Update and post nissen issues

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zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 4/14/2014 3:11 PM (GMT -6)   
Hello friends. A quick recap, I had NF in November last year. Since week 2 post op I've had constant belching. This has worsened with time, and when I saw my surgeon for follow up he said it could be a tight wrap and wanted to do a dilation. I replied that I can get almost any food down without issue, but I do regurgitate drinks and froth. He replied that yes, it is unusual to be ok with food and not drinks but that I am just being a typical awkward woman(sic). He booked dilation for the week after, but since I felt rushed at felt I hadn't really had my questions answered AND he said it will resolve on its own with time, I cancelled and said I would wait a while.

Since then I have had heartburn almost constantly, belching alal the time, I do swallow air too and when I do I feel it gurgle into my stomach before it burps back up. I am now refluxing very hot feeling liquid which tastes sour and acidic.

My gut feeling (pun intended lol) is that the wrap has somehow slipped. I am going to inquire as to how possible that is at my next appointment.

I am off all acid meds now, so don't really want to go back down that road.

Any thoughts would be gratefully received. I'm not sure I trust the surgeon, he seemed so quick to jump to conclusions and it was almost like he just didn't have time to hear me.

Does this sound like a tight wrap or slipped wrap?

Thanks in advance

Liz x

TonyG
Regular Member


Date Joined Apr 2013
Total Posts : 254
   Posted 4/14/2014 3:28 PM (GMT -6)   
Sorry you're going through all of this, Zeldagoblin.

The only way to really know anatomically if there is something wrong would be via a barium swallow and/or endoscopy. And if it were me, I'd be seeking a second opinion with a different surgeon.

If you're refluxing (the hot, acidic liquid), then it's likely that it is NOT a tight wrap as nothing would be getting past it. It sounds like you definitely do not need the dilation, but I would consult with another surgeon to be safe. And when you do that, I would request of your operative report (surgeons dictation) and take that with you to the new surgeon.

Feel better and take care!
-TonyG-
-TonyG-
Nissen Fundoplication April 30, 2013
Pain-Free, Reflux-Free, Sleeping on my back!

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 4/19/2014 4:19 AM (GMT -6)   
Thank you Tony. I have just returned home from a trip to my sister's and have had a bad week with heartburn. I have also started to get pain from my stomach after eating and when I stretch up I feel a pull at the wrap site. These are both new symptoms. Needless to say I am very upset and confused. I can't identify why this could have happened.

1039smooth
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Date Joined Sep 2013
Total Posts : 2114
   Posted 4/19/2014 9:56 AM (GMT -6)   
Liz,

Wow, it sounds like we're in the same boat. I was actually happy I could belch. Sometimes I can open my mouth and I belch without any really effort. I think I failed to mention this to my doctors, but yeah, I was thinking it's a good thing.

The past few days, I've gotten some heartburn. Ironically, I hadn't felt this in a while. Just the day before, I mentioned to my doctor's nurse that I was really just having stomach trouble and not much up above. She said it sounded like the wrap is working at least, but we need to find out what's up with the stomach. I can't see this doctor until June. My second opinion doctor wants me on expensive supplements. Um, yeah, DEXILANT was cheaper pre-surgery. It's just frustrating. He said I might have some gastritis or something and that he's seen worse things heal. Since he's run no tests on me, idk how he can be so sure.

I'm not sure what exactly causes or constitutes a slipped wrap. Nor do I know how it's repaired.

I'm with you and don't want to go back down the PPI road. I had the darn Nissen to get off those, to be able to lay down sooner after eating, and to be able to bend over and be of some use around the house. Almost none of that has worked out.

Did going to your sister's get your mind off thing some at least?

Forgive me if I come off as turning into your thread into being about me. I just wanted you to know I can relate, I understand, and that I care about how you're doing. Keep plugging.

1039smooth
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Date Joined Sep 2013
Total Posts : 2114
   Posted 4/19/2014 9:56 AM (GMT -6)   
Happy almost one-year anniversary to TonyG. :)

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 4/19/2014 3:58 PM (GMT -6)   
Hi there 1039, and thanks so much for your input. I don't mind at all you giving your experiences,it really helps to know I'm not alone! It is hugely disappointing that absolutely nothing seems to be improved upon. My recovery was a little rocky but judging from what I've read it was actually pretty smooth sailing in comparison with some poor souls.

I'm currently popping a Tramadol every other day which is quelling the belching but I am really concerned about addiction or dependency. But it is the only thing that is helping. I hope the surgeon will have some helpful advice. I see him in a week or so.

I actually broke down today, I think it all just got too much. My visit to my sister wasn't really relaxing since I really went to help her after her husband was seriously hurt in a road accident. Things are tricky at home too and I know stress isn't good for reflux either. I'm just pretty gutted I've been through surgery with no real results. Been battling this for about seven years now, it's getting depressing.

Hugs

Liz x

1039smooth
Veteran Member


Date Joined Sep 2013
Total Posts : 2114
   Posted 4/19/2014 6:10 PM (GMT -6)   
You'll have those feelings like you might have been just as well off before. I went with my GI doctor's advice and rolled with it. Sadly, I did no research before surgery and my post-op literature was piss poor. Needless to say, I've had literally a thousand questions for four doctors, my GP, my surgeon, and two GI's.

My dad was sick and my mom couldn't really handle my stuff, too. I just picked a very poor time to go through with it. I try to tell myself some good things. I got off blood pressure meds, lost weight, and I clear my throat much less now. For a while there, I was like my old self and it was nice. I'm still very guarded with what I do from a physical standpoint. Since then, there's been some regression. I think the wrap might still be okay, but something is going on with my stomach. I say I think the wrap might be ok with no confidence. Last couple days the heartburn has come.

I've taken Tramadol before for something or another, but I don't think it was for this. Definitely discuss your feared dependency with the doctor. However, it's certainly understandable to be a little overzealous with something that makes you feel better after you feel so bad. I'm hitting my Xanax a little harder than normal, but nothing crazy.

I think MOST people would be feeling a lot better at this point since yours was done in November. I'm told it can take up to a year to really get there. I know it's frustrating, but everyone is different. My second GI doc says it's not really normal for me to still be this bad off this far out, but it's not unheard of, either. It's been pretty much unanimous that the stress has gotten to me. Lost my dog in August, had my surgery in August, lost my dad in September, dealing with stuff after his death (mom did most of that), but I still think much bothers me subconsciously. I obsessed about myself to maybe protect myself from what my dad was going through. I don't know.

Seven years is a long time. I dealt with mine officially two to three I guess. When it all began, I was pretty heavy and thought I was having a heart issue. Then GI Doctor #1 discovered the hernia, the stage 4 esophigitis, the GERD, and later the Barrett's.

From what I can tell, most stomach stuff is pretty manageable. We just have to be able to tackle what's going on and getting to that point is maybe the toughest part.

I told GI Doctor #2 I'm sure this would kill me and if it didn't, I'd probably want to die. He refuted that statement. Like I said, idk how he can be so sure. But, he is the doctor. Maybe he knows more than me.

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 4/22/2014 4:10 PM (GMT -6)   
Yes, I am trying to be patient with it, and I knew recovery could take time, and am absolutely fine with that. If it were swelling, or bruising or whatever from the op I could cope with that. What concerns me so much is that I feel literally NO resistance when I eat, and I am able to eat anything at all, meat and all that. And this weird freely moving air in and out of my stomach. I am getting really stressed about it. I have soreness at the wrap site and under the left rib. It's pretty upsetting to go through surgery and have it fail.

I see my surgeon on the first of May. He is not a humble man and makes you feel very rushed. I didn't see him at all in hospital, he just did the procedure and left the other staff to do the bedside stuff. I am dreading it, to be honest. :-(

1039smooth
Veteran Member


Date Joined Sep 2013
Total Posts : 2114
   Posted 4/22/2014 5:32 PM (GMT -6)   
I misquoted myself. Pop passed in September. See? Too much going on in my noggin'.

When I had my Upper GI a few months after surgery (I was freaking out), I had to swallow or try to swallow this big pill. GI Doctor #1 was happy there was resistance. Had it gone straight down, he told me the wrap didn't work. At the time, mine was possibly too tight, and said pill might have taken a little longer to go down than it should have.

How fast were you eating pretty much whatever after the surgery? I took months, but I'm still not sure why that is. At one point, I wondered if I'd eat again. The last few months, I haven't had any resistance either and have been very overzealous. You get pumped that you can eat and you overdo it. I ate past full more times than I care to admit, but it just caused a little stomach discomfort. It passed.

Could you describe this freely moving air? I'm wondering if it's similar to what I said when I say I open my mouth and burps come out with no effort.

I get sore in my wrap site, too. I get pain in my right side, not my left. It's parallel with my belly button almost. It comes and goes. I've mentioned it to the powers that be, and it's pretty much dismissed.

GI Doctor #1 is kind of smug and the know-it-all type. He said he'd get me through this and I was touched by that, but I'm not always his biggest fan. I dislike one of his nurses. She made me feel bad for seeing another GI doctor. A thousand pardons. It was unprofessional of her. My surgery was a Friday and I didn't see my surgeon until weeks after. She had another doctor do her rounds when I was in my hospital room on Saturday. Would have been nice had she stuck around.

Definitely go see your doctor on May 1 at least. In the meantime, maybe look for someone else, too. Don't let him rush you. I know they're intimidating, but he works for you ultimately. I saw some of my records from my surgeon and she was like, "He had more pages full of questions," which I laugh at a little, but she never rushed me.

According to all these nice folks here, you're still early on with everything. I understand your concern, and I'm the ultimate hypocrite when I say this, but it is what it is. It's hard not to worry about, but do what you can to block it out some. See, I can't do any of this, but I'm a pretty good preacher. :)

I'm on here often looking for help and trying to find someone to help, so I'll respond pretty fast.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5029
   Posted 4/22/2014 6:02 PM (GMT -6)   
I had one resident tell me he was going to do a dilation while he did an endoscopy even if I refused it. So, I didn't have the endoscopy and that was the last time I went in for a checkup. Yes, I have trouble swallowing, but it's from polio, not the wrap. It's no worse now than before the surgery.

If you can burp and swallow hard food, it doesn't make sense the wrap is too tight. I think patients need to be their own advocates and think for themselves sometimes. It takes months for most people to be able to burp.

If you're having trouble burping all the time, maybe looking into your diet is a place to start. There are all sorts of lists online of gassy foods. Also remember the directions given for drinking - no straws, no carbonated drinks and such. Chew foods well, eat small meals. You know the drill.

For continued pain there's always the barium swallow. Wraps do sometimes slip. Hernias sometimes to rip open. CT will also show if the wrap is above the diaphragm, but it won't show reflux.

I never saw my surgeon even the day of surgery and have only seen under-educated residents since then. But I recommend my surgeon and his seasoned residents for surgery. They have a top rate of success and that's with the worst cases - like my Giant Paraesophageal Hiatal Hernia (GPEH).

1039smooth
Veteran Member


Date Joined Sep 2013
Total Posts : 2114
   Posted 4/22/2014 6:05 PM (GMT -6)   
Alcie,

What's the worst thing a barium swallow might show after having a Nissen done? I'm having one tomorrow. Thanks.

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 4/23/2014 3:37 PM (GMT -6)   
Thanks for the responses. The freely moving air is just that, I am a chronic aerophage, I swallow air a lot, worse whe stressed.. Lately when it gulps into my oesophagus it bubbles straight into my stomach with no resistance, and back out again. It just feels wrong to me.

I am at a loss. If the wrap has slipped I am considering just leaving it and attempting to get back to my life and hope this will go on its own like it did in the months prior to surgery ( Sod's law)

Would really like my life back. Does anyone know if a slipped wrap is dangerous?

Liz x

1039smooth
Veteran Member


Date Joined Sep 2013
Total Posts : 2114
   Posted 4/23/2014 4:39 PM (GMT -6)   
I asked GI Doctor #1 about 'having' to have it repaired if it comes undone. I don't think I asked about it slipping because I don't think I was aware it was an option. If memory serves, he was torn on whether you HAVE to repair it once it's done. One would think it would just return to its old 'normal' state if it comes undone.

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 5/1/2014 10:43 AM (GMT -6)   
So, to update further, I met with my surgeon today, and explained how I'm now having no resistance with food, chronic burping attacks and recurrent heartburn. He decided he wants to take a look with an upper GI endoscopy, for which I'll shortly receive an appointment in the mail.

I was relieved that he didn't want to dilate after he heard my symptoms, so now it's just a case of wait for the endo. Meanwhile, Gaviscon is the staple.

Little bit down about it all really. Aha well, keep on truckin'.

morco
New Member


Date Joined Sep 2014
Total Posts : 3
   Posted 9/19/2014 8:11 AM (GMT -6)   
Hello zeldagobline or anyone with same problems,
I was operated for 4 months Nissen Fundo, since then, my lpr symptoms are getting worse,burning in the mouth and tongue,sore throat caused by permanent burp.I have intolerable pain and I feel bad,it will always stay so? or is there hope that it will be better?
must you still burp?you still have severe lpr symptoms? how are you now?  
I hope that someone has answer for me, I am looking forward to any help and answer
 
Marco

zeldagoblin
Regular Member


Date Joined Mar 2010
Total Posts : 204
   Posted 9/19/2014 3:17 PM (GMT -6)   
Hi morco. I'm sorry to tell you, my heartburn is cured but my lpr symptoms are even worse than before, since they took me off the meds when the op was done. I'm beginning to think I'll never find an answer. I had my op in November last year. A few weeks ago after having literally no good days since the op I opted to try the pariet again, and had three awesome days in a row...then, boom, back to terrible again! Just when I thought I had cracked it. Three good days in almost a year is dreadful.

I still have chronic belching and sore throat off the scale. I've had gastroscope and manometry and ph test all of which has come back normal. I've recently done pepsin test, for which I'm waiting the results.

The one and only thing that helped at all was the Tramadol they gave me for post op pain. It stopped the belching, and killed the pains, but they won't prescribe that for lpr. I'm now having asthma symptoms along with the burny vomit in throat feeling and ear pain and swollen throat. I had some success with amitryptiline and will be asking to try that again when I see the GI guy again.

I feel doomed to a life of excruciating pain and no one who can help me.

There aren't that many like me, so I hope mine is a very isolated case, because I wouldn't wish it on anybody. I am so sorry I can't give you better news. I wish you the very best.
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