Nissen's Fundoplication - post operative advice please

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RobUK74
Regular Member


Date Joined Nov 2013
Total Posts : 24
   Posted 11/16/2013 6:25 AM (GMT -6)   
Hi all, am really helping you can help me with some of your sound advice - its great to find a support network. I'm a 39 year old male, based in the United Kingdom. I had a laprascopic nissens fundoplication along with a rolling (paraesophageal) hiatus hernia repair three weeks ago. I had a great surgeon and was in hospital for four nights. I've been on clear liquids since then and starting to introduce pureed foods at the moment.

I'd like to reach out to you as I have noticed which I would welcome your advice and steer on please!?

1. Tiredness and sleeping patterns - these are all out of kilter and find doing the most simplest of things absolutely exhausting - when it then gets to bedtime I'm finding it hard to drift off and then sleeping for max of 6-7 hours at night - is this to be expected

2. Appetite - really finding this is minimal and consuming c 1000 calories a day - any recommendations on some more interesting pureed diet I can add in - especially on the vegetable/fruit/protein front? (allergic to all seafood)

3. Pain in left thigh muscle - since operation I have had pins and needles in my left thigh muscle and it feels like internal bruising - I've been told this is due to the electrocautery I had - should it last so long?

4. Vitamin supplements - really feel i should be adding these in in liquid form - any recommendation on some great tasting liquid or chewable supplements

5. What exercise should I be doing? I'm walking around but after 15 mins or so I just find I'm whacked!

Really appreciate any help you can give, and great to see I'm not alone.

Best wishes to all!

lajenner
Regular Member


Date Joined Jul 2013
Total Posts : 349
   Posted 11/16/2013 12:44 PM (GMT -6)   
Hi Rob, I'll try and help.

1. You still need a lot of rest. Maybe limit your naps to 45 or 60 minutes during the day, and that will allow for a longer night. At 3 weeks, I was on one hour nap a day.

2. Appetite returns in another week or so. I made fruit smoothies from the 4th day and on. I made them with full fat yogurt, cream, protein powder and fruit cocktail. They were tasty and easy to swallow. I also put chunky canned soups in the blender. I could easily eat a scrambled egg by that point. Thinned mashed white or sweet potatoes are good, even more so with the added calories from butter and gravy. Take a look at my journal and you might find some more ideas. I was allowed a wider variety of foods as long as I pureed them with my teeth, though.

3. No help from me. Sorry!

4. I have been taking a gummy chewable multi-vitamin and a gummy fiber supplement. They are VitaFusion brand - not sure how great the quality is, though. Maybe you could ask your pharmacist for a recommendation. Try calling them.

5. My surgeon told me I could start other exercises at my 2 week follow-up. To be honest, I was not ready, though. 15 minute walk was still really pushing it. I agree. I'd give it some more time.

Read some of the others journals/journeys on this forum. You'll find more ideas for foods.

Here is mine: http://www.healingwell.com/community/default.aspx?f=45&m=2847294
Laurie
Nissen Fundolplication Sept. 10, 2013

RobUK74
Regular Member


Date Joined Nov 2013
Total Posts : 24
   Posted 11/21/2013 10:16 AM (GMT -6)   
Hi Laurie

Really appreciate your reply and help,

Rob

TonyG
Regular Member


Date Joined Apr 2013
Total Posts : 254
   Posted 11/21/2013 11:28 AM (GMT -6)   
Hi Rob,

This has been my experience....

1. In the first week home after being out of the hospital (I was there 3 days), I found myself to be sleepy all the time. Partly due to the pain meds I was still taking, but mostly because I was so bored sitting around all day long. As I tapered off the pain meds, I would take longer walks when I felt sleepy so that I could sleep longer at night.

2. Your appetite will come and go. At some point, to promote healing, you'll need to practically force yourself to eat. By the second week, I was eating very soft scrambled eggs, mashed potatoes, noodles soaked in butter (chewed thoroughly!), protein shakes (ensure, boost, etc), milkshakes, pudding, pureed cream-based soups. I even managed to get a couple of Ritz crackers down with some milk.

3. I'm at a loss with this one, sorry!

4. I would try a gummy vitamin or something chewable washed down with lots of water. My surgeon advised me to stay away from vitamin supplements for the first month as they can irritate the stomach lining so I didn't take them. However, if your surgeon thinks its fine, then follow his advice.

5. I forced myself to walk. A LOT. Everyday, if I felt up to it, I'd increase my walking by 5 minutes. My surgeon specifically told me not to lift anything more than 10 pounds until 2 months from my surgery. However, he said I could walk, treadmill or elliptical after my post-op appointment with him...which was about four weeks after my procedure.

Take care and be well!
-TonyG-
-TonyG-
Nissen Fundoplication April 30, 2013
Pain-Free, Reflux-Free, Sleeping on my back!

Retired Seabee
Regular Member


Date Joined Feb 2013
Total Posts : 129
   Posted 11/21/2013 12:33 PM (GMT -6)   
Some random thoughts about recovery:

Prior to surgery I was told by my surgeon that I would be on clear liquids for two weeks. However when he visited my room after my HH repair and NF he stated that I could eat anything that could be pureed. I had already bought lots of chicken and beef broths and juices. So when I went home I bought regular canned soups and pureed them... I like vegetable beef soup and/or chicken with vegetables so I would puree a half can of whatever soup that I wanted and then add beef broth to thin it out. I didn't actually puree them completely. I pulsed them just enought that there was some texture left. I did the same with a variety of other types of soups, creamed soups, etc. There are many different kinds for all tastes. I also ate lots of puddings. Here in the US we have lots of pre-cooked "Temptations" brand Jello puddings. I like the key lime and lemon merangue flavors but there are many others available. I also ate lots of applesauce.

Saltine crackers and Cheetos are also good. If you are craving crunch, both of these will disolve into a paste after you crunch them up.

Calorie intake: prior to my surgery I did lots of research on the medical proceedure and recovery process. I found that a person of my size--6' tall, 220 lbs who is relatively active needs about 2400 calories per day just to maintain his weight. Since I would be relatively inactive during recovery I would need 1700 calories just to stay even. So I became very calorie conscious.

Protein: At the same time as being calorie conscious, you need protein. Your body uses protein to build cells, etc. A person of my size needs roughly 65 grams of protein per day. If you don't get that much, the body begins to look for other sources. It finds it in your muscle mass. Therefore you need to supplement your protein intake however you can. Protein drinks only supply 10-15 grams. Meat based soup contains protein as well.

I am normally very active. Because I am retired, I normally play tennis every morning. For a few months prior to surgery we had cold weather and couldn't play so I went to our local shopping mall and walked 3-5 miles on a daily basis. Post surgery I began walking about 4 hours after they returned me to my room. I was in the hospital for two nights and walked laps around hospital ward every few hours. I continued walking when I got home. On the third day home my wife drove me to the mall and I carefully walked 1/2 mile while she ate lunch. The next day I drove to the mall on my own and walked a full mile and increased the distance on a daily basis. Our local mall opens at 6 AM for walkers. So, those early hours are great for walking during recovery because it is not crowded and you can set your own pace.

Prior to surgery I bought children's liquid vitamins and took those for awhile. I also took liquid B-12. I also bought a pill crusher so that I could crush up my blood pressure meds. Since I normally take a multi-vitamin for seniors, I started crushing them and mixing them with applesauce.

I hope this gives you practical advice and enables you to cope with the recovery process. I was able to return to playing tennis after my three week checkup and played in a tournament after two months with no harmful effects.

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 11/21/2013 12:39 PM (GMT -6)   
Hi Rob and welcome to HealingWell
 
You have received great advice by our wonderful members. I am going to point you toward some great info you will find in our resources at the top of the page.  I will put the links here so it is easy for you to find. :-)
 
Post-Nissen eating information :
  
 
 
 
 
Pre and Post Op Nissen Fundoplication Information:
 
 
Caution:  This link is for your information only and should never take the place of instructions given to you per your surgeon
 
Post-op fatigue may end quickly after anesthesia or it may linger for a few weeks.  I suspect if you push your exercise a bit more you will feel less tired.  Let your body tell you what to do...........increase your walks to 6 short walks daily for about 10-15 minutes each as this will help you get stronger.
 
The pins and needles in your thigh - may be caused by dehydration as your muscles need fluids.  Drinking large amounts of fluids with meals can stretch your stomach. You may drink fluids between meals as often as you like, but limit fluids to 1/2 cup (4 fluid ounces) with meals, and one cup (8 fluid ounces) with snacks.
 
And gummy bear vitamins sound yummy.
 
Be well,
Kitt

~~Kitt~~
Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.



"She Stood in the Storm & When the Wind Did Not Blow Her Away, She Adjusted Her Sails."

RobUK74
Regular Member


Date Joined Nov 2013
Total Posts : 24
   Posted 11/21/2013 2:55 PM (GMT -6)   
Tony, Seabee, Kitt - thank you so much for your replies and information with in, it's really helped me see some of the errors and refinements I need to take at the moment. It's clear to me that here in the UK we are not being given the whole story by surgeons in terms of the size of the operation or the recovery time. I wish I had found this site sooner, so thank you for your valuable advice! My calorie intake is slowly increasing now c.1500 but happy to keep at this as want to lose weight and use the fundoplication to really change what and how I eat. Really finding smaller meals more often a lot more manageable than the typical meal of breakfast, lunch and dinner... I'll keep updating as I go along - biggest thing I have learnt - patience and listen to your body. Thanks again! Rob

Rebelee08
New Member


Date Joined Nov 2013
Total Posts : 3
   Posted 11/21/2013 4:08 PM (GMT -6)   
I am 3 weeks postop and I had both procedures. They kept me in hospital only over night, but I'm in U.S. and I had to eat scrambled eggs and swallow pills before I left the next morning. I guess that is the difference in being in U.K. and here in U.S.
Protein Shakes, you have to keep your calorie intake up or your going to start losing some weight! Good luck!

RobUK74
Regular Member


Date Joined Nov 2013
Total Posts : 24
   Posted 11/21/2013 4:19 PM (GMT -6)   
Thanks Rebelee I was kept in for four nights due to bloods, and my surgeon has been pretty strict in terms of liquids only for first three weeks, and now on purée and loving very soft scrambled eggs! Also found a great product here in UK called complan which is a meal replacement in a liquid form either as a shake or soup, and not bad tasting either. Amazed at how my appetite and view on food has changed post op - all for the better! Don't mind losing weight, I could do with losing a few pounds!

Really loving this forum, thanks for sharing so much, it does seem that the US has a quicker recovery plan than the us folks across the pond!

Wendy Workout
Regular Member


Date Joined Mar 2014
Total Posts : 173
   Posted 3/9/2014 1:47 AM (GMT -6)   
Ho rob,

Did you get a reason why you could only have fluids for the first 3 weeks? I am 8 days post op. My surgeon has me on a strict fluid diet for 2 weeks so far. No soft foods. I can't even have puréed foods yet and no raw fruits or vegs even puréed in smoothies. Just curios. I see my surgeon next thurs.

Debra

Wendy Workout
Regular Member


Date Joined Mar 2014
Total Posts : 173
   Posted 3/9/2014 1:48 AM (GMT -6)   
Forgot to add. I developed pain to my inner upper left thigh last night. It tries to cramp. I'm assuming dehydration as I cannot get the fluids in. Thin fluids are tougher than thicker fluids for me even though the thicker ones hurt. Go figure!

Wendy Workout
Regular Member


Date Joined Mar 2014
Total Posts : 173
   Posted 3/9/2014 1:52 AM (GMT -6)   
:-) forgot to click notify when there's a response so doing so now. Oops.
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