Laparoscopic Fundoplication

[ArNG11]

Has anyone tried this aggressive treatment for GERD?

[ArNG11]

Here's another ? of sorts. I am using private insurance to take care of a 0% service connected condition, GERD (on appeal) is it possible to have the VA reimburse me for the bill. I can't even get my VA PCP to change and add prescriptions to mirror my civi docs.

[Vync]

I have bad GERD and have had upper GI's done. That's about as aggressive as the VA has been to me. They give me anti acid meds and the GI cocktail. If that fails to put out the inferno, I go to the VA ER where they treat me like a heart patient. Symptoms are near identical. In the end, they usually give me IV mes.

Your regular VA primary care doc is limited to what he can prescribe. To get the better, nonformulary meds, he likely will need to refer you to the GI clinic.

They are supposed to reimburse, but my VA gave me the shaft in that department. They said i could have got the treatment from them and denied reimbursement. I'd keep all receipts and file for reimbursement anyway after they grant SC. They can only say no.

There are some meds that are well known to cause GERD, particularly NSAIDs like motrin. If you are given them to an treat SC condition, it should make it easier to get GERD awarded as secondary. Despite being so widespread, they don't have a dedicated GERD, so they tend to rate it under hiatal hernia.

[ArNG11]

Yeah that is funny. A hiatial hernia can cause GERD to happen. The rating schedules are funny that way. I got connected at 0%. I will find out after my DRO appeal what they finally grant. By regs and medical evidence I should have been at 30% for the GERD. Damned if you do and damned if you don't. I imagine that will head on up to BVA as well. Regional offices play silly.

[georgiapapa]

ArNG11,

Check out the LINX Reflux Management System. This system was approved in 2012 and is used by Dr. Daniel Smith at Mayo Clinic in Jacksonville, Florida. It is GERD surgery using a ring of tiny magnetic titanium beads. It is supposed to be better than the Nissen Fundoplication procedure.

[ArNG11]

thanks GeorgiaPapa. Definitely different.

[georgiapapa]

You are welcome.

My gastro doctor wanted to do the Nissen Fundoplucation procedure on me a couple years ago which I put off and last year he told me about the Lynx procedure he had learned about at a conference where he met Dr. Smith. My gastro doctor told me if I wanted the procedure, he would refer me to Dr. Smith at Mayo but I declined his offer. I had been on Nexium for over 15 years and my GERD was beginning to get worse; however, my new medications (Dexilant and Zantac) seem to keep my GERD under control most of the time so I am not in a hurry for the surgery. Also, if you have the Lynx procedure, you can no longer have MRIs.

Good luck.

[ArNG11]

Thanks GeorgiaPapa. I am a little nervous. Surgery is tomorrow, but Im done with the refractive medications. Dietary changes, sleep position changes, eating schedules, OTC drugs, (Zantac, Tagamet, Prilosec, Milk of Magnesia, TUMS, Rolaids) RX drugs and still no good results. The Nexium had worked when I first started with this back in 08-09, however, it was very expensive even with insurance. So decided to go with Omeprazole and had a few good years, then in 2013 it got worse. Changed to Protonix in 2014 and that worked for a little while and then back to Nexium because the Pantaprozole was not working. This crap really sucks and I decided on more serious actions. The procedure itself has given a favorable percentage of people relief and I am willing to go to the next step. I won't know if the doctor will do a full wrap or a partial until after he gets in there and physically sees what will work best. Anxiety is getting the best of me but heh things could be a lot worse. At least I still have private insurance and I believe I am in good hands. I am in the hopes that I will be in the successful percentage of patients that obtained relief taking the surgical route. Time will tell I imagine.

I am still trying to find references regarding any help from the VA regarding the time I'm going to be away from work and the costs associated with this service connected condition. Does anyone have any references or knowledge if this is possible? I'm still working, however, sick leave has been exhausted a few times over. Having to use vacation time.

[georgiapapa]

ArNG11,

I hope you will keep us posted on how your procedure works out so that others, including myself, can use your input to make a more informed decision on which surgery option might work best for our particular situation. I feel Like I will also reach a point in the future where I will need surgery.

In addition to being more invasive, one of my main concerns with the Nissen Fundoplication procedure was it would be difficult , if not impossible, to reverse the procedure. The Lynx procedure can be reversed and adjustments can be made when necessary. I am sure you and your doctor have discussed the pros and cons of the procedure you have chosen so your procedure will more than likely give you some long needed relief.

Hopefully some of the more knowledgeable Hadit members will have some ideas on how you can get some assistance from the VA regarding the time you will miss from your work. If I come up with something, I will let you know.

Good luck tomorrow and take care of yourself.

Georgiapapa

[ArNG11]

Thanks GeorgiaPapa. I'm not going to deny as I'm waiting here on the prep room before I get my IV. nerves are getting the best of me. I'm committed now, so there's no turning back. Moving forward and advancing is all I have now. I ll catch every one on the flip side. When I wake up and can function I'll keep you guys and gals updated.

[georgiapapa]

Hope things go well for you. I will be watching for your next post.

Good luck and take care of yourself.

[ArNG11]

Well I'm back from Neverland. The operation went well and normally I would have been sent home, however since I have ITP my doctor wants to make sure it does not cause any complications. My throat is sore and I can't take deep breaths or what is considered deep for me, however that is normal after surgery. I have a spirometer and I am working on it so, so far so good. The soreness in the throat should be gone after several days. At that point I can start to assess how it's working for me. Oh and once they start me on solid foods. So far it has been jello and beef broth. Yum. Believe it or not it's not terrible. I did sneak an Ensure, but only because they were going to start me on a more complete liquid diet. By the way Ensure is expensive. Wow.

[georgiapapa]

ArNG11,

I am happy to hear your surgery went well. I don't know if you needed it, but you will probably experience a reduction in your weight. Please keep us posted on your progress.

I had UPPP surgery (sleep apnea surgery) yesterday morning and came home today. Like you, I am currently using a spirometer because I have a sore throat but mine was caused from the removal of my uvula (little hangy down part on the upper palate) and removal of the soft tissue on the backside of my top palate. I also had nasal turbinate reduction surgery at the same time. These two surgeries were to increase the openings in my airways in an effort to reduce the seriousness of my sleep apnea.

I hope you and I both have a quick recovery.

[ArNG11]

Oddly I am 40. I guess drinking the Ensure qualifies me as old

[ArNG11]

ArNG11,

I am happy to hear your surgery went well. I don't know if you needed it, but you will probably experience a reduction in your weight. Please keep us posted on your progress.

I had UPPP surgery (sleep apnea surgery) yesterday morning and came home today. Like you, I am currently using a spirometer because I have a sore throat but mine was caused from the removal of my uvula (little hangy down part on the upper palate) and removal of the soft tissue on the backside of my top palate. I also had nasal turbinate reduction surgery at the same time. These two surgeries were to increase the openings in my airways in an effort to reduce the seriousness of my sleep apnea.

I hope you and I both have a quick recovery.

You know I think it was John99 that had the sleep apnea surgery I am not sure though I have to look at prior posts

[ArNG11]

From what I have read there are a few surgeries that can help with this. Some involve the removal of the adenoids, modifying the plate structure and so type of other reconstructive type modifications.

Edited January 21, 2015 by ArNG11 (see edit history)

[georgiapapa]

John recently had a procedure called the "Inspire System." This is the latest and most advanced sleep apnea surgery. It involves implanting a device in your chest about the same size as a pacemaker and lead wires are run up to your airways. You have a remote control which allows you to turn on the device at bedtime and it keeps your airways open while you are sleeping and you turn off the device with your remote control when you awaken. John can explain the Inspire System a lot better than I can.

I went to my ENT surgeon seeking to have the Inspire System procedure. He did an updated sleep study on me, conducted airway tests in his office and told me I would not qualify for the Inspire System at the present time because of the narrowing in my airways and my BMI exceeded 32. He said if I had the UPPP surgery and lost a little weight, I would probably be able to have the Inspire System procedure. If things work out as planned, I hope to have the Inspire System procedure later this year. Anyone seriously interested in this new procedure should contact John 999 on Hadit.

[ArNG11]

ArNG11,

I am happy to hear your surgery went well. I don't know if you needed it, but you will probably experience a reduction in your weight. Please keep us posted on your progress.

I had UPPP surgery (sleep apnea surgery) yesterday morning and came home today. Like you, I am currently using a spirometer because I have a sore throat but mine was caused from the removal of my uvula (little hangy down part on the upper palate) and removal of the soft tissue on the backside of my top palate. I also had nasal turbinate reduction surgery at the same time. These two surgeries were to increase the openings in my airways in an effort to reduce the seriousness of my sleep apnea.

I hope you and I both have a quick recovery.

I should have answered this as well but I didn't catch it. The reduction in weight would be grand. I am obese no doubt about it. Not being able to jog or run kind of puts a damper on that process, but I still try to walk as much as I can. That's the most strenuous exercise my docs recommend, walking. It's difficult to get around right now, but it will get better. The Spyrometer is a pain but it does help. Then the meds, but they leave me feeling loopy all day and I dislike that. I hope this takes care of the GERD, but only time will tell. I am still on the nexium and will be taken off it gradually.

It's a weird feeling though. I haven't eaten much and I am still bloated from the gas they pumped into my stomach cavity. Feel like I ate a 7 course meal and all I ate today was a yogurt and a cup of soup. The breathing is just as much of a pain as the movement. Deep breaths are painful. But I will say this, I haven't had the fire feeling in my throat. That is a plus. Im sure this procedure will kind of kill my GERD rating but heh no more fiery throat. They also repaired a hiatal hernia. Sad thing is I know that I should have had a 30% rating at least for my GERD, I'm sure that this procedure will effect that rating, although all I am at is at 0% for it. It will be interesting to see how this pans out. I imagine this is going to complicate things but heh it makes the battle interesting.

[georgiapapa]

I can stand to lose some weight as well so maybe we will be both shed a few pounds. Still experiencing some pain and discomfort but not as bad as I thought it would be. The pain meds are helping but I notice it when I am late taking a dose.

You will probably forget about the rating for your GERD if your procedure gives you the relief you need and completely eliminates the need for GERD medication.

Keep us posted on your progress.

Take care.

[ArNG11]

Yeah I will keep posting updates. Ensure, soups, and jello and pudding is what I have been eating so far. I did try a chicken noodle soup and it was ok to take down. I still feel the lump in my throat but not with the fire that was usually there. The biggest complain is just the incision points are really sore. Oh and the shaving of the belly make it itch like crazy but thats minor. The bloating form the CO2 gas is a little embarrassing, Mr. Farts a lot. .10lb lift limit and being careful how I get up and sit down are pain. But heh it could be a lot worse. My doc wanted me off for two weeks but I declined. I reluctantly agreed to One week off work and 10lb weight restriction as far as lifting is concerned. No biggie for me since I am on restrictions for the partial right wrist fusion I had done.

Edited January 22, 2015 by ArNG11 (see edit history)

[ArNG11]

So far so good. I had a grilled cheese sandwich the other day and other than just chewing the food well no problems. The thing that I have noticed so far is the full feeling. It feels like I ate way too much when in reality I did not eat as much as I was able to before the surgery. That's not a bad thing though, I can stand to loose quite a bit of weight. It will take some adjustment. I did have some granola with yogurt and I tolerated that well. The biggest issue is just to chew the food properly. You know, make it mush that way is easier on the digestive tract. I have read that you can't belch after this procedure but what I have noticed with me is that it is a lot harder to do. I can just not very much, it goes out the other end. More flatulence is an unfortunate consequence. That I believe can be moderated with diet and if possible taking Bean O. The spirometer is a pain but it's necessary with pain management and trying to avoid pneumonia. I've been walking around the house and trying to stay mobile. I have been walking the dogs around the yard and today I will start walking around my neighborhood and see how I do. I plan to go back to work on Monday, I'm already on limited duty because of my wrist surgeries so I should be okay, at least I think so. They have me on a 10b weight limit for my wrists and the same because of this procedure so, paperwork and light duty is what I'll be on for a while.