Wednesday 24 July 2013

Week 4 Update

I just finished out 4 weeks of being bionic! Or close enough, with the LINX implanted.

Week 4 was better than week 3 - the heartburn I'd felt was more intermittent. I feel it more (and it's still mild, mind you) on days when I'm at work - I think it's due to sitting down all day, possibly with poor posture; and the inevitable stresses of the workday could be a factor as well. I also drink a lot more water when I'm at work, and drinking lots used to be a reflux trigger...perhaps it's the same effect, just really muted due to the LINX doing its job.

Went on holiday for 3 days and let me tell you, that was when I truly started celebrating over the implant's success. Eating was a breeze, with no reflux or heartburn -- and I made it work hard, with burgers and fries, big Irish breakfasts, chips, BLTs that were heavy on the B...I even had an apple fritter with coffee! Haven't eaten one of those without lots of pain and reflux for literally years - and forget about combining it with coffee. Gotta start watching what I eat soon for entirely different reasons! But I'm not quite ready for that yet. Still enjoying so many previously off-limits treats.

The comparison is really stark when I pause to think about it. 7 months ago when I was on a similar 3-day holiday in Wales I had nonstop pain and reflux, and was eating much less fatty foods.

Basically off the PPIs altogether now. I have some Zantac that I carry around with me but I've only used it once. I do find that I'm taking on average 1-2 Gaviscon tablets per day -- and I could probably do without it but it does help. Even if it doesn't get better than this (and the mild discomfort in the esophagus gets no worse), then I'll be successfully off the PPIs and pleased with the outcome. However...still hoping for more improvement, to the point where I can forget my meal altogether!

Exercise has resumed. I do Pilates most mornings, and cycle to and from work. I've been for a jog once and it is only due to how much I loathe running that I haven't repeated it!

Other supplements have resumed as well, albeit with some swallowing trouble that passes when I'm patient. I take calcium+D, magnesium and omega 3s. I take slippery elm capsules with meals. I hope to get round to ordering some water kefir grains soon so I can get some good pro/prebiotics in the system. I have intermittent, mild IBS and would like to see that gone also.

I've noticed an appetite change as well. My appetite has increased, and returned to what I now remember it used to feel like when I was a teenager. I had sort of an epiphany when I realized what the 'deja vu' I was experiencing was! Actually, I think I'm in a process of figuring out what a normal appetite is... since I'm not uncomfortable with reflux, heartburn, and having my every meal repeat on me for hours on end, I think I'm mistaking that "silence" for hunger at times.

Can't think of much else to report at the moment. Hoping that this time next week I'll report to not having taken a single PPI for a full 7 days! I'll leave you with a picture of Finn McCool's Giant's Causeway...



Wednesday 17 July 2013

Week 3 Update

Week 3 much the same as Week 2, but significantly less dysphagia. I've heard it comes in waves, so maybe it's coming back round again soon. I had only one stuck situation this week where I had to run for the sink, and again first thing in the morning, cold water and a pill. Should've learned my lesson! I was fine the other mornings though...just a one-off. Haven't had any issues with food at work though, which was a concern of mine as I'm in a small office where we all sit together and often eat together. Big sigh of relief there for avoiding awkward moments!! Very dry crackers like saltines are a no-no, but other than that, everything goes down. Water or liquids still seem more difficult than solids.

I have no onsite pain or internal pain. I occasionally have bloating more than usual, but nothing too obvious (I hope). I have a small frame so I puff out anyways after a meal :) I tried fizzy drinks this week, and have decided to swear off them. It wasn't comfortable afterwards with some gas pains for several hours. Just as well - they're bad for you anyway, right? Bit sad about sparkling alcoholic beverages though, as they were always a special (though reflux-inducing) favorite. Perhaps in good time.

I have continued to find that I can eat more, and more comfortably, than I used to be able to. I have been able to eat things like potato chips without more than the average amount of mild burn afterwards, which I assume other 'normal' people get. And if not, it's minor anyway and I don't eat them often. I was getting a bit discouraged about that today, but then I remembered that during my pH monitoring I had a bag of Walkers and my throat/stomach was on fire. The difference is stark, even if it's not 100% on/off.

So all in all, at the moment, I'd say I'm experiencing a 75% cure from my reflux. The number might be higher, as part of the issue is I don't know what 100% would feel like. If the post-meal  discomfort/pressure I described previously were to go away, I think I'd be at 100%. Perhaps in 3 months or so my body will have adjusted to being PPI-less and start regulating digestion more properly again - maybe that's the ticket.

In any case, I still feel like the LINX is a revolutionary device that I'm sure will spread like wildfire if the 10-year results are good.

Any questions are welcome!

Wednesday 10 July 2013

2 Week Update

It feels like ages since the surgery; I can hardly believe I'm only writing a 2 week update!

Incisions: Post-op pain is almost totally resolved. The largest incision is still tender at rare moments and I can feel quite a bit of lumpy scar tissue forming underneath it. But for most of the day I forget that I have had any kind of surgical procedure at all! No pain medication now for anything. Scars are small and already forming new skin and diminishing.

Reflux/HB: It's been a slightly less glowing report than Week 1 - hopefully just as my body adjusts. But the first thing to say is that I'm not really experiencing reflux or belching, or water coming back up the throat like it used to. So on that front I'm still in a whole different category than before.

What I am experiencing on a daily basis is some discomfort post-meals that sort of feel like stuff trying to come back up. Pressure, and discomfort both in the LES area and throat (not from heartburn, just from the pressure -- I think). It feels a bit like the reflux did BUT the point is that it doesn't come back up - i.e. I don't have a bad taste in my mouth or feel anything come through the UES. I would love for this symptom to go away, so that I can not have to "remember my meal" at all after I've eaten it. If you have reflux you'll know what I mean by this, I think! This symptom is also bothersome because I'm a singer, and so to have that feeling while taking a deep breath and trying to produce a sound...can be tough. Sort of like how you can't burp and talk at the same time.

I also have some sharp hiccup-type things after eating fairly consistently. Just a single hiccup, not the actual dreaded hiccups. "Normal" people get that sometimes, so I'm telling myself that it's a good thing because I'm now normal too! But in all honesty, I think it's probably related to the LINX device, and I'm guessing will probably change in the coming weeks.  

PPIs: I'm titrating down on the PPIs. Week 1 was full dose, Week 2 has been every other day, and now I'm heading into Week 3 where I'll do every third day. That might be contributing to the above discomfort. I do have gastritis as well, so some days without the omeprazole I get stomach pain in a very specific spot. I seem to have really localized irritation - and had that way back 4 years ago when I first got on the meds. I'll be trying different ways to soothe this now that reflux is under control. Slippery Elm Bark has been promising before...but I hate the stuff! Recommendations welcome (I've tried a lot already!).

Dysphagia: I had my very first dysphagic moment on day 9, but it was just uncomfortable and nothing patience and water didn't cure. Then all of a sudden yesterday **it got real. Yesterday morning (Day 12) I had a lot of pain trying to get the first swallow down in the morning. Not a nice feeling. Otherwise I was fine throughout the day, trying to CHEW, SWALLOW, PAUSE. This morning was even worse. I took some water, which hurt going down, then took a tiny allergy pill, then a bigger supplement. The bigger one (half the size of a penny) got stuck, hurt like crazy, then the saliva routine started up. I had gushes of it washing up and finally sort of vomited it into the sink (sorry...if you're reading this I assume you want to know the gory details!). Unfortunately, the pill didn't manage to come up, so it was stuck there for another few minutes before passing through the device. Horrid. And I wasn't too keen on drinking more water to get it down either! I made some warm tea which seems to help and then 5 minutes later porridge went down basically fine. First bite of most meals seems the worst.

I had chicken salad at lunch today and had one stuck bite with pain, but no bringing anything back up (thankfully...I was sitting at my desk at work and terrified of rushing into the bathroom!!). I've heard that meats can be tricky, as can breads. I agree on both counts. It seems like if there's a big break between meals then the first swallow is worse as well.

It's weird because sometimes taking a big, painful gulp of water gets things down. Other times water seems to make it much, much worse. Did anyone else experience the water thing?

My note-to-self is warm tea with meals to get things opening before eating. And chewing. And pausing. And no pills first thing in the morning :)

Foods enjoyed: This week was a little less exciting as it didn't involve Indian food, sadly, but in terms of trigger foods I got a few in. I loved eating three slices of pizza (never would've risked it right before a rehearsal...but it was totally fine!), big bowls of breakfast that actually kept me full (I usually had to eat small breakfasts because that was a really refluxy meal, no matter what I ate), grilled sausages. Oh, and dishes with garlic and peppers. Both those foods made their presence known to me for hours after I ate them with reflux and what I'll tactfully call "scented belches".

Activities enjoyed: 
  • Cycling in to work in the morning - formerly always painful because of reflux. 
  • Lying down after dinner - might be habit-forming now that I know how nice it feels! 
  • Not worrying about strong flavors in dishes - though garlic breath is never one's first choice.
  • Eating more in one sitting in general. The nice side effect of this is not having to snack as much.
  • Still not exercising regularly yet, though I cycle to work and back and walk during the day. Hoping to get some strength work in soon, though I want to take it easy on the abs. 

Thursday 4 July 2013

Day 7

Well, we've made it to the last of the daily updates one week post-implant, and the news is all good! I haven't experienced reflux or heartburn (though I haven't started titrating down on the omeprazole yet) and have been able to eat regularly with minimal discomfort. Incisions are already fading as well. I'm no longer taking any pain medication or Gas-X.

Mobility is good, though I think I still have a bit of a protective hunchback pose much of the time because my back is sore by the end of the day! Once the main incision is better healed that impulse will disappear. No exercising yet but walking around fine.

Made it to rehearsal for the show I'm doing as well and managed a few leaps and twirls in the dance number (albeit slightly muted on the leaping front :)

As for lingering negatives, I still do get occasional upward pressure a few times a day that is quite painful but very manageable. After a biggish meal I have more bloating than I used to, and I think I'm still a little bit bloated in general. But that will improve (a) and is still completely work the lack of reflux (b). Also having a bit of dysphagia when swallowing liquids or lighter foods like fruit, bu it's not really painful or anything that patience can't beat.

I'll check back in a week's time for another update.

Trigger foods conquered today: pizza, apple!

Wednesday 3 July 2013

Day 6

Progress continues to be good. A few instances where swallowing has felt constricted, especially (weirdly?) with liquids. Cold ones worse than warm. But if I'm patient, they pass through. No significant problems with food yet. I continue to have occasional pain after eating (see previous posts) but again, no real belching or reflux which makes me SO happy!

Went out yesterday to a coffee shop for two and half hours and my back was pretty sore by the end of it. Didn't mind too much because I was drinking coffee again :)

No significant pain around the incisions, and only a few stabs of discomfort at the implant site itself. I feel lucky because it seems like some people have had many weeks of real soreness around the LINX. Perhaps it's still yet to come for me, but I'm optimistic.

Removed the opsite dressings on all but the big incision, and the scars are already smoothing over. I can tell already that they're going to fade to nearly nothing - in a way, I hope I have one or two battle scars to show for it!

Trigger foods conquered today: Indian food, tortilla chips, coffee, bacon

Tuesday 2 July 2013

Day 5

Really turned a corner today. Didn't need any tramadol, and only took 2 doses of the over-the-counter analgesic. Still getting the uncomfortable upward pressure feeling after eating, but having no reflux or belching is WELL worth it. I could probably be back at work today or tomorrow, for those interested in the LINX and wondering how quickly a return to work could take. I'm off until Wednesday though, and definitely enjoying the free time to take it easy.

As some others have described, my back does get a bit sore after sitting upright or not changing positions. Not sure why - might be that I'm holding myself funny because I'm subconsciously protecting the incisions. Maybe gas related pains. My partner did tell me that I'm "walking like a cavewoman", which I thought was rather indelicate :)

I'm not usually given to making sweeping statements, but especially if the upward pressure type feeling lessens, this procedure will be a life-changer for me. Can't wait to see how it pans out. I'm interested to see how much of the dreaded week 2 to 6 dysphagia I will experience...I don't want to get too complacent and then get a shock!

I'll switch to weekly updates after Day 7, but in the meantime I'll leave you with some more good news...

Indian food for dinner (big trigger) with a little bit of wine, and ice cream afterwards: no reflux!

Monday 1 July 2013

Day 4

Another woozy start to the day. Managed to sleep in spurts, but woke up at 4 needing to hit the tramadol! I certainly miss the hospital bed with its easy up/down movement; it can be tough to get comfortable.

Everything still going down easy and I'm getting more confident which is good. Definitely having an increase in that uncomfortable upward pressure in my esophagus. I remember reading that someone else had this and said it felt like reflux which made her worried that the LINX had failed. It does feel like reflux, but my instinct is that it's just my body getting used to the implant. It's definitely not a pleasant sensation, but it's a long way off from the old acidic/food burp scenario after every meal (forgive the imagery). Even if this is the new normal - and I don't think it is - I'll be happy with the improvement. So much of healing well is staying positive and seeing the big picture. (On that topic, I can recommend a cheesy but engaging read for your next long-haul flight: The Happiness Project by Gretchen Rubin.)

Incision sites are pretty itchy on and off. It's hard to believe that in just two more days I'll be taking off the waterproof coverings on the incisions. The body gets to work repairing itself so efficiently!

Managed to drive to church today and back, but only made it through an hour. The gas bloat makes it tricky to sit in one position with shoulder/back pain. Nonetheless, it was definitely doable to get out and about as long as I was walking very slowly. Every day I feel more and more able. 

By the end of today I was feeling much better than the beginning - basically at exactly 72 hours after the procedure. If you've already had the LINX, when did you start feeling more mobile, etc? 

Food today: banana porridge, blueberries, pork/bacon chili with rice (amazing to eat chili without reflux/belches!), ice cream, crackers, and a delicious square of chocolate to cap off the day.