Laparoscopic Nissen Fundoplication - Success Story

Hi Denise,

My apologies. It wasn't really your blog. It was somebody else's, whose name has slipped my mind [already?? ]. I guess I've seen your name in a few entries, hence, your name has managed to come into mind at that moment that I was posting an entry. Again, so sorry and also, love your work. Your info has been really really helpful.

Please allow me to share my story to date.... as I'm a nervous wreck at the moment. 2 more sleeps and it's all gonna happen. No turning back. Ouch!


I was OK, before I started talking to a friend last week, who's recently had his gallbladder removed. All went well for his procedure and he said that he even watched a video of his procedure on YouTube before his op. I then, somehow, remembered this on Sunday night, and started Googling. Bad move?

I have now seen a few fundoplication videos, which has cascaded into reading online forum posts. Oh nooooooo.....

That's when I started panicking inside. Shouldn't have done it, people around me have said.

Damage has been done and to counter it, instead of looking for post-op issues, I started looking for success stories, as I definitely need to calm myself down - big time.

It has helped in a way and this thread has been really helpful. Thanks, guys!


I also called my GI and he's assured me that it'll be fine and that the surgeon [whom he recommended] performing the procedure is very good and experienced.

He's also reiterated that based on the issues that I've had in the last couple of years [gastritis (2x), esophagitis, severe reflux, chest pains] and tests that I've gone through [endoscopy, manometry and 24-hr ph monitoring] that this is the way to go.

Although my manometry result was normal and that the endoscopy didn't reveal much except for the gastritis and esophagitis [which were very painful] that he saw in August of this year, the 24-hr pH monitoring has shown a DeMeester score of 215.3 [very high indeed] and a total reflux time of > 53% [yes, I had reflux for 12+ hours]. The bulk of that total reflux time was when I was asleep where, according to him, my esophagus was literally bathed in acid. Imagine how I'd feel each morning if I didn't have any med the night before, even with the help of a wedge pillow [that I've had for at least a year and a half now].

Although Nexium in the morning and Tazac before sleeping have helped in getting rid of the pain, his advise is to have the fundoplication surgery so as to eliminate the reliance on the meds. He did say that better off for me to be off meds while I'm still "young" [well, 45 is indeed still young ] and that I will have plenty of time for a few maintenance meds later on in life [as most, if not all, of us will go through]. So, for now, he said to talk to the surgeon about the fundoplication surgery as an option.

Having endured much pain in the esophagus, stomach lining and chest areas on and off in the past 2 and so years [also affected my teeth], including spitting blood if I've eaten something my body has now rejected [chocolate], I went for his recommendation.

I found the surgeon to be very calm and confident when I was talking to him, and hoping that he'll be the same during the procedure.

Well, my GI has recommended him quite highly and my research on him has returned very positive results.

Surgeon had a look at the test results and he said he knows my GI quite well and that if he's recommended fundoplication, knowing how thorough my GI is, then there really isn't much to discuss apart from myself being prepared to undergo the procedure.

Of course I still asked the usual questions [even any fatality incident -- where luckily is zilch to date! Whew! ] and so, the op has now been booked.


Only thing that my GI did warn me against is losing too much weight. I'm 5'9" and slim [74 kgs / 162 lbs] and never been overweight [gaining weight has always been a problem of mine]. I guess I've never been a huge eater and used to smaller meals and I look after myself by going to the gym twice a week and playing basketball on weekends. Hence, one of the struggles, post-op, is going to be weight.

Being of Asian background, where rice is our staple food, looks like congee will be a regular meal for the next few weeks, post-op.

Nothing fat-free for the next few weeks, or up until I can go back to normal eating, so as not to lose too much weight.

Probably protein shakes as well to go with that so that protein, carbs and calories are taken care of.

I think that I've seen some posts re multivitamins [even chewables] are a no-no for the first week or 2?

I guess I've seen quite a few posts re food and drink suggestions that my mind's spinning at the moment as to which ones to try. I guess I'll find out more post-op.


darn, really nervous. But it is time to tackle this issue now before it causes more problems.


Denise, many thanks for your reply. Very much appreciated.

Thanks, Denise!

Had to double-check my DeMeester score from a soft copy of the report that I have. Definitely not a typo.

Yup, will likely create a new thread.

One more sleep!

Mellyann3, I would say a couple of hundred at least would be experienced just my perspective.

I am so glad to hear there is light at the end of this torture tunnel. I feel so bad for all of you who have suffered and still suffer with GERD.

My husband had the nissen surgery on the 29th of January, and he is having a hard time with it. He was actually diagnosed with this disease 3 years ago, but we never knew.

Over the summer he began having attacks at night that would awaken him, thinking he was having a heart attack, we went to the ER ( first aid only where we live), they thought he was faking it because when they hooked him to the EKG and took his BP, it was pretty normal. He even had a doctor walk out on him in the ER because this doctor said my husbands carbon dioxide levels were elevated and he was at the legal limit with alcohol. His lactic acid levels were crazy high and the doctor walks out on him.

Needless to say I was pissed, I went out into the hall and asked him what we should do about the poisoning, the doctor says to have our home and vehicles checked out, but follows up with he doesn't have poisoning and hands me a pamphlet with info about it.

Long story short, I told him what I thought of him and he told the nurse to call the police. I was beside myself. Here is my husband in an ER and the ER doctor refuses my husband. Then the proof of GERD was there the entire time on his medical records, which we obtained the next day.

I saw my husband suffering for 6 months before he finally got treatment. His symptoms were chest pain, throat pain (feeling something on the left side), eye pain, ear pain, nausea, tasting blood for years. He saw an EN&T specialist and had 6 unnecessary surgeries?

He took prilosec, zantac, aloe vera juice, peppermint tea, mylanta, etc. None of these helped at all except the peppermint tea it seemed to help him relax a bit. He finally was introduced to Dexilant and almost immediately felt better.

For months he was zombiefied, did not talk, crying , even contimplating suicide. I am still very worried about him because this GERD has been a part of him for 13 years untreated, even his tongue would be covered with thick white pasty substance daily (doctors treated as thrush).

He is 41, always active (outdoorsy), ex-military (airforce), likes to go out in the woods cut down trees and build buildings and barns and whatever he thinks of next, drink 6 or 12 beers (he is IRISH), and totally hilarious.

This GERD is something that is very dangerous and I hope nobody suffers and gets the same medical treatment as my husband has, for as long as he has. There is nothing we can do now, except hope that his recovery is prompt and life changing. I hope this result for all of you suffering from GERD and hiatal hernias.

He is 3 days post op and miserable. He actually started taking dexilant again, because he says he feels the way he did before the dexilant and the nissen surgery. His surgeon said he's done over 600 of the procedures. After he did my husbands surgery he told me he "did a perfect job". However, I am concerned with this statement now because my husband feels so bad.

The first day post op, he came home w/o instructions about what to eat or drink. I found out on the internet. He eats broth, pudding, yogurt, grits, and decaf green tea w/honey, and sips water. He tried scrambled eggs and the eggs got stuck and he tried for over 5 minutes to get them out because he could not swallow them. We are terrified to try anything else. I mentioned smoothies and ice cream, but he does not want to for fear of the food lodging in his throat again.

Does anyone have any suggestions or similar stories, we are interested in all of your suggestions and opinions.

Added breaks in text for easier reading.

Post Edited By Moderator (dencha) : 2/2/2014 8:31:50 AM (GMT-7)

Hi Mellyann,

Welcome to Healing Well! Glad you've joined us. I found the forum shortly before having my Nissen in February '09, and have stuck around since then to help others the way I was helped.

Your surgeon definitely has not done enough surgeries. The rule of thumb around here is 300+ in a small city, or 1000+ in a big city. 30 is definitely not enough experience. The Nissen fundoplication surgery is an art form, and you'll want to find someone who has done many many of them successfully.

I messaged a friend of mine who lives in Toronto, and she said her surgeon was Dr. Jamie Cyriac at Toronto East General Hospital. She said he does about 500 Nissens a YEAR. That is a highly skilled Nissen surgeon.

I don't know which part of Canada you live in, but if you aren't far from Toronto, it might be worth making a trip. The metropolitan area where I live has about 250,000 people, and there is one doc who "does all the Nissens", so he gets lots of experience.

Even doctors around here don't recommend going to anyone who isn't highly experienced doing this particular procedure. Even a surgeon who is stellar generally, needs to be specifically and extensively experienced in doing the Nissen.

My daughter in law was recommending some great surgeon she knows (she's a physician assistant) and she asked another doc about it, and that doc said he wouldn't recommend using that surgeon for a Nissen, and steered her to that "doc who does all the Nissens".

I had my surgery the end of February 2009, and am so glad I did. It's worth the effort of looking for another surgeon who can do your surgery. You'll be glad you did!

Good luck!
Denise
PS...here's a link to my early recovery journal...it might be helpful to read through it, as you move toward surgery: www.healingwell.com/community/default.aspx?f=45&m=2183443

I too report a most welcome NF success story. I am 8 weeks out, eating mostly normally, bread and rice are out, they both get stuck for now. I am enjoying spicy food and even carbonated drinks in moderation. I am delighted to report I can take deep breaths without any discomfort and seem to have settled in at a 10 pound weight loss, which I wanted. I would recommend this surgery to anyone.

I can also report I am an example of an outpatient NF success, staying in hospital a total of 2 hours. For me this surgery was indeed a procedure and not a major operation. I had no complications and was back to full time work after 1 week.

Question: I am still coughing a fair bit of mucous and choking a little bit. It is much improved but I hoped the cough would go away entirely.

Is this to be expected? I currently take 20 MG Omeprazole daily, I was up to 80 MG daily before surgery. What is your experience?

Thanks, Cary

Hi Mellyann,

I'm certain that Ottawa has at least one surgeon that would fit the bill. It is well worth the wait to get a surgeon who is highly qualified. I know that they have to learn the craft somewhere, but I don't want them practicing on me!

Why not call around GI groups, and see who they refer to for Nissens. See if one or two names pop up regularly. Call the surgeon's offices and see how many Nissens they've done. It'll take some research, but it will be well worth the effort.

Living in Ottawa, you have no need to make the trip to Toronto. Your city is definitely big enough to have at least one great Nissen surgeon.

We love visiting Ottawa! What a beautiful city.
Take care, and hang in there. You'll get the surgery...just take the time to find the surgeon who will give you the very best chance of a great outcome! Stick around this forum for support and answers to your questions.

Best of luck,
Denise

Hi Journey72,

I feel for your hubby. Hopefully, I could post some that might be of assistance in any possible way.

To start with, Denise is spot on. He is in the roughest part of the recovery. The first few weeks post-op are tough and it will test you in a massive way.


Denise pacified me during my initial pre- and post-op days. She was really, really helpful. Thanks so much, Denise! [and apologies I haven't updated my thread in recent times].


I had an NF and HH repair and I will be 9 weeks post-op from tomorrow and the first few weeks were a major struggle.

I think it's not uncommon for anyone who has had these operations to wonder if it were all worth it.

My first 4 days were clear fluids -- juice and broth. They drove me insane. I was so hungry.

I was thinking, how on earth would I survive for 2 weeks without any solid food? [as I got told to be on clear fluids for the first 2 weeks].

On the 5th day, I had to ring up the surgeon's office asking if I could at least introduce oatmeal into my diet. Luckily, they said it was OK, including porridge, providing it was runny. Tell you what, the runny oatmeal I made after that call was one of my best meals ever. Seriously!

So, till I saw the surgeon on day 10 post-op, I alternated between runny oatmeal and porridge during the day. I was not so sad anymore.

When I went to see my surgeon on day 10 post-op, his wife was to give birth so I was arranged to see one of his medical assistants instead [one who assists him during his operations]. Usual checks were done and I had my wounds' dressings taken out and they looked OK. I was also told that I could introduce really soft foods if I wanted to, up to 4 weeks post-op.

Knowing that the first 2 weeks post-op are of utmost importance to the success of the operations, I was really careful with what I ate. I experimented, coz just like what Denise said, you will have to listen to your body. I tried scrambled eggs straight after my appointment, and although I managed to finish what I bought, it was uncomfortable. I knew from that point that my body's not ready as yet for something not that soft. To cut the long story short, I found these 2 combos that worked for me:

- Breakfast: I mixed in a blender the following -- milk [I'm lactose-intolerant so I drink a lactose-free fat-free skim milk], cereal [down here in Australia, best for me is weetbix (high in fibre and low in sugar), oatmeal, banana and mass gainer protein powder [I'm a skinny person so had to be careful not to lose so much weight]. I'd make half-a-litre of this and was excellent every morning. I was pretty much full till lunch.

- Lunch: white rice with tuna from a tin/can [that has olive oil in it]. This was my source for carbs and more protein.

- Dinner: Lasagna. Somehow, even if the dish has meat in it, it is minced and this pasta is really soft and went through pretty well each time.

As I mentioned earlier, I experimented on a few and some got stuck. Food getting stuck is one scary experience! Hence, I lived off those I listed above till I reached my 5th week post-op.


Re post-op pain, I experienced a variety of them.

That shoulder pain caused by the CO2 that they used during the operation lasted for 5 weeks. The medical assistant told me that it'll be there for 2-3 weeks and reason for that was that the CO2 will upset certain parts of the stitches and the pain will radiate to your shoulder blade [it affected my left side].

That was a pain that wasn't too bad coz I knew it will eventually go away.

Others I experienced were pains in the rib cage area and I think anywhere near the wrap got affected too.

There were times that I wondered if the wrap slipped and/or if the surgeon had an unsuccessful operation.

I was feeling some heartburn still during the first few days post-op. One woke me up in the middle of the night and it was really painful.

For a week, I was spitting blood in the morning, just when I woke up. Not a lot, but any blood scared me big time most especially if it was internal. I was thinking that this was probably due to the inflammation [possibly gastritis] that the surgeon noticed during the operation.

I must admit I panicked.

Since the surgeon's going to be away for the whole of January [as the wife has just given birth], I had to see my GI at least.

He told me not to panic and had to remind me that "some funny things" can happen during the first 3 months post-op.

But to pacify me, he let me go through a barrium swallow test to do a quick check on the wrap.

Behold, it showed that no reflux is occurring and that my wrap is doing its job.



Fast forward, I am now 9 weeks post-op from tomorrow.

I can now sleep flat without any heartburn. I used to use a wedge pillow to try to avoid acid wreaking havoc in my oesophagus.

I can basically eat my usual food now, but have been avoiding steak and untoasted bread for now. Maybe later on but not in any rush since I'm not a big fan of both anyway.

Eating can still get uncomfortable sometimes most especially if I forget to chew it in my mouth like a blender.

Hence, as Denise would say it: chew, chew, chew!

I have also decided that, since I haven't had any coffee post-op, might as well quit for good. Instead, I now have 2-4 cups of decaf green tea everyday and it's been good.


I went back to the gym yesterday and man, it was so good.

Just like your husband, I'm an active guy.

I love going to the gym doing weights and swimming.

Re swimming, before, I would struggle breathing. But last night, I found that controlling my breathing during swimming has improved!

However, my legs failed me as they're still weak due to a long absence.

Tomorrow, I'm going back to playing my fav sport: basketball.

After that, a friend's bday and will be my first time post-op to try downing 2-3 schooners of beer. Hope it goes well!



Hence, to wrap up my story to date post-op is that I've now been happy in the past week or 2.

Pains have subsided and each day, it's been improving.

It's still early days though - so I remind myself everyday that it's a healing process.

I love what Denise said to me before when I was really down: surrender to your recovery and follow its lead.

I have and it's been paying off.



Journey72: Hope my journey thus fas can contribute something positive.

I wish you and your husband all the very best.



God bless always.

I just had the surgery done 3 weeks ago, I have had no heartburn and feel good,, my heartburn and acid was so bad I would throw up 3 or 4 times a week, it did not matter what I ate or drank,this surgery was by far the best thing I have ever done for my self. my problem got so bad that I could not control when I was going to throw up and my kids got use to me throwing up all the time which is a pretty sad thing to explain to a 7 year old that daddy is just not feeling good again.which is hard for a kid to understand. the one thang that I learned from this is that if you go to a doc and he does not tell you a good treatment for what you have get a new doc. I delt with this for ten years.
I was on protonix for 8 years and the last 2 of that twice a day and that was not enough, so I took tums a lot it got to the point that I would not go anywhere with out it. all my friends had tums at there house for me and every car had them. I feel like I got my life back .

Hi prairie ranger

http://www.bjs.co.uk/details/article/892411/Laparoscopic-Nissen-fundoplication-after-failed-EsophyX--fundoplication.html.

A little article for you to help you decide.. Also, I think you have to be careful of bleeds as there have been some instances of abcesses after surgery but of course every surgery carry risks .. I haven't had any yet..

Hi baby kangaroo just wondering how your recovery coming along?

I appreciate all of the posts to this forum. I have been nervous about this surgery for weeks now. Besides the Nissen Fundoplication surgery, I am also having my gall bladder removed and a liver biopsy done at the same time. I found out during my last endoscopy, that I had Barrett's Esophagus, and my Gastroenterologist recommended I get this surgery to avoid the possibility of the Barrett's turning into esophageal cancer. I am posting this on 27 March, and my surgery is on the morning of 30 March. I will try and send an update as to my experience with the surgery. My biggest concern is that it is performed correctly obviously, but also what are the rates for long term success with this surgery. Also, I have always been very active (lifting weights, running and hunting, I wonder if I can ever get back to what I consider my normal activities without tearing or undoing the repairs the surgery made? They have put me on a 10 day liquid diet prior to the surgery to deplete my glycogen levels, which is no fun at all, but I guess it will help me ease into the 2 week liquid diet I will continue after my surgery. Any insightful posts would be appreciated. I will try to post an update a few days after my surgery if possible.