# Has anyone heard of Nissen Fundoplication for GERD?



## 16124 (Oct 21, 2005)

I am a 43-year-old male who has suffered for over 20 years from what doctors have diagnosed as gastroesophageal reflux disease (GERD). I have nearly-continual pain in my stomach--right below my ribcage / xiphoid process (the "V" area), general bowel disomfort, and continually changing bowel movement patterns (don't ask). Some doctors have also suggested irritable bowel syndrome (IBS) and other things... I have been able to control most symptoms pretty well with acid products: Prilosec, Zantac, Nexium, etc.Within the last 2 months, however, I have had at least 3 significant pain-panic episodes. In retrospect, I realize that for the past 3 years, I have been being awakened at night with these same episodes, but I thought they were nightmaresâ€¦ Family History: Momâ€"2003, Severe pancreatitis and cholecystitisâ€¦with gallbladder removal. Sister #1â€"2003, GI problems, â€œcleanâ€ abdominal ultrasound, subsequent Hidascan revealed severe gallbladder diseaseâ€¦gallbladder removed. Sister #2â€"2004, GI problems, â€œinconclusiveâ€ abdominal ultrasound, subsequent Hidascan revealed gallbladder diseaseâ€¦gallbladder removed. Sister #3â€"2004, minor history of GI problems, sudden gallbladder attack, emergency surgery for gallbladder removal. Both Sister #1 and Sister #3 have children that have had their gallbladders removed (both at under age 20).I have visited the ER numerous times and have taken the GI cocktail--the doctor has even prescribed Magic Mouthwash for my everyday use (itâ€™s the same as the GI cocktail that they give you in the ER--main ingredient is Novocaine or Lydocaine or somesuch...).My most recent â€œflareâ€ has a LONG arc, so briefly:Saturday, August 27, 2005, 1:30 am: Vacationing in Wyomingâ€"First significant pain-panic syndrome event. Woke in the middle of the night with chest pain and tightness. I felt like I could not get enough air. Friends drove me 90 minutes down the mountain to ER. I thought I was a goner. I was saying my â€œgoodbyes.â€ Really horrible. They checked my oxygen, which was at 95% (very good), but couldnâ€™t determine if anything else was going on. When all was said and done, ER gave me a GI cocktail for esophageal pain and Meclizine for vertigo. Nothing for the panic. Flew home. After four days, I was pretty much back to myself (except for not knowing what the ^%$#### was going onâ€¦).Felt pretty normal untilâ€¦Sunday, October 16, 2005, 12:30 am: Began feeling onset of pain-panic syndrome. Went to ER Saturday night/Sunday morning with increasing vertigo/disorientation/anxiety/pain. Was given GI cocktail for GI pain and Meclizine for vertigo. Abdominal ultrasound came back "clean."Monday, October 17, 2005, 11:00 am: Went to follow-up Dr. appointment. Starting sinking into what I had by now started to refer to as a â€œpain-panic syndrome.â€ Dr. did an EKG, thought he found something suspicious. I was sent to the hospital via ambulance. I received sublingual (under the tongue) nitroglycerin twice for suspicious heart findings. Felt significantly better after receiving nitro and oxygen. Admitted for 24-hour Chest Observation. All day and overnight, underwent EKGs and blood tests every four hoursâ€"ALL came back negative (which is good)â€"showing NO cardiac problems. Tuesday, October 18, 2005, 11:45 am: Discharged from hospital and went to appointment with Gastro surgeon with whom I had worked previously (I work in Medical). I asked him if he would order me a Hidascan, because I didnâ€™t trust that the previous abdominal ultrasounds were sufficientâ€¦ He is a specialist who performs a surgery called a Nissen Fundoplicationâ€"repairs hiatal hernia and stops GERD. His office started scheduling me for all the preoperative tests for the Nissen. He said he would be happy to order a Hidascan.The rest of Tuesday and Wednesday I was at home trying to relax. Upon discharge from the hospital, they did give me some Ativan (Lorazepam) 1 mg to help stop the anxietyâ€"which they had been giving me during my hospital stay. They also increased my stomach meds. I am now taking Prilosec OTC 20 mg twice a day plus a Zantac (Ranitidine) 300 mg before bed for GERD. I am continuing the Meclizine 25 mg (as needed) for the vertigo / dizziness / disorientation. I am trying not to use the Magic Mouthwash too muchâ€"it does get rid of the pain pretty quickly, but I think it starts to mask some of the other symptoms which starts causing problemsâ€¦ I have had some mild headaches, for which I have been effectively taking Acetaminophen (e.g., Tylenolâ€¦), because it is stomach-safe. Not very hungry--really watching what I eat: hard-boiled egg, banana, string cheese, clear broth...Thursday, October 20, 2005, 11:00 am: Went to hospital Radiology / Nuclear Medicine (Nuc Med) department for Hidascan. Really nice tech. Pretty uneventful. Laid still on table for one hour. After an hour, a different tech came inâ€"he was awful. He did not introduce himself. He just said, â€œWell, I guess weâ€™re doneâ€¦â€ Then he asks me, â€œAre we supposed to take your IV out?â€ WTF DOES THAT MEAN? I wanted to scream at him, â€œARENâ€™T YOU SUPPOSED TO KNOW WHAT YOU ARE DOING?â€ I asked if they were going to do the second part of the test (the CCK? / Emptying? portion). He said that â€œtheyâ€ (whoever THEY are, since THEY are not HIM) had sufficient pictures from the first part of the test. He took out the IV and I got far away from him quickly.Home. Nap. Awake. Feeling okay. Finally able to eat a little bit more: chicken salad sandwich. Yay. Watched some TV. At bedtime, I had to adjust all my nighttime meds over the course of about an hour, in order to avoid the syndrome. Slept until noon on Fridayâ€¦YAY!Friday, October 21, 2005, 3:00 pm: My significant other is home from work. We had nice oatmeal-and-toast lunch. Meclizine is keeping me vertigo-free, although I am still experiencing brain-lagâ€¦ Talked with Dr.â€™s office today to ###### that, although it is sometimes supposed to be vomit-inducing, I didnâ€™t get to do the second part of the Hidascan test. They said that Nuc Med said the Hidascan was "normal," showing no disease... I told them (especially after I read Dan's Post on this message board) that I want them to do the second part of the test. They are my advocates and are calling Nuc Med to research / complainâ€¦So, as it stands right now:
Waiting to see if I am supposed to do the second part of the Hidascan.
Starting properative tests for Nissen Fundoplication (to hopefully cure the GERD)
Tuesday, October 25: Upper GI
Wednesday, October 26: Gastric Emptying Study
Wednesday, November 2: Esophageal Manometry/Motility Study
Thursday, November 3: Upper Endoscopy with Bravo/pH Study
No surgery scheduled yet, for either cholecystectomy (gallbladder removal) or Nissen (hiatal hernia repair / GERD cure), but we will seeâ€¦ Thank you for letting my share my story. I would be happy to discuss the bit that I know about Nissen fundoplication with anyone, please email me at frenchfry10###hotmail.com.


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