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Jerry


7-12-99

My brother had just been diagnosed with GERD (GastroEsophageal Reflux Disease), and his primary symptom was globus sensation (a powerful gripping sensation around the throat). We'd talked about it a little, and I knew the doctor had put him on a restrictive diet (low-fat, no chocolate, caffeine, etc.). We'd always teased each other, so I'd taunt him while out on our twice-a-month dinner/movie outings by consuming massive amounts of food.

Little did I know, just one month later, I, too, would be stricken with GERD. While prescription Zantac and diet restrictions were enough to control my brother's symptoms, they didn't even touch mine.

My symptoms included nightly heartburn (extremely powerful reflux which would surge from my stomach to the top of my neck), sore throat, globus sensation, constant burping with acid reflux (150+ daily), chronic halitosis (bad breath), and daytime heartburn 2-3 times per week. Even the simple act of bending over would induce severe reflux.

It began Thanksgiving evening, November 20, 1997. As I lay down to sleep, a surging, throat-eroding acid surged up and down my throat the entire night. The next day, my throat was so sore I had trouble swallowing.

This continued each night. I told a co-worker about it and he recommended that I elevate my head to alleviate the reflux. I purchased a "wedge" pillow and it really helped the nightly reflux. The daytime strangling sensation (globus sensation) around my throat was relentless. I gave up coffee, chocolate, caffeine in any form, most fatty foods, all carbonated drinks, all acid-based foods (salsa, etc.), and lost 20 pounds (from 197 to 177), but I still had globus sensation and nighttime heartburn.

I went to the doctor and he prescribed Prilosec. I was taking two capsules a day, and was symptom free. I continued on two capsules per day for 2 months; I was then weaned to one per day, but the symptoms returned immediately. After doing extensive research on the web, I decided to consult a Gastroenterologist. She performed a GI Endoscopy to inspect the Lower Esophageal Sphincter (LES) and to record the amount of esophageal erosion. I was lucky, I didn't have any erosion, but the LES was basically wide open, allowing acid to reflux at will. She told me to either remain on two Prilosec per day or to consider surgery.

After much discussion with my wife, I opted for the surgery. This entailed having the following tests: GI Endoscopy, 24-hour PH Monitor, Esophageal Motility, and Video Esophagram (or Barium Swallow). The endoscopy was simply a small tube inserted down my throat after being relaxed by a mild sedative administered through a small IV in my hand. The 24-hour PH test was another tube, this time snaked down my nose and esophagus and dangled just above the LES for 24 hours; the PH (or acid) level was recorded on a small device strapped to a belt. The Esophageal Motility test was another (larger) tube snaked down my nose that recorded the strength of the esophagus as I swallowed both with and without water. After these tests, it was time to see the surgeon. He said I was a good candidate for a Laparoscopic Nissen Fundoplication surgery. But I had to have one more test, the Video Esophagram (i.e., Barium Swallow). This test was the easiest of all and entailed standing in front of an x-ray machine and swallowing a heavy, chalk-like substance (Barium), after eating a couple of fizzy alka-seltzers. This test conclusively proved the severity of my reflux. Each time I made any movements that put pressure on my diaphragm, I would reflux. The surgeon said it was one of the worst cases he's seen.

After studying the Video Esophagram results, the surgeon determined that I was a full-blown, legitimate candidate to have the surgery. He said that only one in three qualifies for the procedure, which entails wrapping the upper part of your stomach around the LES, creating a reinforced and tighter LES. He said that all of the tests are necessary to assure that the reflux is there and potent, and that the esophagus is strong enough (and without dysfunction) to force food through the proposed tightened LES.
If the esophagus were weak or dysfunctional in any way, the surgery could create more problems than it could solve.

I scheduled the surgery for November 10, 1998. I went in early that morning, and had it done without a hitch. The recovery was easy and painless; I didn't require a single pain pill the entire time - in fact, I snuck out of my hospital room 12 hours after surgery and had a cigar.

The next 2-3 months were spent on a restrictive soft food diet. For the first six weeks, everything that I ate that wasn't soft would hang up in my esophagus, just above the LES; a very strange and somewhat frightening sensation of choking to death, but being able to breathe - very uncomfortable. But I learned to avoid solid food all together, sticking to soup, yogurt, etc. In fact, even water and liquids would hang up sometimes, especially early in the morning.

On follow-up visits with my surgeon, he assured me that the food hang-ups were normal, and explained that was there was significant swelling in the surgical area around the LES.

I was able to swallow solid food after about two months. I still had food hang up, but it was only when I didn't chew it enough or when I ate too fast.

It has now been seven months since my surgery and I haven't had heartburn once. NOT EVEN ONCE! I feel great, completely symptom-free, and I can swallow food without it hanging up at all, no matter what I eat or how fast I eat it. I AM CURED!

I highly recommend the surgery. As far as scarring goes, I have just six 1-inch scars on my stomach.

To conclude, if I have any regrets at all it would be that now that I have a zero restriction diet, I can and do eat anything I want; when I had GERD, I ate healthier. The GERD was kind of like a life style "governor" if you will.

I am writing this follow-up letter on February 4, 2002.

On November 10, 1998, I underwent a surgical procedure called Laperoscopic Nissan Fundiplication to correct chronic GERD. The procedure, thus far, has been a complete success. I have experienced ZERO reflux since the surgery and I no longer experience Globus Sensation. (A powerful gripping sensation in the throat.)

At the time of the surgery I weighed 167 pounds Ė I now weigh 197 pounds. I can and do eat anything. I havenít found a single food that disagrees with me. Prior to the surgery, I had to avoid many foods such as fatty foods, coffee, chocolate, carbonated beverages, and juices.

As stated in my initial story, I had an EXTREMEY difficult time swallowing solid food for the first three months following the surgery. The food would "hang up" in my esophagus down near the LES. (Lower Esophageal Sphincter.) In fact, for the first year, this occurred occasionally - about once per month. It would mainly happen when I didnít chew well enough or when I ate too quickly. Even to this day I will have food "hang up" but only when I am eating WAY too fast or barely chewing my food. I would say this occurs only once every four months. I can swallow very well now.

I have not thrown up (regurgitated/vomited) since the surgery. I have had to twice due to the flu, but it would not come up. I was afraid to push the issue, and thus controlled the urge with controlled breathing and, for lack of a better term, will power. I think if my body really insisted on vomiting, it would. Admittedly, it would scare me to do so, but Iím convinced the doctor put me back together well enough to withstand it.

Thatís about it. I feel great and highly recommend the surgery to everyone who asks about it.

By the way, I have received about 100 emails regarding my "true life GERD story" posted on the heartburn-help.com web site.

 

 

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