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Old 04-21-2010, 06:24 PM   #16
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Re: Post nissen fundo need some advice and assurance

I've had Barium Swallows twice. They are actually the tests that showed it was reflux that was irritating my lungs. The test will show how your swallowing process is working and will show if anything is coming back up. It will also show how things are going into your stomach. It is a good test for where you are now. I had my second s couple months ago when I had asthma problems to confirm that my Nissen hadn't come undone and to confirm that it wasn't reflux affecting my asthma.

It is an easy test. Quick and easy with nothing to worry about. Just drink lots of water after your test. There is a possibility that the Barium can cause constipation.

 
Old 04-22-2010, 02:09 AM   #17
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Re: Post nissen fundo need some advice and assurance

Oh that is good, because I keep wondering what if the wrap has come undone, or I am still refluxing. The problem is that I also suffer from silent relux, and get a lot of weakness in my voice, and a lot of phlegm, and I am experiencing that at the moment and that's why I wonder if I am still refluxing.
Also I am not doing very well emotionally and I know stress doesn't help. I am unfortunately experiencing some gyno mproblems as well, and it all seems to be going on at the same time, and it is causing too much pressure.
I have endometriosis and had 2 ops last year where they burnt them, but I think it is back, and that doesn't help either.
Also where the wrap is is hurting today.
You must be thinking my God this woman is a real mess.

If the wrap has come undone, woukd they redo the op?

 
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Old 04-22-2010, 08:26 PM   #18
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Re: Post nissen fundo need some advice and assurance

I'm sorry to hear you are having so many problems. My theory is that when it rains, it pours. When one thing throws the body our of balance, other things go out of balance as well.

I actually ended up with a Colonoscopy one week after my Nissen. That Nexium I took for my reflux gave me chronic "D". I found out that week that I had IBS. It has been almost 2 years since I took that medication and I still have problems.

I had shoulder surgery 6 months before my Nissen as well.

I just found out last week that the intubation they did during my a Nissen was probably what caused my recently diagnosed TMJ. I've had ear and hearing problems and face/neck muscle problems and couldn't figure out why. My ENT's and Audiologists said my ears were fine. It took over a year for me to figure out it was my jaw.

Who knew that the reflux would trigger so many other issues.

On the flip side, in the long term, I'm happy with my fundoplication.

I asked my GI doc about what would happen if the fundoplication stitches pulled or the procedure slipped. He basically said we would re-evaluate my treatment. He indicated it would probably be that I'd add a third dose of PPI's daily. (I'm on a double-dose strength of Kapidex basically for life.) I do stress about that. I had the surgery because the PPI's couldn't get my reflux under control. I've read about a few people who have had revision surgeries, but they appear to be pretty rare.

My reflux was "silent" as well. I never had heartburn (except on Nexium). For me it was about a chronic cough instead of hoarseness though. Major impact on my day-to-day living. Eventually it got bad enough it became life-threatening because I was having bad breathing problems. Reflux can really be a sneaky thing with its symptoms.

Take care,
MountainReader

 
Old 04-23-2010, 06:11 AM   #19
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Re: Post nissen fundo need some advice and assurance

Oh God it sounds like you have been through a lot as well. I definitely think stress plays a big part, and unfortunately woth Reflux it is a vicious circle.
just over a year ago I had a really bad toothache they did a root canal and a cap which costed me a fortune but the dull ache was still there, finally I was diagnosed with TMJ, and I was told that chewing too much gum(to help with LPR) isn't helping?!!!
You are definitely right when it rains it pours.
I hope you don't have the need to take another kapidex, and the dosage that you are on now is sufficient.

I move abot a lot, and due to kids I am very active, and keep thinking will this wrap ever last on a person like me.
All the best to you and I will update you once I know the results.
Take Care

 
Old 04-29-2010, 11:31 AM   #20
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Re: Post nissen fundo need some advice and assurance

Just an update from me as promised, had the barium swallow test done yestaerday and saw the surgeon today, he said no sign of reflux and obviously due to the swelling the food is taking longer to go through the wrap but that is expected at this stage.
He said syptoms of LPR will take longer to improve since the vocal cords are weak and need time to improve, and the ittitation that I feel is due to the fact that the food stays in longer, so he said I can try taking some gaviscon before I eat to coat the osephagus.
the only problem is that the barium has made me really constipated and I had to strain quite a lot today and be the born worrrier is now worried about the fact that I might have affrected the wrap?!!!
I hope not, would straining make the wrap come undone, I know it might sound stupid, but I can't help worrying.
I have to say thouhg that I am feeling much better, and if I had to do this surgey again wouldn't think twice.

 
Old 04-29-2010, 06:57 PM   #21
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Re: Post nissen fundo need some advice and assurance

Good to hear everything looks ok. I had my Barium Swallow a couple months ago and despite tons of water had a problem with constipation also. In addition to lots of water, my GI doc had me take a high dose (5x) of Miralax to get things moving along better.

Take care,
MountainReader

 
Old 10-29-2010, 01:29 AM   #22
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Re: Post nissen fundo need some advice and assurance

Hi Aryana70,

Can you give me an update on your condition? In your last post you still weren't feeling much better but your doctor said to give it some time. I had a Nissen on Monday and am refluxing today (Friday). I am wondering if I am one of those people who don't benefit from the surgery or if I just have to wait for things to heal. It seems most people see an immediate reflux cure, but I haven't.

 
Old 10-29-2010, 08:43 AM   #23
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Re: Post nissen fundo need some advice and assurance

You can always call your surgeons office to ask them.

In my opinion, it really is too soon to know for sure. According to my GI doc, it takes about 8 weeks for swelling to completely subside from the stomach. As he explained it to me, "your stomach is angry at you for the trauma you are putting it through". I took this to mean I need to take it slow.

What are your "reflux" symptoms right now? My surgeon said some of the problems post-surgery are from things not making it all the way down, vs the symptoms of things just coming back up from the stomach.

What kind of diet are you on? I was on a liquid, no lump or seed, diet for the first couple weeks then on a soft diet for a while after that. Personally, I continued to avoid the things I avoided in my anti-reflux diet prior to surgery as well.

My GI doc also had me remain on the PPI's. That is contrary to what most people experience so I don't know if it made a difference in my recovery or not.

 
Old 10-29-2010, 09:23 AM   #24
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Re: Post nissen fundo need some advice and assurance

Hi MountainReader,

Thanks for your response. I think I have been pretty good w/ my diet. If there is any problem with it it is maybe that I'm eating too little. Yesterday I had a bottle of ensure, some pureed soup, tapioca pudding and 2 tablespoons of applesauce along with some clear beverages through the day. I used the applesauce to get down two doses of crushed Zantac (my surgeon suggested staying away from pills for a while). I may suggest to my surgeon that I go back on ppi's for a while as you recommend.

I've had an irritated throat for the past couple of days. This didn't bother me as I associated it with the things you mentioned and possibly the tube they put down your throat during surgery. What got to me was a reflux episode last night while sleeping. Don't laugh, but I dreamt that I enjoyed my first belch in a while and then woke up swallowing one swallow after another to push back down what had run up my esophagus. This caught me by surprise and gave me the concern I am now experiencing.

Thanks again for your reply. Are you still on the ppi's?

 
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Old 10-29-2010, 09:37 AM   #25
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Re: Post nissen fundo need some advice and assurance

According to my surgeon, belching is common after the surgery. He said it wasn't coming up from the stomach, but it was air not making it past the surgical wrap and coming back up since it wasn't going down. I had a bit of belching while I was healing as well.

I'm an unusual case. My surgery was very successful, but I never went off of PPI's. I'm 2 years post-surgery and tests I've had recently show it is holding nicely. Unfortunately, I'm overproducing stomach acid and have it coming up in a gaseous form and irritating my lungs so I'm on PPI's for life. My doc told me it was the worst case he has ever seen. (Not something I want to be known for.) Despite my continued problems, I'd do the surgery again in a heartbeat because of the major benefits I've had from it.

I found a good water pour-in from Special K that has tons of protein. I supplemented with that as well.

Just remember, you are still pretty recent from surgery and it will take some time to heal. Keep up your diet. Sounds like you are on the right track there. Please don't rush adding the food back in. I was off of solid meats and bread for about 3 months since they don't break down when you chew. I think it was good advice in my healing process.

 
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Old 10-30-2010, 03:22 PM   #26
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Re: Post nissen fundo need some advice and assurance

Quote:
Originally Posted by WatkinsK View Post
Hi Aryana70,

Can you give me an update on your condition? In your last post you still weren't feeling much better but your doctor said to give it some time. I had a Nissen on Monday and am refluxing today (Friday). I am wondering if I am one of those people who don't benefit from the surgery or if I just have to wait for things to heal. It seems most people see an immediate reflux cure, but I haven't.
Hi WatkinsK,

It is now 6 months since I had the surgery and I am back on 40mg of PPI, but that doesn't mean that my surgery wasn't successful, and I would definitely do it in a heartbeat again.
In my opinion it is way too early for you, my oesaphagus felt really rough the first few weeks and I thought food must be coming up, but that settled after few weeks, and felt much better. I think you are still bruised and definitely will feel better in few weeks.
I am on meds because I started having stomach pains, like stabbing and they put me back on PPI, I went for a second opinion I have done a barium swallow test which was fine, but the gold standard test is the PH metry test and I just did that last Friday and I am waiting for the results. I could see the readings on the machine and it was constantly showing 6.5 to 7.5 range which I believe is not acidic, (I did the test by being off PPI for 8 days).
I am waiting to get the oficial result, I am definitekly feeling much better than before the OP, but what I don't understand is that why I still get burning under breast bone , which to me is symptom of reflux, also for the past 10 days, my larynx and throat don't feel right, I have post nasal drip, voice is weak, and feel there is dust in my throat, not sure if this is reflux!!!Oh also after the surfery I was off PPI for good 6 weeks, but then I am burning mouth which went away after being on nexium.
I will be dicissung this with the consultant when I go back to see him, and I will update you.

Give it time, hopefully you will feel better.

 
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Old 10-30-2010, 05:40 PM   #27
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Re: Post nissen fundo need some advice and assurance

It sounds like your pH test will come back good. We'll keep good thoughts for you on that.

I recently had an upper probe pH test. It was done using a probe that has been on the market since 2008 by Restech. The probe measures reflux in the gaseous form that makes it past the vocal cords. You can have a normal pH and still have gaseous form coming up to your throat.

I stayed on PPI's even post surgery because of digestive issues. Even with that, the surgery was a great option for me as well.

 
Old 08-30-2011, 05:44 AM   #28
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Re: Post nissen fundo need some advice and assurance

Having read this whole thread, it seems to confirm a little trend.

This is the trend I've seen on these boards. Someone else may have seen something different:

If you have a problem that is said, or you believe to be, acid reflux, and you want to get a Nissen but aren't sure if it will be successful or not improve your symptoms, here is the way to tell.

1. It will be an improvement if: You have severe heartburn, stomach centered pain. OR You have severe heartburn and throat symptoms like phlegm and sore throat.

2. It will not improve your situation if: You don't test positive for hiatal hernia, damaged esophagus, other signs of classic heartburn, and you ONLY have throat symptoms such as globus, phlegm, vocal issues, with no classic heartburn.

Maybe there are exceptions, and Mountain Reader is one of those cases, but it does seem like this is, generally, how it goes. And what that implies I think, is that people who ONLY experience throat symptoms without damage from heartburn, etc, have to be careful about acting on the belief that what they have is a rare form of GERD. They should consider neurological causes. Let's wait and see what the researchers find in the coming years. It seems, thankfully, that these complaints are getting some attention nowadays.

 
Old 08-30-2011, 06:25 AM   #29
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Re: Post nissen fundo need some advice and assurance

A simpler way of putting this would be that the more like classic heartburn your symptoms are, the more likely you are going to be happy with the outcome of Nissen surgery.


And... if you don't test for high reflux events with ph tests, and you don't show signs of chronic reflux on an endoscopy and barium swallow, but you are bothered by other things like chronic cough, globus. And if on top of that, your ppis have never really improved the situation, and then you get surgery, you are probably going to wake up with the bothersome symptom still there.

Keep in mind, I am basing this on the personal experiences of people on healthboards who actually post, and on a few journal articles. I could be totally wrong. If so, I look forward to hearing alternative ideas or explanations, interpretations of what others have seen.

 
Old 08-30-2011, 05:27 PM   #30
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Re: Post nissen fundo need some advice and assurance

I think you are partially right. If you dig around on Nissen research on the internet, you will find the percentages of success that people have with Nissen's based upon the symptoms they had prior to surgery.

I can't remember what all the percentages are. I do know that people with breathing related acid reflux problems have some of the highest success rates--somewhere around 85%. I think that is why I had some good success.
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Asthma, Allergies, severe LPR/GERD, TMJD, Hearing Loss, Ulnar Impaction Syndrome, Shoulder Impingement, Plantar Fasciitis, DeQuervains, Hypermobility, possible Ehlers Danlos Syndrome

 
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