Fundoplication complications?

[ashlara]

I had a lap fundoplication and GB removal done almost 7 wks. ago. for persistent laryngitis and after failure of all PPI's. About 2-3 wks. post-op I starting developing severe esophageal spasms and chest pain. I had a repeat UGI that showed the wrap was not too tight, even a tablet went through. The problem now is excessive belching and hiccuping after eating or drinking anything. I had a lot of pain in the major incision for the surgery which was injected with a steroid, and that helped but I worry about possible phrenic nerve damage. But the globus sensation and dysphagia are worse now than it was before surgery. My GI doc has me on liquid Carafate 5 x/day and 300 mg. Zantac BID which have not helped. I think I may have achalasia and need a manometry test done. Any answers?

[ashlara]

I REALLY don't want to repeat the Nissen, I've heard it's risky. What I have read is the bariatric surgeons are the best at doing Nissens. I also researched the 'going down the throat method' and it has the same failure rate right now as lap/open Nissens. There simply are not enough pts. out there that have had it done endoscopically to come up with success rates- there's only 2 yrs. worth of data and my GI wouldn't even consider it. If you could find a great bariatric surgeon where you live I would set up a consultation appt. with your previous records in hand.
My situation right now is that I am asking for my job to find me a position where I do not need to do phone triage. Since almost all RN's in Kaiser do phone triage or teaching, this is going to be difficult. But I need to get back to work, bottom line- I'm not able to retire just yet.

[LindaSueBob]

I had three nissen fundoplications, two with the five incisions and the last October 2010 with the open incision. It too has failed proven by a barium swallow last week. Now my surgeon yesterday wants to send me 100 miles away to San Francisco to have a fundoplication done down my throat. I have researched this and said no yesterday that I don't want it done especially there. My husband would have to take so much time off work, see them, go back for the surgery, stay overnight, come back to get me, go back for checkups plus if there is a problem no one in Sacramento will see me, I would have to go back there. The same surgeon did all three and all three failed. I am going to ask my doctor for a referral to another surgeon for another nissen or else a gastric bypass for reflux not weight loss. Hope you all find help as well, I don't want to stay on meds and they really don't work for me.

[ashlara]

So went to the GI doc yesterday and he did not feel that I had achalasia based on the imaging from my last Barium swallow. He also felt that I do not need the manometry testing. He feels the nerves in my esophagus are overly sensitive and react badly whenever I swallow. So he wants me to try Imipramine very low dose to see if that calms the nerves down. If it does, then he may start me back on Prevecid, which I tolerated very well but lost its' efficacy. He told me my case is very unusual and they may have to send me outside of the HMO system to make sure I'm not aspirating.
Right now I'll take the meds, but I'm going to contact my supervisor as well as HR and let them know what's going on. I may not be able to do my old job again.

[ashlara]

I already have Barrett's but the area is very small and has been biopsied twice for any cell dysplasia, which there was none. I had my larynx scoped twice and that hasn't been done since Feb. so I may ask to get that done as well. I had a soft tissue CT scan done of my neck last April, but I had a horrific allergic reaction to the IV contrast.
The bottom line is, I'm beginning to realize that my voice may never be back to normal, that I may not be able to talk on the phone for 8 hrs. 4 days a week again and I may need a different position w/i the HMO I work for. I'm not ill, I just cannot communicate very effectively.
So I'll get the tests done and see what GI says, then talk to my union and my supervisor about how to get me back to work.

[Flycaster305]

I sure would have the achalasia and manometry tests done, and I'm betting you already have seen an ENT doctor.  
I find it very interesting that my voice issues become seemingly worse when on the phone.  I've flat out burned my vocal chords, but find people have more trouble hearing what I say on the phone than just during normal conversation.  
I'm not a health professional, far from it, but I researched the Lap Fundo. procedure a great deal before I had it, and asked the surgeon I chose to do the work, "what is your biggest worry during this operation"? In my case, my heart would be his worry, but I pressed him for worries outside my condition, and he stated we worried about cutting nerves.  
I'm sorry for your voice problem, I know the frustration.
Also, I'm sure you have been tested for Barrett's?
Best wishes.

[ashlara]

My problems with eating are totally unrelated to what or how much I put in my mouth- as soon as I swallow anything, the problems begin, even in my lower gut. Although I'm having big problems with being bound up as my GI doc put me on Carafate 5 x a day, so that's not helping. My voice is my main concern as my maternal GF died of laryngeal cancer. I work as a phone triage RN and have had a very weak voice ever since this whole mess started. I've been on mostly liquids and try to eat 6 small meals per day.
I feel that there's been some type of nerve damage or the pressures in my esophagus are totally off.

[Flycaster305]

I had the lap fund procedure nine months ago, and as warned it wasn't an easy first month.  Your symptoms and mine seem similiar.  In my case, the PPI's that had worked for years very well suddenly failed to help, and my vocal chords burned to the point I have a whole different voice today.  Also, acid very, very quickly took off my tooth enamel, and my teeth started turning very black.  
I followed the diet requirements very carefully, and stayed on largely a liquid and soft diet for two months.  Certainly I didn't eat any meat of any kind except salmon and tuna at about the six week level, and tried not to overeat.  Every time I did, I had troubles like you describe, but mostly my problems were in the lower digestive tract.  
I'd review your diet, make sure that you aren't eating more than you could put in a deck of cards at a sitting.  Certainly no soda or beer.  I could have a bit of red wine with no problem.  A meal that helped me greatly was to drain the liquid from a can on Campbell's low sodium soup so just the noodles remained, and add some crumbled crackers and a bit of shaved cheese.  That's high energy, some fat and protein, in just the right amount.

Just go slow, see if that helps.  My life is 100% better since the surgery.  I still talk like Kim Carnes sings (Betty Davis Eyes) and had to have my teeth capped, but after the recovery mode, I feel much, much better.
Best wishes, keep us informed.

[ashlara]

I had asked about being checked for the H. Pylori but all my symptoms are high in the throat right now- in any case, my GI doc felt I had no sxs of ulcer and the blood test wasn't warranted. I did ask that question though.
I'm just getting concerned since my voice goes bad right after I eat and I feel I'm regurgitating my food. The whole thing is getting very old. I've been out of work for over 4 months now.

[selmaS]

  Hi since ur GB was removed, were u  checked for H.Pylori?...ask for that to be done.

  Good luck
   "selma"