Nissen Fundoplication Surgery and Hiatial Hernia Repair and Breathing

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Profjulie
New Member


Date Joined May 2011
Total Posts : 1
   Posted 5/22/2011 8:53 PM (GMT -6)   
Three days ago I had the Nissen Fundoplication Surgery (full wrap) and repair of the hernia that the doctor found. I had the intense shoulder pain in the hospital and then neck pain the night after surgery. I actually slept in the recovery room for three hours before going to my room which I believe actually gave me a great deal of rest. Anyway, since coming home I have noticed that I can burp and that a full liquid diet is what my body requires. The most wonderful miracle I have noticed is that for two days I began to seem to need to blow my nose. Now, I realize I have blown out so much that I can actually BREATHE! I have had chronic sinus infections and asthma since I was a child. I know believe it was the hernia and the acid reflux that caused these conditions. I am so excited about breathing that the pain that remains in my shoulders seems not important at all. I went to a wonderful doctor in Santa Barbara, California who I know realize with God's help has given me a new lease and breath on life.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 5/22/2011 9:05 PM (GMT -6)   
Hi profjulie,

Welcome to our yeah yeah yeah Wrapped Club yeah yeah yeah at Healing Well! Glad to hear that you are already feeling relief post surgery! Often it takes a lot longer to get reflux-caused problems to calm down. How wonderful it is that you can already enjoy improvements!

The pain in your shoulder is caused by the gas that was pumped inside your gut to create a better field of vision, as well as irritation to the diaphragm. I found that walking helped to relieve it a lot. The more I walked the less pain I had, and it would increase when I didn't walk. It's worth a try!

Again, glad to hear things are looking up! I had the Nissen surgery to try to improve my very involved asthmatic lungs. Fortunately, the surgery made a big difference, and my lungs improved tremendously. I've also wondered if I had reflux as a child, although I have documented severe allergies.

Again, welcome to the forum!
Take care,
Denise

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 5/23/2011 3:21 PM (GMT -6)   
Remember your wrap will swell so over the next 14 days if you have trouble with swallowing just stick to liquids for a couple of days.
Chew, chew, chew....little bites, too.
Joy

Sheila1366
Regular Member


Date Joined Aug 2005
Total Posts : 384
   Posted 5/23/2011 5:05 PM (GMT -6)   
glad you made it through surgery OK. Looking foreward to getting my problem fixed too.
Fibromyalgia,Gastroparesis,Heital Hernia,Gastritis,Gerd,IBS,Depression,Dsyautonomia,Raynauds Syndrome

SR8CReliant
New Member


Date Joined Jun 2011
Total Posts : 1
   Posted 6/8/2011 5:57 PM (GMT -6)   
It has been 2 wks. since my Nissen and I am feeling wonderful!!! No heartburn anymore. The pain in the shoulders is NOT from the gas in the laproscopic inflation, it is from irritated phrenic nerves which go under and around the stomach, gall bladder, up the spine into the shoulder and neck. This will go away with time, it takes a while. I've been dosing on the Tylenol 3 to kill the shoulder pain, but today is a good day. It is hard to eat small bites and stay on liquid or mush on food, and there will be 4 more weeks of this. I have lost 10 lbs. I would love to lose 30 or more. But being able to sleep without reflux or get through the day without heartburn is my goal... and right now I'm very happy. I'll be returning to work tomorrow, an office job.

I had an excellent surgeon in the Philly area. I put this off for many years, but had to have my gall bladder removed so I told the surgeon to do the Nissen at the same time. So happy I did. It turns out, that I had effectively 2 stomachs. An upper above the diaphragm, and a lower. In between the stomach had fused itself with scar tissue to the diaphragm, so that it wasn't just a hiatal hernia anymore, it was two separate chambers with no hiatal sphincter. He had to cut the stomach loose from the diaphragm, then do the Nissen wrap. This condition prevented any PPI's or ant-acids from really being effective. Should have done the job long ago. Now I know why I was so out of breath all the time, the upper stomach was pressing on the lungs.

The worst part of the procedure was all the pre-op testing: manometry which is like being water boarded, and having a PH meter implanted in the esophagus for 48 hrs. Most of the other testing, like the nuclear swallow, and the endoscopy are all done without any PPI or ant-acid, and that was sheer misery for someone who was quite "addicted" to PPIs. I endured using a very low acid diet, and seem to be all better now. Looking forward to many years of reflux and heartburn free living. Looking forward to eating real spaghetti sauce again!

Sammi67
Regular Member


Date Joined May 2011
Total Posts : 54
   Posted 6/8/2011 6:45 PM (GMT -6)   
It is so great hearing all these positive stories! I'll keep reading until my surgery!

kyheart
Veteran Member


Date Joined Apr 2011
Total Posts : 515
   Posted 6/8/2011 7:14 PM (GMT -6)   
Welcome Prof Julie...
It is a wonderful feeling, being able to wake up and find that something you have lived with for so many years may be gone... I had asthma for about 14 years or so. They diagnosed me about the same time I was beginning to have trouble with my "heartburn". After I had my HH repair and NF, I had no more need for my rescue inhaler or any of the meds I took for the stopped up nose or the sinus drip and drainage.. I also have not taken a Nexium since the morning of my surgery and I had been on two 40mg Nexium a day. I know your relief.. I am so happy for you..
Please listen to your body and let it be your guide as to your diet. I am almost 10 weeks post op and I have been a real chicken when it comes to adding food.. I was full liquid for 14 days and then slowly started adding soft food like baked/broiled fish, slightly overcooked pasta.. etc. I have been fortunate that as long as it is cooked , it does not hurt my stomach. I cannot eat bread and I am following my surgeons advice, no steak yet... the best advice he gave me was... Listen to your body.. let it tell you when you are ready for more..
My advice to you is, come and visit this forum and feel free to ask questions. I thought I was asking some dumb questions and everyone was so supportive and informative and great all the way around... I feel like I am part of a family here... we understand what you are going through because most of us have experienced it in some way..
I look forward to hearing from you as you recover.. Take Care..
Sandi

LadyT
New Member


Date Joined Mar 2011
Total Posts : 9
   Posted 6/14/2011 9:36 AM (GMT -6)   
Hi profjulie,

Would you be so kind to share who your surgeon is...I am located in Ventura California and to no success have found a doctor skilled enough to handle my problems....I have a hiatal hernia, Gallbladder removed years ago. I have been in pain for the past 7 years and all that seems to be is running to the Emergency Room to put the burning fire out of my throat and chest....I've been on a host of meds over the years. I am currently on Protonix 40 mg and Ranitidine 2x a day....which assist to a minimum...without the meds things are worse. :(
I'm so glad your outcome is beautiful...

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 6/14/2011 12:25 PM (GMT -6)   
Is there a Mayo Clinic near you, ladyt?
Joy

justasitis
New Member


Date Joined Jun 2011
Total Posts : 4
   Posted 6/14/2011 5:13 PM (GMT -6)   
Is everyone on here from America . I am having gerd symptoms .I have been on medication for over ten years and it has stedily got worse. I am looking at having the wrap done . I am 55 years old and soooo scared.

justasitis
New Member


Date Joined Jun 2011
Total Posts : 4
   Posted 6/14/2011 5:15 PM (GMT -6)   
Does anyone get burning in their lower tummy?

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 6/15/2011 11:35 AM (GMT -6)   
We have a mixed group here.

justasitis, I had no trouble with the surgery. I had it 18 months ago and am very happy with the outcome.
I was scared too at first because the GI told me only worse case senarios from the surgery. But I became my own advocate and began researching for myself. In the process I found HW and the wonderful people here helped me see both sides of the surgery and I became less scared.
Joy

nursemal
New Member


Date Joined Jul 2011
Total Posts : 3
   Posted 7/6/2011 8:16 PM (GMT -6)   

I am an interesting case....

Several years ago I was referred to a specialist for my asthma. It was very difficult to control and would result in numerous hospitalizations and long term high doses of prednisone. Roughly 10+ years ago I had a barium swallow done and it was found that I had GERD. One thing led to another and I had numerous 24hr pH studies as well as motillium studies and it was concluded that I had Reflux so bad that I was aspirating and not knowing it-thinking it was an asthma flare up- my esophagus was badly burnt and my vocal cords have permanent damage. I was 15yrs old at the time. Normally this surgery-nissens fundoplication- is done in children who have ms, cf or other muscular diseases. At the time it was completed laproscopicly and I had 5 stab wounds. I know I had swallowing problems post op for about 2 months. But managed to wean off my PPI's. From that point my health was well managed.

Fast forward 8 yrs....

My health has had numerous setbacks that are aside from this issue. I had to go back on the PPI's (160mg OD and domperidone 20mg TID) as well, I became severely anemic; B12, Iron and HGB requiring 2 units of PRBC q 3 months. Then last fall I became quite ill. At first I thought I had some gastro bug (I am a nurse), it seemed to settle after a week. 3 weeks later my symptoms came back, constant vomiting and nausea and this burning at the base of my sternum. That soon passed and about a month later it returned this time it was worse. I was vomiting to the point of rupturing my esophagus and was vomiting blood. My blood pressure was all out of wack and I was severely dehydrated. My dad took me to emerg and I had to get potassium infusions, something to clot the bleed in my esophagus and stomach as well as stop the vomiting. I had numerous scopes done and nothing conclusive was found at first. One surgeon thought he had found a double barrel esophagus. What it actually was, was part of my stomach.

Long story short…

Last week I went in for a repair of a nissens fundoplication as well as exploratory surgery which resulted in a gastropexy. What the surgeon did find was a hole in my diaphragm larger than a grape fruit. So he repaired the hole, pulled the ¾ of my stomach that was behind my heart down and sutured it to my diaphragm as well as the abdominal wall. I was discharged 48hrs post op and have had no major complications other than the normal frustrations (swallowing and eating). My question to everyone is this… did or does anyone have any gerd symptoms post op? I still do…


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 7/6/2011 10:47 PM (GMT -6)   
Hi nursemal,

Welcome to Healing Well! You are in the right place, that's for sure!

I also had severe lung issues due to reflux, and had a Nissen 2 years ago, which allowed my lungs to recover. I still have allergic asthma, but I can handle that.

In answer to your question regarding heartburn post-op, the answer is yes.

In the early weeks the wrap is very swollen, and has not settled into place. It's very possible that some acid may escape until things heal.

In addition, you had a redo surgery, so things are even more difficult. Think about the procedure you described! You've put your upper GI tract through another major revision, and it's complaining loudly! Your esophagus is a "dumb organ" and can't discriminate between different types of pain. They're all perceived as heartburn.

I don't think there are many post-op Nissen patients who don't panic when they experience a heartburn feeling. It's a big surgery to go through, and we want to know that it was worth the effort/pain/recovery. Don't worry...it's a natural part of the healing process.

Remember that the swelling continues to get worse for the first two weeks, so don't be surprised if your swallowing gets worse before it gets better. Just take it easy and listen to your body.

Again, welcome!
Best wishes for a speedy recovery.
Denise

texas rt
New Member


Date Joined Sep 2011
Total Posts : 6
   Posted 9/6/2011 6:26 PM (GMT -6)   
Hello All,
I had my Nissen 6 days ago and am so glad I found healingwell.com. I am so thankful to you all for sharing your stories. I have been worrying constantly since the first feeling of heartburn on day 2. I have already lost 12 pounds and was afraid to try anything else because of the terrible heartburn sensation. I am glad to know I'm not alone. I guess this will all work out in due time?

shakehead

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/6/2011 9:12 PM (GMT -6)   
Hi Texas rt,
 
Welcome to Healing Well!  The fears you're experiencing are typical of the fears we all had while recovering from our Nissen surgeries.  I remember fearing that the "heartburn" sensations I had were an indication that my surgery was a failure.  My worries were a waste of time and energy, as my surgery was successful and two and a half years later, I'm very happy I had it.
 
The esophagus is a dumb organ...it registers all pain as heartburn.  Your esophagus has been through a lot, and there is a lot of healing to come.  In addition, it takes time for things to settle into place.  My surgeon told me that while reflux was a highly unlikely cause of my post-op "heartburn" pain, during the early stages of recovery things haven't settled into place yet, and some reflux is certainly possible.
 
Keep in mind that your hernia repair and wrap will become increasingly swollen over the first two weeks, to peak at Day 14.  Don't be surprised if your swallowing gets worse before it gets better again.
 
I suggest that you start a new thread on the main page to introduce yourself and ask questions.  There are lots of experienced members who can offer support and information.  Just click on this link:  GERD - Heartburn, and click on the "Post New Topic" button at the top of the main page.
 
Again, glad you've joined us!
Take care,
Denise

texas rt
New Member


Date Joined Sep 2011
Total Posts : 6
   Posted 9/7/2011 12:49 PM (GMT -6)   
Thank you Denise for your reply! it's really nice to know there are people who can relate! My family is having a difficult time trying to understand what I'm going through.

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 3/2/2012 12:16 AM (GMT -6)   
I was diagnosed with a hiatus hernia when I was 15 years of age. I was taking reflux medications from that time on and as soon as PPI's became available, I began taking them. I had regular endoscopes because of gastric flare ups and for the purposes of just keeping a general eye on things, as should happen when you are a long term user of PPI"S. I was having additional problems with pain in my RUQ in 09, which escalated to bloating and general pain in my sternum,in my back and right around my diaphragm, coupled with these weird breathing problems. Ultrasound found dilated common bile duct( never investigated ) and a fraction test showed my gallbladder at 44%. Gp said nothing to worry about.  I had already been considering a nissen fundoplication anyway, as it was discovered in 2002 that my small hiatus was now large. I went to a surgeon who said he was happy to do the procedure, but wanted to see an endoscopy of the said hernia. As I was already booked in to see a guy who had done the last 3 scopes, he said it was fine to have it done by him, who is in fact a well respected Professor. Imagine my supprise then, when I find out that I have NO hiatus hernia and just Halicobacter and gastritis. In fact, the 2 scopes before that only showed gastritis. So on the very day, I am laying in pre-op and told I have no hiatus but he will do the fundoplication because of gastritis history. So in Dec 09 I go into surgery thinking that nobody believes that I am sick and simply have some reflux. 4 hours later I wake up in the ward and am visited by the surgeon who tells me that he perfomed a procedure on a large complex hiatus hernia, and to the Professors credit, it would have been difficult to spot because of the size of the tear in my diaphragm. My gallbladder also had some quite a few adhesions, as he also had a look at that. It took a while for alot of the symptoms to subside and I no longer suffered from reflux but had a couple of gastritis flare ups. The op was a success and I was able to function normally again. However, after quite a bit of weight gain and 2 days of heavy lifting on my hobby farm, bang. In Nov 11 I had a terrible feeling of pressure and pain and over a period of time, the same symptoms and a few days later, I was having bouts of reflux again. I managed to get in for a scope with the same surgeon who told me that everything is normal except for there being an increase in my LES of approx 4mm. The reflux has gone but the other symptoms persist, and a ultrasound shows that my common bile duct has dilated some more. I gather when my surgeon gets back from holiday, he may investergate this(as ultrasound was ordered by my GP and viewed by surgeons colleague)but my other concern is, that I felt something when lfting, and as a hiatus was missed by an endoscope and a Professor, what's to say it hasn't been missed again. I have a gnawing pain below my sternum, breathing problems and bloating still and it is difficult to where a bra. Has anyone here ever had a wrap herniation, or problems with a hernia being spotted with an endoscope? My surgeon appoint is on the 12/3 which is an long wait again, as this has been going on since November. I ask my GP for a barium swallow meal, but she bluntly refused.

socrfred
New Member


Date Joined Mar 2013
Total Posts : 1
   Posted 3/7/2013 2:58 PM (GMT -6)   
I had my Nissen in 2006, it was an open procedure so I was cut "from stem to stern". After the surgery I lost a great deal of weight which may sound like a good thing, but the rapid weight losscaused me to develope gall stones which lead to another surgery. The relief that I had was minimul but welcomed. You would be surprised to learn how much you miss burping when you have difficulty doing it. Now I have developed another hiatal hernia as well as hernias at the site of the incision from the previous surgery. Why am I posting this you might ask? The reason is for those of you who are waiting for this surgery to think and talk seriously to your doctor before deciding to go through with the surgery. Make sure that your symptoms are not just a nuisance to you but a threat to your health. That is where I am at now. The nissen must be re-done and I must have a major, all day long surgery to fix what has already been fixed. This is my story and I thought I should share it to perhaps help someone make a more informed decision
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