Heartburn post redo-fundoplication

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Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 8/25/2010 12:30 AM (GMT -6)   
Hi everyone,
I'm about 10 days after a redo fundoplication and I'm having moderate to severe heartburn issues after the fact. This is freaking me out a bit since I've gone through a pretty invasive surgery for something that doesn't seem to have worked. To compound things a bit, my surgeon is on vacation for the next couple of weeks so I don't really have anyone to consult. Is this normal? I'm just a little afraid that I'll be chewing Gaviscon in addition to my PPI's and H-Blockers for the rest of my life here.

Advice? Anyone?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/25/2010 9:46 AM (GMT -6)   
Hi Sirkit,
Many, many post Nissen patients go through the panic you're feeling. It's very common. My surgeon said that at this point the wrap is swollen, and hasn't settled into place, so pretty much anything can happen. I panicked just like you are, and figured I'd had the surgery for nothing.

Don't worry. Things will settle down as you heal.
Been there, done that!
Take care,
Denise

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 8/25/2010 4:18 PM (GMT -6)   
Okay, that's what I kinda hoped was happening. It is a little freaky to have the symptoms I'm trying to get rid of happen after the surgery. That the Gaviscon isn't really getting rid of the symptoms is probably a clue that it could be other things associated with the healing as well. I woke up last night with terrible burning around my midsection, oh the joys of this healing...

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/25/2010 8:28 PM (GMT -6)   
The first weeks are the most challenging. Yes, often the sensation of "heartburn" is actually an irritated esophagus that interprets the pain as heartburn.

I don't know if your doc told you, but your wrap becomes increasingly swollen for the first two weeks, so don't be surprised if your swallowing gets more difficult. Once past the two week mark, things begin to calm down and you're on your way.

Are you taking pain meds at night? Although you won't need them much during the day, it is worth taking them at night so you can get some sleep. If you can get your rest you can tolerate a lot more of everything!

I'm glad you've joined us, Sirkit! Welcome to what we post Nissen members call the "Wrapped Club"! You're a full-fledged member now! Please post your recovery progress and if you have any other worries or concerns, post away! We'll do our best to answer your questions and share our own experiences with surgery and recovery.

Take care,
Denise turn

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 8/28/2010 7:23 PM (GMT -6)   
Okay... I'm having a what the heck was that moment here. Last night I was sleeping and suddenly felt like I was choking and had a burning sensation in the back of my throat but not behind my breastbone at all (my GERD always showed up as intense pain in my chest, never choking). I kept trying to sleep and I just kept feeling like I was choking. I ended up sleeping in a chair. This sounds a lot like other peoples reflux symptoms to me but I've never experienced anything like it.

Has anyone experienced this post fundoplication? It was so very strange...

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/28/2010 7:50 PM (GMT -6)   
Sirkit,
Hey, as my surgeon said, anything is possible in the first weeks post surgery. No, I didn't get that experience, but from what I've read on this site, every recovery is unique. That's basically what my surgeon said--just when he thinks he's heard it all, someone comes to him with a brand new symptom or experience.

It is very possible that you're getting some reflux...while some don't ever experience another moment of reflux after surgery, others do. Since your wrap is swollen at this point, (and the new "valve" is very different from the old one it replaced), you could definitely get different symptoms than any you've ever had.

I've heard others worry as you (understandably) are. Do you have your bed elevated? If not, that would be a good thing to do...If so, you could consider adding a "wedge" until your healing is complete.

I hope you don't have a repeat of your disturbing symptoms any time soon.
Hang in there...better times are on their way.
Take care,
Denise

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 8/31/2010 1:10 AM (GMT -6)   
Hi all, once agin here with heartburn symptoms... I guess I'm 16 days post op so that's not much time but it's still so frustrating. I have an appointment with my surgeon in a couple of weeks now. The pain seems to be located at the low point of my brestbone not really the shooting pain right by my heart that I'm used to... I wonder if it may be more related to the wrap just being swollen... I know, I'm just freaking out but it's still frustrating and quite painful *mope*.

babygirl10150
Veteran Member


Date Joined Jul 2006
Total Posts : 639
   Posted 8/31/2010 8:44 AM (GMT -6)   
I know how you feel. I posted a few times freaking out after both of my wraps. It took a good month and a half to two months before I saw any difference after I had the second one. Some days were good and others were awful. I had intense pressure where my wrap is if I tried to swallow too big of a bite. Could you pain be more of a pressure?

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 8/31/2010 3:18 PM (GMT -6)   
Hi baby girl. I don't think it's pressure though some of it seems to be orientation related (sleeping on my right feels weird, sleeping on my left feels fine). The last thing I ate that caused heartburn was pudding... I doubt that got stuck :P I'm hoping things settle, some of my research suggests that around three months recovery is sometimes necessary... not ideal obviously but as long as it works out in the end I guess that's okay. I'm going on vacation in a month and a half I hope things settle by then!

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/31/2010 5:07 PM (GMT -6)   
Was the pudding chocolate? That could be the problem.
Joy

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/31/2010 5:29 PM (GMT -6)   
It is very likely that your esophagus is still very inflamed, and the heartburn you're feeling is just irritation. I've heard that the esophagus is a "dumb organ" and doesn't differentiate between pains, so reads everything as "heartburn".

Actually, pudding could get "stuck"...if there's swelling, it could remain at the wrap site and not all get through--thus irritating further, as it sits there. I had a barium swallow that found (although I thought my wrap was very loose) some barium was being retained in the esophagus after swallowing, then moved up and down the esophagus--presumably propelled by air that was being released by my stomach.

Pudding is at least as thick as barium, so certainly could be retained in the esophagus after eating. Try drinking some water (or warm/hot tea) after eating, to try to ensure that everything gets through. Even when I drink water I can get some retained, and it drizzles out gradually. It never bothers me, but just shows that with a tight wrap or swelling, even a liquid can be retained in the esophagus.

Good luck, and try not to jump to conclusions. Give yourself a chance to heal. Yes, it's frustrating to feel like you're still getting the symptoms you had the surgery for, but you are still in the very early stages of recovery. I've heard that it takes 6 months to heal, and complete healing doesn't happen until a year.

Take care,
Denise

rlopez75
Regular Member


Date Joined Jul 2009
Total Posts : 199
   Posted 8/31/2010 5:53 PM (GMT -6)   
I had those feeling of a burning sensation, but it was explained to me by the surgeon and my specialist that I Was severely inflamed before the surgery and that it could take months for it to subside and for that feeling to go away. Now after a year I still get a "burning" feeling when I eat certaic things like yogurt or strawberries, though I cant burp and my last EGD showed that my wrap was 100% in tact and functional. I would give it time.

Rafael

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 8/31/2010 7:25 PM (GMT -6)   
I agree that pudding sure can get stuck. If the initial swallow doesn't get through it will pile up on you and cause all kinds of problems until it gets pushed through. same goes for mashed taters.

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

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 9/2/2010 1:22 AM (GMT -6)   
Thanks everyone for your comments. You're right, it is fairly early in the healing but I'm ready for this to be done already (not the most patient person with this illness...). For the record, today was a pretty good day, I only used Gaviscon once after a meal and even then only one tab. I'm back to my full dose of Panteloc and Pepcid and that seems to be mitigating the heartburn feeling. Hopefully after a few months I'll be able to back off on the PPIs... *sigh*

GERD11
Regular Member


Date Joined May 2010
Total Posts : 68
   Posted 9/2/2010 7:14 PM (GMT -6)   

I am sorry to say that I had the TIF and had the same the symptoms.  I got results today from my PH Bravo that my TIF failed.

GERD11


Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 9/3/2010 1:39 AM (GMT -6)   
Hey, I'm hoping that isn't the case. I can certainly feel that things are there. When I swallow a good swig of water I can feel it kind of get caught at the bottom of the esophagus and then kind of squirt into my stomach. I would say that's a good sign that things haven't completely fallen apart (that was what happened last time, no adhesions so it fell apart randomly). I'm guessing it's swelling that's preventing the valve from sealing properly. I prefer the positive viewpoint, thanks.

allyh
New Member


Date Joined Sep 2010
Total Posts : 6
   Posted 9/3/2010 9:39 PM (GMT -6)   
Sirkit: I had these symptoms too, but they've mostly resolved now, 11 months post-surgery. I'm eating almost normally and have been able to stop the PPI. Healing took much longer than I would have thought and even in the 8th month, there were things that I just couldn't eat--chocolate and any high-acid foods, for example. (I recently ate a quantity of tomatoes and didn't have reflux that night, whew!) Pasta STILL gets stuck and I've given it up. Sometimes it still feels like my esophagus goes into spasm, particularly if I'm eating too quickly, bringing whatever I'm eating back up (gross, I know, sorry....). I actually feel pretty lucky when reading through some of these posts. The surgery was scary to contemplate and, as it turns out, completely worth it. Good luck with your recovery!

allyh
New Member


Date Joined Sep 2010
Total Posts : 6
   Posted 9/3/2010 9:47 PM (GMT -6)   
Oh, I just remembered this! There were a couple of months of recovery when Omeprazole quit working--awful heartburn and reflux. I switched to Prevacid (double the recommended dose, which my GI guy okayed) which helped some. I also ate apples--which really calmed the reflux down--until I ate something else. Finally I had several sessions of acupuncture and took Chinese Herbs and these were extremely helpful. I really credit the Acupuncture and Prevacid with getting me through a very rough period of the recovery.

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 9/4/2010 3:15 PM (GMT -6)   
So I had a hell of a bad night last night... my own fault, after having an amazingly good day I decided that butter chicken would be a good meal... what was I thinking?! Three hours of heartburn later and a good nights rest and I'm still sore this morning. I'm pretty sure my esophagus got a good acid bath with that one. I think I'll switch back to a full GERD diet for a bit, hopefully that will reduced the damage until this wrap starts working. *sigh*

@allyh: I really hope it's not gonna take 11 months. I have no trouble swallowing so far as long as I chew carefully and completely. I can also burp (could right out of the surgery, could last time too) so no gas issues. Now if only the heartburn would stop my life would be great!

rummaan
Regular Member


Date Joined Mar 2010
Total Posts : 92
   Posted 9/5/2010 11:37 PM (GMT -6)   
Guys, I'm 4 weeks post op and struggling too. I still get the lump in the throat about an hour after eating anything. Along come nausea (the most annoying symptom) and sometimes burning or pain along my breast bone and stomach. I was stupid enough to try a KFC chicken a couple of days ago and some fried fish yesterday. I also over ate a couple of times. The most annoying symptom is slight nagging nausea 1 hour after meals. It lingers for about half an hour then goes. I found that I have a sour taste in my mouth after eating sugary things. Taste of food lingers in my mouth long after eating. I emailed with a few top experts and talked to my surgeon and they all said it's too early and I should give it a couple of months more at least. I just hope because it's heartbreaking to feel the same symptoms after the surgery. Today I woke up from nausea and burning at 4:30 am. But I must admit that I sleep much better in general after surgery, almost flat. Do you experience nausea at all? I found that carafate helps sometimes. Good luck to you all! I'm a little paranoid with all this, I guess it's a reflex ingrained by the years of GERD. Should I have a barium swallow for a piece of mind or is it too early?

Post Edited (rummaan) : 9/5/2010 10:48:28 PM (GMT-6)


GERD11
Regular Member


Date Joined May 2010
Total Posts : 68
   Posted 9/6/2010 11:12 AM (GMT -6)   
rummaan I think it's too early to tell.  I had a TIF that failed and is 100% intact.
I had the same GERD symtoms after surgery and my surgeon said I shouldn't.
The worst part of it is that I am still nauseous also.  I take the carafate also the only thing that helps is Zofran.  My surgeon is going to do more tests and recommends the Nissen fundo.  I do know how you feel having gone through it myself.  It is heartbreaking and depressing but its too early to tell. Your body needs to go through the healing process.
 
I hope it works for you .  Keep us posted.  Good luck and get well!
 
GERD11

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/6/2010 8:53 PM (GMT -6)   
Hi Rummaan,
It's much too early for you to be assuming the worst! Four weeks out you're still in the early stages of recovery. It takes at least 6 months for most of the healing to occur, then a full year for full recovery. Try not to let the ups and downs of the early weeks of recovery get you down. I know just how you feel. I went through similar feelings--I think everyone does. It's a difficult surgery, and certainly not one with cut-and-dried results. We all know that some people come out of the surgery with big issues. However with a skilled surgeon, the outcomes are much more predictable.

Try to relax and stop worrying. Behave yourself with eating...you can try just about anything, but keep it things that can be chewed to a liquid, and small amounts. I'm a big fan of carafate suspension...I have a very sensitive stomach, and to this day I take it fairly regularly, because it calms down my wrap when I irritate it with something. You've had a revision to your GI tract to try to correct a problem that was seriously impairing your health and well being. It's a quirky revision, but it's far superior to the non-functional LES.

I had to get the surgery to protect my lungs, and it has done a good job with that. I would have a redo in a heartbeat if I needed it. I wouldn't want to go back to the way I was before the surgery. It's not perfect, but it's certainly an improvement!

So hang in there...give yourself a few months and you'll be back to eating normally again. I'd say at about 4 months, I was eating anything I wanted to. I still have to eat more slowly and chew carefully. It's a habit now, and isn't any big deal.

Hope you're feeling well tonight.
Denise

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 9/7/2010 12:12 AM (GMT -6)   
Report for the day: Very good day and previous night. Minor heartburn last night that faded really fast, today I only used two tabs of Gaviscon both for mild symptoms (but I didn't want to risk any burning). It's the first day where I think things might actually be working. *thumbs up* I ate pretty mild food but had a full turkey dinner with stuffing (probably not SUPER great heartburn-wise) and had no real heartburn to speak of. I'm excited now :) *bounces around room*

Sirkit
Regular Member


Date Joined Jul 2009
Total Posts : 61
   Posted 9/8/2010 10:38 AM (GMT -6)   
So my last few mornings have been really good. Down to using gaviscon only occasionally (twice yesterday) and I had some more complex food last night and it barely made a rumble... progress! I ate a bagel and a sandwich yesterday and while they were a little tough to get down they didn't get stuck as long as I chewed very carefully.

I'm still taking the gaviscon before bed to ensure that nothing goes crazy while I'm lying down but things appear to be stabilizing. Hopefully things continue to move to the point where I can at least get off using the Gaviscon and start to wean myself off the PPIs and H receptor blockers. *thinking hopeful thoughts*

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 9/8/2010 3:15 PM (GMT -6)   
sirkit. please keep us posted. i know how you feel im 8 days post op and feel very depressed that all my symptoms..cough, throat clearing, water brash all are still here despite the fundo. i have been panicked for a while. they say let it heal and my gi doc says if no improvement at a month then hes worried. he said he will oreder barium test in a few weeks..maybe you could do that to see what it shows. im totally jumping to conclusions as i had a choice an experienced surgeon, and a young good surgeon that has not done many. because the nurse was rude to me at one, i went with the less experienced more pleasant guy. did they do a loose wrap on you..they did me so no problems swallowing and i burp like before, but no improvement. hope things get better for you
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