Coping With Nissen Fundoplication

Hi everyone, my name is Katherine. I am a school teacher and a 29-year-old “healthy” female, other than living with the repurcussions of what the doctor’s think is a slipped nissen fundoplication I lived with chronic reflux-losing weight, throwing up, constant terrible taste in my mouth, not sleeping, and worst of all, losing my voice for almost two years, before deciding to have the Nissen done in January ‘07. It was a miracle cure for the first nine months after the surgery-I was still on Protonix and kept to a diet free of most meats and caffiene-maybe psychosematic, but it seemed to work for me

I started having what I think was gas-bloat syndrome, chest pains, and vomiting partially digested foods- all after catching an evil stomach virus from my students back in October ‘07. I can remember not feeling the same after the violent vomiting episodes and eating became miserable again for me. I went straight to my surgeon, who ordered up an esophogram, and a gastric emptying study for the next week. According to my surgeon and two other doctors, the esophogram showed that the nissen fundoplication had slipped as a result of growing no scar tissue to keep it in place, and it was now sitting too low into my stomach, causing these problems. He wanted to immediately operate, doing a toupet fundoplication this time, with biomesh, to help the partial wrap to stay in place and promote the growth of scar tissue. I believed what he said, as I saw the tests myself, but I just couldn’t rush into another surgical procedure.

I went to a well-known surgeon in Manhatten, NY for a second opinion and piece of mind. He met with me, then ordered up three additional tests: Esophogeal Manometry, Endoscopy with Biopsy, and Bravo PH Study-I had them done last week.
***Caution for the Bravo PH Study that, of course, no one told me…I was in the emergency room for the weekend after having the 48-hour study done. The capsule did not “pass” through me and caused all kinds of chest, throat, and upper stomach pains-I felt as if I was having a heart attack and ironically enough, the only medicine that made the pain subside was nitroglycerine!-Yes, for heart patients, but it also works as an anti-spasmodic and dilates the muscles of the esophagus. I wasn’t out of pain until the capsule did pass… Word to the WISE

So far the test results have shown that I have very little to no acid reflux, as per the PH Study, no esophogitis, no H. Pylori, and my esophagus appeared normal. I have a small hiatial hernia and my nissen fundoplication wrap appeared normal, but slightly loose. This doctor now thinks I have esophageal spasms, but I didn’t have those symptoms until after the bravo study, and then it went back to the gas-bloat symptoms and regurgitation of partially digested food. The doctor put me on amitryptaline, as he said it would help to “relax” me, though I would be much more relaxed if I had some answers as to how to help my symptoms so I could go back to work and lead a somewhat ordinary life!

So, here I am, with two well-known, renowned GI surgeons, with two differing opinions as to what is wrong with me and the path I should take in order to be well. My original surgeon wants to do the surgery, and my upper GI and ENT doctor’s both agree, though we are still awaiting the results of the esophageal manometry (swallowing test for spasms and motility). The other surgeon (second opinion) believes that my problem solely lies in my esophagus and sort of dances around the question of whether or not I need a redo-fundoplication to fix the original wrap. I’m so confused, in pain, and have been out of work for a week as of tomorrow. I just want an answer to why I am feeling this way and what I need to do to fix it-it is scary to me that both these doctor’s could be right , or wrong, and I am at a loss as to what to do next. My insurance co. will not pay for a third opinion, and I’m considering polling my friends and family for a consensus…LOL!

If there are any of you who are suffering, like me, please don’t stop fighting the doctors, and when you’ve had enough of the testing and probing, don’t stop until you get to the bottom of your problem. It’s taking everything I’ve got in me to face these doctor’s and ask them to answer my questions, regardless of their attitudes and dismissals. Do the research on your own-you are your biggest advocate. I won’t stop until I get the answers that I need and deserve. Thanks for listening…