Having NF on Tuesday

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gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 1:56 AM (GMT -6)   
Like so many, I am so scared. I have been reading that there is more swelling at 2 weeks post op, is it best to stay on full liquids for 3 weeks then? My doctor said to progress to soft diet after 1 week.

Retired Seabee
Regular Member


Date Joined Feb 2013
Total Posts : 129
   Posted 4/28/2013 4:45 AM (GMT -6)   
Welcome to the group. Your fears are normal. I am not the moderator--just a rank-and-file member. But I had my hiatal hernia repair and Nissen six weeks ago plus four days and most of my fears were all in my head and did not materialize. I did months of research on the net and studied every document here on HealingWell that was related to Nissen looking for facts and not opinions. I also joined a Facebook support group called Nissen Fundoplication and gleaned their data base for facts. I could not have had the operation with a clear mind if it wasn't for these two groups.

There is no hard fast rule that you are going to personally experience every difficulty that you will read about or any of them. For example the 14 day swelling you mentioned. I didn't experience it. I had the initial swelling but it diminished after a few days and never came back. That is not to say that yours will do the same but as you will read, everyone's recovery is different and you have to go with the flow.

As the date for the surgery approached I began to calm down from my initial fear of this great unknown. I had the best Doctor available in my area. I got in the best physical condition that I could prior to surgery. I also began to realize that for a few hours I was turning my life over to the best trained surgical team that I could find. I am a religious person so I turned it over to God to guide the surgeon to do the best he possibly could.....It was out of my control.

Janeuk
New Member


Date Joined Feb 2013
Total Posts : 11
   Posted 4/28/2013 10:50 AM (GMT -6)   
I had my wrap done last Wednesday in cambridge in the uk and the process was fine and the care I received amazing. I am feeling fine in myself now, I am resting and drinking decaf tea and coffee, homemade soups and puréed stewed fruit, much more than I thought I would in the first week. It is important to take things slowly regarding what you eat or drink, I am hoping the wrap will not swell anymore as it does not for everyone in the first two weeks, and I hope to be back at work in a couple of weeks.

Hope all goes well on Tuesday.

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 11:10 AM (GMT -6)   
Thanks for your encouragement. I am going to stay glued to this forum for the next few weeks. I have been reading a lot. Can either of you burp?

Janeuk
New Member


Date Joined Feb 2013
Total Posts : 11
   Posted 4/28/2013 11:14 AM (GMT -6)   
Hi I am just writing up a detailed posting about the whole experience so hope this helps too. I am not having too many problems with gas, I think I had more gas before the op but this might be because I am not eating that much now! I have had the odd tiny burp but nothing that I would really notice. I had a 270 degree wrap so this might be why.

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 11:17 AM (GMT -6)   
That and gas bloat are my biggest worries.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 4/28/2013 2:11 PM (GMT -6)   
Hi gtnbr,
Welcome to Healing Well!  I had my Nissen a little over four years ago, and I am able to burp, so never really had much trouble with bloating. My surgeon informed me that I wouldn't be able to burp or vomit post-op, and I've found I can do both.  I suspect he gives that warning, because it's a possibility.  I do always carry anti-nausea drugs (my most effective is Compazine suppositories) with me wherever I go, just in case. 
 
You many have already seen it in the Resources section, but here's my early recovery journal:
 
My doctor set me free on Day 5 0r 6 to eat "whatever could be chewed to a liquid (creamy consistency)."  He warned me against sandwiches, untoasted bread, and steak. If you read my journal, you can see that I had uncomfortable symptoms of wrap swelling, which is very normal over the first two weeks or so.  My surgeon also warned me of that..."Your swallowing will get worse before it gets better". 
 
My rule of thumb was this;  I listened to my wrap and stomach and if I tried something that caused discomfort, I just stepped my diet back to liquids/soups, etc.  and tried it again after a little more time had passed. That said, through trial and error I discovered many things that I could comfortably eat very early on.  The main thing is to remember to take very small bites and chew, chew, chew.  If something doesn't chew to a liquid, deposit it in a handy paper napkin and don't swallow it. 
 
I enjoyed using my teeth as my blender...chewing is most of the enjoyment of eating anyway, isn't it?  If you follow the rule of listening to your wrap/stomach, and taking small bites with lots of chewing, you'll do just fine.
 
One other thing...I was told here (and by my surgeon) that if you forget and swallow something that's not chewed well enough, it may get stuck at the wrap site, but don't panic.  Just relax (you'll get some painful spasms for a bit) and take sips of room temperature water or tea.  It'll go down eventually...no need to choke it up like a hairball!
 
No iced drinks (can cause spasms) and no straws (introduce unnecessary air into your stomach).  Stay away from carbonated drinks during your healing stage.  Some people who  are Coke addicts just leave the soda out to go flat, then drink it.  I'm four+ years post-op, and I can drink two or three servings of soda without a problem.  I also enjoy beer, and have no problem with that.  The only thing that caused uncomfortable bloat for me was two glasses of champagne.  Ouch.
 
I've found that if the gas in your stomach gets ahead of your ability to get rid of it (you can use Gas-X after the fact, and BEANO before eating gassy veggies), the gas starts pushing against the wrap and makes it impossible to burp.  Then you'll just have to be bloated and wait until the gas makes its way out the back door.  The gas issues improve dramatically once the healing has progressed.
 
This surgery takes a full six months for most of the healing, and a year for the rest.  The most important thing is PATIENCE.  Surrender to your recovery and let your body take the lead.  You can't rush the healing, and if you can accept that fact, you'll do just fine.  It's the people who want to rush their recovery and stress out if it isn't meeting their expectations, that have the most trouble coping.
 
Glad you've joined us!
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

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 3:05 PM (GMT -6)   
Thank you! That helps a lot. I like the idea of surrendering to my healing. Another thing I am worried about is, I am afraid I will get panic attacks from the pain medicine. Did you have that?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 4/28/2013 3:52 PM (GMT -6)   
Hi gntbtr,
You won't need the narcotic pain medication for long at all.  Be sure to buy some liquid Tylenol, because you'll be switching to that pretty soon.  Really, the surgical pain is minimal with this.  You will probably get some referred shoulder pain, which is very uncomfortable.  If you walk, walk, walk--even when you're still in the hospital...just drag that IV pole with you--the pain will lessen.  I found the more I walked the less it hurt.
Keep asking those questions!
Denise
PS--I didn't get any panic attacks from the meds...
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

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 4/28/2013 4:13 PM (GMT -6)   
gtnbtr

Great advice from Denise. The only one I wasn't able to burp with much was my 1st that was done incorrectly. With the redoes I can burp fairly well. I can't vomit though, but Ill trade that for lack of GERD.
I was released from the hospital on a soft diet and told to advance as I felt I could.

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

luv2drive
Regular Member


Date Joined Feb 2013
Total Posts : 36
   Posted 4/28/2013 5:59 PM (GMT -6)   
Dear gtnbtr

I just had my h.h. repair and full Nissen this last Wednesday, and I read everything on this forum, and believe me, when Denise says to 'walk,walk,walk', do it. I was walking many times on each shift out in the halls, pushing my I.V. along with me and it helps the pains esp the shoulder pains. I did not have any panic attacks from narcotics, they gave me I.V. toradol (similar to Ibupropan) and I.V. tylenol and both of those helped immensely . Good luck.......Linda

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 6:12 PM (GMT -6)   
Thanks Linda, have you ever gotten a panic attack from drugs?
Thanks for your info. I will definitely walk!

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 6:37 PM (GMT -6)   
Thanks Denise. Did you ever get panic attack before?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 4/28/2013 7:04 PM (GMT -6)   
Hi gtnbtr,
 
No, I don't get panic attacks, but my husband had many before he began medication to get it into control.  I know how hard it is, believe me.  Have you had problems with panic attacks using painkillers in the past?  I suggest you discuss you concerns with your surgeon, and maybe even with your anesthesiologist. 
 
You could also bring your PCP into the conversation.  Maybe they'll want to treat your anxiety during this whole ordeal.  Be sure to check it all our thoroughly, so you can feel confident and comfortable.
 
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

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 8:32 PM (GMT -6)   
Well. Here's the truth. I went to college in the early 70's. in the time of Timothy Leary. I tried LSD and it gave me severe panic attacks and paranoia. Never tried it again, but it made me scared of all drugs!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 4/28/2013 8:42 PM (GMT -6)   
Hi gtnbtr,
I don't think you have to worry about pain meds causing any problems.  Like I said, you should discuss your fears with your PCP and anesthesiologist, so they can explain the pharmacology and reassure you.
Hang in there!
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

gtnbtr
New Member


Date Joined Mar 2013
Total Posts : 17
   Posted 4/28/2013 9:42 PM (GMT -6)   
I am going on vacation at 9 weeks post op, do you think I will be able to have a beer?

Retired Seabee
Regular Member


Date Joined Feb 2013
Total Posts : 129
   Posted 4/29/2013 7:22 AM (GMT -6)   
I am a devout coward when it comes to pain. But my personal experience throughout the experience of NF was that I didn't have any that I couldn't have dealt with without any self-administered pain killers. I had the normal anesthesia during the operation. Whatever it was was effective--I don't recall anything until five hours later. Then I was plugged into an on-demand morphine pump. I could push the button any time that I needed to. You can't overdose because there is a timer or something. The nurses said to use it often to stay ahead of the pain. So I dosed myself with no real reason except to "stay ahead". There was aching at the upper left incision and pain in my shoulders from the gas but no other discomfort. I began walking five hours after surgery at my own request because of the advice on this group. After the first walk, I didn't even have them re-attach the pain pump because I didn't need it. It was too much trouble to disconnect all of the tubes and wires whenever I wanted to walk.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 4/29/2013 8:35 AM (GMT -6)   
Hi gtnbr,
Nine weeks is a little early, but you can experiment.  Some sips?  Yes.  Several beers?  Probably not.  Still, everyone is different.  Just be sure to listen to your body and follow its lead. I'm sure I tried some beer throughout my recovery, but I don't remember drinking a whole glass until we went on our vacation at four months.  Honestly, it's hard to remember, so don't hold me to it.
 
I didn't journal my recovery after the early recovery time (I wish I had!), but I did find a 4 week post that I'd put on a different thread.  I added it to my original journal, and I'll copy it here.  It includes answers to questions I asked the surgeon at my four week follow up.  It might be helpful as you make your plans. 
 
Here's my four week post:
 

4 Weeks Post Op Thoughts

 

Just posting for all those people who are cruising the internet to learn more about the surgery as they try to make a decision:

As I've said in previous posts. If you have all the tests (I think manometry is especially important, because as you'll see in posts here and other places, swallowing problems can be a result of the surgery) and select a very experienced and competent surgeon (if you live in a reasonably large city with a good hospital system (my city is not that big--about 250,000--but has 4 hospitals, with a complex of 3 in close proximity, and a medical university) you won't have to go looking in a big medical center--you will do just fine.)

It seems as if a tight wrap (especially if coupled with swallowing problems) is the biggest issue. Perhaps with people who have had severe GERD for a long time, and have suffered esophageal strictures in the past this is an issue as well--I'm not sure. That was not the case with me.

Anyway, as of about week 4, I've been able to eat virtually anything. (I do find I still have trouble with melted mozzarella. It's not the bread of the pizza, it's the cheese. If I eat a pasta dish (crepe manicotti/eggplant roulettes, with melted mozzarella, for example, I have to remove the melted cheese first. I am not great with pasta or noodles, either. Bread is fine, though. Everything needs to be chewed to liquid...don't get me wrong. You have to be aware of your healing and be a responsible eater!)

That said, I never in a million years, thought the recovery from this surgery would be this comfortable and easy. Honestly, the many gastritis/GERD bouts I've had were FAR worse to recover from than this surgery.

I visited my surgeon at week 5, and asked him several questions:

1. I asked him how much weight I could lift…he was a comedian...
"How much could you lift before surgery?" So I guess I'm okay to use my own judgment.

(Note...I have a weak core, so this only applies to weaklings like me, but in the past year I've lifted a very heavy box filled with books twice, and each time I had definite pain at the wrap site.  The second time the pain lasted for a week or so  I think I could blow out my wrap lifting something very heavy, so I try to remember that and ask for help.  Just an FYI.)

2. Any activity limitations?
None

3. Eating?
He said that I can eat anything that I chew thoroughly. Even steak, he said, can be chewed to a liquid. On the other hand, mashed potatoes can be swallowed in a big "bolus", and cause problems.

4. Alcohol?
No problem...

5. Why do I feel full so quickly after eating just a small amount?
He said it's because the swelling causes a stiffness, and that stiffness makes you feel more full than you actually are. The resident I spoke to after surgery, said you lose about 15-20% of your stomach capacity with the surgery. (Actually at week seven, I am able to eat more than even last week.)

6. I asked him about the effect of coughing on the hernia repair. (I have asthma. Although it has responded amazingly to the surgery, and is MUCH better than it was before the Nissen, I had a lung infection that hadn't resolved, then last week got the flu...To make it even more fun, the tree pollen is giving me fits.)
He said that "even water can erode stone". He said that there is a cumulative effect of coughing, straining, etc., that will eventually weaken the repair. These things are unavoidable.

7. What size bougie did he use? 56 French (He uses the bougie to ensure that wrap is not too tight.)

From what the surgeon said, you should be just fine at 9 weeks.  That said, everybody is different, and surgeons tend to underestimate the challenges and length of recovery.

 

Happy day!

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) : 4/29/2013 7:38:58 AM (GMT-6)

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