Nissen and inflammation

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soppendeuff
Regular Member


Date Joined Jun 2008
Total Posts : 27
   Posted 5/19/2012 1:58 PM (GMT -6)   
I am 6 months post-op on a Nissen (LPR, medium hernia). I am still having aching pain in my upper abdomen and it worries me. The pain not a result of swallowing, esophageal spasms or meal size. It feels more like "soreness" - surgical pain.

One reason it concerns me is that few of the "Wrapped Club" seem to have pain 1-2 months after the surgery.

One of my docs (not the surgeon) are trying to figure this out. We've had no success.

So I have two questions:

1. How long did the "surgical" pain and soreness persist for you after the wrap?

2. Do any of you have an autoimmune diseases or inflammatory diseases? I do, and I wonder if my unfortunate propensity for staying inflamed once I get that way from surgery, etc. is contributing to the lasting pain.

Thanks,
Leslie

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 5/20/2012 9:26 PM (GMT -6)   
Hi Leslie,
Welcome to Healing Well  yeah yeah yeah Wrapped Club! yeah yeah yeah Glad you're joined us!
 
It's hard to describe the feeling I can get at my wrap site.  It's more of an irritated feeling...not really pain.  I am a very inflammatory person...a reactive stomach, asthma (reactive lungs) dry, reactive eyes, rosacea...you get the picture.  Because of that I'm not surprised that when I eat certain rough things my wrap starts feeling uncomfortable.  It was made out of my reactive stomach, so it certainly is understandable.
 
The only time I've had actual pain is when I sleep on my left side for any length of time I've been awakened by a sharp pain that goes away as soon as I lie on my back again.  I don't know why that happens...I've always guessed that there's an adhesion there that pulls after some time.  Who knows?
 
I'm 3 years post op. I don't think it's all that uncommon for some of us more reactive friends to get some irritation symptoms even after healing.
 
In your case, don't give up hope that it will clear up in time.  It takes a full year for everything to resolve and adjust.  I found improvements into the second year!
 
Best of luck!
Denise

soppendeuff
Regular Member


Date Joined Jun 2008
Total Posts : 27
   Posted 5/22/2012 9:43 PM (GMT -6)   
Thanks for replying, Denise.

I've decided to ask my gastro doc to test the wrap to see if it is holding. I've had a lower respiratory infection off and on for a month now. It's nerve wracking because the symptoms feel so much like the LPR I had the wrap to get rid of. I have experienced some progress on healing the lungs since the surgery. The idea of going "backward" is heartbreaking and demoralizing.

Hopefully, I'm just being impatient. We "inflammatory types" are on a tough road.

Thanks again!

Leslie

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 5/22/2012 10:10 PM (GMT -6)   
Hi Leslie,
I have terrible allergies and was having a lot of problems with my lungs even after my Nissen.  My asthma/allergy doc was very suspicious that I might be getting some reflux that was creating the problem. 
 
I had the complete workup with all the pre-Nissen testing by a great Nissen surgeon in my area.  I also had a tip-top ENT surgeon check my vocal chords.  The result was that my wrap was intact and all was just fine.
 
My allergist had to admit that my problem was allergy-based and they've worked hard to increase the strength of my serum and adjust my meds.  I'm doing much better, and my lungs are great now.  Still, the pollen this time of year is terrible, and I've got lots of other allergy symptoms.  Knock wood, my asthma will continue to do well...
 
Good luck getting to the bottom of your problem!
Denise

soppendeuff
Regular Member


Date Joined Jun 2008
Total Posts : 27
   Posted 5/23/2012 7:05 AM (GMT -6)   
That's good information. I appreciate your willingness to share it.

I take immunosupressants to control the Crohn's (Humira, currently), so frequent respiratory infections are a major part of my life. They made getting a dignosis on the LPR very drawn out and difficult. It's always hard to isolate what's going on with the lungs (infection? asthma? bronchiectasis? LPR?). I've never had much of an issue with allergies.

I'm probably just be suffering from a lingering infection, but just a hint of what feels so much like the LPR is enough to put me into a PTSD-like state. Like you, I endured the Nissen to put that part of my life behind me.

Much of this pain I'm getting at what I believe is the wrap site is postural. It hurts most when I get out of bed in the morning. The act of getting vertical is painful and it aches for hours afterwards. It then gets irritated by waistbands. I figured that out early on and started to wear maternity pants to survive going to work (a major concession to pain - I've never been pregnant and I despise these pants). I still have pain, but it's much less than wearing a normal waistband would cause.

I think when there is any pressure on my midsection when sitting (waistband bisecting the front of the abdomen), whatever tiny force it produces causes a small internal shift that acts on the wrap, causing pain. Driving is also hard on it. I ended up in the drivers seat for three hours a couple of weeks ago and had significant and constant pain for three days after as a reward. It seems like my fellow "Wrapped Club" members have most of their discomfort from swallowing or the wrong foods or larger meals irritating the wrap. I haven't had anys issue of that sort for months.

I can only think of three things that could cause this: the wrap or surrounding tissue/nerves are inflammed, adhesions have formed that pull on the wrap or there's something wrong with the wrap itself.

I'd be less concerned if this had been happening all along since the surgery, but most of this irritation is relatively new - started in the last couple of months.

If you have any thoughts on this, I'd love to hear them.

Thanks for listening, Denise. You're swell. :-)

Leslie

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 5/23/2012 7:37 AM (GMT -6)   
Hi Leslie,
I had a lung infection at the time of my surgery and was on antibiotics for several weeks afterward.  Finally, at 2 1/2 months my lungs improved a lot. 
 
There's one other piece to this puzzle.  Since my symptoms were atypical and the surgery was aimed at getting my lungs healthy and unaffected by reflux, my doctors know that it doesn't take much reflux to get my lungs going.  Since my reflux was never severe (my DeMeester scores were just a tiny bit above the "normal" amounts of reflux), then we know that it doesn't take much to get them going.  For this reason my asthma doc and PCP have requested that I continue on one dose (40mg) of Protonix before dinner.  I also still sleep with the head of my bed elevated.
 
Knock on wood, my lungs are great (unless I get too much pollen exposure over an extended period--for example on vacation on a small Massachusetts island that has a lot of mold and windows open for coolness) and I'm not suffering with constant coughing up mucous.  My lungs are clear and healthy.
 
In contrast, before my surgery I was on 40mg Protonix before breakfast, 40mg Protonix before dinner, and 300mg Ranitidine before bedtime, and my lungs were dangerously unhealthy.  My PCP called them "life threatening".  I was also on high doses of inhaled steroids (230mcg 4 puffs, twice a day) and intermittent prednosone.  This, to the point where my skin has thinned and it bruise and tears extremely easily.  My dermatologist said I have the skin of a 90 year old. 
 
Since my surgery I'm on 115mcg 2 puffs twice a day and haven't had any prednosone since before my surgery three years ago.
 
Sometimes, those of us with atypical/LPR symptoms need to continue with some type of acid suppressent to deal with the small amount of reflux that is not stopped by the wrap.  If the surgeon were to get reflux to zero, we wouldn't be able to swallow.  Therefore, their goal is to get reflux to "normal" levels, which in the case of people like us, it might just be enough to continue to cause some problems.
 
With your complicating factors, you've still got some healing time in front of you.  Truly, many continue to improve throughout the first year.  It's very possible that some of your pain will resolve itself given time.  Around here you'll hear the saying...6 months for most of the healing and a full year for the rest.  I found that I still got improvement into the second year.  (dumping episides stopped sometime in that year).
 
I understand your frustration and worry.  Like you, I worried that my surgery might be a failure and I went through it all for nothing.
 
It's far too soon for you to reach that conclusion. 
 
This year, because of the strange weather in the early Spring, the pollen levels are off the charts.  Even people who "don't have allergies" are having symptoms.  Something to consider... turn
 
You still have healing time ahead of you.  Don't assume that you're in for these pains forever.  Your insides have been through a LOT.  Give them time to heal and calm down.
 
Hang in there!
Denise
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) : 5/23/2012 6:54:44 AM (GMT-6)

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