carb, low-fat, quit smoking, supplements, dgl, aloe vera juice, you name it. Was it enough? Is there some way to make this reasonable without the surgery? Or should I accept this new kind of reasonable?

The surgeon I've found is very experienced. It will be a partial 270 wrap and would be able to burp, which is a relief. GI docs here are careful recommending this procedure. For the surgeon it was a clear case and my suffering has lasted long enough according to him.

The idea to not go through with it is very real, however. Even though the scale of 'how do I feel now' vs 'how I could be feeling' tips towards the surgery. I'm very aware that reading on forums will most likely give me more reasons not to do it, but somehow I'm convinced I will regret it.

Denises recovery blog was very helpful by the way, but any more insight or advice would be appreciated.

Thank you for reading.
Posted 10/16/2011 12:29 PM (GMT 0)
Welcome here. I am sorry to hear the suffering you have been through. These certainly warrant the operation.

You said you are on 160mg PPI daily. I don't know which PPI you are taking so I can't tell whether 160mg is normal dosage or heavy dosage. But you sounds like you are taking a heavy dosage. In that case, some of the symptoms you mentioned could be the side-effects of the PPI.

When I took Nexium on heavy dosage, I experienced some ulgy symptoms which I thought were due to GERD. After I stopped Nexium, these symptoms were gone to my surprise. So I was sure, at that point, they were caused by Nexium. I then tried some natural therapy and switched to another medication - Pariet.

I am sure there are something else that you may not have tried. Are you physically and mentally strong enough to reduce PPI dosage and try a natural way to manage the reflux? Do you get at least 6 hours of sleep every day? Are you underweight? If all the answers are no, then I think the operation is a safer option.
Posted 10/16/2011 1:21 PM (GMT 0)
Hi WJF,

Thanks so much for the reply. The PPI I'm taking is Pantoprazole/Protonix, so a high dosage. I initially started out with Nexium a few years back, but stopped taking those due to the side effects: headache and dry mouth for instance. Now I hardly have either of those. If I have a headache its mostly due to lack of sleep. Which is also one of the main reasons I considered going through with surgery. I might sleep for 7 hours, but wake up feeling I've slept 4. This coupled with a sore throat full of mucus, stuffy nose, dry eyes, etc.

Sleep apnea tests concluded that there was nothing wrong with my breathing or oxygen levels. I postponed the surgery since I wanted to be absolutely sure there wasn't something else going on at night. Since these tests didn't show up anything I decided to go through with it and talk to a few surgeons.

Reducing PPI is something I've tried. Without much success, and things mostly got worse. Also prior to pH monitor tests I stopped taking them altogether, which resulted in heavy reflux episodes with acid ending up in my mouth frequently. It was quite extreme. This was probably partly due to rebound from stopping the PPI, but years before this, this wasn't uncommon either. The surgeon also suggests a clear mechanical/anatomical problem, although my hiatus is described as 'slightly wide' from a scope. My weight is OK by the way. I'm built tall and thin, and always have been.

But as you say, reading certain regiments people have trying to control this, thoughts cross my mind of whether I've gone far enough in my own attempts.

What were the symptoms/side effects you were having from Nexium?
Posted 10/16/2011 2:05 PM (GMT 0)
Can i know will it 270 wrap toupet or hill repair?
I guess i will get 270 wrap soon also ...

I am hoping for the best for your surgery.. New life!

Ahn
Posted 10/16/2011 2:31 PM (GMT 0)
In addition to the common side-effects of Nexium - constipation, diarrhea, bloating, indigestion, I was also hit by anxiety and night-time panic attack. These were not written in the paper that came with the drug. So my doctor did not believe anxiety is an effect of Nexium. He advised me not to worry too much and try to relax myself. My family and friends said the same thing. I was actually convinced by them and tried many ways to relieve the anxiety - such as listening to music, breathing, self-hynosis. None of them worked. One day I decided to stop Nexium completely. To my surprise, all these anxiety, panic attacks vanished into thin air. I was later hit by withdrawal rebound, but that's another story.

Your sleep problem sounds like a nighttime reflux to me, one that you are not conciously aware of while you are sleeping. I usually will wake up instantly after I am hit by a reflux at night. Reducing PPI and switching to natural therapy carry some risks. I was hit by insomnia, night-time reflux when I did such thing. I see some progress recently - no more reflux and hearburn (when I off the medication), some weight gain (I was underweight). I am now back on medication because I was sleepless due to acidic/gassy stomach. When I have enough sleep for some time, I will attempt again. Sufficient sleep and healthy weight are needed to withstand any pain that arises from such endeavour

From you described, I think the operation is a better option. But it's no harm to keep reading and looking for different opinions.
Posted 10/16/2011 4:30 PM (GMT 0)
JMRL

Welcome to HealingWell.. I am so glad you have come to this forum.. I too had some very real reservations about whether to have the Nissen done or not. I had suffered for about 12-13 years before I was even told there was a procedure that could be done to fix GERD and Hiatal Hernia. I was always told "You will just have to learn to live with it." Well I got tired of living with it and decided to investigate. I found out about the Nissen and I was referred to a great surgeon that had done somewhere around 1700 of them and I was set... almost.. as a rule the surgeon gives you some information about the procedure but not about the recovery.. I was told 4-6 weeks you will be back to normal... NOT!! You will usually have almost immediate relief from your symptoms. You will have to watch your diet, depending on your doctor... you will have 5-6 days up to 2 weeks of full liquid. With this you can put anything you want to eat in a blender and you still get your flavor and nutrient.. the most important thing is to CHEW CHEW CHEW and take very small bites. the first few weeks your appetite will be much smaller so you will need to eat 5-6 times a day. Some docs just tell you to eat as tolerated, that is where the chewing comes into play.
Please do not be afraid of this surgery, I am 62 years old and I had mine ion April 1st this year and I would so do it over again. Before the surgery, I got up at least once a nite throwing up acid. I was on 2 Nexium a day and had been on PPI's of some type for 12 years. I had pain from the hernia and I had constant drainage down my throat, unrelenting coughing and I was on a rescue inhaler for ASTHMA.. since my surgery, I have no drainage, no coughing, I do not use my inhaler any more.. no ASTHMA.. it was reflux induced.. 13 years I thought I had asthma and in one day it was gone.. Am I happy?? You bet..
Yes the idea of this can be scary, and yes if you do not take care with the recovery you will not fair well. But, if you are ready to get rid of GERD, please forge ahead.
If the diet is an issue, think about 6 weeks (or possibly more, depends on your rate of recovery. At your age it should be fairly easy) of a special diet compared to the rest of your life with the symptoms you say you have now...
The most important aspect of this surgery is that you are confident in your surgeon and you are confident it will fix your issues. You should ask your surgeon questions and you can come here to ask all of us who have gone through this, where we are now and what we feel. Do not let someone push you into the surgery if you are not sure of it, but, do not balance your decision on a few who have for what ever reason, had a bad experience with it. It is not always a success. Usually it fails because of an inexperienced surgeon or an impatient patient. There is always a chance that it just won't work, but I have not heard of that. Mostly there is an underlying issue that causes failure.
Please stay with us and let us help you through.. we are happy to be here for you..

Reach for the Sunshine... Rainbows will follow
SANDI yeah turn yeah turn
Posted 10/16/2011 10:51 PM (GMT 0)
Hi

Excellent reply from Sandi, she is absolutely right. I had my nissen on 15 august just gone. I was hit by gerd/lpr quickly, full on, out of nowhere, with violent vommiting at night. After 2plus years of trying the usual and unusual treatments I had no options left and was put forward for surgery in march. I regret putting it off, I sufferred five more months than I needed to. I know not everyone has a top percentile outcome, but I am so so glad I had it.

I weighed in my mind 'can I live like this'?. No was my answer, then I found out logical and honest answers from surgeon. He told me in his experience 5% had negative outcome. That meant a redo or an undo. 10% reported being no better, no worse. Rest -85%- reported anything from slight improvement to fully symptom free. he also said if I ended up in the 5% I had to be prepared. I was ready for that. The severity of my symptoms took away the choice though, you need to weigh carefully your own percentages and be 100% behind your choice. I thought if I owned the decision it would be easier to deal with any fallout, so far so good.

remember that folks with bad experiences may be more likely to post on some sites than others. I have found this forum very helpful as people are honest and without any other agenda than to help.

Good luck to you however you decide

Kevin
Posted 10/16/2011 10:55 PM (GMT 0)
jmr1-
Sandi has given you some very good info. If you have done the required tests and you have a well qualified surgeon with lots of successful nissens and he believes you are a good candidate for this surgery the odds are in your favor for a successful surgery.
My surgeons only had me on liquids for a couple days and then I could eat any soft food I tolerated. and advanced my diet after my first follow up to anything I could tolerate minus steak and soft breads. This doesn't mean you can't eat beef or bread, just need to be wary of solid beef and soft breads. Toast usually goes down well and I have had good results with bread that have a hard type crust. If you really take your time and wait between each bite to be sure it went through you may be able to eat steak and any breads around 4 to 6 weeks or so. I am about 7 weeks out from my 2nd redo (done open) and I am eating basically anything I want to.

A big help if something does get stuck is to relax and drink some water to push it through or if it's really stuck the esophagus will fill and you body will get it out similar to a cat with a hair ball, but way easier.

As Sandi said, most of the horror stories can be traced back to either a surgeon with less than ideal skills, someone who wasn't a good fit for this surgery, someone who isn't willing to be patient and let their body heal before posting a horror story. Remember the outside will heal long before the inside does. This isn't a out patient surgery like tonsils or gallbladder, this does take anywhere from 6 months to a year to be fully healed.

Take care,
Bill devil
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