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Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/11/2012 10:25 PM (GMT -6)   
I'm a 37yr old with silent reflux. I don't feel it's too silent since I feel like I'm choking, I get shortness of breath, tightness in chest and overall feeling of terrible when i know im "refluxing". I've had diagnosed reflux for 4 yrs but know I've had undiagnosed for longer. I take 60 of dexilant but don't feel it works so well now. I've developed anemia from the dexilant. Saw dr Horgan at USCD today and he said Nissan fundoplycation is good option for me but anyone know of any long term restrictions? I'm a runner. Will I be allowed to run? Also I see a lot of people on here have had the surgery but still can't eat certain things cause they get reflux? What should this do for me then if most of my symptoms are silent anyhow? I don't get the burning in the chest but most of my symptoms are like anxiety with shortness of breath, tightness in chest and neck, etc. thank you for any help

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 10/12/2012 6:28 PM (GMT -6)   
Liz-

with silent reflux you can have more damage to your esophagus and not know it. Definitely need to do something to get it under control. As for running, I have been told by 3 different surgeons that once all is healed I can do anything I want to. The only thing that restricts me from still wrenching on cars and leaning over hoods all day is my ribs. If they didn't hurt so bad I'd still be doing that and playing softball still.

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

Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/12/2012 6:35 PM (GMT -6)   
Thanks bill. So have u had the surgery 3 times or am I miss reading your signature area? I thought its a one time shot? My other gastro today just told me to avoid the surgery cause it won't last long but the surgeon is saying I should do it. I feel so confused on what to do especially when I'm having "good" days. Tell me your honest opinion, do u really feel like it helped you? I mean no meds, no swallowing problems, etc. I see a lot of people complaining of swallowing difficulties and still only eating soft foods almost a 1yr later.

TheSiXness
Veteran Member


Date Joined May 2012
Total Posts : 541
   Posted 10/12/2012 7:54 PM (GMT -6)   
I use to run in college before all my symptoms started happening. I recently had the TIF procedure done. I'll have good days and bad days. If you plan on going slow you should be fine. I only have trouble when I try and do a hard work out. I'll get acid in my nose after a mile and a half. It sucks. My throat and nose closes up, but I can run fine at 7:45 mile pace.

I'm thinking of having the Nissen sugery done also because I'm having horrible asthma. Hopefully there some runners on this forum with some answers.

Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/12/2012 8:23 PM (GMT -6)   
How long ago did you have the tif procedure? This is the one I wanted but my surgeon, who is known for this type of procedure, won't do it? Was your reflux silent or typical. Do you still take medicine? Do you feel your good days are like your days prior to the tif procedure? The tiff procedure is like a fundoplycation, do u feel the tif is not working now and the fundoplycation will work better? Thank you so much for writing me!

TheSiXness
Veteran Member


Date Joined May 2012
Total Posts : 541
   Posted 10/13/2012 12:12 AM (GMT -6)   
I had the TIF done about 9 months ago. I had silent reflux. In my opinion the TIF procedure didn't work that well. My throats in less pain, but I've developed really bad asthma and sinus congestion since my surgery 9 months ago. The pain maybe down, but overall with these new symptoms I'm worse off. I'm currently not on ppi's at the moment and have managed to live off them for about 4 months now. They do help a little bit, but controlling my diet help's more. I'm on a low acidic, low fat diet.

I think the fundoplication is a better procedure for silent reflux. From my understanding it has a higher success rate at treating people with silent reflux then the TIF. The Tif procedure definitely sounded better when I was talking to my surgeon initially though. My main reason for getting the tif over the nissen is that I didn't want scars on my stomach...but it turned out that I had to have a hernia repair with my TIF, so the doctor had to make 5 little incision in my abdomen anyways.

The TIF works best on people who have small hernia's and have mainly typical reflux symptoms. My problem originally was that I had a very large hiatal hernia and silent reflux. It seems like I may have not been the best candidate for the TIF in the first place. I think the nissen will help me because it will make a tighter wrap and it's better suited for people with larger hiatal hernias. However, with a tigher wrap there can be some complications like bloating, difficulty burping, difficulty swallowing, difficulty vomiting but if it get's me breathing, talking and running better, it'll be worth it.

If the full nissen complications scare you, theres other surgeries like the toupet fundoplication. This would wrap your stomach around your esophagus like the nissen, but only does it 270 degrees. This apparently allows you to burp easier because it's not completely wrapped around your esophagus.

Also, I'd like to point out that even on the esophyx TIF brochures/website they recognize that the nissen procedure is for people with severe gerd/large Hiatal hernia and is the next step up from the TIF procedure.

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 10/13/2012 7:20 AM (GMT -6)   
Lizard.. this is very interesting to us who have LPR and are considering LINX surgery. Dr. Horgan is one of the relatively few doctors who has installed the LINX device (magnetic ring to supplement the LES). Did he mention LINX as an option for you? If he didn't, it's worth asking him about. And if you would, please report back here on what he said -- as there is limited data on LINX surgery success for atypical reflux symptoms.

I am quite interested in LINX surgery since from what I have read, the recovery is easier and once healed, it's as if the LES was repaired without doing the Nissen stuff to the stomach. Any type of activity should be fine with LINX because after a couple of weeks, it is anchored in place by the body. I am a very active person and I'm also looking for a surgical option that wont limit activity much in the short or long term (e.g. with Nissen they say don't lift over 5 lbs for many weeks).

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 10/13/2012 8:08 AM (GMT -6)   
Hi Liz,
Silent reflux is more challenging because it does its damage quietly.  Typical reflux is much easier to diagnose, and GI docs more readily consider other options when medication alone doesn't work. If you are not responding to medication, there aren't a lot of choices.  Nissen fundoplication is considered the "gold standard" for eliminating reflux. 
 
Here is a great resource that looks at a variety of reflux treatments and discusses the surgical and non-surgical options:
 
As far as running goes, it seems to me that it will only be an improvement once you're healed.  Granted, your running will be restricted until you have healed, but once that occurs it should be a much improved experience.  I don't run, but rather fitness walk, and before my Nissen that walking would  rev up my reflux in a big way.  Once I had the surgery that no longer happened.  I can only imagine that running would be much more likely to bounce reflux out of your stomach than walking.  In my opinion, the surgery would greatly improve that part of your life. 
 
There is no guarantee regarding the length of time any given Nissen will last.  This is likely because of so many variables in surgeons and patients.  There have been studies that follow Nissen patients for 10 years and the general rule is that 90% of those patients consider their surgeries successful and continue to be happy with the results. 
 
Here at the forum we've heard from one or two post-Nissen patients who had surgeries lasting 20+ years.  Of course, that is always heartening.  The vast majority of those of us who make the decision to have the Nissen do so after many years of suffering. Medication alone works for most GERD patients, which is why this surgery is not well-known among the public.  For those of us who aren't that lucky, there aren't a lot of choices.  Nissen surgery should be a last resort, after all other options are ruled out. 
 
In my experience, those with silent reflux have the most difficult time with Nissen recovery.  Since they haven't suffered pain in the same way as those with severe typical GERD, the challenges of recovery seem more daunting. Some of the atypical symptoms that they experience before surgery will be the last to disappear during recovery.  While high volume reflux is stopped pretty much immediately after surgery, some symptoms that are caused by sensitivity take longer to improve.  It sounds as if your silent reflux isn't all that silent, though, as you have some real GERD-related symptoms.
 
I assume you've had all the testing?  What was the result of you 24hr PH monitor and manometry?
Those are very important tests that provide the surgeon with the information necessary to inform his/her decsions.
 
Good luck in your quest for answers!
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.”

Post Edited (dencha) : 10/13/2012 8:11:08 AM (GMT-6)


Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/13/2012 10:08 AM (GMT -6)   
Hi everyone. Thank you for your responses. I will ask about linxs. I know the tiff or espoghyx procedure the dr wouldn't do on me and said there wasn't enough research on long term benefits. It was all weird to me since this doctor is known for his incision less gerd repair. Ill inquire more and report back though. I apparently only have a small 1cm hernia that disappears and returns. I've had a bravo ph for 4 days. 2 days off meds and 2 days on med. while office meds I refluxed 121 times normally during waking hours (which makes me think my reflux is somehow stress related but I don't feel all that stressed) two days off meds I refluxed about only about 20 times a day. So supposedly the medicine worked when this test was done 2yrs ago. It's just recently (last yr) that I felt the meds aren't working all that well anymore. My motility test showed my lowest number was 40 and my highest was 80. Idle said normally this the numbers should be 120. He said he didn't know if my motility is bad because I have reflux or if my motility is causing reflux. I'm assuming this is why some people after the gerd surgery report problems swallowing. He is going to repeat my motility study to see if I've improved since being on meds and sated the same or got worse. I just would hate to go through this surgery and not be able to swallow or still have to take meds. It's weird that if I stop my meds now my reflux is way out of control. It all started with sore throats and shortness of breath and loosing my voice. Now if it doesn't work it's sore throat, stomach pain, tightness in throat, chest, neck, feeling regurgitation, almost as if my body has to have the meds now! The dr is also going to make me do a test he calls the marshmallow test where he has me swallow barium and a whole marshmallow. He's doing another look in my espogas, and motility before we proceed with surgery. I agree with te comments that a lot of people who aren't having success we don't know what type of dr did the procedure, what symptoms these people had, how their test looked compared to mine, it's just scary cause I find more negatives than positives. I've only met two people who got te fundoplycation and it hasn't been many yrs. I want alot of people who's over 10yrs to tell me the truth on everything. Their tests there success or non success. I wonder if any of dr horgan patients would talk? Haha.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 10/13/2012 11:43 AM (GMT -6)   
Liz,
If your motility is an issue, I would expect that your surgeon would choose a partial wrap (270) rather than a full Nissen wrap.  Some of the people who struggle after surgery may not have had sufficient testing and as a result had the wrong procedure. 
 
Remember that people who aren't having difficulties (and those who aren't internet "junkies" like us) don't ever post a single word online.  That's why the scientific research sites are so much higher than what you'd expect looking at online forums:
 
It's a tough decision I know.  I went through the same struggle.
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.”

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 10/13/2012 11:23 PM (GMT -6)   
Liz-

Here is my absolute honest opinion of my nissen. I eat anything I want to. I do occasionally have food get stuck, but it is usually my fault for going back to eating fast as I had to in the Navy. If I eat normal, no problem. I have had a few beers and White Lightning without any problems.
Would I do it again?....In a heart beat. It has totally changed my quality of life. No more daily and nightly meds for GERD. I do rarely get some heartburn, but so do people without GERD.

Here is a link that is on our resource thread about why I had to have 3 nissens in 5 years. Only the first was bad, actually done incorrectly. That why it's so important to be sure your surgeon has done lots of these successfully.

www.healingwell.com/community/default.aspx?f=45&m=2337138

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

Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/14/2012 11:40 AM (GMT -6)   
Thanks bill, was your reflux silent or regular? Do you have a lot of throat clearing now? Stuffy nose? When you say difficulty swallowing do you feel food gets stuck or do you feel it moving slowly down? Did you have a motility test done prior to your nissen? If so what was your numbers? Thanks so much
Liz

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 10/14/2012 12:22 PM (GMT -6)   
Liz-

I had silent at first and then full blown GERD. I don't have any issues with throat clearing or nose issues, well unless I catch a cold.
I do have food get stuck once in a while at the wrap when I eat too fast. I used to have it get stuck all the time before my nissen ay a higher level though.
I do have motility issues now after my esophageal perforation, but I don't know what the numbers are from either of my 3 manometries. I had the full work up of tests before all 3 nissens.

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

Lizard
New Member


Date Joined Oct 2012
Total Posts : 7
   Posted 10/14/2012 2:03 PM (GMT -6)   
Ok that helped me. I have never felt my stop when swallowing so I guess that's a good sign for me. I used to feel like I forgot how to swallow and used to feel like it was going down slow then fast but since being on dexilant that went away. I guess I'll know for sure when they do the motility again. So your reflux sounds like how mine started out and now of course if I don't take Meds it's full gerd too eventually. Thanks so much Bill, I'm grateful for the info you told me. Everyone on here is helping me and I'm so grateful!!!! If there is anyone else out there who wouldn't mind telling me their findings too? I'm checking this all the time.
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