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Acid Reflux / GERD Message Board

Acid Reflux / GERD Board Index

I really appreciate the feedback from everyone who replied. Mountainreader Ė thatís interesting what you write about not being able to close the sphincter completely and itís something Iíve been thinking about a lot since there have been a couple of incidents that feel like minor reflux and I was wondering if this could be a sign of things to comeÖfor the very logic you used. I hope not.

Sunshine Ė Iím not sure if I should give my doctors name out or not. I really like him, and I hope that comes across in my posts but Iím still trying to figure out if this worked or not. I did my research and he came highly recommended but Iím not sure if I should post names to the forum yet. Iíd like to know where I stand in the recovery before I start passing out business cards. No matter how much I like my doc . Iíd rather people pick their surgeon based on their own research rather than, potentially, my thumbs up or down. Does that sound weird? Let me think about it.

My apologies for the delay in posting but itís been a hectic and stress filled time since my last post. First a status update. Iím back to work and glad to be. Itís harder than I thought it would be but Iím coping. Mainly my energy is really low. By mid day Iím winding down.

Iím not on solid food yet. Iíve been using a food processor to turn most of my meals into soup, thick soup, but soup. Things move slowly through the repaired sphincter at the top of my stomach. Itís a tight wrap for sure. Basically once a week I have a scrambled egg and waitÖif I start getting chest pain or stomach pain or if it feels stuck, i.e. things back up around it, I donít eat anything like it for another week. One week later, the scrambled egg test again. So far my body is telling me that itís not ready for this level of solid food. Iíve been mixing power protein drinks in an effort to keep my fast weight loss from damaging muscle tissue like my heart. 70 grams of protein a day, minimum, but this has the side effect of filling me up so my calorie intake on an average day is just over a thousand calories. Not a lot for a guy my size. Iím working on ways to get this number up but I fill up so fast and Iíd like to be able to get more healthy calories into my body rather than just ďhigh proteinĒ processed items. Vegetables would be nice. Iíve been cooking broccoli and cauliflower really soft and mashing them in my mouth. Not a lot of calories and I canít each large amount s but if makes me feel better to eat some vegetables. Iíve lost almost 30lbs since the surgery. Too much. Too fast in my opinion.

My headaches have gotten better, not completely, but enough to let me sleep through the night. You never realize how amazing sleep is until you canít do it. I went more than two weeks without normal sleep. The headaches so bad that I would pass out from exhaustion only to wake up in pain an hour or so later. It was awful. The spinal MRI came back clear but the doctor said that they usually do and that he did not expect to see anything. Basically you canít isolate a single nerve on an MRI. He suggested a brain MRI but admitted he was fishing. When my headaches passed enough to allow me to sleep three hours, then five hours, then all through the night I figured I was on the mend. My intake of anti-inflammatory pills was down quite a bit and I was sleeping. I canceled the MRI fishing expedition. The next week I went back to work and noticed that the headaches were increasing during the day. Iím still able to sleep through the night but in retrospect I believe that whatís happening is Iím turning on my side which relieves back pressure and takes the stress off the area that is causing the headaches. At work I sit and am putting pressure on my back soÖheadaches (just my crazy theory) anyway the MRI is back on. Iíll let you know what, if anything they find. Iím guessing that it will be nothing. Give us $200 and pass go.

My thyroid biopsy came back clear just non cancerous nodules on my thyroid. YEAH!!! No thyroid cancer! But I now have to come back twice a year to have the thyroid checked with an ultrasound to see how big the ďnon cancerous nodulesĒ are getting and to make sure that they donít become cancerous. Iím not quite clear but apparently they take growths on your thyroid quite seriously and must follow them regularly. So, no cancer YEAH!!! Tests twice a year for cancerous growths BOOO! I donít mean to be ungrateful and Iím THRILLED NOT to have thyroid cancer but me being me, Iím going to worry about this testing every six months.

FinallyÖstatus update almost done so please bear with meÖ my doctor found a lump over my left breast ( I canít believe that I just used that word in relation to me!) Since Iíve lost so much weight my ďman boobsĒ really just soft pectorals, have been shrinking. My body burns fat and etc, etc, etc. During an office visit to follow up on the thyroid tests he had ordered I told him about some discomfort I had continued to have on my left chest. Let me back up. One of the strange things about my acid reflux was that I hurt in atypical places when I would have a reflux attack. My chest would hurt, my back would hurt and my stomach would hurt. This was considered normal with really bad reflux. In addition I would get pain that would stretch across the top of my left pectoral and sometimes under the arm. ALL my doctors told me that everyone was wired differently and that it was referred pain because of the reflux. ďYouíre just wired strange and when the acid washes up you also feel it hereĒ

My MD said so.
My cardiologist said so.
My bariatric surgeon said so.
Various emergency room technicians said so (I told you all in my first post that early on I spent a lot of time in emergency rooms)

I thought nothing of it. So, almost two months after surgery to fix my reflux, Iím still having the periodic pain stretching across the top of my left pectoral (man boob) so I do what anyone would do. I tell my doctor. He examines me and finds an oval shaped lump in my breast (it still feels awkward using that term about myself). Ok. Now I get to go have a Mammogram and then an Ultrasound for that. He asked me if I ever noticed it before and I told him,Ē no.Ē ď But I had a lot more padding there before also and frankly Iím just not in the habit of doing breast examsĒ (on myself anyway. Sorry thatís an uncalled for observation but I do have a typical male fascination with breasts. JustÖnot...mine ). I go in for my tests on the 27 and 28th of December. Iím just getting numb with the news of finding additional things.

Letís seeÖanything else? Oh, I grew a really thick beard and kept it. I work at a large company and a lot of my co-workers had no clue I was out on medical leave so itís been funny to see their reactions to my weight loss and the beard. It never fails to give me a chuckle as some co-worker or executive I know passes me and does a double take.

ďDid you lose weight?Ē ďWhen did you grow the beard?Ē or my favorite they donít recognize me at all. Iíve ridden in an elevator with people Iíve worked with for more than 16 years who did not recognize me until I spoke. Now these are casual work acquaintances but its amusing none the less.

Ok. The thing you most likely are here for. Surgery. The post game wrap up.
For those of you considering having this surgery you have to make your own decision. There are lots of people with varying opinions on this forum and others but speaking for meÖ Iím glad I did it. I have not had a reflux attack in almost two months. Iím very sorry I waited as long as I did. I should have had this done five years ago at least.

If you are going to do this then get a surgeon who has done this a lot, hundreds and hundreds of times, with a high success ratio. If thereís not someone in your area then book a trip on Southwest and find a surgeon who has the experience and the success rate.

Second, if you are going to be dealing with some type of paid medical leave which involves insurance companies (here to forth referred to as clowns) then prepare to have your benefits cut off midway through your recovery. After the Clowns revoked my short term benefits halfway through my recovery and in complete disregard for my surgeonís instructions, I was caught un-prepared. I found myself with a substantial portion of my incomeÖgone. Fortunately I have a savings I was able to live off of but for those of you less fortunate PREPARE FOR THIS! You will be declined. You will be canceled. You will be forced to appeal. Know this in advance! Have a draft letter ready to go with your doctor. Make the clowns provide you specific reasons why they are cutting off your benefits. If they are not clear then you canít overcome the objections. Have some money put away just in case! The clowns suck. They are polite. They are calm. They are human beings on the phone but they are clowns and the tools of more powerful clowns! Know it. Believe it. And, be prepared for it so you donít lose your cool (like I did). You can defeat them at their own game because you have the facts on your side.

Go on an inspection visit of the hospital or surgery center you are going to have the procedure at. Do your research. Ask questions. How new is the hospital? What type of trauma care do they have? When was the last time the ORís were upgraded? Donít show up and be disappointed by any number of things you could have found out up front. Itís one less thing to worry about.

Get some help for post recovery. That first week is critical. My sister came into town to help me and thank god for her being here. She was fantastic and I appreciate her more every day.
Stock up on the food stuffs you will need because the lifting restrictions are a serious pain. I found that a cane for getting up and down helped a lot. Some people have even said a walker but thatís kind of extreme for me.

To Be Continued
I checked into the surgery center at 5:00am and by 5:30 I was in my tear away surgical gown being wheeling into surgery. It was cold in there. Freezing. They put three heated blankets on me to stop the shivering. I said hello to everyone. I talked to the anesthesiologist and told him ďagainĒ about my reactions to anesthesia in the past. I talked to the nurses and reminded them of my latex allergy and lastly I asked I told them how much confidence I had in my doctor and them but

ďPlease donít screw up and take out a kidney by mistake.Ē
They all chuckled then I felt strange I asked,
ďDid you administer the anesthesia?Ē ďI thought I had to count backÖĒ
At that point I was out cold.

I woke up in recovery with some chest pain and a bag of ice on my abdomen. The nurse gave me ice chips as I became more aware. Other than the slight chest pain I felt pretty good. I was guessing some left over reflux pain. After an hour the surgeon came out of another procedure he was doing and stopped by. According to him it all went well but it was complicated by several things

1. There was a lot of scar tissue in the way that he needed to clear out.
2. The hiatal hernia was much bigger than the scans showed.
3. My stomach was WAY out of position so they had to secure it in place with mesh and titanium screws.
4. The esophageal sphincter was pretty much wide open.

It went well but it was complex. I remember thinking at the time about a video I watched of a Lap Nissen Fundoplication being done. I donít know how these surgeons can tell what is what inside because from point of view it was just a bunch of raw meat. Weíre basically meat sacks. Hats off to surgeons everywhere and warning to those of you needing to go under the knife. Get a surgeon with lots of experience! Donít be embarrassed to ask other doctors. Research your surgeon.

By 2:30 I was ready to go home to my own bed. They required you to be able to get up and move around on your own and some other basic things then they let me go home. Three dayís after my surgery my doctor told me that he considered putting me in the hospital but ultimately decided I was good to go home. I canít tell you how much better being in my own bed in my own home made a difference. Iím a tall guy and hospital beds are not designed for me. I was happy to be going home. Getting up the stairs to my 3rd floor apartment was tough and slow going but I did it on my own. I was home and in my bed!

That first day I really felt good. I was up that night and drinking chicken broth. No terrible nausea and the pain killers were awesome! Donít be fooled people. They pump a lot of drugs into you for the surgery and itís easy to be tricked by the lack of pain into believing you are ok. By Day 2 the drugs are passing out of your system and the pain is coming in. I had liquid hydrocodone and it got me through day 2 and 3. You should rest. You should sleep and sleep and sleep. You should stay hydrated. Itís hard but you have to other wise youíll end up in the emergency room with a bag attached to your arm. You need to eat your broth and try and keep you calories up even if you donít have an appetite. You should also keep an eye on your surgical incisions to make sure they donít appear to be infected (usually oozing yellow is an indication of infection but there are others).
Let me recommend ďBoostĒ high protein drinks. Vanilla flavored. You canít have chocolate and strawberry boost is disgusting tasting. Vanilla is a good base flavor. In order to keep my protein up I bought a Cuisinart drink mixer a and mixed the following,

One 8oz bottle of boost vanilla high protein
2 Scoops of Trader Darwinís Soy Protein Powder
A dash of Mexican vanilla for more flavor
A little Cool Whip extra creamy for texture and flavor
A little trader Darwinís apple pear cider for flavor or cherry juice sometimes. Both were good.

Blend for at least a minute because that soy protein is grainy. Egg protein was better mixing and high in protein but very expensive and very eggy flavored. I found that I could deal with the Soy Protein taste better because it did not overpower the other flavors the way egg protein did.

You wonít move you bowels for a few days but my surgeon said that was normal. Ohhhhh! Hereís good tip! Donít eat a lot of binding foods the day before surgery. Try to have a nice bowel movement before you go in for surgery. I pigged out the week before surgery on all the things I was not going to be able eat after. This was a big mistake. It was satisfying but ultimately I went into surgery feeling like I had to go the bathroom but was unable to do so. It also makes the four days after surgery without a bowel movement very, very uncomfortable.

So on that scatological tip Iím going to end this entry. Just over four pages is enough of my ranting I think. Iíll leave you with this. The surgery was not anywhere near as bad as I feared. Most of my complications seem to be unrelated to my surgery although not all of them. I wonít know for another month or so if the reflux is truly gone because my surgeon says it take s a minimum of 90 days for the swelling to go down. The swelling could be the reason I donít have reflux right now. I wonít know until I know. You know?
The success rate for this procedure is high. 95% success rate. These are very good odds but there are other odds you should know about. 10% of the people who have this procedure have some type of Vegas Nerve damage. Thatís still very good odds but you need to know this and understand what the risks are.

In the end, if you are like me, you have no choice. You have to roll the dice. You have to have the surgery because you risk other more horrifying consequences like extreme pain and esophageal cancer. You have to do the research. Find a great doctor you are comfortable with. You need to have a plan in place.

Donít get freaked out by these and other forums. People come here seeking information and to talk about their problems with reflux and surgery not necessarily to talk about how wonderful it went. The majority of posts are filled with legitimately negative reports by people seeking help with real problems. Donít let it overwhelm you. Use these posts as a tool and understand that, based on the statistics, there are far more people with success stories that youíll never read about then failures you will read about. Talking with your surgeon to better understand the risks and the odds for success of these procedures is critical.

Good luck to all of you in whatever choice you undertake.

Next time Iíll make it shorter with an update.

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