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Acid Reflux / GERD Message Board

Acid Reflux / GERD Board Index

About me: Female, age 53, height 54, weight 153
Health issues: Constant GERD and regurgitation using Dexilant and Nexium each one time per day, large hiatal hernia, chronic cough and asthma-like symptoms - wheezing and shortness of breath, high blood pressure controlled with meds, high cholesterol controlled with meds, physically active - 1-2 hour workouts 3-4 times/week

I just had a Nissen Fundoplication and hiatal hernia repair 6 days ago. I have only good news to report. I had been nervous about having the surgery and procrastinated for a couple of years. In fact, I was so nervous about this surgery that I cried as I was being wheeled into the operating room. My fears were about whether permanently altering my innards would bring relief or be a new source of even more difficult problems like an inability to swallow or burp, perpetually choking on food, and/or never being able to enjoy eating again.

Day of surgery (Friday) Surgery 9-11am, Recovery 11am-12:30pm - The worst pain I have experienced from the surgery was in my neck and upper back. I was able to control the pain through the IV pain pump meds (Fentanyl). For the first 24 hours, I was on no fluids of any kind - not even ice chips. I was given a tiny sponge on a stick and was told I could wet it with water and swab out my mouth, but later I found out that the nurse who gave that to me was not following strict protocol and I should stop using it.

Day 1 (Saturday) The surgeon ordered a swallow xray for that afternoon to see if there was any "leakage" in the esophagus, sphincter, or stomach. This is the first fluid I had swallowed since midnight before surgery. There was no leakage but the nasty tasting liquid made me nauseated, so I was given an anti-nausea med in my IV. I never gagged or vomited and the nausea only lasted for 30 min or so. Once the surgeon saw there was no leakage, I was put on liquid only diet and the transition to oral pain meds began.

As soon as I was allowed to swallow, I noticed that not only was I able to swallow, but that I was also able to burp. Each swallow and burp was somewhat painful due to swelling. Liquid intake obviously led to the need to urinate, but because the general anesthesia had a residual effect, my bladder was asleep, and I had to have a foley catheter that was left in place until today.

I took the oral liquid oxycodone with milk to prevent stomach irritation or, by the next day, with applesauce. I found out that once I transitioned to oral meds, they were on a by-request-only basis (Dosing would not be up to the nurse to initiate and I would have to keep track of when my last dose was in order to prevent a "pain cycle".) and the oral meds were not as effective at relieving pain as the IV med. I woke up during the night having gone too long between doses feeling a lot of high abdominal pain and had to request a dose of pain meds. It took about 30 min for the pain to subside.

Day 2 (Sunday) I was swallowing and burping well, drinking fluids (water, juice, chicken broth), swallowing applesauce, managing pain, off of oxygen, getting out of bed and walking well, so I was released from the hospital at noon with a written prescription for liquid oxycodone. My husband drove through the pharmacy at Walgreen's but the only location with that med was about a 20 min drive away. My husband took me home, got me set up in bed and then went to the other Walgreen's for the prescription. The most difficult transition from hospital to home was getting the angle just right in bed. It has worked well to have a variety of pillows that I can move around to go higher or lower, and sometimes it has felt good to nap while sitting up in a straight backed chair with a pillow behind my back.

Day 3 (Monday) - Day 6 (Thursday-today) Most of the pain I've experienced during this time period is from gas. I found that from the moment I swallow, gas forms and puts pressure on my sore diaphragm. On Tuesday, I started taking Gas-X Prevention, one capsule in the morning and one in the evening and the gas is manageable. And every day is better than the day before. Less pain, less swelling, less gas. I've been able to shower, walk around, even fold some laundry. I saw the surgeon this morning to have the urinary catheter removed and he says everything looks good. He said to go slowly transitioning to "real" food (small bites, well-chewed) from my soft-food-only diet but he didn't give a set time frame for when to add in "real" food. He also said that the gas is forming because of the oxycodone's affect on the large intestine and that I can start taking Tylenol or ibuprofen during the day. He said that once I am off the oxycodone and eating in a regular pattern, I should return to a "normal" state of minor, non-painful gas production.

In just 6 days, I have these benefits: no heartburn whatsoever, no heartburn medications, more lung capacity and no choking since the hiatal hernia is gone, no coughing other than normal clearing of my lungs, swallowing and burping normally and without pain, decreased pain and swelling in the abdomen, full nights of restful sleep while lying relatively flat on my back.

I don't know how much weight I've lost, but I'm sure I've lost some due to low caloric intake over the past 6 days. What I expect is that I will be able to eat normally at some point in the future, but I hope that normal will include not over stretching my stomach with large quantities, and that by eating smaller quantities I will experience natural weight control. I think an aspect of having a large hiatal hernia is that I didn't get a natural sensation of fullness at the right time during a meal and I would end up over-eating. The only way I could somewhat control regurgitation was through a strict, legalistic approach to timing each bit of intake and precisely regulating the size of meals. My hope is that I can live more freely and live well enjoying good foods but have the sensation of feeling full on less intake.

Blessings to you as you approach your surgery date. I hope you are encouraged by my experience.

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