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Old 11-13-2005, 01:39 PM   #1
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***1 Week Post Nissen***

I had my nissen last Monday. came through the surgery very well. No problems eating. Unfortunately, I am still clearing my throat continuously. The surgeon said it will take time.

Any insights or comments.

Barnett

 
Old 11-18-2005, 08:51 AM   #2
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Re: ***1 Week Post Nissen***

do you have any problems such as alot of gas you can get rid of? are you still geting heartburn? cause i am i will never ever have this done again. i have just felt horriable since it has been done. i can deal with heartburn but the other problem's on top of it are just making life miserable for me.

 
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Old 11-18-2005, 02:15 PM   #3
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Re: ***1 Week Post Nissen***

I've been very lucky. No gas, no constipation, feeling quite good, if I must say so. But I am still braying like a mule. And none too happy for it. I'm off next week to NYU Voice Center to have them check my voice out. I just might have to re-learn to speak again.

Just what I need right now.

 
Old 11-18-2005, 03:07 PM   #4
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Re: ***1 Week Post Nissen***

i wish throat problem's were the least of what i had to deal. with well good luck im happy it worked out for you.

 
Old 11-18-2005, 04:47 PM   #5
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Re: ***1 Week Post Nissen***

Glad to hear you are recuperating. Sounds as though, unfortunetly, the outcome of a Nissen depends primarily on the skill of the surgeon. If you are clearing your throat continuously, you may have LPR--something an ear nose and throat doctor is trained to address. I'm surprised you doctor only said "it will take time", not "let's put you on a PPI twice daily to give your throat a chance to heal"....unless he feels that the surgery will stop ALL reflux 24/7. If not, it only takes 3 episodes of reflux per week to cause substantial voice box damage. I am FINALLY feeling better now after being on PPI's twice daily since last May---and who knows what will happen if I get off them. Your doctor is correct that it takes a lot of time. I haven't followed your story so maybe you already knew this or have already been on PPI's.

 
Old 11-19-2005, 05:53 AM   #6
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Re: ***1 Week Post Nissen***

I've been to every ENT doctor around for the laqst two years. Was onm every known PPI, nothing worked. I tried the surgery, although I was told by the ENT andthe surgeon that LPR is more difficult and can take longer to heal post surgery. I am still hoping, because I am still braying like a mule. Not a lot of fun.

Barnett

 
Old 11-26-2005, 02:58 AM   #7
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Re: ***1 Week Post Nissen***

Hi bserchuk,

It's been a long road for both of us. I am due to have the fundo on 13/12
so I am interested in what your recovery experiences are going to be. I have been warned that there is the likelyhood of gas for a little while post op mostly due to the air inflated into the abdomen to carry out the surgery. We have posted over the last year and I remember you were suffering pretty bad with LPR. Vintagegirl, is right the success of the fundo is down to the experience of the surgeon. Thankfully, mine specialises in this type of keyhole surgery so I can only be hopeful.

Surgery is the last option in the treatment of GERD or LPR so the issue of returning to PPI's is not relevant. Meds have failed and that is why you need the operation. The wrap should effectively shut off all reflux since that is its purpose. Some reflux may happen but this is down to the wrap not being tight enough. Surgeons sensibly tend to do a partial wrap first to see if it ends the reflux since a full wrap can cause other problems of trapped food etc. We can only be pleased that some people find relief through PPI's but that suggests to me that their situation was more diet and lifestyle based and not structural such as a hiatal hernia or loose sphincter. PPI's are not the answer to these problems. If only they were we would not be forced into surgery.

It could be that the damage to your vocal cords and throat tissue will take time to heal but if there are no more occurences of reflux this should just be at matter of time. Perhaps of greater concern is the damage done by the acid in the nasal cavity and sinuses. This may take longer especially if there is now a separate infection in there. The throat clearing you are experiencing is probably from Post Nasal Drip as your nasal membranes are still inflammed and causing congestion but again if there are no more reflux incidents then this should heal. It is any damage in the sinuses that concerns me and that is why I am awaiting a CT scan to see if there is any infection there. Do you suffer from congestion, PND or sinus headaches ?

My very best wishes and keep us informed of your progress

Last edited by ginger65; 11-26-2005 at 03:16 AM.

 
Old 12-04-2005, 12:59 PM   #8
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Re: ***1 Week Post Nissen***

Thank you for the e-mail.

I'm still having problems. I went to a new ENT doctor and went to see my primary doctor yesterday. Bith said that my throat looked fine, so in that respect the surgery must have helped. I find that I am stillcearing my thorat constantly. What this is, I cannot say. I do know that my primary gave me xanax and it has helped immensely in calming my throat down. I am also scheduled to begin voice therapy at NYU. I am going to a new gastroenterologist at the end of the week. I am still worrying that I might have blown the wrap with my constant throat clearing since I had the fundo, which will be exactly a month ago tomorrow. In all, this is very debilitating and tiring. In the back of my mind I am telling myself that the surgeon did not do a good job, but intellectually I am having trouble confirming this.

Hopefully this week will provide some new results and answers.

Best,

Barnett

 
Old 12-06-2005, 08:07 AM   #9
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Re: ***1 Week Post Nissen***

Bserchuk,

Please read this carefully because I'm not so sure you have been given the right information. First, are you clear on the difference between LPR and GERD? Was your Nissen performed for GERD or LPR? In terms of treatment and recovery, GERD and LPR are treaded with the same medications (PPIs), but if you have LPR, you MUST MUST MUST be on at least 2 doses a day, not 1 dose like GERD. When I got LPR, my doctor didn't recognize it as independent from GERD, told me I had "a little throat and larynx redness", and put me on 1 dose of Nexium a day. I was on it for 5 months and it did nothing. When I found a doctor who knew what she was talking about (bless you Eugenia Vining, ENT at Yale in New Haven), she inisisted that I take 2 doses a day, preferably at the same time. For the first time in 6 months, I stopped coughing - and it took about 20 minutes for me to feel better. In 1 week, I was completely back to normal except for the nasty Xanax addiction I had developed after a well-meaning doctor told me to take it 3 times a day to "calm down". Be careful with the Xanax! It is highly addictive when you take it every day. I became physically addicted to 3 mg a day (taken 1 mg 3 times per day) and I was totally and completely unable to wean myself from it, though I tried for weeks. It was not a mental addiction - it was purely physical and I recognized for what it was - I had gotten "hooked" after 2 months of using it. Against my doctors advice, I voluntarily checked myself into a detox center, no joke, because my body freaked out every time I tried to stop taking the Xanax. The center thought it was a joke too, because everyone else there had long-term, heavy drug and alcohol problems. The center actually told me to leave after 2 days because I didn't have a serious enough problem. Nonetheless, I still had to take Depakote, which is an anti-seizure medication, for 6 weeks which prevents seizures when coming off a benzo like Xanax. Your cough has nothing to do with your being anxious or worried or not calm enough. If you are coughing or have a sore throat, you probably have a nasty case of LPR and need to increase your PPI dosage. I have tried several PPIs, and effectiveness differs dramtically. On Nexium 2x per day, I have 95% recovery, which is quite livable. I still cough after eating, but it's manageable. I substitued Priolosec OTC for Nexium for 3 months, and the LPR came roaring back. Not a good substitute. Back to Nexium. I also tried a variety of the other prescription PPIs, which also failed to contain the LPR. I have read of instances where LPR patients require 3 or 4 doses a day - 2 may not be completely effective, mostly because one dose of PPI lasts 17 hours - it is truly not a 24 hour medication, but most people don't notice the other 7 hours when they are sleeping, or they stagger the doses - one in the morning and one at night.

Physical Xanax addiction can also cause a horrible sense of hearing your heart beat loudly - so loudly that you can't sleep or focus. And the only way to stop it is to take more Xanax. You've been warned. It's a great drug if you just need it occasionally, but it is an addictive ***** if you take it every day. I got started on it because I had been coughing for 4 months, and did not have a proper diagnoses. My family inisted I see a psychiatrist, thinking that it was a mental condition. The psychiatriest thought I had anxiety and gave me the 3x a day prescription. It couldn't have been more wrong or more debilitating.

Please email me if you want to talk about this. I'm a woman, and was 28 when this occured.

 
Old 12-06-2005, 08:32 AM   #10
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Re: ***1 Week Post Nissen***

Dear Aswander:

Thank you so much for your e-mail. Yes, I was diagnosed with LPR and was on NExium (40 mg) 2 X daily) for 10 months and I just kept getting worse. I also had a FEESS test and a videostroboscopy which showed LPR. I went for the surgery on November 7, and have been pretty miserable since. Actually, the surgery was the easy part. I have had no real problems with the nissen and can eat, swallow, etc. very easily. But the LPR and throat clearing came back with a vengeance. The surgeon said give it time, but the incessant throat clearing made me crazy. I went back on 2 nexiums per day and was also put on 0.5 mg of xanax, which I just started taking two days ago. Since I feel rerasonably well today, I have not taken a xanax. I sometimes takes tylenol allergy pills which seem to help. I was also tested ad nauseam by allergists, and everything came back negative.

I will be going to the NYU Voice Center to help with my voise, and am also going to see a new gastroenterologist.

Needless to say, this has been a debilitating and exhaustive experience. I am trying to be optimistic, but some days it is very difficult.

Barnett

 
Old 12-06-2005, 08:52 AM   #11
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Re: ***1 Week Post Nissen***

You poor thing!

I've been wondering how effective the Nissen could be for an LPR patient. Because with LPR, the Upper Esophageal Sphincter has lost pressure, right? But doesn't the Nissen only tighten up the lower area, where the Lower esophageal spinchter was? If that's the case, and even small amounts of acid escape the Nissen, can't the acid continue to travel up beyond the UES and continue hitting your Larynx? From what I understand, it take minute amounts of acid to irritate the Larynx, whereas the lowere esophageous is much more resilient because it has natural protection.

Do you take your Nexium at the same time? Or do you space them out? Have you tried increasing your dose to 3 or 4 times daily? The pills only work for 17 hours - maybe your case is so severe that you need a double dose in the morning and another double dose at night.

Also, do find relief lying down? For some reason, before i started Nexium, the coughing would subside only if I was lying completely prone, on my right side.

 
Old 12-06-2005, 08:55 AM   #12
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Re: ***1 Week Post Nissen***

One other thing - have you ever considered the Mayo clinic for a complete, multi-disciplinary evaluation?

Who are your current doctors? Are you in a major metrolpolitan area?

 
Old 12-06-2005, 09:21 AM   #13
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Re: ***1 Week Post Nissen***

Yes, I live in the New York City area, so I'm going to see a doctor there. But I do not see any panacea at this point.

Double dosing would be fine. Unfortunately, my plan only covers one nexium and I can purchase the other from Canada. I've read of others who take four pills a day. My question is, where do they get the pills. Do they also use two PRILOSEC over the counter. I've asked this question a few times and have never received an answer. Perhaps you know.

I've got to say that I am severely depressed and at times I feel like ending it all. This has become too much for me.


Barnett

Last edited by bserchuk; 12-06-2005 at 09:26 AM.

 
Old 12-06-2005, 09:42 AM   #14
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Re: ***1 Week Post Nissen***

Barnett,

I'm not sure, by your response, if you are currently double dosing or not. Because if you are not, that is probably why you don't get any relief. But if you are, then I'm not so sure about adding in Prilosec. It wouldn't hurt to try. I've never taken Prilo in conjunction with Nexium, just either or and Prilosec didn't work. But I do have a suggestion given the high cost of Nexium. First, my own health plan officially covers only 1 nexium a day. However, they make special exceptions, and the mail-away pharmacy I use (Medco RX) has a special hotline for my doctor to call to get the special dosage. If you go through the proper channels, your plan is likely to make an exception. Just get your doctor or the assistant to call the right number. Also, the pharma reps give away tons of samples to doctors. Ask your doctor for a handful of nexium samples. Trust me, she has hundreds sitting around at no cost to her. Experiment with your dosage until you get it right. Don't explain it that way to her - just tell her you lost the remainder of your prescription and need to cover a week or two before it can be refilled.

Should that fail, get a close relative or friend to claim heartburn. Nexium is such a common drug and prescription that it gets prescribed everywhere and to everyone. Your friend or relative may accidentally leave the bottle at your house. It's not your fault that the Nexum is so damn expensive. It is truly price-prohibitive, but I know what it's like to be at your wit's end - this stupid disease interferes so horribly with your life that I know what you're thinking. I know someone is going to rain down hard on me for ethics, but there is no reason why Nexium should cost $280 a month for 30 pills.

 
Old 12-06-2005, 10:50 AM   #15
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Re: ***1 Week Post Nissen***

wow i feel bad for you i had 4 bottle's of nexium with 90 pills each in them. that i gave away because i couldn't breath on them some alleric reaction. i fortunaly get my meds for free so this wasn't of any cost to me. i can't understand why these insurance company's don't cover what you need. maybe the head guy's of these company's should get a good case of gerd then maybe they will relize what it is to need med's. i have been on protonix for allmost 5 years now160 mg a day. i also had the surgery that didn't really help. they are telling me that food is getting stuck and that is what is causeing me to feel heartburn im back on liquid diet. i go for a scope on thursday so they can insert a balloon to open the hole so i can eat. if that doesn't work im gonna have to have another surgery to loosen it. i just see no end to this it really is a nightmare.

 
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