PEH Surgery in December

Hi, All! I've been reading all of your experiences with the nissen wrap and I'm very grateful to have this information. I am having surgery for a giant paraesophageal hernia on December 13th. about 2/3 of my stomach is where it should not be. I didn't think I had any symptoms until I started reading this forum. I have been severely anemic for years but no one told me it was related to the hernia which I've also had for many years. I also have asthma. I was told by the surgeon from my last HMO that he didn't believe in doing surgeries because the hernias just return. The surgeon at my new medical group scared me into believing I might die if I didn't have the surgery. Now that I've read about it myself I've decided it's the right thing to do for me at this time.

I do have a few questions that I haven't read the answers for so I appreciate any words of wisdom about these things.
• I live alone in a 2 story house with bedroom and bath upstairs. Is that going to be a problem- going up and down stairs? I won't have anyone around to help me if something goes wrong.
• How long before I can drive? I will be the one doing grocery shopping, etc, so I need to know just how much soup, juice to have in the freezer.
• My regular doctor (not the surgeon) has said I'll lose a lot of weight. That's not a problem as I NEED to lose a lot. I need a hip replacement and I have difficulty walking. The doctor thinks this surgery will help my hip and may put off the need for surgery. I hope that's true. I have read that most of you have lost weight but have any of you lost a LOT?

By the way, I'm 59, female and just retired from teaching.

Thank you for any advice!

Hi starryeyed, hope you are feeling well today.

As Bill said, I had a GPEH too, and I'm older and mostly alone. I could feel the stomach trying to roll/twist when I turned over in bed. Had it done so, the blood supply would have been cut off, and I would have had half an hour to get into surgery or it would have killed me. Believe your new doc!

First, I hope your doc has made you jump through the hoops, get the esophagus measured, check your swallow. I have an extremely weak swallow, so my surgeon did a "Toupet," partial Nissen, so I would be able to swallow past it. (google it) My esophagus was a bit short, so they had to "let down" more of it from the mediastinum.

Since this is a good bit more involved surgery, you'll be in a little worse shape than the usual Nissen patients, but still not intensive care. That just meant 4 days in the hospital for me. I was up, sitting a little, 2nd day, but I didn't have to get meals (broth, juice). I was happy for the vacation from the house. IV pain meds are a lot better than crushed pills too.

You won't be able to drive for at least a week, probably 2, maybe need a driver to get to the post-op appointment. Even then you can't lift anything, so stock up enough clear liquids for 2 weeks, "full" liquids for another 2 weeks (just means added milk which you can get ultra-pasteurized so it will last, may have to look for lactose-free to find ultra pasteurized). Then a month of easy foods you can mash to completely soft - canned soup. Google some online post Nissen diets.

The rest of the crowd gets to eat regular food earlier, but with a GPEH don't push it!

Your doc won't give you the diet info until you go home, won't give you the pain med Rx until then either. (I think it's stupid not to give info way before surgery so the patient can prepare.) You'll need a driver and plan to stop on the way to fill the pain meds. It'll be liquid to start, maybe a liquid to prevent constipation too. Take them on time! Don't let the pain start or it will get out of control. If you have sensitivity to pain meds, vomiting and such, make sure the doc knows it so you don't get something you don't tolerate! Ask for a Rx for Zofran or something for nausea. If you vomit you can wreck the wrap. I did.

Going upstairs shouldn't be a problem unless it's horrible now. Just limit it. There are rental places for patient needs if you think you might need a bedside commode. Try Salvation Army or Goodwill if you can't find a rental.

I didn't lose any weight overall, just a couple of pounds in hospital, probably fluid, which I gained back. I just ate/drank a tiny smidge every hour or two. You can ask for "food" any time you want it in the hospital. You can only tolerate 1/4 cup for first week. Some people do lose weight. Do keep hydrated to stay out of trouble.

I had more trouble because my GPEH was due to a car accident. Seatbelt shoved my stomach into my chest, broke ribs, worsened my back, had other damage. I have fibromyalgia which adds to pain too. You may feel lots better than I did, even with a bad hip.

Do you have Holiday plans, not travelling? It would be a good idea. You'll be on full liquid or pureed food.

Ask if you have more questions. (See old posts - search box at top of page) Let us know how you're doing. Best wishes.

Good for you doing your homework!  Being prepared makes it lots easier.  I'm glad you are cognizant of the seriousness of this kind of hernia.  I think you have a good doc looking out for you.

There are several good stories of easing asthma symptoms on this forum.  Put asthma in the search box.  Since so much of your stomach is in your chest it is probably affecting your lungs and also your heart.

I'm glad you have someone who can help at least a little.  You won't need much.  Just don't let them send you home before you're ready.  I stayed 4 days, partly because I told my docs I would be alone at home most of the time. 

This isn't a lot of fun, but it's lifesaving in our cases.