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Fundoplication
(Surgery that Cured My Aching Heartburn)
Since about 1971 I had suffered from terrible acid reflux (GERD, heartburn.) I first sought medical help in early June of that year as I was rehearsing in Princeton, New Jersey for America’s Youth in Concert’s first European tour. The physician didn’t seem terribly concerned at that point, but for me, it was more than a nuisance, it was painful and getting worse. I attempted to survive on OTC remedies (Alka-Seltzer, Tums, Rolaids, Maalox, Mylanta, etc.) and prescription medications (Zantac, Tagemet, Prilosec, Nexium, etc.) Each seemed to work for a time but the ailment continued to get worse. I also slept on an 11-inch "wedge" to elevate my head to discourage the acid's ascent into my throat. Eventually, I sought the advice of another physician who suggested an "upper GI" scoping. I asked what this entailed, and was told that a tube would be forced down my esophagus into my stomach to see what was going on. He also told me that he would snip small pieces of the lining of the stomach for later examination under a microscope. (Although he didn’t tell me this, it was to check for abnormal things like cancer.) I asked where he would do this procedure, and was told that he would do it in the chair where I was sitting.
That sounded a bit drastic to me and I thought that "I can just live with it." That was a huge mistake as the ailment became increasingly worse. I also had been told, because I was a singer, the vigorous use of the diaphragm probably had added to the difficulty. I thought, "I should have remained a clarinet and piano player!" Life almost became unbearable. I would awaken in the middle of virtually every night with huge amounts of stomach acid in my throat and mouth. I would suddenly sit bolt upright choking, coughing, and in misery. Inhaling the nasty acid would induce pneumonia which would last for days, and this was a daily (nightly) occurrence. Hydrochloric stomach acid is not something I would wish on my worst enemy!
As my torture increased, I made the decision to allow the medical professionals to do the proposed "upper GI." I had visited Dr. Samir Cook who did the scoping, who later told me that I had the "worst eroded esophagus" he had ever seen. He even speculated that I might require an "esophageal transplant." I asked "how is that done? Do they take the esophagus from a cadaver?" He answered, "No they take a portion of your intestines and transplant them as part of your esophagus." I thought, "That could leave a really bad taste in your mouth." In addition to my badly eroded esophagus, my vocal cords and teeth had been damaged as well.
In the summer of 2003, after 32 years of continuous gastric distress, I was referred to Dr. Adrian Park, a gastric surgeon at the University of Kentucky Med School. He examined me and ordered several tests. He also told me that he would be leaving to take a new position in Maryland and that if I wanted to have the surgery, I should do so immediately. He explained that he would make 5 punches in my abdomen and would use robotic arms to grab the top of my stomach (the fundus) and wrap it around my esophagus, after which he would stitch the fundus to create a new "valve" to keep the acid in my stomach and not allow it to flow freely into my esophagus, throat, and mouth. This was all because the esophageal sphincter had been destroyed by beautiful singing!
He further told me that unless I would follow his instructions exactly we should say goodbye and depart now. I assured the surgeon that I would do exactly as instructed and surgery was scheduled for one week later. Post-surgical instructions included clear liquids for the first 2 weeks, followed by an additional 4 weeks of liquids. Surgery was performed and instructions were followed verbatim. While I lost several pounds during the recuperation, the results were astounding – virtually no acid reflux. When the "wrap" loosened a bit, occasional heartburn returned but I have been able to control it with Nexium and careful attention to my diet. I probably could return to Maryland and have my stitches tightened, but at post 80 years of age, being alert to the best diet is probably the better decision instead of incision. By-the-way, I was able to keep my original esophagus!
Nissen Fundoplication
