Lets be the change

[letsmakeachange]

Hello,

I feel that the medical community is stuck in 1955 re: the issue of GERD, LPR, etc. The Nissen is not the gold standard we think it is; I feel that the medical community is not working hard or smart enough in finding ways in which to treat patients; contradicting each other, ignoring or contradicting ENT findings.
My personal experiences have been a litmus test and I believe you all have encountered similar experiences.

We need to organize and do something or who knows when something will be done.

Please contact me at if you have been unsuccessfully treated for acid reflux at USC, UPMC, or Johns, etc...

Please advise....

[Flycaster305]

LPR and GERD are so closely related it is difficult for me to know which was the more significant diagnosis.  Answering your questions, in order:

The first symptom was a hoarse voice which slowly worsened, as well as a sore throat and a feeling like I had a 'lump' slowing down the peristalsis process.  I also developed a cough, and a trip to the ENT ended up with the traditional tests including a scope.  It was diagnosed as acid backing up the esophagus and getting through the higher valve that is meant to keep acid out of the upper esophagus.  He also suggested I have an endoscopy to determine what was happening to allow acid to back up at all.  The endoscopy showed a hiatal hernia as well as Barrett's Esophagus, a pre-cancerous condition where the acid changes cells in the esophagus.  
Also, my teeth started turning black, acid was destroying my tooth enamel.  I raised the head of my bed, and started getting the tests for a NF procedure.  This included a motility test, as you can't have the procedure if you have a swallowing disorder, and another test to determine the degree of a hiatal hernia.  Usually one has an acid test, but having one in my case would have been a DUH! moment. my teeth turned almost completely black in about a month prior to the procedure, and I scheduled a re-coating of my teeth at great expense after the procedure. It takes two months of very tight diet control after the surgery to really determine the success of the procedure.  However, since the procedure, I can eat tomatoes, peppers, onions, etc. and in the years since, I haven't had a single GERD or LPR symptom.  It was a complete success.

I'm pretty old, I was 66 years old when I had the procedure (you are forgiven for your youth :)

Prior to the procedure I swam a mile three times a week and walked vigorously three miles a day three days a week.  After the procedure, I continued that regimen until I had a very serious heart condition develop several years later.

It is difficult to determine what caused my initial problem, but it is suspected my already aggrevated hiatal hernia totally gave way when I had a bowel obstruction.  I was an amateur boxer when I was young and had bad defensive skills, and apparently developed scar tissue in the intestines.  I also commercial fished and was knocked about deck a lot resulting in broken ribs, so who knows?   The bowel obstruction caused some violent vomiting and that is thought killed the upper valve in the esophagus.

Before I had the procedure, I checked several surgeons and talked with them, and was offered a list of patients to contact by each.  I chose a surgeon who had done over 100 procedures and the people I contacted were very pleased.

The operation done in 1955 is far different than done today.  Surgery today is far, far less invasive than what was done even ten years ago.  That said, I would warn whoever is thinking of having the procedure to understand that nature is better when it works.  Also, the dietary restrictions following the surgery are incredibly strict, people usually lose about 10 pounds.  Further, one can't eat as much following the surgery unless they stretch the stomach.  Also, days of drinking carbonated drinks and beer, etc. will be over forever, you can't burp very successfully.  

I hope that helps.  

[letsmakeachange]

Thanks for your response Flycaster305,

To fully understand your premise I would need to know more about your original symptoms pre-Nissen and your symptoms post-Nissen.

Did you have LPR symptoms or just GERD? Please enumerate the pre- and post- symptoms...
You have had no symptoms post-Nissen?
How old are you?
What was your activity level pre-?
What is it afterwards?
What casued your original issue - hernia; lazy esophagus
The people to whom you have spoken have no issues post? Wow (who was their doctor?)

My hypothesis is that the Nissen, which was founded in '55, is outdated, and that there should be something better available; regenerative medicine needs to be focused on and we cannot get complacent on a surgery that does not replicate the orignal anatomy in all of its 'angle of his' glory - Daniel Nocera MIT talks about learning from and copying nature.

While I am sure some people accept anything that is provided to them, I would need to better understand what it was that you were delaing with and what it is now with which you deal to understand if the surgery was as effective as you think; if one doesn't mind minor symptoms becuase one's lifestyle is sedentary due to, for instance, one's age, then a prevention of larger symptom experience may be helpful and lauded. But for a large group of people, 85% is not 100%. And when doctor's offices are as busy as McDonalds, I wonder how effective treatment is in the long run.

Smarter is available if we push harder and require a better product!