New GI Doc Post-Nissen

Hi All,

I had an interesting experience during my visit with a new GI doc I saw yesterday.  I was referred to him by my PCP, since in our new home I didn't yet one.

As it was our first visit, he had a lot of questions for me.  I'd had my other two GI docs and the Nissen surgeon in this area send him reports, so he already had a thick stack of information--probably never a good sign!

The reason I think it was interesting is that it gives a little insight into GI attitudes toward atypical symptoms and Nissen surgery.

He was interested in my pre-Nissen history, which I provided, along with my own commentary on how my GI doc in my old city wouldn't recommend surgery in the face of overwhelming evidence provided by my PCP and asthma docs.

His comment--"He wouldn't want to recommend a surgery that might not help you."

He questioned whether I actually noticed improvement after surgery (which I did, once I overcame the lung infection I had before, during, and after surgery.)

That's the problem.  These GI docs are fearful of recommending surgery to those of us with atypical symptoms, and the reason is that generally our symptoms are in reaction to a rather small amount of reflux.  A Nissen surgery does not bring reflux to zero...that would be too tight and not allow food to enter the stomach. 

As you know from posters here, a person who had been through the surgery and recovery with no change in symptoms would not be a happy camper. 

Actually, I went into the surgery with that distinct possibility in my mind.  I was willing to take that chance, because I was out of options.  At least my doctors could rule out reflux as the culprit.

One more thing:

I thought I was due for a colonoscopy, but my calculations were wrong and I'll be waiting a couple more years.  The GI doc told me that the prep is better than it was, because it doesn't require as much to drink.  He said there were just two doses, but one had to be taken in the middle of the night.

Because I'd told him that when I drink a lot of water it sits at the wrap site and takes some time to drizzle into my stomach, he said that I would have to sit up 1-2 hours after taking the middle of the night dose.  I'm assuming it would be irritating to the esophagus if it sat there for any length of time.

I don't know if this thread is interesting to anyone, but thought I'd post it just in case.

Best wishes,

Denise

Hey Denise,

Did you have the 360 wrap? Sorry, I can't quite remember.

Thanks for posting! Any little bit helps :)

Ashley

Hi Denise --

Do I remember reading in one of your threads that you continue to take PPIs? Sorry if I have that wrong.

Thanks!

-Bruce

Thank you, Denise, for that clarification! You've been my "gold standard" for the Nissen and respiratory reflux, but I'm not sure there's much hope for my situation since I can't tolerate the PPIs.

I suppose I could continue, like you, sleeping elevated, and perhaps continuing with the Gaviscon before bed...if I chose to go ahead with the Nissen. If you don't mind me asking, how much benefit do you attribute to the Nissen, and how much to the Protonix? Was there ever a time, post surgery, when you didn't use a PPI? If so, how did you feel during that time?

Thanks!

-Bruce

I have dysphagia (probably borderline globus sensation without the knotted muscle) laryngitis/hoarseness if I speak more than three or four minutes, phlegm, gurgling and popping noises when I breathe, burning in my mouth in the morning, and occasionally episodes that reach the back of my throat when standing. I also have moderate eosinophilic esophagitis, which is attributed to the reflux and not a food allergy.

-Bruce

According to the post-surgery Bravo test, I'm in the low "normal" range, down from a score of 24 or so. Yes, the severity of the symptoms is less, but still enough to make me miserable...and unable to sing, which was my passion in life.

-Bruce

Hi Bruce,

I attribute ALL my lung improvement to the surgery and the surgery alone.  I was on tons of PPIs before my surgery and my lungs were horrible.  I was using a nebulizer for treatments several times a day.  I was on 4 times as much inhaled steroids with additional oral steroids when things got really bad.  Once my poor sick lungs had time to recooperate after my surgery, they improved 100%.  I haven't had to take prednosone since my surgery.

Yes, there was a time when I didn't take PPIs, and I wouldn't be taking them now if my asthma doc hadn't insisted on it.  I have severe grass, weed, mold, dog, and tree allergies, so I do get some asthma problems during pollen seasons when I spend too much time outdoors.

My allergist has spent the fall and winter building up my allergy shots with a much stronger formuation in hopes that it makes me possible to join the rest of the world in enjoying the beautiful outdoors during pollen season.  I hope it helps, but I don't have all that much confidence that it will.

Last year I tried to ignore my allergies and go out and hike daily.  It was fine for maybe a month, but then the constant exposure caused me all kinds of sinus and lung issues.

Once I stayed indoors and no longer was exposed to all that pollen, my lungs cleared and have been fine ever since (except for a moment mid-December when I aspirated food or drink.  That took several weeks to resolve, but it was nothing like my pre-Nissen lungs.). 

Because my allergist is struggling with my allergy issues, he wants to rule out any possibility that things are being made worse by a possible reflux episode.  Hence he requested that I take the 40mg Protonix before dinner.  I spoke to my PCP about it and he agrees that is a good idea with my history. 

Good luck finding an answer...

Denise

PS--Joy had atypical symptoms including throat-clearing.  She definitely found relief with her partial wrap.

Thanks, Bruce.    That's why it's such a frustration to see GI docs so closed-minded about suggesting and suporting the surgical option for people with atypical situation. 

I would have avoided the permanent damage that was done to my adrenals and skin if I had not had to wait so long for surgery.

Denise