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Old 04-06-2009, 09:12 AM   #1
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Possible Surgery after Bravo

Hi. I have been having issues over the past year. Endoscopy showed Stage 2 Esophagitis. Just did Bravo test last week. Dr. is referring me to surgeon. I am having a hard time reading the Bravo test results. It said in a 2 day period, I had 154 refluxes, with the longest being 19 minutes. Time pH <4 = 156. Fraction Time pH <4 = 5.7.

Does anyone know what this means? If I have to have surgery, what is the process and recovery time? I am not looking forward to this at all! Thanks for any information you may be able to provide.

 
Old 04-06-2009, 07:09 PM   #2
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Re: Possible Surgery after Bravo

I had my second 24 hr pH test this year. They took the readings for reflux incidents frequency and duration and turned them into a score for me. For me they used the DeMeeter scale. Basically, my score came back in the extreme category. The Manometery they did at the same time confirmed that my LES wasn't closing properly.

By this point for me, none of the typical treatments were helping at all and my quality of life was bad. Everyone has different reflux effects. Mine resulted in a chronic cough and constant major asthma attacks triggered by the acid hitting my lungs.

I chose the surgical route at that point. (A serious decision indeed.) The procedure I had was the Laproscopic Nissen Fundoplication. They made 6 small incisions on my stomach. The procedure involved taking the top part of my stomach (fundus) and pulling it around the esophagus. They then stitched my stomach to itself. Basically, now every time my stomach contracts, it contracts around my esophagus. This creates a "barrier" for the acid/food to keep it from coming up--like the LES should have been doing.

It's different for everybody. I noticed the results immediately.

Healing time is a bit subjective. My doc released me to go back to work when I felt up to it. About a week was recommended. I took two weeks and was good with that. Initially, I had some fairly intense left side pain. I'm assuming because they moved things around in order to access them. The worse for me was that it hurt so much to get up and down. In particular, getting in and out of bed. The movement of sitting up used muscles that were very unhappy with me. I was also scared that I would overdo something and pull the stitches.

Restrictions post-surgey: No lifting over 5 lbs for about 6 weeks. (Ask your surgeon.) Liquids only for the first 2 weeks. (Again ask your surgeon, some let you eat sooner.) Soft foods after that for a while. Things that don't take much chewing. I stayed off of all meats and breads for a couple months. (Not all surgeons require this.) Continue with anti-reflux diet I was already on. My surgeon said I could go off of reflux meds, but my GI doc said absolutely no so I'm still on two PPI's per day.

Restrictions long term: Always chew your food well and take small bites. Don't want things to get "stuck" above the procedure. Never gain weight past what you were before the surgery. You run the risk of pulling the stitches. Most people can no longer vomit. It makes being sick a bad experience. Ask your surgeon for some anti-nausea pills to keep on hand..."just in case".

The stomach stays swollen for up to three months until it totally heals. You will need to be careful with your swallowing of solids during that time. The weeks on the liquid diet were tough for me. By the end of the first week, I was going crazy. It was a bit more difficult for me because I'm on a no dairy diet as well. Anything that will melt in the mouth is considered a liquid per the doc. Stay away from any "seeds" or other solid pieces during that time. No strawberries in your smoothie.

I was a bit slow during the first week. By the second week, I was moving ok, but not at full steam. They say you can go back to playing most sports after a couple weeks. I was actually back bowling after about a month or so with dr's clearance.

I'm about 6 months post surgery. At this point, there are days that I forget I had the procedure. As I stated above, I had immediate results. My biggest problem pre-surgery was a chronic cough and breathing problems from the acid hitting my lungs. At this point, I have no reflux related breathing problems. I do have some periodic nausea problems that I didn't have before. I don't know if it is Nissen related or if it is IBS that I've been diagnosed with since last October. Never had nausea issues before. It is a troubling feeling having all my muscles working to vomit, while at the same time working to push things down.

All in all... I'd choose surgery again in a heartbeat.

 
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