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Old 07-13-2011, 01:54 PM   #1
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Nissen fundo in august - nervous! Help!

Hey everybody, I've posted on here quite a few times about my hiatal hernia. Ive had it for about 9 years now & I have taken Nexium every since the day that I was diagnosed (9 years ago). I finally got diagnosed after I was experiencing horrible acid reflux & went through many tests, including scopes & barium xrays. The Nexium worked for the first few years to control my acid reflux, but I have always experienced nausea & constipation off and on, depending on what I eat, you know? I just figured this was something I had to deal with. Its now affected my breathing for while - I cant get a deep breath in. Long story short, after many tests over the past couple months - Im having a nissen fundo in August. Im just looking for someone to give me a no b.s., honest view of how things will go. Im really nervous, can someone please tell me how their experience was & what my recovery will be? (i.e. pain, nausea, diet, weight loss, etc.) Thank you so much! Im really nervous!

 
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Old 07-13-2011, 08:24 PM   #2
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Re: Nissen fundo in august - nervous! Help!

I had my Nissen Fundoplication surgery October 8, 2008. You can read the many threads on my story if you search back through my postings around that time.

Long story short, while I still have problems I still consider the surgery very successful and would choose it again in a heartbeat due to the severity of my symptoms.

I don't have a lot of time to chat tonight, but please feel free to ask me any specific questions you might have. I'll be able to take more time walking you through my experience later if you don't gain what you want from my postings.

Good luck,
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Old 07-14-2011, 01:13 PM   #3
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Re: Nissen fundo in august - nervous! Help!

About me: Female, age 53, height 5’4”, weight 153
Health issues: Constant GERD and regurgitation using Dexilant and Nexium each one time per day, large hiatal hernia, chronic cough and asthma-like symptoms - wheezing and shortness of breath, high blood pressure controlled with meds, high cholesterol controlled with meds, physically active - 1-2 hour workouts 3-4 times/week

I just had a Nissen Fundoplication and hiatal hernia repair 6 days ago. I have only good news to report. I had been nervous about having the surgery and procrastinated for a couple of years. In fact, I was so nervous about this surgery that I cried as I was being wheeled into the operating room. My fears were about whether permanently altering my innards would bring relief or be a new source of even more difficult problems like an inability to swallow or burp, perpetually choking on food, and/or never being able to enjoy eating again.

Day of surgery (Friday) Surgery 9-11am, Recovery 11am-12:30pm - The worst pain I have experienced from the surgery was in my neck and upper back. I was able to control the pain through the IV pain pump meds (Fentanyl). For the first 24 hours, I was on no fluids of any kind - not even ice chips. I was given a tiny sponge on a stick and was told I could wet it with water and swab out my mouth, but later I found out that the nurse who gave that to me was not following strict protocol and I should stop using it.

Day 1 (Saturday) The surgeon ordered a swallow xray for that afternoon to see if there was any "leakage" in the esophagus, sphincter, or stomach. This is the first fluid I had swallowed since midnight before surgery. There was no leakage but the nasty tasting liquid made me nauseated, so I was given an anti-nausea med in my IV. I never gagged or vomited and the nausea only lasted for 30 min or so. Once the surgeon saw there was no leakage, I was put on liquid only diet and the transition to oral pain meds began.

As soon as I was allowed to swallow, I noticed that not only was I able to swallow, but that I was also able to burp. Each swallow and burp was somewhat painful due to swelling. Liquid intake obviously led to the need to urinate, but because the general anesthesia had a residual effect, my bladder was asleep, and I had to have a foley catheter that was left in place until today.

I took the oral liquid oxycodone with milk to prevent stomach irritation or, by the next day, with applesauce. I found out that once I transitioned to oral meds, they were on a by-request-only basis (Dosing would not be up to the nurse to initiate and I would have to keep track of when my last dose was in order to prevent a "pain cycle".) and the oral meds were not as effective at relieving pain as the IV med. I woke up during the night having gone too long between doses feeling a lot of high abdominal pain and had to request a dose of pain meds. It took about 30 min for the pain to subside.

Day 2 (Sunday) I was swallowing and burping well, drinking fluids (water, juice, chicken broth), swallowing applesauce, managing pain, off of oxygen, getting out of bed and walking well, so I was released from the hospital at noon with a written prescription for liquid oxycodone. My husband drove through the pharmacy at Walgreen's but the only location with that med was about a 20 min drive away. My husband took me home, got me set up in bed and then went to the other Walgreen's for the prescription. The most difficult transition from hospital to home was getting the angle just right in bed. It has worked well to have a variety of pillows that I can move around to go higher or lower, and sometimes it has felt good to nap while sitting up in a straight backed chair with a pillow behind my back.

Day 3 (Monday) - Day 6 (Thursday-today) Most of the pain I've experienced during this time period is from gas. I found that from the moment I swallow, gas forms and puts pressure on my sore diaphragm. On Tuesday, I started taking Gas-X Prevention, one capsule in the morning and one in the evening and the gas is manageable. And every day is better than the day before. Less pain, less swelling, less gas. I've been able to shower, walk around, even fold some laundry. I saw the surgeon this morning to have the urinary catheter removed and he says everything looks good. He said to go slowly transitioning to "real" food (small bites, well-chewed) from my soft-food-only diet but he didn't give a set time frame for when to add in "real" food. He also said that the gas is forming because of the oxycodone's affect on the large intestine and that I can start taking Tylenol or ibuprofen during the day. He said that once I am off the oxycodone and eating in a regular pattern, I should return to a "normal" state of minor, non-painful gas production.

In just 6 days, I have these benefits: no heartburn whatsoever, no heartburn medications, more lung capacity and no choking since the hiatal hernia is gone, no coughing other than normal clearing of my lungs, swallowing and burping normally and without pain, decreased pain and swelling in the abdomen, full nights of restful sleep while lying relatively flat on my back.

I don't know how much weight I've lost, but I'm sure I've lost some due to low caloric intake over the past 6 days. What I expect is that I will be able to eat normally at some point in the future, but I hope that normal will include not over stretching my stomach with large quantities, and that by eating smaller quantities I will experience natural weight control. I think an aspect of having a large hiatal hernia is that I didn't get a natural sensation of fullness at the right time during a meal and I would end up over-eating. The only way I could somewhat control regurgitation was through a strict, legalistic approach to timing each bit of intake and precisely regulating the size of meals. My hope is that I can live more freely and live well enjoying good foods but have the sensation of feeling full on less intake.

Blessings to you as you approach your surgery date. I hope you are encouraged by my experience.
PenelopeK

 
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Old 07-14-2011, 01:41 PM   #4
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Re: Nissen fundo in august - nervous! Help!

Cards, we are in the same boat! I havent scheduled mine yet as I am still trying to find the right surgeon, but I am thinking December 2011. I am very, very nervous after reading all the horror stories on the net, that is for sure. I will certainly share any other websites I find with POSITIVE data, and I hope you do the same as well!

Penelope, THANK YOU THANK YOU THANK YOU! I know you are only 6 days out, but thank you for being so honest about your nervousness! I know I am very scared because I fear the worst for this complicated surgery!

MountainReader, thank you to you as well. I have lurked these boards for a while now and I really like your honest and up-front approaches to the subjects!

-B33

Last edited by Believe33; 07-14-2011 at 01:44 PM.

 
Old 07-14-2011, 02:16 PM   #5
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Re: Nissen fundo in august - nervous! Help!

Mountainreader, I want to say thank you. Anytime I post on here, you are always there with a reply & to make me feel better. You have given me very useful information & have been honest, so thank you very much. I really appreciate it
Penelope thank you SO much for all of the details! That is so helpful, you have no idea! Im 29 years old & have had this hernia since 20 years of age. My doctors tell me that this is highly unusual & rather large for someone my age. So, after the years of suffering & many tests, they think surgery is my best option. Im actually looking forward to it, because I can't wait to breathe again. Im a little afraid of the pain, but it seems like its worth it. Did you have breathing problems before, and if so, did they improve after the surgery?
Believe 33 I am so nervous too. But it seems like we both really need it! And while I have heard that the recovery can be quite painful, I've also heard each person say that they are happy they did it

 
Old 07-15-2011, 01:58 PM   #6
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Re: Nissen fundo in august - nervous! Help!

One more quick question - when will i be able to drink alcohol after my surgery? My surgery is August 11th, and my bachelorette party is scheduled for August 27th (I'm getting married December 3rd), Im thinking that it needs to be rescheduled to maybe September or October.

 
Old 07-15-2011, 04:11 PM   #7
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Re: Nissen fundo in august - nervous! Help!

I had a dor fundoplication (partial wrap) for achalasia after they did my myotomy (to cut the LES). But I think for your question a wrap is a wrap.

Don't let them move you to your room from recovery without giving you a pillow to hug. Request this because no one else will think of it. Then when they move you onto or off the gurney hug it tightly to your abdomen. Hugging a pillow helps to immobilize your sore insides and helps to greatly reduce that pain.

The worst pain I felt was the constant migraines the anesthesia triggered. If you are prone to migraines, bring your own meds. It takes forever for them to get you any.

The second worst was the pain from the gas. I've had laparoscopic surgery before but this is the first time I've had gas pain like that. Heat packs on my shoulder helped tremendously but it took forever for them to bring those too. I had hubby bring a few of those instant heat pads (Theracare) with him the next day.

Other problem was the dryness in the back of my throat. Made coughing, everything hard. In the early morning hours I got the nurse to bring me some saline water and I dripped this down the back of my throat through my nose. Blessed relief!!!! You can buy a bottle saline spray or drops at almost any store.

Sad to say but sooner or later you will have to cough and that is painful. I avoided it as long as I could and started getting panicky because I couldn't breath. Finally I did it and brought up a big glob of sticky mucus. Then I could breath. Use you the spirometer they give you faithfully. It's a little gizmo you blow into to exercise your lungs. You will find you are not able to breath deeply post surgery because of the anesthetic and this helps.

What hospital personal forget is that you can't see anything behind you. You can't turn around because your gut hurts too bad. There was a chair beside my bed for me to sit in that I never saw because it was behind my line of sight. I would have been up earlier if I had known there was a chair there! So look for the chair and get up and sit in it as soon as you can. That makes the discomfort easier to bear. You will up walking the next day and that is very sore. If you can get a family member to push the IV and catheter set up while you hold the pillow to your stomach I think it is easier. Just take it slow and go no further than you have to.

Bring a small clock too to keep track of when your pain meds are due. The nurses won't. Keep it on that table that swings over your bed. You won't be able to see it if its on the bedside table behind you.

Hygiene. Wash your hands whenever you can. Bring some Purel to clean your hands (under the fingernail too) and keep your fingers away from your nose and mouth. You can pick up some major infections in hospitals. My mother picked up MRSA that way.

So bring extra meds, heat pads, saline drops or spray, clock and Purel. A comic book and an mp3 player outfitted with some bitchin earbuds and a playlist full of loud music to get your mind off things is a good idea too. You won't be up to reading that first day. Audio books are good too. Who cares if you have to listen to the same chapter five times? Just set it up to loop and sooner or later you will remember what happens. I always bring a small box to keep all my stuff in. A little lock for that is a good idea too. Never know how sticky-fingered your roommate's hubby might be.

Honestly the first two days were the worst and first night post surgery in the hospital was the worst of that. My migraines made me uncooperative and snappish and things would not have been so bad had it not been for them. Once I got home things got better quickly. Second day home I was running up and down the stairs cleaning up because some service people were coming. Dumb thing and I paid for it that night with extra pain but it gives you an idea of how you will feel. I was back down to my normal level of pain meds within 5 days I think (I take pain meds for a chronic pain problem).

I release a tiny burp with each swallow. That's my sign it did get into my stomach.
It seems to me that I cannot eat as much volume as I used to. I'm slim anyway but there is no way I could eat a large meal now without some major discomfort.
Diet. My doctor told me I could eat whatever I wanted as soon as I could eat (he developed the surgery I had so -biggie in the field). That turned out to be pizza I'm sorry to say. And being a nutritionist, I'm very sorry. But my husband caught me in the middle of something and I had half of it down before I realized I had actually got solid food into my stomach for the first time in a month. However, I chew food into nothing so it all reaches my stomach blenderized and soft.

Hope some of this helps. I've had a number of surgeries and they are all different. I am so glad my surgery is over and everything works again. It's been three years and you can barely see the scars and I have very fair skin.

 
Old 07-20-2011, 04:34 PM   #8
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Re: Nissen fundo in august - nervous! Help!

Re: "Cards" question about alcohol after surgery.

I just had a small glass of wine last night (11 days post surgery). I'm off all pain meds, even Tylenol, so I didn't think it would hurt as it sounded good. I think it made me feel better - better digestion, better sleep. But I don't know about a full-fledged bachelorette party! You might not feel like the revelry of such a party only 16 days after surgery.

And to answer your question about breathing from several days ago. I find that my diaphragm is still sore and that I shallow breathe more than I should. I have to make myself take a deep breath. But I'm able to take deep breaths so I don't know why you wouldn't be able to also.

 
Old 08-11-2011, 05:34 PM   #9
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Re: Nissen fundo in august - nervous! Help!

Teddybearhero,
I read your posts on this board, and I want to ask you about a few things (regarding achalasia and your procedure).

Did you ever have any other symptoms like trouble breathing (I have a near constant "shortness of breath")?
Rapid or thumpy pulse?
Strange soft stools?
Constipation?
Trouble burping?
Bad frequent flatulence?
I am guessing you regurgitated food and liquids, but ever a thick clear mucus?

I am guessing your surgery was a success? has it relieved your symptoms?
I have a feeling of pressure in my chest for hours after I eat, and it has been thought that I have gerd, but I really don't think I do.
I also regurgitate mucus with food in it often after meals, and this relieves the pressure in my chest.
I constantly have to clear my throat and spit because mucus/spit just sits there at the top.
And you can see my other symptoms int he questions I asked above.

Please get back to me, I have been miserable and depressed for 10 months now. I want an answer, no one should live like this.

Last edited by hb-mod; 08-12-2011 at 05:46 AM. Reason: Removed quote

 
Old 08-16-2011, 11:25 AM   #10
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Re: Nissen fundo in august - nervous! Help!

I had this done about six and a half years ago. My acid reflux was unmanageable and unbearable.

I followed their progressive diet and it seemed to go with what I was able to tolerate. I don't think I was even hungry for four or so days, so don't be freaked out about not being able to eat anything.

I was home and a bit uncomfy for about a week. I was told it wouldn't take that long away from work, but I have a hard time working when I'm uncomfortable so was glad for the whole week. For a few weeks after the surgery I wondered if it was worth it. It was THEN that I got hungry and grew tired of eating pea soup. I'd have occasional discomfort and remember getting frustrated with it from time to time.

For several months it was very hard to swallow things that I didn't chew well. Once in a while I'd forget and not be careful and swallow something too big, or too quickly and it was quite painful.

I was very active with running, cycling and such and it took me a long time before I could run without my stomach hurting. Maybe six weeks or so.

Six years, and two pregnancies later and I can count the number of times on one hand that I've had to resort to anything stronger than a Tums for reflux. I just had my wrap checked via endoscope and it's in place and still working well.

So, speaking to me now I'd highly recommend it. If you'd have spoken to me within the first few months I'd not have been so sure.

Good luck!

 
Old 08-18-2011, 06:40 PM   #11
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Well everyone, I had my nissen fundo on august 11th(7 days ago) and I feel GREAT!! My doctor is amazing! When I woke up in recovery, my nurses were amazing and I felt slight discomfort, but nothing major. They took me to my room a short time later, I was in the hospital for about 29 hours. I have to say, this surgery turned out to be the best thing I ever did for myself. I havent had any reflux since I woke up 7 days ago. I also breathe deeply for the first time in 10 years! I cant wait to run again, I should be able to breathe just fine while I exercise now, I can't believe it! My hospital stay was nice. Yes it was quite painful, but my pain has completely gone away now. I pain in my stomach, because of my incisions, and also in my chest, because of the surgery itself. The most pain that I had was when I breathed in deeply. My chest and ribs hurt pretty badly for the first few days, but my doctor said this was to be expected. I must say, the IV sure is nice, it gets the medicine to your blood in no time :-) Although, I found myself getting up to use the restroom about every 20-25 minutes, because of it. In the hospital, my diet consisted of popsicles (which were a lifesaver!!!), grits, pudding and soup. I was released on Friday afternoon, and kept that same diet until I saw my doctor about 5 hours ago. I've lost 11 lbs! I cant imagine putting any of that weight back on, because I have no appetite. And I dont just mean Im not hungry. I mean - I literally do not know what it feels like to feel hungry. I just eat a little every few hours b/c I know I need some nutrients in my body. It is the strangest thing. But, Im getting married in December, so losing a few more pounds is fine with me! I wasn't overweight to begin with, but now Im skinny! Its definitely a nice perk Another thing is that I can't burp. I was told about this, but sometimes it can be quite painful. I feel the burp coming in my stomach, but then it gets to my chest and wont come out. Sometimes it is an intense paini But I know it will get better. I saw my doctor today and he told me that the surgery went fantastic, which he was please about, since Im so young. He really wanted it to go well. He said Im recovering nicely. He said I can drive now (yey!), and I can start introducing food slowly into my diet. But, he wants me to stay away from bread and meat for another couple weeks. I also can't work out for 3 more weeks. This of course drives me insane because I am a harcore cyclist. I really miss it, but I don't want to risk injuring myself. So, my surgery was only 7 days ago. I havent had pain meds in 4 days, Im losing weight and I feel better than I have in 10 years!! This surgery was a lifesaver for me!! SO glad I did it!!! Very worth it!!

 
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Old 08-18-2011, 09:59 PM   #12
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Re: Nissen fundo in august - nervous! Help!

Glad to hear you are doing so well.

Your hospital meals were a feast compared to mine. I got broth, jello and water. I did clear liquids for about the first week.

I didn't get to add the thicker soft foods for 2 weeks. I added the solid meat and bread in at about 3 months. I guess every doctor is different when it comes their recommendations. My main suggestion is to make sure you take small bites and chew well when you start in with more solid foods.

It's funny. I spent my night in the hospital having to get up to go the bathroom frequently. I couldn't always go though. The nurse said it was because of the anesthesia. It was crazy though because they had me in those pressure boots the entire time I was in the hospital though so I had to call for the nurse every time I had to get up and go. I also needed help just getting out of bed also. I felt like I spent the entire night calling them. It was embarassing having them stand there while I tried to go and couldn't. It was the kind of stuff they don't tell you before surgery...

I was totally opposite on the burping. My first couple weeks I burped a lot. My surgeon said it was air that wasn't making it down past my esophagus that was coming back up though, not what was trying to come up.

Are you taking a multi-vitamin? If not, it might be worth starting. I found a good chewable one from Centrum that I took after my surgery so I didn't have to swallow something large that wouldn't go down.

Your pain will gradually get better. One day, you will suddenly realize that it is gone. That is a day to look forward to.

Are you moving around any quicker? I know I moved very slow the first week and faster the second, but I wasn't up to normal speed until a couple weeks out.

Take care,
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Old 08-18-2011, 10:08 PM   #13
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Re: Nissen fundo in august - nervous! Help!

Quote:
Originally Posted by MountainReader View Post
Glad to hear you are doing so well.

Your hospital meals were a feast compared to mine. I got broth, jello and water. I did clear liquids for about the first week.

I didn't get to add the thicker soft foods for 2 weeks. I added the solid meat and bread in at about 3 months. I guess every doctor is different when it comes their recommendations. My main suggestion is to make sure you take small bites and chew well when you start in with more solid foods.

It's funny. I spent my night in the hospital having to get up to go the bathroom frequently. I couldn't always go though. The nurse said it was because of the anesthesia. It was crazy though because they had me in those pressure boots the entire time I was in the hospital though so I had to call for the nurse every time I had to get up and go. I also needed help just getting out of bed also. I felt like I spent the entire night calling them. It was embarassing having them stand there while I tried to go and couldn't. It was the kind of stuff they don't tell you before surgery...

I was totally opposite on the burping. My first couple weeks I burped a lot. My surgeon said it was air that wasn't making it down past my esophagus that was coming back up though, not what was trying to come up.

Are you taking a multi-vitamin? If not, it might be worth starting. I found a good chewable one from Centrum that I took after my surgery so I didn't have to swallow something large that wouldn't go down.

Your pain will gradually get better. One day, you will suddenly realize that it is gone. That is a day to look forward to.

Are you moving around any quicker? I know I moved very slow the first week and faster the second, but I wasn't up to normal speed until a couple weeks out.

Take care,
MountainReader
I couldn't always go either! It took me until a couple days after to urinate normally. How funny. That's a really good point about the multi vitamin. I really need to get some. I feel so weak. M moving around much better yes :-) I also needed a lot of help for about the first 5 days to get up from laying down. I do feel like I'm getting my stomach muscles back though. It sure is frustrating b/c I'm so bored! And I'm off work for 2 more weeks!

 
Old 08-18-2011, 11:01 PM   #14
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Re: Nissen fundo in august - nervous! Help!

I went back to work after 2 weeks, but I really should have taken an extra week. I was pretty tired and still moving a bit slow when I returned.

I understand the bored thing though. I actually flew the day after I was released from the hospital so I could recuperate with family. At least I was bored in a different environment. The airline was great when I flew out. They provided wheelchair services from the car to gate and gate to car on the other end. I was most worried about the 8 bottles of liquid meds I had with me and checking them through security. I was having tons of asthma problems due to my reflux and couldn't go off the meds so my pharmacist compounded them into liquids since I couldn't swallow solids, but the bottles were huge! I was just waiting for security to stop me because of all the liquids...especially the narcotic stuff.

At this point, you might be able to take some short trips out walking. I was in Las Vegas and did some walking around a local casino. I felt like I was moving around like some of the seniors that that were playing there. It didn't bother me much though since I was happy to be out and about, even if I was slow.

As for the stomach muscle thing, all those twinges when I moved reminded me that they had to move a lot of stuff around to get to the surgical site and to move things into place. All that stuff needs to settle in addition to the actual surgical swelling.

Sounds like you are really on track though. Here's to 2 successful surgeries!! Maybe our stories will help others who are dealing with the non-typical severe side effects of the acid reflux.
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Old 08-18-2011, 11:47 PM   #15
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Re: Nissen fundo in august - nervous! Help!

I wish I was in Vegas you lucky duck! Yeah I am bored. But I also get tired very easily, so I know that if I did go back to work too soon, I would regret it :-) The doc said its due to the anesthesia. He said it could take up to 6 weeks to feel normal again. Oh well, it was totally worth it!

Yes, I am so glad that we both had such good luck. I hope others have the success that we did!

 
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