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From: trigonometry1972 on 7 May 2008 19:51


christophe wrote:
> This is my first post for some time and I hope all of my friends on
> this site are faring better. For a while, I decided to stay away in
> order to remain positive before the fundo. As it turned out, my fundo
> was long delayed, but I finally had it last Friday.
>
>
> I had a 270◦ wrap. The surgeon made the decision on the spot because
> of the relatively good condition of my esophagus.
>
> When I was informed on Saturday, I was in a state of rage. I have
> heard stories about the high failure rate of these wraps.
> Nevertheless, he remained confident in his work. I also suspect he has
> had bad experiences with very tight wraps. I wish I knew all this
> before surgery and I told him!
>
> The upshot is that my recovery post-op is going very well. I am onto
> soft and pureed foods. In fact, I was having them as early as the 2nd
> day in hospital!. I am still getting saliva coming up to my throat,
> although apparently this has nothing to do with the wrap, but the
> difficulty of some liquids going down. A modified barium swallow
> showed no reflux or esophageal spasms.
>
> I am now very worried, but I am feeling quite well. I didn't take the
> pain killer last night and got out of hospital yesterday morning. I
> guess if the wrap lasts 5 years, I'm extremely fit and so probably
> could get it done again. In saying that, anything less than 5 years
> and the surgery is a failure in my books.
>
> I don't want to give the impression that recovery from a fundo is
> smooth sailing. I did have quite a lot of pain and was a little
> nauseas after going from clear fluids to a thicker soup for the first
> time. I can only imagine what recovery from a full fundo would be
> like. The worst part of my recovery, however, is by far my doubts
> about the partial wrap. I always thought that if manometry was
> successful, that is, if it didn't point to swallowing or motility
> problems, the surgeon would attempt the tightest wrap possible.
>
> One curious detail about my experience was my surgeon's response to my
> concerns on day 2. He said that if necessary, he could change the wrap
> from 270 to 360, but the time to do it was while I was in hospital -
> while the holes were fresh :) He did say that while tighter wraps
> were more successful for periods longer than 5 to 7 years, studies
> before that time period the two wraps were equally good for symptom
> prevention. He also wanted the ability to use medication again if
> necessary.

I'll make a couple of suggestions as I've been thru a fundo
and I was back on h-2 acid reducers after about a year
and on PPI meds after several more years.
Do NOT go back on coffee.
Explore alternative medicine as I believe much GERD/reflux
is worsen by too little stomach acidity which is still
very acid when refluxed.
For me the H-2 Acid reducers helped, the PPI meds helped
but they never relieved all the symptoms and added some
of their own. The fundo helped, I was near normal for
about a year. I could have extended this remission just
by avoiding some of the worse foods such the above mentioned
coffee and highly acidic fruits.

Also I suggest weight loss and a program of exercise to
maintain the weight lost after the fundo. I'll suggest
a very low carb, high veggie, moderate beef, high fish,
high nut, no pork, very little chicken, high coconut, high olive oil,
rather limited milk,
eggs only rarely diet. This diet will help address
metabolic syndrome and insulin resistance and
proneness to inflammation.

I take betaine HCL capsules with many meals and I sleep on
a incline when I judge I need it. 12 to 18 inches of incline not
the foolishly small 6 or 8 inches. I've kept myself
symptom free for nearly 4 years, and I am doing FAR better
than when I was listening the orthodox Doctors and taking
their toxic prescriptions. These days I can digest a boot
provide I have enough betaine HCL caps with a meal.
Dypepsia gone.
Reflux gone.
Burping gone.
No thanks to conventional care.

This may not work for you. I am not a Doctor.
This was written for your entertainment and it
not medical grade advice.
From: trigonometry1972 on 7 May 2008 19:51


christophe wrote:
> This is my first post for some time and I hope all of my friends on
> this site are faring better. For a while, I decided to stay away in
> order to remain positive before the fundo. As it turned out, my fundo
> was long delayed, but I finally had it last Friday.
>
>
> I had a 270◦ wrap. The surgeon made the decision on the spot because
> of the relatively good condition of my esophagus.
>
> When I was informed on Saturday, I was in a state of rage. I have
> heard stories about the high failure rate of these wraps.
> Nevertheless, he remained confident in his work. I also suspect he has
> had bad experiences with very tight wraps. I wish I knew all this
> before surgery and I told him!
>
> The upshot is that my recovery post-op is going very well. I am onto
> soft and pureed foods. In fact, I was having them as early as the 2nd
> day in hospital!. I am still getting saliva coming up to my throat,
> although apparently this has nothing to do with the wrap, but the
> difficulty of some liquids going down. A modified barium swallow
> showed no reflux or esophageal spasms.
>
> I am now very worried, but I am feeling quite well. I didn't take the
> pain killer last night and got out of hospital yesterday morning. I
> guess if the wrap lasts 5 years, I'm extremely fit and so probably
> could get it done again. In saying that, anything less than 5 years
> and the surgery is a failure in my books.
>
> I don't want to give the impression that recovery from a fundo is
> smooth sailing. I did have quite a lot of pain and was a little
> nauseas after going from clear fluids to a thicker soup for the first
> time. I can only imagine what recovery from a full fundo would be
> like. The worst part of my recovery, however, is by far my doubts
> about the partial wrap. I always thought that if manometry was
> successful, that is, if it didn't point to swallowing or motility
> problems, the surgeon would attempt the tightest wrap possible.
>
> One curious detail about my experience was my surgeon's response to my
> concerns on day 2. He said that if necessary, he could change the wrap
> from 270 to 360, but the time to do it was while I was in hospital -
> while the holes were fresh :) He did say that while tighter wraps
> were more successful for periods longer than 5 to 7 years, studies
> before that time period the two wraps were equally good for symptom
> prevention. He also wanted the ability to use medication again if
> necessary.

I'll make a couple of suggestions as I've been thru a fundo
and I was back on h-2 acid reducers after about a year
and on PPI meds after several more years.
Do NOT go back on coffee.
Explore alternative medicine as I believe much GERD/reflux
is worsen by too little stomach acidity which is still
very acid when refluxed.
For me the H-2 Acid reducers helped, the PPI meds helped
but they never relieved all the symptoms and added some
of their own. The fundo helped, I was near normal for
about a year. I could have extended this remission just
by avoiding some of the worse foods such the above mentioned
coffee and highly acidic fruits.

Also I suggest weight loss and a program of exercise to
maintain the weight lost after the fundo. I'll suggest
a very low carb, high veggie, moderate beef, high fish,
high nut, no pork, very little chicken, high coconut, high olive oil,
rather limited milk,
eggs only rarely diet. This diet will help address
metabolic syndrome and insulin resistance and
proneness to inflammation.

I take betaine HCL capsules with many meals and I sleep on
a incline when I judge I need it. 12 to 18 inches of incline not
the foolishly small 6 or 8 inches. I've kept myself
symptom free for nearly 4 years, and I am doing FAR better
than when I was listening the orthodox Doctors and taking
their toxic prescriptions. These days I can digest a boot
provide I have enough betaine HCL caps with a meal.
Dypepsia gone.
Reflux gone.
Burping gone.
No thanks to conventional care.

This may not work for you. I am not a Doctor.
This was written for your entertainment and it
not medical grade advice.
From: christophe on 8 May 2008 04:53
On May 8, 9:51 am, "trigonometry1...(a)gmail.com |"
<trigonometry1...(a)gmail.com> wrote:
> christophe wrote:
> > This is my first post for some time and I hope all of my friends on
> > this site are faring better. For a while, I decided to stay away in
> > order to remain positive before the fundo. As it turned out, my fundo
> > was long delayed, but I finally had it last Friday.
>
> > I had a 270◦ wrap. The surgeon made the decision on the spot because
> > of the relatively good condition of my esophagus.
>
> > When I was informed on Saturday, I was in a state of rage. I have
> > heard stories about the high failure rate of these wraps.
> > Nevertheless, he remained confident in his work. I also suspect he has
> > had bad experiences with very tight wraps. I wish I knew all this
> > before surgery and I told him!
>
> > The upshot is that my recovery post-op is going very well. I am onto
> > soft and pureed foods. In fact, I was having them as early as the 2nd
> > day in hospital!. I am still getting saliva coming up to my throat,
> > although apparently this has nothing to do with the wrap, but the
> > difficulty of some liquids going down. A modified barium swallow
> > showed no reflux or esophageal spasms.
>
> > I am now very worried, but I am feeling quite well. I didn't take the
> > pain killer last night and got out of hospital yesterday morning. I
> > guess if the wrap lasts 5 years, I'm extremely fit and so probably
> > could get it done again. In saying that, anything less than 5 years
> > and the surgery is a failure in my books.
>
> > I don't want to give the impression that recovery from a fundo is
> > smooth sailing. I did have quite a lot of pain and was a little
> > nauseas after going from clear fluids to a thicker soup for the first
> > time. I can only imagine what recovery from a full fundo would be
> > like. The worst part of my recovery, however, is by far my doubts
> > about the partial wrap. I always thought that if manometry was
> > successful, that is, if it didn't point to swallowing or motility
> > problems, the surgeon would attempt the tightest wrap possible.
>
> > One curious detail about my experience was my surgeon's response to my
> > concerns on day 2. He said that if necessary, he could change the wrap
> > from 270 to 360, but the time to do it was while I was in hospital -
> > while the holes were fresh :) He did say that while tighter wraps
> > were more successful for periods longer than 5 to 7 years, studies
> > before that time period the two wraps were equally good for symptom
> > prevention. He also wanted the ability to use medication again if
> > necessary.
>
> I'll make a couple of suggestions as I've been thru a fundo
> and I was back on h-2 acid reducers after about a year
> and on PPI meds after several more years.
> Do NOT go back on coffee.
> Explore alternative medicine as I believe much GERD/reflux
> is worsen by too little stomach acidity which is still
> very acid when refluxed.
> For me the H-2 Acid reducers helped, the PPI meds helped
> but they never relieved all the symptoms and added some
> of their own. The fundo helped, I was near normal for
> about a year. I could have extended this remission just
> by avoiding some of the worse foods such the above mentioned
> coffee and highly acidic fruits.
>
> Also I suggest weight loss and a program of exercise to
> maintain the weight lost after the fundo. I'll suggest
> a very low carb, high veggie, moderate beef, high fish,
> high nut, no pork, very little chicken, high coconut, high olive oil,
> rather limited milk,
> eggs only rarely diet. This diet will help address
> metabolic syndrome and insulin resistance and
> proneness to inflammation.
>
> I take betaine HCL capsules with many meals and I sleep on
> a incline when I judge I need it. 12 to 18 inches of incline not
> the foolishly small 6 or 8 inches. I've kept myself
> symptom free for nearly 4 years, and I am doing FAR better
> than when I was listening the orthodox Doctors and taking
> their toxic prescriptions. These days I can digest a boot
> provide I have enough betaine HCL caps with a meal.
> Dypepsia gone.
> Reflux gone.
> Burping gone.
> No thanks to conventional care.
>
> This may not work for you. I am not a Doctor.
> This was written for your entertainment and it
> not medical grade advice.

I think you underestimate the reasons or lifestyle choices that
influenced my decision to have the surgery in the first place. I want
to drink coffee (in moderate quantities, but at least 1 a day) and I
want to consume alcohol. During my rehab, I am not having coffee (too
much gas). In saying that, I can't see much difference between coffee
and the chocolate flavored sustagen ( http://www.sustagen.com.au/recovery.php
) which they have me taking to make sure I don't lose too much
weight.

I agree with almost all of your lifestyle recommendations for reflux.
However, you write that your wrap worked for a year and that you could
eat or drink anything. If I was you, I would have undertaken revision
surgery, but again that is a lifestyle choice. I think you need to
understand one fundamental distinction between the old LES and the new
wrap: the latter is passive, but the former is sensitive to some of
the triggers you mention.

In writing all of that, I will maintain my body weight and indulge in
the old vices more moderately than before. I also agree with you about
the PPIs and other medication. In fact, my inability to tolerate the
side effects of the medications for gerd was another reason for
undertaking surgery.
From: trigonometry1972 on 9 May 2008 06:52
On May 8, 1:53 am, christophe <chris_p...(a)optusnet.com.au> wrote:
> On May 8, 9:51 am, "trigonometry1...(a)gmail.com |"
>
>
>
> <trigonometry1...(a)gmail.com> wrote:
> > christophe wrote:
> > > This is my first post for some time and I hope all of my friends on
> > > this site are faring better. For a while, I decided to stay away in
> > > order to remain positive before the fundo. As it turned out, my fundo
> > > was long delayed, but I finally had it last Friday.
>
> > > I had a 270◦ wrap. The surgeon made the decision on the spot because
> > > of the relatively good condition of my esophagus.
>
> > > When I was informed on Saturday, I was in a state of rage. I have
> > > heard stories about the high failure rate of these wraps.
> > > Nevertheless, he remained confident in his work. I also suspect he has
> > > had bad experiences with very tight wraps. I wish I knew all this
> > > before surgery and I told him!
>
> > > The upshot is that my recovery post-op is going very well. I am onto
> > > soft and pureed foods. In fact, I was having them as early as the 2nd
> > > day in hospital!. I am still getting saliva coming up to my throat,
> > > although apparently this has nothing to do with the wrap, but the
> > > difficulty of some liquids going down. A modified barium swallow
> > > showed no reflux or esophageal spasms.
>
> > > I am now very worried, but I am feeling quite well. I didn't take the
> > > pain killer last night and got out of hospital yesterday morning. I
> > > guess if the wrap lasts 5 years, I'm extremely fit and so probably
> > > could get it done again. In saying that, anything less than 5 years
> > > and the surgery is a failure in my books.
>
> > > I don't want to give the impression that recovery from a fundo is
> > > smooth sailing. I did have quite a lot of pain and was a little
> > > nauseas after going from clear fluids to a thicker soup for the first
> > > time. I can only imagine what recovery from a full fundo would be
> > > like. The worst part of my recovery, however, is by far my doubts
> > > about the partial wrap. I always thought that if manometry was
> > > successful, that is, if it didn't point to swallowing or motility
> > > problems, the surgeon would attempt the tightest wrap possible.
>
> > > One curious detail about my experience was my surgeon's response to my
> > > concerns on day 2. He said that if necessary, he could change the wrap
> > > from 270 to 360, but the time to do it was while I was in hospital -
> > > while the holes were fresh :)  He did say that while tighter wraps
> > > were more successful for periods longer than 5 to 7 years, studies
> > > before that time period the two wraps were equally good for symptom
> > > prevention. He also wanted the ability to use medication again if
> > > necessary.
>
> > I'll make a couple of suggestions as I've been thru a fundo
> > and I was back on h-2 acid reducers after about a year
> > and on PPI meds after several more years.
> > Do NOT go back on coffee.
> > Explore alternative medicine as I believe much GERD/reflux
> > is worsen by too little stomach acidity which is still
> > very acid when refluxed.
> > For me the H-2 Acid reducers helped, the PPI meds helped
> > but they never relieved all the symptoms and added some
> > of their own. The fundo helped, I was near normal for
> > about a year. I could have extended this remission just
> > by avoiding some of the worse foods such the above mentioned
> > coffee and highly acidic fruits.
>
> > Also I suggest weight loss and a program of exercise to
> > maintain the weight lost after the fundo. I'll suggest
> > a very low carb, high veggie, moderate beef, high fish,
> > high nut, no pork, very little chicken, high coconut, high olive oil,
> > rather limited milk,
> > eggs only rarely diet. This diet will help address
> > metabolic syndrome and insulin resistance and
> > proneness to inflammation.
>
> > I take betaine HCL capsules with many meals and I sleep on
> > a incline when I judge I need it. 12 to 18 inches of incline not
> > the foolishly small 6 or 8 inches. I've kept myself
> > symptom free for nearly 4 years, and I am doing FAR better
> > than when I was listening the orthodox Doctors and taking
> > their toxic prescriptions. These days I can digest a boot
> > provide I have enough betaine HCL caps with a meal.
> > Dypepsia gone.
> > Reflux gone.
> > Burping gone.
> > No thanks to conventional care.
>
> > This may not work for you. I am not a Doctor.
> > This was written for your entertainment and it
> > not medical grade advice.
>
> I think you underestimate the reasons or lifestyle choices that
> influenced my decision to have the surgery in the first place. I want
> to drink coffee (in moderate quantities, but at least 1 a day) and I
> want to consume alcohol. During my rehab, I am not having coffee (too
> much gas). In saying that, I can't see much difference between coffee
> and the chocolate flavored sustagen (http://www.sustagen.com.au/recovery.php
> ) which they have me taking to make sure I don't lose too much
> weight.
>
> I agree with almost all of your lifestyle recommendations for reflux.
> However, you write that your wrap worked for a year and that you could
> eat or drink anything. If I was you, I would have undertaken revision
> surgery, but again that is a lifestyle choice. I think you need to
> understand one fundamental distinction between the old LES and the new
> wrap: the latter is passive, but the former is sensitive to some of
> the triggers you mention.
>
> In writing all of that, I will maintain my body weight and indulge in
> the old vices more moderately than before. I also agree with you about
> the PPIs and other medication. In fact, my inability to tolerate the
> side effects of the medications for gerd was another reason for
> undertaking surgery.

I understand. I agree about the chocolate flavored drink. When I
was presented with my first post op in the hospital it was clear
broth,
pea soup, and coffee. I lost 15 pound from the operation.
I did have the problem of food stacking up on top of
the LES and having to wait for it to pass. It did. I'd walk around
and gradually it would go down. After 3 or 4 months that
problem was gone.

The old triggers were a problem after the fundo started to weaken.

While I don't touch coffee, tea, cola, I've been known to have a beer
or wine on a fairly regular basis since without ill effect
on the esophagus after I adopted use betaine HCL /w pepsin.
I've also had chocolate now and then but it isn't a friend.
It is also a headache trigger for me.


From: tj1 on 30 May 2008 03:45
Christophe, how are you doing now?

I had the operation over a year ago, and by far the thing that works
best for me to avoid reflux is to eat small meals. I can drink
coffee, alcohol, chocolate, and just about anything else without
getting reflux. However, if I over-eat, then I will have problems.
Eating small meals keeps my stomach from getting too stretched out,
and keeps pressure off of my LES. Plus, the meal digests quicker and
then there's nothing to reflux. It's taken me awhile to learn this,
as before I would eat a big meal, or a series of big meals over a
period of time and and my stomach would get all stretched out, and I'd
start to get reflux. Then I'd worry that my wrap had come undone.
But then after a 7 day course of reglan and small meals I'd be fine.
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