Surgery soon for GERD and hiatal hernia

Hi Kim,

I had this surgery 9 weeks ago. Before surgery I had GERD/LPR and a hiatal hernia for 12 years. Mostly controlled by PPI(Protonix) medication. I decided on surgery to fix the hernia and to end dependence on the medication. I was concerned/scared of the surgery but I had access to a great surgeon and the time was right with work and family. I'm glad I had the surgery since I'm off the medication and healing is well underway from the problems I had before.

Here's a few things I've learned going through this process.

This is major surgery. Your abdomen will be inflated with CO2 to make space. Your liver is moved to gain access to the stomach and LES so the hernia can be pulled down and the LES is commonly reinforced with a bio-mesh material. The fundus of the stomach is then wrapped around the esophogus and stitched to create the wrap. Some surgeons use a plastic tube inside the throat to set the tightness of the wrap and others don't (mine didn't).

Your stay in the hospital is determined by your surgeon. In my case it was one night in the hospital.

The process/healing after surgery depends on a lot of factors. Everyone is different but here's some things I experienced and read are common to others.

The CO2 gas causes a lot of pain and discomfort until your body deals with it. Walk as much as possible in the hospital and in the days following. It helps.

You must not lift anything heavy. 10 lbs or a gallon of milk is about it for 8 weeks. Don't strain your mid-section.

You'll be on a liquid diet for a while. Everyone is different but expect the first month to be mostly liquids. Jello, pudding, blended soups and protein drinks. Because of swelling and the smaller size of your stomach expect to get full fast. 4 to 6 ounces might be about it.

Read these diet guidelines (http://www.upmc.com/patients-visitors/education/nutrition/pages/diet-after-nissen-fundoplication-surgery.aspx) for help with food choices. Gas producing foods will cause painful bloating problems for a long time after surgery. I still avoid a lot of foods because of painful bloating. Simethicone (Gas-X, Phayzme) is helpful.

Narcotic pain medications cause your digestive system to slow down so take them as needed but with caution. Because of extreme nerve pain in my shoulder I took them for three weeks and needed to use laxative products ranging in effectiveness to deal with the problem.

You'll need time off from work. Two weeks or greater depending on your individual response to the surgery. Recovery really can't be rushed. It just can't. I was off three weeks, part time the fourth and fifth. At six weeks I was back to full time.

Other issues to note. Hiccups are really painful early in recovery. Trouble swallowing and dealing with foods that don't get through the wrap can cause a lot of pain. The mental and physical strain will make you think you've made a big mistake. You'll think the wrap has failed or it wasn't a good wrap because you'll feel terrible. Don't hesitate to call your surgeon or doctor for help and advice. It's not something you should grin and bear.

Side effects: You can loose your ability vomit. You'll need anti-nausea medications. Dry heaving is a risk to the wrap and is one of the things that can damage it early in recovery. I didn't have too many problems with it but if I felt the least bit sick I took the medication.

Some people completely loose the ability to burp. I could softly burp at about 5 weeks. It's not much relief but I'm glad I can.

It's a lot to take in. Ask whatever questions you have. It's very intense going through this recovery. I'm glad I did because it has fixed the problems I had. But, it hasn't been easy to recover and I'm still early on in healing. Each week that goes by gets better.

Kim,
I am scheduled 4 weeks from today for the hernia repair and a floppy Nissen Fundo. I am also very nervous about the surgery and what to expect after. After many years of suffering I am looking forward to feeling better. I am trying to keep a positive, mind over matter attitude.

Celerity-dad, that was a really good breakdown of what to expect, Thanks!

Are there any pre-surgery suggestions to make the first week home any easier?

teria,
Here's some things I believe are good to have on hand.
- A heating pad. (It helped ease the mid-section discomfort and gas problems.)
- Slip on shoes good for walking.
- Comfortable clothes that don't constrict your mid-section at all.
- Pillows and blankets. (You might feel colder while your body is dealing with fewer calories to burn. I did a lot but it was February.)
- A handy box of tissues.
- Your pain and nausea medications with jello cups to help them go down.
- Ducolax suppositories. A box of 4 should be fine.
- Gas-X or Phayzme. Chewable tabs or dissolvable strips. Just know the dosage is lower with the tabs and strips. Phayzme can be purchased on Amazon with 180mg of Simethicone per dose. I still use a couple of those per day.
- Water to sip on throughout the day.
- I had ginger and Chamomile tea. (I sweetened it with honey and had these often to stay hydrated.)
- Rice, almond or soy milk as an alternative to dairy milk.
- Look at the diet recommendations regarding foods that cause gas. Avoid them. (I thought any blended soup would do. Anything with onions and garlic caused me serious grief.)

Keep in mind what Pat said above regarding being patient. Swelling comes and goes throughout the recovery and it feels like everything is going backwards. It's just part of the process.

Hope that helps,
Mark