Posted 5/24/2012 9:16 AM (GMT -6)
This is the problem: If a surgeon created a wrap that was tight enough to get reflux to zero, you wouldn't be able to swallow. It's a delicate balance. Tight enough to keep acid in the stomach while loose enough to allow swallowing.
All a surgeon goes for is "normal" reflux. Everyone gets some reflux. The general rule of thumb is that any DeMeester score <14.7 is considered normal. This is the conundrum that we're faced with. If you're at all sensitive to small amounts of reflux you'll feel even a little reflux as it migrates into your esophagus.
The majority of people who get a Nissen have a very high DeMeester score. I've seen scores of 70 or 80 here on the forum. Those people will find immediate relief, and won't be bothered by a "normal" amount that might make it through the wrap.
People with more atypical symptoms are likely to be more sensitive to any small amount of reflux that makes it through. For instance, my DeMeester score was very borderline...it was something like 14.8. Obviously my surgeon can't get my reflux to zero, so I'm still getting some level below 14 or so. This is the reason it's so hard to get GI docs to refer atypical GERD sufferers to surgeons.
In my case whatever the surgeon did was successful. I still have some reflux--this is assumed. Therefore my asthma doc and PCP both have requested that I continue to take Protonix 40mg before dinner. Also, I still sleep with the head of my bed elevated. This is all an attempt to keep my lungs protected from ANY reflux at all.
I've been able to take a tiny fraction of the asthma meds I took prior to surgery, and my lungs are great. Prior to surgery my lungs were in "life-threatening" condition. I am sharing my experience so you can get some perspective. It's possible for a Nissen to be successful even if you still have to take a PPI or H2blocker afterward.
I understand your frustration. You had a difficult recovery and you're feeling like you're back where you started. I doubt that. If your wrap is intact, you can expect improvement. From my calculations you're nearing the 6 month mark. Keep in mind that you will continue to make improvements through the first year. I continued improvement into the second year, believe it or not!
Take the Nexium, and try to baby your stomach by choosing foods that are not triggers for you. Back off a bit on what you're eating. It's possible that your esophagus is reacting to the tests that you had and is irritated. Take it easy for a while...no rough foods--just things that can be chewed to a smooth consistency.
Don't give up hope or panic. This is a bump in the road, but it's not forever.
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.”