hill repair-anyone

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joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 6/29/2010 7:44 PM (GMT -6)   
so as i get closer to surgery for severe lpr, not controlled by tons of pills and a fiery red/sore throat that will not heal i wonder if anyone has had the hill repair. all they offer in iowa are fundos and i want a durable success and hear mostly bad about fundos. My gi doc says 60% of patients with fundos still require ppis. if that is the case what is the point. is it really that unreliable?

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 6/29/2010 8:46 PM (GMT -6)   
Joe,
You're still searching????
Have you tried a nearby state?

Joy

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 6/29/2010 9:12 PM (GMT -6)   
yes, things are deteriorating rapidly and the one surgeon i saw was completely clueless. any suggestions on how i search. iowa only offerf fundos

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 6/29/2010 9:13 PM (GMT -6)   
Hi Joe,
The point is that even though many who have the Nissen (or other) surgeries to repair their dysfunctional LES need to take PPI's, most often there is a marked improvement of their symptoms.

I had the Nissen surgery for uncontrolled asthma. There were no promises that it would work (similar to your LPR diagnosis), but I had run out of options and I had to try it.

The results aren't perfect, and my reactive stomach (and a small amount of continued reflux) requires a single dose of PPI (I had been on 2X a day) to maintain my lung health.

No, it's not perfect, but yes, my lungs have been 100% better since the surgery. They'd been out of control, and my health was terrible.

So...just because you may need some PPI's after surgery doesn't mean that you won't be happy with the results.

Everyone is different, but I thought you might like to remember that the perfect shouldn't be the enemy of the good!
Best wishes!
Denise

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 6/29/2010 9:19 PM (GMT -6)   
denise,

it is good to hear. i am so miserable and have respiratory issues resulting from all the reflux. i would settle for 1 ppi and significant improvement. did you have a full wrap? glad that you are better. thanks for the perspective..i guess with all the technology it is easy to expect perfection, not realizing the reality of this disease

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 6/30/2010 8:57 AM (GMT -6)   
Joe,

You are in Iowa, you are not that far from Mayo Clinic.

However, you have the University of Iowa Hospitals and Clinics in Iowa City. They have a excellent reputation too. I don't know if they do the procedure you are wanting.

There is a surgeon not to far from you that I have read others talk of that doe the Hill repair, Dr. Gregory Pulawski, MD, Indianapolis, Indiana. Special Expertise:
Digestive System Abnormalities; Liver Diseases; Minimally Invasive Surgical Procedures.

I have no personal experience with this physician so this is strictly FYI.
Kindly,
Kitt

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 6/30/2010 10:01 AM (GMT -6)   
Joe,
Yes, I had a full wrap--it is a loose wrap, so I'm able to burp and vomit. I don't get the types of gas/bloating issues that others experience. It's a balancing act for a surgeon--tight enough to keep acid/bile down, and loose enough to allow easy swallowing and not create other uncomfortable issues.

I actually coughed my guts out before and after the surgery, so there is some possibility that a stitch may have come undone, creating my mild reflux issue. I was on high doses of steroids before during and after the surgery as well--influencing the strength of my internal tissue.

That said, I'm thrilled with the results. I'd had no idea what to expect. First, the recovery was much easier than I'd expected. I have a surgeon who believes in trusting his patients to be responsible eaters, so after just 5 days was told I could eat anything that could be chewed to a liquid. That made the recovery much better, since I wasn't stuck on liquids or soft foods for weeks. I had virtually no problem with swallowing/eating once the first few weeks of swelling,etc. were over. It took a few months for my stomach to allow more than very small amounts of food, but by about four months, I was eating normally. I'm still very careful to chew food slowly and thoroughly.

You're right...the technology isn't perfect. Few GI docs trust the new procedures, as their reliability is less well known.

I can just say this...my surgery worked well...not perfectly, but it did the trick by protecting my lungs from constant inflammation. If it should fail, I would have a redo without hesitation. As an asthmatic, I can't afford not to have the repair. I just wish I'd had the courage to do it years earlier, before the steroids caused permanent skin damage--it tears and bruises extremely easily--like a 90 year old.

But hey...better late than never!
It is most important that you find a surgeon who is highly qualified and experienced in this particular surgery--whether a full or partial wrap, your surgeon is the most important component to the potential success of the procedure.

Best wishes in your search for answers. Try to be positive but realistic. The surgery isn't a panacea...it's not going to make your GI tract the way it was before you started having any problems. It'll just improve the situation. There will always be little quirky differences you'll deal with, but in my case they're well worth it. The more prepared you are for the recovery and changes, the easier it will be to accept your recovery. It sounds like you're ready. When things get bad enough, the downside of the surgery becomes the lesser evil.

I continue to be a very satisfied customer!
Take care, and best wishes.
Denise

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 6/30/2010 1:21 PM (GMT -6)   
Joe-
Please email me. (it's on my profile) I might be able to give you some names of doctor s to talk to.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09


joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 6/30/2010 2:33 PM (GMT -6)   
thanks kitt, the u of iowa seem more worried about generating revenue than my health. they are a frustrating bunch and are poor at returning calls and communicate poorly with their own departments. i may look up that fella in indy?

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 6/30/2010 2:49 PM (GMT -6)   
Joe,
My little brother just moved up to Iowa last week with his family. They live in Ames now. I hope the doctors up there are good.

Joy

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 6/30/2010 4:55 PM (GMT -6)   
ames is a nice place. they will like it there

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5028
   Posted 6/30/2010 5:26 PM (GMT -6)   
Hill repair is probably not any more durable than any of the others. But the main thing is to get the APPROPRIATE procedure for your particular condition - based on your testing. You need to go to a major center, see a surgeon who has done thousands of procedures, and not accept a one-size-fits-all procedure just because that's the only one a surgeon does.

I had a modified Nissen, called a Toupet fundoplication. It's a partial wrap. I can't burp much or vomit at all, but I take no PPIs and have no reflux.

Learn about what happens if you have a short esophagus and discuss it with the surgeon.. If you've had a hernia for a long time this can happen. My docs had to dissect quite a lot to get enough esophagus freed up, so they wouldn't have to do a Collis.
Alcie
 
 


opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/1/2010 11:54 AM (GMT -6)   
Not sure how far away you are from Chicago, but there is an excellent surgeon there at Loyola university, He runs the department for swallowing disorders. He sure helped me get my life back.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09

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