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bobdigi
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Quote bobdigi Replybullet Topic: Fundo jitters
    Posted: 17†Oct†2017 at 8:38am
Hi. This time tomorrow I will be at QA hospital either awaiting or having surgery on my hiatus hernia and having my fundoplication.
When I had my scope 3 months ago the Omeprazole wasn't working too well. The last few weeks however I've had no heartburn but still lots of reflux.
The fact the tablets are now doing their job is making me doubt surgery is the right decision.
I'm 38 and have been on ppi''s for about 5 years. I don't like being on them.
Pro's to a successful surgery, are no more reflux, no more ppi's, less chance of Barrett turning nasty and no more hiatus hernia or future Barretts.
Possible Negatives of an unsuccessful surgery are dumping syndrome, damage to Vegas nerve, trouble swollowing, possible re-wrap and constant bloating.
I'm pretty sure I'm going ahead with surgery but I am having doubts.
If the ppi''s still weren't working I would be a lot more confident I am doing the right thing. The fact they are working, makes me wonder.
Do people think I'm nuts for having surgery when the ppi''s are working?
Or is a hiatus hernia, Barretts, almost constant reflux and life time on ppi's a good enough reason to have surgery?
I know this is my decision to make etc but am curious what other people think?
Thanks, Bob.
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RickyCM
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Quote RickyCM Replybullet Posted: 17†Oct†2017 at 9:54am
Good Luck!
Exactly my thoughts - though I'm nowhere near the surgery yet.
Your negatives are all new to me and rather terrifying.
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chrisrob
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Quote chrisrob Replybullet Posted: 17†Oct†2017 at 10:04am
Good luck, Bob.

"I've had no heartburn but still lots of reflux." - that's the reason you need fundo rather than PPIs.
The omeprazole may be "doing its job" but that is only to reduce the acid not the reflux - and even non-erosive reflux needs to be addressed as it can cause lung damage - including bronchiectasis, idiopathic pulmonary fibrosis, pneumonia etc.

Forget the scare stories and trust the surgeon. Dumping syndrome is quite unlikely with an ordinary fundo and vagus nerve damage is unlikely with with a good surgeon.

You'll be fine.
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bobdigi
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Quote bobdigi Replybullet Posted: 17†Oct†2017 at 10:24am
Thanks Chris. I would never put any preasure on somebody to give me the answer I want. But I was secretly hoping you would tell me reflux, even with no "burn" should be addressed.I have, I estimate, over 50 noticeable reflux episodes a day. There's probably more I don't realize. But the over 50 ish, are the ones that reach the back of my throat Nd i need to swallow. I have suffered with rhinitis which I often wonder is reflux related.
So to "wrap up" I'm glad you think even non erosive reflux needs attention.
Thanks again.

Edited by bobdigi - 17†Oct†2017 at 10:27am
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SueC
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Quote SueC Replybullet Posted: 17†Oct†2017 at 8:02pm
Well well Bob, despite your best intentions you are still letting the demons eat away at you. At the risk of sounding like a broken record I think you have excellent reasons for going ahead with the fundoplication. My ppl drugs were very successful, no further acid burn almost from the time I started to take them but for me the three main factors in pushing for surgery were that like you I didnít want to stay on the drugs for life, I didnít want any further reflux matter washing over the already mutated barretts cells and I didnít want to risk the lung damage which I am becoming increasingly convinced is a greater risk than developing oesophageal cancer. Iím not a medic, nor a statistician but I believe the data which says the likelihood of progression from Barretts to cancer isnít high - unfortunately I do have a family member who died in his early 50s so the slight risk is nonetheless a risk, however I believe that the risk of lung damage from reflux is really only in the early stages of recognition. If we donít fix the mechanical cause of the problem and wait 10 years or so imagine the irreversible damage the lungs could suffer. It might not be a view shared by everyone but Iím very happy in my mind with my decision to have the fundo surgery.
You have done a lot of research into possible side effects of the surgery, as do we all but the vagus verve and spleen damage arenít likely to occur - surely you are at more risk of falling off your ladder in your line of work? I had some vagus nerve issues pre diagnosis, my oesophagitis was so severe a structure had developed which caused swallow difficulties and the food being stuck at the stricture put pressure on the vagus nerve and that causes an almost instant loss of consciousness - that really wasnít an experience to be repeated. I regained consciousness having smacked my head very hard on a stone floor and was carted off to A&E in an ambulance. Recovering from the fundo has been easy in comparison!
Seriously though Bob, I hope you can find peace of mind and can go forward with confidence, you are fit, healthy and well-prepared so believe that all will go well and that you will heal really well. And enjoy all those walks. I know the area well and have done many walks from Gilkicker to Stokes Bay, canít beat it 😀 Every possible good wish for tomorrow, I look forward to hearing how your recovery goes.
Sue
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bobdigi
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Quote bobdigi Replybullet Posted: 17†Oct†2017 at 8:46pm
Thanks Sue. Again!!!!! I am feeling better about it now at 8:40pm than I was this morning. I just woke up and lied there thinking "maybe I don't need this" Then I stupidly looked online and read about possible side effects. Anyway I'm more positive in the fact I'm making the right decision. I'm no longer looking online. And to be honest I wasn't particularly aware of the damage reflux can do to your lungs before today. And I thought I was getting pretty knowledgeable on reflux.
Anyway thanks for helping to talk me off the ledge again Sue. I will be reading your posts in the morning. And i will update when I'm feeling up to it. Thanks again.
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chrisrob
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Quote chrisrob Replybullet Posted: 18†Oct†2017 at 1:54pm
Assuming Bob's operation is going, or has gone, well today.

As a coincidence, whilst looking for something else, I cam across this debate from 2010 which is worth a read:
Medications versus surgery for GERD: debate over treatments for persistent heartburn.

The case for medication:
"In some studies with properly selected patients, meaning those who truly have acid reflux, you can get over 90 percent relief with these medications," says Dr. John Dumot, section head of community gastroenterology at the Cleveland Clinic and a specialist in advanced endoscopy.

The case for surgery:
"In the hands of specialists and people who do it well, you can achieve a 90 percent success rate on a straightforward GERD patient," says Dr. Namir Katkhouda, vice chair of surgery at the University of Southern California Keck School of Medicine.

Katkhouda goes on to say:
"If you take PPIs you will inhibit acid," he says, but you will continue to reflux other material from the stomach, which may include bile, a digestive fluid produced in the liver. Bile may cause more damage to the esophagus than acid, he says, and this damage can lead to esophageal cancer in a small number of cases.

He believes that anyone who develops the precancerous condition known as Barrett's esophagus should have anti-reflux surgery.

"A lot of gastroenterologists will disagree with me on that, but I'm concerned about the risk of cancer. If I have Barrett's, I'll get surgery."
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bobdigi
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Quote bobdigi Replybullet Posted: 20†Oct†2017 at 9:12pm
I'm on day 2 of recovery and doing pretty well. Sleeping on and off and have a lot of wind. But pain wise I'm doing OK. More discomfort than pain. Without being too gross I'd like the wind to calm down and to use the loo as I haven't since Wednesday morning. But hopefully it won't be too long.
I've eaten jelly, yoghurt and a bit of custard. And I've had a few of the shakes the hospital gave me. So Far a few Small BURPS, But No Reflux I Don't Think.


Edited by bobdigi - 20†Oct†2017 at 9:13pm
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