Posted 12/23/2015 7:34 PM (GMT 0)
I decided to write a blog about my recent LINX procedure done on Dec 16, 2015. The other ones I have seen on this subject were back in 2012/2013 when the FDA first approved this procedure. As a registered nurse, I would like to write about my experience and get feedback from others who have had this done and especially anyone who has had it in place for more than a year or so.
I had my surgery done in Tampa, Florida, by Dr. Gopal Grandihige of Suncoast Surgical that specialize in gastric surgery. He was highly recommended to my by my gastroenterologist because he has done the most of these procedures in the state of Florida. I really did not want to have a Nissan Fundiplication done because as a nurse, I see patients in pediatrics where I work that have had it done. Their parents say the worst thing is their child not being able to vomit. It is also a permanent fix, whereas the LINX device can be removed.
I had read several of the forums on line from people who had had the procedure done, so I kind of had a heads up as what to expect post operatively; taking into consideration that everyone is different.
I woke up in the recovery room with severe abdominal pain; most likely related to the air they pump in during any laproscopic procedure. A dose of Dilaudid helped immensely. I was able to go home shortly afterwards without being asked to eat or drink anything. I was the second to the last person in the recovery room and it was after 5pm, so they really just wanted me out of there. I was given a prescription for Percocet and was told to use Activated Charcoal capsules for post op bloating. I was told to stop my Protonix.
I was sore the first few days, but nothing major. I think I took a total of 8 Percocet in 48 hours, and I used Motrin after that. It was very difficult to urinate for 48 hours, but I think that anesthesia plus the Percocet contributed to that. I was also wearing a Scopalamine patch because they did not want me to vomit post op, and those can really cause issues with urinating. Once I took the patch off, things improved rapidly in that department!
The bloating and shoulder discomfort has been the worse. The activated charcoal does work, but not for long. My doctor told me I had to swallow a few bites of food every 3 hours while awake so the scar tissue that forms around the stays pliable. Swallowing wasn't difficult the first few days, but now that I am 7 days post op, I have noticed an increase in the pain when swallowing. I have learned to take tiny bites, chew thoroughly, and drink small amounts. It still hurts immensely when I first start eating, but after 10 minutes there is less pain. I just am eating smaller amounts because it takes so long to eat, and then I start feeling very bloated and full. Burping has been difficult but I am now starting to spontaneously burp (and yes, it also hurts, but it hurts so GOOD to get that air out!)
What I am hoping to find out from readers who have had this procedure, is how long do these symptoms last? My doctor said plan on 3 months of having to swallow frequently so the scar tissue does not end up constricting the esophagus. If I cannot swallow food, I need to call him and he will put me on a strong dose of a steroid to slow the scarring process down. I really cannot tell if I am refluxing or not because hiccups and burps and swallowing all feel like a real sudden, severe reflux. I have started coughing again, but it hurts to take a deep breath due to bloating so I am not sure yet if that is the reason.
Advice I would give to those contemplating this procedure would first and foremost be, find a doctor who has a lot of experience with this procedure. Since it got FDA approval in 2012, three years later hospitals are suddenly jumping on the bandwagon and this procedure is becoming the new pot of gold for a lot of facilities; especially "for profit hospitals" like HCA. I asked my doctor why he didn't do this procedure at one of the Baycare facilities he has privileges at, and only did it at an HCA facility. He said when he first put the proposal out there to start doing this surgery, only HCA would agree to provide the special equipment he needed. Now HCA wants to start doing it at a lot of their facilities, which means a lot of inexperienced doctors will be out there performing this surgery after attending a class. I don't think it is a majorly difficult procedure, but I also don't think after viewing the videos of the procedure on line that it is a simple "see one, do one, teach one" either. Find a skilled surgeon who has a lot of experience doing the LINX procedure.
If you have issues with constipation, get yourself cleaned out prior to surgery and take some kind of stool softener daily to prevent constipation post op. Pain medications are notorious for causing constipation and it just made me feel even more like I ate the entire 20 lb turkey by myself. I used sennakot and Colace and I did get some relief. Not only was burping hard, but passing gas was just as difficult for some reason.
Don't just eat soft foods like yogurt, puddings, etc. I was told to eat pastas, ground beef, tender meats and veges, but avoid bread and NO carbonated drinks for at least 2 weeks. Bread can be difficult to swallow, and I certainly did not need to introduce any more air into my stomach with soda! I still have some right shoulder pain with swallowing, so I don't think it is just air that causes that, but it is radiated from the esophageal sphincter opening up.
Eating slowly, chewing thoroughly, and swallowing with small amounts of liquids seems to work the best. I have lost 5 lbs already because right now, food is NOT fun. As a nurse who is used to gulping down a meal in 5-10 minutes, it has been a HUGE change in eating style for me. My doctor suggested granola bars and such as "snacks" for my every three hour swallowing adventure, especially at work. I have been able to eat them, but I find that high sugar foods just increase bloating and discomfort.
One concern I have is the long term effects of this device. There have been questions of esophageal erosion from the device opening and closing over years of use. Unfortunately, since it is still a fairly new procedure, there are no 10 or 20 year results. I am curious as to any problems or issues along these lines that other LINX users may have experienced over the past few years.