A Nissen fundoplication question

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Tena believes
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   Posted 12/5/2017 5:29 PM (GMT -7)   
Hello my name is Tena I am three and a half months post-surgery for Nissen fundoplication and I know that what I've read so far that everybody says that it's pretty normal to still not be able to really eat normally and the gas and the bloating, but is there some point that anyone knows or can maybe give me kind of a pointer to where you would think that you would need to go back to your surgeon or go to a doctor to see if everything is normal? I guess one of the things that concerns me is my weight loss I can literally see my bones.

SharonZ
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   Posted 12/6/2017 5:48 AM (GMT -7)   
You should be having follow-up appointments with the surgeon, especially if you have having issues eating normally and losing weight. You should have no problems following a soft diet and advancing to a more regular diet over the next few months. You have to eat 6-8 meals daily, I drank a lot of protein smoothies. As I progressed from liquids, I was able to eat things like scrambled eggs, oatmeal, creamed soups, and a lot of other foods as long as I chewed them to a liquid. Take a look at the UPMC post-Nissen diet, it's the one I used and I think it's one of the better ones out there. We aren't medical professionals on this Forum, if you feel something isn't right, call your surgeon.

SharonZ
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   Posted 12/6/2017 5:51 AM (GMT -7)   
You should be having follow-up appointments with the surgeon, especially if you have having issues eating normally and losing weight. You should have no problems following a soft diet and advancing to a more regular diet over the next few months. You have to eat 6-8 meals daily, I drank a lot of protein smoothies. As I progressed from liquids, I was able to eat things like scrambled eggs, oatmeal, creamed soups, and a lot of other foods as long as I chewed them to a liquid. Take a look at the UPMC post-Nissen diet, it's the one I used and I think it's one of the better ones out there. I know you said before you didn't see anything in the diet for post-surgery. It is specifically put together for after the Nissen surgery. We aren't medical professionals on this Forum, if you feel something isn't right, call your surgeon.

Tena believes
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   Posted 12/6/2017 7:08 AM (GMT -7)   
Thank you Sharon, I would like to give you an example of a day of eating in my life, hope you don't mind. morning I eat a cup of gluten free hot cereal with a scrambled egg, butter, and rice milk. ( I am gluten sensitive and to some degree dairy sensitive.) then I drink 1/2 juice and water about a cup. when I get to work I eat a piece of peanut butter toast soaked in milk. I snack on pudding, peanuts, sometime yogurt. lately it causes even more gas! lunch is a sandwich on toast with turkey soaked in soup. around 3.30 I eat a bowl of cereal. then supper chicken, sweet potatoe, greeen beans. but usually by this time I am so full of gas and bloating that I some time make myself eat anyway just for the calories. I understand that you all are not doctors but my surgeon is really no help.. Thank you for any help I just feel kinda lost..

SharonZ
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   Posted 12/6/2017 7:48 AM (GMT -7)   
I had issues with dairy also, so I basically temporarily eliminated it for a while. I hate to say this but the gas is just something that you have to get used to, at least for the time being. You are probably not able to belch, at least not as you used to, and the gas builds up until it is eliminated the only other way. I think maybe peanuts are giving you trouble. They are sometimes difficult to digest and will cause gas/bloating. You could be having something as minor as a food sensitivity. It's just a trial and error thing. You need to start taking some sort of anti-gas medication, but on a more regular basis.

I'm sorry I can't be of much help to you. The issues you are having are normal, and it's a shame that your surgeon didn't discuss them in greater detail before the surgery. I was well aware of what recovery would be like, and it was still slow and grinding.

Tena believes
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   Posted 12/6/2017 8:58 AM (GMT -7)   
I revisited the Nissen diet and my surgeons office gave me a similiar one on my first follow up. but at 8 weeks the surgeon released me and told me I had no restrictions. so how long do you follow the diet? I would guess till you find yourself able to eat more easily.. and with out gas and bloating.. it just seems that I have the gas and bloating with just about everything I eat. and that I guess is where I am having the problem. because I am so full of gas and bloated I can't eat a lot. Thanks again! ( I take beano, and gasx and also take a zantac at lunch. I also drink aloe vera to help soothe my stomach.) the peanuts were suggested by the Nutritions at my surgeons office...

Post Edited (Tena believes) : 12/6/2017 9:02:15 AM (GMT-7)


SharonZ
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   Posted 12/6/2017 9:39 AM (GMT -7)   
I still think you are really early in your recovery. Yes, to your response about the diet - I kept following the UPMC diet for quite a while. If I found I was having excessive gas and digestive issues, I went back to a softer diet. You are going to have gas/bloating issues regardless of what you eat - it's just a fact. I still suffer with occasional gas/bloating at over three years later. You've had major surgery and your digestive system is angry. You have to listen to your own body, do you feel that you were ready to be released to a normal diet at 8 weeks? Most people will tell you no, but everyone is different. The recommendations from your surgeon (and mine), are just suggestions. You may find, as I did, that there were foods that just didn't work for me at that particular time. I felt my best at approximately 1 year, but I found around the 6 or 7 month mark I was noticing more improvement.

celerity-dad
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Total Posts : 105
   Posted 12/6/2017 10:24 AM (GMT -7)   
Tena,
I'm 10 months post Nissen and the gas and bloating has diminished to a large extent. The 7th month on is where I noticed things improving. I can also release a little air from my stomach when I feel stuffed, which is often. That ability developed over time and it's not full relief but it helps a little. You may or may not develop the ability over the next few months. Hopefully you can, but don't put it on your schedule. I still carry Gas-x with me always but I use less and less.

As far as diet and weight loss goes I fully understand the challenges. Your full all the time, bloated and uncomfortable. Still, I feel better without food. I became lactose sensitive post surgery. So no whey protein or regular milk. Artificial sweeteners also caused me stomach upset. I track my diet using Myfitnesspal and use a macro based diet plan to maintain my weight. I lost 27 lbs post surgery that I didn't need to lose. Myfitnesspal will calculate your caloric needs based on your profile to give you an idea how much you need to maintain your weight. Because I don't feel hunger post surgery and a small amount of food makes me full I will under eat if I didn't track.

Here's a few suggestions that have seemed to help me with caloric needs and avoiding gas build up.

-- Always chew to a liquid.
-- Cook all vegetables and steer clear of any known gas producing foods. I use the FODMAP diet guidelines for choosing foods to include or avoid.
-- I use digestive enzymes before my meals. Just one capsule at the start.
-- If your tracking your food intake try and keep note of the amount of fiber your getting. I slowly increased my fiber intake and I believe it's made a big difference for me. 10 g per 100 g of carbohydrates in your diet.
-- Dried fruits are a great way to add calories without volume. I found some without added sugar that I add to my breakfast everyday.
-- I found "fairlife" lactose free ultra filtered milk to be a real blessing to me. High protein and easy on my stomach. I've been drinking it since my first month post surgery. The whole milk is great for keeping my calories up.
-- I've avoided yogurt and most regular dairy. However, I tolerate ice cream and cheese well in moderation so that helps with calories as well.
-- Eggs and egg whites are my go to source of protein. I scramble eggs every morning. It's the one protein rich food that I tolerated well post surgery.

Many people don't mind the weight loss side effect of this surgery but it was of great concern for me. And it was much more dramatic and unhealthy than I expected. I use a website called Avatar Nutrition to help me with my macro based diet. There's a small monthly fee but its been a real help over the last 6 months. It doesn't tell you what to eat just helps with how much and the recommended protein, carbs and fat breakdown of your diet.

Hope this helps. Everyone is different when it comes to recovery so the above are just suggestions and what does or doesn't work for you now may change as time goes by and your body adjusts.

12 weeks is still early recovery. 20 weeks I felt more in control of things but bloating and eating enough dominated my thinking. 7 months is when I noticed a marked change in the bloating problems. This 10th month feels great compared to previous months. I still don't get hungry and if I eat a big meal I feel awful and my shoulder hurts. Hang it there and be patient.

-Mark

Post Edited (celerity-dad) : 12/7/2017 10:21:42 AM (GMT-7)


Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted 12/7/2017 7:00 AM (GMT -7)   
Thank you all I am going to look into all of the websites and put them to use.. I feel very thankful to God who helped me find this forum! Thanks again!

Tena believes
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   Posted 12/8/2017 8:29 AM (GMT -7)   
Good Morning, I would like to ask Mark what brand of egg protein do you use and does it contain xylitol? also did you have any ibs problems before surgery?



Would also like to ask Sharon do you eat more of a normal diet now at 3 yrs.

SharonZ
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   Posted 12/8/2017 9:03 AM (GMT -7)   
I eat a mostly normal diet. I no longer drink alcohol, or carbonated drinks (my choice). I still have some difficulty digesting things like steak and salad, but for the most part it is a normal diet. I'm careful not to overeat and have not had any major issues. It's still possible to get heartburn, so I don't treat the surgery as a free pass to eat everything and anything in large amounts.

Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted 12/8/2017 9:56 AM (GMT -7)   
Thanks Sharon. would you say that that is normal for this surgery? do people ever go back to eating normal like a hamburger and homemade fries, or pizza?

Post Edited (Tena believes) : 12/8/2017 11:01:28 AM (GMT-7)


celerity-dad
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Date Joined Mar 2017
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   Posted 12/8/2017 12:49 PM (GMT -7)   
Tena,
I mostly use Cage free egg whites from Costco and cook them with regular eggs in the morning. I rarely use any powdered supplements because most have artificial sweeteners. I buy some MuscleEgg which is flavored and has sucalose as a sweetener. Over the last few months I've become less sensitive to sucalose but even then I limit how much I ingest. I now use some protein infused waters. Helps with hydration and adds some protein intake. They use whey isolate which has very little lactose. Protein2O and Protein Water from Costco. It uses Stevia as a sweetener.

I didn't have any diagnosed IBS before surgery. I decided on surgery when the protonix became less and less effective and I was starting to wake up at night with serious stomach pain. It was time to get things fixed.

-Mark

SharonZ
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Date Joined Mar 2014
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   Posted 12/8/2017 1:12 PM (GMT -7)   
Yes they do, Tena. Everyone is different, I take no PPIs or any stomach medication, but some people continue to need them after surgery. Some people do develop food sensitivities, but it's basically trial and error. It's a slow process and it's better not to rush things. I didn't worry about when I could eat certain foods, I was motivated by feeling a little better every day and not feeling exhausted.

Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted 12/11/2017 9:10 AM (GMT -7)   
Thank you both for your answers I too was on protonix and it stopped working. tried dexilant and prilosec with bad side effects.. I have been very concerned with the bloating and weight loss.. that is where I was having anxiey from. but, since talking with the two of you I have come to a calmer state. I do drink Isopure wasn't sure with the whey but, I only drink a little at a time. I also found a pea protein with stevia. thank you for encouraging me from your own experience.


Tena smile

Post Edited (Tena believes) : 12/11/2017 9:47:21 AM (GMT-7)


Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted 12/12/2017 9:00 AM (GMT -7)   
Hello, I was wondering have either of you had dilation? ( Sharon and Mark) and I was wondering Mark if you have been able to pick up weight?

hope you don't mind all the questions...


Thanks
Tena

SharonZ
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   Posted 12/12/2017 9:23 AM (GMT -7)   
Tena:

I never had a dilation. Unless you have swallowing issues, they aren't necessary.

I don't mind the questions at all!

Sharon

celerity-dad
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Date Joined Mar 2017
Total Posts : 105
   Posted 12/12/2017 9:38 AM (GMT -7)   
Hi Tena,
I didn't need a dilation. No problems swallowing after the first couple weeks which had some painful hiccup episodes.

I have gained back healthy weight with some very careful management of my nutrition and exercise. For me it was a rapid loss of 27 lbs (205 to 178 in three months) and so far I've regained 15 lbs without a lot of fat regain over the last 6 months. It seems rapid but I was pretty dehydrated at my lowest weight so I regained a few pounds of water weight.

Ask away. Recovery is a marathon process. No need to do it alone.
-Mark

Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted 12/14/2017 3:30 PM (GMT -7)   
Thank you both for your response. I'd like to ask you a question mark at what point were you able to start gaining weight I'm still hovering at the 105 to 106 mark which does concern me. Was it after the gas sort of diminished some because that's where I found the struggle I try to eat as many calories healthy calories as I can but because of the gas and bloating I find myself not being able to. I'd like to ask another question of both of you did either of you ever have problems with your bowels any dumping experiences think I've had a couple of those. I had found this Pea protein that I thought was pretty good and I tried it but it seemed tocause a lot of gas so I haven't tried it again. I'm going to try the muscle egg. can you drink it by itself like in a smoothie? I don't know if this would be too much trouble and that maybe I'm not ready for it yet but I'm really interested in your meal plan for a day from breakfast to supper and snacks in between Mark it makes me feel good to know that you picked up weight that gives me hope that I will pick up weight again. and again just hearing from the both of y'all just helps me to get a lot more calmer so thanks again for taking the time.

SharonZ
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Date Joined Mar 2014
Total Posts : 1028
   Posted 12/14/2017 4:55 PM (GMT -7)   
Tena:

I can't stress enough that you are really early into your recovery and will suffer from setbacks, I'm not surprised that you are not gaining weight yet. Please keep in mind that everyone's recovery can be different. If you try something that doesn't agree with you, stop taking it and revisit it at a later date. I used Beverly UMP Protein Powder, to make smoothies with some ice and fruit, as tolerated. Bloating, gas, dumping syndrome, are all things that are happening because your body's digestive system needs to reset. I can't offer you a meal plan, because for quite some time I followed the UPMC post-nissen diet. Maybe Mark can give you more suggestions in that area. You might want to make an appointment with a nutritionist for some help.

Tena believes
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Date Joined Nov 2017
Total Posts : 21
   Posted Yesterday 8:27 AM (GMT -7)   
Thank you Sharon.... I am a finding that I am getting impatient with the whole thing! but, I know I can't rush it. I did call and made an appointment with a nutritionist this morning. Thanks for you patience... and encouragement. Have a good weekend!




Tena

Post Edited (Tena believes) : 12/15/2017 8:40:10 AM (GMT-7)


SharonZ
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Date Joined Mar 2014
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   Posted Yesterday 9:13 AM (GMT -7)   
Tena:

That's great news, I think you will really benefit from a nutritionist. It will put your mind at ease over your loss of weight.

Have a great weekend!

Sharon
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