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Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 12:51 PM (GMT -6)   
Hey folks, a few weeks ago I was at the gym and doing preacher curls leaning up against the machine putting pressure on my chest while lifting, and I think I hurt my hiatal hernia. That following night I had severe esphogeal spasms, and the past few weeks all the old symptoms have returned. Including severe gerd, chest pain, loss off appetite, lack of energy bassically every symptom I had before my surgery back in 2008. I had been feeling great and acid free up until this recent damage, but despite all that it's not as bad of pain as it was the 1st time around however its still pretty bad.
 
I'm pretty sure the endoscopy will show that my wrap has became loose, of course im not 100 percent positive but sometimes when you know you know. Assuming someting terrible has happened, whats the deal with a re-do I have heard they have high failure rates and I'm wondering why that is so, and is it worth it to get another one, I would like to know what my options are. Any help would be greatly appreciated...this is terrible and im only 26.

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/14/2011 1:03 PM (GMT -6)   
Hi cmac --

Sorry to hear of your difficulties. There is a lot of help available to you on this messageboard.

If I might make a suggestion, add to your previous post. That way, others may contribute to your thread while reading what has already been offered by others, and there isn't a need to repeat important facts and/or symptoms. Plus, it keeps the messageboard a little more tidy and not so cluttered with duplicate threads.

Welcome to the group!

-Bruce

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 12/14/2011 1:29 PM (GMT -6)   
Cmac,

I answered your previous post, and I had my barium swallow xrays on Monday which turned out "negative." Next step for me is an endoscopy to see if I have esophagitis, gastritis, or any other condition caused by reflux through my "wrap" and into my esophagus. I know you said you were having barium swallow xrays too.

You might also want to suggest to your physician a 24 hour ph monitor or possibly a Bravo device implanted at the time of endoscopy to measure acid reflux events in your esophagus to see if you are actually refluxing. I've had both, and I certainly favored the 24 ph monitor over the Bravo device which stayed in my esophagus for ten days before sloughing off.

If you are leaning toward a redo, as I believe I am, I suggest you find the best surgeon around to perform it, for I understand the surgery can be difficult, and sometimes a lap nissen turns into an "open" nissen depending on what the surgeon runs into.

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 2:14 PM (GMT -6)   
The last surgeon did a good job though, it did last 3 years until I over excerted myself, and who would the best surgeon be? I live near DC so john hopkins and all of that is in reach for me, what made you draw the conclusion to get a redo??

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 2:14 PM (GMT -6)   
any idea on the failure rates?

dongar
New Member


Date Joined Dec 2011
Total Posts : 4
   Posted 12/14/2011 2:17 PM (GMT -6)   
Cmac,
I just had my redo yesterday - so can't really say if it will hold but my last 24 hr impedence testing showed 81 episodes of reflux so I definitely needed it done. In thinking about testing - Bravo only measure acid so in my case (since i was on an acid suppressor) it didn't show much - my reflux although almost continuous is non acidic. My surgeon was impressed with my impedence testing though :)

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 2:48 PM (GMT -6)   
What is impedence testing?, and I would hate to have to go through that motility test again sticking stuff down my throat, but I need this figured out quickly as possible folks. I'm suppose to begin training for U.s Customs in march, and I know this hernia is going to be a major issue if not fixed. I can't even begin to lift a weight without being in pretty bad pain, I did a ct scan which revealed nothing I guess my next step is to get an endoscope. However, I know my hernia was small before its a stealthy little bugger and hard to find.

Once they did surgery though I was feeling so much better for the past 3 years, if only I didnt push myself so hard I probably wouldnt have gotten hurt again. Is a re-do common man im scared.

donut9
New Member


Date Joined Sep 2008
Total Posts : 4
   Posted 12/14/2011 3:04 PM (GMT -6)   
cmac-if i remember correctly the impedence test is like the motility but you keep it in for 24 hours.  It's horrible but it gives the most accurate reading.  I am also contiplating a redo but keep putting it off because of these tests.  I actually think it's worse than the surgery.

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 5:53 PM (GMT -6)   
They didn't make me do that one, I was lucky they had enough evidence to do it without the 24 hour ph monitoring especially with the visible hernia. I just wish I could find out more about the re-do and if I should go to my same surgeon who did the last one.

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 12/14/2011 6:13 PM (GMT -6)   
Cmac,

First, you have to establish you are truly refluxing, and that would require an endoscopy, 24 hr ph monitoring, or implanted Bravo device. If it is determined you are refluxing to a degree causing GERD, then you would decide if you wish to undergo surgery again, or just try to live with a daily PPI medication. PPIs don't work for me, so I may go ahead with a redo after my endoscopy scheduled for the last week of December if it is revealed I have severe reflux. If you were happy with your first Nissen, I guess you could go with the same surgeon once again. Then again, I doubt you could do much better than a Johns Hopkins surgeon.

Not all hiatal hernias cause reflux. In fact it is said, "not everybody who has a hiatal hernia will have GERD, but everybody who has GERD will have a hiatal hernia"

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 7:51 PM (GMT -6)   
Yeah all I know is, it did so well for 3 years but now it seems its hurt, is it possible for only one part of the nissen to come unraveled? Or would they have to do the whole wrap?

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 12/14/2011 8:20 PM (GMT -6)   
Cmac,

There are only 3 sutures holding the fundus area of your stomach around your esophagus, and you could have possibly popped a suture or your wrap could have migrated up or down your esophagus so it is no longer wrapping the LES. There are many possibilities and only diagnostic testing will determine what your problem is.

It is my understanding during a redo, the prior wrap is taken down, the correct boughie (spacer) is put down your esophagus to the location of the LES, and then the fundus is once again wrapped around your LES and sutured in place. I'm sure this is a very simplified description of what actually happens during a redo.

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/14/2011 10:02 PM (GMT -6)   
Have you heard about higher failure rates for re-do's and why?

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 12/14/2011 11:06 PM (GMT -6)   
It is my understanding an original Nissen will last 10 years before requiring a redo, but then again, I've also read over 60% of people who have Nissens are back on Proton Pump Inhibitors not too long after their first Nissen.

It's such a fine line for the surgeon to walk. Make the Nissen too tight, and the patient has difficulty swallowing and bloating problems. Make the Nissen too loose, and the patient has continuing reflux.

To answer your question, I don't know why a Nissen Redo wouldn't also last ten years if performed by a competent surgeon.

I think you just have to be very careful, and if you discover you did damage your original Nissen while doing preacher curls.......if I were you, I'd give up on weightlifting following a redo.

I've read stories of patients damaging their Nissens by vomiting after surgery, and I read a story of a guy damaging his Nissen by drinking excessive amounts of beer shortly after surgery, so it seems anything is possible.

You're lucky you had three good years after your Nissen. From day one, I don't believe my Nissen was made tight enough, and I've had three years of discomfort.

dongar
New Member


Date Joined Dec 2011
Total Posts : 4
   Posted 12/15/2011 11:17 AM (GMT -6)   
So far so good on my redo :) Cmac I'm in Northern Va if you want the contact info on my surgeon - he does over 100 per year.

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 12/25/2011 9:32 PM (GMT -6)   
Yes my friend that would be greatly appreciated the weird part is they are having trouble pin pointing it, the one endoscopy says it seems slightly loose, the barium swallow didnt reveal any damage. On my endoscope i had done recetly my esphogaus looked pretty burnt up and mouth burns too its hard to eat, I would really like to know about that surgeon...this is pretty bad.

Cmac3721
Regular Member


Date Joined Dec 2011
Total Posts : 36
   Posted 1/19/2012 10:23 AM (GMT -6)   
hey dongar do you know the name of that doctor??

Dave234
Regular Member


Date Joined Oct 2011
Total Posts : 338
   Posted 1/20/2012 12:04 PM (GMT -6)   
dongar, can you tell me the name of your surgeon? I also had a surgeon in Northern VA who does over 100 per year. Perhaps it's the same one???

Dave234
Regular Member


Date Joined Oct 2011
Total Posts : 338
   Posted 1/20/2012 12:05 PM (GMT -6)   
Cmac, how much weight were you lifting? I really want to get back into weightlifting and this story is troubling.

LocalGuy23
Veteran Member


Date Joined Sep 2011
Total Posts : 620
   Posted 1/20/2012 11:54 PM (GMT -6)   
Same here, haven't gone trough nissen yet but want to know exercising limitations

Dave234
Regular Member


Date Joined Oct 2011
Total Posts : 338
   Posted 2/8/2012 10:34 AM (GMT -6)   
Hello?

Anyone? Anyone know?

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 2/8/2012 12:55 PM (GMT -6)   
Well I have had 2 redos, but not because of anything normal. My redo surgeons told me they expect it to last 10 years plus. My last surgeon told me they usually say 10 years because that;s basically the average since it was first done. He did say that with the advancement of techniques today he thinks they would last more like 15 years or more. Now that is just his opinion without any documentation.
As for whether the failure rate is higher with a redo I believe that depends on the skill of the surgeon doing the redo.

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

speedygerd
Regular Member


Date Joined Jan 2012
Total Posts : 87
   Posted 2/8/2012 11:55 PM (GMT -6)   
Is there a limit to the number of redo's that can be performed? What is the limiting reactant in the having the surgery performed multiple times if necessary? Scar tissue / adhesions? Does the stomach start to break down from the trauma? Something else entirely?

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 2/9/2012 1:41 AM (GMT -6)   
speedy-

I've had 3 and Michelle is going for her 4th. My only problem with any more redos is that it will have to be done open because of the amount of stomach and esophagus surgeries I have had.

When they thought I would have to have mt esophagus removed last March, the surgeon was concerned the stomach might not function completely normal(area of fundus for wrap).

My last surgeon said everything looked good after he cleaned up the scar tissue and my wrap was completely tore apart. He said it went back together perfectly and said If I need another one there shouldn't be a problem.

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

speedygerd
Regular Member


Date Joined Jan 2012
Total Posts : 87
   Posted 2/9/2012 1:23 PM (GMT -6)   
Bill,

Thanks a lot for your reply and info - it certainly makes me feel better.

Based on the severity of my symptoms I know I'm headed down the road to surgery one of these days, so it's nice to know that there isn't necessarily a limit to the number of times you can get fixed up.

Thanks again,

Lucas
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