Shoulder pain post repair nissen surgery

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Date Joined Jan 2011
Total Posts : 2
   Posted 1/23/2011 7:38 PM (GMT -6)   
i just had my second lap nissen surgery in mid-dec 2010.  I had my first surgery done Jul 2008 and it subsequently slipped in 2009.  The initial tear in my diaphragm was only 2cm, and they found this when they went in for the first surgery.  It wasn't repaired with a mesh, just sewn together.  Subsequently when it tore again the tear was 5cm, which the surgeon described as "unusual".
I had some shoulder pain post surgery the first time around, it lasted a week or so.  This time it has been 5 weeks and I am still getting significant shoulder pain. I brought my review appointment forward 2 weeks due to the pain... and a stitch that had popped out which I didn't want to infect (all wounds now healing nicely, surgeon re-used 3 of my inital wounds so only 7 scars in total, rather than 10!) and he suggested that I may have 3 complications.  The first being blood pooling under my diaphragm causing pressure. He doesn't think this is the problem, given the passage of time and said that if this was it then it would resolve itself by absorbtion back into my system. 
The other two potential complications are spleen related, he said that he may have aggrivated my spleen and it is taking a while to settle or given that the blood supply for the spleen comes from the area of the stomach associated with my wrap that my spleen may by dying (sounds pleasant!).  I did question him about this and he said it isn't a huge issue and some nissen surgerys result in the removal of the spleen if there is excess bleeding. 
He didn't want to do a CT scan just yet as he didn't want me exposed to any extra radiation if we could avoid it.  So I have a review appointment in just under a fortnight.
I must say that I am extremely happy with my 2nd round of surgery, the first was done in a medium sized hospital and all they did prior to the surgery was a gastroscopy.  This time around I had a barium swallow, gastroscopy, ph study and manometry, plus 3 consults.  The surgeon actually returns my calls if I have any concerns and squeezed me in when I was having the pain issues.  I didn't even get a review appointment from the first lot of surgery.  This time around the original wrap was undone and a mesh was used to repair the hernia. 
The surgeon also wouldn't let me eat or drink for 24 hours and then not until I had done a gastroswallow to ensure that there were no leaks.  Then only clear liquids for 24 hours and slowly building to normal liquids for a fortnight and then soft foods after that.  Chocolate is a liquid!
following both surgeries i had no reflux at all - until I felt the wrap slip while out jogging, after which the reflux returned to pre-surgery levels.  So far so good this time with the exception of the shoulder pain.
The shoulder pain first time around was only in the right shoulder, this time it is either left or right, I also have some pain in my left side at the base of my ribcage.  Not happy about the pain, but the surgery was more complex this time around.
Has anyone else had this experience? Especially with spleen complications or post-2nd wrap?

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Date Joined Feb 2009
Total Posts : 7188
   Posted 1/23/2011 10:53 PM (GMT -6)   
Hi litlmis,
Welcome to Healing Well! Glad you've joined us. Actually shoulder pain is a very common side effect of Nissen surgeries. Many here have struggled with it. Before I had the surgery, and was coming here to learn and prepare myself, I was puzzled by the shoulder pain symptom. What could the shoulder possibly have to do with this surgery?

I've heard two theories...pressure on a nerve that refers to the shoulder, and loose gas caused by the CO2 that they pump into us to blow up our bellies so the surgeon can have a better view.

I had heard that walking was helpful, and after my surgery (while I was in the hospital overnight) a nurse suggested that I walk the halls whenever I got out of bed to use the bathroom. That was good advice. Personally, I found a strong correlation with how much I walked and the pain severity. The more I walked, the less pain I had.

I'm not sure when my pain subsided, but I know I've heard of people who've suffered with it for quite some time.

I'm glad to hear that you've had good results from your Nissen, and I hope your redo heals quickly and well.
Stick around! It's always good to have experienced people to share with others.
Take care,
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