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GERD & Acid Reflux
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Posted 12/4/2011 2:05 PM (GMT -5)
Basically I can get a free Nissen operation from my insurance but I want to cure my LPR symptoms. My surgeon is highly experienced especially in cases with LPR. I am confident he can do a good job. However, I am worried about the post operative healing as I have a moderate case of gastritis which I need constant food and liquid in my stomach or else the pains get severe. This could be do to the LPR as well.

I've recently read that a board member has flown to Italy to get the LINX procedure done for 20k euros. I'm not sure how much that is in US dollars but I"m sure that's a lot. I strongly believe in the LINX and I love the fact that you can go to a regular diet almost right after the procedure. It seems like the right approach but supposedly us US citizens can't get it cause it is not FDA approved even thought he got it. My question is, how did he get it and do you think it's worth it to cure LPR.

Nissen vs. Linx for LPR......that is the question.

Thanks.
Posted 12/4/2011 3:47 PM (GMT -5)
20k = 20,000 Euros  converts to  $26,777.34636 USD today.  Now don't forget the airfare, hotel etc.............

I would talk in depth with your surgeon expressing your fears re post-op issues.

Of course you may be able to afford the cost of going to Italy for this procedure.  I wish you the best and keep us posted.

Kindly,

Kitt

Posted 12/4/2011 4:44 PM (GMT -5)
I wonder if u could call your insurance, explain your situation, and see if they will pay for it. On a side note, it looks like the euro is in trouble, so maybe the procedure will get cheaper. Seems like every time someone quotes the price for linx, it goes up.
Posted 12/4/2011 4:51 PM (GMT -5)
i wouldnt go foreign...at least not just yet

how does one get follow up treatment 5 thousand miles away... and other issues

i wouldnt jump the gun on the FDA review, there are issues...

lets see what two years with those magnets pressing in... point... by... point... by...point.... on the LES does in a follow-up

hang loose
best wishes
mock turtle
Posted 12/4/2011 5:20 PM (GMT -5)
My GI also wants me to stop thinking about LINX - he says it is too new and Nissen is a better alternative since it has been around and there is no foreign object involved.

I'd been thinking about TIF though. If the GERD is not severe, I think TIF probably can do the job the same way Nissen does. Why don't we see more TIF stories here?

I am sure others have seen this - but wanted to see if you all have comments on these stories:
www.gerdhelp.com/PatientStories.aspx
Posted 12/4/2011 5:24 PM (GMT -5)
PPI-LESS,

My issue is more about LPR than GERD. Like most of us, we have been blindsided and consumed by this GERD/LPR thing and want the best for it.

I haven't seen much success stories regarding TIF and LPR. Even Nissen. However, when I spoke with my surgeon yesterday he was confident he could knock out the LPR symptoms still allowing me to burp. That it huge. I'm worried about my gastritis pains cause I usually need something to eat often to keep it the pains at a minimum. But maybe if the LES is closed, the stomach will heal as well? I'm not sure.

I thought the LINX was such a novel idea since we can return to a normal diet so soon and it does little the stomach. But I know its new and most surgeons would do what they are comfortable with. For me, the LINX just makes sense. But if there was that one guy who traveled to get it even without FDA approval I would want to do that and if it fails have my trusty surgeon here remove it and do a Nissen.

What do you think?
Posted 12/4/2011 5:35 PM (GMT -5)
Maximus,

I've been doing a lot of research into these surgeries for the last 8 months or so.

Even if LINX is reversible, it is not as simple as it seems. One will have to undergo a surgery to get it removed.

I am most concerned about any impact of the magnetic beads sitting on the outer soft tissue of the esophagus. Erosions and Migrations are the two aspects of this device that require long term study (technical literature on LINX points out that long term studies on these aspects are lacking).
Posted 12/4/2011 5:47 PM (GMT -5)
I had a TIF 7 months ago. I had some stomach issues to work out after the surgery but after they were cleared up it is working for me. My DeMeester went from over 28 to 5.8.
Posted 12/4/2011 5:47 PM (GMT -5)
PPI-LESS,

I remember reading about the migrations and erosions.......however, at this point I think I would prefer that than the actual LPR symptoms itself.......maybe lef the LPR symtoms heal......than by that time an improved LINX will be out.......But at this point I'm sure how much time we all have. I myself am on the brink of doing Nissen just to attempt to get rid of these LPR sympoms. And yes PPI's do nothing for me. I believe it's because of the UES or LES or something. It's more of a vapor that does the damage to us not so much liquid acid. But if the the LES can be tight enough through Nissen or the LINX that could help us out a lot I believe.
Posted 12/5/2011 8:10 AM (GMT -5)
Maximus, I also have that constant need to eat to keep the gastritis quiet thing going on. I find licorice (DGL) helps a lot. Is it worth some experiments to see if you can find something that controls that specific symptom, so that if you had a Nissen you would be able to cope? Maybe there's a medication (like an appetite suppresant) that would just keep that side of things quiet whilst you recover from surgery? Metaclopramide is what was recommended to me for that, but it makes me drowsy so I've never tried it. It would be fine on a temporary basis whilst recovering from an op though wouldn't it?

If you feel you want to go for a surgical option then I agree with the other posts - you need something nearer to home for your after care. Why not have a chat with your PCP or gastroenterologist about specific drugs to control the gastritis symptom, which could be taken alongside whatever else they'll be giving you during the post op recovery phase. And you can ask to try them out at home first (e.g. 3 or 5 day supply of each thing, just to test). It may be that something simple like a whiff of codeine is enough to keep the gastritis quiet?

That's what I'd do anyway.........!!

MMM
Posted 12/5/2011 11:25 AM (GMT -5)
Hello,

Thought I'd throw in my experience, being 12 days post op from a Nissen.

I have not had difficulty staying full. Since the surgery, my stomach has a different idea of "full" and its about a cup of food a meal, maybe a bit more lately. It was not difficult to stay nourished during the liquid phase by drinking ensure through the day, you actually get a decent amount of calories.

Now that I'm up to pureed foods, I don't feel nearly as restricted. I've had all kinds of soups, mashed potatoes, overcooked pasta, ice cream. I just eat slow and listen to my stomach to know when its full. Haven't felt hungry at all.

I used to get hungry a lot and I thought after the surgery I would be constantly starving. That was not the case.

Hope this helps. I also agree that your doctor may have some solutions for your concerns. Its just day 12, but the Nissen has already been very good to me, so I only have nice things to say about it.
Posted 12/5/2011 12:17 PM (GMT -5)
I am 5 days since my Nissen and do best with pureed soups and such (my daughter came home and cooked for me all weekend), no solids yet. The item I have the hardest time dealing with is cold water which sort of gets stuck!

I have a question on the Weight Loss part of the recovery. Before I left the hospital the nurse informed me I would be losing about 30 lbs. over the next year. I guess I had not done enough prior research on that issue. I eat healthy, not a lot of carbs, do/did nautilus every other day and cardio on the alternate days. I certainly expect I'll be losing some muscle mass weight during recuperation and at 59 there's always a few extra lbs every woman is willing to say goodbye to ... however I'm somewhat concerned about losing that much weight. Wouldn't want to end up looking like an old bag of bones when I'm pretty happy with the way I looked prior to surgery. I've lost 3 lbs to date.
Posted 12/5/2011 9:11 PM (GMT -5)
I'm leaning toward Nissen......The linx just seems so far away at the moment. This is again strictly for LPR sysmptoms.
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