Swallowing problem post fundo. The saga continues.

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buzzmoz
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Date Joined Mar 2012
Total Posts : 52
   Posted 8/29/2012 6:36 AM (GMT -6)   
Hi All
It has been a few weeks since I have posted as I try to get on top of this problem, and getting any real plan of action from the surgeon has been a journey that I think I could write a book about.
By the look of the barium swallow, it would appear that there is a problem at the hiatus repair. I am currently suffering badly from indigestion and hope it will pass quickly. I have taken nexium, have drank mylanta and have also had slippery elm to drink. I am not sure that it is reflux exactly, but I think it maybe food and drink fermenting in my esophagus. Boy this is really causing me grief and just want to able to swallow properly like I did before surgery. I had a repair in two places apparently and worry that the mesh is rubbing on my esophagus.
Has anyone had this problem before and has getting a stitch cut fixed the problem? My fundoplication looks kind of tight as well and I wonder if this is also part of the problem?  cry

Post Edited (buzzmoz) : 8/30/2012 8:20:06 AM (GMT-6)


Baza
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Date Joined Jan 2011
Total Posts : 513
   Posted 8/29/2012 6:55 AM (GMT -6)   
Hi buzzmoz,sorry to hear about your problems,your story sounds similar to mine,i joined in one of your earlier posts about problems after the op.I had problems swallowing and still am having trouble,my hiatal part was done too tight ansd surgeon went back in a undone two stitches.im still getting a hold up somewhere in there and im waiting for surgeon to do something about it,apparantly hes away for a month on holiday.I too am taking ppis but dont seem to help much.ive also had a dilation which did help a bit but im still not right.Maybe you could try a dilation to see if that helps,i was given a very gentle dilation as not too disrupt the wrap too much. Barry

Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 8/30/2012 9:52 AM (GMT -6)   
I wouldn't rush into any repairs or changes in only a few weeks. It takes a few months for all the swelling to go down. After only a few weeks I was still eating only very soft foods, mostly liquids.

If you had swallowing problems before surgery, you will still have those problems after it. Nissen only tightens the valve. I have a post-polio throat, so a weak swallow to begin with. That's what the beforehand testing was all about. I only had a partial wrap because of this. One of my surgeon's minions insisted I needed a dilation when I mentioned difficulty swallowing, but I refused to even let him do an endoscopy because he said he'd do the dilation even if I had refused it. A few months later swallowing got lots better, back to my normal.

Baza
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Date Joined Jan 2011
Total Posts : 513
   Posted 8/30/2012 11:28 AM (GMT -6)   
Hi Alice,you mention in your post that the Nissen only tightens the valve,but your hiatus is also tightened or closed tight around your esophagus during the surgery so this can also cause problems with dysphagia. Barry

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 8/30/2012 5:20 PM (GMT -6)   
Thanks for responses.
Hi Baza, I thought I read in one of your posts that you were swallowing better. Have things not improved at all?
Hi Alcie, I am 5 months post op and have had one dilation. I had no testing prior to surgery, nor did I have any swallowing problems that were obvious to me. (this is my second repair) The first surgery was successful. I know things can take a while to settle down from what I experienced from my first surgery. It is very concerning to me that I still have problems swallowing which over time have become more symptomatic, rather than settling down.
Regards
Buzz

Alcie
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Date Joined Oct 2009
Total Posts : 5004
   Posted 8/30/2012 8:37 PM (GMT -6)   
Wow, Buzz, no testing? It sounds like you need it now. You can read about all the types in older posts. Put some keywords in the search box at the top of the page. My doc nearly made me redo the Bravo test because it fell off after one day. He said it wasn't really necessary though, since my stomach was stuck in my chest. Thank goodness! My valve was stuck open and I had to go without any acid prevention medication for 10 days for that one.

Why did you need a second op if the first one was sucessful?

My surgeons said they don't use mesh because it can erode into the esophagus. They only use other bits of the patient's own tissue to strengthen the diaphragm.

Yes, Barry, hiatal repair often accompanies a Nissen. Indeed it could be too tight.

Baza
Veteran Member


Date Joined Jan 2011
Total Posts : 513
   Posted 8/31/2012 4:48 AM (GMT -6)   
Hi Buzz,im still getting a hold up in the esophagus somewhere,i ate some scrambled egg recently and i had pain and foamy saliva coming up into my mouth,very uncomfortable feeling but it eventually passed after 20 minutes.Then theres thing i eat and theres no problems, even bread!Im at a loss,im convinced i have a problem with swallowing that was missed before surgery tho i never noticed it before.This surgery has just shown up the problem. Are you going for another dilation Buzz? Barry

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 8/31/2012 10:59 PM (GMT -6)   
Hi Alcie. Repair was due to reherniation and a recurrence of symptoms. My mesh was biological and I'm told one of the best.
Hi Barry. I'm happy to say that the burning in my esophagus has subsided and I will now endeavour to go without PPI's to see if everything goes okay.
I have alot of pressure in my chest abdo region off and on which alters my voice sometimes. It's like someone sneaking up behind and squeezing me whilst I'm talking. I'm so fed up with whole thing and all the wishing in the world won't alter things.
I am scheduled for surgery this month to have a stitch snipped and hope that this will fix the problem and then the surgeon and I can go our seperate ways.
It has been a very trying time physically and emotionally. The last procedure 5 months ago is the second time I have undergone surgery and it has been with the same surgeon.
I tell you, the guy you talk to before surgery is a different guy to the one you talk to after surgery if things are not going to plan post op. It's distressing as I was going really well recovery wise (except for the minor swallow problem) until the 8 week mark when swallowing worsened and other symptoms reared there ugly head. I don't feel I can communicate effectively with him anymore as he just shrugs, doesn't answer questions fully, says if this doesn't work, we'll try this and if that doesn't work, we'll try this and then are you sure you can't just live with this cause if I cut a stitch, you might end up with reflux again. Cutting the stitch was part of the plan before and apparently wasn't a problem to do so. Now, different story. I have tried letting things settle and have been hoping desperately that things would improve without intervention but I have this nagging feeling that the mesh is causing the problem and I don't want it to bore a hole in my esophagus. Ignoring it will not fix it and I don't want to have ongoing problems that may in fact worsen, all because the surgeon wasn't interested enough to address the problem that he potentially created.
Sorry for my rambling but this thing has really consumed me to the point where I am no longer socializing as eating is often difficult and it seems to be all I ever talk about and therefore dominates any topic of conversation.
Trying to stay on top of things and hoping for the best
Regards
Buzz.

Baza
Veteran Member


Date Joined Jan 2011
Total Posts : 513
   Posted 9/1/2012 3:05 AM (GMT -6)   
Hi Buzz,im with you totally on this,i agree with everthing you have said,i feel the exact same.My surgeon and his team where my best friends before the surgery but when as you say things havent gone to plan they dont want to know.My thoughts are that they know or have been trained how to do the surgery but dont know how to diagnose problems that may occur after,in my case i think its a lack of experience as my surgeon has done a hundred odd nissens and i was told on this forum to make sure a surgeon had done thousands.I find it interesting that your problems started at the 8 week mark because mine too started around that time.I remember phoning the surgeons secrectary telling her i felt really unwell at that time.I also have become a recluse because of my symtoms and im driving my wife and daughter mad constantly talking about problems.Life is so miserable at the minute.Just hope somewhere done the line this can get better for you and myself. Good Luck and all the best to you! Barry

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/3/2012 6:45 AM (GMT -6)   
Hey Baz,
Did you suffer from reflux after you had the stitch cut or before? I have really bad heartburn again today and don't know what has triggered it. I don't know for certain that it is food related. Does anyone think that if my esophagus is rubbing on the mesh it would be causing those sort of symptoms. It's like something is squeezing my esophagus up near my throat and my tongue feels burnt and my ears are aching as well. I can only eat jelly and icecream and feel really quite sick. I don't know for how much longer I can tolerate this.
I think I'm going to have to stop eating and see if that helps.

Baza
Veteran Member


Date Joined Jan 2011
Total Posts : 513
   Posted 9/3/2012 7:05 AM (GMT -6)   
Hi Buzz,i had heartburn or what felt like heartburn around the 8 week mark after surgery,at that time i wasnt eating much only those ensure drinks,yoghurts etc.When they undone they stitches a barium was done and it went through ok,a few days later i felt the symtoms where back.I dont trust those barium tests as you only drink a mouthful of liquid and its not like eating a meal.My surgeon said im only thinking ive got reflux or heartburn because things are tightened up done there,if thats true its exactly the same sensations,and im well over 6 months now and im still ill.The only way to tell is to go through all the pre op testing again and im not being offered that.I know how your feeling Buzz,this is a nightmare that you shouldnt have to go through,ive lost all faith in surgeons and doctors,if they know your ill why dont they look into it and help. Barry

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/3/2012 7:44 AM (GMT -6)   
Hey Baz
I just hope to God that this surgeon does the right thing by me and does all that he can to help me with these symptoms. You know, I honestly believe that he thinks that either I don't really have much of a problem or if he just ignores things, the symptoms will eventually disappear. I wonder if maybe my vagus nerve is suffering some kind of irritation? I hope I wake tomorrow heartburn free as the swallowing problems are enough to contend with.
I have my fingers crossed for you too Baz
Regards
Buzz

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/11/2012 5:48 AM (GMT -6)   
Ahhhhh, heartburn still. It's heartbreaking and not to mention uncomfortable. Taking some leftover nexium and drinking mylanta but it doesn't seem to be knocking it on the head. It doesn't get worse when I lay down though, which is unusual so it leads me to believe that it is not reflux.
I don't know where to go to next for help, as I know my surgeon is not interested and hasn't been since the very mention of those 4 little words. I'M HAVING PROBLEMS SWALLOWING!

ericapeace2000
Forum Moderator


Date Joined Mar 2012
Total Posts : 1110
   Posted 9/11/2012 7:04 AM (GMT -6)   
Buzz,
SO sorry you are still having problems. It must be very frustrating and dissapointing. Can you consult another surgeon or doctor?
GERD Moderator; Diagnosed GERD, no other medical conditions (this one is enough)

Post Edited (ericapeace2000) : 9/11/2012 11:54:28 AM (GMT-6)


biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 9/12/2012 6:08 AM (GMT -6)   
Buzz/Barry,

I have symptoms very similar to yours and am going in for my Nissen Takedown surgery next Tuesday. My surgeon is also going to adjust the hernia repair (loosen) just to ensure there can be no more issues. I am so excited to NOT have to worry about the wrap anymore. My surgeon told me the stomach would be basically back to normal. If you are truly struggling that much, as I am, and it is significantly impacting your life, I would strongly suggest your request that your surgeon "undo" the wrap for you. I am just a little over 2 months post op of my original Nissen and I have had nothing but significant issues since.

I am so grateful that my surgeon is going to Takedown the wrap for me. :)

Mike

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/12/2012 7:44 AM (GMT -6)   
Hey Baz, Erica and Mike
I have had a second opinion, the results of which were discussed today. The way the 2nd opinion was handled was less than desirable and was more than a little humiliating to say the least. By no fault of the 2nd opinion guy I must stress and more the un-professionalism from staff and surgeon that did the op. Anyway the 1st guy, he was due to go in and cut a stitch in my crural repair this week. I however chose not to go ahead as to be brutally honest, I no longer trust that he will do the right thing by me anymore and am relieved in a sense that the 2nd guy suggested that I should wait, but didn't rule out that a laproscopic investigation could be done as I was booked on friday. I actually believe that the sugeon that did my op is a good surgeon, IF HE GETS IT RIGHT THE FIRST TIME, because he cannot bear to acknowledge or address any mistakes that have occurred as a consequence of surgery. I seen the 1st guy 2 hours after and requested for the 2nd time to see my barium film in real time and guess what, I still can't view them because of another technical glitch. No film from 2nd op, no recollection of things that were done, NO INTEREST.
The problem that I have is in a sense is a geographical one as I live in Western Australia, and as my 2nd opinion guy says, "Perth is a small place, and everyone knows everyone"
That basically means it will be very difficult for me to get any hands on interventions in Perth because of misplaced loyality.
I will see how things go over the next few weeks and will continue to try and adjust my diet accordingly and hope that things settle somewhat. I am feeling socially isolated in a sense as swallowing problems fluctuate daily.
Thanks all for listening to my rant.
Regards
Buzz

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 9/12/2012 11:53 AM (GMT -6)   
buzzmoz-

Sorry to hear you surgeon has treated you this way. I have been very lucky to have 2 great surgeons who have constantly followed up with me after my last 2 nissens. My 1st redo surgeon gave me is email and cell number to be able to contact him anytime. He even called me and emailed me at 6 months and 1 year post op to check on things. My 2nd redo surgeon has checked on me every 2 months to see how every thing is going.

Since you had mesh repair for the hernia, that may be the problem or a combination of it and the repair being too tight. If the hernia repair is too tight the esophagus can't work as efficient.
Hope you get some help soon.

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

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/13/2012 1:00 AM (GMT -6)   
Thankyou Bill
It has indeed been a terrible journey in the sense that he never seemed interested in my problem from the get go and came across as not being the least bit concerned about my problem, right down to making fun of me with his secretary 8 weeks post op when I phoned with concerns that my swallowing had worsened. Whilst she probably knows little, if anything at all about worsening dysphagia, he does. Obviously he considered it funny.
I felt a little embarrassed for the 2nd opinion surgeon (I'll call him 'J'), as I think he tried to ensure that I got a decent assessment. It was however marred by the fact that the 1st surgeons (I'll call him 'A' for obvious reasons) secretary told me what J's assessment was before I had even seen him to discuss his findings. J of course denied this and said that A was yet to hear the outcome. A's secretary however, had told me that they had been waiting to hear from me for days to discuss the said results.(I didn't want to humilate J with this information however, as I was feeling humiliated enough for all concerned.)
Awkward for J, as although I don't agree that A should learn the results before they are discussed with me, he has cleary extended a courtesy to his colleague, not knowing that A whispers everything into his secretaries ear.
It was a difficult decision for me to seek a second opinion in the first place, but it has been all the more harrowing as it has been carried out in such an unprofessional manner and I then have to wonder if the advice that I have received has been given to me as a means to appease me. I sure hope not.
J says that A feels sorry for me and is very sympathetic that I am having such problems. I asked one of my dearest friends to accompany me on my consultations because of A's attitude and when she heard about how sympathetic A has been, she nearly choked. Obviously he has painted a different picture to J. As a result of everything that has happened, I in fact had already decided that I no longer want this surgeon to consult me not long after having booked the surgery as I don't believe that he has my best interest at heart.
Problem now is, if things don't get better who do I get to help me?
And Bill you are right about the esophagus not functioning properly, as J pointed out in one frame on the barium that resembled a saw teeth like pattern on my esophagus that is a indication that the esophagus is working too hard to swallow.
I hope and pray that things settle and my esophagus is not damaged in any way.
Thanks to all again for reading my rant, and I hope that it is not too hard to follow
Regards
Buzz.

Baza
Veteran Member


Date Joined Jan 2011
Total Posts : 513
   Posted 9/13/2012 2:41 AM (GMT -6)   
Hi Buzz,so sorry to hear that your going through all this,its very hard when feel theres noone can help.I can tell you im feeling the same,my surgeons registrar wrote to my GP saying that i was having anxiety over my op and that is causing all my problems! I cant believe it,total rubbish,my GP said its a" blame the patient " one.Im trying to get a second opinion but i will have to travel as theres only one surgeon here doing this surgery.I hope you can get this sorted Buzz,theres someone out there who can surely help you! Barry

buzzmoz
Regular Member


Date Joined Mar 2012
Total Posts : 52
   Posted 9/14/2012 10:49 PM (GMT -6)   
Thanks for your reply and concern Baz,
I sure hope there is someone out there that can help us. I told my surgeon that I don't want to feel uncomfortable contacting him if there is a problem, like when my swallowing became worse 8 weeks post op and he made a joke of it to his secretary who relayed his smart A@$e comment back to me. How am I suppose to trust and rely on someone who exhibits the epitome of unprofessionalism and zero compassion all the time? This is how clever he thinks he is. Our last consultation was tense as you would imagine and so at one point we are discussing my weight when he makes an adverse comment about obese people he treats, in saying that next to them, I look emaciated. This guy obviously doesn't realise that we people ' the patients' are his bread and butter and a majority of these patients are morbidly obese and go there for sleeving as I'm sure as a last resort. I wish I'd never met the guy, and in actual fact I was meant to see his partner originally but alas, I cannot turn the clock back. I live in hope that things will settle down and I will continue to seek help from somewhere, but I will never trust him again in the sense that I don't imagine he would cause me direct malice, but I don't imagine that he would do all that he could to alleviate my problems either. It is a horrible feeling having lost confidence in the person who is treating you.
I am still having heartburn symptoms that fluctuate in severity daily that is effecting my tongue and ears. No clue from him why? I am taking nexium which only offers minor relief if any. I am starting to wonder if they are esophageal spasms. Also that feeling of pressure in my chest is often there. Second opinion guy says big part of swallowing problems are anxiety and I agree that anxiety does play a role, but honestly for someone who has been through what I have been through, I'm feeling fairly well balanced considering that my surgeon is a goose. (No offense to the bird intended)
Take care Baz, and know that I sympathize with you.
Regards
Buzz
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