Upcoming Nissen surgery

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I have recently been diagnosed with esophagus spasms the conclusion my doctor has come to is that I need Nissen surgery. I'm supposed to have this done the 13th of September and I'm wondering if this is the right thing to do. I have a small hiatal hernia I have regurgitation and acid reflux but I can live with that I have three years. (In I have eaten in the last 6 hours)- In just the last year when I walk three and a half miles an hour for an hour and a half on the treadmill everyday. I would find myself having to stop because of chest pressure. It would stop me dead in my tracks! Long story short after many heart test and test by the gastroenterologist and being denied by my insurance for the links procedure! The surgeon says my only choice is the Nissen procedure and he cannot guarantee that it will help stop the esophagus spasming! He said in five years when the Nissen doesn't work anymore maybe the insurance will cover the links and I can get the help I need!! Has anybody gotten the Nissen procedure because of esophagus spasms?

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  • Posted

    I had a nissan with a fundilplication with a 3 in myotomy at my LES it did not take any of the spasms away that was in oct. 16 so finally went to our mothership in danville pa and had a poem procedure done .while the dr. was doing the procedure about 5 min. Into it i had a spasm and he could not move the scope till it relaxed this was done in june 17 the procedure is making a myotomy inside my esophagus which was about 5 in. Now remember a average esophagus is about 9 in.so i have had an 8.5 in. Myotomy it helped a little but now having severe spasms all up an down my esophagus.i have not worked since jan.30 2017. And by the way I am an SURGICAL technologist in our operating room . I hope this helps in making a decision. Let me know if you want a list of my 9 meds I am on let know. Michael Hunnell here nice to meet you.
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  • Posted

    I am sorry i forgot to ask if you were diagnosed with achalasia? The spasms get bad and won't let food into the stomach there creating spasms

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    • Posted

      Hi Michael thank you for responding. The gastroenterologist had me do two tests with holes in my nose which I will never do again esophageal manometry and pH Impedance. They found I did have a small hernia regurgitation acid reflux and they're guessing that it's esophagus spasms. I never heard the word achalasia. Unless they said it and I don't remember it. My problem is I eat food and within the next 6 hours if I try any exercising walking fast, ... Anything that will speed up my heart hence the reason for heart tests. I passed all of them thank the Lord!!! If I don't eat anything I can exert myself all I want. Any little bit of food about 10 minutes into exerting myself puts extreme pressure in my chest stopped me dead in my tracks! If I drink a little water or with some miracle I burp, that relieves the pressure, but then it starts right back up again if I tried start exerting myself again!!! They're saying that it is Barrett's disease there is scarring on my esophagus but all the medications they put me on none of them help. So the surgeon said what all I'm left do is the Nissen procedure. So what I'm trying to understand by your messages is that I should not go through with it on the 13th!!

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    • Posted

      Okay I looked up achalasia and I'm pretty sure I don't have that my lower spinster stays open all the time so that the bad taste I have in my mouth all the time if I would have had the links that would have allowed food only to go down and nothing to come back up. And that's what I need my spinster closed!!! And I don't know what wrapping the stomach around the esophagus has to do with closing the Spinster!!

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  • Posted

    It will all depend on whether it is the reflux that causes the spasms.

    ​It is possible that spams continue / develop after surgery, as it is possible that it is the nerves that cause the spams.   I think you should probably ask your surgeon for his assessment of what is causing the spasms.

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    • Posted

      Thank you so much and Islands that is wonderful advice! I will be calling them tomorrow and asking that very question! Thank you thank you thank you 😊

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  • Posted

    Please please get a second, even a third opinion. Even if you have to fly out of state to another to see another specialist. If your circumstances will allow for that. This is a very invasive procedure and you MUST have all your "I's" dotted and "T's" crossed. If I didn't do it regarding my Pancreatitis I would have ended up having a very dangerous and radical surgery that I did NOT need. That, and being a health care professional saved me from one of the biggest mistakes I could have easily made. Dr's's do not know everything. And unless you have two or three different opinions first, I would NOT have the surgery until you do. I'm not saying that you don't or want need it, I'm only saying that there may be other less invasive options you are not aware about and/or your Dr. doesn't know about or think you are a candidate for. One of the best pancreatic surgeons in the Southeast told me that I was NOT a candidate for something that I felt in my heart I was. And I proved him wrong. Follow your heart and your instincts always and educate yourself enough to understand and know that whatever decision you make, you are making the best one. Certain surgeries can cause life long adverse reactions and I don't want this to happen to you or anyone else. Do your homework and do it well. 

    DJ-RN

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  • Posted

      Hi Julie, I don't understand your doctor. Usually when you get pain in your chest like I use to get. Oh my god I would think i was having a heart attack. I had my lower sphincter cut out which they can do using POEM or a Heller Myotomy. A Nissen Fundoplication is a 360 degree wrap of your stomach wall around your esophagus. Did you already have poem? I had poem a year ago and had a partial wrap in April of this year and on September 14th I'm having a Toupet Fundoplication which is a 270 degree wrap of the stomach wall around the esophagus to block acid from coming up the esophagus. Please let me know what tests you have had. Something is not right 

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    • Posted

      I'm sorry I do not know what POEM or a Heller Myotomy is. I haven't had a chance to look it up yet. Right now I'm in the process off getting my insurance to approve again. My surgeon is going to do a peer-to-peer with the chief medical officer of my insurance. To plead my case so I can have the Linx procedure I feel in my heart of hearts this is what I need. The doctor does feel that it's my reflux that is causing the spasms. The Nissen procedure is cancelled. I know it would not have helped me at all. Just cause a lot more problem. If insurance does not approve this Linx procedure. I will be finding another doctor! Thank you everyone for your help greatly greatly appreciated!!!💕

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    • Posted

         Julie, the very most important thing you can do for yourself is research before doing any procedures or surgeries and ask your doctor flat out how many have you done and at what success rate. They all lie somewhat but some keep it close to the truth. One doctor told me he was flying all over the world to teach doctors this new procedure and that the instrument was invented for him. Turned out I was his 2nd victim and his first was an hour before me. I wanted to put my doctor into the hospital as a patient. Now because of him I'm having a more serious surgery next week. 

             Could you explain this Linz procedure? I have never heard of it. If you have it done follow the doctors directions to the t and take your time getting back to normal. If you rush it you may regret it. I wish you luck and good health

             Bob

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  • Posted

    The Linx device is a metal bracelet which is magnetic and is designed to hold the lower oesophageal sphincter closed, but with sufficient flexibility to open when required for swallowing.   It is a sensible approach to controlling reflux for some people who do not respond to PPI medication like Omeprazole.   It can also be used when a hiatus hernia is being repaired I believe.

    ?Occasionally you can have a blockage or problem higher up in the oesophagus that causes regurgitation and spasms, and the lower oesophageal sphincter is relatively OK.   The important thing is that the diagnosis is made after all the relevant tests.   It will depend on what is causing the regurgitation and where in the system this is occurring.   The analysis of where the problem lies, if it is an achalasia-type problem, is through high resolution manometry to illustrate the pressure exerted by the peristaltic muscles at different points along the length of the oesophagus;  and a time swallow test of substances with different consistencies like marshmallow etc.

    ?Sometimes spasms do occur after surgery.   We had a meeting of around 27 achalasia patients on Monday evening, and the great majority of them found that spams improved after myotomy surgery.  When the spasms continue afterwards it can sometimes be because of scar tissue after the operation.   I think reflux can be a cause of spasms, and if the reflux is controlled, this should logically improve, if indeed reflux is the actual cause.

    Sometimes spasms can occur after anti-reflux surgery with gastric bands and, in some cases, the Linx device.  

    ?There are a number of different variations of the fundoplication wrap which can be 360 degrees or only a partial wrap.   There are illustrations of this in 'A Patient's Guide to Achalasia' that you can download from the website of the Oesophageal Patients Association (under the Oesophagus and Achalasia).

    On the question of having a Nissan procedure to resolve spasms, I imagine that it would only take place if it were definite that it was the reflux that was the cause of the spasms.   

    There is a long term health benefit in reducing exposure to reflux.

    I am sorry if this is not a definitive answer to whether you should go ahead or not!

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    • Posted

      Thanks Alan, I wonder why this was never even brought to my attention? Too late now. 
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    • Posted

      Thank you Alan, the linx is the only thing that I feel will work for me. It is the least evasive only the holes poked to get in there. No sutures in my stomach! Ok the update my doctor did do a peer-to-peer with the CMO of my insurance and surprise surprise surprise he was denied! Then he was told I need or they need to send in a second appeal! This will be the second appeal for me personally, and the third for the Medical Institution. So they're sending the paperwork to me I'll fill them out again with the same info again. It's crazy when it's something you need it seems you have to fight for it! And when it's something you know is not right they agreed to it with no problem approved! Sorry I'm having a pity party! 🙏

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