Hi mattinthehat,Welcome to Healing Well! Glad you've joined us. As someone who always had low DeMeester scores, I can understand your frustration. I had mine without taking PPIs, and my first was 4 and second nearly 15...both within or near to "normal". That said, the reflux I was having was making my asthma uncontrollable. Both my PCP and asthma docs thought that reflux was the culprit. I had the surgery after 6 years of horrible health, only after my PCP's continued pressure finally got my GI doc to send me to a surgeon (although he wasn't sold on the idea).
I had the surgery four years ago, and after two and a half months my lungs healed and I've been better ever since. I do have asthma, so I still need to treat that, but I'm 100% better than I was pre-Nissen.
As a second grade teacher I used my voice a lot. Before my Nissen there were days when it hurt to talk. I used to sing with my kids, too, and gave that up as well. I still can have voice trouble, though. I have severe allergies and I cough a lot, so although I've had periods when my voice has been completely normal, I can lose its quality by coughing too much. Still, it feels so much better than pre-Nissen even when I cough too much, and no longer feels so strained.
Just keep in mind that there are no guarantees that you'll never need PPIs post Nissen. Sometimes people do need them...generally at lower doses. Even with that, 90% of post-Nissen patients (even those who need meds) are happy they did the surgery, as their quality of life has increased greatly.
From what I've read, non-acid reflux can be very hard on the larynx as well. If you're getting that, it could be the reason you're having so much trouble.
I definitely think that the Nissen was worth it. If you get a great surgeon who has done many Nissens (hundreds to 1000+) you will have a much better outcome. Generally the bloating is a short term issue that resolves after the post surgical swelling resolves. I do chew my food more carefully, but other than that I eat completely normally and can enjoy things I couldn't pre-Nissen.
I'm sure others will be by to share their experiences.
Good luck with your decision!
Best wishes,
Denise
PS...here's my early recovery journal so you can see what one person's Nissen recovery was like:
https://www.healingwell.com/community/default.aspx?f=45&m=2183443