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Kelly, Alumna Mentor
@kdubois

Posts: 290
Joined: Mar 24, 2016

I'm scheduled for Nissen Fundoplication surgery @ Mayo next Tuesday...

Posted by @kdubois, Oct 13, 2016

… 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.)

Liked by barbara

REPLY

Hello @kdubois,
Thank you for sharing your history and concerns about the surgery. I would like you to meet @SherryD and @maxmaximus3; since they’ve both had Nissen Fundoplication surgery done, a few years ago, they might be able to help you with your questions.

I commend you for being an advocate for your health; here is a great article from Medline Plus which will also give you an in-depth look at the before and after care of the surgery:
http://bit.ly/2edWi1b

I wish you the very best, and would love it if you would let us know about your experience after the procedure.

Hello @kdubois: I read about your Nissen Fundoplation Surgery in October. How are you feeling? and how did the surgery go
Let me know. I too might be having the surgery. Carees

@caress

Hello @kdubois: I read about your Nissen Fundoplation Surgery in October. How are you feeling? and how did the surgery go
Let me know. I too might be having the surgery. Carees

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@caress

I’m so glad I had this surgery! Mayo did an awesome job… they answered my questions before I was even able to ask them every single time. They made sure to take extra special care with anesthesia and pain care because I don’t properly-metabolize so many medications.

One of the reasons we did this surgery is because I also don’t properly-metabolize proton pump inhibitors and H2 antagonist medications, so this surgery allowed me to stop taking these drugs for the first time in 12.75 years. Eventually, these drugs would have caused me to have liver damage/failure.

I haven’t had any GERD or heartburn at all! I can now sleep laying down like a normal person. I can eat dinner later at night now because I had to finish eating before 6 p.m. before. I don’t have to worry about drinking a glass of water when I’m working in the garden and then bending over and having it come right back up my esophagus again. Eventually, the GERD issue could have caused esophageal cancer.

The worst part of the surgery is actually the pain you get in your shoulders afterward. During the surgery, they fill up your belly with gas to help them see what they’re doing. (I think they use CO2.) The gas ends up rising to your shoulders and slowly dissipates from there. This hurt more than the five abdominal incisions did. Since I can’t take pain drugs, they got me a heating pad to put across my shoulders. That helped a lot.

The diet afterward isn’t as bad as what other hospitals post on the Internet. As long as you follow the instructions they give you, you’ll do fine.

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

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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?

@caress

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?

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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.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

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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

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

Jump to this post

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.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

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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.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

Jump to this post

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.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

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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.

@caress

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.

Jump to this post

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.

@caress

Thank you kdubois for your post, it has helped with a lot of questions I had. Unfortunately I won’t be able to travel to any Mayo Clinics
I’m so weak, I’m losing blood from this hernia and its hard for me to think about any travelling….I should hear from my gastroenterologist
today about my barium-xray test I had yesterday. Thank you again and all the best to you.

Jump to this post

I 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.

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