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Nissen Fundoplication
I am a Mayo Clinic patient (past or current).
Your interests: LAPAROSCOPIC NISSEN FUNDOPLICATION Your experience as a Mayo Clinic patient (if applicable): Today is one week since surgery at the Jacksonville Clinic. It was a positive experience, in that the care was excellent. Now home in Boca Raton, I am 7 hours by car from my doctors. Although I have a local doctor at home, I feel the need to connect with others who have had this surgery. Anything else about yourself: The main symptom I suffered with was chronic cough. I also have been diagnosed with Asthma. Last summer I became a patient at National Jewish Health in Denver, CO, a hospital that specializes in Respiratory disease. I was diagnosed with Bronchiectosis, probably caused by GERD. I had been on the GERD diet, proton pump inhibitors, inhalers, antibiotics, cough meds, the works. Turning over every leaf possible, I was led to the Mayo Clinic. Somewhat cynical about the outcome, I chose to have the surgery. This week has been difficult. I experienced low grade fever, and belching every few seconds for hours on the fifth day out. This has finally stopped and I am now on soft foods, really I'm clinging to blended still. I would like to hear from others that have had this surgery.
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Thank you for the all valuable information. I've heard horror stories if they wrap too tightly its impossible to vomit. Have you ever heard that?
Is an esophagram where they give you a drink and then they x-ray you as you swallow it? My gastro never mentioned any problems with the esophagus.
I guess its this very large hiatal hernia. Oh it must have been terrible not to be able to take pain meds for the shoulder. Did you have any pain in the stomach
area or diaphgram area? Did you have a problem swallowing after you woke up from surgery? Please excuse all my questions. I'm so petrified
to have this done. May I ask you a personal question? Would you be able to give me the name of the surgeon that performed this surgery
Again thank you for the information.
Regards,
Caress
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2 ReactionsI've heard about the wrap being too tight from one person, I think here on Connect, but I'm glad I had the surgery.
For the esophagram...
1. The radiologist stands in a small area nearby looking at a screen. There is also at least one other person with you while you are having the test. They are wearing something to protect them from the radiation.
2. They have you step up onto a platform, put your back up against it, and then drink a small amount of alka-seltzer. They watch it go down your esophagus, and they tell you to try not to burp. They then give you some barium with a straw, have you drink it, and watch it go down.
3. They then lower the table so you are laying down with your back on it. They have you drink more while laying down and watch how your esophagus works. (They hold the cup and straw for you.)
4. While you are laying down, they then have you flip over to lay on your stomach, and they have you drink more while they watch it.
5. Then, they have you turn onto your back and onto your front again. Maybe drinking some more barium.
6. After they are finished, they'll put the table upright again, and you are done.
The barium wasn't that bad and seemed thinner in consistency than I remember from years ago.
Afterward, Mayo gave me a bottle of water to drink to help get the barium out of my system. At home they didn't, but I knew to drink a lot that day from learning so at Mayo.
What size is your hiatal hernia? Mine was three-to-four centimeters. In imaging reports, radiologists act home called it small, but every Mayo radiologist called it large. (I thought that was interesting.)
The incision pains weren't bad at all and never have been. I do get small pains in my abdomen now. My PCP think it's my diaphragm. As soon as they started in early November, I emailed Mayo and they called me within 15 minutes to discuss. (
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.
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2 ReactionsCan 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.
My surgery went very well, and I'm so glad that I had it done! I don't have to sleep sitting up anymore. I don't have to avoid certain foods anymore. I NEVER have heartburn/GERD.
Here's how it went:
• My husband and I flew into Rochester on a Sunday.
• The next day, I had a pre-op appointment with my surgeon and a PA, and I did my pre-surgery labs. (They also had me do one imaging test to check the functionality of my esophagus because some of my tests the August before indicated that it didn't always function properly, but they found that it does.)
• The surgery was on a Tuesday, and I was discharged Wednesday afternoon.
Mayo will allow you to fly home the same day you were discharged if you want to. I chose to stay until Saturday.
They will give you food guidelines because you can't just eat normally right away.
The follow-up imaging is done at your home location, and you then mail Mayo a CD of the imaging. After they review it, they will call you for the follow-up appointment.
Weirdest thing is that most of the pain was in my shoulders afterward despite that I had five abdominal incisions. Apparently, this is normal because while performing the surgery, they fill your tummy up with gas (CO2, I think). They only way for the gas to dissipate from you body is for it to rise up to your shoulders. They will give you pain meds for this. (I can't take pain meds, so they put some kind of warming device on my shoulders, and when I was back at the hotel recovering, I used ThermaCare.)
I would not go to a general surgeon for this. Here's why... they needed to detach my diaphragm, esophagus, and stomach and move them about two inches lower. They then tack everything down, and then they perform the wrap of the stomach around the base of the esophagus. (If the esophagus is performing correctly, which they figure out via an imaging test called an esophagram prior to the surgery, they will do a 360º wrap of part of the stomach around the base of the esophagus. If the esophagus doesn't, then they perform a 270º wrap of the stomach.
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1 ReactionI believe what you want is a thoracic surgeon.
Have you been to Mayo before? They will likely want you to meet with a GI doctor first, and they will then order testing and maybe some labs. You usually don't get to choose which doctor you get, but that's okay because they are all great.
I see Dr. Jeffrey Alexander in GI. He then finds a thoracic surgeon. My thoracic surgeon is Dr. Francis Nichols.
I first met Dr. Alexander in January 2016.
I had a follow-up with him in August, and at that time he said that I was now a candidate for the surgery because I had lost some weight, was healthier, and they had also learned that I cannot take PPIs due to genetic issues. He asked if I could stay a week longer to do the testing and have a subsequent follow-up with him and the surgeon because I lucked out and another patient had just cancelled all of these same appointments I needed.
At the follow-up, I met with him again, and then he pulled a thoracic surgery PA and Dr. Nichols into the room. We talked everything over, and Dr. Nichols then pulled his schedule/calendar up on the computer screen and we picked a surgery date.
how do you feeling now? ı have dumping syndrome:(after nissen surgery