Had first Nissen ( note first) and the doc said to be careful with what I ate--no bread, rice, etc as it might get stuck and need follow-up surgery; asked him about vomiting--how do I do that- he said, well you can't; I said- really? Yup! Watched everything I ate, and if I even thought for a moment the food was bad, did not eat it--wanted to take no chances with vomiting. But 7 years later, had violent vomiting episode and the Nissen "popped"- I could feel it give way; the pressure stopped, but the GERD returned. Second Nissen performed by same physician- said he had not heard of anyone needing a second. All the same precautions taken. Second one failed 5 years later-- "slipped" --same feeling as before. Went to surgeon of some local fame and he said a third one would result in about a 25% success rate. Also said that my problem sound more like an emptying problem- tested and yes the emptying was very, very slow! Recommendations:
1. implant pacemaker type device to stimulate the lower muscle to allow for better emptying; or 2. subtotal gastrectomy with roun-y-- ie, remove most of the stomach, and attach small pouch of stomach (tangerine sized) to small intestine; First option would last about a year, and most people came back for the gastrectomy. I opted for the one time fix- no stomach caused many other issues- intestinal gas was beyond description- found OTC chewable 3x day, and that helps-- but if I miss one dose, I have to be away from people. I carry a bottle with me at all times. Had some loose stool issues that became a little more prevalent. Still was not getting better--final straw- colonoscopy revealed tumor; most colon removed. No further spread, so far, but subsequent colonoscopies have been horrendous- not the prep-- the poor prep and being accused of failing to follow directions- after 3 colonoscopies, finally had a doc give me a tentative OK- prep still not good, but enough to say you are probably OK....nice....
So now have major diarrhea all the time- 2 hour max limit between toilet sessions- even at night! No one can give me any insight into how to fix- been to Mayo and am very disappointed with lack of outcomes--not sure who to go to, if anyone....
Be vigilant; be your own advocate; do not take the docs word as gospel--ask questions until you get your answer...not theirs; that part I am still working on...
best to all, Bill