Nissen's Fundoplication - post operative advice please

Hi all, am really helping you can help me with some of your sound advice - its great to find a support network. I'm a 39 year old male, based in the United Kingdom. I had a laprascopic nissens fundoplication along with a rolling (paraesophageal) hiatus hernia repair three weeks ago. I had a great surgeon and was in hospital for four nights. I've been on clear liquids since then and starting to introduce pureed foods at the moment.

I'd like to reach out to you as I have noticed which I would welcome your advice and steer on please!?

1. Tiredness and sleeping patterns - these are all out of kilter and find doing the most simplest of things absolutely exhausting - when it then gets to bedtime I'm finding it hard to drift off and then sleeping for max of 6-7 hours at night - is this to be expected

2. Appetite - really finding this is minimal and consuming c 1000 calories a day - any recommendations on some more interesting pureed diet I can add in - especially on the vegetable/fruit/protein front? (allergic to all seafood)

3. Pain in left thigh muscle - since operation I have had pins and needles in my left thigh muscle and it feels like internal bruising - I've been told this is due to the electrocautery I had - should it last so long?

4. Vitamin supplements - really feel i should be adding these in in liquid form - any recommendation on some great tasting liquid or chewable supplements

5. What exercise should I be doing? I'm walking around but after 15 mins or so I just find I'm whacked!

Really appreciate any help you can give, and great to see I'm not alone.

Best wishes to all!

Hi Laurie

Really appreciate your reply and help,

Rob

Some random thoughts about recovery:

Prior to surgery I was told by my surgeon that I would be on clear liquids for two weeks. However when he visited my room after my HH repair and NF he stated that I could eat anything that could be pureed. I had already bought lots of chicken and beef broths and juices. So when I went home I bought regular canned soups and pureed them... I like vegetable beef soup and/or chicken with vegetables so I would puree a half can of whatever soup that I wanted and then add beef broth to thin it out. I didn't actually puree them completely. I pulsed them just enought that there was some texture left. I did the same with a variety of other types of soups, creamed soups, etc. There are many different kinds for all tastes. I also ate lots of puddings. Here in the US we have lots of pre-cooked "Temptations" brand Jello puddings. I like the key lime and lemon merangue flavors but there are many others available. I also ate lots of applesauce.

Saltine crackers and Cheetos are also good. If you are craving crunch, both of these will disolve into a paste after you crunch them up.

Calorie intake: prior to my surgery I did lots of research on the medical proceedure and recovery process. I found that a person of my size--6' tall, 220 lbs who is relatively active needs about 2400 calories per day just to maintain his weight. Since I would be relatively inactive during recovery I would need 1700 calories just to stay even. So I became very calorie conscious.

Protein: At the same time as being calorie conscious, you need protein. Your body uses protein to build cells, etc. A person of my size needs roughly 65 grams of protein per day. If you don't get that much, the body begins to look for other sources. It finds it in your muscle mass. Therefore you need to supplement your protein intake however you can. Protein drinks only supply 10-15 grams. Meat based soup contains protein as well.

I am normally very active. Because I am retired, I normally play tennis every morning. For a few months prior to surgery we had cold weather and couldn't play so I went to our local shopping mall and walked 3-5 miles on a daily basis. Post surgery I began walking about 4 hours after they returned me to my room. I was in the hospital for two nights and walked laps around hospital ward every few hours. I continued walking when I got home. On the third day home my wife drove me to the mall and I carefully walked 1/2 mile while she ate lunch. The next day I drove to the mall on my own and walked a full mile and increased the distance on a daily basis. Our local mall opens at 6 AM for walkers. So, those early hours are great for walking during recovery because it is not crowded and you can set your own pace.

Prior to surgery I bought children's liquid vitamins and took those for awhile. I also took liquid B-12. I also bought a pill crusher so that I could crush up my blood pressure meds. Since I normally take a multi-vitamin for seniors, I started crushing them and mixing them with applesauce.

I hope this gives you practical advice and enables you to cope with the recovery process. I was able to return to playing tennis after my three week checkup and played in a tournament after two months with no harmful effects.

Tony, Seabee, Kitt - thank you so much for your replies and information with in, it's really helped me see some of the errors and refinements I need to take at the moment. It's clear to me that here in the UK we are not being given the whole story by surgeons in terms of the size of the operation or the recovery time. I wish I had found this site sooner, so thank you for your valuable advice! My calorie intake is slowly increasing now c.1500 but happy to keep at this as want to lose weight and use the fundoplication to really change what and how I eat. Really finding smaller meals more often a lot more manageable than the typical meal of breakfast, lunch and dinner... I'll keep updating as I go along - biggest thing I have learnt - patience and listen to your body. Thanks again! Rob

Thanks Rebelee I was kept in for four nights due to bloods, and my surgeon has been pretty strict in terms of liquids only for first three weeks, and now on purée and loving very soft scrambled eggs! Also found a great product here in UK called complan which is a meal replacement in a liquid form either as a shake or soup, and not bad tasting either. Amazed at how my appetite and view on food has changed post op - all for the better! Don't mind losing weight, I could do with losing a few pounds!

Really loving this forum, thanks for sharing so much, it does seem that the US has a quicker recovery plan than the us folks across the pond!

Forgot to add. I developed pain to my inner upper left thigh last night. It tries to cramp. I'm assuming dehydration as I cannot get the fluids in. Thin fluids are tougher than thicker fluids for me even though the thicker ones hurt. Go figure!