Nissen Fundoplication

Ugh... yeah, I have a 4 cm hernia. Horrible to live with. They do nissens all over the place, just be sure to have an doctor who's done a ton of them before, and a thoracic surgeon will be better than a general surgeon. Good luck!

I just googled surgeons at Hackensack Medical Center in NJ that do nissen fundoplications for hiatal hernia and I found one that does robotic
surgeries, did you ever hear of that?

I've heard of them, but because my mom was a surgical nurse for 40 years. She's always has positive things to say about stuff like that. I actually don't know what they did on me, but it had be something close. I had five laparoscopic incisions that were each only about an inch long. I know they do it using a camera. Smaller incisions instead of one big incision makes it so you don't have to stay in the hospital as long.

I don't know what size large hiatal hernia is is a 4 cm considered large? My friend told me to go to NYC but I don't know any doctors
there. What a problem, I really don't want surgery, but I can't live like this being so weak....I know this is a difficult
surgery and I don't want to suffer for the rest of my life after surgery

... and I was wondering if anyone has ever had this surgery before. If so, 360º or 270º? What was your physical recovery like? What was your diet after surgery like and for what duration? I know that I won't be able to eat normal food for a while, and I will lose some weight, but at least I won't have heartburn anymore!

(As background, I'm excited for this surgery! After years of GERD issues and taking medications like Nexium due to a failing sphincter and hiatal hernia, Mayo figured out that I don't properly-metabolize proton pump inhibitors (in addition to a bunch of other medications), and this was why I was so comprehensively sick for years. After stopping these meds, I lost a ton weight, and revisited my GI doctor. He said that since I can't take PPIs and had lost so much weight, I was now an excellent candidate for the surgery.)

Mayo did call it "large" in all of my imaging from the past year.

The only medical center I know about in NYC is Mount Sinai, and it's pretty large and well-known.

If it's any help, I've also had my gallbladder removed (age 40) and had my appendix removed in 1991 with a four-inch incision (age 19), and this fundoplication surgery was *much* easier on me than those two were.

The biggest plus is that the surgery allowed me to stop taking all of those proton pump inhibitor drugs. These drugs were NOT intended to be used long-term -- I think no more than 14 days or so. And here's a very important fact to know... even if you don't have genetic polymorphisms like I do, drugs like Nexium (esomeprazole) inhibit the liver enzyme that your body uses to metabolize all medications that are also metabolized via that enzyme. It basically slows down the your body's ability to get that drug out of your system. Nexium actually inhibits the enzyme that it itself needs to be metabolized. And if you are on any other medications that are also metabolized by that enzyme, it slows down the metabolization of those meds, too.

Unfortunately, the overwhelming majority of doctors out there have such a rudimentary understanding of this system (called cytochrome P450), that they have no clue about the ramifications of long-term use of certain drugs like this. Frankly, I'm *stunned* by how little doctors know about this system of the body and how each drug they add or remove from a patient's regimen can morph how the patient's entire drug metabolization methodology.

I've been using PPI's for years and years, that's probably why my gastroenterologist told me to get a bone density test and it was
discovered I have osteoporosis. May I ask what is polymorphisms? I'm taking an iron pill for this weakness, B12, my Vit. D for the osteoporosis and calcium. I'm not feeling any better though, that's why I'm so scared that he will tell me I'm losing blood. The dr. doesn't even know how I'm feeling right now, all this weakness. I agree I am very surprised doctors don't realize how pills have bad side effects for some people.

I just saw your question regarding polymorphisms.

Mayo figured out that I have multiple cytochrome P450 liver enzyme drug metabolization polymorphisms. P450 is a huge system in our bodies that does different things. Part of it is in the liver and consists of a bunch of enzymes that help us metabolize medications, hormones, and toxins. Mayo figured out that a bunch of my enzymes are polymorphic, meaning they are mutated, causing me to improperly-metabolize many medications, which I had been taking for years. One of these medications was Nexium and its generic equivalents. The thing is, even if you don't have polymorphisms like I do, you can still be negatively affected because many drugs inhibit these enzymes from working properly. Nexium even inhibits the very enzyme that it itself needs to be metabolized, so if you take it for a super-long time, which for me was 12+ years, it can make you sick, like it did me.

I've written to you once before on this Nissen Fundoplications and I just read of so many people swearing about the Mayo Clinic. I have
not even returned to my gastroenterologist because I know he will send me to a general surgeon, I think I'm just plain scared of surgery.
How did your surgery go? Were you in a lot of pain? and how long did you stay in the hospital. I don't know how much longer I can go
on like this, feeling so sick all the time, feeling weak, dizzy, nauseous. I do take nausea pills twice a day.

Can you suggest a thoracic surgeon from Mayo Clinic that does Nissen Fundoplication. Its time I start doing something about this
hiatal hernia. But I don't know of any doctors that do this surgery near my home. Any help from you would be so greatly
appreciated.