Nissen Fundoplication

Posted by Lindabeth421 @lindabeth421, Jul 5, 2011

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.

Liked by mike1942, Anonymous

@kdubois

… 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.)

Jump to this post

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

REPLY
@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

No, I have never been to the Mayo Clinic
I hope what you say is true, that they are all great
Don’t need any mistakes or problems at my age, I’m 75yrs. old
This hiatal hernia never ever bothered me only having the heartburn
Its only been bothering me on and off for the last year. I get very weak
and no energy, I think I’m losing blood, so my gastroenterologist wants
me to have a colonoscopy which I haven’t done either.
Not crazy about the prepping for it.

Do the doctors mention to lose weight, before surgery? I’ve been trying for years without success.
How are you feeling now? Are you happy you went thru with it?

Let me know, thanks so much for the information
Regards,

Caress

——————————————–
On Wed, 2/15/17, Mayo Clinic Connect wrote:

Subject: @kdubois replied to I’m scheduled for Nissen Fundoplication surgery @ Mayo next Tuesday…
To: barpet63@yahoo.com
Date: Wednesday, February 15, 2017, 12:49 PM

.
Mayo
Clinic
ConnectReply
by @kdubois
in Digestive
Health on Wed, Feb 15

Reply
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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REPLY
@caress

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

Jump to this post

I’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. (

REPLY
@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’ve had excellent doctors in all of the specialties I’ve seen there… GI/Hepatology, Endocrine, Sleep, Nephrology, Pulmonary, Neurology, and NeuroPsychology. (Hmmm… I think that’s all of them.) Doctors at Mayo don’t strictly stick to 20 minutes and then kick you out the door like they do elsewhere in the country. They spend as long as you need with them. I’ve even had Mayo doctors chat with me and walk me to the elevator, and I’ve had Mayo doctors hug me after giving me good news. These are truly nice people.

As part of the pre-surgery testing, they will most likely have you do a manometry and then an esophagram if they want to further-test your esophagus after the manometry. You will need to go off of any PPI and H2 Antagonist medications, and then they will most likely want you to have an endoscopy (I think). They are checking to see what level of esophageal burn you will have from the hernia and not taking the medications. I’ve had them all performed there, and I’ve also had a colonoscopy there. Instead of prescription stuff for the prep, there is a prep that I do that uses Dulcolax and Miralax. You can google it and then ask your doctor before the colonoscopy if they feel this is a viable alternative. It’s much more tolerable when it comes to having to taste it.

Many surgeons won’t perform many types of surgeries if people are heavy because the weight can negatively-affect the outcome. In January 2016, I weighed in at Mayo at 198 pounds. After they figured out that I don’t properly-metabolize certain medications later in the year, I was weaned off of them, and I lost ~50 pounds by the time I went back to Mayo in August.

I cannot even tell you how glad I am that I had this surgery. I wish I had done it years sooner!

REPLY
@kdubois

… 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.)

Jump to this post

Yes I had that test, it wasn’t too bad. I have no idea the size of the hernia, my gastroenterologist never told me
and I never thought to ask. Did they tell y ou why you’re getting small pains in your abdomen and what is it from, will they
go away.

REPLY
@kdubois

… 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.)

Jump to this post

Well I have a lot of thinking to do, my weight is a little more than yours was, over 200, what I should do is make an appointment
to visit these doctors and then they can tell me how much weight I have to lose before they can operate. Another thing does your
medical insurance pay for most of the care before and after surgery. Again you’ve been such a big help to me and I truly appreciate
all the detailed information you gave me.

REPLY
@caress

Yes I had that test, it wasn’t too bad. I have no idea the size of the hernia, my gastroenterologist never told me
and I never thought to ask. Did they tell y ou why you’re getting small pains in your abdomen and what is it from, will they
go away.

Jump to this post

They don’t know why I have the pains. With that said, it’s definitely getting better with time. It doesn’t worry me at all, and it doesn’t prevent me from normal activities.

You never know regarding the weight… you and I are different heights and have different circumstance, so they may be willing to perform surgery. Never know until you ask.

Interestingly, I literally just spoke with Medicare today regarding insurance, and I also obtained some Medicare/Mayo payment info from Facebook last week when I saw that someone else asked about Medicare and Mayo answered them.

I have two insurances. I have Medicare Part A as my primary for in-patient hospitalization, and my secondary insurance is via my husband’s employment. Mayo is billing my in-patient, hospital stuff from October to Medicare Part A first. Anything not covered will then be billed to my secondary insurance, which Mayo has always accepted despite that I live in Western New York. The Medicare Part A deductible for 2016, when I had the surgery, was $1,288, so I will owe that amount to Mayo. (The Medicare Part A deductible for 2017 is $1,316.)

Based on your age, I assume that you have Medicare Part A, which would be used toward the surgery & hospitalization; Mayo would submit your claims and Medicare will reimburse them directly. With that said, you should be aware that Mayo is a non-participating provider under Medicare Part B, which is used to cover out-patient visits, etc. This means that Mayo sees Medicare Part B patients, but they do not always accept assignment for payment. When this happens, per Medicare, Mayo submits the claims for Part B claims to Medicare, then Medicare pays you, and you would be responsible for reimbursing Mayo.

Some info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare

REPLY
@caress

Well I have a lot of thinking to do, my weight is a little more than yours was, over 200, what I should do is make an appointment
to visit these doctors and then they can tell me how much weight I have to lose before they can operate. Another thing does your
medical insurance pay for most of the care before and after surgery. Again you’ve been such a big help to me and I truly appreciate
all the detailed information you gave me.

Jump to this post

See above for some answers to these questions. And you are very welcome!

REPLY
@kdubois

… 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.)

Jump to this post

I have a feeling they would tell me to lose some weight, I’m only 5’1 and over 200lbs. So to protect me
I know they would rather me lose the weight. Again thank you so much for all the valuable information.

REPLY
@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

Good Morning kdubois: I’m re-reading your post about Nexium, I have a feeling I kinda have that sort of problem with Prevacid. A lot of times when I take Prevacid, hrs. later I may feel a little heartburn, I don’t know if that’s from what I eat, or the problem you were talking about enzymes being polymorpbhic, I’m just guessing, don’t really know. Did you ever think to go to the Florida Mayo Clinic? I was thinking about it because its closer. Let me know, again thanks for all the detailed information which I needed to make a decision about this hiatal hernia. Were you ever a nurse?

REPLY
@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 considered going to the Florida offices, but I ended up going to Minnesota due to logistics. After seeing the success I’ve had at Mayo, a friend of mine took her daughter to the Florida location and has had much success there.

Regarding the Prevacid, which is an H2 Antagonist, from my experience, I don’t feel they are as strong as proton pump inhibitors (like Nexium), so that could be why you feel the acid reflux sooner with Prevacid than with Nexium. It could also be whatever food you had eaten at the time.

They only way to determine if you have cytochrome P450 enzyme drug metabolism polymorphisms is to have genetic testing performed like I did. Currently, it is very expensive and insurers usually don’t cover the costs, BUT last week I learned from Mayo’s Center for Individualized Medicine that sometime mid-year 2017, they are planning to make a larger set of pharmacogenomics tests more-available and at a very reasonable price. (The tests will use saliva instead of blood.) They will be orderable via your Mayo Clinic primary doctor if you have one, or your home PCP will be able to order the tests via Mayo’s pharmacogenomics partner, OneOme. They’ll mail the test kit, you create the sample, and you then send it back to them for processing.

I’ve never worked in the medical field directly. I’m currently not working, but my trade was technical writing, meaning that I wrote specifications for software, user’s guides for software and hardware, and technical documents. I have written for several medical devices. My PCP calls me his “professional patient.” (My mother was a vascular surgery nurse for 40 years though.)

REPLY
@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’m learning more from you than I have ever learned from a doctor. I just went to look at the “Prevacid” I take, its not the Prevacid
you buy over the counter. Its called Lansoprazole manufactured by Breckenridge. I called it Prevacid only because it was easier to remember. But I take this as directed sometimes most times i’ll get a little heartburn an hour later. So I don’t know what the heck to take anymore. You should consider working with your doctor as his physician assistant.

REPLY
@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 looked it up, and Prevacid and lansoprazole are the same drug. (Drugs have two names. In this case, Prevacid is it’s “brand” name.)

And it is a proton pump inhibitor. My doctors had always told me to take my PPI capsule every morning to obtain the best relief from GERD during the day. If you are still getting heartburn, and you are taking it as prescribed, I suggest talking to your doctor.

If you Google lansoprazole, the resulting page will show a turquoise-colored box on the right side of the page, and you can read more about it. This info is derived from valid, reliable sources, including Mayo Clinic.

After my medical experiences for the past decade-plus, I’m considering getting an Advanced Certificate in Analytic Epidemiology, which will help me perform better research. I want to write a book about what happened to me… due to my symptoms of P450 drug metabolisms issues, which doctors around the country are widely-unaware of, I was misdiagnosed with a rare endocrine condition, had brain surgery that I later learned I never needed (which resulted in a brain injury), etc. My home doctors were prescribing me tons of medication of that I don’t properly-metabolize, making me sicker and sicker as time went on. Doctors know about the P450 system, but they are pretty much unaware off the issues that can be caused by inhibitive/inductive drugs on Cytochrome P450 system, which can happen even if you don’t have polymorphisms. And the more meds you take, the more likely you are to be subject to adverse drug-drug interactions. (I’ll also need a pharmacist to co-author it with me.) If I hadn’t taken myself to Mayo Clinic in September 2015, had them work on me for following 1.25 years, and had these pharmacogenomics tests done, I’m certain that I would have passed away by the end of 2016 due to these drugs and the “healthcare” I was receiving at home.

REPLY
@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 always took the Prevacid 1/2 before dinner cause I didn’t want any problems at nite and wanting a good nite’s
sleep. So like I said before I don’t know if this Prevacid isn’t strong enough, or its actually my body having bad interactions
with it, or depending what I eat that nite. I have an appt. tomorrow with my primary care and i’ll ask him what to take, knowing
him he’ll probably give me Nexium haha. Oh no, you had brain surgery that you didn’t need and now you have brain surgery
oh my oh my, how awful, I hope you sued them. Thank God you found the Mayo Clinic. God Bless You, you sound like you;’re
doing amazingly well. Thank the Good Lord!

REPLY
@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 hope your appointment turns out well today and that you find relief soon.

I cannot sue my doctors. I learned about the misdiagnoses and brain injury six years after they occurred, and in the state I live in, the statute of limitations for medical malpractice is only two-and-a-half years. My primary care doctor and pharmacist have been prompting me to write them a lengthy letter to help them “learn” what they did, which I plan on doing soon.

I’m doing much better, which I entirely attribute to Mayo clinic. With that said, I still don’t feel “normal” and I know it will take time. I’m still detoxing from these medications, but I started acupuncture in January, and it is helping with the chronic body pain and inflammation. (I can’t take pretty much all heavy-duty pain meds because I don’t properly-metabolize them, and basic meds like Tylenol and Advil don’t really help, and I don’t want to take anything long-term.)

If my symptoms haven’t progressed by mid-year, I already talked to my PCP and he supports me in sending me back to Mayo’s Center for Individualized Medicine to see if they can help me.

REPLY
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