Glad you got your results, and discussed them with your doctor. It is so difficult to have the tests and wait around for that follow-up appointment!
I had the surgery in February 2009. Honestly, I had no other options (although my GI doc told me I could have surgery or stay on meds...pretty much what yours did). My lungs were in horrible condition, and my PCP and asthma docs were at wits end...I had been sick for 6+ years and there was no controlling asthma.
The GI doc didn't have any confidence that the surgery would help, as my reflux levels were quite low. Thankfully, the surgery has worked extremely well, and my lungs are healthy again.
I had no idea if the surgery would work, but I had to rule out reflux, so I went forward with it, and happily, in about two and a half months, I started to see positive results.
I am extremely satisfied with my surgical results, and live my life normally and happily. That said, I certainly wouldn't have gone through it with the reflux levels I had, if it weren't for my lung involvement. Yes, I'd get bad heartburn at times, but it wasn't like I was regurgitating food and acid into my mouth on a nightly basis.
GI docs seem very hesitant to push people toward surgery, as the recovery is challenging, and the results aren't guaranteed. The PPIs are so effective that there isn't as much need for most people to get a Nissen, as the meds do the trick.
I know you've talked to "Cindy123" who lives in Toronto, and she was a case where a GI doc/surgeon encouraged surgery. She'd had only silent reflux, and could have done fine on PPIs but was fearful, I assume, because of what she was told about the affects of reflux on the esophagus. She struggled greatly with the recovery, because she hadn't been suffering prior to the surgery, so the recovery was much more difficult to deal with. She could have gone on with just PPIs and have done just fine.
If you're not having horrible reflux symptoms, why not take the "wait and see" approach? I am an advocate for the surgery...it can improve quality of life greatly for people who need it. Still, it's not a surgery to take lightly. Even though you can go back to living completely normally after healing, there are always some quirky changes you'll have to deal with.
Often people fear using PPIs long-term, but GI docs (and my PCP) are very comfortable with their long-term use. There is absolutely no guarantee that you'll never have to take PPIs after having the surgery (though at lower levels), so I personally don't think avoiding the medication is enough reason to get the surgery, though I know it's the reason some opt for surgery.
I know I haven't answered your question. I think you're the only one who knows how much your quality of life is being reduced due to reflux. That would be the biggest reason to have the surgery. If you're on peak dose of PPI and you aren't getting good results, it can very negatively affect your quality of life. Then it's time for surgery.
Good luck with your decision! Keep us posted...
Nissen Fundoplication 2/09
"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.”