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  • GERD/LPR and Fundoplication Story

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    Old 06-28-2005, 07:33 PM   #1
    scooteratw
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    GERD/LPR and Fundoplication Story

    I just wanted to throw my own story on here for everyone's perusal. I am a 28-year-old male, dealing with reflux.

    I'm a singer by profession and for the last three years I had been having unexplained phlegm in my voice that was extremely persistent and very difficult to clear. I had no idea where it was coming from. I tried diet modifications (like no dairy/no caffeine, etc.) to no avail. Finally went to see ENT and he was suspicious of reflux of the LPR sort, but wanted to narrow it down. My symptoms were--onset of phlegm right after eating, thick and difficult-to-clear on the vocal cords, post-nasal drip and the general feeling that there was a lump in my throat or that some small amount of food or phlegm was sticking somewhere in my throat. A look into my throat showed no damage to the cords.

    We did a sinus CT scan to rule out a sinus infection, tried nasal sprays to see if they might decrease the drip, had allergy tests done to see if I was reacting to something. No incriminating results there...so he was fairly sure it was some form of reflux.

    I remained skeptical because I felt I didn't have all the typical symptoms that you read and hear about. No heartburn of any kind, no gagging, no regurgitation of food, no waking up in the middle of the night coughing, no pain. Just awful phlegm. I also experienced no change in symptoms after taking Prilosec and Nexium for prolonged periods. I thought maybe I was just having a swallowing disorder.

    So he ordered a Barium x-ray of me as I swallowed. No disorders detected, but they did find a hiatal hernia. Hmmm...those can cause reflux, can't they? Well, I still wasn't convinced. My ENT sent me to the doctor he studied under.

    This new doctor after listening to my case history, was also fairly sure I was suffering from this silent reflux, LPR--or as he called it, LERD...a modification on the acronym GERD. He even pointed out small irritated bumps in the throat as well as pronounced tooth enamel decay, both evidence of prolonged exposure to acid and stomach juices. I was put on Nexium twice a day as well as Zantac at night. I followed a strict diet. I raised the head of my bed. I didn't eat for three hours before bed. I avoided bending over. I was religious in following these changes. Still--no improvement.

    I submitted myself to a 24-hour pH probe test to see if there really was reflux activity. To my surprise, the results were shocking--in a 24-hour period I had over 30 cases of reflux, more than several making it all the way up to my throat and almost all occuring when I was upright...not when I was lying down, as is the case for most GERD sufferers. It was then that I realized that the doctors were right and I was the one being pig-headed. It seemed that I was one of those people that no amount of Nexium was going to help...there was something physically wrong with the sphincter that lets food into the stomach. It was shooting up not only acids, but stomach enzymes and juices--things that the throat and esophagus are not designed to handle, at least not for prolonged periods of time. And no amount of acid-blocking medicine is going to stop a physical problem.

    I decided to have surgery. Specifically, I had a laparoscopic Nissen Fundoplication. It has been almost 4 weeks since the surgery. Recovery has been okay--the initial diet changes to allow the healing process to occur have been difficult. Anyone for another glass of Ensure? Blecch. I have lost more than 10 pounds and it has been difficult trying to gain the weight back so I can stop looking like a waif. Yes, I had and still have occasional pain as a result of the surgery. It's mostly esophageal pain right now, but I am optimistic that as time passes, the tissues will heal and the muscles will strengthen. The days following the surgery were very hard for me, but I am so much more mobile now--I can walk, drive and stand up for prolonged periods of time.

    As for whether or not the surgery has helped the phlegm problem....the jury is still out on that. I have noticed some changes, but I was told by the doctors not to expect a drastic improvement, especially with the kind of symptoms I was having. It can take time for the tissues of the body to adapt. Some people have immediate improvement of symptoms, they said, although these patients are primarily the ones with GERD. LERD or LPR patients can take longer to improve, possibly months to notice any change. This medical team I am under has taken such good care of me, I do feel like I am in good hands and I trust them. So I am being patient.

    Hopeful, but patient.

    If any other LPR/LERD sufferers had the Fundoplication Surgery, I suppose I would be interested to know what your recovery was like, just for the sake of comparison.

    Thanks for reading. I'll try to update you as I continue to heal.

     
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    Old 06-28-2005, 08:03 PM   #2
    mike-2005
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    Re: GERD/LPR and Fundoplication Story

    Hey


    How are you? I was just wondering if you also had a pH manometry test besides the 24 hour pH test and what were the results of that? Did they find out how weak the sphincter is? How did you decide which wrap to go with, the full instead of the partial one? And finally any side effects with the surgery? I am having mine in december break (because of school) so I was just wondering what I should expect. I wish you all the best with the recovery.

     
    Old 06-29-2005, 03:52 AM   #3
    ginger65
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    Re: GERD/LPR and Fundoplication Story

    Hi scooteratw,

    Thanks for your excellent post. I have similar symptoms to you. Tried PPI's for 3 months (standard in UK) and was told that since no improvement to forget them....didn't mind that as the side effects were horrible. Had endoscopy which highlighted sliding hiatus hernia and h.pylori. They seemed to think the pylori was the cause of my problems. I very much doubted it. They found no significant damage to esophaegus but I told them they wouldn't since I do not get heartburn. Last week underwent the manometry test and 24 hr PH monitoring. I pray that this will show that I have a high volume of incidences of upright reflux if not that severe in terms of the actual acidity levels. This is what I feel happens to me.....low level acid refluxing at regular intervals during the day and night. Bit concerned about it though as I did not notice many significant incidents during the 24 hrs (just bloody typical) or maybe I am just so accustomed to them that I do not notice them. I definitely feel that my sphincter / hernia is the problem and that that is why the meds did not work at all. Surgery is always the last option but having tried the dietary and lifestyle changes for many months with no effect I feel that this is all I have left. Wish you the very best with your recovery and any updates will I am sure help me and others who are contemplating this route.

     
    Old 06-29-2005, 06:40 PM   #4
    scooteratw
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    Re: GERD/LPR and Fundoplication Story

    Mike--I don't think I had a pH manometry test, so I can't tell you what the results were there. I do think it was pretty apparent that the lower esophageal sphincter was weak, but I don't have any way to tell you just how weak. I believe I had a full wrap and left that decision up to the doctor. I do know that they inserted a tube down the esophagus during the wrap to make sure that it would not be too tight. Side effects from surgery included massive dull shoulder pain from the CO2 gas dilation during surgery and total lack of energy due to the liquid diet on the first week. The intestinal gas was also quite painful because, of course, there was no real food inside me, just liquid. I would say make sure you have at least 1 week of rest and relaxation and following that, very little in the way of strenuous activity. I still haven't gotten back to the gym and have been told to avoid lifting anything over 10 lbs to make sure that everything inside can heal properly.

     
    Old 06-29-2005, 06:48 PM   #5
    scooteratw
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    Re: GERD/LPR and Fundoplication Story

    Ginger--I would let your mind rest easy about the pH probe analysis. It took 2 or 3 weeks for them to get me my results. While I was wearing it, they told me to go out and eat anything--tomatoes, citric juices, chocolate, greasy fried foods, you name it--anything but carbonated beverages. I also did not notice any instances of reflux while I wore the probe, but I never could "feel" reflux as it happened anyways. Still, my results were very conclusive! I would give yourself at least, and I stress at least, 6 months on the PPI meds, but see what your doctor says. Surgery is a very serious step, probably more so for us LPR sufferers because of the less severe (but still equally as worrisome) symptoms that we are dealing with. Thanks for your good wishes!

     
    Old 07-03-2005, 05:11 AM   #6
    mjcm123
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    Re: GERD/LPR and Fundoplication Story

    Scooteratw, you seem very happy with your surgeon. Who did you use and at what location?

     
    Old 07-05-2005, 06:36 PM   #7
    chele429
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    Re: GERD/LPR and Fundoplication Story

    Hi Ya'll----I am new to these boards, and I posted on the digestive board, not knowing that there was this GERD board.

    I have LPR, been battling this for a while (In 2001 went to ENT for hearing issue, which STILL is not resolved, but along the way they found a tumor in the back of my throat during the exam; auto-immune disease per blood test; severe case of vertigo from the various leaning positions for the hearing evaluations; and then this lovely LPR issue).

    after many scopes in the office and plenty of those Ph probe test, six months or better on 4 to 6 Nexiums a day (Prevacid did not work at all; Nexium kept that lump in my throat at bay and also did reduce the severity of the acid readings on the probe tests, but not the frequency), I did the Nissen. That was in Jan. 2003. I also have Barrett's esphogus (spelling?)

    Now I am back on Nexium 2 a day, and also Reglan to move the food out of my stomach faster (horrible side effects so I don't take this as religiously). Doing another scope later this month to biopsy some of the spots from 2003 and the doc is talking about 'tightening' the fundo. Anyone heard of this? Not too sure at this point if that is the road we will take---depends on the findings of the scope. Did swallowing test last month, but the radiologist could not get a good picture b/c the reflux was so strong. At this point, I am not only refluxing acid (how much can I be making with all the Nexium??) but also fluids and stomach content.

    I am a little nervous not knowing what the options are ---this doc is so set in one way on thinking it needs to be tightened, then next breath it is a 'but let's see what we see' attitude! Are doctors ever patients???

    Thanks for the vent session


    Michele

     
    Old 07-26-2005, 05:03 PM   #8
    scooteratw
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    Re: GERD/LPR and Fundoplication Story

    Hey again to everybody--

    I am now almost 8 weeks out from surgery and will soon be back to a normal diet. I had no problems getting thru the adjusted diet, although I will admit to some frustration as everyone around me could have hot dogs and corn-on-the-cob and chili on the 4th of July, but I will soon be back with them in less than a week.

    I still have to eat fairly slowly and I have noticed that I get strange, singular hiccups after I eat. That is, I get one or two hiccups and then I'm done. My doctor said that it is the stomach bloating from the inability to burp and that it then "rubs" on the diaphragm causing a hiccup. Gas-X helps me get rid of this to a certain extent. I think it's funny more than anything else.

    As far as the recovery/disappearance of symptoms like the thick phlegm--I have seen some improvement, but nothing drastic yet. I still get terribly thick phlegm after I eat, but once it clears, it tends to stay away now. I am also clearing my throat much less, which is a relief. I don't know if I'll ever get back to zero amounts of phlegm, but if I do, the doctors say it could take months, some people even take a year. I remain optimistic!

    MJCM--I went to the Univ of MD Medical Center in Baltimore. There are a couple surgeons there that do this through the AeroDigestive center; my surgeon was Dr. Scott Roth.

    Chele--I don't know what to tell you as far as "tightening" a wrap. Mine was just the initial surgery.

     
    Old 07-27-2005, 08:17 AM   #9
    terrienne
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    Re: GERD/LPR and Fundoplication Story

    Hi !

    Check out Dr. Norm ! He has a post on ' Gerd, Please Help ' by Angela..,

    You will see my name in response to her !

    I think this could really be of some help to you..,

    Hope so, and Good Luck,
    Gee Gee

     
    Old 07-27-2005, 08:19 AM   #10
    terrienne
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    Re: GERD/LPR and Fundoplication Story

    ATTENTION ! SOOTERATW,

    PLease see my post..., It my reply to You !

    Gee Gee

     
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