Do the surgery or not?

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M8
Regular Member


Date Joined Feb 2012
Total Posts : 24
   Posted 7/26/2012 2:10 PM (GMT -6)   
Please see my previous post for more details if needed. http://www.healingwell.com/community/default.aspx?f=45&m=2352707

As some of you’ll may know I have had problems with GERD for years. I’m young (28) and active and feel as though I have run out of options. From my first post I indicated that I have been on PPIs for years and for the most part they have helped me manage my acid reflux. That was till the beginning of this year where I had an extreme case of unmanaged acid reflux that nothing would stop it for a few weeks. Since then my reflux would go from completely unmanageable to a fairly consistent amount of pain caused by the acid reflux.

Since my last post I have flown to Florida to visit with a very highly recommended Gastrologist. From speaking with other doctors and such apparently he is # 1. He performed another motility, 48 hour Bravo, and endoscope. The motility test showed that my esophagus is working correctly except for my LES, which is very weak. The Bravo showed that I do have bad acid reflux. The endoscope didn’t show a hiatal hernia but he said it was common for it to not be visible all the time because it is most likely a sliding hiatal hernia. Two other doctors have said that my hiatal hernia is 2.4 cm.

Anyway long story short is he said I’m a perfect candidate for the Nissen Fundoplication, but ………. due to my employment and the activities that I do while at home on vacation I should not have the surgery done because guaranteed I will blow it out within 2 – 3 years. He brought up the point that no matter how good the surgeon is its impossible to create something better then what I was born with and I have already torn that apart. Most surgeries deal with the removal of something that then heals but with a Nissen you are repairing.

Well now is where it comes into I’ve run out of solutions. I really like my job at sea as a Deck Officer. To me its a career that I like many others do for the majority of their lives. Its hard to switch from a career at sea to land, especially over night. I also enjoy so much coming home from work and do things like working with my tractor, going sailing, cutting trees down, moving dirt/gravel, and such. To make it simple my job and my home life require not extreme heavy lifting/pushing but do require a strong body.

I trust the specialist in Florida and now have major concerns with having a surgery that would forever change and restrict my life. For someone like myself that enjoys and looks forward to working at sea and outside while I’m home its almost a death sentence. Plus with being so young and it appears that Nissens have a life span that will most likely not get anywhere close to out living me.

Any opinions or advice would be greatly appreciated. The reflux has gotten to the point that I cannot take the pain anymore. I have reflux everyday all day. I'm really glade to have found this website because the huge wealth of information and care that everyone provides.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 7/26/2012 4:01 PM (GMT -6)   
I have one thing to say...

Where will you be in 5 years? 10 years? 20 years?
Joy

bowecho
Regular Member


Date Joined Nov 2011
Total Posts : 146
   Posted 7/26/2012 4:25 PM (GMT -6)   
The Nissen restrictions aren't that severe. I think you'll find you will still be able to do plenty after the surgery.

I had my Nissen 8 months ago, and I'd have no concerns going sailing, cutting trees down or operating machinery if I had a reason to. I currently play softball every week, run several times a week, I've been kayaking, hiking, mountain biking, quite a bit of physical activity. Personally, I would shy away from heavy lifting, but I'll do anything else. I have no worries or fears of damaging my Nissen, nor does my surgeon.

There may be a few more strenuous things that you may want to hold off doing for a while, maybe the most strenuous activities requiring heavy lifting you would avoid doing at all, but I bet within several months you'd be back doing many of the activities you love.

Its a tough decision. You can't take the pain anymore, but on the other end, the thought of being restricted from doing some of the things you love is painful as well. You will need to weigh the pros and cons carefully. I wish you the best!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 7/27/2012 6:37 AM (GMT -6)   
Hi M8,
Bowecho has made some excellent points.  I guess the ball is in your court.  You know that without a doubt you're a good candidate for a Nissen that would improve your comfort, but don't want to give up the things you do that would almost certainly create a situation where your Nissen would fail. 
 
It's a Catch 22, but you are going to have to decide which is more important.  As someone who loves the sea, you're probably familiar with the Thomas Aquinas quote, If the highest aim of a captain were to preserve his ship, he would keep it in port forever”.  Yes there are risks with surgery, and yes, you would need to make some changes in your behavior--in particular the heavy lifting aspects. 
 
You are the only one who can decide which is more important to you.  At some point your reflux may become so debilitating that you will no longer feel that it is a choice.  That's what happened to me.
 
Wish there were simple answers.  Nobody can tell you what to do.  It's your life, and you need to choose.
 
Glad you've joined the forum!  It's a great place to bounce your questions off others and receive support and encouragement.
Good luck!
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.”

M8
Regular Member


Date Joined Feb 2012
Total Posts : 24
   Posted 7/28/2012 12:28 PM (GMT -6)   
Thank you for everyone's comments. I've answered and added to some of your comments below.

couchtater said...
Where will you be in 5 years? 10 years? 20 years?


5 Years? Getting married to my girlfriend of the past eight years and starting a family. Yes I know its about time but I'm fortunate and she has been very patient.
10 Years? Doing what most do with young kids but probably still going to sea for a living.
20 Years? By then I may have moved shore side, but who knows

bowecho said...
The Nissen restrictions aren't that severe. I think you'll find you will still be able to do plenty after the surgery.

I had my Nissen 8 months ago, and I'd have no concerns going sailing, cutting trees down or operating machinery if I had a reason to. I currently play softball every week, run several times a week, I've been kayaking, hiking, mountain biking, quite a bit of physical activity. Personally, I would shy away from heavy lifting, but I'll do anything else. I have no worries or fears of damaging my Nissen, nor does my surgeon.

There may be a few more strenuous things that you may want to hold off doing for a while, maybe the most strenuous activities requiring heavy lifting you would avoid doing at all, but I bet within several months you'd be back doing many of the activities you love.

Its a tough decision. You can't take the pain anymore, but on the other end, the thought of being restricted from doing some of the things you love is painful as well. You will need to weigh the pros and cons carefully. I wish you the best!


The highly recommended Gastro in Florida, explained that I can easily find a surgen that will swear that he can give me something that will never tear apart but he is full of bull. He explained that after healing from the surgery I will feel well enough to do anything I want but its guaranteed that if I continue to put pressure on my mid region by lifting, pushing, etc. I will tear apart the surgery. His recommendation for me to make it last is to lift no more then 25 lbs. That restriction is what really blows me away but I guess I've got to make it last for another 50 years or so.

dencha said...
At some point your reflux may become so debilitating that you will no longer feel that it is a choice.


That is what is occurring to me now. There is almost not a single second in the day that I don't have reflux. I'm trying to hang on for as long as possible but I can't take it anymore.

I guess it all boils down to the fact that I just want to make sure that I've rulled out everything I can do and that I'm making the right decision. The Linx Device has a high success rate on paper but by some of the comments on this board it doesn't represent what may be actual truth. Is this true? Plus I don't know if I would be accept as a patient because of my possible heital hernia and the waiting list that is getting longer by the day.

I still don't know why back in December almost overnight my reflux went from being manageable with one 40mg tablet of Protonix to nothing and I mean no PPI, H2 Blocker, or Tums could keep my reflux down. I'm amazed that it can go from managed to unmanageable with no warning but neither do the Doctors. If anyone has any other ideas I'm open for them.

Thank you again for everyone's comments.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 7/28/2012 1:11 PM (GMT -6)   
Hi M8,
Perhaps you lifted something very heavy and caused your herniation to increase, which led to increased symptoms?  Just a thought...
Denise

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 7/28/2012 2:23 PM (GMT -6)   
What I meant with my question is ....
Do you want to continue to suffer or have the surgery and limit yourself some?

I've lifted a 60 lb child and walked half a block with her in my arms without damaging my wrap. I've thrown up for 12 hours straight twice and it's still intact. The wraps are tougher than you think.
Joy

bowecho
Regular Member


Date Joined Nov 2011
Total Posts : 146
   Posted 7/28/2012 10:33 PM (GMT -6)   
I would recommend talking to a surgeon that actually performs a significant number of Nissens to get a more realistic idea of restrictions. While its true, no surgeon would ever claim that their Nissen is 100% fail proof, the restrictions your Gastro doc describes seem to be quite extreme and conflict with the information many members here are told by their surgeons. All of the highly recommended Gastro docs I saw were very good doctors, one of them even had very negative things to say about the surgery, but they didn't do 1-2 Nissens a week like my surgeon, so his description of restrictions were much more meaningful to me.

Could any physical activity I do tear my Nissen? Sure, there's always the very small chance it could happen. But, the thought of always living in fear of damaging it is not very appealing. I plan on living my life the same way I did before this terrible illness and surgery (minus the bad eating habits), I'd rather do that and acknowledge the risk than live a less fulfilling life. If I had to live like that, I may as well not have had the surgery.

Good luck with everything, I understand the decision your facing. Many of us here have gone through this, so this site is an excellent resource.

Post Edited (bowecho) : 7/28/2012 10:36:01 PM (GMT-6)


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 7/29/2012 8:50 AM (GMT -6)   
Bowecho,
Your comments bring to mind Thomas Aquinas quote to which I often refer:
"If the primary aim of a captain were to preserve his ship,
he would keep it in port forever."
There is always a risk-benefit ratio in whatever we do.
Enjoy your life!
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.”
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