Post Nissen Fundo day 10 had choking episode

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jen830
New Member


Date Joined Aug 2011
Total Posts : 15
   Posted 9/19/2011 10:08 PM (GMT -6)   
Hi Everyone,  My name is Jenny.  had lap nissen fundo on Friday Sept. 9th.  Week One recovery went very well - incisions healing well, not in too much pain, stopped pain meds after day 4 or 5, able to drink my liquids.  I even started back walking and feeling really good.
 
Week 2 has been different story.  Severe gas/cramping/diarrhea started around day 5-9.  (Meds are reglan q 6 hrs, and pepsid 2x/day)
Aweful IBS like symptoms after full liquid diet and especially at night.  Today has been much better thank God.
 
Last night I had a very scary episode.  I ate about 4 or 5 ounces of plain yogurt with pureed fruit, then took one bite of a pancake and literally thought I was going to die.  I obviously should not have eaten that one bite as I was ordered to remain on clear/full liquids for another 2 weeks.
My esophogus started to painfully spasm and I had this feeling that I was either going to have to vomit the food up or choke.  It was so scary, I am terrified to try to eat ever again.  Unfortunately and fortunately I did vomit, mostly phlegm and that bite of pancake that I did not chew before swallowing.  I certainly know now that small bites and lotts of chewing is what I will be doing in the future.  Is this what happens when solid foods are eaten?  How long before I will be ever to enjoy a regular meal with my family?  Please understand, I am grateful I had the surgery due to a LARGE hiatal hernia with severe reflux and barretts esophagus, but I have had moments of feeling so depressed that I will never be able to eat normally again.  I have lost 23 lbs. (10 intentionally prior to surgery), and I could stand to lose another 20 lbs.  thats been the upside of this whole deal and I am absolutely elated that I can sleep flat on my back or roll over on my tummy again.  I immediately started sleeping better which is truly wonderful. However, this whole choking gagging food getting stuck thing scares me.  It seems like my swallowing feels differently also.  I am in the medical profession and begain reading all of your wonderful blogs about a month before my surgery, but I just wasn't personally prepared for this aspect of the operation.  How can I deal with this in the future, any suggestions?  I know that I must chew chew chew chew chew my food when and if (haha) I ever try to eat again.  I also know that perhaps it will take me longer to eat solids.  After that episode, I will wait as long as I am told by my surgeon, I see him in 1 week. 
jenny

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted Yesterday 2:09 AM (GMT -6)   
Jenny-
What you experienced is actually comparable to a cat getting rid of a hairball. If the food won't go through the wrap your esophagus will fill up and purge itself. Not truly vomiting. In time you will learn to tell when something gets stuck and you must relax and drink something to push it through or purge it. I had this happen a lot with my first nissen, but with my 2nd and now 3rd I have learned to feel the signs when something is getting stuck and now that I have learned to relax and not panic and use water to push it through, also it helps to make sure you have very good posture. The straighter things line up the easier it will go through. Sometimes drinking a warm liquid prior to eating will help relax things too.
Remember things will swell into the 2 to 3 week mark and then things will be easier to eat.

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

jen830
New Member


Date Joined Aug 2011
Total Posts : 15
   Posted Yesterday 9:10 AM (GMT -6)   
Thank you so much Bill. your hairball analogy was right on. I will be very careful in my future attempts to eat and follow your advice exactly. thank you so much. Another question. I have noticed after reading these boards that often this surgery needs to be repeated. Is this common and what happens to make a repeat surgery necessary? I guess I must accept the fact that I will become good friends with my surgeon...who happens to be wonderful. I will try to get a sense of humor about it instead of feeling depressed about the whole thing.

jenny

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted Yesterday 3:52 PM (GMT -6)   
Jenny-
for me I had an inexperienced surgeon the first time and it was done wrong, took almost 3 years to figure it out. My 2nd was perfect for 2 years and during a follow up EGD for baretts they tore my esophagus and what they did to repair it destroyed my wrap. that surgery was on March first and got my nissen redone on8/24. My belief is some people don't get the proper testing before having this surgery or have inexperienced surgeons as I did.
As long as you have all the tests and they show you are a good candidate for the surgery and have a good surgeon all should go great.

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

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted Yesterday 5:51 PM (GMT -6)   
It's my understanding if you had all the proper testing and a great surgeon it will take years before you need it fixed again. I know one person who's wrap lasted 20 years.
Joy

Gritty
Regular Member


Date Joined Mar 2011
Total Posts : 82
   Posted Yesterday 6:56 PM (GMT -6)   
I had my first big choke on a piece of toast a couple of weeks in. It's scary stuff but gets much easier to manage after that first one. Give it another week and try again with smaller bites and you'll see the difference. In two weeks it gets even better and within a month you could be eating fairly normally again.

Good luck!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted Yesterday 8:01 PM (GMT -6)   
Hi Jenny,
I just wrote a long response to your post complete with quotes and answers, and I lost it all! shakehead
 
First, welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah Glad you've joined us!
 
Bill's explanation of the hairball episode is exactly right.  If you have some water (no ice) or tea handy when you eat it will calm down the esophagus and help to get food through the wrap.  Pills can also get stuck and cause irritation, so be sure to drink lots of water after taking anything.
 
I'm sure your surgeon puts you on liquids to help avoid that problem.  Unfortunately surgeons don't provide a lot of information.  You need to know that your wrap becomes increasingly more swollen in the first two weeks, peaking on or about 14 days.  As that is happening, your swallowing will get more difficult, spasms are more likely, you may get things stuck,  and you may experience pain that feels like heartburn (your esophagus is a "dumb organ" and it interprets all pain the same.  Also, after a day of swallowing even just water, your wrap can get sore and tired.
 
This will improve over time.  The swelling will gradually subside, and your swallowing will get better.
 
Stay away from ice water.  It will increase spasms.
 
I was on normal food from Day 5 or 6.  My surgeon just warned me to eat only things that could be chewed to a full liquid. (no steak or bread)  I just experimented, and deposited non-chewable foods into a handy napkin.  I took tiny bites and chewed, chewed, chewed.  I had only one problem two months or so in, when I swallowed a partially chewed cherry tomato.  I was in a restaurant and only had ice water.  I had spasms and discomfort, but it went through with some work, and all was well.   I learned my lesson, though and always ordered hot tea with my meals so it would be handy if I needed it.
 
Your eating will gradually improve over time.  You will also be able to eat more normal amounts.  It is a very gradual thing, and it's hard to say exactly when you'll be eating normally.  I went on vacation at 4 months and that is a benchmark for me.  We went out to eat daily, and I was eating everything.  Still, I ate smaller bites and chewed thoroughly.
 
The majority of your healing (your insides have been through a lot...a revision of your upper GI/hernia repair) will take place in the first six months and the rest will take a year.  I continued to have more finely tuned healing into the second year.  Your outsides heal so quickly that it is deceiving.
 
Try to surrender to your recovery and follow it where it takes you.  If you struggle against it, you will have a more difficult recovery.  Just go with the flow! 
 
Again, glad you've joined us!
Happy Healing!
Denise

jen830
New Member


Date Joined Aug 2011
Total Posts : 15
   Posted Today 6:19 AM (GMT -6)   
Denise, thank you. Thanks to all of you for you help. The last few days have gone much smoother, thankfully. My entire GI tract has settled down and I am feeling much more hopeful. I have become very creative with my meals. I enjoy cooking so I decided to make myself some nice soups and so I did. melt alittle cheese or add alittle sour cream and everything is delicious. Even added few croutons to my soup and they went down just fine. Since most of you agree that swelling peaks at day 14, I will heed the warning and enjoy my soups and full liquids until well into week 3. I am on day 13 today. I see the surgeon Mon, 9/26 for my follow-up, though quite honestly I trust your advice as far as diet progression more than the surgeon. They are always in such a hurry with a waiting room full of patients. I will take my little list of questions, but continue to rely on the advice of the wonderful caring people on this forum. I am truly grateful to you all. I will focus on getting stronger everyday and just relax about the whole thing. I am on the mend and Life is Good!
Jen

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted Today 11:00 AM (GMT -6)   
Jen-
I knew a few others would pop in here soon. I know what you mean about doctors having limited time with each patient, that is why I am so thankful to have the surgeon I do. He has never been in a rush and I believe he schedules extra time for people he feels may have additional questions. Like my final visit before surgery e talked for almost 45 mins. He has an awesome bedside manner and shows up everyday when he has patients in the hospital. Even if it's just to say hi and how's things going. He came in at 6am every day I was in the hospital and changed the dressing himself each morning. But I have had an almost 4 year relationship with him and don't know if that has anything to do with it.
I just had my 4 week follow up this morning and he made sure I didn't have any type of hernia and went over how my diet was going. Made sure to ask about 6 times if there was anything else I had any questions about and if I thought of something made sure to answer it in people terms, not medical terms. He has officially released me, but told me if I have any questions at all to call right away. He even explained why I have stomach muscle pain still even though the incision isn't sore. He said he pulled the muscles a little tighter to make sure they didn't sit in the same place where I had scar tissue from my feeding tube from my esophagus repair. He prescribed flexeril to help loosen them up a bit since I get very sore sitting for long periods like car rides or when I lay on my left side.

I wish everyone had a surgeon as I do. I believe more people would go into this surgery with a lot less questions. My surgeon at Loyola who did my first redo was almost exactly the same way and never let me leave an appointment or left my room without making sure I completely understood what was going to happen or why he was doing certain things. He would stop by my room every day also even if he didn't get done with surgery until 9pm, he still stopped by. I guess I have been very lucky. Actually the surgeon who did my last one recommended I see this surgeon at loyola because he knew him well.

Enough rambling. You have any questions don't hesitate to ask. With so many of us here who have gone down this road we can be a great wealth of knowledge and love to help anyway we can.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted Today 11:04 AM (GMT -6)   
Hi Jenny,
Glad to hear that things are going better today.  It's a gradual process, but if you can relax and just go with it, you'll do just fine.  Keep a positive attitude and know that all this healing is the beginning of a better quality of life.  It's well worth the effort!
 
We're here to answer questions, share our experience, and offer support and encouragement.  I'm so glad you've found us.  Like you, I was welcomed into the forum by more experienced members when I had my Nissen, and that's why I stuck around to help others. 
 
No question is "stupid"...any little thing that worries you, or any question you have lingering in your head...just ask it!  We'll do our best to shed some light on whatever it is.
 
Take care!
Denise tongue

kyheart
Veteran Member


Date Joined Apr 2011
Total Posts : 515
   Posted Today 8:47 PM (GMT -6)   
Jenny

It is good to see that you are doing better. Denise knows what she is talking about, she and the others Bill, Kitt and Joy were so supportive and caring when I was early in my recovery.. they still are but, back then they helped me through some rough times.. Please feel free to ask any questions you may have and someone or all of us here will try to help you through this recovery time.

Relaxing into the recovery is your best bet. If you are anxious, your body will feel it and react accordingly. A positive attitude is paramount in recovering this surgery. There will be parts of the recovery that you will wish hadn't come up, but in the end you will be glad you had the procedure done.

Please stay with us here at the forum and become a part of our HealingWell family.

Reach for the Sunshine... Rainbows will follow

Sandi
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