Semantics Question about "physical abnormalities"

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aeshleyrose
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Date Joined Jul 2011
Total Posts : 656
   Posted 3/27/2012 7:56 AM (GMT -6)   
Okay. Saw the surgeon today, who said that the Nissen is NOT done here in Finland for people who don't have a physical abnormality. I was a bit emotional at the time and didn't clarify, so I depend on all of you to do it for me! turn

If my pH test comes back with results, that DOES mean that the LES is not closing properly and is therefore faulty, correct?

Thanks!

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 3/27/2012 8:13 AM (GMT -6)   
Hi Ashley,

Hmmm. Good question. I don't really know the answer. I am guessing he means physical abnormality like a hiatal hernia, but that is just what comes to mind when I read it. I am guessing that if your PH comes back very high the surgeon may retract that statement, because ultimately that is all that matters in my mind. My PH tests have always come back borderline high only...hopefully someone who has had that experience can give a better response based on what they heard first hand from their doctor.

aeshleyrose
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Date Joined Jul 2011
Total Posts : 656
   Posted 3/27/2012 8:27 AM (GMT -6)   
Thanks Dan. I'm kicking myself for not clarifying further but it was quite a day and I didn't.

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 3/27/2012 8:34 AM (GMT -6)   
Don't. I've done the same. You could always call to clarify or email. I don't make a habit of it, but I have called and left questions w/ nurses and even emailed a doctor before. You could always do that, or just wait until you both go over your PH test to ask. Are you getting it soon?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 3/27/2012 8:36 AM (GMT -6)   
Hi Ashley,
That's no different than the standard here in the States.  Nobody is going to do a Nissen on someone whose LES is working properly and does not have a hiatus hernia.  If your LES is insufficient but you don't have a hiatus hernia, I'd think you'd still be a candidate.  If you have neither of these things, a Nissen WOULDN'T HELP YOU!
 
When you hear of people who have no relief of their symptoms after the healing stage of the surgery, they very likely had symptoms that were not actually caused by reflux.  Therefore the surgery didn't solve their problems, and they went through it all with little or no benefit. (It takes time things to resolve after surgery, and improvements may not be noticable until there is time to heal whatever was being damaged by reflux.)
 
So bottom line, if you don't have a physical abnormality, why do anything?  They'd be CREATING a physical abnormality by performing the surgery. 
 
I really think it's just a communication issue...your surgeon was not saying anything unusual.  It's just the way he/she SAID it that created angst.  Believe me, I understand your frustration.  As my lungs were dangerously unhealthy and I was taking high doses of steroids (that have left me with adrenal insufficiency and skin that bruises and tears extremely easily), my GI doc dragged his feet and refused to take my reflux issues seriously.  It's maddening!
 
Hang in there.  It'll all turn out fine...Look at me!  I'm breathing easy on a tiny fraction of the steroids I took prior to my surgery.  It took time, but eventually we got there.  I should have pushed more as well.  I was a bit gunshy after reading all the scary posts online.  Be your own advocate, but understand that the pace is normally pretty darn slow.
 
I think that some people rush into surgery and aren't prepared for the changes it creates.  Better to go slower and be really ready!
 
Happy thoughts!
Denise
 
 

Faith224
Regular Member


Date Joined Sep 2011
Total Posts : 299
   Posted 3/27/2012 9:36 AM (GMT -6)   
Hey,

I'm curious to know more about nissen candidacy. My ph test came back highly abnormal-- 64 episodes of reflux into my throat! However, my manometry was normal and showed that the pressure in my sphincters are normal. Would I be a candidate since my manometry was normal?
Feel Good,

-Faith

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 3/27/2012 10:37 AM (GMT -6)   
Faith,
I'm no GI doc, but the reality of your reflux episodes should trump the manometry results.  You're getting reflux, so I would think it's likely that your LES is behaving intermittently...relaxing sometimes and doing its job other times. 
Have you discussed the results yet?
I'll be interested to hear your GI's response.
Best wishes,
Denise

Faith224
Regular Member


Date Joined Sep 2011
Total Posts : 299
   Posted 3/27/2012 10:50 AM (GMT -6)   
Hi Denise,

I go to an ENT (Dr. Koufman) and she believes that I am experiencing transient relaxations, but also thinks that I am one of the "lucky" clients who can benefit from diet alone. However, I did ask her if someone would operate on me with my manometry results and she believes they would but said that she doesn't want me to do the surgery before we try all the other alternatives.

I hope nissen is an option for me in the future.
Feel Good,

-Faith

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 3/27/2012 3:15 PM (GMT -6)   
Good luck, Faith!
I hope that the diet works like a charm for you.  The transient/intermittent LES pressure changes makes lots of sense.
Let us know how it goes!
Denise

Faith224
Regular Member


Date Joined Sep 2011
Total Posts : 299
   Posted 3/27/2012 4:40 PM (GMT -6)   
Thanks so much Denise!
Feel Good,

-Faith
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