Yesterday was the 1-year anniversary of my life-changing surgery. I believe I have a normal life again although it's not the same normal as I had before the GERD began nearly 20 years previously. But it is normal to me now.
These differences are few, though. Still no carbonated beverages, since I can't burp, for the most part. Very very occasionally a small amount of air will work its way back up past my wrap, but it is not often enough to be sure I could burp when I needed to - 95% of the time, at least, I can't. For the same reason, I can't drink through a straw, which is would mainly be an issue at fast-food drive-thru places. But we keep a bottle of water in the car for those occasions. And speaking of air, what can't come back up, has to pass on through. So I'm more flatulent than I've ever been, and don't have much control over that. I try to not be rude about it but, well, like I said, I don't have much control over that.
As for foods, I probably only get "stuck" a couple of times a month now. Smaller bites and thorough chewing are second nature. Large bites are painful going down, even if they don't get stuck. As I've mentioned, cooked pork and bread are the main problems, like if I have the very rare (as in infrequent) hamburger on a bun for example.
My appetite is about 75% of what it was prior. I graze more now. Eat less at meals, get hungry sooner afterward, and eat again. Sometimes my meals that don't get finished I just leave sitting on the counter; in an hour or so I'll go back and finish it. I've also noticed that motility is better. If I eat to the point of fullness (not uncomfortable fullness of course), and then walk around or even sit back with a cup of tea, 10-15 minutes later I can eat a little more. This is good for buffet restaurants, where I eat my small plate of food and finish before my husband is half-done with his mounded up plate. By the time he's halfway through his second plate and I'm sitting there bored, I can go have a dish of soup or a dessert (sugar-free of course!) or something - then we finish up at the same time.
I love to rearrange the furniture in my house, but heavy lifting is still off-limits. The last time I tried (a couple of months ago), I was in a world of hurt in the area of my wrap for 2-3 days afterward. I've since read that heavy lifting is never a good idea after a wrap, no matter how long it's been since the surgery. This isn't a huge issue to me anymore since the arthritis in my spine also limits lifting, but just another difference.
Raw vegetables was another thing my surgeon warned me against, both for digestibility and for gas issues. I can eat small amounts, but they do give me a bellyache if I eat too much, and they do increase the level of gas I need to get rid of. So I can eat them, but I limit them. Gone are the days of eating a whole head of cauliflower dipped in ranch dressing in one day!
Even though the early days were more difficult for me than most, recovery was slower and more painful, and I do have some (minor!) limits now, I would do it again in a heartbeat. And, in cases like mine where all else has failed, I would definitely recommend it. It is a major surgery, it is life-altering, and it physically changes the inside of our bodies, permanently. It has a fairly high failure rate (depending on who you ask), and can cause more problems than it was intended to solve in a few cases. For these reasons it isn't a surgery that should be taken lightly or gone into without a lot of research and prayer. But for me, it was literally a lifesaver and many times every single day I am thankful that I had the opportunity to get it done!
Friday, December 2, 2011
Thursday, November 3, 2011
11 Months! #fundoplication
This is a post that I made to the Facebook Nissen Fundoplication group (a closed group but FULL of helpful people!) in reply to someone who wondered if life is ever normal again after this procedure. It pretty much sums up my life now, so I am reposting it here as my 11-month update.
"It's been 11 months for me. I consider it a 'new normal' and certainly 100% better than my 'life' (if I could even consider it that) before. I take smaller bites. I chew more thoroughly. I keep a warm beverage handy especially when eating things that I know have a tendency to stick (breads - even my home-made low-carb breads - and roasted pork mostly). I don't drink anything with carbonation and avoid caffeine. I keep simethicone tablets for when I eat 'gassy' foods because I totally love vegetables and they are a huge part of my diet as a low-carber. I have to stop eating at the first sign of fullness, or expect PAIN which I'm sure is a sign that there is pressure or stretching at my wrap - not a good thing if I want my wrap not to fail! I think that's about it. But it's all 2nd nature now, and it's normal now and certainly MUCH less restrictive and easier than how I had to eat before the NF surgery. . Back then I not only had to worry about what I ingested would cause but how it would taste or feel coming back up."
Here, I would add that prior to the surgery I was very apprehensive about what life would be like afterward. I'm a lifelong foodie. I'm happiest when I'm dealing with food, creating recipes and cooking and planning meals and grocery-shopping...and I was sure that all of this would come to a screeching halt after such a major change to my gut. AND I WAS WRONG. With a few minor changes as listed above, the foodie part of me still lives, and lives well! Even better, in fact, because I no longer get sick every time I eat!
This is a surgery that is considered a last resort, after all else has been tried, and especially where Barrett's is involved. (As a side note: less than 1% of people with Barrett's develop esophageal cancer, which is the greatest fear of many who have it. I have it, but don't fear it. There is a separate procedure where a surgeon can ablate the damaged tissue.)
So I know that nobody goes into NF lightly. It dramatically alters our digestive tract, and there's no going back. It has a higher failure rate (especially over time) than most surgeries, according to most. There is a long recovery, and no, life is not ever the same afterward.
It is hard when people are where I was a year ago, with their fears and anxieties...and it is impossible to fully share my joy in life now, compared to before, because their fears get in the way. And it is true that this surgery doesn't always have such a positive outcome, certainly; nobody can guarantee that everyone who has this procedure will have the same great results that I did. But I can - and do - happily share my own, and hope that it helps them :).
"It's been 11 months for me. I consider it a 'new normal' and certainly 100% better than my 'life' (if I could even consider it that) before. I take smaller bites. I chew more thoroughly. I keep a warm beverage handy especially when eating things that I know have a tendency to stick (breads - even my home-made low-carb breads - and roasted pork mostly). I don't drink anything with carbonation and avoid caffeine. I keep simethicone tablets for when I eat 'gassy' foods because I totally love vegetables and they are a huge part of my diet as a low-carber. I have to stop eating at the first sign of fullness, or expect PAIN which I'm sure is a sign that there is pressure or stretching at my wrap - not a good thing if I want my wrap not to fail! I think that's about it. But it's all 2nd nature now, and it's normal now and certainly MUCH less restrictive and easier than how I had to eat before the NF surgery. . Back then I not only had to worry about what I ingested would cause but how it would taste or feel coming back up."
Here, I would add that prior to the surgery I was very apprehensive about what life would be like afterward. I'm a lifelong foodie. I'm happiest when I'm dealing with food, creating recipes and cooking and planning meals and grocery-shopping...and I was sure that all of this would come to a screeching halt after such a major change to my gut. AND I WAS WRONG. With a few minor changes as listed above, the foodie part of me still lives, and lives well! Even better, in fact, because I no longer get sick every time I eat!
This is a surgery that is considered a last resort, after all else has been tried, and especially where Barrett's is involved. (As a side note: less than 1% of people with Barrett's develop esophageal cancer, which is the greatest fear of many who have it. I have it, but don't fear it. There is a separate procedure where a surgeon can ablate the damaged tissue.)
So I know that nobody goes into NF lightly. It dramatically alters our digestive tract, and there's no going back. It has a higher failure rate (especially over time) than most surgeries, according to most. There is a long recovery, and no, life is not ever the same afterward.
It is hard when people are where I was a year ago, with their fears and anxieties...and it is impossible to fully share my joy in life now, compared to before, because their fears get in the way. And it is true that this surgery doesn't always have such a positive outcome, certainly; nobody can guarantee that everyone who has this procedure will have the same great results that I did. But I can - and do - happily share my own, and hope that it helps them :).
Thursday, October 6, 2011
10 Months PostOp - and counting! #fundoplication
Things are going well. Very well. My appetite, and the amount of food I'm able to eat, is now about 75% what it was before the surgery. I guess my stomach is adjusting? I still have occasional trouble with pork for some reason, and hamburgers on buns (which I rarely eat anyway), getting these stuck. But the pork situation is getting better.
One experience I did have, last month, was AWFUL! I had run out of my anti-nausea pills (Zofran) because, while I typically only take 1-2 a month, I had to take 2 in a single weekend. On Monday I planned to call my doctor for more, but I didn't get to it, then woke up with a massive headache and nausea on Tuesday morning. I called my doctor for a refill of the Zofran, and was told I had to get it from the surgeon's office. I called the surgeon's office and was told I had to get it from my primary doctor. Meanwhile, I started retching.
Talk about PAIN! It was awful. And I'd heard of stories where retching could cause failure of the wrap, so I was also afraid...and it was only getting worse. I had no choice but to get to the ER. My sister called ahead of time and explained, so that I could get some zofran as soon as I got there. But first I had to explain to the receptionist - who didn't know about the wrap, why I couldn't just vomit...then had to explain again to the triage nurse but thankfully she did, and got me a zofran tablet right away, the minute I got to the gurney.
(My "roommate" in the 2-bed room was a MAN! I didn't know they did that, it wasn't very comfortable for me, but really I was too sick to care.)
I was there for 9 hours, during which I got an IV, 3 doses of dilaudid for the headache and stomach pain, and 4 doses of Zofran. The last doses they gave me one of each to carry me over on the hour-long ride home, and I had an instantaneous reaction of extreme severe itching all the way up my arm and shoulder, so I got a dose of benedryl in my IV also. I was half-asleep and dopey as heck for the rest of the evening from all the drugs, but at least the retching had stopped (although nothing they gave me helped the headache).
The best part is, they gave me an rx for 20 more Zofran tablets. Lesson learned...no way will I let myself run out of them again.
One experience I did have, last month, was AWFUL! I had run out of my anti-nausea pills (Zofran) because, while I typically only take 1-2 a month, I had to take 2 in a single weekend. On Monday I planned to call my doctor for more, but I didn't get to it, then woke up with a massive headache and nausea on Tuesday morning. I called my doctor for a refill of the Zofran, and was told I had to get it from the surgeon's office. I called the surgeon's office and was told I had to get it from my primary doctor. Meanwhile, I started retching.
Talk about PAIN! It was awful. And I'd heard of stories where retching could cause failure of the wrap, so I was also afraid...and it was only getting worse. I had no choice but to get to the ER. My sister called ahead of time and explained, so that I could get some zofran as soon as I got there. But first I had to explain to the receptionist - who didn't know about the wrap, why I couldn't just vomit...then had to explain again to the triage nurse but thankfully she did, and got me a zofran tablet right away, the minute I got to the gurney.
(My "roommate" in the 2-bed room was a MAN! I didn't know they did that, it wasn't very comfortable for me, but really I was too sick to care.)
I was there for 9 hours, during which I got an IV, 3 doses of dilaudid for the headache and stomach pain, and 4 doses of Zofran. The last doses they gave me one of each to carry me over on the hour-long ride home, and I had an instantaneous reaction of extreme severe itching all the way up my arm and shoulder, so I got a dose of benedryl in my IV also. I was half-asleep and dopey as heck for the rest of the evening from all the drugs, but at least the retching had stopped (although nothing they gave me helped the headache).
The best part is, they gave me an rx for 20 more Zofran tablets. Lesson learned...no way will I let myself run out of them again.
Wednesday, July 13, 2011
Diet and #GERD
This is NOT about the "standard GERD diet" that most doctors recommend, but that doesn't help so many people who are still living on antacids, PPI's, etc...this is different and, even if you believe that "low carb" is a fad diet (it isn't, but this isn't the place to debate it), if you are desperate or even want to try something different - and harmless - or avoid surgery or strong medications, read below, follow the links, see what others - including physicians and the MANY people for whom it worked - have shared, and consider if this might at least be worth a try for yourself.
My own personal experience: Only during a few months between 1991 and 2010 did my GERD ever abate, and that was when I first started eating low carb. Those first 3 months of eating this way were bliss! I could lay flat, I didn't cough and choke on my own stomach acids, I had amazing relief! And I was eating lots of fats also, tons of fatty foods, as most low carb plans are NOT high protein as so many of its detractors (and the press) would have you believe, but rather high fat. The body uses fats for energy much more efficiently than it uses sugars and starches, which are part of the problem for many - if not most - GERD sufferers.
However, one slice of bread - low carb bread - or a single dish of low-carb cereal or one cookie, and it all came back. I could not tolerate ANY grains whatsoever. I have read reports of GERD sufferers who, after eliminating wheat in all its forms from their diet, found relief; apparently wheat sensitivity is quite common (as is lactose/dairy) although most are unaware, and eliminating these foods can help. But in my case, any grains at all in my system would start the reflux which, a few years later, became violent.
This is no secret. It is well-known by some in the medical profession and all of us who have lived it, that eliminating grains and sugars (even "natural sugars" - sugar is sugar is sugar) and in some cases dairy from the diet can bring relief from even the worst reflux issues for many people and do for them what myriad drugs had not, enabling them to start living their lives normally again. If you are having reflux issues but are wary of the NF surgery...if you have a failed wrap...if your surgery wasn't effective for whatever reason...there are some resources that you may want to check out. Read and learn and, maybe, give yourself some relief :).
Heartburn Cured, from the blog of Michael R. Eades, MD (medical)
How Low-Carb Improves Acid Reflux, from The Migraineur (anecdotal)
Reader who cured GERD with low-carb diet interviewed on TV, from The Healthy Skeptic (video)
Low Carb Plus Raw Veg for GERD, Life Extension Forum (anecdotal)
My GERD is Cured! Low-carb Hits the Mark, from Pain, Pain, Go Away! (anecdotal)
Low Carb and Heartburn (forum, anecdotal, multiple)
GERD Sufferers, Rejoice! from Mark's Daily Apple (informational)A Low Carb Diet for GERD
Gastro-Esophageal Reflux Disease (GERD), but Thomas Cowan, MD (medical)
My own personal experience: Only during a few months between 1991 and 2010 did my GERD ever abate, and that was when I first started eating low carb. Those first 3 months of eating this way were bliss! I could lay flat, I didn't cough and choke on my own stomach acids, I had amazing relief! And I was eating lots of fats also, tons of fatty foods, as most low carb plans are NOT high protein as so many of its detractors (and the press) would have you believe, but rather high fat. The body uses fats for energy much more efficiently than it uses sugars and starches, which are part of the problem for many - if not most - GERD sufferers.
However, one slice of bread - low carb bread - or a single dish of low-carb cereal or one cookie, and it all came back. I could not tolerate ANY grains whatsoever. I have read reports of GERD sufferers who, after eliminating wheat in all its forms from their diet, found relief; apparently wheat sensitivity is quite common (as is lactose/dairy) although most are unaware, and eliminating these foods can help. But in my case, any grains at all in my system would start the reflux which, a few years later, became violent.
This is no secret. It is well-known by some in the medical profession and all of us who have lived it, that eliminating grains and sugars (even "natural sugars" - sugar is sugar is sugar) and in some cases dairy from the diet can bring relief from even the worst reflux issues for many people and do for them what myriad drugs had not, enabling them to start living their lives normally again. If you are having reflux issues but are wary of the NF surgery...if you have a failed wrap...if your surgery wasn't effective for whatever reason...there are some resources that you may want to check out. Read and learn and, maybe, give yourself some relief :).
Heartburn Cured, from the blog of Michael R. Eades, MD (medical)
How Low-Carb Improves Acid Reflux, from The Migraineur (anecdotal)
Reader who cured GERD with low-carb diet interviewed on TV, from The Healthy Skeptic (video)
Low Carb Plus Raw Veg for GERD, Life Extension Forum (anecdotal)
My GERD is Cured! Low-carb Hits the Mark, from Pain, Pain, Go Away! (anecdotal)
Low Carb and Heartburn (forum, anecdotal, multiple)
GERD Sufferers, Rejoice! from Mark's Daily Apple (informational)A Low Carb Diet for GERD
Gastro-Esophageal Reflux Disease (GERD), but Thomas Cowan, MD (medical)
Thursday, July 7, 2011
Links: Doctor's Post-Op Guidelines after Laparoscopic Nissen #Fundoplication
This is a list for those who have questions, and also to show the VAST differences in how different surgeons instruct their patients. My own doctor was fairly conservative in his instructions, which was consistent with my own reading of patient accounts. It seemed that the people that had the most issues many times ate too much - or the wrong things - too soon, or resumed activity - or strenuous activity - too soon. Anyway, you will see below that recommendations do vary widely, and since we are all different, the doctor who actually did the surgery, along with our own gradual experimentation will be our best guide :).
Since there are so many, I'm just listing 10 to provide the basic ideas. But if you search the web, you will find LOTS more.
from Winchester Surgeons, Winchester, TN
from Aaron S. Bransky, MD, Plano, TX
from Casco Bay Surgery
, Portland, Maine
from Surgical Specialist of Plano, Plano, TX
from The Crawford Clinic, Anniston, AL
from Surgical Associates, PC (multiple locations)
from Newton-Wellesley Surgeons, Inc., Newton, MA
from Oregon Surgical Specialists, Medford, OR
from Tampa Bay Surgical Group, Bradenton, FL
From Cedar Surgical, Tacoma, WA
Since there are so many, I'm just listing 10 to provide the basic ideas. But if you search the web, you will find LOTS more.
from Winchester Surgeons, Winchester, TN
from Aaron S. Bransky, MD, Plano, TX
from Casco Bay Surgery
, Portland, Maine
from Surgical Specialist of Plano, Plano, TX
from The Crawford Clinic, Anniston, AL
from Surgical Associates, PC (multiple locations)
from Newton-Wellesley Surgeons, Inc., Newton, MA
from Oregon Surgical Specialists, Medford, OR
from Tampa Bay Surgical Group, Bradenton, FL
From Cedar Surgical, Tacoma, WA
Tuesday, July 5, 2011
7-Month Post-Op Update #fundoplication
First, I have been more careful with lifting/pushing since my June 15th entry, and have no more problems with that type of pain.
Second, my eating is going fine, still mainly pork that gets stuck, although I did have on incident of bread sticking. I still haven't tried my beloved raw cauliflower and broccoli, sooner or later I might but I got the sternest warnings about those from my surgeon, so I don't really want to try - yet.
Third, I've made these awful noises every so often since the surgery. I think they're awful anyway, my husband says it's not so bad...but on the Nissen Fundoplication group on Facebook there was a discussion of these sounds by some of the members; they described it like a seal barking (yeah, that's it!) and the conclusion is that it is caused by some sort of spasm in the esophagus. No word from them on iAdf it ever goes away, but I guess I will find that out on my own, given enough time.
Fourth, I am afraid to hope, but I think I MIGHT be burping! I don't know if that's good or bad, but I think I've burped a couple of times, not just the shallow burps from air in my esophagus before it ever reaches my wrap, but real burps. When it happens I'm not paying that much attention so that I can properly identify where it came from, but maybe...
Fifth, I bent over after eating one day, and felt this awful yet familiar feeling in my throat...it took a few seconds to recognize it as ACID! I was horrified, certain that my wrap was failing, and got myself pretty worked up. However, it hasn't happened since. Put together with what I just wrote, it would make sense that IF air is coming back up at times, it could bring a little bit of acid (which I know my stomach is still full of!) with it. But it doesn't seem to be a sign of wrap failure, since it only happened that once, a couple of weeks ago. I even tested my wrap by eating something and then laying down flat on my bed to fall asleep. Nothing. I'm good.
And happy :).
Second, my eating is going fine, still mainly pork that gets stuck, although I did have on incident of bread sticking. I still haven't tried my beloved raw cauliflower and broccoli, sooner or later I might but I got the sternest warnings about those from my surgeon, so I don't really want to try - yet.
Third, I've made these awful noises every so often since the surgery. I think they're awful anyway, my husband says it's not so bad...but on the Nissen Fundoplication group on Facebook there was a discussion of these sounds by some of the members; they described it like a seal barking (yeah, that's it!) and the conclusion is that it is caused by some sort of spasm in the esophagus. No word from them on iAdf it ever goes away, but I guess I will find that out on my own, given enough time.
Fourth, I am afraid to hope, but I think I MIGHT be burping! I don't know if that's good or bad, but I think I've burped a couple of times, not just the shallow burps from air in my esophagus before it ever reaches my wrap, but real burps. When it happens I'm not paying that much attention so that I can properly identify where it came from, but maybe...
Fifth, I bent over after eating one day, and felt this awful yet familiar feeling in my throat...it took a few seconds to recognize it as ACID! I was horrified, certain that my wrap was failing, and got myself pretty worked up. However, it hasn't happened since. Put together with what I just wrote, it would make sense that IF air is coming back up at times, it could bring a little bit of acid (which I know my stomach is still full of!) with it. But it doesn't seem to be a sign of wrap failure, since it only happened that once, a couple of weeks ago. I even tested my wrap by eating something and then laying down flat on my bed to fall asleep. Nothing. I'm good.
And happy :).
Wednesday, June 15, 2011
Quick Update - Pain from ???
All things great, except for occasional belly pain. It has felt like acid so I've continued taking Ranitidine (one of the meds I used pre-op) on the assumption that I still have lots of acid down there, it's just no longer coming up. However the last couple of days I've had some sharp pains around the area of my wrap that started soon after twisting my body as I tossed a large bucket of water up over a railing. I've really slowed down a lot since then, as doing too much adds more pain, just in case a stitch started to tear through or something. No reflux or even heartburn, but just the pain.
Last night the pain kept me awake much of the night. It felt like acid but I'd taken the Ranitidine at bedtime, but it also felt sharp in that same spot. Logically I'm thinking, "OK, so maybe there's a little tear from the other day, and when I lay down a little acid leaks into it and causes so much pain?" Not sure...I don't think I'm going to call the doc just yet, but rather I will go back to small meals, softer food, and not a whole lot of water-bucket-tossing, and see if things calm down. If they don't - or get worse - or I start refluxing again - I'll be calling the doc for sure! Loving this post-NF life and not willing to go back! :)
Last night the pain kept me awake much of the night. It felt like acid but I'd taken the Ranitidine at bedtime, but it also felt sharp in that same spot. Logically I'm thinking, "OK, so maybe there's a little tear from the other day, and when I lay down a little acid leaks into it and causes so much pain?" Not sure...I don't think I'm going to call the doc just yet, but rather I will go back to small meals, softer food, and not a whole lot of water-bucket-tossing, and see if things calm down. If they don't - or get worse - or I start refluxing again - I'll be calling the doc for sure! Loving this post-NF life and not willing to go back! :)
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