Nissen Fundoplication on 1/21/14

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justinf
New Member


Date Joined Jan 2014
Total Posts : 4
   Posted 2/8/2014 10:56 PM (GMT -6)   
I had a full Nissen Fundoplication on 1/21/2014. What follows is my recovery journal as well as a description of my pre-operative condition. I know it is pretty long and detailed, but I thought that it would be useful to those who are going through the same thing as reading other people's stories was definitely helpful to me. I did not sugar coat anything and was pretty detailed. I apologize if anyone is grossed out, but I think the it is best for people to know the whole truth.

Pre Operative Condition and Decision to go ahead with the Surgery
My Pre-operative condition while severe, is not nearly as severe as many other people's stories which I have read.
First of all, I am currently 30 years old. When I was a kid (like 8 or so), I had a dry cough which lasted for like a year.
Initially, they diagnosed me with Asthma. I got an inhaler and all that fun stuff, and when it didn't help they were stumped.

A year or so later, they admitted me to the hospital where I had a 48-hour PH test performed. (At that time, I had no idea what they were doing. All I knew is I almost threw up on the nice nurse that put the tubes up my nose and down my throat).

Back then, there was no 48-hour Bravo capsule test. I had to wear a little computer (about the size of a Zach Morris 80's cell phone) with a button on it. I was supposed to hit the button every time I coughed, and my dutiful mother was supposed to write down the time of the cough and describe it. I stayed in the hospital for 2 nights with the tubes up my nose and down my throat and tried to get through it.

The result of that was they diagnosed me with something called "Refluxesophagitis". I think it is similar to GERD, maybe that is what they used to call it. Anyway, they put me on Tagamet (I think that was an early form of acid blocker). And that solved my coughing issue and a few years later I stopped taking it and was fixed.

Fast-forward to 2003. My sophomore year of college. I started a co-op position (essentially a rotational work program) at a company. I started drinking coffee regularly for the first time. I also had more stress than I had when I was taking classes. I started having heartburn at work. And like bad heartburn. So I got some Tums. And I brought them to work and I would pop them when I had heartburn. But every so often I would go into a meeting and forget to bring my tums. And I would get heartburn so bad that I couldn't focus on the meeting. A few times I excused myself from the meeting and ran to my desk to get tums. Ultimately, I learned that I needed to always have tums with me. So I started carrying around a small pill bottle with tums. And I am talking about the Ultimate strength tums, and I would at least take 2 each time.

One day I stepped back and looked at things. I was taking 10-20 tums a day. I figured it was time to see a doctor.
And I know you are thinking: "Just stop drinking coffee". Well, I did try that for a bit, and it didn't really help. And plus, I had to be at work at like 7 am (which mean getting up at about 5:30) because we were working with people in China.

So I saw a doctor in my hometown and he diagnosed me with GERD and prescribed me Nexium (40 mg once a day). That helped with the heartburn, but I still felt the "reflux" (i.e. food regurgitating back up). Lettuce was a particularly bad offender in that I would taste it all night.

So I stayed on Nexium all through college and through 2013. Though almost every time I would change insurance (every few years) they would make me try all the generics and cheaper drugs before approving Nexium. So I would go through a few months of inadequate acid control, and eventually my Doctor would write an override request and it would get approved. In 2013, my insurance stopped covering it completely. It wasn't in the "higher tier" so it cost more than other prescriptions. They simply would not pay for it. I would have to pay full retail for it. I priced it out and that was about $2200 a year. I looked for those "discount" cards, but they only work once and bring it down to like $50 for the first month. So not really affordable anymore. I could get pantoprazole in generic from my insurance for $10 a month. So I tried that. I did that for 10 months and it "worked" in that if I didn't take it, I would really feel heartburn. But whereas with Nexium, I would sometimes get breakthrough at night, with pantoprazole, I was getting breakthrough between noon and 5 pm. So it definitely wasn't cutting it. So my Doc prescribed Ranitidine to take mid-day when I felt any breakthrough. And that sorta worked, but again, it still wasn't cutting it. That is when my general practitioner started more actively talking to me about the surgical option. I had looked into the surgical option a few years before but decided against it when I found out that the surgery could be ruined if you ever vomited (I later found out that that is true in the early stages, but that you might be able to vomit later on). My GP recommended a surgeon that several of his patients had used and that he knew was really good. So I setup a consult.

My Surgeon was Dr. Jeff Cross (in Denver, CO). He is a great doctor and is very patient with my millions of questions. I came in with questions and fears after reading the forums. I read research papers on the efficacy rates and side-effect rates of the various procedures (Full Nissen, Partial Nissen, TIF, Lynx) and asked him questions about that.
He didn't do the TIF or Lynx, so he referred me to another doctor to look into those options.
I had the standard pre-op tests: Upper GI, 48 Hour Bravo PH test, Barium Swallow, Gastric Emptying test, and the dreaded Esophageal Motility test (i.e. the one with the tube).
The tests said that I had a weak Lower Esophageal Spincter (LES) and that I definitely had acid in my esophagus from the PH test.
I could have told them that as those were the worst days for me in a long time because they don't let you take your acid blockers while you are doing that test and for several days before. I couldn't sleep in my bed during the test because it was so bad.

So, my conclusion was that I probably needed to do the surgery. In the meantime, I had found out that there is a thing called "Nexium Packets". They are designed for children who cannot swallow the Nexium in pill form. Essentially it the stuff inside the pill in a little packet which you mix with water and drink it like a sludge. That was actually covered by my insurance (though at the top co-pay rate). I got some to try and it worked almost as good as the Nexium pill. So from November 2013 until my surgery on January 21st, 2014 I took the Nexium Packets instead of the pantoprazole and Ranitidine combination.

Dr. Cross did Full Nissen Fundoplications and partial ones. In my investigation of other options, I came across the TIF (Transoral Incisionless Fundoplication) and the Lynx.

The Lynx seemed like the most ideal option as it had lower side-effect rates and seemed more natural in that it was essentially just going to help my weak LES to close up after food went down. It would likely let gas come up (i.e. less bloating) and I would likely be able to vomit.
I don't vomit much, but when you need to and you do, you immediately feel better. And I was wary about losing that ability.

In order to see if I was a candidate for the Lynx, I needed a High-Resolution Manometry test. Yes, that means they need to stick more tubes up my nose and down my throat. So I did that, and boy did it suck. They had trouble in my left nostril and couldn't get it through and just kept pushing. And then they finally got it through and got it down almost all the way, but they couldn't get it to go the whole way down. SO they had to pull it out and try the other nostril (which did work). Like I said, it SUCKED.
The results said that I had a little bit of a weak swallow (even though I had no problem swallowing the stuff they give you to swallow). That was news to me. But they said it was too weak to do the Lynx on. I was devastated. I was really hoping to have the Lynx. Even if I was a candidate, then it was likely going to be a battle with the insurance company to get it covered since it is still deemed an "experimental procedure". The Doc that did the Lynx said that my insurance company (United Healthcare) approves about 50% of these and it usually takes 3 appeals, which takes about 3 months to get all done.

So I was back to the Nissen, and Dr. Cross, when seeing my normal motility/manometry test followed by the weak high-resolution motility/manometry test, he thought it was safest to go with a partial wrap. So I was happy with that, because a partial wrap has a little less incidence of the main side-effects I was worried about (i.e. inability to vomit and bloating).

Then about 1 week before the surgery, I had a 3rd opinion. This Dr. was the doc I had originally wanted to see regarding the Lynx (but when I had my appointment, I was swapped out to his partner). So I had my 3rd opinion to see what he thought of my test results and to confirm whether the partial wrap was the way to go.
He said that he just found out that with my borderline weak motility, that I might actually still be a candidate for the Lynx and I would need one more test to decide that. At this point it was kinda too little too late, because even if I was a candidate, I would have to wait about 3 months for the insurance shenanigans and even then it might not be approved.
He recommended that I have the full wrap instead of the partial, because he was more concerned with having adequate reflux control and that the side-effect rates weren't that much different in his experience. He also mentioned that going from a Full to a partial (if they had to go back in to change it) was much easier than going from a partial to a full. That made sense to me (though the idea of going in twice was certainly unattractive). So he called Dr. Cross (who he knew well) and they both agreed that the full was the way to go.

My "full" Nissen is what Dr. Cross called a "Loose-Floppy wrap". I don't know exactly how it differed from a full nissen, but he made it sound like they definitely would not wrap it too tight and but that it would be tight enough to control the reflux.

At this point, I was as comfortable with the approach as I was going to be. I was down to the go or no-go decision.
For me, this was tough. My heartburn was mostly controlled with Nexium. For now, I can get the Nexium Packets on my insurance. But who knows next year? And other ones don't work as well. I still have reflux (regurgitation), which is annoying, but certainly not critical. I worried about being on PPIs for 10 years already and looking at the idea of being on them for the rest of my life. And I was worried about the long-term effects of PPI use (osteoporosis, not being able to absorb other minerals and vitamins). And also there is the pretty low chance of Barret's esophagus and esophageal cancer. And if I did have to pay full retail for Nexium, 1 year of that is about what I would pay for the surgery (with my current insurance). And what happens when ObamaCare kicks in full gear? Is my company going to drop my insurance? Am I going to have to go onto the exchange and get a plan with a huge deductable? Will they even cover an "elective" surgery like this? And the timing was as good as was going to be family-wise. My wife wasn't pregnant, we were starting to get in the groove with the 2 little ones, and so forth. If I didn't do it now, I probably wouldn't be able to do it until after the next kid was born. And then it would be even harder on my wife to wrangle 3 kids while I recover and am totally useless.

So I was leaning towards still doing the surgery. I replied to a guy named newlifeinkiss (www.healingwell.com/community/default.aspx?f=45&m=2532349) on the forum after reading his story and asked how he was doing now (his pre-op condition and number of procedures and complications is much worse than mine.) In some sense, I think the decision for surgery for him was a lot easier because his pre-op condition seemed unbearable. After replying that I was having the surgery in a week, he graciously reached out to me and offered to give me a call to answer any questions I had. He definitely made me feel a lot more comfortable about having the surgery. He had a partial and then later got Barret's esophagus and then had cancer treatment for that, and ultimately a full nissen. And he said that he would do it all over again. He gave me lots of helpful advice for coping with the recovery and give me a lot of info on what to expect. It definitely put my mind at ease, and also made me realize that I needed to try to eat as much as a could before the surgery (to try to eliminate the weight loss I would suffer in the recovery period).
He also recommended getting some pajama pants a size too big and a back pillow (like one of these: www.amazon.com/gp/product/B007SF9RPE/ref=oh_details_o05_s00_i00?ie=UTF8&psc=1).
I credit his advice with the mostly smooth recovery I have had (read below).

He also checked in with my the day of my surgery via email and for many days after that. And has been very helpful during my recovery. It helps to have someone to talk to who has been through it and can understand the weirdness that is recovering from this kind of surgery.


Surgery (1/21/2014)
Prep was uneventful. They put the relaxing medication in the IV and the last thing I remember was being wheeled down the hall.

After Surgery (1/21/2014)
I am told that the surgery went well by my wife and don't remember much after that.
In and out of sleep.

Day 0 Post Op (In Hospital) (1/21/2014)
Goals: Urinate, Drink clear liquids, walk around.
First off: No Heartburn!
I was having heartburn before the surgery (since I wasn't able to take my Nexium in the morning of the surgery). And even though my surgery was first of the day around 7:00 am while waiting for prepping I started to get heartburn (with an empty stomach). So to have no heartburn, was a pretty awesome feeling.

The evening of the day of surgery I slept a lot in my hospital bed and tried to drink some clear fluids. I had trouble staying away for more than 5-10 consecutive minutes.
Was on some sort of pain medication in the IV which had a button I could press to get more pain meds into my system. I think it may have been morphine.
They also put anti-nausea medication in the IV and IV Tylenol.

At some point I had an episode where I wretched (dry heave) once. That hurt a lot.
Also, everytime I would drink any fluid, I would always have to burp almost immediately after. It was a burp from the esophagus up (i.e. not from the stomach).
If I didn't burp, then I would feel pain that sorta felt like acute heartburn (which was the air being trapped in my esophagus).
If I burped, then it was relieved. The pain that the stuck air caused was very painful.
The worst part was that I had several bouts (10-20 minutes probably) of hiccups. Excruciatingly painful hiccups. Essentially, if I didn't burp after taking some liquid, it would turn into the hiccups (which I started calling "paincups"). Once these started, it was hard for me to get them to stop. While the hiccups were going on, it was acute pain in the esophagus with each hiccup.
I eventually googled some hiccup elimination techniques (I had tried drinking water slowly, which didn't really work).
The one thing that did work ultimately was holding my breath and holding my hands over my mouth and nose.
Supposedly this causes more CO2 to go in and relaxes the diaphragm.
It was also around this time, that I found out that using a straw is the worst idea in the world as you take in so much extra air.
I started taking sips from a cup instead of using a straw.
I tried to drink some Ensure for dinner, but only got a little bit in.

I did feel some stomach full-ness and cramping, so I tried to walk around a little bit in the hallway after dinner.

I was able to urinate at some time during this day, but it often took a long time to get started (sometimes several attempts and going away without urinating) and once I did start, it would take several attempts (stopping and starting) to empty my bladder.
Shifting my weight tended to make me feel the urge to empty out the rest of my bladder.

Day 0 Post Op (Night) (1/21/2014)
I didn't sleep many consecutive hours this night partially because of nurses coming in and checking things, but I think more so because I slept so much during the day.
I saw every hour at least once. I had at least 2 or 3 bouts of "paincups"
The "paincups" are very distressing if you can't get them under control.
I went for another short walk around 4 or 5 am.


Day 1 Post Op (Still at Hospital) (1/22/2014)
Dr. Cross came in early in the morning to check in on me. He said the surgery went well and gave me some details on what to try to accomplish today so that I could get discharged.
I slept off and on throughout the morning.
I felt pretty good around lunch time and had a small amount of potato soup and some other liquids.
After lunch, I felt so tired! I slept most of the afternoon away off and on. And felt like I had no energy.
I was trying to get discharged this day, but it wasn't looking good.
I was really tired, and I had a slight fever, which they were monitoring in case I got an infection.
When dinner came, I had a few fluids (tea, and some other stuff), but didn't have any of the soup they brought me. I didn't have much of an appetite and sipping followed by burping was hurting a bit.
Ultimately, I was able to finish the Ensure I started the previous day. That did the trick. I all of a sudden had some energy and was feeling a lot better. I walked around the ward for about 30 minutes after that, and ultimately drank some more apple juice and tea and other things.
about an hour later I drank another full Ensure and did some more walking.
Getting discharged was looking more optimistic if I just kept up my energy up.
I was waiting for my wife to arrive back at the hospital (after putting the kids down to bed) so that I could get discharged. While doing this I probably dosed off twice or so, and drank more fluids to keep up my energy.
I got discharged around 9 PM and my wife drove us home.

Day 1 Post Op (First night at home) (1/22/2014)
I had tried to lay down flat in the hospital bed earlier in the day which was very painful. So I knew sleeping in my bed with my wife wouldn't really be an option.
So my options were a swiveling rocking chair and ottoman or our couch which has leg rests that pop up and can recline a bit.
I tried both options throughout the night and eventually figured out that the couch was better as I could lay on my side against the back of the couch, slightly reclined and essentially "be laying on my side" without actually having gravity pushing down as if I was laying on my side.
I slept more than the first night, but still not a ton, probably due to sleeping a lot that day again.
At this point, I am able to drink liquids at a more normal pace (i.e. not just a sip), and I don't always have to burp right after. And I haven't had the painful hiccups in a while, which is awesome.

Day 2 Post Op (At Home) (1/23/2014)
You don't realize how much your core muscles are involved in urinating until they hurt to use.
While I am still urinating appropriately, it still takes a while to get started, and sometimes I go away without urinating at all.
I am hoping to get a bowel movement in today, so I am taking some things to try to get that moving: Metamucil, eating cream of wheat, etc.
Also, later in the day, I had my first cup of coffee (actually a latte) after my surgery. I was hoping this would cause me to have a BM since coffee usually does the trick for me.
I still haven't had a BM yet, but the coffee didn't cause any heartburn.

Today I took a shower for the first time since the surgery and it felt really good. It took a while to get all of the adhesive gunk off of my skin from all the tape they used for IVs and what not.
I have been itchy a good bit today (not just the surgical site but other areas of my skin).
This is apparently one of the possible side-effects from the Oxycodone pain medication.
I also had a low-grade fever (~99.5) a few times today.
I called the on-call Dr. to ask about the fever, itching and the fact that it takes a while to start urinating. He mentioned that that was pretty normal and that I could take some Benedryl for the itchiness.

I have some pain in my surgical site still (especially towards the tail-end of the pain medication's window), but I am able to walk around (and up and down stairs) without much pain. I even laid down in bed today and look forward to sleeping in my bed tonight.
For breakfast, I had some cream of wheat and some apple juice and an Ensure.
For lunch I had some vegetable broth and some jello.
For dinner I had some potato, bacon and cheese soup (that I had made prior to the surgery). I blended it up real well with the immersion blender (Yes, bacon can blend too), and it tasted really good and I ate a decent-sized bowl. It did take a long time, and I should have added much less cheese or no cheese at all, as that was a little tricky to chew.
I was able to lay down in a bed today without significant pain. I will be sleeping in bed tonight.

Night 2 Post Op (1/23/2014)
Tonight I slept in the bed. It was good except that I got really sweaty at times and then got chills.
about 2:30 AM or so, I got up because I was sweaty and cold. I was shaking and my teeth were chattering. It was time to take my pain meds, so I went ahead and did that.
I then was walking down the stairs to the basement (where my clothes closet is) to get a dry shirt. Somehow I slipped on the 2nd step and slid down the whole staircase on my side and butt.
Fortunately the stairs are carpet and I didn't hit my head or my surgical site at all. I was sore and had some rug burns, but that is about it. I think my fall was due to a combination of being tired and also probably a bit dizzy from the pain meds. I have since been more careful on the stairs.
Other than that, the night went pretty well.

Day 3 Post Op (1/24/2014)
Day 3 was pretty good. I had more cream of wheat for breakfast, had some potato soup for lunch and for dinner I made a sweet potato soup.
I also got some stuff done on the computer.
Between the work on the computer and making the soup, my body was kinda worn out after dinner. By that I mean my shoulders, neck and other muscles were all aching.
Some of it also could have been due to my fall. But I think most of it is from the fact that I am trying to not use my abs, and therefore other muscles get more of a workout than usual.
Also, I still haven't had a BM yet.
Also, when I urinate, it can still take a little while to get started.
I called the Dr. regarding the BM. They advised me to take Colace and some Miralax.
Colace was the first pill I had taken since the surgery and I was able to handle it no problem.
If I haven't gone by tomorrow afternoon, I was supposed to call back and they may give me some stronger stuff.
I feel like there is stuff in there, but it hurts when I try to push (because of my abdominal area all being cut up).
The BM is my one remaining goal for the first bit of recovery.
I have also been drinking coffee in hopes that that will jump-start that process. It doesn't give me heartburn, but it also hasn't started the process yet.

Night 3 Post Op (1/24/2014)
Before bed I had a mild fever of between 99 and 100.2 degrees. By the time I went to bed it was back around 98.
This night I slept in my bed again. I put a fan on in my room and pointed it at me and used a lighter-weight blanket. That helped me to not sweat as much through the night.
I also got some dry clothes and brought them to my room so I wouldn't have to take a trip downstairs if I needed some dry clothes in the middle of the night.
I woke up once about 4:30 am and was a little sweaty and shaking a little bit. It was a little more than 6 hours since I had last taken the pain meds. (I have been instructed to take them every 4-6 hours as needed, and have thus far generally been taking them every 4 hours).
So I took the pain meds and went back to sleep.
I woke up about 6 am to the baby crying and got back to sleep for a bit and eventually got up at 7 am

Day 4 Post Op (1/25/2014)
Feeling pretty good this morning. I still know that I had surgery, but I don't have much pain. No bloating pain, or anything else.
Started the morning with some Colace and Miralax.
I had some instant oatmeal for breakfast and that went down ok.
I also had some coffee.
Today I plan to make another soup. I also want to start stretching out the pain medication doses to longer than 4 hours in between if I can.
But most of all, I am hoping for that BM to arrive.

This afternoon while taking a shower I noticed that the skin around one of the incision sites had an orange tinge. I called the on call Dr and sent her pictures of it. She said it was nothing to worry about and was likely due to the cleanser the put on the surgical sites prior to cutting.
The Dr also advised me to get some Milk of Magnesia and some Magnesia Citrate for the lack of BM.
She said to take the milk of magnesia first and if nothing happened in 4 hours to drink half of the bottle of the magnesium citrate.

I drank the Milk of Magnesia dose and followed it with 8 oz of water as directed. That was hard because my stomach felt so full already.

I was not feeling great because I had to go #2 but couldn't yet. My lower back hurt and my stomach just felt full.

At dinner I reheated 3 of the soups I had made earlier in the week for a trio of soups. I also had some milk.
When almost done with dinner I felt so full that it was just hurting to put more in.

I then spent an hour on the toilet and had my first BM. I will spare the details, but it was a combination of being the most constipated I have ever been in my life followed by diarrhea. A most unpleasant experience, but at least it happened.

While I was relieved that I had accomplished the task finally my body was in a lot of pain. My surgical sites really hurt. I had a headache. I was really sweaty and achy. And my stomach was kinda nauseous.

Fortunately it was time to take some more pain meds and anti-nausea medicine.
Throughout the next few hours I went back to the bathroom because I felt I had to go again. But each time I only had gas to expel. It was hard to distinguish gas from the urge to go #2.
After that I rested the rest of the night and went to bed early.

Night 4 Post Op (1/25/14)
I slept pretty well though I got 3 or 4 times to go #2. Most of them were just gas but one of them was real.

Day 5 Post Op (1/26/14)
I woke up today feeling worse than the previous day. Whereas before I felt well enough to make soup and be up and about for part of the day. I felt more achy and that I had to stay nearby the bathroom in case the urge came for #2.
I had instant oatmeal for breakfast. I also had a mocha with Chocolate Ensure as the milky chocolate part of it.
I also tried orange juice for the first time.

Ever since the BM last night I sorta feel like I have small episodes of heartburn. I hope I didn't hurt the wrap last night. It was hard to tell between what I thought might have been heartburn vs an upset stomach. While I didn't have crazy heartburn from the orange juice (which would have been the case pre-op) it didn't sit well. My stomach hurt in both pain from the surgical sites and from an upset stomach.
After several false alarms I did have another BM in the late morning.
Mostly spent the morning watching TV in bed.

For lunch my stomach was still upset so I had some strawberry jello. Later on I had a poached egg (which tasted fantastic and went down easy) and some chicken noodle soup. (Mostly just drank the broth.)
My stomach started feeling better from both pain and upsettedness after that.
I had another poached egg later and a little bit of potato soup for dinner followed by a strawberry milkshake

Night 5 Post Op (1/26/14)
This night was the worst one in a while. I got up probably 4 times because I thought I had to go #2. other than 1 time, it was just gas. I had some trouble getting back to sleep because of some pain. The one time I got up, it was 50 minutes before I could take more pain meds, so I tried to go back to sleep. I woke up (or got back up) about 45 minutes after my dose was allowed and I took them.
I slept in until 8 am, which made it about 7 hours since my last pain meds. I was in some pain and was hungry, which was also a little painful.

Day 6 Post Op (1/27/2014)
I have some stomach pain and a headache. I took my meds as soon as I woke up at 8 am.
For breakfast I had a poached egg and some apple cinnamon oatmeal.
I took some Miralax with iced tea.
I still have a bit of a headache 1 hour after taking the meds.
Today I have my followup with Dr. Cross.
I am hoping to return to work tomorrow.
As it turns out, I or the Dr. messed up the scheduling of the followup appointment, so I had to reschedule it for 2 days from now.

Night 6 Post Op (1/27/2014)
I started taking 3 Ibuprofen (600 mg total) instead of the Oxycodon this evening.
I am taking it every 6 hours.
I was able to make it the first 6 hours OK. I took it again at 11 PM and made it till morning.
I still woke up several times tonight due to bathroom or sweating.
But I don't think I had to go BM just to find out it was a just gas.
That seems to be normalizing.
Tomorrow I plan to start back at work.
I work at home on a computer all day. So the main challenge will just be sitting at the computer all day and some extra talking.
Talking a lot tires me out a bit.

Day 7 Post Op (1/28/2014): First day back at work
I stayed on the Ibuprofen today (my first full day of it).
Today was pretty good. I was able to work a full 8.5 hour day with a little break at lunch time.
I probably should have gotten up and walked around a bit more during the day, though I at least tried to do that while on phone calls.
I sat with a lumbar pillow in my desk chair, which helped me be a bit less upright.
Overall, I would say that it went well. I can definitely feel the pain in my stomach and in other parts of my body (back, neck, etc.) more on the Ibuprofen.
It is more of a dull annoying achy pain. It didn't keep me from working. It is just annoying.
Also, I may be experiencing some heartburn. I drank some V8 splash Strawberry Banana juice and it makes me burp (similar to when I had reflux) and I have a little bit of an apprehensive feeling in my chest. It is hard to tell if it is mild heartburn or just that I am feeling the pain in my esophagus now that I am on Ibuprofen.
It isn't dabilitating like my heartburn was when I wasn't on Nexium. So it is definitely better with the surgery than before.
I took 2 tums towards the end of the afternoon. It didn't seem to do anything, so maybe it is esophagus swelling pain.
I took a few nausea meds today still because I felt a little nauseous at lunch.
It is hard to get excited about meal-time.
Even though I am starting to eat some soft solids, it is still hard.
Part of it is that when I am stressful about work, I tend to not eat as well and enjoy eating as much (Especially breakfast).
Hopefully tomorrow will be better.
I had a poached egg and some strawberries and cream instant oatmeal for breakfast.
I had some potato bacon soup and apple juice for lunch.

Night 7 Post Op (1/28/2014)
Tonight my pain level was decent. The pain feels mainly just achey in my stomach.
I am still waking up soaked with sweat several times during the night. This happens whether I have the fan on low next to my bed or not.
Overall, apart from the sweating it was a pretty good night of sleep.

Day 8 Post Op (1/29/2014)
Today was my 2nd day back to work.
Though it was pretty hard to get up this morning when my alarm went off, overall my day went pretty well.
I took a little break at lunchtime to sit in a more comfortable chair with a heating pad on my back.
During my calls, I laid on the floor in my office to stretch out a bit. I mainly laid on my side.
I am still off of the narcotics and taking 3 Ibuprofen every 6 hours.
I am still taking some anti-nausea medications. I am not taking them at the maximum frequency anymore.
I have my follow-up appointment this afternoon so my work day will be shortened a bit.

My follow up appointment went well. My doctor was thrilled when I handed him my 8 pages of recovery journal.
Fortunately, my Doc is very patient with my millions of questions and he said he will miss me when my follow-ups are done because he wishes other patients were as meticulous as me.
The Doc said he wants me to get a new Barium Swallow test to get a new baseline for my post-operative anatomy.

I am officially off the narcotics (unless I have some major pain). I have been on Ibuprofen for 2 full days now. I am coming down with a cold which is unfortunate. But at least I can take both cold meds with Tylenol and Ibuprofen at the same time.

I drove home from the doctors office today because the Doc said I was fine to drive after being off the narcotics for a few hours. It felt good to not have to be carted around everywhere now (though I am glad that my wife was able to make the follow-up appointment).

I tried a taco salad tonight for dinner. (without the chips). But I have no reflux due to the lettuce (one of the biggest sources of reflux for me pre-op) and it was pretty good. I made sure to take small bites and chew it thoroughly. The meat on the taco salad got cold before I could finish it, so I didn't eat it all.
One thing I have noticed is that while I eat slower (due to being cautious) than I used to (I used to shovel it in and I was usually up and cleaning the kitchen before my last mouthful was swallowed), it isn't incredibly slower like I feared. From talking to my Doc, it sounds like when I am fully healed, I will be able to eat at the speed that I should be eating. i.e. a normal pace and not shoveling it in.

So far, in the solid food department, I have had: hard-boiled pickled eggs and pickled beets, poached eggs, Taco Salad, Bananas, and instant oatmeal.

Overall I am doing well. The second day of work went well. I think less pain than yesterday.

I took off my bandages on my incisions tonight since the Doc said I could whenever I wanted. One of the scabs came off with the bandage unfortunately, but I put a butterfly bandage on it to keep it together and a band-aid on top and will keep an eye on it.

One thing hurts: laughing. Hurting when I laugh sucks. Because my kids are 2 years and 6 months. And they (especially my 2 year old) do funny stuff all the time. My wife and kids are leaving in a few days for a week to visit her parents in Florida. They will have fun, and I will get a nice break to heal in peace. No diaper changes, no laughing with/at the kids, and such. It will also be the first time I have been without them at home (i.e. not on a business trip) ever. It will surely be kinda weird, but I am looking forward to some time to relax.

It is still hard to believe that I haven't taken Nexium in 8 days AND I have had coffee for a few days now AND I have eaten lettuce.
The Final test for me will be hot wings and beer. I look forward to that, but am still going to be cautious and not rush it.


Day 9 Post Op (1/30/14)
Work today went pretty well. For lunch I had some soft pasta noodles. When I finished up working I felt pretty terrible.
I realized I hadn't taken my Ibuprofen at 2 PM (it was now 5:30, so 9.5 hours since my last dose.)
My incisions hurt a good bit. I also noticed I was pretty nauseous. I took the Reglan and the Zofran as fast as I could. I felt like i had to vomit. I was feeling my mouth was really salivating which happens before I vomit. I wretched a little bit probably twice.
I then took my Ibuprofen and went and laid in bed. I was really cold and achey. I was hungry and knew I needed some food, but didn't feel like eating anything. I tried to drink some Ensure and some chicken broth.
I think the cold was really starting to kick me while I was down.
Then I started to have diarrhea. All the liquid I could stomach to get in me was just emptying right away. So I tried a little bit of thin crust pizza and some buttered toast.
My wife went to the pharmacy to get my prescriptions filled and get gatorade and such.
The evening was really awful and I felt like I had a big set back. I was really excited to try pizza tonight but wanted nothing to do with food to due to my nausea, chills and diarrhea.

By about 11 PM I was able to get some gatorade in me and 3 slices of toast (total).

Hopefully tomorrow will be better.

Day 10 Post Op (1/31/2014)
Today went pretty well. Work was pretty crazy, and I didn't really get to eat lunch until like 3 pm. I forced myself to snack though, and felt much better than yesterday. I had a banana for a morning snack, and around lunch I had some refried beans.
I tried to eat some thin crust pizza while on a conference call. That was a bad idea! I went back to my old eating habits of eating too fast and not chewing enough. I think I experienced my first food getting "stuck" in my esophagus.
It felt like a painful air bubble in my esophagus around the middle of my breastbone (similar to when air would get stuck on the first few days), but I couldn't burp up the air to release it.
So instead, I sipped some drink to push the food down (like I had read to do on the forums and by talking to other patients). I felt like I couldn't really talk. My mouth got really watery like I feel when I am about to vomit. It was pretty painful. It eventually cleared up after enough slow sips of drink.
I actually at one point sent an IM to another person on the conference call saying "Can you lead the call, I am having trouble breathing". Then I said "Well, I can breathe, but I just feel like crap".
A great moment in my professional life for sure.
After my conference call I did have some more thin crust pizza, but I made sure to sit at the table, and cut it up small and chew a lot. And take a sip of drink every few bites.
It certainly taught me to be more cautious.
I ran some errands after work to get some groceries and prescriptions and such. This time I didn't feel really worn out when I got home. I am starting to have some more energy.
When I got home, I decided to make some rotini pasta with some red sauce (everyone else was having pasta, and it looked good).
I also had a caesar salad with it.
It was pretty good, but I only ate about half of what I made because it took so long to eat. And I reheated it twice while I was eating because it kept getting cold.
After dinner I had a strawberry milkshake to get some extra calories in. It made me feel a little bloated and I had to burp up a good bit of gas.
But on the positive side, at least I can burp up some air, which I feared I wouldn't be able to after the surgery.
Tomorrow, my mother-in-law (who came out to help with the kids after the surgery since I am useless right now), wife and kids leave for my in-law's place in Florida. I will be staying to recover alone. I think it will help as I will be able to just focus on my food and relax a bit.

Day 11 Post Op (2/1/2014)
My wife and kids left early this morning. I got up early to help them get out the door and then slept in until about 10. That was nice. I had a late breakfast of pickled eggs, pickled beets and raisin toast.
My goal for the day was to a) eat well, b) plan out my meals for the rest of the week and c) go to Sam's Club and the grocery store to get the provisions I would need.
I am going to a movie in a movie theater tonight with a friend, so it will be nice to get out for a bit. I will be sure to bring medications, Ensure and water.
Around lunch time is when I went to run my errands, so I brought an Ensure with me and a banana to snack on figuring I would eat lunch out.
Well lunch time on Saturday is the best time to go to Sam's club, because that is when the samples were out in force.
They were selling meatball subs by the front door, so I bought one without the bread (essentially meatballs, sauce, and mozzerella cheese in a cup), and it was pretty darn good.
I made sure to cut the meatballs in quarters (they were already swedish meatball size), and chew thoroughly. I brought a bottle of water and drank after every few bites. No food got stuck.
Then I made it to the samples, and let me tell you, getting the samples at Sam's club is a GREAT way to help you figure out what food you might be able to eat. And since I was shopping for food for the week, it also helped me plan out my meals.
I found that I could eat some of the pulled pork they had, so I bought that. I also picked up some shrimp and lobster ravioli. At the grocery store, I picked up some crab legs to steam up later in the week.
For dinner tonight, I am making stuffed shells with red sauce and salad.
Tomorrow night is the superbowl, and I am going to make some hot wings and bring them to the party and carefully eat them. It may be the first time anyone has eaten hot wings with a fork and knife, but if that gets me eating hot wings, I will do it!

Day 12 Post Op (2/2/2014)
Today went pretty well. I got up, ate some breakfast and went to Mass. After Mass, I ate some stuffed shells for lunch and then ran some errands so I could do some touch-up painting around the house.
Around 3:30 I headed over to some friends' house for a Superbowl party. I was thinking of trying hot wings and beer or soda.
I had hot wings cut off the bone and a slice of pizza for dinner tonight. It went pretty well. Nothing really got stuck. I felt like I maybe had a little heartburn, but I didn't have any issues sleeping at night.
I started trying 2 Ibuprofen instead of 3 at 7:30 PM today. We will see how that goes.
I ended up not trying soda or beer. I drank Gatorade instead. I still get air bubbles that sometimes become painful until I burp when drinking water or any other non-carbonated drink to fast. So I figured that adding carbonation would probably not be worth it.

Day 13 Post Op (2/3/2014)
I woke up today and had some oatmeal, yogurt, and coffee for breakfast. It is Monday, so thiys will be my first full week back to work. I am still trying the 2 Ibuprofen every 6 hours instead of 3.
Work went fine today. I had a really long meeting so I didn't get to eat lunch until about 1:30.
I decided to go to McDonald's to try some chicken nuggets and fries and a shake.
I brought it home. I was able to eat it fine, though I cut up each nugget into 6 or so pieces and I had to eat the fries more slowly than my usual "inhale them" pace.
For dinner, I steamed some crab legs at home and had some mashed potatoes and green beans. All went fine and it was delicious.
All in all, I am doing pretty well. I can feel a minor achy pain at my incision sites still, and I still bend from the knees instead of bending over at my waist. But other than that (and eating slowly) I feel pretty normal.
I am able to do a normal day's work, and then after work do some errands and get some stuff done around the house.
When the wife and kids return I will be in a situation to be of more use for sure.

Day 14 Post Op (2/4/2014)
Today marks the 2 week point in my recovery. I am doing much better than I thought I would be at this point.
I am eating a variety of solid foods.
So far, I have not yet tried breads that weren't toasted, steak and other such meats, and any carbonated beverages.
However, at this point, I feel like I am having a relatively normal diet. At least one that I can get enough calories on without too much trouble.
Since I am still not eating a ton at meals, I need to make sure to keep snacking in between meals.
But all in all, I am feeling great. My incisions hurt a little bit still, but it isn't prohibiting me from working during the day and getting errands done during the evening.
I had my first carbonated beverage tonight since the surgery. It was beer. It went fine. I just had to drink small gulps slowly and burp a lot.

Day 17 Post Op (2/7/2014)
Nothing much to report. I almost feel back to normal. I still have to eat carefully and slowly, but I am able to eat most foods. I even had a peanut butter sandwich (with bread) the other day. And I had an egg McMuffin yesterday morning for breakfast.
Yesterday I had my followup Barium Swallow. Fortunately, they didn't make me take the gas crystals (the pop-rocks things they make you drink to put a bunch of air in your stomach) since it still hurts a bit if gas is trapped down there. I almost threw up during while chugging the Barium because it is pretty nasty after a while.
But other than that, it went fine.
I will have to wait to hear what my Doc thinks of the results.
Today I had a burrito bowl at Chipotle for lunch and dinner (half for lunch and half for dinner) and it was pretty good (as long as I kept reheating it).
Overall, I feel pretty good. My incisions are still a little sore, but I am able to be useful again and eat normal foods, so I would say I am well on my way to full recovery.
I will be updating less frequently now as there isn't a whole lot going on that is different each day.

Day 18 Post Op (2/8/2014)
This will be my last update for a while as things are moving along pretty well.
Today I went to IHOP for breakfast and had eggs, sourdough toast and my favorite crepes (the ones they took off the menu which they still make for me). I think the toast got stuck once, so I still need to be careful about how fast I eat. But everything was delicious.
For lunch I had a BLT in a pita pocket. Bill recommended flatbreads or pitas as being easier than regular bread. And let me reiterate that I had a BLT (Bacon LETTUCE and Tomato). Before the surgery, I would just have a BT because the lettuce caused too much reflux to be worth it.
For dinner I had hot wings and tater tots. And this time I ate the hot wings off the bone like a normal person. It went fine. Tomorrow the wife and kids return and I can't wait to see them.

I hope that my journal (thought probably overly detailed) will at least help someone who is either contemplating or recovering from this surgery. Overall, I am confident I made the right decision and I look forward to being fully recovered. I am happily surprised that I am eating most normal foods again at this point. I thought that I would be on liquids for a solid 2 weeks. They say that everyone's recovery is different, and I can definitely attest to that. Fortunately, I had a pretty easy recovery I think. And I hope everyone else has a similar or easier experience.

Jill_2013
Regular Member


Date Joined Feb 2014
Total Posts : 70
   Posted 2/9/2014 3:50 AM (GMT -6)   
Wow... thank you so much for the extremely detailed story. This definitely eased up some of my fears and questions to my upcoming surgery! I was also concerned about the burping and vomiting but in your story you cleared that up. Im glad your surgery went well. Im hoping mine goes as smoothly as yours did.

New Life In Kissimmee
Regular Member


Date Joined Sep 2012
Total Posts : 32
   Posted 2/9/2014 5:50 AM (GMT -6)   
I am so glad that everything is continuing to go smoothly! This is a great outcome and I think you made the decision to have the surgery done. I know there's not a lot of information on the Internet on what to expect but with your Recovery Blog, I think you pretty much took care of that! LOL smilewinkgrin

I'm glad to have a fellow brethren of the WRAPPED CLUB! lol

Continue healing well my friend....

justinf
New Member


Date Joined Jan 2014
Total Posts : 4
   Posted 2/9/2014 3:52 PM (GMT -6)   
Jill_2013 I am glad it helped. To be clear, I haven't vomited yet. but the anti-nausea meds have helped with that and I am just sure to carry them around when I am out and about.

One thing that I am not sure that I mentioned that I definitely experience. It is something that New Life in Kissimmee had warned me about. When you get hungry, it actually kinda hurts. So it is always a good idea to carry a snack around with you or have something handy. That is why I snuck an Ensure into the movie theater. Though if someone stopped me, I doubt they would have made much of a beef.

Also, one other word of advice. Make sure when you are eating that you are focused on eating (with possibly the TV on or something to make you relax.) The most trouble I had was when I would relapse into my old way of eating. I have 2 young kids, so before the surgery my pattern of eating was, eat as fast as I can before I have to get up to get something else for the kids. and eat as fast as I can so I can get bathtime started. My kids and wife come back today :-), so I will just have to be even more careful that I keep on my slower eating. On the up side, if I don't get enough to eat at dinner time, I can always snack later at night, or drink an Ensure (I still have about a case of them left).

lobstahguy
Regular Member


Date Joined Jul 2013
Total Posts : 332
   Posted 2/9/2014 4:18 PM (GMT -6)   
Incredible courage. I dont think i have the strength to go thru this.

Jill_2013
Regular Member


Date Joined Feb 2014
Total Posts : 70
   Posted 2/10/2014 1:56 AM (GMT -6)   
Thanks again Justin!

justinf
New Member


Date Joined Jan 2014
Total Posts : 4
   Posted 2/10/2014 8:57 AM (GMT -6)   
Thanks New Life In Kissimmee
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