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I had always heard of Nissen Fundoplication as a last resort too. In the CF community reflux is quite common and most parents I know who have faced this decision have gotten 2nd, 3rd, 4th opinions. Ricky was a candidate about five years ago and I got a second opinion which ended up in him not having the surgery. He does fine on reflux meds. Of course for someone who does not have improvement on reflux meds, surgery might be the right choice.
Another thing to consider, a person who has had Nissen cannot burp or vomit. This may not seem like a horrible thing but it is good to be able to vomit when you've got food poisoning, for instance! :)
Have you asked if they can just do surgery on the hernia (I guess that's plural now, actually) and not the Nissen to see if that will help with the reflux?
All of this just my humble opinion, of course, but something to think about.
Best wishes,
Becky in CA
thanks for the information becky. no, i didn't know that you can't burb or vomit after the procudre, which seems like an important thing to leave out. i haven't had much time to look into it, except for quick searches on the internet ( always dangerous, of course ).
indeed, kris and i are going to advocate that they repair the hiatal hernia and not perform the nissen procedure, unless they give us good reasons for doing it. and even then, i'd imagine that we'd get a 2nd, 3rd and 4th procedure.
I can comment on the ROP post-op by saying - Are you sure we didn't have the same eye surgeon? Those are the exact odds we were given the second week AFTER surgery. I am happy to report that Kyle's vision is still perfect. It is something that we have followed up on every month though -just in case there is a change.
I agree on trying to hold off on the fundo op. Sounds the hernia may be the issue. Kyle is experiencing Kidney refulx (Hydronephrosis) - they are holding on it's repair for a while, because his stomach reflux actaully contributes to it, and the Hydronephrosis often goes away after regular reflux resolves. Strange how all of these things affect other issues in ways that you normally wouldn't realize.
Good Luck :)
The fundo isn't such a bad operation. Burping is still possible, but what happens is that there isn't as much flexing of the pyloris after to allow the stomach contents from rising up past the repair. This is a good thing. I've had many patients who've had this procedure done and the results are amazing!
It's scary and overwhelming, I know. But the hernia can be repaired at the same time and with the fundo in place, another herniation in that location is far less likely.
Hoping and praying for all of you!
By Da Goddess, at 4:40 PM
well, for now we're going to wait and see if the reflux improves with non-surgical treatments and a little time. apparently, it's standard operating procedure for them to do both the fundo and the hiatal surgeries - meaning that i'd have to push pretty hard to get them to not do one and not the other. the fundo seems to be one of those areas where you can get the entire continuum of responses when you ask if it's effective and relatively safe. a recent journal of neonatology article on GERD, certainly indicates that it's something to do with eyes wide open:
The success rates of the
fundoplication procedure have been variously
quoted as between 57-92%. Mortality in large
series has ranged from 0-4.7%. The overall
complications rates have varied from 2.2 - 45%,
most common being breakdown of wrap, gas bloat,
intestinal obstruction and infections.that said, i've heard from plenty of people that the effects of untreated, chronic reflux can also get quite ugly and that's it's worth the risk. at least we have a little time to do more research and hope that the barley in his feeds helps keep things under control.
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