About to be wrapped - LPR

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soppendeuff
Regular Member


Date Joined Jun 2008
Total Posts : 27
   Posted 11/29/2011 3:32 PM (GMT -6)   
My surgery is Friday and I'm strangely looking forward to it. I've been suffering from what my doctors thought was severe adult onset asthma and constant respiratory infections for over three years now. I recently stumbled upon a three year old lung CT report from when I first got sick a that mentioned a hiatal hernia. I'm pretty good with the medical stuff by now (I also have Crohn's Disease) but didn't know what it was, so I researched it and saw the symptoms of silent reflux staring back at me as a list that reflected all my troubles.

Tests showed that I have a raging case of LPR with no heartburn symptoms at all (three doctors missed this diagnosis entirely- they seemed to be perfectly okay with me suffering everyday). Having experienced enough misery, I've opted for the surgery.

I have a couple of questions, though.

For the lung complication folks - For whatever reason (bad luck?), my lungs have been REALLY tight the last few days. I don't think I'm getting sick, but it's a bit worrisome as I've been hitting the albuterol pretty hard. Is there any reason particular to this surgery that would make this extra problematic? I'd prefer to go ahead on the scheduled date.

For everyone - Can/Should I lower the head of my bed immediately after the surgery? I really don't sleep well like this and would love this concession to my illness to be well behind me. My shoulders are so sore - I am a side sleeper and my shoulders do not care for the added pressure this position puts on them.

I've read quite a bit of this forum. Lots of great tips on here for the recovery process that I know I will never get from the doctor. I believe that all your shared experiences will be a lifesaver for me. Thanks to all of you.

Leslie

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 11/29/2011 4:31 PM (GMT -6)   
Hi Leslie,
I can't write more now, but I'll be back to weigh in on your questions.  I was wrapped in February 2009 because of a horrible lung issue.  My asthma had been made uncontrollable by my GERD.
 
I definitely have some things to share and will be back soon to add more.  I just wanted to welcome you to the Healing Well forum!  Glad you've joined us.
 
Take care,
Denise

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 11/29/2011 6:25 PM (GMT -6)   
Hi Leslie --
 
I have not had the Nissen procedure, but the TIF in August.  From everything I've read about the Nissen, it does not eliminate reflux instantly in most folks, but can take a few weeks as the swelling from the surgery subsides.  This because of "puckers" and unevenness in the wrap from swelling.  Based on this, I would not sleep flat right away.
 
I understand how you feel about sleeping on an incline.  I am back sleeping on an incline myself, and it causes bad sciatica pain because my discs can't decompress during the night.  I have to religiously do traction exercise on the floor to pull my vertebrae apart, to keep myself mobile.
 
-Bruce

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 11/29/2011 6:25 PM (GMT -6)   
I was in your position two years ago.
The lung tightness will not hamper the surgery. If you're have issues the doctor will give you a treatment to help you.

I'm a side sleeper too and didn't do well with the tilted bed either. I spent five days after my surgery sleeping in my lazy-boy because it hurt to stretch out flat for me. On day five I lowered my bed and have enjoyed side sleeping ever since.
One word of warning though, the first couple of days I tried sleeping on my side was uncomfortable due to the stitches pulling some.
Joy

efit
Regular Member


Date Joined May 2011
Total Posts : 127
   Posted 11/29/2011 7:59 PM (GMT -6)   
Leslie,

Good luck on your upcoming wrap. I suffer from LPR myself so I will be eager to hear how your recovery is going. The folks on this site are a wealth of information and very kind. Did you try PPI's at all? Just curious.

Take care,
Liz

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 11/29/2011 8:19 PM (GMT -6)   
Hi Leslie,
I'm back!  I had to finish up our decorating and get the house cleaned up in preparation for tomorrow morning's arrival of our little year old grandson.  He picks everything up off the floor, so vacuuming was a must!  It'll be interesting to see how he reacts to all the decorating.
 
Anyway...first, the lung problems as they relate to the surgery;  I actually had a lung infection when I had the surgery.  It was one of those catch-22 issues.  The reflux was (presumably) causing my lung problems, and I couldn't get them healthy enough to have the surgery.  For that reason, they went forward with it.
 
I was concerned about the general anesthesia causing my asthma to take a dive.  I'd read that asthma is a risk factor for general anesthesia issues.  I have a good friend who is a nurse-anesthetist, and he set my mind at ease.  He said that they put medication into the oxygen/gas they're giving you (I assume it's albuterol), so there won't be a problem. 
 
My asthma doc ordered a nebulizer treatment the morning of my surgery--just before the procedure.  I had been on high doses of steroids for quite a while, and because of that had symptoms of adrenal insufficiency, so I was also given a boost of steroids to avoid going into shock.
 
My lung infection did not clear, although it had been treated with an antibiotic, and I was still full of mucous after the surgery.  At that point I was started on Rocephen antibiotic shots daily for a few days, as my PCP was not anxious to put any antibiotics into my upper GI tract.  (I have a very sensitive stomach, and antibiotics are one of the triggers.)
 
I was very fearful that my wrap would be ruined by my constant, severe coughing.  My husband even had to do lung PT on me, to help raise the mucous.  On top of that, my internal organs were made very fragile because of the steroids, and my surgeon told me he considered adding mesh to help support my hernia repair.  He decided against it because in his words, "mesh can cause other problems".  Instead, he put a few extra stitches in to help hold it.
 
I was nebulizing several times daily, taking high doses of oral steroids, and coughing like no other.  Still, my wrap held.  Thankfully!
 
It took two and a half months for my lungs to respond to the surgery and begin to improve.  It was amazing to me. It was May--in the midst of my usual problem time, because I have allergy induced asthma.  Even with all the pollen, my lungs THANKFULLY got better!  My PCP and asthma docs both thought the surgery would help my lungs, but my GI doc wasn't convinced.  He held up the surgery for 4 long and unhealthy years while my asthma doc and PCP wrung their hands and filled me with steroids in an attempt to keep me breathing.
 
Fast-forward two and a half years...my lungs are they best they've been in years.  I've gone from a pre-surgery inhaled steroid dose of 4 puffs 220mcg steroid inhaler twice a day (1760mcg) to   2 puffs 115mcg steroid inhaler twice a day. (460mcg).  That's what the surgery did for me!  Since I do have allergies which can affect my lungs, I still have to maintain meds.
 
My GI doc wasn't anxious to recommend surgery because my 24 hr PH monitor DeMeester score was within normal range (just a hair over 14).
My asthma doc says that's where GI docs drop the ball.  They're only concerned with large amounts of reflux that can damage the esophageal tissue, and don't realize how little acid it takes to wreak havoc on the lungs.
 
I'm not a good one to ask regarding an elevated head of the bed.  My husband also had reflux, although the bed has always been elevated due to my issues, it doesn't hurt his situation either.  He has diagnosed stenosis and has had sciatica, so there have been times when the elevated bed bothered him.  He uses pillows as positioners, and that has solved his problem.
 
I found the elevated bed helpful after the surgery, because it seemed to take pressure off the wrap and incisions.  Because my lungs are so sensitive, my asthma doc wants me to continue to be proactive, and continue some anti-reflux measure even though I have no symptoms at all.  Also, as a proactive measure, as well as the fact that I have a reactive and very sensitive stomach, I'm still take 40mg Protonix before dinner. 
 
I have always been a side sleeper my entire life.  However, since my surgery I can't sleep on my side for long periods.  I'm pretty sure that there are some adhesions that pull when I like on my side, and after a few hours I get some pain that wakes me up.  As soon as I change position I'm fine.  That's why I'm stuck sleeping on my back most of the time now.  I have never heard of anyone else with that problem.  Some, like Joy, describe that type of discomfort only during the healing stage. 
 
I don't love an elevated bed, but I'm honestly used to it, and I'm actually more comfortable for a number of reasons, including the comfort of my wrap.  Who knows...it might be related to my constant coughing post-op and how it affected the healing.  Still, it doesn't bother me to have to make that concession.  It's well worth having healthy lungs again.
 
I hope this has helped in some way.  While I have unique issues that don't relate to most people, I hope what I've written gives you some insights regarding what you might expect.
 
Good luck with your surgery!  I know how you feel.  Once I made the decision to have the surgery, I couldn't get it soon enough.  I just wanted to get it over with and begin healing.  I also was fearful that my lung condition would stop me from having the surgery.  I think that if I could go through in the condition I was in, your tightness shouldn't be a problem.
 
Best wishes!  Soon we'll be welcoming you to our Wrapped Club!
Denise

soppendeuff
Regular Member


Date Joined Jun 2008
Total Posts : 27
   Posted 11/30/2011 5:53 PM (GMT -6)   
Thanks for all the replies. What a kind group of people you are. My chest tightness decided to go away today, for which I am very grateful.

Liz: I did try the PPI's. They didn't really do much for me. But they really angered my Crohn's Disease and that's a fire my gastro doc and I know not to mess with - thus the surgery becoming the best alternative.

I am no stranger to surgery - I've had a few (hysterectomy X 2, intestinal resection, tosillectomy, septoplasty for deviated septum). I lean strongly towards being a believer in surgery. It's always helped me in the past.

Thanks again,
Leslie

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 11/30/2011 8:36 PM (GMT -6)   
Leslie,
Good luck with your surgery on Friday! 
We'll be here to yeah yeah cheer you on yeah   yeah and answer any questions you might have.  People in the forum helped us when we needed it, so we stuck around to help others.  Glad you've joined us!
Best wishes,
Denise
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