Hi folks,

​If you're reading this blog, you're very likely suffering from horrible GERD. I can relate! I was also suffering from awful GERD for many years. Here's a quick update on where I'm at 5.5 years after surgery:

​--Ninety-nine percent of the time, my stomach feels just as good as it did six months after my Nissen Fundoplication, which is just about perfect. I eat whatever I want, drink one coffee a day, and have occasional alcohol. My only limitation is that I can't drink soda--it makes my stomach burn. 

​--I have had two episodes that felt like heartburn (but were not proven to be reflux by imaging studies) during periods of intense stress in the last two years. Both times, the feeling of heartburn subsided after a few weeks. The last time this occurred, my doctor switched me from Aciphex to Dexilant, and that got rid of my symptoms. 

​--My stomach meds are now just Dexilant once a day and sometimes Axid once a day. I take these for the chronic dyspepsia that I've had since I was a teenager.

--The Nissen Fundoplication was the best things that I've ever done!

​Wishing you good health!
​Debra

Deciding whether to have a Nissen fundoplication was one of the most stressful decisions of my life. Despite having had several surgeries for other ailments, I found the decision to have an NF to be agonizing. Neither my surgeon nor my gastroenterologist would guarantee that my voice would return. They couldn’t
guarantee whether my asthma would improve. And they couldn’t tell me whether I
could wind up with painful trapped gas or some other horrible complication for
the rest of my life. Ultimately, my decision was one of desperation and a total leap of faith.

Here are a few suggestions to help make your decision a little easier:

You’re probably a good candidate for a Nissen Fundoplication if…

 --Both your surgeon and your gastroenterologist agree that you need to have the surgery.

 --Another doctor (such as an ear, nose, and throat physician) thinks you should have the surgery.

--You’ve tried every nonsurgical intervention (meds, bed raising, stress reduction,
elimination diet, etc.) and you’re still suffering.

 --Your reflux is damaging another part of your body (such as your esophagus or vocal cords).

 --You’ve developed a disability from the reflux (such as voice loss).

 --You can’t eat, or you can barely eat.

--You can only tolerate a very limited number of foods.

--You feel like your life revolves around your reflux symptoms.

 --Your life has become extremely restricted because of your reflux.
 
Do you have any other suggestions to help people make the decision to have an NF? Please share your thoughts.

I was lucky to have a surgeon who was both technically gifted and who had
outstanding communication skills. This is a rare combination, but I believe it
is crucial to find the BEST Nissen fundoplication surgeon and also one with whom
you can communicate.
 
Both my gastroenterologist and the one I consulted for a second opinion gave me the same advice: You must go to the BEST surgeon for your Nissen fundoplication. Not a really good surgeon, not a great surgeon, but the BEST. The surgeon’s skills
will determine the success of your surgery!

Ten Steps for Choosing the Right Surgeon

1. Ask your gastroenterologist for referrals. 

2. If you got a second opinion from another gastroenterologist, also ask him/her for
referrals.

3. Ask your primary care physician if he/she knows these surgeons, and if not, would he/she be willing to do some research for you?
 
4.  Research the surgeons on the web. Look at Yelp, HealthGrades, Vitals.com, and other physician-review websites. Does the physician average 4 or more stars out of 5? That can be a good sign (although not a guarantee) of a physician’s abilities. Be wary of a physician who averages fewer than 4 out of 5 stars. Also Google your physician’s name plus “sanctions,” “lawsuit,” and “malpractice” to see if he/she has been involved in any lawsuits.
 
5. Make a detailed list of questions to bring to your consultation with the surgeon. Write them down in order or importance. Make sure you ask about possible adverse events, your expected results, the number of NFs he/she has done, the number of complications his/her patients have experienced, and number of deaths. Be sure to ask the doctor how he/she will respond to you if you have a complication or pain that does not respond to medication during recovery. Take notes during the consultation.
 
6. Pay attention to how much time the surgeon spends with you and how seriously he/she takes your concerns.
 
7. If you interview two surgeons, and they give you different recommendations, go back to your gastroenterologist and discuss this with him/her.
 
8. If you get a bad vibe from a surgeon, follow your gut instinct and choose another
surgeon.
 
9. If you feel that the surgeon didn’t listen to you or rushed you out the door without answering your questions, keep looking for another surgeon.
 
10.  If you need to travel out of your area to find the best surgeon, do so.
 
If you do some basic research and go with your gut instinct, you will be able to
choose the best surgeon for your Nissen fundoplication.


 

Friends, I am sorry for slacking on my posts! The good news is that right after I started this blog, I got a new job. The bad news is that I became too busy to post, but I promise to make up for that.

Almost a year after my surgery, I'm enjoying the best health I have had in twenty years. In a nutshell:

* My voice improved 85%.
* My asthma decreased 95%.
* My only food and drink limitations are caffeine (I drink it once a week maximum, because it can cause burning in my stomach) and alcohol (I stick to one drink three times a week).
* I'm taking a fraction of the medication I was taking pre-surgery: One AciPhex, no Reglan, 1-2 Axids or so a month (if I watch the caffeine and alcohol, I don't need Axid at all), minimal simethicone, no prednisone, and minimal inhalers. 
* My stomach feels completely NORMAL for the first time in my adult life.

I went on a Caribbean cruise in January and had fries, a milkshake, and a margarita on the same day--and my stomach felt great!

Good health is an amazing feeling!


 

Four months post-surgery I’m enjoying my new stomach. Since the holiday eating season began, I’ve indulged in Mexican food and margaritas three times, Middle Eastern food, pizza, cake, cookies, and wine—and my stomach feels great. 

But it definitely is a new stomach. The GERD and its complications are gone, and the delayed gastric emptying remains. What’s brand new is that I can’t burp, I have occasional hiccups, and I have mild gas/bloat.

So, what’s it like to not be able to burp? Before surgery, I belched almost every
time I ate or drank anything. It helped to relieve the constant trapped gas in
my stomach (I now know that with each belch came acid reflux). I was very
worried that I would be one of the people who couldn’t burp after surgery. 
 
The first month or so after surgery, not burping was a very strange experience. When gas was trapped in my stomach, I could feel it expanding uncomfortably, but the only thing I could do to relieve the pressure was walk immediately after eating or drinking. 

By about two months after surgery, though, I had much less trapped gas, and the
disturbing sensation diminished significantly. On those rare occasions now when
I feel like I really need to burp, I swallow a few times, and the feeling passes. That’s it!
 
I do take precautions to avoid swallowing air: I don’t drink from straws, I 
avoid slurping soup or hot drinks, and I don't have carbonated drinks. I eat
small amounts of gassy foods, such as beans, every few days, rather than
consuming large amounts daily (some people swear by Beano, but I can’t tell if
it works). I eat small meals, stopping when mildly full, and I eat slowly (I’ve
been doing this for years, anyway). Taking simethicone as needed with meals
helps a lot.

Many people can burp after a Nissen fundoplication, but some can’t, and you won’t
know until you have the surgery. But, don’t let it stop you, because there is a real benefit to not burping: I know for sure that I’m not having GERD!

In my next two blogs I’ll talk about my hiccups and gas/bloat. 

Tomorrow is the four-month anniversary of my life-altering Nissen fundoplication for GERD. I’m telling you about it because there are so many scary Nissen stories on the internet and few positive ones, mostly because people who are happy with their surgeries don't bother to blog about it.

I'm a 46-year-old woman who has suffered with GERD and asthma for 25 years. Most of those years my GERD was controlled with one daily AcipHex. But over the last decade, both my GERD and my asthma increased significantly.

In early 2011 my GERD became so bad that I had to take AcipHex twice a day and one Axid each day (or two Axids and one AcipHex a day), a lot of simethicone for gas, frequent metaclopramide for delayed gastric emptying, and prednisone bursts up to six times a year (along with a lot of Xopenex) for asthma flareups. Both my gastroenterologist and allergist suspected that GERD played a role in my asthma, but they couldn’t confirm it.

During a particularly bad GERD episode in May 2011, I lost my voice for two months. My ENT said it was caused by GERD and recommended a Nissen fundoplication. I refused, because until this point I had been able to cope with
my GERD by increasing my medications, and previous episodes of voice loss had
resolved themselves within a month or so.

This voice loss was different, however: my voice never returned. I could speak for only a half hour a day. Not only was I feeling extremely ill all the time—the burning in my esophagus was ruthless and constant, food sat in my stomach for hours, and I was always bloated and gassy—but now I was also trapped in my body, without a
voice.

Unemployed, unable to even make it through a job interview without losing my voice, and incapable of talking with my family and friends, I began to despair. A year before I was an outgoing salesperson with an active social life; now I stayed home, avoiding answering the phone and slowly withdrawing into a world of deep depression.

I spent much of 2011 trying to figure out how to cope with my new voice disability. At the end of the year, I went to a motility specialist to get a second opinion on my GERD options. He said that I was a candidate for a fundoplication but that it was essential that the surgery be performed only by the top expert in the field.

In December 2011 I wound up having the first of two unrelated surgeries—the first one a cancer scare, the second, an extremely painful surgery with a long recovery.
Throughout the year, my stomach problems remained unrelenting, but I put them on
the back burner while I recovered physically and emotionally from the surgeries.

But in May 2012, my GERD went to the next level. I began having constant burning in my throat and esophagus, and the reflux was so intractable that I could hardly eat or drink water. I went to a new ENT who specializes in voice disorders; he told me I had scar tissue on my vocal cords most likely caused by reflux. At this point I was so desperate that I began to revisit the idea of having a Nissen fundoplication.

I asked my long-time gastroenterologist for a referral to a surgeon. He told me that he recommended only two surgeons, one of which was in my area. In June I went for a surgical consultation; in late August I was on the operating table.

Four months later, I’m enjoying the best health I’ve had in a decade. I have no reflux, my voice is 75% improved, and I’ve had almost no asthma. My throat and esophagus no longer burn. I eat just about everything (I do avoid caffeine and carbonation, and I limit alcohol to two drinks a week). I take just one AcipHex a day and have not needed prednisone for asthma. I barely use Xopenex. I have a lot of
energy, I sleep well, and my depression is gone. I’m enjoying having a completely normal stomach about 85% of the time.

Until my fundoplication, I had no idea how much suffering I endured because of GERD. I can say without hesitation that this surgery is the best thing I’ve ever done.

Stay posted for future blogs on my consultations with the surgeon, my decision-making process, the healing process, and my current health and lifestyle.