Hi all

I've posted quite a bit on the run up to this operation so I thought I would let you all know that I had the op 2 days ago and so far all seems very successful. The pain has been more than I expected, but the results are currently worth it. I can eat solids and burp already and of course most importantly no reflux or heatburn so far!

Congratulations!! I hope you continue to heal quickly. Who did your surgery?

A Mr Paul Peyser in Truro, Cornwall. It was a partial 180% wrap, with a small hiatus hernia repair.

Any gas/bloat or gastritis?

just a little bloating so far, but not too distressing yet. I'm eating very slow.

Good for you Blasterboy, I hope your recovery is going well and congrats on the operation, too.
A few questions ..... How long does the operation last? Did the doc give you any time frame for recovery? Was it local or general anaesthetic? ..... Were you out cold during operation? Can you resume normal/usual activities soon? It sounds like you are home already; were you kept in overnight? ....sorry for all these questions!

If all goes well, I bet you'll feel like a new person. Man, you can then eat or drink whatever you want? That sounds too good to be true for us GERD sufferers!

ps.... where is Truro, Cornwall ?? :confused:

Stay well.

Gosh, that sounds so good, eat drink and be merry, haven't been able to do that for almost a year! I'd like to know the answeres to those questions to.

Gosh I'm a little sore this morning, but I was sent home with a stash of painkillers and they are coming in handy.

The operation lasted between one and two hours and if you're interested in checking a video of one out, sign up to websurg.com and they have some of operations on-line, morbidly fascinating for anyone thinking of a fundo. Also the University of Maryland have an on-line video of an operation they did, run a search on LAPAROSCOPIC NISSEN FUNDOPLICATION VIDEO to find this.

So I came out of hospital two full days after surgery and I've been feeling generally well but somewhat groggy, I'm falling asleep in any place I sit, lol. They surgeon said it's important for me to keep reasonably mobile, so moving around the house is ok.

My last PPI was before the operation and since then I've been eating some solids and mainly soft foods and everything is going down well with NO REFLUX afterwards, hehehehehe :-) One day at a time though, it is early days, but I think that I will treat myself to a glass of orange juice this morning. :D

Cornwall is in the South West of England.

Hey Blasterboy


Congrats with the operation. Hopefully you will recover quickly and everything will be back to normal. I was just wondering how long you had the GERD before you did the surgery and which test did you do and with what specialist (G.I., surgeon) in order to decide to go with the surgery. And one last thing, what did your test results show? Sorry for this being a little long. Thank you.

Blasterboy,

.... thanks kindly for all the info. Hope you heal fast and that you will feel great with no setbacks or complications. You must be relieved anyways that the operation is over and done with. Also, you must keep us updated on your progress! We're listening.....

I didn't realize you were in England (southwest).... wow, that's cool. :cool:

Keep well !

ps... And yes, enjoy your orange juice, or "OJ" as we say over here. Bottoms up!

mike-2005

I had GERD for about 8 years before surgery, but it got a lot worse over the past 2 years. To check whether I would benefit from surgery I had an endoscopy and Manometry and 24 hour PH test. It's especially important to have the manometry to test whether the muscles in the oesophagus work correctly. I was diagnosed as an ideal candidate for surgery due to the result of these tests; they were pretty unpleasant, but if my recovery continues well it will be well worth it.

Thanks for all that information, gives us refluxers a good plan to go on if need be, hopefully won't come to that but ya never know with this stuff.

Well day 4 after the surgery and already I can eat toast and it goes down a treat and I can move around the house quite well, most of the soreness has gone. So far as the 5 surgery wounds go, they are tiny and not bothering me at all. And most importantly still no reflux at all!

Still early days but I fell quite excited by the results so far..... :bouncing:

I am really glad it went well for you and continues to go well.
I am scheduled for the same surgery on Friday and am a bit nervous. I am most concerned about the swallowing after surgery and the pain. My other concern is I am scheduled for a lap but was warned it may be changed to an open due to my weight. I am over weight by about 30 pounds. I have been losing (15lbs :bouncing: ) but I am concerned about a fact I will not be able to change over the next few days

Any further words of advice??? :eek:

Blasterboy, how is the gas/bloat?

So far I'm not having any notable problems with gas or bloating, although I'm taking laxatives as the post op painkillers bungded me up, I'm hoping to clear that today......

I'm really glad I had the partial wrap 180% and I think this is most popular in the UK due to less problems with bloatings and swallowing ect. Although the full wrap is the Gold standard in this field, so far my experience is great from the partial.

dzybe35, I was also nervous about the pain, but the pain killers I was given throughout post op took care of it, don't be shy to ask for more if you need to. I really hope that it can be done by keyhole for you as recovery time is so fast. In fact I've just woken up on day 5 after surgery and I feel great. Not much pain and I can eat fine! AND STILL NO REFLUX. It's quite exciting. One problem I am having though is the hiccups, but them seems to pass quite easily.

Hey Blasterboy,

Great news that your fundo went so well!! :)
Glad to hear things are going well post-op, and wow... you drank orange juice??!! How lovely!!!
I hope someday I will be able to have the fundo... I tried 40mg prilosec twice daily with 300mg zantac twice daily, and feel worse than when I took 30mg prevacid twice daily with the 300mg zantac twice daily. I have had no ph or manometry testing though, only EGDs.
Please please keep updating us on your progress!!
Jenny

Had a bit of a scare yesterday, as I developed chronic diarrhoea and was worried as I've heard that this can be a rare complication of the Nissen if the surgeon nicks the Vegas vein (straight to worst case scenario hey!) I was also feeling sick with it and even though I only had a partial wrap it is not a good idea to be sick after this operation (although most people can't actually be sick, they would have dry heaves apparently.) Anyhow I'm pleased to report that I wasn't sick and the "runs" passed after 24 hours. I feel much better today although my insides are sore again after the workout they had!!!

The ongoing good news, is

Still no reflux at all
No serious wind and I can actually burp quite well :-)
Orange juice tastes so lovely once I got past the 1st nervous gulp.
Am back to work today after 8 days
The 5 incisions needed for the laparoscopic surgery are healing extremely well, in fact I've had no pain from them really.
AND NO PPI's needed for me since the operation!!!!!!!!!!! It feels pleasantly strange to wake up in the morning and not have to roll over and take my pills.

Life is exciting all of a sudden; I'm looking for to a vindaloo next week, lol.

It's a shame many suffering people are so afraid of the Nissen Fundoplication, I think that there's a lot of fear going around from the fact that most posts are from unfortunate people who've had bad experience from the operation. All statistics point to it been 90% successful in curing reflux and gladly I'm currently in that side of the statistic.

I must say that I would be more nervous to have the full wrap though as all my research points to the partial wrap been less problematic post surgery.

Blasterboy, the only thing holding me back is that my doctor tells me there's no way I won't be back on meds within one year. I don't want to go through surgery for a few good months. Did your doctor tell you how long you can expect the wrap to hold.

I've also been looking into the full wrap. I wasn't even aware of the partial wrap until you had it. How do they choose which kind to do?

I'm glad it worked for you and that's great that you're recovering so quickly!

Blondy I guess that you're in the USA as I think the full wrap is very much the favoured choice over there. In the UK the Partial "anterior or Posterier" wraps of 180% or most popular. Run some searches on them. Ultimatly it's my understanding the the full wrap has the best chance of keeping reflux fully at bay, but I must say that you're doctors opinion is very negative, given some of the studies that I've seen online. Hopefully the following link of a webcast will display

http://www.or-live.com/umm/1202/content/prep.cfm

It's of a webcast the the University of Maryland did of a full wrap operation. It paints a very calm and positive picture. Run a search for it if the link doesn't work, its essential viewing for anyone considering a fundo.

My doctor is a pediatric gastroenterologist. I think that is why he doesn't have patients that have the wrap remain very long- because his patients are still growing. It would probably be a different story for me because I'm done growing, but I'm too old for a peds surgeon to want to deal with and too young for an adult one, so I'm in kinda a crappy situation.

I don't think any fundos are really done too often in the US anymore, but that's just what my GI said. I will check out the link and have been doing searchs. Thanks for the help.

Hi Blondy. I don't have any percentages, and I know many GI's think the Fundo is risky, but there are also many people who seem to be having it done in the US. Search 'fundo' on this board and you will get a slew of threads (many with problems as this is where problems end up - but many happy results as well). Do a search on the web and you will get even more insight into surgical proceedures that are currently being done and others that are in development.

For Blasterboy

I had an endoscopy two days ago which highlighted a small sliding hiatus hernia but no significant osophaegal damage. I believe I suffer from LPR so no surprise there. They also found H.Pylori for which I am taking Heliclear. I have been told that the hernia is common and not something to worry about. I have a PH monitoring scheduled for June at St Thomas's, London which I hope will show evidence of LPR.

I was wondering if you think I could make a case for the fundo. I note your hernia was small so was there any other significant osophaegal damage ? Were you told that it was the cause of your reflux ? I am thinking of asking for barium X ray to see if the upper and lower sphincters are ok and if the hernia is interfering with the proper function of the LES. I do not want to go on PPI's again as terrible side effects and 3 months of pantaprozole had no effect. I see my case as a quality of life issue (constant mucous, globus, bad taste and bad breath) as opposed to any significant medical reason.

Would be interested to hear about your condition and fundo. On what medical grounds / symptoms was it sanctioned and was it private or on the NHS ?

PS Sorry if you have posted these points earlier but I am new to these threads.

Ginger, I didn't suffer from LPR very much, just had some sore throat problems until I had my dose of PPI's increased.

My situation was quite different from where you are, in so much as I had been on PPI's many years and was needing increased doses, plus I was having food/juices refluxing into my mouth. The medication was about 90% effective on average, but at 32 I didn't fancy a life on PPI's, although I didn't suffer any cronic side effects from them.... Also I'd tried changing many foos habits. I stopped drinking Alcohol and coffee and smoking and certain food stuffs.

It is quite promising for you the they found that bacteria, many people have reflux problems clear up once that's treated!

So my Endo also showed a clear Oespohagus, given that I'd keep my reflux well treated I guess that helped, but my surgeon said 50% of cases that can benefit surgery have a generally undamaged Osophagus. Because of that I needed the PH test to check that my symptoms of hearturn coincided with actual reflux and from this test I was proven that my case was quite cronic and 85% of the time I pressed the button the machine picked up acidity up the Ospohagus etc. Also I had a Manametry which is essential for anyone considering the Fundo as they need to check that your Osophagus is still effective in moving food down to the stomach; if they operation is done it is essential for the ability to eat that the Osophagus Muscles will work!

From the results of these test I was advised that I was an "ideal" candidate for the operation in so much as my symptoms are the type that this operation best treats.

In my opinion it's way to early for you to consider an operation, but the ongoing tests will be the best "opinions" I presume and I think the choice is very personal, it's really a lifestyle operation and I made my desicion based on that premise.

Thanks Blasterboy,

I know in the realms of some people's long suffering I am at an early stage but it is really getting me down. The symptoms on their own would be no more than an irritation but their link to bad taste and breath is the biggest problem. Recently I have been regurgitating very small food pieces and find great difficulty in swallowing pills.....they seem to stick in the throat. I would not wish to undergo the fundo without due cause but when I've only got this far through my own persistance and money I am determined to get it resolved. You did not say if you had it done on the NHS. I have been told a BUPA fundo is over £ 4k. Bit too much just now having paid for a private tonsilectomy (chronic crypts and stones which they feel was reflux and mucous created).

My resistance to further PPI's are based not only on their failure to work (double dose) but my many years experience on and off Cimetidine for a peptic ulcer ( which now seems likely to have been caused by the H.Pylori). The thought of a lifetime on increasing levels of PPI's is hellish. Anyway as you say I hope that clearing the Pylori will help but I fear that the sphincter(s) are not working properly. Just what part the hiatus hernia plays in that I don't know.

I read that the fundo is often used for or in conjuction with an other surgical method to fix a hiatus hernia. Do you know if your fundo was used to correct your hernia.

Thanks for your help.

Ginger, I don't think Cimetidine is a PPI, the generic PPI's in this country are Losec and Zoton, Omaprozole and Lanoprozole or the drug names.

Fortunatly I have private health care with Bupa, so after seeing two NHS Gastro doctors who both advised the Fundo I switched to Private health care treatment. Really lucky they covered me as in Cornwall the is an 18 month waiting list for an Endoscopy on the NHS, shocking really!

The Fundo was used to repair my Hiatus Hernia, but the impression that I got was that the Hernia was not really the cause of my problems, but something that was worth fixing whilst they were in there.

There's a lot of posts on this forum for LPR, I would adivse reading through them for a great source of advice and info on your particular suffering.

Blasterboy, how is your recovery coming?

I've had the "Runs" since last Wednesday, so I'm finding that inconvenient and frustrating. It is possible that I've picked up a bug that going around in my area, but likewise it is also a common post op complaint. I'm hoping it will pass very soon. Other than that I still have some minor shoulder pain, but that's it.

I can eat anything I want in theory now, but because of the persistent bowel problem I have to be careful what I eat. I've lost 5 kilos from this, but I don't think it's the type of weight that will stay of very easily, once I get my appetite back.....

I'm back to work no problem and still had no reflux, hehe.

Hi Blasterboy,

Thanks for the advice. I too have the trots from the Heliclear. Yeah I know that Cimetidine is not a PPI and I must admit for peptic ulcer pain it was brilliant. However, prolonged use left me lethargic and increased my breast tissue. I noticed the same effects on the Pantoprozole and my ENT told me that since it had not improved the reflux the side effects were not worth suffering. He instigated the endoscopy and felt that given my age (38) a fundo repair was the best route. He was a BUBA consultant but when you get to the NHS the view tends to be different. Without sounding wicked they would leave you to endure. They seem to be looking at severe impairment such as Barretts as justification for surgery and not quality of life per se. However, I will continue to persist and hope that the PH monitoring and manametry will help.

I am encouraged by your recovery having no incidents of reflux and hope it continues. One final question for you. You say the hernia was a minor causal element but was it confirmed why you were refluxing ? Was your lower sphincter loose and how did they confirm this ? I understand a Barium X ray is the gold standard.

Cheers

PS There a many excellent threads on LPR or GERD but it would help if they could be all brought under one heading. Not sure how to do this though.

It was a loose Lower sphincter that was causing my problem.

Hi Blasterboy,

How was your loose sphincter actually picked up so I know which route to take.

Much appreciated

The surgeon pumped air into my stomach during the endoscopy and it came up and out too easily. I think the problem for classic reflux is a loose lower sphinter.

Hey Blasterboy


I was just wondering how is your recovery coming about? Have the "Runs" stopped or are they still going? Any other problems, like swallowing difficulties or gas/bloating? Please let us know. Thanks.

Hi Mike, things are going really good thanks. Both the Surgeon and my General Doctor think the "Runs" are from a gastric bug that's doing the rounds locally. Just my luck, to catch it so soon after a "Gastric" operation, hmmm. Anyhow, it's getting a lot better the past 24 hours, as I was advised to take Imodium and this has allowed me to eat properly again and live outside a certain radius of the toilet, lol. Really it is great to be able to eat what I want and get no reflux...

I haven't had any swallowing issues at all and I can actually burp as good as before the operation, which I presume is stopping me from suffering from any stomach bloating. I think this is a good advantage of the partial wrap. Actually I'm just a "gassy" now as I was before the operation on both fronts etc..

Also I started exercising again today, did 30 push ups with no discomfort at all and my wounds healed amazing fast. It's only two weeks since the operation tomorrow and my life is nearly back to a normal rountine!!!

The only thing I have to be careful about is eating too fast, it seems to get backed up at the lower sphincter and is somewhat disconcerting, but I was advised not to panic when this happens and be patient, it soon passes, usually with a burp, lol.

Well the "Runs" have duly passed on by :-) And I had a can of Coke today, with no problems from it!!!

I can't believe how fast I've recovered from this surgery and I'm so relieved that all seems successful. I will post if anything changes over the next few weeks, hopefully that won't be nessasery. :wave:

Hey blasterboy


Glad to hear that your "RUNS" have passed away, the thing with the surgeon damaging the vagus nerve is a terrible thing, probably worse than having the reflux itself. I was just wondering, have you tried drinking coffee yet? And can you lie down after you eat? I am guessing you should be able to do it with no problem. Keep us updated on your condition/recovery please. I am seeing a surgeon on May 9th and one on May 17th to talk about surgery (in Toronto, Canada). If you have any advice for me, it would be really appreciated. Thanks and Take care.

Yes I was a bit paraniod about the Vagus vien been damaged as it must be quite aweful to suffer the permenant side effects of that. It does seem that I'm safe from that now, but it crossed my mind.

I don't drink coffee anyhow, but I had a can of soda the other day and that went down well and tonight I had a big bag of sweets (that's candy stateside, lol,) and I didn't get an once of reflux from it, what a joy I tell you!

All the best with your visits to the surgeon tomorrow and next week mike2005. I think the best advice I can give is to do lots and lots of research and read all the forums that relate to you. You could even watch videos of the surgery if you sign up to websurg.com I found it morbidly fascinating ;)

Cimetidine is an H2 blocker.

Hi all

My 4 week update....

I am still prone to the runs occasionally, but this is well controlled with Iomdium. I fully expect this to subside within the next fews weeks and am not especially concerned about it anymore.

I do have some strange pain in my left shoulder, this is concerning me a little. It seems to be a continuation of the pain I initally felt straight after the surgery (because they pump your stomach full of air, it causes nerve reaction of sorts in the shoulder.) From my research though this normally passes after a few days and it did so initally for me also, but then returned intermitently and now consistently. I guess it's possibily caused by something else, but it seems consitent with that initial pain as mentioned. Any suggestions on this would be appreacaited.

Regarding Reflux, I'm still free of that and enjoying eating and drinking "whatever I want!"

Hello Blasterboy


How are you? I was just wondering how you doing and how is the surgery recovery coming? Any pains, any more reflux? Do you still have the runs? Let us know how things are going? By the way, did you have GERD or LPR? Thanks and take care.

Hi Mike

The runs are still there, although they are improving slowly as hoped. The pain through my left shoulder is still there though, I saw my surgeon about this last week and he said it could last up to 3 months!!! I can feel the pain at any given time on any of three points

1. Just below my last left rib, towards the solar plexus
2. About 3 inches above and just to the left of centre from the solar plexus
3 And in the middle of my left shoulder.

It seems to be on a nerve line and apparently it is not uncommon for this type of pain to linger. I have a somewhat low threshold to pain and so this has been bothering me and especailly I would like to be completely off the pain killers!

I'm not getting any reflux or heartburn, which is great and I feel that I can eat what I want still, although I do get what I call "hot burps" from certain foods (maybe non-gerders get this anyhow?) The hot burps can be unplesent smelling and I find this a little embarrassing, but really many people can't even burp for months after this operation, so from that point I'm fortunate as I'm not too "farty" and I'm not getting any bloating, so a little hot burps, no big deal.....

I must say that the overall recovery time (six weeks now) has been longer than I thought. After two weeks I thought I was sorted, but the mentioned problems are dragging on. I guess having your digestive system altered in such a way is not a quick fix!

Well, over 10 weeks since the surgery and I'm frustrated by progress on my post operative complaints. I still have this aweful pain around the bottom of my left rib cage and in my left shoulder. This is apperntly due to Diaphramatic Iritation probably caused by some nerve damage or intrustion during the operation. Their is a good chance it will pass with more time, but I'm becoming less hopeful on this as it seems to be getting more persistent all the time!

I also still have a loss bowel, but that's slowly improving; on the upside I've forgotten how heart burn feels like, hehe.....

Still, my opinion is that due to many inherant risks someone should only consider this operation if they are REALLY suffering.

Blasterboy, sorry you are still struggling. In your case, would you have the surgery again today knowing what you know? Are the new symptoms worse than the old?

too early for me to make judgement on that really, as there is a good chance that these issues will heal with the next few months. I guess my realisation is that full recovery from this operation can take a lot longer than I expected.

Hey blasterboy


How are you doing? I was just wondering how it's coming with the recovery. Anything new from the surgeon/doctors? How are the side effects (runs, pain,etc). Are you still reflux free? Let us know please. Thanks and good luck with the recovery. Hopefully things will be back to normal in the near future. Mike

Hi Mike, thanks for asking how I am.

Actually I'm on holiday with my in Ukraine with my Ukrainian Fiance and the pain was persisting in it's unplesent manner and it turned out to be a real bind to get a refil on my painkillers. So I went to the local hospital for a check up and it was quite funny really, a bit like something from SCRUBS. I had about 6 doctors crowding around me, whilst I lay on the bench (I guess they were curious to see what sick English people looked like, lol) and they agreed that my pains were nerve related and referred me to the neruology department. I felt like a VIP as the referal was instant and 30 minutes later I was talking to a really impressive Nuerologist and he diagnosed that me pain was two fold. 1st from the damaged/irritated nerve and 2nd from an irratated stomach (go figure!) Anyhow I now have a course of 5 days intensive treatment starting tomorrow and it includes



Cortasone cream applied topically
IV administered with drugs to protect my stomach and calm it
revised painkiller schedule (less than previously in the assumption I wont need so many!)


That's about it I think. I guess I'm hopeful as he seemed confident, I certainly think it will help a little at least so I'm game for it and I have time to plan it in during this trip! He thinks it might help the loose bowl, but on that point I'm seeing improvement and feel confident it will settle either way within the next few months.

I'm still reflux free, but given I'm taking 20mg Omoprozole a day to protect me stomach from the painkillers, I'm cautious on that point.

Still eating whatever I want though and other than the above I've well recovered.

Hi Everyone, I thought a 5 month update was worthwile for this post.

I am glad to report the I am still reflux free and now I'm not taking Nsaids (for post surgery pain) I have no need for the PPI's at all. I can still eat whatever I want, I've not noticed any restrictions in my diet AT ALL, I can even drink Soda's! I think this is one of the main benefits of the partial wrap is that I can belch no problems and so bloating hasn't been a problem for me.

I think I've turned a corner on the loose bowel. I'm really starting to notice that I'm not loose as often as I used to be and if I am, it's only a couple of trips to the toilet maximum, not like the old days of 6 times in an hour! I guess it's that the gastric system can take time to re-establish itself from the shock of the surgery and I'm very confident that my bowels will completely settle before too long.

The only nagging problem is the pain I'm still suffering since the operation. It's still there and not getting better. My surgeon said he's not had this type of lingering pain in any of his patients before and my research leads me to believe that it's not very common. I guess I've been a little unlucky on this one, but hey I've been very fortuate in so many other areas of my recovery that I can face this one for the time been. I've been reffered to the pain management clinic so I'm hoping some nerve blocks will take care of the pain.

So that's me for now. Am I glad I had the operation at this point??? Sitting on the edge, but probably yes! So long as the pain is taken care off, I most certainly am!

So this operation.... what kind of person qualifies for this kind of surgery.... what are the results.....
I have had GERD/severe stomach problems for over 12 years and I would love to know a way to fix it, since medications don't do a thing to make it better.