Posted by Shirley on August 1, 2009, 10:25 pm
67.134.197.X
Hernia MD, you seem to have a lot of knowledge in a lot of hernia issues. I would like your opinion on the discomfort and pain I am experiencing from my 2nd Lap Nissen Fundoplication.
1. My background starts in my early 30's as experiencing a lot of heartburn and acid reflux. I started with conservative treatment where I raised my bed, ate early dinners, and light. This seemed to help a lot.
2. Overtime things came and went and I started to have swallowing problems. I was prescribed Prilosec and Nexium over several years. They seemed to help.
3. Then about 5 years ago, I got a little worse for some reason with pain which I couldn't explain. I went in for another exam and had numerous tests and this time they discovered a hiatal hernia and a little bit of Barrett's esophagus. Another test discovered medium sized hiatal hernia which wasn't present a year earlier.
4. I visited a local surgeon and he suggested a Lap Nissen Fundoplication could be the way to go. After listening to what he had to say and then having some further tests, I decided to go for it.
5. In 2005 I had the operation. It completely eliminated all reflux and pain. The hiatal hernia was also repaired. I had not problems until about 7 months ago.
6. I went in for a follow up to complain of chest and shoulder pain. I had some flatuence at the time also which was extremely excessive.
7. It was determined that the Nissen Wrap (a complete Wrap) had slipped a couple of centimeters. I believe the doctor said the stomach is pressing against the lungs (if this makes sense to you).
8. I waited and had more tests and pretty soon it was just a little too uncomfortable. The surgeon suggested a having the Nissen wrap redone. He had also suggested a couple of other names of surgeons I could see for a second opinion but I decided to stick with him because he seemed to say he was one of the best Bariatric surgeons in the area.
9. I had the operation in Mid June. It seemed to help initially but I am getting the left shoulder pain again and some chest/breast pain and some right shoulder pain (at times but not nearly like the left side).
10. It has not been two months but I wonder if I should be experiencing this discomfort this late out? I do have a little swallowing difficulties at times. It could be that this is to be expected since I am this early in the recovery?
11. One surgeon that was recommended to me for a second opinion who I never had seen was Dr. Ralph Aye at Swedish Medical Center. This is what I have heard from him about re-surgeries:
"This is exactly the type of work I have specialized in during my entire practice, originally through open surgery, and now generally with a laparoscopic approach. I’ve personally performed or assisted on over 1500 repairs. Increasingly I see patients for whom their previous lap Nissen has failed and a re-operation is necessary. Usually these re-operations can be done laparoscopically also. My partner and I are also working with a new approach to difficult cases, such as patients with Barrett’s esophagus, where the chance of failure with Nissen fundoplication is higher than in those without Barrett’s, in which the best elements of both Hill and Nissen repairs are combined. To date we have had spectacular success with this approach".
12. If my pain continues, do you think I should see Dr. Aye?
Thank you Hernia MD for your advice.
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