What is this blog all about

I recently underwent a medical procedure to treat my reflux disease. Up until I was diagnosed with silent reflux I didn’t know anyone being treated for reflux. After I was diagnosed I found out that many of my friends and colleagues are suffering from and being treated for reflux. Many of these friends and colleagues are interested in my decision to have my reflux treated surgically and are curious on my day to day recovery. So … rather than trying to keep everyone updated individually I decided to try my hand a writing a blog.

How this all started

Some time in early 2018 I developed an annoying cough. The cough kind of snuck up on me over time. This cough was not necessarily unusual for me as I have allergies and a history sinus issues and bronchitis which often results in a congested cough. However, this cough never really improved regardless of the over the counter medication I tried.

Since I’m a guy I ignored this progressive cough for about a year. By March of 2019, my breathing made a gurgling noice when I would lie down to sleep and I was unable to have a conversation or speak in a meeting without having a coughing fit. My wife was concerned and my colleagues were beginning to ask if I was okay. This prompted me to finally visit my general practitioner who took an x-ray of my lungs and did some test to try and identity the issue with not much luck. With the belief that my issues were related to my asthma and allergies I was referred to a cough specialist at a Asthma / Allergy clinic.

The doctor fairly quickly diagnosed me with “Silent Reflux”. This was really the first time I heard anything about reflux. The doctor put me on a stick diet of grilled chicken and vegetables and water … period for 6-8 weeks. I threw myself into this diet and after the 8 weeks my cough had improved. However, my breathing was still gurgling and if I laughed my cough resurfaced. On top of that, at my follow-up visit after the diet my asthma was aggravated enough that my asthma medication was increased. A week later my asthma was no better and after several more weeks of weekly visits I was referred to a lung specialist.

The Lung specialist ordered more x-rays and a c-scan of my lungs. These test revealed pneumonia in the lowest part of my left lung. Great! something that can be treated! After a significant prescription of steroids and continued increased asthma treatment the pneumonia was beaten. Unfortunately, my lungs still didn’t sound good but the hope was that given time this would work itself out now that the pneumonia was gone. Oh …and by the way all this time I’ve been prescribed zantac and omeprazole to keep my silent reflux in check. This is where I stayed through most of 2019 …. better but not cured and taking zantac and omeprazole daily.

Had Enough

By the end of 2019, the zantac and omeprazole wasn’t really dealing with the reflux. The cough had not come back full force but I was constantly clearing my throat and coughing up phlegm. In December I scheduled appointments with an ear nose throat doctor, the lung specialist and my general doctor determined to find someone that could help. The first doctor I saw was my general which was the first time I had saw him since my silent reflux diagnoses. After discussing the issue with him I canceled my appointment with the ear nose throat and lung specialist and made an appoint with a heartburn specialist he referred me too. This was the best decision so far!

The heartburn specialist listened to my symptoms and did some basic test at my first appointment and then explained that she would like to conduct three test to and try and confirm exactly what was causing my issues. I agreed with her recommendation and was able to get the first test done that same day.

Test Conducted:

1) Barium Swallow x-ray : Barium Swallow: What to Expect, Side Effects, and Cost
2) Esophageal Manometry : Esophageal manometry – Mayo Clinic
3) Esophagogastroduodenoscopy (EGD) with a Bravo PH device : Esophagogastroduodenoscopy (EGD) | Johns Hopkins Division of Gastroenterology and Hepatology

This last EGD test was conducted over the last week of the year while I was on vacation. It wasn’t that bad and proved to be telling.

Test Results

The technician that called to discuss my results prior to my follow-up with the doctor got a bit more information from me and said “you are definitely not an edge case”. The doctor confirmed what the technician said and provided some concrete reasons. The bottom line is that my esophageal sphincter had moved above my diaphragm which was causing my body to put negative pressure on the sphincter causing it to not function properly. In my case the cause to my reflux was a “non-recoverable” condition … meaning it would not heal or resolve over time or with medication.

The Choice

Now that we have a concrete cause of my silent reflux identified I had a choice. The heartburn specialist said I could continue to treat the reflux with medication which would help with the symptoms but that relux would still be occurring. If I took this approach I would need to come back periodically to have me esophagus checked since on-going reflux would damage it so that would need to be monitored. The other option was to have surgery to repair my diaphragm, relocate my esophageal sphincter where it needed to be and repair the hiatal hernia that was also discovered during testing. The surgery was not without risk but had a high success rate and should resolve the reflux.

When I considered that medication would only mask my symptoms rather than treat the cause and would have to be maintained for the rest of my life with unknown impacts to my health, it didn’t seem like the correct choice. The LINX (https://www.linxforlife.com/) surgical implant recommended by the doctor seemed like a good choice as it attacked the cause of the reflux and it didn’t require changes to my internal anatomy like other surgery options required. I decided on January 7th 2020 that I would have the LINX device implant …. The surgery was scheduled for January 31st.

The lead up …

With the decision made I started following the pre-op directions of my surgeon. This meant adding 30 minutes of walking to my daily workout schedule. One Sunday 2/26, I started the 5 day all liquid diet to shrink my liver prior to surgery. Remarkably, the all liquid diet was not as bad as I expected … not sure why but apparently I don’t need all the food I enjoy eating!

Surgery Day

Up early and to the hospital by 6:30am. A good discussion with the surgeon reaffirmed that I was making the correct decision. The surgery took place at 8am as scheduled, was completed by 9:30 and I was out of recovery and back in my hospital room around 11:30am.

Food …. after a week on nothing but liquids I ordered big for Lunch. Soup, Swedish meatballs with mashed potatoes and ice cream!! I was able to eat about half of what I order with only some minor discomfort when swallowing. I did make sure to chew my food thoroughly and only swallow every 20-30 seconds. It took a long time to eat but all went well.

Walking …. the doctor said walking would help with bloating and discomfort so walking I did. Multiple 30 minute walks around the hospital helped as the Doc said it would and it showed the doc I was ready to go home.

The doc gave me the choice to head home around 5pm or to stay the night if I wanted. I felt good but I had had surgery before and knew that often the worst pain comes a few hours later. I really didn’t want to put my wife and kids through that so I decided to send them home while I stayed the night. The night was uneventful and the pain I was expecting never showed up (Thank God!). Modern surgery is amazing.

Day 1 (Feb 1st)

Saturday morning started with another 30 minute walk around the hospital floor followed by breakfast. I was able to eat a full breakfast again with just some minor discomfort when swallowing. Definitely had to eat slower. Headed for home around 10am with the only medication being a weeks worth of muscle relaxers and Ibuprofen.

The afternoon was spent catching up on office work and trying to eat something every hour to keep the scare tissue from getting too stiff.

Saturday evening I experienced dysphagia while eating dinner. Not fun but I had been warned that it could happen. Basically, felt like I had a belch stuck right at the bottom of my lungs. Walking around helped and the feeling passed. Didn’t eat much for dinner.

Day 2 (Feb 2nd)

Sunday morning means coffee and Chris Wallace Fox News Sunday followed by Sunday morning mass. After church we met the in-laws at Rockwood restaurant to hear about their latest trip to Mazatlan and get some lunch. Fish and chips for me and all went well but I definitely can not eat as much as I used to be able too. Basically, could only eat about a third of my meal but I’m not hungry.

The afternoon brought the Superbowl!! We stayed home to cheer on the Chiefs. We had our own Superbowl party by making several different appetizers. Eating through out the game went well but more dysphagia came in the evening.

Day 3 (Feb 3rd)

Back to work. Eating once an hour is more difficult than it sounds. Apples, oranges, and bananas are on the menu today. I was able to work a full day without issues. My lunch time workout is now my lunch time walk … 2 miles. No real swallowing issues throughout the day but more dysphagia with the evening meal. I’m starting to see a pattern. Evenings are more difficult when it comes to dysphagia. It’s much better to eat small meals/snacks over an hour rather than sitting down for a meal. I also have to make sure I stop eating when I am no longer hungry … No more finishing my plate even if I’m full.

Day 4 (Feb 4th)

Pretty much a repeat of Monday except a longer day a work which is fine. Getting more into a rhythm with snacking every hour. Eating is going well. Did cough up some phlegm that seemed like reflux. Not sure if it was reflux or a result of sinus drainage. Overall, I have not had any reflux since the surgery.

Day 5 (Feb 5th)

Another good day at work. Eating once an hour is making it difficult to eat an evening meal. Kristin made a great cauliflower Broccoli bake that I was not able to eat … I tried and very quickly had a dysphagia issue that was quite painful but passed after 5 minutes or so. I was able to eat some ice cream later in the evening so that was good!

Day 6 (Feb 6th)

Thursday was a repeat of Wednesday but I was able to eat an evening meal!

Day 7 (Feb 7th)

Friday!! One week since I had the LINX device implanted. Overall, I’ve been pleased with the surgery and my recovery. I believe the reflux has been stopped but I never had heartburn with my reflux so it is kind of difficult to be sure. I’ve been working to change my eating habits as I was told I would need to do. The first week of chewing my food more and eating slower wasn’t that bad. Dysphagia is not fun and is sometimes painful and a bit disturbing. The good news is if I pay attention it seems that I can avoid dysphagia for the most part.

Day 8 (Feb 8th)

Up early on Saturday to get Abigail to the bus by 6:15. Then an hour and half drive up to Alexandria to meet Kate and Austin for breakfast. Breakfast started out rough … the first two bites didn’t go well and I had to walk around for a few minutes to help the dysphagia pass. The good news is that the feeling passed and I was able to rejoin everyone and finish my breakfast! After breakfast we headed for home to run some more errands. At around 1pm we were driving by the local micro brewery and decided to stop in for a beer. 1st beer since having surgery. The doctors had told me to avoid carbonated beverages but I figured one beer couldn’t hurt … I was right! Following our beer we picked up some sandwiches and headed for home. Unfortunately, our late lunch started the same way breakfast did with me walking around waiting for the first couple bites to go down. But again, once the initial discomfort passed I as able to finish the sandwich. The rest of the day was pretty uneventful.

Day 9 (Feb 9th)

Sunday morning started with eggs wraps and coffee for breakfast followed by Church. By the time we got back from church the roast I had in the roaster was done so we were able to have a rare family sit down meal. Swallowing issues seem to be taking a break today … just had to chew thoroughly and take my time. No issues.

Day 10 (Feb 10th)

Back to work bright and early. Also able to get back in the routine of eating something every hour. It is hard to do that over the weekend. Everything went well throughout the day but the evening meal was difficult again. I think part of the problem is that I’m full by the time dinner time arrives.

Also noticing that if I eat past being full I still cough up reflux gunk. I’ll mention that to the doctor tomorrow at my follow up visit but I assume the answer is going to be to not over eat ! 🙂

Day 11 (Feb 11th)

The day passed by uneventful. After work I had my post op check-up with the surgeon. The check up went well as everything is healing as it should! The Doc and I did have a good discussion where I was able to ask about the occasional reflux that I’m coughing up. She said that this is normal and is due to something called pooling that occurs after surgery and will resolve over the next couple of months. Some of the more interesting things we discussed …

• The bloating and over full feeling I’ve been having in the evenings is probably due to a couple of things. First off, my stomach won’t empty out in 60 minutes as it should because it is still in shock from surgery. This will get better over the next few weeks. Secondly, I probably need to eat less fresh fruit and raw vegetables as they break down slower and therefore stay in my stomach longer. This means I need to find different things to snack on during the day while I’m eating once an hour
• She basically told me that the easy part of recovery is about over and the difficult part will start soon. 😦 Sometime around the 2 weeks after surgery the scare tissue starts to get really stiff around the LINX device. This will make it difficult to swallow and increase the amount of dysphagia I experience. The amount that this happens varies from person to person. If the situation gets too bad I can get a steroid shot but if I can avoid that it will be better long term as the scar tissue serves an important role in anchoring my esophagus sphincter muscle in place and actually helps the LINX device work. So .. the goal is to get through this period without needing a steroid shot.
• The doctor also told me that if I feel like food gets stuck that I need to give it time and I can try a sip of water or a bite of apple sauce. But if the food is still stuck after 6 hour I should call. I’m like …6 hours! … 10 minutes sucked … I’m definitely calling if something gets stuck for that long. 🙂

I wrapped the day up by going shopping at Sams and buying quite a bit of soft food and apple sauce just in case.

Overall a very good day.

Day 12 (Feb 12th)

The day went well with no issues. After work I grilled out steaks in an effort to help us forget about the polar vortex blowing through outside that was pushing the temperatures down below zero. Steak with potatos and carrots was great! No issues eating … so much so that I baked chocolate chip cookies after dinner and consumed several of them as well.

Day 13 (Feb 13th)

Started the morning off with some Greek yogurt that the doctor said would help my gut recover from the omeprazole I had been taking. Turns out that if you take it for more than 6 weeks if messes with the bacteria in you stomach and it takes your stomach a few weeks to rebuild the good bacteria and get rid of the bad bacteria after you stop taking it.

The day progressed without issue and wrapped up with a nice bowl of soup with grilled cheese sandwich for dinner. No dysphagia today!

Day 14 (Feb 14th)

Friday!! The day was uneventful from an eating perspective. We went an watched the high school section wresting champions which was a lot of fun. After the match we went to a local bar -n- grill with friends. We ordered apps to share…I didn’t have anything to eat for dinner so I was hungry. The first couple bites didn’t go so well and I had to get up and walk around a bit. Once the feeling past I was able to sit down and eat and drink the rest of the evening without issue.

Day 15 (Feb 15th)

Nice day in MN. Took the dogs for a 3 mile walk. No food issues today 🙂

Day 16 (Feb 16th)

Sunday morning…. political talk shows, breakfast, and church … all went well. Picked up a fried chicken meal for the family on the way home from church. First couple bites were difficult and required me to walk around a bit but the feeling passed quickly and I was able to finish eating without an issue.

Day 17 (Feb 17th)

Monday … back to work. Snacking throughout the day is easier during the week. No issues eating today. Got 5 to 7 inches of snow today that needs to be plowed off the driveway … you gotta love MN 🙂 At least it isn’t frigid cold outside so plowing will be fun.

Day 18 (Feb 18th)

Another uneventful day. I think maybe I’m getting used to eating more slowly as that last few days have been good as far as dysphagia has been concerned. Kristin made some great comfort food for supper …. pork chops with rice and cream of mushroom soup in the crock pot! I was able to eat a good sized plate with no issues.

Still having an occasional cough with some regurgitation but it is reducing and no longer concerning since the Doc. says it is normal and will go away over time.

Day 36 (Mar 7th)

Well it has been awhile since I updated this blog so I thought I should give people an update. The rule of “no news is good news” hold true over the past few weeks. I just haven’t had much to report because things are going well. I’ve been able to eat pretty much anything I’ve wanted too and the episodes of intense dysphagia are only occuring maybe 3 times a week. I’m able to drink BEER !! 🙂 without any real issues again. I occasionally get bloated but a walk or just moving around seem to help. I’m still waiting for the intense difficulty that the doctor told me was coming to show up. Hopefully it never does. I’ll try to update this blog a bit more often but you can assume if I don’t make any updates all is good on my end.

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