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NF surgery after failed TIF procedure

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Posted 10/21/2013 11:36 PM (GMT 0)
Back in April I had the TIF procedure. It worked for a while, but recently if I drink a normal amount of liquid (any liquid- water, milk, juice, alcohol, you name it) with a meal, I experience regurgitation. Even when the TIF worked at its best, I still experienced one LPR symptom that just would not give up.

A few weeks ago I ended up in the ER because of a gallbladder attack. My gallbladder ultimately was removed, but before that happened, I threw up. A lot. Until there was nothing left in my stomach at all. That seemed to be the straw that broke the camel's back, and the TIF was done for. (My boyfriend kept telling the ER staff that I wasn't supposed to be throwing up, but it still took them 3 hours to give me Zofran.)

Today I went in for a follow-up appointment with my surgeon (for the gallbladder surgery) and discussed the issues I am having with him. Much to my disappointment, I found out that I cannot have the LINX system implanted, but I can still go with nissen fundoplication. I really don't want to live the rest of my life with regurgitation, excessive mucus, and a lump in my throat, so I'm scheduled to have surgery this Thursday. It was now or around Thanksgiving, and I'd like to have a shot at eating somewhat normally by then, so I decided to get it over with.

Thanks to the knowledge and skill of my surgeon, and the many people who have posted their experiences here, I feel like I was able to make an educated decision about this procedure. I'm terrified (I'm a worrier), but optimistic. I plan to continue to post with the hope that my posts can help out others as they weigh the options available.
Posted 10/21/2013 11:52 PM (GMT 0)
I had the NF after a TIF. It's certainly possible, can't say how much it has helped though, I'm only 12 days out.
Posted 10/28/2013 4:48 PM (GMT 0)
Today I am four days out from surgery. Everything seems to be going as it should. The first two days after the procedure I slept, though i did get up to walk around the hospital in hopes of relieving some shoulder pain. Right now I am staying with my parents so I'm not alone too much, which is nice. My boyfriend had to go back to work today. Kind of bummed that I am going to miss the first Halloween in my own house.

Yesterday I was hit with a horrible wave of nausea and had to disrupt the PA's weekend to have her call in a prescription. I warned her that i would probably need something for nausea, but she seemed to doubt it. Anyway, once I took the medication I was fine. I have felt the need to burp, but can't actually do so, which may not be a bad thing. I seem to suffer from some gas pain when moving from a sitting to standing position. Not quite sure what to do about that or how long i should expect it to continue. As far as food goes, I've been sticking with Boost and apple sauce, which is going down largely without issue.

I wish i could get outside and walk, but it's getting pretty chilly here in northern MD.Tomorrow i'll be venturing out to go to my grandmother's house, so we'll see how the car ride on back country roads works out. Seems pretty silly for a 92 year old to be taking care of a 27 year old, but my anxiety over this recovery means i don't want to be alone with just the dog for company.
Posted 10/28/2013 8:42 PM (GMT 0)
Haha that's funny. I have been staying with my grandma lately also. It is strange that an 83 year old is taking care of me. Yeah, I have a lot of anxiety too.
Posted 10/28/2013 8:59 PM (GMT 0)
I've been reading about your recovery- so sorry things aren't working out just yet. Hoping it gets better for you soon!
Posted 10/29/2013 9:53 PM (GMT 0)
Day 5

Today I was able to ride in the car just fine. I ate two cups of soup and a small bowl of applesauce without much issue. However, I still feel like my stomach is trying to burp, and when it can't, it refers the pain to my left shoulder. Is this normal?

As far as meds are concerned, I did take one pain pill and an anti-nausea med.

I have had no reflux at all since surgery, but I still have the feeling of a lump in my throat. Has anyone had surgery fix this issue? I don't understand why I still have this sensation if it is caused by reflux. My guess, and hope, is that as the irritation in my esophagus/stomach subsides, this feeling will go away. But for right now this is pretty frustrating.
Posted 10/29/2013 10:06 PM (GMT 0)
The lump in the throat could be caused by the tube they put down your throat to perform the surgery.
Posted 10/29/2013 11:04 PM (GMT 0)

KitKat,

Did you go to Johns Hopkins for your surgery?

FC

Posted 10/29/2013 11:41 PM (GMT 0)
FC,

No, I went to Virginia Hospital Center. I live in VA but am recovering at my parents' place in MD. My surgeon is based out of Lorton, VA and is supposedly one of the best in the area. Having grown up in the greater Baltimore area, I considered Hopkins, but in the end the more local option worked out better for me.
Posted 10/30/2013 8:03 AM (GMT 0)
KitKat,

I had the same procedure in August with that surgeon. How was your post op care with him and his staff? I am able to eat normally (sort of) and the pain has subsided. Still have to take PPIs.

I read your earlier notes about driving on the roads. I hit a massive pot hole in D.C. 3 weeks out and was in pain for days.

FC
Posted 10/30/2013 12:59 PM (GMT 0)
FC,

When I was discharged from the hospital, I didn't actually see the doctor, but I did see the PA. When we went over diet, we talked about the SPLAT diet that he recommends and she actually recommended something much more conservative. After I had the TIF I was a lot more conservative regarding eating than the doctor suggested because of the information I found here, and I planned to take it very slow after this procedure as well. So far I have not scheduled a follow-up appointment.

When the TIF failed, I was afraid the surgeon would not accept it. (Before seeing him, I was seeing a GI doc who would not accept the failure of PPIs.) But this doctor actually listened and came up with a plan B immediately. So I have to give him a lot of credit for that.

Do you have a "loose floppy wrap"? I don't because of the failed TIF. The PA said they could not dilate the wrap as they usually do, so it is tighter than normal. I'm not complaining; I need this thing to last a long time.
Posted 10/30/2013 11:08 PM (GMT 0)
KitKat,

I don't think I have a floppy wrap. The pain was pretty bad the first 21 days but it comes and goes now. Are you working? I took 4 weeks off and it was hard for me to get back.

I am having some nausea tonight so I am drinking ginger water. I have the nausea pills just in case. Still have those gas pains now and then between the shoulder blades.

FC
Posted 10/31/2013 12:45 AM (GMT 0)
FC,

I am sorry to hear you experienced pain that long. I haven't had too much pain yet. I still had some pain pills left from my gallbladder removal. I've been using those rather than having the new prescription filled, and I still have quite a few left. Tonight the incisions have been bothering me though. I also experienced some pain today when getting in and out of the bathtub. So I may take some medication before going to bed. I know I haven't reached the point of peak swelling yet, so maybe the pain is ahead of me. I definitely do have some pain in my left shoulder when by body tries to burp, but can't. However, it is a quick, sharp pain that disapates pretty quickly.

As far as work goes, I took three weeks of short term disability. I am a bit worried about going back, but I'll just have a little more than a week before getting another break for Thanksgiving. My biggest concern is having the energy to make it through a full day at work since I am only consuming about 300-500 calories daily. In less than a week, I have lost almost ten pounds.
Posted 10/31/2013 6:19 AM (GMT 0)
KitKat880

Yes the referred pain is normal and will go away with time. The lump sensation will also go away with healing. How long it takes depends on how much damage was in there.

As for weight loss I lost about 20ish pounds with my nissens. Keeping hydrated is the most important thing early on.

Take care,
Bill
Posted 10/31/2013 12:18 PM (GMT 0)
KitKat,

How did you get cleared for ST disability? The surgeon and PA refused to give it to me and I was lucky to have vacation time to use. His office told an individual I know the same thing when they had their operation a year earlier.

I never took any pain pills once I left the hospital because of the constipation, and side effects. Eat mini meals if you can through the day. I weigh 113 lbs and have been maintaining.

FC
Posted 10/31/2013 12:55 PM (GMT 0)
Bill,

Thanks for your response. I have been really bad about drinking fluids. My whole family is on me about this daily. I'm afraid I'm going to drink too much or too fast, causing my stomach to expand, putting pressure on the wrap and either destroying it or weakening it early on. Is this a legitimate concern, or am I being ridiculous?

FC,

I discussed ST disability with the office's scheduler when I went in. She never acted like the paperwork would be a problem. I even asked if I could have 3 weeks instead of 2 and she said that was fine. So far the office has sent at least one form over to the insurance provider. I was contacted my a rep regarding ST disability a few days ago though, and they hadn't received anything documenting my return to work date, so I have to call the office today to find out what's going on. I really hope they aren't suddenly going to pull the rug out from under me....
Posted 11/2/2013 12:24 AM (GMT 0)
Days 8 and 9

Yesterday I added a new food to my diet: mashed potatoes. I made them very runny and added some butter, and they seemed to go down just fine. Afterward, my body tried to burp, but it didn't work. Got the usual referred pain in my shoulder. Still no signs of refluxing any stomach contents!

I also went for a long walk, probably about 2 miles. I took my time, but I think I overdid it. I haven't been moving around too much, and my legs were not very happy about the exercise. I also started to have a little bit of abdominal pain. So last night I took a few prescription pain pills, which I had not taken in days. I slept very well and did not wake up until almost noon.

Today I had more mashed potatoes with no issue. I also had some apple juice and hot chocolate; no problems there either. My dad brought home pizza for everyone else. I stayed out of the kitchen while they were eating. I didn't even want to smell it! I did go for another walk, but only a mile this time.

Tonight I am having some abdominal pain again. This is very disappointing, since I really hadn't had too much pain since coming home from the hospital. I'm hoping this is normal at this stage of the game and I haven't damaged my wrap.
Posted 11/5/2013 9:44 PM (GMT 0)
Day 10

I did something really stupid. My family went out for dinner and I tagged along. I was supposed to have a vanilla milkshake, but made the mistake of having sweet potato fries, thinking I could chew them to mush. This was a dumb idea and I won't be trying that again for some time. Fortunately there was just a little bit of stomach and referred shoulder and back pain, which went away pretty quickly.

Day 11

Back to soup and mashed potatoes after yesterday's dumb experiment. Still no reflux, so I guess my wrap is still doing just fine. Everything is pretty much the status quo.

Day 12

Today I ran some errands with my mom. My energy seems to be increasing. There for a while, it wore me out just to shower and get dressed in the morning. Unfortunately, my appetite is increasing. Nothing I eat stays with me for long. It seems to go right through my digestive system. This could be awkward when I return to work...

Day 13

Had canned fruit today. Seemed to go down okay, but I was running to the bathrrom soon after. Had what felt like reflux several hours after breakfast. Hopefully that is not the case.
Posted 11/19/2013 8:08 PM (GMT 0)

KitKat,

How are you feeling? Haven't seen you post in a while? Have you had your follow up appointment with Dr. G?

FC

Posted 11/28/2013 3:02 PM (GMT 0)
Happy Thanksgiving!

I haven't posted in a long while; life got a little hectic after I went back to work. At a little over a month out, I am doing alright. I tire out pretty easily, as I still am not getting as many calories a day as I probably should. Fortunately I have been able to get back to eating pretty normally at this point. Last week I ate a couple slices of pizza (very thin crust with light cheese) and it went down just fine. I also was able to eat grilled chicken breast, though I had to cut it into very small pieces, dip it in sauce, and chew very well. It was worth it though! Tasted so good. However, I was not able to eat the whole thing. My stomach seems to fill up very quickly. I'm not complaining, because it makes it a lot easier to eat the right portions.

I do still struggle with any kind of thick bread. If I don't chew extremely well, it can get stuck and cause issues. Initially stuck food caused a lot of pain. Right now it only is a bit uncomfortable and produces a feeling similar to reflux, but I'm pretty sure it's just the stuck food moving around and not actual reflux. I have only had one instance since surgery where I think I may have experienced regurgitation, which is pretty darn good considering I used to regurgitate everything that I ate or drank.

Last week I went out for happy hour with a few friends. I avoided beer and had wine instead. I felt a little bloated after the second glass, but no reflux! However, I didn't eat anything (was afraid to challenge my stomach) and ended up with a killer headache and nausea on the way home. It was a good thing I had my zofran with me.

I have been horrible about following up with my doctor. I need to schedule an appointment before Christmas. I've been avoiding it because I don't want to push my luck at work and take more time off.

My biggest complaint about the surgery is that it didn't fix the tight feeling/lump in my throat. Since I am no longer having reflux, I think this could be caused by anxiety, or that muscle in my throat is used to clamping shut and just can't get out of the habit.
Posted 11/28/2013 6:36 PM (GMT 0)

Happy Thanksgiving KitKat,

Email me at my email address on my profile page. I am local to you and we both used the same surgeon. Have some questions to ask you. 

FC

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