Posted 6/12/2015 6:57 PM (GMT -6)
Thanks to everyone who has posted for being a great resource. I have been lurking on this site since the day before my surgery, when I almost chickened out because of all the horror stories. Then I found this thread, to my great relief. I’ve referred to your journals on a daily basis ever since, to let me know what was coming next so I wouldn’t stress about each new development.
17 days past surgery, I believe I am having a typical—and good—recovery. I keep hearing from aides at the surgeon’s office that their post-Nissen patients are their happiest ones. So posting a truly positive report feels like something somebody needs to do!
about me: 54 year old female, overweight but healthy for my age, no athlete but reasonably fit, respiratory allergies and sleep apnea, maxed out on reflux meds for silent GERD. I chose the surgery to get off the meds and (as a possible bonus) address persistent hoarseness in my speaking and singing. It also seemed wise to head off any serious damage to my esophagus. But I must admit I have not been made miserable by GERD as so many folks on this forum have.
I had a terrific surgeon, without having been savvy enough to pick him—my trusted ENT made the recommendation. This surgeon does several Nissens a week. He welcomed questions and inspired confidence. However like many on this forum, I found that there were some normal aspects of recovery that I did NOT learn from him, nor from the prep materials given to me. Still, I lucked out. I hope everyone else chooses their surgeon more carefully than I did!
I also stumbled into doing some right things beforehand. I lost 35 lbs in the nine months before surgery and became more fit with a trainer’s help, mostly to address an arthritic knee but also as a byproduct of good acid reflux hygiene—no late meals, a 12 to 14-hour fast between dinner and breakfast—in hopes I could resolve my issues that way. (In the end I couldn’t, of course.)
Another thing I didn’t plan, but benefited from: My surgeon spoke of this as a same-day surgery from the beginning. When, at the hospital check-in, they mentioned most people stay overnight, I made it clear that I understood it to be same-day surgery unless there were complications. From what I’ve read on this forum, staying in the hospital, even a good one, can mean mismatched care from overworked personnel – being served the wrong food or meds, being kept in bed when you should walk, etc. I went in at 8 am, was in surgery around 11, and after an extended recovery-room time (standard procedure for those with sleep apnea), was allowed to leave as soon as I could burp, swallow water, and walk slowly down the hall—about 4 pm. (Even though I had a small hernia repaired as well!) I was comfortable at home and my husband made sure my meds, liquids, and short walks happened on schedule. Why not have a full-time nurse instead of an eighth of one?
I’m pretty sure all of this helped me bounce back quickly.
Some other tips based on my experience (with thanks to everyone who supplied hints in one way or another on the forum):
• Ask your surgeon if s/he tends to do a loose or tight wrap, and discuss what’s right for you. Mine was a loose 360. I was able to burp almost as soon as I awoke from surgery. Burping really helped relieve the shoulder/collarbone pain of the first couple of days. (Though some worry that a loose wrap won’t fix the reflux, I have been off meds since surgery and I don’t believe I am refluxing at all.) I’ve also had less of a struggle with swallowing than many on this forum.
• Walk as soon as you can after surgery, and more every day. It doesn’t have to be vigorous. Your body will tell you what it can handle. This helps relieve gas and you might feel better sooner.
• Burps will give way to flatulence, a natural stage of recovery. Don’t be embarrassed. Let it go!
• Take naps. Healing is hard work for your body and it will get tired. If you have sleep apnea, use your CPAP religiously, to guard against stressing the wrap in any way.
• Sleep with a pillow supporting your abdomen and hold it close when you turn over in bed. Your innards have been rearranged, and this will cushion the shifting of your organs while they are still tender.
• Stay on pain meds if you need to. Don’t be heroic. I went off very naturally a week after surgery—for others it might be two—just by forgetting to take them. Transition to simpler stuff if you don’t like being on codeine. Fortunately, there aren’t a lot of nerve endings in the area that’s been messed with.
• Especially in the second week, take extra care to have small sips and bites and go slow. If the second week is indeed the peak of wrap swelling, it seems like a funny time to transition to soft foods, as my diet plan directed. But you can always retreat to liquids if you need to. Some doctors advise liquids for two or three weeks, and I can see the logic in that.
• At the first sign of a full or pressured esophagus, stop and wait for it to go down. Sometimes sips of liquid help reluctant food down – tea works for me.
• When they say small meals six times a day, they mean it. Do it. If you wait four or five hours between meals, you’ll eat too much or too fast and be very uncomfortable. I’ve found that eating every two or three hours keeps me from having too much at a time.
As I head into day 18, I’m feeling great. Foodwise, I was on three days clear liquids, three days full liquids, then soft foods (like yogurt, mashed potatoes, toast, cheese, etc) as much as I could tolerate. I am now s-l-o-w-l-y eating some easy solids – scrambled eggs, flaky fish, soft-steamed veg – and just started drinking tea with caffeine, all with no ill effects. When I mentioned the 14-day peak of swelling—much discussed on this forum—at my follow-up, which happened to be on Day 14, the surgeon countered that swelling starts immediately and lasts for four weeks. But I admit I did feel a distinct easing of the pressure on Day 16. So now I feel free to gradually add things back to my diet. In a few days I may try a half-glass of wine. I hope to be on a nearly normal diet by the time I go on vacation in four weeks.
I’ve lost eight more lbs. since surgery. I’ve tweaked my fitness regimen – midlevel cardio and light stretches, nothing that stresses the abs – and weight machines are at least six weeks away. But all that walking after the surgery made it easy to get back to a routine. I’m just now moving to a fairly vigorous level.
I went back to the office after two weeks, plus a transitional couple of days working from home. The only challenge has been bringing the food I needed in the right amounts, and making sure I stick to the schedule. It's easy to get caught up in meetings and forget to eat.
As a plus, my voice is less hoarse. Also, I’ve reduced one of my allergy meds by half. (Maybe all that phlegm I used to get was caused by reflux?)
My apologies that this is so long, but I hope it is encouraging to any folks on the fence who may be suffering from GERD a lot more than I was. If I am enthusiastic, with minor problems solved, think how great you will feel! Just do your homework better than I did – you don’t want to rely on luck. Get a great surgeon, schedule at a time when you can spend two or three weeks on recovery, and commit to the process in a positive frame of mind. You’re going to feel so much better!
And thanks again to all the great moderators and participants on this forum!