Chest pain after 11 weeks post Nissen?

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porcelain doll
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Date Joined Mar 2007
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   Posted 1/2/2008 12:36 AM (GMT -6)   
Hello:  Tomorrow is my 11 week anniversary of my Nissen fundo/hiatal hernia repair.  I am still having chest pain that just doesn't go away.  I thought that by now it would have subsided but it hasn't.  I don't take anything for it, I just try to ignore it but it can be annoying and very uncomfortable.  I would like to know if any one else out there had this chest pain for a long time post op?  I did mention this pain to the surgeon and he said it is part of the healing process and just be patient (easier said than done).  I just hope that my wrap hasn't slipped?  This chest pain has me worried.  I would appreciate any input on the subject.  I am even thinking of asking the surgeon to do a barium test to make sure everything is in its place.  Thanks, Barbara...

doghouse
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Date Joined Oct 2007
Total Posts : 138
   Posted 1/2/2008 1:43 AM (GMT -6)   
Did your surgeon say it could be adhesions from having the surgery? Just curious. I know you can get adhesions from having a laporoscopy for endometrosis....didn't know if it's the same for other parts of the body.

HappilyWrapped
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   Posted 1/2/2008 9:04 AM (GMT -6)   
Barbara,

Tapped in the morning to see if you've posted at all. We started this journey down "Nissen Lane" at the same time and I was wondering how you were doing. When I saw your post, I decided to drop you a line.

I remember you mentioning chest pain many weeks ago and I'm pretty sure you mentioned it wasn't a sharp pain - but a dull one. I've got chest discomfort also - once I began to eat normal food again I started noticing it (I eat everything now but avoid spicy, carbonation and I keep portions very small - I even had a small sip of wine at Christmas). It's not a searing pain, it's a funky pressure uncomfortable type of feeling in the lower chest area I know the wrap is located in. Sometimes I notice it more than other times and sometimes it's faint but "there" - it depends on how I move, sit, lay, etc. Our stomachs have spent many, many years in one position and we've now wrapped them into a new and unnatural position. Somehow I think 11 weeks for you and 10 weeks for me isn't enough time for all the internal healing to take place. I would anticipate many months before the feeling subsides - in other words "patience". My surgeon has said the same as yours - this feeling is part of the healing process.

I had an endoscopy just before Christmas (for gallbladder, not GERD related). It showed a perfectly normal and healthy esophagus - a huge difference from what was down there this past summer. The GI doctor also took pictures of the wrap as the endoscope was on its way down and let me see what it looked like from the inside. You'd be amazed to see how the stomach is actually pulled around and you would not be surprised by any pain you feel now. You'd be wondering why you aren't feeling worse.

If your surgeon would go for it, a test to reassure you that the wrap is still in place would be well worth it. You'll feel better once you can actually see that all is well inside. I know that the endoscopy did that for me - it was sort of an extra benefit from the gallbladder diagnosis procedure.

Wishing you a very happy, healthy, New Year. 2008 is going to be great!

tiredofGERD
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   Posted 1/2/2008 10:01 AM (GMT -6)   
Hi,
 
I am now just over 2 weeks postop and now what you are feeling.  Although my chest pain isn't constant it is usallay after I eat something that is to think or to chunky.  I feel the pain and have a hard time breathing.  I have to get up walk around and just concentrate of breathing, it sometime lasts an hour other times it lasts a few minutes.  I am still battling with being nauseous.  My surgeon did not give me a prescription for it, I was just told to get gravol.  That seems to be keeping it at bay mostly, although  pretty much at the 3 -4 hour mark I need to take more.  I am hoping this goes away soon.  I also get very nauseous in the car.  anyone else?
 
 I am really getting tired of eating pureed food.  I am also having problems with liquid seeming to get stuck above the wrap.  If I cough it seems to go down a bit better, but I seem to have alot of mucous in my throat.  Did you have this?  Once I cough and move the mucous around the liquid goes down fine.  It is kind of nasty. 
 
Well better go rest some more
 
Michelle

porcelain doll
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Date Joined Mar 2007
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   Posted 1/3/2008 1:23 AM (GMT -6)   

HappilyWrapped:  I was so glad to hear from you.  I have been wondering how you have been doing.  We really were comparing lots of notes on our Nissen journey.  You did hit the nail on the head when you say it is a sort of funky pressure.  Sometimes, I feel as if I can feel the pressure all the way up my throat.  The last visit I had with the surgeon was pretty rushed because he had an emergency and had to leave.  I forgot to mention to him the damage I sustained on the arm where I had my i.v.  It still hurts alot and don't know when it will improve.  Also, I can't sleep on my side or if I turn a certain way the chest pain becomes really bothersome.  I am still not working and just taking easy, one day at a time.  I like you don't drink carbonation, and have to keep my portions small.  In fact, when ever I finish eating I am still hungry but never eat to get full.  I guess I will give it a little longer and if the pain doesn't improve then I will get the tests you have suggested especially for my own peace of mind.  Did you ever get your gallbladder removed?  Good luck and keep in touch....Barbara....

Michelle:  I didn't have any breathing problems but I did have lots of nausea.  I still get nausea every so often but take my medication.  Just last night at 4 in the morning I woke up nauseated and took my pill and it helped.  I just make sure I always have my pill.  I am not sure what gravol is as I am taking promethazine (generic for pnergan (sp???).  I didn't have problems with things getting stuck because I was very careful.  Sometimes I can feel a little mucous but not too bad.  Maybe if you took a nasal decongestant that might do the trick.  Good luck.........Barbara...


HappilyWrapped
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Total Posts : 183
   Posted 1/3/2008 9:20 AM (GMT -6)   
Barbara,

You said, "Sometimes, I feel as if I can feel the pressure all the way up my throat." I get this, too. Almost constantly. However, I attribute it to the change in physical structure of the stomach. It's annoying sometimes, but I'd rather have that than heartburn. I anticipate these things will improve with time and I'm planning on "time" being more than 3 months. I'm sorry you still don't feel up to working; I'm back to my old routine and have started exercising again. Just basic yoga stretching - I don't do stuff where you wrap your left toe around your right ear while standing on your hands :) I wish for you to feel as good as I do really, really soon.

No, I have not had gallbladder surgery. I've had ultrasound with ejection fraction (sp?) and it has been determined that the gallbladder functions perfectly. The endoscopy was to collect bile and test for crystals - this was done just before the holiday and the GI doctor won't be back in the office until next week to provide results. So far, all symptoms point to gallbladder but gallbladder tests show it's healthy. If there are no crystals in the bile, I will stop pursuing the gallbladder issue and just avoid foods I know are triggers for pain.

My best wishes to you.

TammyGrl0528
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   Posted 1/3/2008 1:32 PM (GMT -6)   
Barbara,

I am glad to see you are getting some answers to your questions here.

I hope you get all that you need here, and that you start to feel better soon!

Wishing you the best.
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porcelain doll
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Date Joined Mar 2007
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   Posted 1/5/2008 1:11 PM (GMT -6)   
HappilyWrapped:  Yes, that pressure and chest pain drives me crazy and I had it all day yesterday but I agree with you that I'd rather have that annoyance anyday than that nasty heartburn.  I am so glad you are getting back to your routine.  I am still not there yet and I think having the two surgeries back to back didn't help things either and could of slowed my recovery.  I have an appointment with my ob/gyn next week and he always does a complete yearly physical with lots of blood work, mammogram, and bone density test.  I hope my blood work comes back ok but will know if perhaps I am anemic.  I just know my osteoporosis will come back worse since I was on double doses of PPI's.  I am so glad to hear you are doing better with your gallbladder.  I read somewhere that PPI's can affect your gallbladder.  Perhaps, your gallbladder has improved since you are not taking anymore PPI's?  Yesterday, I had lunch with a cousin who hadn't seen me in a while and couldn't believe how I looked.  She said I was too skinny and didn't look healthy.  She also couldn't believe how little I ate.  I do have to agree with her that I don't look healthy, I even see it in my eyes.  I was wondering if you have this appearance?  I was telling her that I feel as if I have aged 15-20 years with this surgery/recovery.  Hopefully, my blood test should provide a clue as to my metabolic state.  Take care and I really do feel relieved to know that this chest pain is normal and part of the overall recovery.  Barbara......

HappilyWrapped
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Date Joined Oct 2007
Total Posts : 183
   Posted 1/5/2008 9:15 PM (GMT -6)   
Barbara,

The problem with my gallbladder has been diagnosed. Tests showed the organ functions properly, and it is totally healthy. The problem is with the sphincter of oddi. It's the valve that the bile moves through and if it doesn't open/close properly, you get all the symptoms of gallstones. When they remove a gallbladder, the sphincter does not get removed. Sometimes a person will have pain even after the gallbladder has been removed and many times it's caused by the sphincter of oddi. Because my pain is intermittent, I have chosen to do nothing to resolve the problem - now that I know what's causing it, I can live with it just fine. When an episode of pain occurs, I will take 4 tsp of liquid motrin (ibuprofen) and get relief within 30 minutes. Because the gallbladder symptoms began long before I started PPI treatment, I know PPIs did not cause the problem.

Yes, my weight loss has been noticed. However, 30 pounds lost when I started at 170 pounds at 5'2" means I get tons of compliments. I have stopped losing weight and am now holding steady. I get compliments on how healthy my skin looks. I watch my calories to ensure I get at least 1200 per day. I'd like to lose 10 more pounds and will have to work at it like everyone else with diet and exercise now that I can exercise again. I am learning what exercises to avoid that make my chest feel "funkier" than what is now normal. I'm sorry you feel you have aged - I feel as though I'm back in my 30's and I'm older than you.

I know you are scared to eat too much because you have felt bad after overeating - I've done this, too, so I understand how totally miserable you can feel. But I find that if I stick to the recommended portions I do fine. The food pyramid portions give me adequate nutrition but don't make me over full. Of course, each person has a different stomach capacity and you may have been left with less than me. I use this USDA web site to track my daily eating - it is free and is a great aid - http://www.mypyramidtracker.gov/ I created a user account and each day I enter what I consume for each meal and snack. I can then asses what nutrients I am lacking and see my caloric intake. You'll be interested to see the calorie count of what you are eating each day. That may be helpful information when you have your doctor appointment and it may help you help yourself to put back a little weight.

I'm sure you have had lots of advice about eating, but I'm going to add more. Get a cast iron frying pan, season it, and make yourself eggs in it or cook meat in it or make a pot of chili (obviously with the spices turned down). The iron gets into your food and will help prevent anemia. This is an old remedy from long ago that doctors told their patients to do when they needed to ingest more iron. Then start downing the Boost or other meal supplement drinks as snacks to add more calories to your diet without filling your belly too full.

I'm hoping things get better for you soon.

porcelain doll
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Date Joined Mar 2007
Total Posts : 128
   Posted 1/8/2008 10:29 PM (GMT -6)   

HappilyWrapped:  I am so glad you found the answer to your problem regarding your gallbladder.  Yes, I am very familiar with the sphincter of oddi but was never tested for that.  All they told me was that my gallbladder was dysfunctional and had to come out.  I think it is better if you don't have to undergo another surgery.  I am glad you are enjoying your weight loss.  As for myself, I don't get compliments because my family tells me that I don't look healthy.  I have lost about 40 pounds all together since this gerd debacle mess started and the last time I went to the surgeon I weighed about 123 but I had my clothes/shoes on so maybe give or take a pound or two.  I would agree with my family that I don't look healthy.  I am still not up to working yet and having to deal with those teenagers shinanigans right now.  Even when my 14 year old argues with me that alone puts me in a frenzy because she loves to argue and get under my skin (because at that age they think they know everything).  I will give it a couple of more weeks before I go back to work.  I think I just need time to heal but like I said before this chest pain is getting to me.  I have made an appointment with the gastro doctor but I can't see him until Feb 18, as I would like his opinion on the chest pain.  The surgeon said it is a part of healing and to be patient but, from what you tell me and what I have read from others in the heartburn forum the chest pain is normal. 

I did manage to go to the pyramid tracker and I think I am going to keep track of my calories.  I think it is a good idea.  I am also drinking ensure and hope that it helps.  My problem is still too much constipation and he doesn't want me to strain (that really worries me) as I am scared that my hernia could burst if I were to strain too hard.  I am taking a stool softner but I can't drink as much water as I used to and he wants me to drink around 80 oz of water a day which I find impossible.  Do you find this a problem and do you feel too full after drinking water?  Also, did your surgeon talk to you about straining?  I know we talked about heavy lifting but was wondering about the straining, did he give you any advice on this.  Did you also have a hiatal hernia repair?  I almost forgot, I haven't purchased an iron skillet but am eating the cow's liver still, a small piece about twice a week and I think it does help.  Luckily, I do like liver since my mother used to make us eat it and to this day my sister can't stand the sight of it.  I will close since I am just rambling on and I am so glad to see you are posting on the forum.  Barbara....


TammyGrl0528
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Date Joined Jun 2007
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   Posted 1/9/2008 9:43 AM (GMT -6)   
Barbara,

I am glad you are finding comfort in this site. Unfortunetly, I have no advice to offer on this matter, but there are plenty of others who are helping you just fine, so that is GREAT!

Wishing you the best.
 GERD Forum Moderator
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 Diagnosed with Generalized Anxiety Disorder (GAD) and Panic Attacks.
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HappilyWrapped
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Date Joined Oct 2007
Total Posts : 183
   Posted 1/9/2008 10:59 AM (GMT -6)   
Barbara -

I tapped back in specifically to check to see how you were doing in case you had posted any plea for information - after all, we started this at the same time.

I can understand now why your weight loss is more of a concern than mine - you lost more than me and started closer to your normal weight than I did. It makes total sense that you don't have energy to deal with work when you need all your strength right now just to perform basic functions. I'm glad you have an appointment with the GI doctor - sounds like that's a good route to take. He'll be able to address the constipation and weight issue better than the surgeon.

I do not feel too full after drinking water - unless I get really thirsty and so something dumb like try to chug a large glass or an entire bottle. I don't just take small sips, but I try to limit the amount I swallow at a time otherwise I feel a bit uncomfortable for a little while. I do drink herbal tea throughout the day so I get my liquids in forms other than plain water.

No, my surgeon never mentioned to avoid straining to "go" but it's something that I had heard somewhere that it was good to avoid. I did recently have a period of constipation and totally understand now about the reason for not straining - I thought for sure I was going to blow the stitches. I tried a softener (Dulcolax) which put me too far in the other direction. So once things "slowed down", I modified my eating to include more fiber and more veggies and have had no problems since. I have a great recipe for a super yummy muffin that has raisins, banana, whole wheat flour, apples and applesauce - one for breakfast each day seems to be keeping things "moving" nicely. I'll share the recipe if you are interested. My veggies have increased to garden salads, spinach, beets, green beans and peas as well as the carrots, potatoes and sweet potatoes I had started with. Once I began adding different colors, things got much better in the bowel department even though I don't drink as much water as I should. I still don't feel totally great after eating beef (although it's yummy going down) and pork is a no-no for the sphincter issue, so most of my protein comes from fish and poultry. Other than a banana, I haven't tried fresh fruit yet - I'm sure it will be fine because everything goes down nicely now, I just haven't done fruit.

Yes, I had the hiatal hernia repair.

You mentioned eating liver. Just a thought - iron is constipating, do you think that might be a contributing factor?

I'm glad you found the pyramid tracker. I like the way the site allows you to analyze your food intake by calories and by nutritional content. You'll be able to see what nutrients the foods you are eating contain and what vitamins/minerals are lacking with what you are currently eating. If nothing else, it will give you great information to take to the GI so you can give a visual of what you are consuming. He'll be so impressed with your pro-activeness to bring him solid information.

Take care.

HappilyWrapped
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Date Joined Oct 2007
Total Posts : 183
   Posted 1/15/2008 7:39 AM (GMT -6)   
Barbara -
How's it going? Chest discomfort subside at all?

TammyGrl0528
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   Posted 1/15/2008 11:15 AM (GMT -6)   
You know Happily, we are on the same track here, cuz I was thinking about her today too! Funny stuff!
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 Diagnosed with Generalized Anxiety Disorder (GAD) and Panic Attacks.
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porcelain doll
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Date Joined Mar 2007
Total Posts : 128
   Posted 1/16/2008 12:13 AM (GMT -6)   

Sorry I haven't posted lately but I appreciate you all thinking of me.  I do try to keep up with the gerd board but sometimes I can't get to it everyday. 

HappilyWrapped:  I am still trying to get better but have noticed if I do too much the chest pain really gets bothersome and hurts and hasn't gone away.  I think it is a way of my body telling me to take it easy and don't over do it.  I still don't lift anything heavier than a gallon of milk.  Do you still have that pressure feeling that seems as if it is coming from your throat?  What a weird sensation?  It still hurts some if I look back towards my rear view mirror when I drive.  Yes, I have lost alot of weight but what you say does make sense because I did start closer to my normal weight and then lost even more weight.  I went to my ob/gyn last week and will have my bone density/mammogram on Thursday.  I just know my osteoporosis will be worse after taking all those massive doses of PPI's.  I will refuse to take anything oral for it, like Fosamax or Actonel.  I once took Fosamax a long time ago and always blamed it on my acid reflux but don't really know for sure.  I guess I could try the injection one but a pill is out of the question since those pills can cause acid reflux in the first place.  Also, on Friday I have an appointment with a orthopedic (sp) doctor to have my arm checked.  I still have horrible pain on my left arm where I had the i.v. and the doctor said that I probably sustained nerve damage but that it wasn't the surgeon's fault but the staff (great another problem).  I want to know if perhaps I could have therapy or do something so that it will improve.  It hurts so bad that at night I sleep with a heating pad on the damaged arm but it doesn't even help.  The consipation is getting alot better since I am eating all bran cereal and make sure I eat a salad to increase my fiber intake and it seems to help but of course the consequence of so much more fiber is added gas (like I need/want more gas).  I just can't drink lots of water especially right now.  I hope that this will improve in the summer.  I always get scared to "blow my stiches" like you said and know that I just have to be careful.  I make porcelain dolls (hence the name porcelain doll) and wonder if I will ever be able to pour my own dolls, as some of the molds are quite heavy.  Some of my favorite dolls were the large ones.  Do you ever wonder how you got the hiatal hernia to begin with?  My surgeon said that you can get them 3 ways, either childbirth (which was not my case since both my daughters were c-sections), straining, or heavy lifting.  I think in my case the heavy lifting of molds and straining is what did me in.  I am glad to have an appointment with the gastro as I think he would be better to answer all of my questions on the heavy lifting and straining but my appointment isn't until Feb 18.  Luckily, I can pretty much eat what ever I want but in small portions.  I don't know why you can't eat pork as it doesn't seem to bother me.  I guess I will close and HappilyWrapped and Tammy thanks for thinking of me....Barbara......


HappilyWrapped
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Date Joined Oct 2007
Total Posts : 183
   Posted 1/16/2008 7:55 AM (GMT -6)   
Porcelain Doll,

You asked, "Do you still have that pressure feeling that seems as if it is coming from your throat? My answer is yes, but not all the time like it used to be. The pressure in my throat and chest have subsided quite a bit. It's a noticeable sensation if I go to a restaurant and consume too much, but on a day-to-day basis it is much improved. Either that or it's become the norm and I don't notice it any more.

I don't do well with pork because it's a trigger for gallbladder sphincter trouble. I also found out that decaf coffee is a trigger. It seems it's the acid in the coffee that bothers the sphincter and not the caffeine. By avoiding foods I know are problems, I've been able to keep the gallbladder spincter pain at bay. I went to my naturopath physician and she went over several items that would cause a problem - following her suggestions has helped immensely.

Thanks for the chuckle I got when you referred to not needing more gas. I know EXACTLY what you mean.

I do think eventually you'll be able to pour your own porcelain - just not at 3 months post op. I'm going to hold at a 50 pound limit permanently just to be on the safe side - which for me will be a bag of dog food. Right now I do lift more than a gallon of milk, however, I haven't graduated to the 50 pound mark yet. If something is too heavy for what I can handle now I feel the pull and put it down right away. I also know what you mean about turning your head when driving - it's a funky sensation that I get depending on how I turn. I'm sure it will be gone a year from now and we'll forget all about it ever feeling that way.

I do sometimes wonder how the hiatal hernia came about, but then I remember 2 obnoxious children born the old-fashioned way as well as a long time history of straining with constipation. Then I add in lifting computer equipment since the days of it being much bigger and heavier than it is now along with all the other things I've lifted over the years that were probably heavier than I should have been attempting and I figure I earned that hernia all on my own.

I think you're smart to not do fosimax or actonel right now. I think at our age you can do better with diet and exercise once you feel up to it. Plus the last thing you want to put into your stomach right now is an item known to irritate it.

Take care and good luck at the orthopedic doctor.

HappilyWrapped
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Date Joined Oct 2007
Total Posts : 183
   Posted 1/20/2008 8:15 AM (GMT -6)   
Barbara,

How did you make out at the orthopaedic doctor (you did spell it right in your post - over the years it has become acceptable to drop the "a")? You mentioned having an appointment on Friday for your arm.

TammyGrl0528
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Date Joined Jun 2007
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   Posted 1/21/2008 3:29 PM (GMT -6)   
Barbara,

Again, thinking of you. How are you doing in general?

Hope all is going well sweetie!
 GERD Forum Moderator
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 Diagnosed with Generalized Anxiety Disorder (GAD) and Panic Attacks.
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porcelain doll
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Date Joined Mar 2007
Total Posts : 128
   Posted 1/21/2008 9:49 PM (GMT -6)   
HappilyWrapped:  Hi, I went to the orthopedic doctor on Friday and he said what I had was a calcification deposit on my left shoulder and he even showed me the x-ray and could see a small white pea size round thing on my shoulder.  He diagnosed it as tendonitis and said that I need physical therapy and gave me a prescription for Celebrex 200 mg but wanted me to ask my surgeon if it would be okay to take since I am still recovering from the surgery.  He said if the therapy didn't improve the problem then he would give me a cortisone shot to help with the pain.  I told him that I thought that perhaps they had given me nerve damage due to the i.v. being on my left side but he said that it was unlikely and that it probably was just a coincidence that the tendonitis occured after my surgery.  I decided not to take the Celebrex because I just don't want to take 2 steps backwards when it comes to my stomach.  I should of asked him if this calcification deposit occured because I take large doses of calcium for my osteoporosis.  I have to go back in 3 weeks and hopefully I will remember to ask. 
 
I am so glad to hear your pressure feeling is going away.  I can still feel mine and it comes and goes during the day.  I am anxious to just feel normal but am glad to say I don't have anymore heartburn.  It is good to hear that your gallbladder situation has improved and maybe since you are no longer on PPI's all will improve all the more.  I think that the PPI's damaged my glabladder.  My surgeon said that there were no gallstones in my glallbladder but stopped working.  I think it is a good idea to have a weight limit but for me 50 lbs is still too much.  I notice if I lift something too heavy I get that pain, kind of like you said a pull sensation and then I know to take it easy.  I wonder if the funky sensation is the hiatal hernia or the wrap, what do you think?  Maybe it is both.  As far as my bone density test goes I don't know the results since I haven't seen the ob/gyn doctor yet.  I will probably opt to try the Boniva but it has to be the injection.  Hopefully, now that I have stopped the PPI's my bone loss has stopped some.  I am taking the Climara hormone patch and I hope it is helping me too.  Another thing I have noticed is that the cold weather is really bothering me.  If I go outside and get too cold I will start to shiver and sort of shake.  My mom thinks this is happening to me because she thinks I am sort of weak.  Does this happen to you?  I am not even living in a cold area as I live in Southwest Texas which is not too cold compare to other areas.  Take care.....Barbara....

HappilyWrapped
Regular Member


Date Joined Oct 2007
Total Posts : 183
   Posted 1/21/2008 10:19 PM (GMT -6)   
Barbara,

I'm sorry the cold is bothering you. I wonder if it's because you lost so much weight and don't have as much insulation as you did before?

No, I don't have a problem with the temperature which is a good thing because I live in New England. That's a tad cooler than your location in the winter. If I lived where you are I'd be drooling over chile verde and sopapillas - two items that I had while traveling out your way a long time ago and both of which aren't available here. New England restaurants think a sopapilla is a tortilla chip with some cinnamon and sugar sprinkled on it and chili verde here is a green liquid in a bowl for dipping a tortilla chip into. I would just love to test this new wrap with that amazing pork concoction then cool my mouth with a honey-filled pillow of delight. I do hope that when you feel up to it that you will have a bite of sopapilla for me - yummmmmm!

Good choice on the celebrex - I'd be afraid to take a medication that might cause stomach problems, too. I hope the physical therapy works to relieve the pain so you won't need a shot.

I don't know if the pulling sensation is the wrap or the hernia repair. Could be either because they're up close and personal to each other.

Take care.
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