Really need some reassurance - heartburn 6 days post Nissen

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badbrewin
Regular Member


Date Joined Jan 2008
Total Posts : 24
   Posted 11/28/2011 10:30 PM (GMT -6)   
Ok, so I've read some posts on how the wrap may need weeks / months to heal properly. I had the Nissen done 6 days ago and the heartburn and hoarseness resurfaced at about 3 days post op...very depressing to say the least.

Can some other members please tell me what your short and mid term post Nissen experience has been like? Did you perhaps get some early heartburn which then subsided over time? The objective for me was to get off the Nexium because I swear it was killing me slowly (healthy 41 y/o with joint pain and recurring anemia) and I do not want to go back to taking it. I don't see the surgeon for another 2 weeks, but any chance he puts me back on it temporarily until we gauge the progression?

Perhaps someone can also explain the mechanics of the wrap. If there is currently localized swelling and swallowing is difficult in the early going, I just don't understand how the acid can get through. What changes mechanically over time as the wrap heals?

Thanks for looking and comments much appreciated.

Tony

Post Edited (badbrewin) : 11/28/2011 8:36:09 PM (GMT-7)


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 11/28/2011 10:52 PM (GMT -6)   
Hi Tony,
Don't worry!  Early reflux is definitely a common problem.  Many surgeons automatically keep their patients on PPIs during the early weeks to protect their healing wraps, and to avoid the problems you're describing.
 
The thing is...your wrap is swollen now.  Your stomach was pulled, stretched, wrapped, and stitched...it's major surgery.  This trauma causes swelling, and because of this the wrap may be misshapen, and can allow some reflux to slip by.
 
At the same time, that swelling can make it difficult to swallow. 
 
My surgeon told me that "anything was possible in the early stages of healing," when I asked him about the possibility that I was having reflux.  I had called him in fear that my surgery had failed.
 
Believe me, my lungs were in terrible shape for many years, I was on high doses of steroids before, during, and after the surgery, and was coughing severely.  I was very fearful that I'd gone through the procedure for nothing.  My lungs never improved for two and a half months. 
 
It's not easy to be where you are.  You're struggling with the normal post-op issues of eating, and when you're still feeling the reflux you had the surgery to alleviate, it's frightening.  I understand.  Believe me, I've been there.
 
I do think your surgeon would put you back on PPI's for a while...just until your wrap has some time to heal and reduce swelling.  He would not want you suffering and worrying!
 
I hope my attempt to explain what's going on is helpful.  If you have any additional questions, or something is unclear, ask away!
Hang in there.  It'll get better!
Denise
 
 

badbrewin
Regular Member


Date Joined Jan 2008
Total Posts : 24
   Posted 11/28/2011 11:04 PM (GMT -6)   
Hey Denise,

Thanks for the quick reply. Sorry to hear about your lung problems and I know it's tough as I've had my share of wheezing and with the ensuing hoarseness causing me to cough small amounts of sticky mucus.

In your case, are you saying the gerd subsided within 2-2 1/2 months? How are you today and are you OK now?

Best

kyheart
Veteran Member


Date Joined Apr 2011
Total Posts : 513
   Posted 11/28/2011 11:14 PM (GMT -6)   
TONY
Welcome to the wrapped club... and don't be upset about what you are experiencing.. your wrap will swell for about the first 14-15 days and your feeling of heartburn is most probably your esophagus sending you incorrect signals. The esophagus is a "dumb" organ and it sends the message that any pain you feel there is 'heartburn". As far as the Nexium goes, some Drs. don't take their patients off of the PPI as soon as they have had the surgery, others do.
If you feel you need them call your dr and tell him your concerns. whenever you are concerned about anything, if you feel you need to... call your doctor... but you can always come here and ask questions of us about anything....
I am 8 months post Nissen and I am doing quite well.. I did go off PPI's immediately but, I am told and have read that this is not necessarily the way to go. Each of us deals with this thing called recovery in a different way. In early days the wrap can be swollen in different amounts and different places (analogy: like a warped record) and it is possible for it to allow reflux while swollen.. but as I said, it could also be the esophagus sending wrong information.... I have only my experience to speak from.. Please feel free to come here and ask as many questions as you like, the members here at the forum are a family and we will support you in your recovery and we are happy to help you in any way we can..
Believe me, you will be hearing from many more here shortly.. you will receive a wealth of information and suggestions.. please try to flow with your recovery and do not try to hurry it.. if you have not been given any direction on diet, please go slowly and try to stay on soft/liquid type foods that can be chewed to a liquid until the wrap stops swelling..

Please stay with us and come to us for answers..
Reach for the Sunshine... Rainbows will follow
Sandi

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 11/28/2011 11:23 PM (GMT -6)   
Tony,
My reflux was an on and off issue throughout my healing.  It often seemed to follow an eating issue...a noodle  or pill getting stuck, etc. 
 
I think you would do well to get back on your PPI's until you're further into the healing process.  I know you don't like the symptoms, but if you can get through this rough spot without worrying about reflux symptoms, you will find your recovery easier.  
 
Hang in there...you're at the very, very beginning of recovery!
It will get better...promise!
Denise 

badbrewin
Regular Member


Date Joined Jan 2008
Total Posts : 24
   Posted 11/28/2011 11:24 PM (GMT -6)   
Thanks Sandi. This is the type of reassurance I was hoping for and thanks for having taken the time. It freaked me out when I first felt the heartburn a few days back since it only resurfaced following meals (despite them being mostly liquid), so I was obviously concerned.

I will definitely get in touch with the surgeon tomorrow to ask whether I should continue with the Nexium, but I'm also wondering how difficult it may be to get a sizable medication like that down a more narrow stricture. I was hoping to be done with the Nexium, but if it will be for a couple more weeks, then so it will be.

Will gladly welcome anyone else's similar first hand experience.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 11/28/2011 11:41 PM (GMT -6)   
Tony,
The PPI I have taken is Protonix 40mg, which is a very small, bullet shaped pill, and is easy to swallow.  If the Nexium works better for you, you could open the capsule and put it into applesauce.  Don't chew, but swallow a little at a time.
 
I'm sure your doc will have a solution for you.
 
Have you considered the possibility that the "reflux" you're experiencing is actually a refluxing of what is being stopped at the wrap site?  Food/liquids that sit there can actually ferment and become acidy.
 
That is also a very likely possibility.  In that case, of course, PPI's wouldn't do a thing to help.  That might be how you can differentiate the problem.
 
Good luck getting to the bottom of the problem!
Denise 

Jesper A
Regular Member


Date Joined Nov 2011
Total Posts : 131
   Posted 11/29/2011 2:14 AM (GMT -6)   
Hi Tony.
I am 22 days post op and @ my day 4 I felt the reflux too. When I called the doctor he said that I should get back on the PPI's for at least two weeks and only then slowly lowering the doze.

I can still feel my throat is irritated but I also think it is slowly (very slowly) getting better.

J

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 12/10/2011 4:42 PM (GMT -6)   
stay on ppis and do not be surprised if u need them for life.  after my surgery the doc told me to stop 2 ppis a day cold turkey.  that is bad.  fundo is not perfect.  the problem is is is designed for u to reflux at a normal rate it does not stop it totally.  so if u have lpr there is a chance it will just make it so you get no better or no worse.  the smallest amount of reflux causes atypical symptoms that is something the docs. dont understand and it is why lpr ifs lifelong.  all you can do is take the stupid pills eat the best you can and try your best to ignore it. i clear my throat hundreds of times a day and have had fundo and take 2 to 4 ppis a day.  i am a bit of a sour grape because i tell people to plan for the worst and hope for the best.  research shows even 2 ppis a day dont suppress all acid.  so fundo and ppis still leave some acid which is just enough to cause throat clearing hoarseness.  i just found a gi doc who stated this and said most ents and gis dont get that even a small amt of acid get us lpr sufferers.  i take carafate before i go to bed too.  just stay busy and know it waxes and wanes.  its just our life.  its up and down and while most might not like me saying it its true.  i asked my gi doc(new one) if lpr is ever cured and he said no,,u just cope

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 12/10/2011 6:35 PM (GMT -6)   
Joe,
Like you, I am very sensitive to ANY acid that manages to escape.  On top of that I have a reactive stomach, which needs calming down.  I agree that people who have LPR/fundo are more likely to need continued PPIs.  Your doctor is so right that a little acid can still reflux even with the surgery, and most surgeons are happy if they get the reflux to "within normal range"--obviously  not good enough for people who are super sensitive.  My asthma doc says that most GI docs aren't aware that a very little amount of acid can create big problems in the lungs.  That was the most serious of my problems post-Nissen.
 
My PCP has me continue on PPIs even though I've had surgery, to ensure that my lungs are protected.  I can say this; the surgery was enough to FINALLY clear up my lungs.  If I have to take PPIs the rest of my life, I'll gladly do that.  Before I had the surgery no amount of PPIs (40mg Protonix before breakfast and dinner) augmented by Zantac (300mg AM and 300mg PM) was enough to stop my horrible, debilitating asthma.
 
This is the reason that GI docs and surgeons are hesitant to do surgery on LPR cases.  There's no way to stop every bit of acid from possibly refluxing without making the wrap so tight that it would be impossible to swallow.
 
I feel that the inconvenience of the wrap/PPI issue is a small one to pay for healthy lungs.  Obviously though the wrap isn't perfect, I'm much healthier than I was before the surgery.  For that reason I can say I'm happy with the results.  My symptoms are not as clearcut, since I have severe allergies as well.  I can say unequivocally that my lungs are 100% better than they were, so I'm happy.
 
Sorry you're feeling frustrated.  I understand.  Actually I didn't know if the surgery would even help my lungs.  I was just out of options and need to at least try.
 
I hope things improve for you soon.
Denise

Post Edited (dencha) : 12/10/2011 4:41:09 PM (GMT-7)

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