Too tight of a nissan wrap

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lexilu
New Member


Date Joined Jul 2011
Total Posts : 12
   Posted 7/27/2011 8:53 PM (GMT -6)   
Hi Everyone,
I am 8 weeks post op. 1 weeks post op I ended up in the hospital for another 8 days since I could not keep anything down, after tests It was determined I have dsyphagia and had the  esophagus dilated. I am still unable to eat anything that is not liquid or mashed well and only about 3 tablespoons at a time.  I am taking zofran,bentyl and pain medication, the spasms, belching and nauseau are horrid. The surgeon keeps telling me I need to be patient and it will take 6 months before I see good results.
Does anyone have any ideas to control the belching and spasms?
 
It has been suggested that it might be to tight, anyone experienced having to have it loosened up?
 
Does anyone have a Surgeon in the greater phoenix area?
Susan

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 7/27/2011 9:53 PM (GMT -6)   
Hi Lexilu,

It sure sounds as if your wrap is too tight. At eight weeks, it's common to still need to move back and forth between easier, softer foods, and more normal diet, taking tiny bites and chew, chew, chew. Gradually over the first four months,though, you should be moving toward less difficulty eating.

I believe it is totally unrealistic of your surgeon to expect that your swallowing won't improve for 6 months. That is definitely not typical. Yes, you will need to eat more carefully, but you should expect to be able to eat more than liquids or soft foods at this point.

That said, everyone is different, but it's still hard to believe that it isn't too tight.

Hopefully somebody will be by who has experience with this particular issue.
Good luck, Lexilu. Hopefully things will continue to get better.

I assume you aren't drinking from a straw, or having carbonated beverages. I was also told that I shouldn't talk when eating, as it would cause me to swallow more air.

I am sorry you're struggling like this. Hope things turn around soon.
Denise

lexilu
New Member


Date Joined Jul 2011
Total Posts : 12
   Posted 7/27/2011 10:46 PM (GMT -6)   
thanks Denise no I don't have any carbonated beverages or drink thru a straw. As a matter of fact I use a spoon for most liquids or take very small sips at a time if the liquid is thin enough.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/27/2011 11:00 PM (GMT -6)   
I agree it seems to be too tight. I had a similar issue with my first nissen and yes you have to wait a couple months before you have it dilated. If you do it too soon you have a much higher risk of blowing the wrap apart. That is where I stand right now and looking to get #3 soon. Mine has been ruined by a stent while my esophagus was healing from a tear. Mine was just about perfect too. I did develop a stricture, but it was higher up my esophagus, and had it dilated. Had a second scope a couple weeks later to recheck it and that's when my esophagus tore.
Something that might help is warm liquids to help relax the wrap a bit and may help with the spasms too.

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

lexilu
New Member


Date Joined Jul 2011
Total Posts : 12
   Posted 7/28/2011 10:23 AM (GMT -6)   
they are thinking that I might need to have the wrap itself loosened, the esophagus is not constricted, the thought is that the esophagus does not have the motilty to move the food thru the wrap.

am I correct in that the dilation is done to open the esophagus not the wrap?

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/28/2011 11:12 AM (GMT -6)   
They can dilate the wrap also. I had my first one dilated twice. Once at 8 week and again at 12 weeks. That is why they have to wait so the wrap has had a chance for osmosis(sp) where the ends are healed, and there is less chance to blow it apart.

Sometimes they will loosen up an their own after the swelling goes down and been in use a while. You said they think you have motility issues? Didn't they test for this before your surgery? they should have so they know what wrap to go with. If you have some motility issues they usually do a partial wrap vs. a 360 degree wrap. There is a 270 degree and a 180 degree that they can use.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 soon I hope

lexilu
New Member


Date Joined Jul 2011
Total Posts : 12
   Posted 7/28/2011 3:57 PM (GMT -6)   
They were unable to due the motility test, I have vocal cord dysfuntion due to a toxic inhalation accident 18years ago and when they went to due the test my vocal cords shut down and I could not get air, therefore it was never completed.

I was not aware that they could do different degree's of wrap and dilate the wrap. The surgeon tells me he would need to cut the suture to loosen the wrap.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/28/2011 5:51 PM (GMT -6)   
Sorry they couldn't test it before hand. It is probably the most important test to determine which wrap to do. If you know ahead of time about motility issues they also could have done what's called a "loose" wrap. I don't have motility issues, but my surgeon has a lot of success with it stopping reflux and yet loose enough to let food through without much dysphagia. I had my first one dilated probably 3 times before it was comfortable, but since mine was done wrong it eventually had to be redone.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 soon I hope

Digidawinwa
Regular Member


Date Joined Nov 2009
Total Posts : 23
   Posted 7/29/2011 12:11 PM (GMT -6)   
I was 8 wks post op day before yest... I have wondered if my wrap was too loose... until I get to forgetting to chew and swallow something a bit too large and it sticks... have been eating just about everything since around two wks after surgery.  I just have to remember to chew and chew and chew!!  My surgeon did tell me that he has only had ONE person that he had to go back and loosen up the wrap... he does a LOT of Nissens.... I hope you get some relief soon.
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