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Journey72
Regular Member


Date Joined Feb 2014
Total Posts : 45
   Posted 2/20/2014 8:35 PM (GMT -6)   
I am 3 weeks post Nissen now and I have some questions for those who have gone through this procedure.

Why is it some days I am able to eat solid foods and others I feel like I'm dying?

I drink hot decaf green tea w/honey before I eat anything, because it seems to relax my esophagus so I can eat.

I chew, chew, chew my food and it still gets stuck? I drink plenty of water, but the tea, I drink all day long.

I still have reflux, so I still take the Dexilant. When the food gets stuck in the wrap, my chest gets tight, I get pain all the way around to my back, and up to the back of my head, even behind my eyes, and I begin to sweat?

I measure all of my food, I eat no more than 1/2 cup at a time.

The weird thing is I can eat cookies, chips, pepperoni, m&m's w/ peanuts, and pudding or jello. Some days I can eat clam chowder, mashed potatoes w/ carrots (pureed), ravioli, and even pizza?

I don't understand what is going on, this process I understand will take a long time. And healing takes a long time too, but I think it's crazy what I can and can't eat, even when.

Thanks

TonyG
Regular Member


Date Joined Apr 2013
Total Posts : 254
   Posted 2/21/2014 12:34 PM (GMT -6)   
Hi there Journey72!

At three weeks post-op, I'm surprised you're eating solid food. I was told specifically by my surgeon (and others on here given the same advice by theirs) that I was to be on a strict liquid diet until I saw him for my follow-up appointment (4 weeks from my discharge date). My diet consisted of lots of water, pudding, yogurt, really loose scrambled eggs, loose oatmeal, loose mashed potatoes, smoothies, milkshakes, soup, and protein drinks. I didn't dare try anything solid until my surgeon said it was okay. Even then, I was super careful. Small bites and chewing till it was almost liquid. Please be absolutely careful about your diet. Advancing it too fast will cause you more problems and will delay your recovery.

I would argue that this soon after surgery you definitely are not feeling reflux. The only way your esophagus knows to communicate pain or discomfort is by making you feel like you're having heartburn/reflux. At this point in your recovery the area surrounding the wrap is still VERY swollen inside. I imagine that this "reflux" you're feeling after you eat is because your diet has been advanced too quickly and it is irritating the wrap site, causing MORE inflammation, which then makes it tighter and more difficult for anything you eat or drink to get down.

Your symptoms are likely not because of the amount of food you're eating, but WHAT you're eating. Harsh acidic food (pepperoni, tomato sauce) will definitely irritate the raw surfaces inside that have just been operated on. Go easy on your body...it's been through a lot in the last three weeks and it will take time for it to get back to normal.

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

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 2/21/2014 10:31 PM (GMT -6)   
Hi Journey,

Tony has given you some great advice. I concur with his thoughts. At three weeks, you're still in the midst of healing, and your esophagus is still very sensitive and irritated. it's very likely that more food than you think, is sitting at the wrap site and creating additional irritation.

The esophagus is a "dumb organ", and it interprets all pain as reflux. At your stage of recovery, there's no doubt that you're still getting pain.

The things you're eating are not conducive to having a comfortable esophagus/wrap. I suggest you rethink the things you choose. Because you "can eat them" doesn't mean you should.

My surgeon didn't have me on liquids for 4 weeks like Tony's, but I was very careful about my eating, and only ate things that could be chewed to a liquid. I never swallowed anything that wasn't chewed to a liquid/creamy consistency. I did eat clam chowder, but only the broth, potatoes, veggies (very soft in the soup), but NO CLAMS, as they couldn't ever be chewed to oblivion.

Only eat things that can be chewed to a liquid. Take small bites and chew, chew, chew. Stay away from chocolate chip cookies, and peanuts, etc. If you're having discomfort, you need to rethink what you're doing. Back off the aggressive foods you're eating, and stick with soft foods, or foods that are easily chewed to a LIQUID consistency. Anything that doesn't chew to a liquid should be discreetly deposited in a paper napkin. Don't ever swallow anything that isn't a liquid/creamy consistency.

Sips of room temperature water or warm tea after each bite, will help your swallowing, and ensure that things have a better chance of getting through, rather than sitting at the wrap site.

Bottom line...if you're having discomfort, you're progressing your foods too quickly. This recovery takes 6 months for most of the healing and a year for the rest. You're at 3 weeks, and very likely still have significant swelling, that can cause eating problems as well.

Good luck!
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

Journey72
Regular Member


Date Joined Feb 2014
Total Posts : 45
   Posted 2/22/2014 11:09 AM (GMT -6)   
Denise and Tony

Thanks for your advise it makes a lot of sense. I guess that because the pain is because of the foods I choose to eat, but I am not a soft liquid foods kind of guy. I have tried the liquid foods and soft foods, but they are also making me sick. Even pudding and yogurts are getting stuck. It's everything I eat and it's not every day they do this. Like I said, the hot tea seems to relax everything and then I can eat. I do stick to the liquids as much as possible, but when I have these cravings for these other "bad idea" foods.
Although I do notice that if I stand upright, the food, no matter what foods, does not get stuck? My doctor never told me these things I hear from the forum. He told me to introduce solids asap, so that my wrap and esophagus could adjust. I have to throw up the food when it gets stuck, because water does not wash it through the wrap and I get extreme pains in my chest and back. The surgery itself, I've never had much pain from.
We are all naive to things, and this is where I am most naive. I will take your advice and stick to the liquids. I have read that many people have eaten very scrambled, scrambled eggs. This is a food that I cannot eat whether
I sit or stand? I have lost 12 lbs since this surgery, I don't want to lose a lot of weight, what can I do about that? I would ask my doctor, but it seems as though he is naive to this surgery as well.
Thanks everyone

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 2/22/2014 11:28 AM (GMT -6)   
Hi Journey,

While some surgeons expect their patients to remain on a liquid diet for extended periods of time, this is not universal. Like you, I'm not the "liquid type". My recovery would have been torture if I had to stay on liquids for weeks and weeks.

This was my eating protocol, and it worked fine. Above all--LISTEN TO YOUR BODY. I was on liquids the one day I was in the hospital, and my surgeon sent me home on a soft diet. I saw him at Day 6, and at that time he told me to eat "whatever can be chewed to a liquid".

My mouth and teeth became my blender. Instead of sticking foods I ate into the blender to liquify, I enjoyed that task via my own mouth and teeth. In my opinion chewing is the best part of eating anyway.

If something I ate didn't chew to a complete liquid, I didn't swallow it. I always kept paper napkins nearby, and deposited the offending food there. It was a trial and error process, and I was extremely careful. When a surgeon sets a patient free to use his/her own good judgment, rather than doing the easy thing and sticking to liquids, that patient has to take the responsibility to eat carefully.

As long as you chew your food thoroughly, you won't need to "throw the food up" if it gets stuck. My surgeon said that if I were to forget and swallow something that wasn't completely chewed, don't worry. Just relax, take sips of water or warm tea, and it'll go down eventually.

I was eating out at a restaurant and ate a cherry tomato without thinking. Ouch. I got the typical spasms with the stuck food, and stupidly only had ice water to drink. Still, I took sips, and the tomato did go down. I had some painful spasms in the process, but all in all, it didn't last long. After that I always ordered tea with my meals. Water without ice, also...just in case!

You are right that small meals still are important at your stage of recovery. Many, many foods will chew to liquid...not just soft foods. Saltines (and a variety of crackers), toast (NO untoasted breads), etc. chew easily. Of course veggies and meat cooked to a tender, soft consistency (no steak), when chewed thoroughly to a liquid consistency, are fine. Really, you can try anything. Just remember the rules: small bites, chew, chew, chew; eat in an upright position (as you have discovered), and ONLY swallow foods that basically disappear in your month. There are a world of foods out there that fit this protocol.

My surgeon told me that even mashed potatoes can get stuck. It's the small bites, and chew, chew, chew that works best. Scrambled eggs only work if you can eat them scrambled SOFT, and beat them up with some milk.

Take sips between bites, and wait for the first bite to go down before taking the next bite.

Puddings and other sweet things can make your dumping/diarrhea worse, so stay away from sweets at this point, as much as possible.

Hopefully these suggestions will help. You don't have to punish yourself with going back to liquids. Use your head, select foods carefully, and chew, chew, chew, chew, chew. If something doesn't chew to oblivion, don't swallow it.

Many small meals are preferable at this point. Do you have a slow cooker/crock pot? Stick a nice piece of meat, some carrot, onion, potato, a package of Lipton Onion Soup Mix, and a cup of water in the pot. Cook on low for 10-12 hours. I'm not saying you can definitely eat everything in there, but at your stage when I did it, I was able to eat the veggies as well as the meat, although I expected to only be able to eat the meat-flavored veggies.

If you have any gas issues, be sure to take BEANO just before your first bite of any veggies/gas producers you eat. It'll help prevent the gas, and I used it a lot during my recovery. I don't need it now unless I make a diet of bean soup, or chili, etc.

If you have any more questions, ask away. Your questions/our answers help others looking for information as well.

Hang in there...you're in the very infancy of your recovery. You'll get back to eating all those food favorites. Just not yet.

Best wishes,
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) : 2/22/2014 9:35:29 AM (GMT-7)

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