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What's Up With All The Tipping?



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Whoa there Green. Calm down. I know that you're very worried and right now you're very uncomfortable and anything you eat causes you grief. But trust me, it can get better and if you play your cards right, it will!

The very first thing you should to TONIGHT is to elevate the head of your bed.

You will probably be told to take some kind of medication that will calm down the cough and reflux (making your throat burn) and the pain in your chest. That will take some time to get resolved because yours is in such an inflamed and angry state.

I have had a hiatal hernia for 20 years. At least I did until I had the LB surgery. When my doc did the surgery, he repaired my hiatus hernia. Many of the people who post at LBT, have one too or did until they had theirs repaired. It is usually diagnosed with an upper G.I. series of x-rays.

I didn't consider the surgery sooner because the surgery for many years was not all that successful and many times made the situation worse. That was before doctors became so proficient at laparoscopic surgery.

My LB doctor was chosen by me because for years he has been a leader in the laparoscopic surgery for correction of a hiatal hernia. He has taught many other doctors how to do the procedure and has done thousands himself over the years. He decided to start doing the LB surgery because with his exposure to so many overweight people who he treated for their hiatal hernias; he knew how difficult it was for them to lose weight and keep it off. He felt that the Lap Band was the first thing with a relatively low risk and high success rating, and since he'd been working in the "neighborhood" for so many years, with a laparoscope, it was a natural transition.

You have to understand though that I lived for over 20 years with my hiatus hernia. Gaviscon was the drug of choice back then, but I just couldn't gag the stuff down. Nowadays, they have Prilosec and Prevacid which are much more effective. The one that worked the best for me was Prevacid. When I took it and elevated the head of our bed, it was almost like I didn't have a hiatal hernia anymore. Sweet relief!!!

So don't worry too much. It is definitely treatable. Personally, I wouldn't recommend a repair since you already have the LB, but of course I'm not a doctor, much less YOUR doctor. If you can get a medication to work for you, long enough for it to calm the area down, and you stay really aware of what you eat and drink, and smoke... you can whip this into submission.

Now for the not fun part. You really do have to quit drinking coffee or tea for a while. You have to quit drinking Scotch (or other alcohol) for a while. You really do have to not eat chocolate. And smoking really aggravates it. You need to stop that too. You just have to baby it until you get the thing under control. Spicy foods are out. You can forget chicken fried steak or barbeque, at least for the time being.

Yeah I know, for a while it's going to be a huge, seemingly impossible way to live. But when you have as many problems as you're having, you just have to give it a chance to heal as much as possible and then baby it for a longer period of time. The Prevacid takes about 3 weeks to really kick in, but you'll find yourself not coughing and uncomfortable after a meal.

Any other wisdom out there for Green on this topic?

Who loves ya, baby? :)

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P.S. None of my doctors ever mentioned it, nor have I read any literature on it, but I swear that the other problem that you were having (when I diagnosed you as having picked up a bug on your last trip to Mexico), was also a symptom that I had to deal with when I had the hiatus hernia. I never knew when it was going to hit me and for years, it was a real problem. I did find that taking refrigerated acidopholis that I bought at a health foods store helped tremendously in getting that under control.

Sorry I missed the proper diagnosis on that one. I remembered the bug I picked up in Mexico and how bad that was long before I had the hernia, and never dreamed that your problem could be as a result of a hiatus hernia! Two very different problems, but both with the "dumping" symptom. If you'll pardon the term. (A real term in medical books, by the way.) :)

Here's some :):girl_hug::):girl_hug: and :kiss2::kiss2::kiss2::kiss2: coming your way. Hope you feel much better soon!

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@ BJean: ugh! I have a hiatus hernia and this is what has been causing me so much grief over the past 6-7 weeks. I had an upper G.I. exam done this morning at 8 A.M. and this was the diagnosis. Of course my first reaction was jubilation because it ain't cancer - in fact I hugged the antique doc who was overseeing the tests when he gave me the news - but now I find myself eating the reality sandwhich and thinking that a hiatus hernia is seriously ugh! for Green. I went on the internet as soon as I got home and I saw the creepy little diagrams, eh. blehhh!

I will be seeing my doc tomorrow in order to discuss my latest health issues. I do find myself wondering whether this hernia thing is the result of my band surgery or not. I still find myself feeling much happier about my new-found slenderness. On the other hand, I am kind of freaking out about this hernia bizness! Oh! I am in such a flap!!! And my throat continues to feel like it has been painted with acid and I cough a lot and I am hoarse when I speak. I do sound like a Goodfellow, if ya know what I mean.......:omg:

Green...

Do you have a wide hiatus or a hiatal hernia? Either way, if you had it at the time of your banding it would have likely been fixed at that time. Or it should have been fixed at the time. My guess is you didn't have it then. Obesity can cause a hiatal hernia. It's just 1-2 stitches and it's fixed. The scars are exactly the same scars for banding.

In the meantime are you taking any proton pump inhibitors? Something like Nexium, Protonix, Prevacid, anything? If not, you might want to talk to your doc about that and see what he says. It can make a huge difference. If you are hoarse and such from reflux, this must come to an end. That's not good.

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Bubble: What's the difference between a wide hiatus or a hiatal hernia?

My doc said that if mine was too big he wouldn't be able to do the LB surgery. Another woman was in one day too that I met who had a really big one. She was having to get it treated which was likely to take 6 months or so. But after it had calmed down, she was going to be able to get the band.

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Bubble: What's the difference between a wide hiatus or a hiatal hernia?

My doc said that if mine was too big he wouldn't be able to do the LB surgery. Another woman was in one day too that I met who had a really big one. She was having to get it treated which was likely to take 6 months or so. But after it had calmed down, she was going to be able to get the band.

This link explains it better than I can.

eMedicine - Hiatal Hernia : Article by Waqar A Qureshi, MD

Essentially, a hernia is a hole that requires 1-2 sutures to close. A wide hiatus is where part of the diaphragm should be a small "V" shape and instead it is an exaggerated "U" shape. It usually requires a single suture to tighten it up a bit. I've seen the procedures several times and it's pretty cool to watch the repair.

My doc fixes them right before he places the band.

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Oh, thanks. I thought the terms were interchangeable. Yeah, my doc fixed mine when he placed the band.

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Oh, thanks. I thought the terms were interchangeable. Yeah, my doc fixed mine when he placed the band.

One thing I thought was kind of interesting was that there is connective tissue that attaches the diaphragm to the esophagus. It's like on a huge roast, you know that thin but tough tissue paper like stuff holds the pieces of the roast together? Connective tissue is like that.

When they are doing a hernia repair they only cut enough of the connective tissue to get to where they will be working when they are going to place a band. As little as possible is cut. When they are just doing a hernia repair and not a band too, they cut all the connective tissue so they are really cutting the diaphragm away from the esophagus.

For some reason this is preferred, they prefer not to cut much connective tissue if they will be placing a band after the hernia repair.

I noticed it and asked why and although he explained it, between his accent and Spanish version of medical terms, I really didn't understand what the heck he was talking about. I'll ask again when he's not operating and has time to really explain the reasoning to me. Not sure why I thought that was interesting, but it was at the time. :cry

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Bubble that is definitely interesting. If you find out why they don't cut the connective tissue completely when there's a hernia repair, I'd sure be interested in learning why too. I wonder if it is so that the hernia repair will stay in place better?

It also makes me wonder if there's a correlation between bandsters with hernia repairs and those without, as it relates to weight loss? Thanks for any info you can share.

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Bubble that is definitely interesting. If you find out why they don't cut the connective tissue completely when there's a hernia repair, I'd sure be interested in learning why too. I wonder if it is so that the hernia repair will stay in place better?

It also makes me wonder if there's a correlation between bandsters with hernia repairs and those without, as it relates to weight loss? Thanks for any info you can share.

I never thought about that... the correlation between bandsters with hernia repairs and weight loss issues. That's interesting, I'll ask him. I'm going for a fill with someone else the middle of next month. I'll ask him.

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I had a series of upper G.I. X-rays and what I have is definitely a hiatal hernia. The elderly doc involved with examining the pics told me so after my photo op was completed. He was quite interested in my lapband hardware, by the way. :) I know that I didn't have this when I was banded last September. The sore throat and hoarseness and the irritating cough are all recent developments in my life, dating back to shortly after my latest fill. Since then I have had a defill, figuring that this would put a stop to my symptoms. (Interesting to hear that my other disgusting dumping problem may have been related.)

Anyhow, this morning I phoned the Lapband folks who did my band. I spoke to a nurse and she is going to talk to the doc. If I do need surgery to fix the hernia I want him to do it; I don't want my band to be damaged while the hernia is being repaired. I sure do love my band! ;)

As for meds, my doc has me taking omeprazole which isn't giving me any relief so far. I guess I really will have to cut out the spicy food, scotch, dark chocolate, etc for awhile.... *sob* :think

Thanks to both of you for calming me down and giving me advice and allowing me to freak out!!! :kiss2:

I will be going to my doc soon in order to learn the results of my unsatisfactory blood tests. Another ugh in store for me. :tired

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As for meds, my doc has me taking omeprazole which isn't giving me any relief so far. I guess I really will have to cut out the spicy food, scotch, dark chocolate, etc for awhile.... *sob* :think

:tired

Omeprazole won't work the day you take it. The absolute minimum amount of time is 24 hours before you even begin to see a difference. It can take a few weeks before it kicks in but you should be noticing a difference reasonably soon.

BJean is correct, you do need to cut out a lot of excess acid causing foods, raise your bed, don't eat before bedtime, no alcohol, etc. This does need to be treated so it does not cause "forever" esophageal problems such as cancer, scarring, stricture, etc.

The surgical fix for this is pretty amazing. When you wake up in recovery you'll already notice a difference. It's an immediate cure. But it is very similar to banding. The nerve that gets irritated and makes your shoulder hurt will really kick in after this procedure. But the recovery is pretty much the same as banding but ... NO POST OP DIET! Yippeeee! :)

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I've been taking omeprazole for over a week now and before that I was poaching my husband's pantoloc. My throat still feels awful and I now sound like a member of the mob when I talk. :omg: I am going to cut out the acid foods and drinks, a toughie for me as I love the taste of items which fall into this category. :help: Green is not a happy grrl. :think I guess I will discover mo' bad news when I see my doc for she wants to discuss the results of my latest blood tests with me. :sick This may call for a really big shopping spree! :phanvan

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Green...

When do you see your doc for lab results?

In about a half hour from now. :phanvan

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