Another Nissen Story - 8/24/11

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randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 8/28/2011 1:57 AM (GMT -6)   
Hello all,

I've never posted here but I just got a laparoscopic Nissen fundoplication on 8/24 and figured I would share my experiences of the recovery so people like me can learn about their options. I'll start from the beginning.

I'm 22, younger than most here it seems! I first noticed symptoms of GERD probably 3 years ago. It started as a mysterious pain in my left breast. I was worried about my heart until I noticed that the pain corresponded to digestion. Before I knew it the pain had mostly moved up and to the center of my chest, and felt unlike any pain I had felt before. I learned what heartburn was, and found that most people managed it quite easily. I bought a 14-day course of omeprazole, and felt pretty good for the four months I was told it would work for. Symptoms started to come back, I took another 14-day course, and didn't have quite the same luck.

It was such a gradual transition, but before I knew it, I was having heartburn and other GERD symptoms all day every day. I started various PPIs and H2 blockers daily, twice daily, nothing seemed to have any effect. I massively restricted my diet but still suffered. I had found a few trigger foods (like soda), but by and large my symptoms did not correlate to what I ate (nor did they correlate to what popular literature will tell you causes heartburn). I got an endoscopy this past March and the doctor found severe inflammation at the esophageal junction as well as a hiatal hernia. Thankfully the biopsies showed nothing serious. He changed my meds to a new PPI/H2 combo and told me to come back in six weeks.

Well as I expected the new meds changed nothing, so he referred me to an expert laparoscopic surgeon who he told me could perform the Nissen. Based on my hiatal hernia, severe inflammation, and lack of response to medical intervention, the surgeon was happy to take my case, but wanted to perform some more tests. He asked that I discontinue all of my meds in order to get proper test results. I was fearful, knowing about the dreaded PPI withdrawal reflux that is said to occur. Luckily, I never got it--in fact, I felt a little bit better than usual, and was starting to question whether I should really be trying to get such a major surgery. But then I thought about how I still needed to chug Maalox to get through the day, and that the possibility of esophageal cancer would be hanging over me the rest of my life if I didn't do anything, and my confidence was restored.

I got an esophageal motility test, which determined that I had an incompetent LES. My surgeon described it as "brakes without brake pads." I got the 24-hour pH test, unfortunately on a rather good day and didn't quite meet the threshold score. This disappointed my surgeon; however, I still had a massive number of incidents of reflux over the 24 hours, even if they weren't very long. I had a video esophagram (barium swallow) as well, I guess to confirm that my swallowing was good enough to undergo surgery.

Due to the non-positive 24-hour pH, my surgeon said that he wanted me to be very confident that I understood all about the risks and benefits and still desired the surgery, and to know that I could continue with meds for another year or two as an alternative. My heart sank, thinking about my misery over the last couple of years, so I told him I was going to go for it. I got a call the next Monday from his office, they told me they had a date three weeks away. It was a bit scary hearing that it would be that close, but I had already done plenty of research and had been mentally preparing myself for a long recovery (although hoping it will be much shorter).

Well 8/24 was the day. The surgeon was two hours away, and my surgery was scheduled for 7:30am, so I had to leave at about 3am to get there in time for all of the prep. I ended up getting just 45 minutes of sleep. It all felt a bit surreal. I had been dealing with GERD day by day for so long (well of course 3 years is nothing compared to some of the people here), and now I felt like time had fast-forwarded me into this surgery. I got into my hospital gown, got IVed, kissed my girlfriend goodbye and then the drugs time travelled me about six hours.

I woke up in my hospital room feeling groggy and with a killer pain in my neck and shoulders. That day was a bit of a blur. They kept me just on IV fluids, no liquids to drink yet. I had mild pain and soreness in my abs behind the incisions but my neck was much worse, although the morphine controlled it well. They kept asking me to rate my pain on a 1-10 scale and I don't think it ever went above a 4 or 5, although I'm not sure the nurses believed that because they kept telling me I didn't need to act brave for them. My throat also got pretty sore. The anesthesia didn't leave me with any nausea. I thought that the morphine made me a bit nauseous once and asked for something like Zofran, but in retrospect it was probably just extreme hunger. I amazed myself with the amounts and frequency of my urinations, and it was annoying having to disconnect my calf squeezers and get out of bed every time to stand up and actually pee, but it made me be a bit more mobile so I suppose it was a good thing.

The night went pretty okay as well. I slept in fits, then would wake up and be unable to get comfortable for an hour or more. It was always a bit easier to fall asleep after my next dose of morphine, but I was restricted in how often I was allowed to get it. The nurses and doctors were pleased with my recovery though and I got my first clear liquids meal the next morning. I made sure to eat very slowly and certainly did not finish the tray, but it was nice to even get some water for the first time in 36 hours. Swallowing was no trouble, and I even made a few (small) burps. I watched some cheesy morning TV, eventually got my clear liquids meal, and my first dose of a liquid painkiller for which I would be getting a prescription. By early afternoon, they saw that I had tolerated liquid foods and liquid medicine and decided I was ready to be discharged! My surgeon came by and told me that everything had gone great, I was a textbook case, and that he did the surgery in under an hour (both nissen and hiatal hernia repair). He told me I could progress straight to full liquids, and in three days I could start adding soft foods. These timetables seem a bit fast to me so I'm going to be a bit more conservative I think.

My girlfriend took me to a nearby hotel (we didn't want to be 2 hours away for my first night out of the hospital), and I got to say hello to my puppy! He's not even 4 months old so I think he was a bit confused about being brought to a hotel and acted out a bit, but he was still able to warm my heart. I was moving pretty slowly but I felt pretty capable, stairs were no trouble. I had some juice and jello, as well as Gas-X to try to move the gas along through my system. I fell asleep around midnight, woke up at 6am thinking I felt nauseous, but then I realized it was just pressure from the gas, and I sat up until a bit of it passed. I managed to get a bit more shut eye and then we all drove back home.

Since being home I've been having juice, jello, broth, milk (soy and cow's), Ensure, and even some vanilla ice cream. I tried cream of wheat but I found it too bland to force down really. Everything's gone down well so far. I've been careful not to do too much in one sitting. Occasionally when in the past I would have burped, I'll do something involuntary reminiscent of a hiccup, and that does hurt a bit. I've noticed some sensation now and then down in my throat that reminds me much of heartburn; however, I am not concerned, as people here like to call the esophagus a dumb organ in terms of pain. I'm sure right now it has plenty of non-heartburn pain to report!

I've been fairly active (having a puppy kind of forces that). I've made sure not to lift objects over 5 pounds but it's likely I've exerted that much force in other ways, so I have to make sure to be more careful about that. My incisions don't hurt really unless I touch them, and even then not so much. One of them looks a bit gross with some red stuff and bruising around it, but it's not getting worse and I've made sure I don't have a fever, so I don't think that it's infected. If it still looks like this in a couple days I might ask for some antibiotics. I still haven't gone number two yet, I suppose due to the pain meds (which I'm weaning myself off of), hopefully the stool softeners kick in soon.

All in all, it seems like I'm doing quite well compared to some cases, so hopefully it all continues this way. Even though I haven't made it fully around the bend yet, I'm optimistic and I hope my story encourages other people out there that there are options when PPIs do nothing. Don't resign yourself to a life of GERD!

I'll try to keep this updated if people are interested.

Post Edited (randybobandy) : 8/28/2011 12:48:15 PM (GMT-6)


aeshleyrose
Veteran Member


Date Joined Jul 2011
Total Posts : 656
   Posted 8/28/2011 2:46 AM (GMT -6)   
Hey RandyBobAndy,

What a great story, and so encouraging. For sure keep us updated.

Also, how is the heartburn now? Are you feeling it a little, or not at all? My main problem (that you might commiserate with) is chest pressure when I'm on the Nexium... just super-uncomfortable chest pressure. Did you have that before, and how does it feel now?

Hang in there buddy! It sounds like you're having a pretty good recovery, I couldn't be happier for you.

Take it easy,
Ashley

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 8/28/2011 12:53 PM (GMT -6)   
Most everything I ate would cause chest pressure, for which I would drink Maalox so I could burp it out. I'm feeling chest pressure now, but I think that's just gas from the surgery and unfortunately it has to leave on the other side, which takes a bit longer. I feel mild heartburn occasionally as well but I'm not convinced it's actually heartburn, since my esophagus is surely swelling swelling swelling.

The incisions are already looking less gross, and I finally had my first BM! Now I just gotta stop watching TV and get back to working. Being self-employed is nice but it also means I don't get paid for sick days :/

kyheart
Veteran Member


Date Joined Apr 2011
Total Posts : 515
   Posted 8/28/2011 1:11 PM (GMT -6)   
RandyBobAndy

Welcome to the wrapped club....yeah turn yeah turn

Please stay with us and let us know how you are doing and if you have questions about what is happening, ask us, we have all been there.. Most importantly, if you have read any of the posts here, your wrap will be swelling up to the 14-15 day.. at that time it will start to go down.. if you have issues please feel free to ask if this is normal, as I said most all of us have been through it.

Please also, listen to what your body tells you when it comes to everything!!! If you do/eat something that you shouldn't have, your body will let you know right away. Do not brush this knowledge off.. Listen to what your body tells you!! Your recovery will go very smooth for you. If you are curious as to what foods you should introduce and when, ask here, most of us have experienced it and will be happy to share our experience and knowledge with you.

Reach for the Sunshine.. Rainbows will follow.. cool
Sandi

Post Edited (kyheart) : 8/28/2011 12:15:24 PM (GMT-6)


couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/28/2011 5:09 PM (GMT -6)   
Welcome fellow Wrapper!
Sounds like you're doing fine. Those hiccups are a killer though! Holding a small pillow on your belly eases the pains during them.
Joy

Darryl
Regular Member


Date Joined Aug 2011
Total Posts : 100
   Posted 8/29/2011 9:05 AM (GMT 0)   
Howzit Randy,

Thanks for your post. It really helps me put in perspective what I might be going through ten days from now. TG yours went well, and I hope that mine may emulate yours! Your post is very encouraging for people like myself (and thousands of others I'm sure) that are sitting on the anticipation side of the surgery. If you read my post about the 21 day countdown, you will see that some of us are a little apprehensive about what to expect.

Hope you have a good recovery!

Darryl

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 8/29/2011 11:20 AM (GMT -6)   
Thanks everyone for the support!

Things are still going well, although I wish that these Ensures weren't so sickly sweet. It's the protein I want, not the sugar!

I couldn't resist a guilty pleasure yesterday, and I had a big delicious lime popsicle. Unfortunately it made me feel a bit refluxy, so I guess my tummy wasn't ready for something that acidic yet. It was still totally worth it though :)

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/29/2011 11:22 AM (GMT -6)   
Try muscle milk, randy. It's high in protein and low in sugar.
Joy

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/29/2011 11:29 AM (GMT -6)   
Does muscle milk have actual milk in it?

Rita
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/29/2011 11:30 AM (GMT -6)   
No, it's lactose free. I believe it's soy based.
Joy

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/29/2011 11:51 AM (GMT -6)   
Thanks!
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 8/30/2011 12:58 AM (GMT -6)   
Thanks for the advice couchtater. FYI, looking at the ingredients, it appears to be whey-based, not soy. Although it is still lactose-free.

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/30/2011 8:10 AM (GMT -6)   
Hubby went to Wal Mart yesterday for soy shakes and they were totally out of them. Must be a lot of folks out there looking for non-dairy energy drinks.

I can't have chocolate, the strawberry tastes fake and that leaves vanilla if I can find them.

R.
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

aeshleyrose
Veteran Member


Date Joined Jul 2011
Total Posts : 656
   Posted 8/30/2011 8:40 AM (GMT -6)   
I used to drink Vanilla Muscle Milk just as a supplement, and the Vanilla is deeee-licious!

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/30/2011 8:48 AM (GMT -6)   
Someone else mentioned Muscle Milk yesterday. Is it dairy-free and can you get it in the States?
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/30/2011 5:57 PM (GMT -6)   
Yes, it's very easy to find in grocery stores, pharmacies, and super stores.
Joy

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/30/2011 6:14 PM (GMT -6)   
I looked at their link and there really are a lot of varieties.
Which one do most post-NF patients tend to use if you happen to know.

Thanks
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/30/2011 6:19 PM (GMT -6)   
I drank the high protein kind during my recovery.
I drink the diet kind now, when I can find it in the stores.
Joy

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 8/30/2011 6:23 PM (GMT -6)   
Thanks, Joy. I'll go get some tomorrow. I'm worn out today. I also think I'm undernourished since I'm not eating very much at all.
Falling down is part of life, getting back up is living. -Unknown

Lap Nissen Fundoplication August 1, 2011

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 9/1/2011 11:26 PM (GMT -6)   
How are you randy?
I know it still to early to ask,
but are i am really curious about your condition? did the you still suffer from heart burn. chest pain, lump in the throat ect things after the surgery?
like your condition, mine also not getting better with PPI or other meds

i am planning getting my PH test & manometry soon..

best wishes for you

Ahn

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 9/1/2011 11:26 PM (GMT -6)   
How are you randy?
I know it still to early to ask,
but are i am really curious about your condition? did the you still suffer from heart burn. chest pain, lump in the throat ect things after the surgery?
like your condition, mine also not getting better with PPI or other meds

i am planning getting my PH test & manometry soon..

best wishes for you

Ahn

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 9/2/2011 12:42 AM (GMT -6)   
I feel that I am doing well. My diet is about half liquids and half soft foods, and most things I seem to tolerate well. Some foods have still bothered me, including a lime popcicle, and applesauce (seems strange but it always set my heartburn going), as well as a protein powder that I blended with milk (I think there must have been too many teeny air bubbles). Today I had lots of spanish rice, some cheesy scalloped potatoes, vienna sausages, and even some well-chewed tortellini and it all went down great!

When I do get pain at the base of my throat now, I'm not convinced it's heartburn. It feels sore in a way a bit unlike heartburn, so I am hoping it is just the swelling of the wrap. Everyone says that swelling peaks at day 14 or 15, so I just gotta be patient and optimistic.

I count myself lucky that I'm not dealing with any nausea or difficulty swallowing, and I only have a little bit of fatigue. Today I went hiking with my puppy (his first hike!) so I think I'm doing well. My incisions are getting really itchy. It takes all my willpower not to scratch all the scabs off :P

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 9/2/2011 1:01 PM (GMT -6)   
I've been having some weird pain in my throat the past 36 hours. I looked back there this morning and there's a nasty canker sore right next to my uvula! Well at least that means it isn't reflux.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/2/2011 10:45 PM (GMT -6)   
Hi randybobandy,
 
Glad you found out what was causing the pain.  I just wanted to stop by and remind you that the esophagus interprets all pain the same, so your brain registers "heartburn" even when you've got swelling or surgical pain.
 
Also, you're coming up on two weeks and reaching peak swelling.  If you have some discomfort or pain when swallowing it won't be surprising.  Once you pass that milestone, things start calming down, the swelling decreases, and the healing continues.
 
Happy Healing! yeah
Denise
 

randybobandy
Regular Member


Date Joined Aug 2011
Total Posts : 24
   Posted 9/5/2011 3:45 AM (GMT -6)   
Thanks dencha, it's very helpful to consider that every time I get some pain.

I can't believe I'm already on the 12th day of recovery! I continue to do quite well. I've found that I am absolutely useless in the mornings, but after forcing myself to drink an Ensure I can usually get my brain to turn on and stop being a zombie. Diet is much the same, in a day I usually have an Ensure, a protein shake, and some carrot soup, flavored rice, cheesy potatoes, and jello. It's getting old, I gotta think of some new things to eat now. My wrap often feels sore in the evenings, and I usually take a single dose of my liquid pain medicine each night, but I only have one dose left so hopefully it won't bother me too much in the future.

I took my puppy to the dog park for the first time today, it was so much fun watching him able to romp around with other dogs off leash for the first time.

On the other hand, I am very quickly coming down with a nasty cold right now. My throat feels awful and I can feel my whole system starting to clog up. Colds always hit me worse than most people so I can tell I'm in for a fun week ahead. Ugh
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