Recovery Problem - Post Fundoplication

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Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 7/27/2012 11:58 AM (GMT -6)   
Hi, I had a fundoplication 2 weeks ago and was on a full liquid diet for that time.  When I started with more "soft food" yesterday I had a piece of soft chicken that I didn't chew well enough and as it went down is really hurt me.  Since then I have been having constant reflux symptoms and pain.  I hope my fundoplication didn't come undone or that I didn't do permanent damage.  Has anyone ever experienced this in their recovery?  Up to that point everything was fine except for the usual discomfort.  I have a follow-up appointment with the surgeon in a few days. 
 
Thanks

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4978
   Posted 7/27/2012 6:27 PM (GMT -6)   
Hi Bobbi.  Welcome to the forum.
 
You're only two weeks out of surgery.  At least you learned about chewing.  We all need to chew, chew, chew, not just for a while but forever.  It's about digesting with our new smaller stomachs.
I wouldn't expect you did any damage from just swallowing food.  It's really easy to create pain that lasts.   I wouldn't worry about rushing to doctor unless you have severe pain or bleeding.
 
Best wishes, and welcome to the club.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 7/27/2012 7:24 PM (GMT -6)   
Keep to very soft foods because you're still swollen. If you have to chew take small bites and chew very well before swallowing.
Keep your portions to 1/2 cup a meal or less right now.

You probably just bruised it a little, it's still very tender in there.
Joy

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 7/27/2012 7:42 PM (GMT -6)   
Hi Bobbi,
Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah
 
What you're experiencing is completely normal, and I guarantee getting a piece of chicken stuck will not damage your wrap.  It can irritate it, and irritate your esophagus, which can create reflux-like symptoms, but it can't harm your wrap.
 
The esophagus is a "dumb organ" (many surgeons have said this to their post-Nissen patients) and it interprets all pain as reflux.  So when you have irritation or pain caused by swelling and your problem swallowing, it can feel exactly like reflux.  Don't worry for a moment.
 
Here's my early recovery journal, in case you didn't run into it in the Resources:
It might be helpful to see another recovery experience and compare it to your own.
 
At two weeks post-op, your wrap is pretty close to peak swelling, so it's normal for swallowing to get even more difficult.  You might want to stick with soft foods and even liquids for a while longer, until the irritation subsides.
 
If you can surrender to your recovery and follow it where it leads, you'll find that your recovery will be a lot easier.  People who struggle against what is, and try to rush their recovery find it frustrating and difficult.  It takes a full 6 months for most of the healing and a year for the rest.  You're at the very beginning of the process, and it's the most difficult part of recovery. Once your wrap swelling goes down things will start to improve.  Hang in there!
 
Best wishes,
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.”

GerdyGirl
Regular Member


Date Joined Feb 2012
Total Posts : 69
   Posted 7/28/2012 12:04 AM (GMT -6)   
Sounds like your esophagus is just irritated from you eating something it was still too swollen to handle. Guaranteed a little piece of chicken won't break anything :) It just might hurt to swallow! Take it slowly with advancing your diet, you'll be able to eat chicken again soon enough. Totally agree with any pain being interpreted as reflux. Wait till you're 3-6 months out before worrying that the surgery didn't work.

Jonh71
Regular Member


Date Joined May 2012
Total Posts : 121
   Posted 7/28/2012 3:30 AM (GMT -6)   
I had this issue with swallowing at about 3 weeks when I was chopping carrots for kids dinner and ate a piece. This was a big mistake (it was an autopilot reaction as I always pick at raw veg when preparing a meal) and I was in a serious amount of pain for a few days. It eventually settled down and did not do any damage and was not the first time I had an issue swallowing something that got stuck. I had issues with bread also which I found out 8 weeks in when trying to eat a sandwich. My only advice would be to let things settle a bit and if you feel after a few days it is no better see your doctor, as long as there is no bleeding or sickness give it time.

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 7/28/2012 7:08 AM (GMT -6)   
Thank you for your encouragement.  I will decrease the portions I eat for now and hope for the best.  It is just that after the "chicken" episode I feel like something changed in the healing process.  Hopefully it is, as you have indicated below, just irritation.  We'll see with the doctor on Tuesday at my previously booked post-op appointement. 
 
I find that keeping the morale up is the hardest at this time.  This is a first for me.  I will need all the morale boosters you guys can throw my way.  I will also have a good read of your recovery journal dencha.
 
Merci

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 7/28/2012 8:38 AM (GMT -6)   
Hi Bobbi,
You're at the toughest part of recovery.  This will improve.  The chicken episode has changed your healing process, in that it added an new assult to an already beleagered lower esophagus/wrap.  Remember that your stomach has been stretched and wrapped and stitched around your esophagus.  Your internal organs have been moved and held and tools have made their way through your insides, definitely causing havoc on their way.
 
This recovery takes time, patience, and courage.  Don't spend a moment worrying that this is a forever problem.  During the first couple weeks many post-Nissen patients wish they'd never had the surgery.  It's that's challenging.  Never fear, this will pass.  Those people who were ready to give the Nissen a heave-ho are so thrilled with the results once healing is complete that they look back on their recovery with amazement.
 
Have you seen this diet information:
It might be helpful to you, if your surgeon didn't give you much eating guidance.  My surgeon turned me loose at Day 6 to eat anything that could be "chewed to a liquid", but believe me, I was extremely careful and stuck to soup for a while...I ate whatever was in the soup, though, with tiny bites and chew, chew, chew...I still had a few moments of pain...especially at your stage.  On or about two weeks is the WORST.
 
Be sure to stick around the forum. You'll get lots of information and support.
Happy healing!
Denise

MultiFundo
Regular Member


Date Joined May 2012
Total Posts : 46
   Posted 7/29/2012 5:47 AM (GMT -6)   
As Denise points out -- there are LOTS of different suggested diets following fundoplication.

Personally, now on day 5 following third procedure, my doctor has me on clear liquids only until day 15, and then going on full liquid for another 2 weeks. After the first fundoplication, a different surgeon had me eating macaroni and cheese (a food many people will tell you is a nightmare for a while) on day 5.

If you find chewed chicken at week 2 is too much -- cut back. Go back to pureed foods. It isn't a defeat -- your body might just need more time.

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 12/2/2012 4:55 PM (GMT -6)   

Eh Guys, it's now been over 4 months since my surgery and I was doing so well until about a week ago.  I was symptom free, was eating and drinking all I wanted (in smaller quantity though), and then during one supper last week the reflux symptoms came back quite strong.   I have been eating less since then and the symptoms are less but still are there.  Could I have irritated the eosophagus so bad it now hurts.  I have to admit that the week before I was on vacation in San Francisco and might have eaten and drink too much.  That certainly didn't help.  Anyone ever experienced this?

sad

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 12/2/2012 5:16 PM (GMT -6)   
Hi Bobbi,
Welcome back!  The recovery takes 6 months to a year for complete healing and upper GI tract adjustment to the changes.  You'll have some ups and downs, it's very normal.  It sounds like you overdid it and your esophagus/wrap is irritated.  Remember that the esophagus is a dumb organ (as my surgeon said), and it interprets all pain as reflux.
 
Just back off the rough foods for a while.  Take small bites and chew your food completely.  Only swallow things that have been chewed to a liquid (creamy consistency) for a while.  No alcohol, spices, acidic foods for a bit, until things feel better again.
 
If it keeps up and is bothering you a lot, you could ask for a script of Carafate suspension, which will coat the esophagus and help it heal.
 
Don't worry for a moment.  This too, will pass, and you'll be back to living it up!
Happy healing!
Denise
 
 
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

ladyinred
Regular Member


Date Joined Oct 2012
Total Posts : 36
   Posted 12/2/2012 6:28 PM (GMT -6)   
Hi....I had my nissen surgery on Tuesday morning.  It was an open surgery.  Not sure if what I'm feeling is normal or not.  I am so tired all the time.  I had a fever and very low bp in the hospital the first night.  I was also having issues voiding so they had to put in a foly cath.  They took it out the next day and I seemed to be fine but again having trouble going....I get the urge but just can't do it.  Very frustrating.  I am only having water, cream of wheat cereal, prune juice, applesauce and cottage cheese.  I'm kind of hungry but it's not bad.  I am still on my meds - ibuprofen, Tylenol and oxycodene.  I've been waking wit headaces to (they've been a life long issue but had seemed to be fixed).  I was released on Thursday afternoon.  The pain from my incision seems to 'pull' but isn't awfully bad.   I go back to my surgeon on Dec. 13.
 
My belly still seems numb on the left side since the epidral  - is this normal?  I've never had an epidural before. 
 
Thanks,
 
Sharon
RA, OA, Fibramilgia, scleritis, hiertal hernia, GERD, cardiomyopathy, sleep apnea

Virgogirl67
Regular Member


Date Joined Feb 2010
Total Posts : 130
   Posted 12/2/2012 6:52 PM (GMT -6)   
Hi all,

I had my surgery almost a year ago. Denise, your diary helped me a lot prior and the first month or two after - thanks so much.

Bobbi, Denise is right, trying to relax trough issues like you just had is very important. I had a terrible experience with swelling and thought I damaged the wrap for good. All of the sudden, around day 8 or 9, I stopped being able to eat soft foods. It was like trowing up, but not really because nothing was making it to my stomach. However, it was as if my esophagus would fill up and I would have to wrench to get rid of the build up.

I was eating over cooked noodles in chicken broth. It was the first several bites, and I ate no more, yet I was stuck in this cycle of fluid build up and wrenching the fluid out.

I suffered through a few days of that and called the surgeon because I was certain I damaged the wrap. It did feel like reflux again. So she had me come in and do a barrium swallow test while being x-rayed. They showed the wrap was in place, but even the liquid barium was going in very slow. It was due to swelling. I was scheduled for 4 weeks off work. By the time I saw her I was 2 weeks into that time. She extended it by 2 additional weeks until she was sure I was doing ok. It took what seemed like 6 days to finally calm down. Then I would have a bit of this off and on for the following 2 weeks. I did get anxious when it happened, which I think made it worse. So, even though painful, it is important to try to stay calm and relaxed.

I so wish I would have done a diary like Denise. It would have not only helped me remember the time frames more exact, it would help others because I think no 2 Nissen's are the same.

I have had a very good year after all of that cleared up. Week 5 I had a return of reflux, but I really do think it was like a "phantom" reflux, it cleared up within a week.

Right now I have had 3 weeks of a viral infection, mosty terrible bronchitis. I have been coughing hard and often for weeks now. I am on a couple different meds, which I think are making me feel like I have reflux, when it's probably just irritation to my stomach.

Denise, you had a lot of coughing due to your Asthma right? I have ashtma too. Did you have this same concern, hurting your wrap, with the amount of coughing? I think i rememeber reading that in your diary.

Thanks - Anita

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 12/2/2012 7:08 PM (GMT -6)   
Hi Anita,
Yes, I did worry about coughing my wrap right apart!  My surgeon told me not to worry, and my GI doc (bless his heart) said, hey, you can always get a redo...no bg deal!  I coughed for two and a half months straight during the recovery period, and I coughed hard and constantly.  I was taking two or three nebulizer treatments a day, and my husband was pounding my back for postural drainage to help me get the gunk out.  Long story short, my wrap did fine.
 
I still have allergic asthma, although my lungs have been amazing since my surgery.  I haven't done a nebulizer treatment since then!  Still I cough quite a bit during allergy season.  No problem, but I understand the worry.
 
Hope your bronchitis clears soon!  I was a second grade teacher for 25 years and was working in a disease incubator!  I got so many colds and because of the asthma they lasted forever and killed my lungs.  I retired a couple years ago, so I'm not exposed as much, and it helps, but the surgery was the real key.  When I was in the classroom with all those germs AND had reflux affecting my lungs I was a MESS.
 
Feel better, and thanks for posting!  As you know, it means a lot to hear from someone who's been there, done that!
Take care,
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 12/2/2012 7:14 PM (GMT -6)   
Hi Sharon,
Welcome to the yeah yeah yeah Wrapped Club! yeah yeah yeah You did it, and are on the other side!  Remember that you're in the toughest part of your recovery.  After two or three weeks you'll notice a big improvement. 
 
 Just rest, eat many, small meals, no iced drinks, no straws, and walk around your house a little whenever you get up to go to the bathroom to help relieve the shoulder pain and get your strength back.
 
Also, remember that your wrap will become increasingly swollen over the next two weeks or so, so don't be surprised if your swallowing gets worse before it gets better. 
 
We're here for you whenever you have a question or need support and TLC!
Happy healing!
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

Post Edited (dencha) : 12/3/2012 8:18:30 AM (GMT-7)


opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 12/2/2012 11:36 PM (GMT -6)   
Sharon-

My last redo was an open surgery too. The numbness that is sticking around is most likely from the nerves that were cut. I had a thoracotomy on my left side to repair a hole in my esophagus on 3/1/12 and my left side of my belly went numb from that. It started to come back and after I had my open nissen redo on 8/24/12 it went totally numb again. I still have a lot of the numbness still but it has gotten a bit better. Nerves only grow something like 1mm a month if I remember correctly

So yes it is normal.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

Virgogirl67
Regular Member


Date Joined Feb 2010
Total Posts : 130
   Posted 12/3/2012 6:22 AM (GMT -6)   
Nerves are tricky things. I had an open hysterectomy from hip bone to hip bone a few years ago and it took almost a full year for me to get feeling back around the incision area. So I do think that is pretty normal.

Bill you have been through a lot - an inspiration to those of us that have such concerns over our initial, and hopefully only, Nissen.

Take care,
Anita

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 12/22/2012 5:00 PM (GMT -6)   
hey Guys, I am getting quite discouraged here.  I am now more than three weeks after the "restart" of my reflux symptoms and I can't seem to be able to shake it off.  Should I go on a liquid diet again?  I am on constant reflux symptoms as soon as I eat anything.   Shoot after 4 months after the surgery I was doing so well.  I don't want to lose anymore weight.  Could I have irritated the oesophagus that bad?  Help!!! What do I need to do???  mad  

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 12/22/2012 7:07 PM (GMT -6)   
Try liquids for a little bit then slowly increase to solids again.
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, Degenerative Disk and Facet Disease, and Allergies

When life throws you lemons....
Pick them up and throw them right back at them! :))

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 4/1/2013 7:25 PM (GMT -6)   
Eh Guys, I haven't posted for a while. I am now even worse than I was before XMas. Although I am back on PPI medication my reflux is extremely painful. My esophagus feels very irritated and swollen. I have tried to go back to a semi liquid diet with mitigated results. Should I go back to a full liquid diet? For how long? I am very discouraged and may need some psychological help soon.

I had two occasions since XMas where I felt a big pull in the lower esophagus area/left side while shovelling and exercising. It hurt for a day or so then it stopped. I am so concerned I damaged the surgery.

I had a baryum test done last week and the Dr saw some reflux (initial results). I have a gastroscopy on the 13 May.

I will take any advice you have. Help please!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 4/2/2013 6:38 AM (GMT -6)   
Hi Bobbi,
I'm sorry to hear you're still struggling with your recovery.  What you're experiencing is unusual in its intensity.  During the first year you can have some ups and downs and irritate your wrap/esophagus due to the swelling, healing and adjustments that are going on, but the severity of what you're dealing with seems out of the norm. 
 
I'm glad to hear that you're going for a follow up with your doctor.  Your description of pain doesn't sound right to me.  If it's strictly from irritation it doesn't seem like it would be lasting as long as this.  I'm no expert, though, so don't hold me to it! 
 
I'm sure your doctor will have more answers for you.  I know it's hard to wait for your appointment (why do they always have to be such a long way off?).  Until then, you'll need to deal with the reality you're living with, which is pain and irritation.  The rule of thumb is to always listen to your body.  If your wrap/esophagus is giving you problems, then baby them with soft foods that are chewed completely.  Stay away from any irritants like acidic foods, alcohol, and spice.  Don't swallow anything that is not chewed to a smooth consistency.  Otherwise thing will be scratching their way through your lower esophagus and wrap as they make their way into your stomach. 
 
There is one other thing that comes to mind that might help with the discomfort.  You could see if the doctor would prescribe Carafate suspension.  It has coating qualities that can help protect the esophagus, wrap, and stomach and help with healing.  It's quite expensive, so it's important that you have good prescription insurance, but if you do, be sure to call your doctor's office and request a prescription. 
 
If you don't have good insurance the next best thing is Sulcrafate tablets, which are generic.  You can put a tablet in a little medicine cup, add a little water/and stir it with a toothpick.  Then throw it back like a shot.  It will coat the esophagus and wrap on the way down in a similar way that Carafate does.  It's the same medication, but the suspension does a better job.  Still, I think you would find some relief.
 
Good luck with all this.  Glad you posted so you can get some support as you work through this problem.
Best wishes!!
Denise
 
 
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 4/4/2013 5:40 PM (GMT -6)   
Thanks Denise. I will talk to my doctor re. the Carafate. My wife is a pharmacist and told me it is known as sulcrate in Canada. She says that she doesn`t see a lot of this being prescribed since the PPI pills seem to have the favor of Drs.

Last bit of news... I just fell victim to budget cutting in the medical world. Got a call today from the hospital to let me know that my 13 May gastroscopy was cancelled. Not postponed but cancelled since they just closed the endoscopy unit in another hospital in Ottawa. They are now only doing gastroscopy to patients with cancer for the time being in the hospital where I was going to have this done. They will call me back they said...just great!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 4/4/2013 5:54 PM (GMT -6)   
Hi Bobbi123,
As I'm sure your wife has told you, Carafate/Sulcrafate is an old drug. I can tell you this, though. I had a period of time when my wrap/lower esophagus were giving me fits (reason unknown) and the Carafate made a huge difference.  I had been treating it with Maalox which didn't seem to be doing much.  I finally realized that I had some Sulcrafate tablets from my pre-Nissen days and got one out, mixed it with a little water, and threw it back.  IMMEDIATE relief from the pain I was having.  I have a reactive stomach, so I always keep Carafate on hand, just in case.
 
No guarantees that it will work like that for you, but it can't hurt.  It can only help coat and protect.
 
This austerity worldwide is becoming more and more of a problem.  I'm so sorry to hear about your cancellation.  Can you go to another hospital to get it done?  Good luck with that whole situation!
 
Best wishes,
Denise
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

Bobbi123
New Member


Date Joined Jul 2012
Total Posts : 7
   Posted 4/5/2013 8:10 PM (GMT -6)   
Denise, just a quick question. My wife just brought me (after I received the proper prescription of course) the tablets. They are Sulcrate which is the name in Canada. Is the liquid solution better? I asked for the tablets and this is what I received. I did not realise that it also came as a liquid. Actually only realised it after I read your inputs again. You indicate that you can disolve the tablets. Does this do the same thing? How much water? My wife is kind of looking at me awkwardly since the professional in her has not seen this done before.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7180
   Posted 4/5/2013 10:39 PM (GMT -6)   
Hi...the liquid is better, but more expensive. If you can get it, do. Until then, though...put the sulcrafate tablet in a medicine cup or shot glass and add enough water to make a little slurry. the just "throw it back" like a shot. If you take it that way it has a chance to coat your lower esophagus and wrap instead of just your stomach. The suspension is better,but it should provide some relief, though.
Good luck...hope it helps!
GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle
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