Toupet fundoplication - Recovery Journal

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Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/8/2014 7:16 PM (GMT -6)   
Hi all,

After 3 cancellations, I finally had my fundoplication (toupet)! It was last Thursday, so today is my 6th day post surgery. It's also my first day not taking any pain medication, so hooray for that as well!

I arrived at the hospital around 7:00, and was in surgery by 8:00 after a brief meeting with the doctors involved to review everything once again. I had my pre-assessment a week earlier, and that was all clear. I was in surgery around 8:00 and was finished around 12:30. After spending a day in the recovery ward, I was able to go home around 18:00. I have 5 small incisions as they were able to do the whole thing laparoscopically and thankfully didn't have to convert to open surgery. They have dissolvable stitches and waterproof dressings; I was told it was safe to remove the dressings after a week if they don't come off naturally on their own before then. I'm on clear liquids for the 1st week, non-clear liquids the 2nd week, mushy food the 3rd week, and soft food (and hard food) 4th and 5th weeks as I feel up to it. And fizzy carbonated drinks once I've mastered harder solids.

From what I understand the surgeon telling me... I had a toupet fundoplication, large hiatal hernia repair/stitching up the diaphragm, and since there was apparently substantial damage to the lower end of the esophagus, the damaged section was resected (and presumably re-formed) before the fundoplication itself.

The pain hasn't been too bad. Before today, I was on paracetamol and codeine every 4-6 hours which was helpful. And today, I haven't taken anything and been okay. Unfortunately, they were pills and I was never a good pill taker to begin with, so taking the pills after the surgery was very difficult. I had to have them cut into 1/8ths to be able to swallow them. Initially, it was the incisions that hurt the most, as well as a very bad sore throat and my right shoulder was incredibly achy. Now, those things are much better, and instead, it is deep inside my upper abdomen that feels tender and bruised. Leaning over is painful, taking a really deep breath is tender/sore, and I've got strict instructions to not lift anything for 8 weeks.

My stomach is making all kinds of wonderful noises - rumbling, grumbling, growling, moaning... and I can sometimes feel painless little spasms (best I can describe it) in the abdominal area. I've been burping a LOT; mostly after drinking anything. (though apparently at night I burp in my sleep too) Sometimes I feel like the liquid gets stuck halfway down my chest for a second or so before finally going all the way down. Sometimes I feel quite nauseated and heartburn-y (for the technical term), but that usually passes after a few minutes and feels a bit better with a few burps. Sometimes there's chest pain and tightness, but again that usually lasts for a few moments and is usually relieved by a burp or two. I'm guessing (hoping!) that the heartburn feelings and chest sensations are still from the healing/recovery process and not indicative that the wrap has failed in some way - especially so early on.

The skin under my dressings is becoming very itchy; I suspect the skin healing has commenced!

I'm very tired, and sleeping a lot with many small naps during the day. I suspect this is due to a combination of recovering from the operation, and essentially being on a very low calorie diet. I'm hoping in a few days I will feel able enough to take a small walk down the street to a local cafe, sit for a while, and walk back home - for some light exercise to prevent adhesions and to get out for a little while. I have initially 2 weeks signed for being off work; I'll wait and see how I feel at the end of this week, but I suspect I will be requesting a renewal of the sick leave paperwork. The fatigue level has surprised me... I knew I would be healing and not eating much, but I feel really wiped out all the time. Much more than I imagined.

All in all, I think not going too bad so far. I will have a follow up appointment in a few weeks, and hopefully, will be told the wrap is fine and settling well. I'll keep my recovery thread updated; hopefully it can be informative to people looking for a recount of personal experience.

Post Edited (Altair) : 4/11/2014 7:44:47 AM (GMT-6)

Veteran Member

Date Joined Nov 2012
Total Posts : 532
   Posted 4/9/2014 10:40 AM (GMT -6)   

Sounds like you are doing great! 6 days post op and no painkillers is fantastic.

I hope that you continue to do well and keep us all informed of your progress.

May I ask why you had a resection - as someone who has a motility problem I was not aware that this could be done.

Enjoy being reflux free :-)

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/10/2014 5:15 PM (GMT -6)   
Thank you for the well wishes. :)

I have (had?) a motility problem as well with gastric emptying, but I was told it wasn't severe.

The consultant and myself didn't previously discuss a resection. I was originally only going to have the fundoplication and hiatal hernia repair. When I was in recovery and he was discussing the outcome with me, he said that there appeared to be a lot of damaged tissue when he went in and had a look. The extent of the damage was apparently very pronounced, and he was having a hard time working with it.


Today has been the first hiccup with my recovery. (sorry, graphic bodily function details to follow... advance warning!)

Yesterday I had a small walk to a local cafe, had a sit down, and eventually had a gentle waddle back home. A little sore and tender, but okay.

Today I tried non-clear soup and had a little splash of milk in my tea. Plus the usual clear liquids for drinking and sipping throughout the day. Still liquid, and everything felt okay going down. But then I had my first bowel movement post surgery. It was immensely painful. :( Constipated at the beginning with some straining (and I know you're not supposed to strain so soon after surgery!), and then exceptionally foul smelling diarrhea. Then a few minutes of a small respite, then more diarrhea. And my stomach was very very vocal about the whole process, emitting loud gurgling rumbling noises.

I hope everything's okay... how do you know when something's gone wrong with a fundoplication? Do you get symptoms? Is it only discovered (perhaps incidentally) at a follow up?

The only thing I may have gone a bit awry with is perhaps lifting? I've been feeling a bit better, so I've been around the house helping with odd things here and there as I don't want to feel like a useless wet rag. I've carried some slightly weighty things, but nothing I would normally consider "heavy." I hope I haven't accidentally overdone it.

The good thing today: my bandages came off, and the wounds are healing like a charm. Very small, very neat, slightly slightly bruised and looking like they'll fade in no time.

Veteran Member

Date Joined Dec 2008
Total Posts : 4961
   Posted 4/10/2014 8:51 PM (GMT -6)   

Welcome to the Wrapped Club!

It's normal. You have just been taking liquids in and that's what is going to come out. Plus right now your digestive system isn't happy and will be very vocal about it. It will most likely give you more grief as things swell more too.

Take care,
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/11/2014 2:44 PM (GMT -6)   
Thanks for the reassurance. Today was a better today. :) Still having exceptionally loose bowel movements, and usually a lot of them at the same time, but no more pain with them - which I can imagine is a good thing and step in the right direction.

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/15/2014 5:03 AM (GMT -6)   
Today, I tried some mushy pureed food for breakfast. I made sure it was pretty soft and squishy to begin with, took small bites, chewed everything as thoroughly as I could...

I swallowed, had a feeling of chest tightness, like it had gotten stuck, and then I vomited. :( :(

Is that normal?

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/24/2014 2:42 PM (GMT -6)   
It's now 3 weeks post surgery, and I thought time for an update.

I recall reading somewhere (I believe it was this forum) that recovery is more of a marathon than a sprint, and this is proving to be very accurate.

The shoulder pain has completely subsided now, and taking a small walk each day has definitely helped with that.

I'm still feeling tender and bruised in the abdominal-wide area, but nothing too severe that I've needed anything stronger than the occasional paracetamol. I went to the pharmacy and got dissolvable tablets; best thing I ever did!

I have had a few attempts with soft food, and it's been rocky. I've thrown up 3 times, and have since throttled back and will be going back to baby food for a few days before trying again. I contacted the surgeon, and he said that occasional vomiting with my wrap is okay and expected during this transition. I only need to worry if I am so nauseated I cannot keep anything down (constant vomiting) and/or if the vomiting is particularly violent and painful. I was very reassured to hear that; I've been worrying like mad about the integrity of my wrap. It's like my little baby!

I've found that colder things irritate more than warm/hot things. Also, swallowing is a bit harder in the morning... almost as if my esophagus has, overnight, forgotten a bit how to swallow. But once I get going, I'm normally okay. Chew, chew, chew... and chew some more. Making sure things are mushy and lubricated, and small bites. These have been key for me.

Heinz baby food has been a lifesaver! I was very skeptical; however, after the liquid diet I was desperate for more flavour and was very pleasantly surprised at how much I'm tolerating/liking the baby foods. The sweet and sour chicken and rice blend has been a hit. And Farley's Rusks... mmm!

I'm still feeling quite tired and need a nap in the afternoon after I've had a walk in the morning.

I've gotten my sick leave extended from an initial 2 weeks, to another month on top. The doctor said that although it was done lap and on the outside doesn't look too involved, a LOT happened to my insides and for most people, more than 2 weeks is needed for a full recovery. At least, he said, no working until I'm back to a semi-normal diet and getting the appropriate calories and nutrition.

So, overall okay, but it's definitely slowly but surely, and a bit of one step forward, two steps back.

Veteran Member

Date Joined Nov 2012
Total Posts : 532
   Posted 4/24/2014 3:38 PM (GMT -6)   
Hi Altair,
Sounds like you are making good progress. You may I'm sure have a few setbacks in the road to recovery, but I really hope that you feel better soon.
Good to hear that you are doing some walking and I hope that your reflux has all gone now.
please keep us updated on your progress, and i wish you a speedy recovery! :-)

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 4/28/2014 11:47 AM (GMT -6)   
I'm having a hard time right now.

I've caught a cold, and despite trying to remain topped up on as much liquid cold medicine as permitted, I'm still sneezing and coughing a LOT. My abdominal area is really sore - too much irritation with the coughing, I suspect. Generally speaking, I'm feeling really crummy and terrible from the waist up, all the way to my head.

I'm terrified the wrap will get damaged with all the coughing, if it hasn't been already!


Regular Member

Date Joined Apr 2014
Total Posts : 40
   Posted 4/28/2014 1:11 PM (GMT -6)   
Sorry to hear you are not feeling good now, but it sounds like you were recovering quite well from the surgery.
Thank you for posting your experience it really helps, as I am scheduled to meet with the surgeon Thursday.
good luck and hope you feel better!

Regular Member

Date Joined Aug 2013
Total Posts : 39
   Posted 5/2/2014 8:15 AM (GMT -6)   
The transition from total puree to soft food is a nightmare.

I'm feeling very depressed about it all. Whenever I try something with any texture - vomit!

Liquids are fine, and anything so blended that it is practically liquid slop is okay too... but anything with any kind of texture or the slightest bits or lumps... bam! Not so good.

I've been trying going back a step for a few days to baby the wrap, but whenever I attempt to take that step forwards after a period of babying, I vomit the food back up after one or two spoonfuls. Been doing this for maybe three cycles now, and I can't seem to progress past slop without throwing up.

I'm supposed to go back to work in two weeks, and I cannot even tolerate soft food. I'm feeling very helpless and frustrated.

Forum Moderator

Date Joined Feb 2009
Total Posts : 7188
   Posted 5/2/2014 9:15 PM (GMT -6)   
Hi Altair,

Sorry you're struggling with your eating transition. I suspect that your wrap is swollen right now, which makes it more difficult to get food past it and into the stomach. Your "vomiting" is equivalent to a cat coughing up a hairball.

If you take very small bites and chew, chew, chew your food thoroughly until it is a liquid/creamy consistency, you should do better. Even though you're making a transition to more challenging foods, you must still chew much more carefully and thoroughly than you ever did pre-wrap.

Take small bites, chew thoroughly, and don't swallow anything that doesn't basically disappear in your mouth. You're too early in the healing process to be managing chunks quite yet. This is very normal.

Listen to your body. Listen to your wrap and your stomach. If you try something and it doesn't work well, move back to something a bit easier to handle. This isn't forever. You're in the early stages of a recovery that take six months for most of the healing and a year for the rest.

Try not to allow yourself to get impatient and frustrated. Your body will heal, and you will be able to eat normally again. Right now, though, you need to take it very slowly. Just because you can't eat these things today, doesn't mean you never will. Your body will need time to heal. Your upper GI tract has undergone a major revision, it will take time to heal and adjust to the changes.

If you have to go back to soups and blended foods for a little longer, it's not the end of the world. In the long run, you'll be better. Remember why you had this surgery. I know it's hard not to want to rush the process and move on to a more normal diet, but try to give your body the time it needs to heal. It will heal.

If you can surrender to your recovery and follow its lead, you'll find things much easier to handle. No matter how much you'd like to hurry things, you can't. Your body will take its own sweet time to heal, and if you can accept that fact, you'll find your recovery much more bearable.

Your mouth and teeth can be your blender. It's a trial and error thing, but if you keep a paper napkin handy, and only swallow things that chew to a complete liquid, you will do much better. Taking very small bites and chew, chew, chew, is the answer. You can enjoy the chewing, and yet your food will be of the same consistency it would be from the blender.

Have some warm tea or room temperature water handy. Take sips between bites, to encourage more muscle movement in the esophagus to push things through. My surgeon warned me of the difficulty swelling would cause when ate.

He said not to worry if something got "stuck". Just relax, and take sips of water/tea, and it will eventually get through. I remember those days (I'm 5 years post op), and I know that stuck foods come with spasms that are painful. This is not a forever condition. Try to go with the flow, and take it slow and easy.

Hang in there! It gets better!
Happy healing,

GERD/Heartburn Moderator
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.”
Eckhart Tolle

New Member

Date Joined Mar 2014
Total Posts : 10
   Posted 5/7/2014 12:43 AM (GMT -6)   
hELLO FELLOW GERDERS i THINKi AM LOST .....BUT ANY AYW my problems are lessening I think due to not eating as much as I was in my former gluttonous madness but still maybe a little too much vino the moment . I hope I can navigate my back the other threaders where I was before ....Hello hello for now and anon .... yeah
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