Op day plus four (Tuesday)

Good night's sleep.  Didn't have to take any painkillers in the night - mostly undisturbed sleep.

No BM yet so I take another sachet of the laxative.  Second shower, then change some of the dressings and incidentally have a look at the stitches.  The new dressings are too big really, and I drop one of them on the floor after I've started to peel off the backing so probably I'm one short, but I didn't change all of them as at least one of them didn't need changing.

Feeling a lot better today.

T prepared a small bowl of pasta with bolognaise sauce for lunch; she cooked the pasta so it was ultra soft, and the sauce was mince-based, so no lumps. I was feeling desperate for something a bit more solid and it went down a real treat.  Even though it was all quite soft, I chewed everything as small as I could.  Delicious. My stomach felt very full though.  Loved it so much I had a bit more at tea time (meal times have become frequent and small - most of them can't really be given names.  Tea time is about 4 - 5 p.m.)

Hopefully the stomach will persuade the bowels Ke Nako (It's Time!)

Bed early - 9.30 p.m.

Op day plus three (Monday)

More of the same. I'm beginning to feel like the soft food snacking isn't enough though - I'm actually feeling HUNGRY!

I've examined the operation area now I'm feeling more bendy.  Why did they shave my right thigh? T thinks they must have had a shaving newbie and they were checking his/her work - I think maybe it's a way of checking they were sober (just joking, folks).

England end up thrashing Sri Lanka at the cricket - very exciting last session (if you're an England supporter!)

Still no BM so take a sachet of the laxative tonight - just one, don't want to risk overdoing it.

Op day plus three (Sunday)

Taking it easy today.  TV, lying down, snacking, napping: that's about it, really.  Haven't got the concentration powers to read. T is waiting on me but now and again I get up and around, I must get some mild exercise. 

Op day plus two (Saturday)

Woken up at 4 a.m. again.  Feel a lot better than yesterday.  Breakfast arrives (late) and I'm starving.  Yoghurt, scrambled egg, coffee.  Feel hungrier.  Surgeon appears 9-ish, seems very happy with my progress, asks me if I want to go home... nearly bite his hand off.  About half-an-hour later, T is here, the drip is out, I'm given some dressings so I can change them once at home when I need to.  Then sign myself out and walk to the pharmacy downstairs where I get a big box of painkillers and laxatives (I asked for the latter, I still haven't "been", but the surgeon is unconcerned).  Then to the car park to wait for T's Mum.  I sit in the front seat, the seat belt seems to avoid my wound area (but probably should have sat in the back).  T's mum takes it slowly, it's only 5 minutes anyway.

I have to say the care I've received has been first class.  The staff have all been lovely:   friendly, professional, excellent.

Feel soooooo glad to be home.  Tired from the extra exertion, feel a bit light-headed but no more than uncomfortable on the pain front.  Later on, manage a shower - on my own, though T stands (well, sits) guard in the bathroom just in case.  Also shave for the first time in 2 days.  Afterwards I am completely knackered.

Painkillers make me feel a bit sleepy, but as the day comes on I feel more uncomfortable so I have no choice.  Watch the European Champions Trophy final, Man Utd are outclassed by Barcelona, then straight to bed.

Op day plus one (Friday)

Woken up at 4 a.m., mostly because the guy in the other bed needs work done on him - he's clearly a lot worse off than me.  The doctor appears about 9 a.m. and tells me again (he popped in after the op yesterday) that everything went well.  He has some photos of my insides and explains them.  I can see the stitches where he mended the hiatus hernia which was allowing my stomach to protrude through the diaphragm, also the stitches where the fundus has been wrapped around my oesophagus.

The only worry is that in the stomach he found some very small polyps - they appear white in the photos. They are very small and he seems very confident they are benign but he has taken biopsies to have checked.

He seems confident I'll be ready to leave tomorrow (op day plus 2) as long as I can eat.  He asks me if I want to try soft food for breakfast, so I do.  I think it was yoghurt (my memory of this time is not perfect - but then again it never is), but anyway it goes down smoothly. As I'm finishing T and her mum arrive and I tell them I'm feeling OK.

The rest of the days passes slowly and with many naps.  I have coffee, and at lunch I have yoghurt, jelly and custard.  There is additional pain relief, but not as much as yesterday.  I am tired and still a bit light-headed but otherwise feel fine.  I manage to use the toilet several times on my own, but still no bowel movement (this is a normal side-effect of the surgery, and anyway I've hardly eaten anything).  Tonight I'm off the drip (the line is still in my arm, though) and I get a sleeping pill and fall asleep within 15 minutes.

Operation Day (Thursday)

I'm back home again now, but before I get into detail I want to talk about how it all happened, as if I was telling it on the day.

Thursday, 5 a.m. alarm call. Not much to do really, I can't eat or drink so basically just a shower and in theory a bowel movement.  In actual fact, not the latter, I guess it's the nerves. T and I get a lift from her Mum to the hospital, which is only 10 minutes away (less if you exclude the parking).  7 a.m. as requested, sign in at reception, very easy as I'd done most of the paperwork last week.  Up to the ward and shown to my room, a 2-bed room with shower/bath and toilet; no-one in the other bed when I got there.  I wasn't given an op time but I noticed 3 others on his list.  Two of them were a lot more serious than mine, and it's good to be reminded that actually, I'm quite lucky to be only in for elective surgery.  Although the temptation is to change my mind...

Into the gown - got T to tie it up at the back for me so at least for now no-one can see my backside.  The room is warm and clean and the bed comfortable.  No view though, unless you count an alleyway between me and the theatre block.  The nurse gets a medical history, about a hundred questions about allergies, past operations, etc. etc. We get an explanation of everything that's going on and eventually T leaves (did I notice a bit of eye-watering there?).  Now it's about 8 a.m. and I'm on my own.

The anaesthetist pays me a visit and introduces herself.  I wait.  Rather than stay in bed (I'm going to be lying down enough in the next 24 hours), I get up and walk about the room.  The sun is up now, but the view hasn't improved. The sky is grey and drizzly, not the sort of day you want really - I can't help thinking "What if something goes wrong and this is my last day?"  I'd rather a view of the sea and a blue sky, perhaps a bit of birdlife like at home.

Anyway, the call comes just before 11 a.m., I'm put on a trolley and go down a floor and round to the theatre waiting room where I watch TV for 10 minutes (no sound) before I'm wheeled into theatre.  The surgeon is cracking jokes to put me at my ease and everyone is smiling and laughing.  There is a TV, presumably for the laparoscope(s). Then the needle goes in (about 11.10) and it's goodnight, Vienna.

Come round (hooray!) about 12.45 in the recovery room.  Woozy but able to tell the time so not too bad.  The next couple of hours are a bit hazy - I'm in and out as I nap - but I can remember finding the cricket on TV, England vs Sri Lanka.  The start has been delayed by rain so I didn't miss any! Although in the end I see both wickets that fell today, I probably miss a lot of the play while napping.

There is some pain, but not excessive.  I get painkillers, very effective, and they also help me sleep.  They've managed to do the op laparoscopically (there's a chance that if there was a problem, I'd have to have the full incision, which basically doubles the recovery time and more painful).  I have 5 small-to-medium plasters in my stomach area: have a look at the photo (taken on Monday, after I'd managed a shower).  One is a mm or so below the breastbone and I notice over the next couple of days that this one gives me the most grief as its rubs against the bone occasionally.  The stitches aren't the dissolving kind, I have to return to have them taken out.

I am  given a glass of ice chunks to suck on (my mouth is quite dry) and the water goes down OK.  At some point I feel the urge to urinate, and a nurse watches me to the bathroom.  I don't need her help! The toilet is just inside the door and with the aid of the safety rail I make it on OK (I don't lock the door).  The stream is a bit weak but my diaphragm area is sore and squeezing is not easy.  Back to bed, very pleased with myself.  I'm a bit light headed but feel competent.  I probably shouldn't sign anything legally binding at this point, though.

One thing that worried me about what I found on the Internet is a lot of people found that after the op they could no longer burp.  My surgeon explained beforehand that he preferred a slightly less tight tying around of the fundus so this shouldn't be a problem.  There is a lot of gas coming out in the other direction at the moment - as I understand it they inflate with gas during the surgery.  I don't think you can possibly imagine how delighted I am when I get my first burp up!

One day left

Have pretty much done everything I think I need to do ready for tomorrow.  Had to go out yesterday go get some pyjamas (I usually sleep in the nuddy - I assume that probably doesn't go down too well in hospital).  Chosen myself a book to read and decided I'll take my book of Times crosswords (I hope I'll be awake long enough).  If all goes well I'll be out on Saturday.  I've done a living will (better to be safe) and arranged for T to send a text message to my children when I'm awake and OK.

I've got to go without food and drink from midnight tonight.  My meal this evening needs to be something non-dangerous - I've got to get up at 5 a.m. tomorrow and don't want to spend ages in the bathroom...

Allegedly for the next few days I'm not going to be eating too much, certainly nothing solid - no steaks for a while (or any chewy meat).  So we've got lots of soft stuff, soups, yoghurt etc. for me when I get home.  And it sounds like my bowel habits might be disrupted.  Fun, fun, fun...

Why I've waited so long

Firstly, let me just say that I'm not an expert.  I'm just a patient.  Any knowledge is based on what I've gone through and what I've read.  Some of my opinions may be wrong.  In fact, if I were you I'd treat them all as wrong!  Go and see your doctor! Don't just live with it!

So I looked at how complicated the operation looked and thought: "My symptoms aren't worth risking having all that done".  To be honest, it looked like the beginning of the long slide into old age - the first sign that my body has begun to betray me.  And I put off action, knowing that eventually I would probably have to give in to fate anyway.

The best website I've found for answering the sort of questions I was asking was:
http://www.surgcare.co.za/B_PC_hiatus.asp#WHB_HHNF

Over the next year or so, the symptoms have got  steadily worse.  For example, one night a month or so ago, at 1 a.m., I woke up almost choking on my stomach acid.  This was not the first time, but the first time it's been so very bad.  My guess is that I sick up acid which I then breathe in, and my windpipe tries the best it can to deal with it.  I was finding difficult to breathe and I was seriously considering ringing my medical aid number.  Slowly, over an hour or so, my breathing got easier, although my throat felt as though it was burning.  I was frightened, and I thought: I'm not going to let this happen again.  But I still waited a couple of weeks, and the next week I had (in the daytime) very bad indigestion which lasted four days, which I tried to control with more antacids several times a day.  And then it just cleared up overnight and it was like nothing had happened.

In both these new events, there was nothing obvious that could explain why it had happened. No particular food or drink that could have set it off.  And so I rang the surgeon I'd visited before and booked to see him.  It took a week.  This time I took my better half, who deserved to have it explained better than I could, as she was going to have to put up with the consequences (indeed, she has done - for years!)

So we went through it all again, and this time, with research and hindsight, I think we took more of it in and asked more intelligent questions. He agreed I sounded like I was more in need of the op than before.  And when he asked if I wanted to go away and think about it, I looked at T (my better half) and said to him: no, let's book me in.  He had a space in his schedule six days away, and so we booked.  And now I'm counting down.

So we went to the pub, had a meal and some beers (a risk, I know!), looked at the view (the Indian Ocean) and contemplated what's got to be done in the next week.

Five days to go.

What it is and why I'm posting about it

I'm about to go into hospital to have a Nissen Fundoplication. Which is all very well and ordinary, nothing rare at all, except that when I consulted the Internet (the fount of all knowledge) to find out about my op, all I found was a lot of confusing advice (a lot of it too scientific) and very little personal experience.  So I thought maybe people who get to the same stage as me in the future might like to know what it is, what it feels like, what effects it has and whether it's worth it.  I've got a week to go and I'm counting down.

I'm in my mid-50s now and I've been having "heartburn" (a catch-all description of a number of symptoms) for years:  it's probably at least 20 years since it first started.  Indigestion was the first sign, but we all get that, don't we?  As the years went past, some foods and drinks became - well not exactly dangerous, but risky. Anything with onion in it, orange juice, red wine, carbonated drinks (anything over a couple of glasses), beer: all these things (and more) became a source of discomfort ranging from mild burning to downright pain.  Lying down after eating or drinking became a no-no - even small meals mean a minimum now of 4 hours before lying down, big meals even more.  Waking up at night and scoffing Rennie (a brand of antacid tablet - calcium carbonate) became a way of life.  In extreme cases, burning liquid rose up into my throat in the night while I was asleep and got breathed in down my windpipe - very, very unpleasant.

I'd been on PPI's (Proton Pump Inhibitor) drugs for some time, to keep my excess stomach acid under control, but despite trying several different brands, at increasing doses, my symptoms got worse.


So, I went to the doctor, and he sent me to hospital to have a gastroscopy.  For the unitiated, a tube with a camera on the end, stuck down my throat to take pictures of the area around the entrance to my stomach, to see what was happening.  The first time this happened, I was given the option not to be knocked out, and boy, do I wish I'd not taken the option up.  Believe me, the gag reflex is very strong.  But I survived it and they said I'd got a small hiatus hernia (the stomach bulging up through the diaphragm) and Barrett's Oesophagus (basically, scarring of the area just above the stomach).  They did a biopsy and I didn't have anything nastier (such as stomach cancer) - obviously, a relief.  They called it Gastro-Oesophageal Reflux Disorder, or GORD (they call it GERD it the States).  We kept the symptoms under relative control with drugs and I put up with them - they still were bearable and intermittent.


But I got older, retired, and spent more time eating and drinking stuff I enjoyed (this may or may not be connected), and gradually the symptoms got worse.  In 2010, they got so bad I went back to the doctor and I was referred to a specialist and then to a surgeon and this was the first time I heard of Nissen Fundoplication.

When I got home, my first stop, as usual, was Wikipedia:

http://en.wikipedia.org/wiki/Nissen_fundoplication

More of my history to follow.  6 days to go.