I'm sorry to hear you're having so many problems. I'm not sure I can help, but will give it a try. I suggest that if you haven't already, you call your surgeon's office and arrange a face-to-face meeting with him/her/or medical staff.
In the meantime, here's my take:
1- Can any of this be considered normal healing? Maybe I'm doing something wrong, or maybe it will get better. It seems like the symptoms have gotten progressively worse, but can that reverse?
True high volume reflux symtoms are not normal. Still there can be symptoms that do a great job of mimicking reflux because, as I'm sure you've read here many times, "the esophagus is a dumb organ" and it interprets all pain as reflux.
I do believe that a loose wrap can work just fine, and continue to hold food and acid in the stomach well, while allowing you to burp. I actually discussed this with my surgeon because I had the same worries as you.
It is possible that acid can reflux during the early weeks. That said, high volume refluxing isn't typical. Food at the wrap site can ferment if it is there a long time, and certainly can mimic real reflux.
If you've pushed too much with your eating it's possible to back off and begin eating the way you did at an earlier stage. If you do this for an extended period of time you should see some improvement if that's the cause. It won't be immediate, though. Patience.
2- Is there a way to assess whether my wrap is intact? Would I know if it had come undone? I haven't been having the nightly, massive volume reflux from before, so that gives me some hope.
That is a very good indication that it's not a failed wrap. I believe I mentioned to you before that it's possible to get reflux after Nissen surgery, but it will be much, much less frequent and less intense. The surgeon can't create zero reflux without making it impossible to swallow. Burping is another benefit that can come from a wrap that is not too tight. Bloating can be debilitating with a too-tight wrap.
I would guess that if you tell your surgeon that you're no longer getting high volume relux while sleeping he/she will feel very confident that your wrap is a huge success.
3- Does anyone know if, in the event that I need to be repaired (either because the wrap has come undone, or if it wasn't tight enough to begin with), can that be done laparoscopically? Or is that always an open-surgery?
I asked my GI doctor this very same question. During my recovery I had a lung infection/asthma issue that was causing me to cough forcefully and constantly. I was very worried that I would ruin my wrap and would need a redo.
My GI doc said that a redo could indeed be done laproscopically, which was a big comfort to me. I had heard other places that it would need to be done as an open procedure.
On the topic of open procedures, our moderator, Bill, has had an open redo and he said that he was very surprised that the recovery was about as easy as the laproscopic surgery recovery.
4- How long would one normally want to wait before considering another surgery?
My guess is pretty close to the year mark, as at that point you'd have healed "completely". Still, if someone were in severe stress, I'm sure that it could be done sooner. However, a good surgeon will be very hesitant to perform a redo before you've healed completely, because it's not something that should be done unless it is absolutely necessary. Each redo surgery is more difficult than the last, so you want to avoid a possibly unnecessary one.
I don't know if I've helped at all, but that's my take on your situation and questions. I'm sure others will be by to weigh it.
Hang in there!
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”
“Worry pretends to be necessary but serves no useful purpose”
“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Post Edited (dencha) : 4/14/2012 9:18:28 AM (GMT-6)