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  • 6 Months Follow Up

    Well, its now been six months. Went to the GI's office Monday and saw the PA, rather than the doc. (He was apparently stuck in a procedure, but I didn't feel like waiting.)

    Basically, I have been feeling quite well for the past 3 months. Probably better than anytime in the months before my procedure. I have had a few very minor reflux or pain episodes, but almost always minor, and short. Often the pain I have encounted followed eating something that (I suspect) causes irritation on the way down (apple juice, cinnomon, anything acidic.) Aside from my regular meds I have probably only taken 5-10 antacid tabs in the pst 3 months. (Before I was taking several a day in addition to the meds.) I've also had much relief from the ferquent need for throat clearing in the am, which was an improvement that came soon after the procedure.

    Since I failed on my "step down" 2 months post stretta, I have been keeping my meds at the same level (2ppi and 2 pepcid per day.) I have also cut out all dairy products (replaced with soy milk), so its impossible to isolate the real cause of my improvement, but I'm not complaining.

    The PA suggested I try to step down again, which I probably will very gradually. The most useful part of my visit was she told me of a store to go to find ice cream made from soymilk. (I've been making my own, but it can't compare to the stuff I found in the store )

    So, I'm better for now, (but usually as soon as I say that I get worse, so I was almost afraid to post anything.)

    Randy

  • #2
    Randy!!

    Thank you so much for letting us know how you are doing. Glad to hear that you have been happy with your results. Did the PA expect you to have any rebound when you began your slow step-down?

    Keep in touch and continue to improve.

    All the best ! b

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    • #3
      Didn't think to ask that specifically, although my plan is to be very gradual about the step down. She seemed to agree with that.

      Randy

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      • #4
        Hi Randy,

        My name is Dave and I'm writing you from Toronto. I'm on the Nissen Fundoplication Board next door on this same forum and someone on that board pointed me in your direction. I had the Nissen back in January after a terrible diagnosis by a surgeon and had the surgery. Long story short I developed a ton of problems after that surgery and needed to have it reversed. Since then I'm still struggling with some very unexpected, unwanted side effects from both surgeries such as stomach pain and bowel problems. In addition my GERD has gotten worse and I'm interested in knowing more about the Stretta procedure, what's involved, side effects, how you are dealing with it etc.. Not so much for right now, I have enough on my plate just trying to recover from what I have been through with these stupid surgeries, but more for the future if the GERD doesn't get under control with medication or gets worse and I need to look at some NONE SURGICAL !!! lol, means of dealing with it.

        Any insight you can provide would be much appreciated. Thanks very much.

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        • #5
          David,

          Stretta is a procedure that uses radiofrequency to tighten up the LES. The fundo tries to do this by wrapping part of the stomach around the LES. The stretta is performed just like a regular endoscopy except the probe has a small balloon at the end, with a RF generator around it. When the procedure starts they put the probe down to the LES, inflate the balloon,then turn on the RF to burn the muscle tissues. (There is also water cooling to prevent the inside of the LES getting burned.) Once the muscle begins to heal, it scars, tightening up the muscle, and hopefully making the LES less likely to allow reflux up. It takes while for this to happen, perhaps many months, so results don't appear instantly.

          Side effects are pretty minimal. At first there is some swelling (which provides some immediate relief, but it may not last) and in my case, there was some pain for about a week. I had to eat soft food for about 2 weeks. Aide from that, no side effects.

          BAsed on studies, Stretta can be very effective for some people, but not for everyone. In many cases, it seems people no longer need meds, and live happily ever after. For others, it doesn't seem to help much or any. There are also a few "horror stories" where people felt there problems became much worse after stretta.

          In my case, I did not get results right away, and in fact, things got worse before they got better. However, as discussed above, things are now getting better for me. I havefor the last few days cut out one of my daily meds (pre lunch pepcid) w/o any noticable ill effect. However, I can't really say I'm one of the "success stories" at this point. I'll continue to step down my meds and see how that goes.

          The main reason I selected stretta was that it is the most studied technique, probably the simplest, and if it didn't work, I could still do the fundo. Unlike Enteryx, it doesn't place foreign substance in your LES.

          You might want to consider Gatekeeper as well, and maybe the Plicator procedure. Gatekeeper is more in the study stage at this time. If it works, it might be the best, since it is also reversible.

          The main thing with the endoscopic procedures is that you are not laid up for weeks after the fundo, and have far fewer side effects. The downside is that they don't always work, or may not last as long as the fundo. However, all the procedures are new, so there is no real data on how long they last.

          You can find lots of articles on by googling "GERD Stretta Studies" for ex.

          At this point, I am not sorry I did the procedure. With all the fundo horror stories I've read, I'm glad I didn't go that way. Time will tell, however, if I feel this way six months or a year from now.

          Randy

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          • #6
            Hi Randy,

            Thanks so much for your response. I wish I had been as smart as you and really looked into the potential pitfalls of the fundo. I would have saved myself from the surgery and all the issues I'm dealing with as a result, which hopefully will continue to improve over time.

            So it sounds like the stretta was a good decision for you, at least for the time being. You are feeling some relief and you certainly haven't been set back by any unwanted side effects. When you say some people had bad results, does this mean there reflux got worse??

            Never heard of teh gatekeeper? what's that?

            Thanks again

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            • #7
              David,

              Gatekeeper is another endoscopic procedure, where they place "hydro gels" (sort of like contact lens material, I beleive) in the LES. This bulks up when it gets wet, and the tightens the valve. Its now under study. There is another thread in one of the other forums that deals with it.

              As for Stretta, I can't say how much of my improvement is due to it, and how much is due to eliminating 100% (almost) of milk products from my diet, and replacing with soymilk. However, I am feeling better now. Of course, I've had long periods before where everything went great, only to be followed by periods when almost nothing seemed to work. If this holds up, then whether it was stretta or not, the procedure was a success, since I avoided (for now at least) the fundo, even if all it did was delay it long enough for me to find a new strategy. In the end, I'm still not ruling out the fundo.

              The ill effects of Stretta have been talked about in some earlier threads. A poster named Hani tried it w/o success. He also had a failed fundo, and poor response to PPIs, however. There were 2 people who died during clinical trials, both due to pnumonia (sp?). Apparently, this is something that could happen during any endoscopy but its pretty uncommon. One of the fatalities had alzhimers (another one I can't spell for sure) and his family decided not to treat him. (Says something about the kinds of patients admitted to clinical trials.) The other one had the symptoms of pnumonia, but did nothing about it.

              Anyway, good luck and take your time deciding what to do.

              Randy

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