Update after early 4 months post op

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BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/3/2012 1:22 PM (GMT -6)   
Hi there.
I had Nissen Fundoplication surgery last Thursday (4 days ago) and am a real worrier regarding health issues so have found the whole experience rather difficult so far and I'm just at the start!

I had a hernia repair as well. My surgeon said that I had a "huge" whole in my diaphragm.

I had a lot of pain for the first 2 days/nights post op but it's much better pain wise today.

My concerns are:

1. As of last yesterday afternoon and today I have developed a horrible sour taste in my mouth (mainly all over my tounge - especially at the back). With my constant anxious state I am immediately thinking it's 'Acid' and the wrap has failed. However I am not getting other reflux symptoms (like burning or pain I used to get with reflux).

2. For 2 weeks before the op I started coughing up mucus. This is still happening post op and I am concerned that the coughing could damage the wrap. I was told by hospital staff that I had to cough the mucus up otherwise it could turn into a chest infection. They also said that coughing wouldn't damage the wrap. I have read since that coughing is bad though??! I am coughing carefully and not having coughing fits or anything like that but it still concerns me.

3. I am having a hard time drinking much fluid. I can only sip every 10 seconds or so or I get the feeling I need to burp and then it hurts in my chest a lot as my body goes through the motion of burping but then it feels like the wind can't get past the wrap which I guess causes the pain - is that normal?

4. Eating is a little easier. I am only eating soup, ice cream, jelly (jello) etc. I eat slowly and after a while I get the same sort of pain I get when drinking. It feels like I need to do a big burp and hurts for a while. Does that mean I am full when this happens? I don't get the normal feeling of being full so am trying to work this all out.

Thanks for any advice or help you can give me as I am worrying about it all.

Post Edited (BritishBeef) : 12/17/2012 3:37:59 AM (GMT-7)


Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5028
   Posted 9/3/2012 2:18 PM (GMT -6)   
Welcome Brit.
So far your recovery seems pretty normal - as a patient, not a doctor! It'll get better. sure is scary though, for a while.

You might try not sipping quite so often. Every time you sip you are going to swallow air. While the swelling is bad, and it can get worse for a couple of weeks, you won't be able to burp much, if at all.

Your nurses are right in that you have to cough out mucus. Try holding a pillow fairly tightly over your stomach.

Are you home yet? If so, do you have an appointment to see your doctor for a follwup?

I'm sure Denise or someone will write more reassurances.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/3/2012 3:06 PM (GMT -6)   
Hi British Beef,
Welcome to the Healing Well yeah yeah yeah Wrapped Club! yeah yeah yeah Like Alcie, I think your symptoms are quite normal at your point in the recovery process.  And like Alcie, I'm not a doctor, but did have this surgery three and a half years ago and shared many of the symptoms and concerns you have.  In fact, here is the link to my early recovery journal that I posted here on the forum:
 
I'll try to speak to your questions and concerns:
 
1. As of last yesterday afternoon and today I have developed a horrible sour taste in my mouth (mainly all over my tounge - especially at the back). With my constant anxious state I am immediately thinking it's 'Acid' and the wrap has failed. However I am not getting other reflux symptoms (like burning or pain I used to get with reflux).
There is a very good chance that your wrap has swollen due to the trauma of surgery, and food/liquid is being held back at the wrap site.  This is a very common problem, and nothing to be concerned about.  Actually, your wrap becomes increasingly more swollen over the first two weeks.  After the swelling peaks at or about the 14 day mark, you'll begin to experience gradually improvement.  This is totally normal.
 
I actually called my surgeon to ask about reflux symptoms I thought I was having.  His response was that at my stage in recovery "anything was possible".  There could be food and drink held back by the wrap, or it was possible that the swollen and misshapen wrap is letting a little acid through.  Either possibility is nothing to be worried about
 
It takes a full 6 months for the majority of healing to occur, and a year for the rest.  You're at the first baby steps of recovery, and will certainly have lots of bumps in your road to recovery.  It's totally normal and to be expected.

2. For 2 weeks before the op I started coughing up mucus. This is still happening post op and I am concerned that the coughing could damage the wrap. I was told by hospital staff that I had to cough the mucus up otherwise it could turn into a chest infection. They also said that coughing wouldn't damage the wrap. I have read since that coughing is bad though??! I am coughing carefully and not having coughing fits or anything like that but it still concerns me.
If you read my early recovery journal you'll see that I coughed hard and nonstop before, during, and after my surgery.  Like you, I worried that my wrap would be damaged.  I had an additional risk factor in that I had been on high doses of steroids and my internal tissue was extremely fragile.  Because of that, I was even more worried.  I had tons of mucous to cough out, and it did hurt to cough.
 
I can tell you, though, that I had no damage done to my wrap, and it has remained intact.  Alcie is correct...hold a pillow to your stomach when you cough.  Also if you irritate an incision with your coughing (my left rib area incision was extremely painful) I recommend ice.  I lived with ice on that spot until the healing process took over and the pain subsided. 
 
I coughed a lot for a full two and a half months until the healing process cleared my my poor lungs.  It almost seemed as if it happened overnight, but of course it was a long healing process.

3. I am having a hard time drinking much fluid. I can only sip every 10 seconds or so or I get the feeling I need to burp and then it hurts in my chest a lot as my body goes through the motion of burping but then it feels like the wind can't get past the wrap which I guess causes the pain - is that normal?
 If you're anything like me, swallowing is painful at your stage of the game. I didn't even want to swallow my saliva at that point.  Be sure that you're not using a straw, as it introduces more air into your stomach and creates more bloating.  If you read the description of my swallowing in my recovery journal, you'll get an idea of the painful swallowing I experienced. 
 
Avoid iced drinks, as it can cause spasms in your esophagus. It's normal to have bloating post op and not be able to get any burps through the swollen wrap.  Don't try to burp.  The best burps at your stage of the game is when your stomach burps itself. You could try chewable Gas-X tablets.  They can be helpful.


4. Eating is a little easier. I am only eating soup, ice cream, jelly (jello) etc. I eat slowly and after a while I get the same sort of pain I get when drinking. It feels like I need to do a big burp and hurts for a while. Does that mean I am full when this happens? I don't get the normal feeling of being full so am trying to work this all out.
Ice cream is very cold and can create some of the esophageal pain I mentioned.  If you don't get full, be sure to limit your intake to 1/4 to 1/3 of a cup at a time so you don't overfill your stomach and create pain and irritation.  Eat many meals throughout the day.  Try warm tea or soup rather than ice cream.  I think you'll find it easier to take.
 
Glad you've joined us!  Stick around for lots of support from others who've had the same recovery experience.
Very 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.”

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/4/2012 4:38 AM (GMT -6)   
Thanks for the replies, it's much appreciated!

@Alcie Thanks for that. One of my nurses told me about the pilow thing but to be honest I stopped recently using a cushion because it's stopped hurting when coughing. I will go back to using one now though.

I am at home (came home after 2 nights). I have an appointment in 4 weeks to see my surgeon again for a follow up.

@Denise Thank you for your detailed reply. It has made me feel better. I have read your diary and it was fascinating. I hope I have as good as a recovery as you (bar the lung issues!).

I have something else I am concerned with. Lately, I have been having bouts of severe nausea. I had one that started late evening and lasted all night. I took some anti nausea tablets I was given by the hospital which you put under your top lip and leave to gradually dissolve (takes a couple of hours) but they didn't seem to help. It was hell.

I am obviously very worried about heaving or vomiting in case it ruins my wrap. Is it normal to get nausea? I haven't taken any pain meds for over 24 hours so I know it's not a side effect from those.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/4/2012 1:32 PM (GMT -6)   
Hi BritishBeef,
You are right in wanting to avoid vomiting or even retching.  Be sure to contact your surgeon's office and let them know what's going on.
 
I've always found that when I feel nausea Zantac or PPIs can help calm things down.  It gets that acid under control and helps my stomach feel better.
 
Another thing...I've used Zofran (the kind that melts in the mouth) and Compazine suppositories.  The suppositories are by far the most effective in dealing with nausea.
 
Take it very easy with eating and baby your stomach.  Smart to avoid the narcotic pain meds if your stomach isn't feeling well.  Liquid Tylenol is the easiest on the stomach. 
 
Is it normal to have nausea post op?  Yes.  It's an individual thing, though.  Some have it and others don't.  Take it seriously, though.  It is important to avoid vomiting at your early stage of recovery especially, and actually always.  I vomited twice since my surgery...at the one and two year mark.  I used compazine suppositories to keep me from repeated vomiting episodes.  Just once each time, and no untoward effects.
 
Hang in there!   It gets better.
Take care,
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.”

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/5/2012 5:03 AM (GMT -6)   
Thanks so much for your replies Denise they are soooo helpful. Really appreciated.

Unfortunately I'm now going through a rough time at the moment. I have started having very painful diarrhea. I was up all night long with cramping and regular diarrhea. As a result I got less than an hour's sleep!

Is diarrhea yet another side effect of this surgery? If so, how long does it usually last? It's hard enough drinking as it is without losing valuable liquid in other ways. Not having any fun at the moment :(

On top of that I have been diagnosed with oral thrush which explains the sour taste in my mouth. Unfortunately it seems to also have given me a dry tickly cough. I was coughing most of the night. I think the coughing has irritated one of my incision sites as it's quite painful today. A doctor had a look at my incisions yesterday and said that they were healing fantastically well.

I have managed to get prescribed some Zofrax for nausea which I had to take last night. Seems to have helped somewhat.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/5/2012 9:51 AM (GMT -6)   
Hi British Beef,
You're definitely going through a rough time, to say the least.  Sorry about the thrush, but at least you know what's causing the sour taste. I assume they're giving you an oral rinse for that.  It shoud start working.  Here's a link to information about thrush:  http://www.mayoclinic.com/health/oral-thrush/DS00408
 
Yes, unfortunately diarrhea can be a symptom after a Nissen surgery.  I never had it to the extent you're describing, but I believe I've read of others who have.  Joy, a longtime member here always explains it as "liquid in, liquid out" and found that it improved once she started with more solid foods.  My experience was I'd first get a gurgling sound after eating which is a symptom of "dumping syndrome" (http://www.mayoclinic.com/health/dumping-syndrome/DS00715) which is a reaction to the trauma during surgery.  This improves gradually as you heal.
 
Still, if you're having severe diarrhea that is keeping you awake, please be sure to call your doctor.  I wonder if it's a reaction to the thrush treatment?  Did it start after your first dose?  I don't know if that's possible, but be sure to discuss all options with your doctor.  Your surgeon's office must have experience with this, so you should probably give them a call as well.  Perhaps they'll sugest a treatment to get you through this time.
 
Hang in there!  It will get better!
We're with you as you work through this recovery!
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.”

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/5/2012 7:53 PM (GMT -6)   
Hi, denise took the words right out of my mouth.
As long as you're drinking liquids you'll have diarriha. Try eating some very watery grits. It will bulk you up and help slow you down.
Joy
When life throws you lemons....
Pick them up and throw them right back at them! :))

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/8/2012 2:00 PM (GMT -6)   
Thanks again guys. Yep I have Thrush treatment on the go. Thankfully my diarrhea has stopped after taking some diarrhea treatment although that has bunged me up a bit I think!

Just had a very horrible experience. Had a bout of hiccups that lasted over an hour. They were every 10-15 seconds and hurt. As I had a large diaphragm repair it am concerned that hiccups like that could cause damage. They were full body contorting hiccups too. Hideous.

I'm still have a really hard time drinking. I'm quite dehydrated as a result. I try to drink a little often but just get the full feeling and discomfort after small amounts. Especially if I have eaten in the past couple of hours. Is this common?

Post Edited (BritishBeef) : 9/8/2012 1:03:16 PM (GMT-6)


opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 9/8/2012 2:10 PM (GMT -6)   
BritishBeef-

That is very common. Do the best you can to stay hydrated. Being dehydrated will make you feel worse. The hiccups came when my stomach was full. When I stated getting them I knew to stop eating right then. I had hiccups with all 3 nissens and nothing was damaged from them.

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

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/9/2012 6:22 AM (GMT -6)   
Thanks for that Bill.
This morning I am having some pain breathing in whilst stood. I guess the hiccups have aggravated my healing diaphragm?

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 9/9/2012 8:03 AM (GMT -6)   
They can definitely make things sore. I can remember cringing every time I would hiccup during the first couple weeks of recovery.

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

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/10/2012 4:15 AM (GMT -6)   
Having a worry again today. Last few nights I have been feeling what feels like reflux during the night whilst in my semi-led down position. Last night it felt a little worse and I even have it this morning too. Should I be worried? I'm terrified that I am going through all this for nothing. It just feels like a bubbling up at the back of my throat and in my chest (at the wrap site). It's uncomfortable too. It feels like what I used to get before the op.

Is it too early to tell yet? I am 11 days post op now. HAs anyone else experienced reflux type sensations so soon after op? Did it go away?

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/10/2012 11:37 AM (GMT -6)   
Like Denise says, "the esophagus is a dumb organ. It interpets everything as reflux."
You're still swelling inside. Sometimes you get little leaks because the swelling is irregular and is not making a solid seal.
Give it time.
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, and Allergies

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

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/10/2012 9:13 PM (GMT -6)   
Hi British Beef,
It's totally normal to have reflux feelings.  It's absolutely possible to even get some reflux, as Joy said.  The wrap is swollen and becoming more so daily as it reaches peak swelling at about the two week mark or so.  The discomfort increases as the swelling increase.  Some surgeons suggest that their patients continue to take PPIs for the first few months to provide more comfort and protect the wrap.
 
Don't worry...It happens to most of us!  It did me, that's for sure.  I called my surgeon at about your point in recovery to ask him about it, and he said, "At your point in recovery, pretty much anything's possible".  It could be a little reflux, or it could be pain that the esophagus is misinterpreting.
 
Hope you're feeling well otherwise!
Have a great day,
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.”

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/11/2012 1:25 AM (GMT -6)   
Thanks guys. Sorry about the questions but as you can tell I'm paranoid about it. Had a bad night's sleep last night. A couple of my incision sites were painful and I couldn't get comfortable. Also along with the feeling of reflux, I had a period where I had an irritating dry cough - another reflux symptom :(

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 9/11/2012 7:55 AM (GMT -6)   
BritishBeef-

As Joy and Denise have said you are experiencing very normal issues for your point in recovery. I wish more of the surgeons would pay attention to their patient's recovery issues and keep a journal on them so they could for warn their other patients about this. Seems such a simple thing to do, but they don't do it.
With the hiccups and such the incisions can definitely get sore too. The upper left one may bug you for quite some time. It's the one they use to retract the liver and such, so it had alot of manipulation and pressure through it.
I do remember getting a slight cough after mine, but used my spirometer too help with that. Did you get one of those to help clear your lungs after surgery?

Don't ever worry about asking us questions. That's part of the reason we are still here even after we had a successful surgery. I know I sure wish I had found this rite before my first nissen.

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

biged11543
Regular Member


Date Joined Jul 2012
Total Posts : 42
   Posted 9/11/2012 8:16 AM (GMT -6)   
Hi BritishBeef-

I had/have similar symptoms as you and I'm at the 2 month post op point. Unfortunately, my surgery was not a success and, to that end, I am having the Nissen Takedown surgery next week. My wrap is just simply too tight and unnecessary. When I visited my surgeon last, and he realized that I've lost 42 pounds in 2 months, he immediately agreed to "undo" the wrap.

Bill, Denise,

You two see to provide some of the best advice/insight here.....when I have the reversal, my surgeon basically said my stomach will be back to normal and that the post op recovery diet will be NOTHING like that of the Nissen post recover diet. Sound right?

Also, this coated tongue won't go away....I'm guessing it's due to things getting stuck and fermenting and coming up into my mouth and coating my tongue....again, sound right? I'm hoping that once my wrap is "undone" I will be able to swallow and eat normally and nothing will get "stuck" as there is no wrap.

All feedback greatly appreciated!!

Thank you

Mike :)

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/11/2012 8:17 AM (GMT -6)   
opnwhl4 said...
BritishBeef-

As Joy and Denise have said you are experiencing very normal issues for your point in recovery. I wish more of the surgeons would pay attention to their patient's recovery issues and keep a journal on them so they could for warn their other patients about this. Seems such a simple thing to do, but they don't do it.
With the hiccups and such the incisions can definitely get sore too. The upper left one may bug you for quite some time. It's the one they use to retract the liver and such, so it had alot of manipulation and pressure through it.
I do remember getting a slight cough after mine, but used my spirometer too help with that. Did you get one of those to help clear your lungs after surgery?

Don't ever worry about asking us questions. That's part of the reason we are still here even after we had a successful surgery. I know I sure wish I had found this rite before my first nissen.

Take care,
Bill


Thanks Bill.
Yes I agree that surgeons should give more info. Mine did the job and I saw him a couple of times again but was out of it. I got no info on release and was told to look up diets etc. on the web!! I'm in the UK and went private expecting better than that!


I wouldn't be concerned about the cough if it was a productive one like the one I had immediately after surgery (which went away). This is a new one that's dry and tickly at night which I used to get with my reflux prior to surgery - hence my concern.

Weirdly, I have what looks like a suture poking out of a hole next to one of my incisions. My surgeon said that no sutures were used to close the incisions, just glue! Anyway, this strange fraying piece of thread poking out of my stomach seems to be becoming an issue as it's started to swell up and become very red and sore. I'm seeing a doctor about it later today.

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/11/2012 8:19 AM (GMT -6)   
biged11543 said...
Hi BritishBeef-

I had/have similar symptoms as you and I'm at the 2 month post op point. Unfortunately, my surgery was not a success
Just when I was feeling a little more positive........

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 9/11/2012 11:27 AM (GMT -6)   
British Beef,
Mike's situation is unique.  I've worked on this forum for over 3 years and what he is describing is a very uncommon experience.  Do not let someone elses unique issue lead you to assume that you're going to be in the same situation.
 
Worry and fretting will not help this recovery go any faster, and instead will make it seem far slower, and may even take precious strength away from your body as it heals.  Surrender to your recovery and follow it where it takes you.  Hang in there.  It gets better!
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.”

eLaReF
Regular Member


Date Joined Aug 2012
Total Posts : 74
   Posted 9/14/2012 4:51 AM (GMT -6)   
Hi Mad Cow :)

In the UK too. I'm 9 years in (went NHS) and am still fine.

I was coughing at night too a couple of weeks ago and was worried that my wrap might be coming undone. I went to my GP and was told that I had a nasal drip from an infection in my sinuses - got a nasal spray and I'm fine now.

As you're in the UK, thought I'd mention it as it could just be a bug that's going round/

Cheers.

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/14/2012 10:36 AM (GMT -6)   
dencha said...
British Beef,Mike's situation is unique. I've worked on this forum for over 3 years and what he is describing is a very uncommon experience. Do not let someone elses unique issue lead you to assume that you're going to be in the same situation.

Worry and fretting will not help this recovery go any faster, and instead will make it seem far slower, and may even take precious strength away from your body as it heals. Surrender to your recovery and follow it where it takes you. Hang in there. It gets better!
Best wishes,
Denise


Thanks Denise. You are right and I'll just go with the flow.

BritishBeef
Regular Member


Date Joined May 2011
Total Posts : 38
   Posted 9/14/2012 10:39 AM (GMT -6)   
I am experiencing a sharp involuntary intake of breath every 30 minutes or so at the moment. Has anyone else had this strange symptom? I am now 2 weeks post op and these involuntary breaths started a few days ago but nowhere near as frequently as they are right now. I have looked into it online and it seems like lots of people have this issue. One thing I noticed is that quite a few of the people had had recent abdominal surgery. I had a huge whole in my diaphragm that needed repairing during my Nissen Surgery so there must be link. Just wondering if anyone else has had this side effect post Nissen?

My eating is both harder and easier at this point. For some reason everything is getting stuck after the first bits of a meal I try. Then, after about a couple of minutes it seems to relax and I am able to eat quite well. I can now eat a LOT more now too which is great. I am able to drink much more now as well. I have stopped losing weight and have even put a couple of lbs on.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 9/14/2012 12:18 PM (GMT -6)   
The food swallowing trouble is due to the swelling still going on inside.
The breathing issue is normal. It's your diaphragm getting adjusted to the changes to it. I had attacks of hiccups that would last for hours.

Parts of the quirks.........
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, and Allergies

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