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Old 12-21-2012, 02:13 PM   #1
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Question Post Nissen Fundoplication Questions

I just had my surgery on the 18th about 3-4 days ago. I'm just curious from others experiences how it felt to eat at first and how much trouble you had. I was only only ice chips in the hospital (about a 36 hour stay) though was drinking some water and had several spoonfuls of butternut squash soup prior to discharge. I even had a couple prilosec all with seemingly no problems though i was feeling like I still had acid reflux. The doc said that was just the swelling and irritation. Since being home I've still not eaten much. I take a few spoonfuls of soup but then it feels like I'm trying to swallow a golf ball with pain and pressure in my chest at the level my my esophagus would join my stomach. I've been able to eat a few really soft carrots from the soup but whether there is a solid or not it seems only several spoonfuls and then I get that pressure. My doc had said taking pills was ok right away though he did give me a liquid pain med which i rarely take as it does nothing for the swallowing type pain/feeling. So I also tried to take a stool softener (dulcolax soft gels) one each the last 2 days. Both times it really hurt or at least was incredible pressure (again the swallowing golf ball feeling) for about 15 minutes or more afterward. I've not had a first bowel movement yet but given in the past nearly four days my total food intake has amounted to not much more than the equivalent of a can of soup don't really expect one yet.

I wonder what to expect.

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Old 12-21-2012, 08:24 PM   #2
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Re: Post Nissen Fundoplication Questions

I had my Nissen Fundoplication in October 2008. 4 years ago now. They did my surgery as outpatient with a 23 hour stay in the hospital.

My surgeon had me on a liquid only diet for the first 2 weeks, until I went for my surgical post-op visit. He was VERY STRICT with me on LIQUIDS ONLY for that time. He said I couldn't even have a strawberry smoothy because of the seeds in the strawberries. I stayed on clear liquids for the first week, than moved to adding other liquids.

Popcicles, broths, protein water,etc... worked well for me during the first week.

I had all of my medicines made into liquid by a compounding pharmacist so i didn't even try swallowing solid pills. They make a Prevacid in Solutab version that dissolves in your mouth. That might work well if you need a good PPI.

I was nervous about overdoing things so I didn't force the quantity of the liquids. For the most part, I remember doing ok.

Pain killers can "plug you up like Hoover Dam" according to my PCP. It was a four days for me because the dulcolax the surgeon gave me didn't do anything. I called my GI doc and he said to take a double dose of Miralax until I was better, then cut back to the regular prescribed amount. That worked like a charm. Ironically, I was scheduled for a Colonoscopy a week after my surgery. The Prep certainly took care of any lingering problems I might have had.

Anything involving my core muscles caused me major pain for a few weeks. I couldn't even get out of the bed by myself for the first week because my core muscles hurt so much. I don't think I tried straining for a BM, but I imagine it would apply.

Hope you feel better soon. Be patient, healing will come. My GI doc explained it to me this way: "Your stomach is angry at you for the trauma done to it. It will take about 8 weeks for the swelling to fully subside."
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Old 12-22-2012, 05:08 AM   #3
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Re: Post Nissen Fundoplication Questions

I'll share my experience .... which is maybe 3 weeks more than yours (11/27/12). I shared same symptoms. Was advised to be very careful & deliberate in my swallowing. Limit the amount of air I may be swallowing. When I was sipping soup I was adding air. When I swallowed water I noticed I would swallow twice (probably reaction to my throat being sore). This has helped, but I'm a very long way from feeling great. Re the bowel movement ... at least a week after surgery. I started taking Miralax 2x/day immediatley after surgery. Was off the hydrocodon on day 4 in order to improve chances of reduced constipation. Still not eating much. What I do eat is high in protein so I'm not too fatigued at end of day. I have to keep telling myself recovery will be longer than I expected and I will see the benefits down the road .... Just not soon enough.

 
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Old 12-23-2012, 04:46 PM   #4
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Smile Re: Post Nissen Fundoplication Questions

Thanks for the info Mountain Reader. Yes my doc was much less strict on the liquids. I don't know if this involves the type of surgery or not. He says though, what he does is not the typical thing you find when one looks up a nissen on the internet. Instead of wrapping the fundus(upper stomach) around the esophagus and suturing, the way he explained it was by taking his pant leg in both hands between th thumb and other fingers and then pushing up with those other fingers thus forming a circumferential pocket to prevent regurgitation.

For food he said I could have soup including that with soft particles like vegetables and pasta or rice. Though the reality is soup or liquid I can only take a fews spoonfuls and then can't eat anymore. I do seem to do a little better with popsicles though only marginally so I'll try to make some protein ones.

After the surgery, how long did it take before you were off the liquid diet?

How long did it take before you could eat any significant amount say like drink a cup of water or eat a bowl of soup?

How long before solids, not simply starting but actually being able to take more than a bite or two?

Being so far post procedure do you have any reflux symptoms or any issue turning side to side when you sleep?


I fortunately it sounds faired better than you in the pain. I was getting out of bed and walking around on my own while still in the hospital. I was bent over for the first several days because the 5 lap sites were making my abdominal muscles feeling very tight but getting up and walking around does relieve that and gently stretch the area so I'm trying to do that. I've barely had enough to eat to create a BM but started taking gummy style vitamins and fish oil a few days ago. I seem to handle those quite well. Between that and a few noodles and few pieces of carrot and an enema to speed the process and make it strain free, I had my first BM today which is just over 5 days out.

Coughing has not been a big deal but the few times I have sneezed this week, oooohhhh mmmaaannnn!! I felt like I was tearing open two of the lap sites. It felt so much like like that I had to physically check each time but it's been all good, just very painful.

Thanks for the well wishes, the questions above on food are my biggest concern now as I was aware portion size would be limited but not as severely limited to just a couple spoonfuls like it has been.
Thanks again. )

 
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Old 12-23-2012, 05:01 PM   #5
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Thanks for your reply Ameekusa. May I ask specifically what you are able to eat and in what quantity? I was thinking about the whole swallowing air thing myself. I think that is why the fruit juice popsicles I've found or ice cubes work better for me than trying to drink fluid. I have my first protein popsicles in the freezer right now so hopeful it will work well.

Were you able or allowed to eat soup the first week?

If not how long on clear liquids?

How much fluid or solid can you tolerate at a sitting?

Any acid reflux symptoms any longer?

I've ben amazed at not being more fatigued than I am given my lack of food though I think that may start catching up with me if I can't get more calories in me.

I've been fortunate my throat per se has never been sore it's just the bottom of my esophagus where it connects to the stomach that has felt that swallowing a golf ball feeling when i get just a few spoonfuls of liquid in me.

Are you feeling positive all in all now or are you feeling you have as many or more symptoms as you did before?

Thanks for the reply, I wish you continued and even speedier recovery.

 
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Old 01-27-2013, 01:48 PM   #6
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Re: Post Nissen Fundoplication Questions

Hey guys,

I've had the op on the 9th, and while i'm admittedly being very impatient with the recovery i have something i need to check.

Did any of you have issues drinking "normal" amounts of water in one go in the weeks after the procedure? I can't drink more than a sip or two of water at the same time or it will feel like it just parks itself (and hurts) in my oesophagus. Most of the time it feels like it won't go down either.

Also, how much weight did you guys lose on average during the two month (more or less) recovery?

 
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Old 01-27-2013, 02:53 PM   #7
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Re: Post Nissen Fundoplication Questions

I had my procedure on December 19th and what you describe sounds right in line with issues I had but it does get better. Preprocedure my doc told me I could eat soups right away and take all my vitamins. He didn't mean broth, he said I could eat soups with vegetables and rice and noddles etc. Based on that which I questioned several times, I was very ill prepared for the reality but talking to folks on here as well as other docs helped greatly.

So for me I'm a very fit person with exposed abs prior to surgery. I say this only to say, the 14 pounds I lost, I didn't think I had to lose and that was just the first week. Fortunately i was able to stem the loss after that before i melted away. ;o) I tried the soups but could perhaps take one spoonful before being unable to take more, i could not drink fluids for the same reasons as you. And i certainly couldn't take any vitamins, trying to take a pill caused intense pressure from not going down or getting stuck. What i found i could take was popsicles so i got some fruit juice popscles and made popsicles from protein drinks. It was not the cold but rather the slow process that allowed this to work. Even so initially i could not finish a single popsicle so i was excited the day i sat down and in an hour while chatting with folks ate 4 of them. )

Next was soft protein bars as my doc wanted me to have 60 gram of protein per day. I also found gummy vitamins which i could get down as well. Slowly i added powdered soups like clam chowder and potato that i could make as thick or runny as i wanted. I was able to eat smoked salmon within two weeks though regular salmon fillets did not work. Some things are surprising such as roasted nuts within a few weeks worked fairly well but even know things like scrambld eggs still aren't working well. My thought is if you take a funnel and crush up nuts they go through but no mtter what you do to scrambled eggs, the consistency still would not let them go through. Thats what it must be like inside too.

I found once i could drink fluids that warmed fluids worked much better. I'm sure i've still got another month or so before i can eat normally but it does get a little better every day. It would have been nice to have been told all this before. It would not have changed my decision, i'm glad i had the procedure, but especially that first week it would have changed what i prepped for myself and possibly have prevented so much weight loss.
Good luck

 
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Old 01-27-2013, 05:07 PM   #8
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Re: Post Nissen Fundoplication Questions

Hi,

My Gastroenterologist told me it takes about 8 weeks for the swelling of the stomach to completely subside due to the trauma the surgery causes. It does take some time to get back to "normal".

Do you have a 2 week follow-up with your surgeon? Make sure you ask about this. If it continues to bother you, you can always call the surgeons office and ask.

I lost about 15 lbs total. I had some weight to lose though so that wasn't a problem for me.

Does your surgeon have you eating solids yet? Mine had me on comlete liquids only for 2 weeks, then 2 weeks of soft foods before introducing solids. I waited about 3 months before adding back solid meats and breads.
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Old 01-27-2013, 07:39 PM   #9
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Re: Post Nissen Fundoplication Questions

Hey guys,

I've had the op on the 9th, and while i'm admittedly being very impatient with the recovery i have something i need to check.

Did any of you have issues drinking "normal" amounts of water in one go in the weeks after the procedure? I can't drink more than a sip or two of water at the same time or it will feel like it just parks itself (and hurts) in my oesophagus. Most of the time it feels like it won't go down either.

Also, how much weight did you guys lose on average during the two month (more or less) recovery?


my apologies, i wrote a long detailed reply to your questions that seems to have dissapeared into the ether. i hope this one gets through. anyway in summary

my procedure was in mid/late december. i lost 14 pounds the first week which i didn't have to lose.

in spite of my doc saying i could eat soups right away with vegetables and noodles and rice with no problem, reality was i could not eat and drinking due to air trapping caused me the same problems as you. i found i could eat popsicles as the pace is so slow and made some with fruit juice as well as protein drinks. once i could drink, i found warm liquids much easier. the first things i could eat were soft protein bars then smoked salmon, then roasted nuts all within the first two weeks. What you can eat may surprise you as nut which break down well especially dry roasted go down on me fine but i still can't eat scrambled eggs cause they just clump up too much and won't go down. I've still got a long way to go but by he second week with protein supplements had stopped the weight loss and also found i could get gummy vitamins to replace the pill form i could no longer take despite my doc saying otherwise. the gummies though i could eat from week 2. right now i'm eating some tilapia fillets and while i started on fast cook oatmeal a few weeks ago, just today i went to the slow cook, bulkier variety. the amounts i can drink now are pretty substantial as well. i know patience is not easy but, it does get better and better each day. )

 
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Old 02-02-2013, 12:34 PM   #10
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Re: Post Nissen Fundoplication Questions

Thanks for all the replies guys.

Y'all lost way less weight than me. Including weight loss from the month before my surgery (hernia was wreaking havoc on me. This is what made me get the surgery after all) till now about a month after the surgery, i've lost about 14KG.
Stemming the weight loss is kind of a huge hurdle for me because i'm quite unused to light yet nutritious food. And having to eat 6-8 times a day just makes things that much worse.

As for eating, soups go down fine. As long as it's just the liquids or really soft solids anyways. Tuna salad, ice cream and stuff like that seem to work too but i really need to eat at a slow pace otherwise it gets "stuck" leading to pain and my body seeming to go into mucus production overload until i get it out. I have managed to eat small chunks of chicken tho as long as i chew them really well.

I was informed by my surgeon and dietitian too about stuff taking at least two months to start getting normal. Here's hoping that goes by quick. I have a lot of weight to put back on.

 
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