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chrisrob
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Quote chrisrob Replybullet Posted: 10 Aug 2017 at 8:33am
But it's saving money in the short term and costing more in the longer term.

"From a National Health Service perspective, LNF may be cost-saving after 8 years compared with maintenance PPI therapy for the treatment of GORD." Short-term cost effectiveness and long-term cost analysis comparing laparoscopic Nissen fundoplication with proton-pump inhibitor maintenance for gastro-oesophageal reflux disease

"on the basis of current evidence, laparoscopic fundoplication represents a cost effective means of treating GORD rather than lifelong medical management." A Comparison of the Cost Effectiveness of Pharmacotherapy or Surgery (Laparoscopic Fundoplication) in the Treatment of GORD

If a referral isn't forthcoming from your doctor, ask for a second opinion.
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itf56_2
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Quote itf56_2 Replybullet Posted: 10 Aug 2017 at 3:06pm
Got a GP appointment for Sunday afternoon which presumably means it won't be my regular GP. Just a question of how interested they are.

Were you able to control your reflux with Omeprazole between Nissens or not?
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steveb8189
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Quote steveb8189 Replybullet Posted: 10 Aug 2017 at 3:43pm
The PPIs only help with the acid not the reflux. Give you aren't experiencing heartburn you may notice no difference with taking the pills.
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chrisrob
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Quote chrisrob Replybullet Posted: 10 Aug 2017 at 3:47pm
You're lucky to get a GP appointment.

I booked one a week ago for the only available slot they had - in 7 weeks' time(!) - and it's with a GP I've never heard of instead of my preferred GP who knows me. So that means half the consultation time will be taken up with me advising him of my history. (That's the reality of lack of staff retention and the funding cuts. They've brought NHS to its knees and now they're sawing its legs off.) Just hope my increasing extreme fatigue and leaden limbs is nothing serious.

Hope your locum (or whatever) will be more helpful. I have found that can sometimes be the case.

My problems between fundos were more to do with reflux than acid (which I managed with 300mg ranitidine and Gaviscon as required). I practised all the advice I give others about managing reflux but the blackout coughing fits recurred along with other reflux symptoms.

As I demonstrated with this paper, Prevalence of Extra-Oesophageal Reflux symptoms amongst acid refluxers and perceived efficacy of regular medication and reflux reduction intervention:"In the management of symptoms of extra-oesophageal reflux, acid suppressant medication did not appear to be effective whereas reflux reduction surgery was."
Which was coincidentally echoed in a separate paper: Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale published at the same time: "LNF achieves better improvement than PPIs for LPR."
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itf56_2
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Quote itf56_2 Replybullet Posted: 10 Aug 2017 at 4:01pm
It's because I live in the impoverished North. We're part of an extended hours pilot. You can normally get an appointment but it's pot luck who you see and if they care, there's no continuity at all and that always explaining history is something I know far too well.

Edited by itf56_2 - 10 Aug 2017 at 4:01pm
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itf56_2
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Quote itf56_2 Replybullet Posted: 10 Aug 2017 at 4:12pm
And chris obviously I hope yours is nothing of any note. Thanks again for providing this forum and the rest of your work.

Edited by itf56_2 - 10 Aug 2017 at 4:13pm
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itf56_2
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Quote itf56_2 Replybullet Posted: 13 Aug 2017 at 3:01pm
Saw the locum who inevitably upped my PPI dose and said to try that for a month then go to 20mg and see how it goes, and has asked that my GP surgery refers to me to get my Nissen looked at but apparently it's up to them whether they do the referral or not!
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bobdigi
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Quote bobdigi Replybullet Posted: 15 Aug 2017 at 9:12pm
How long did you need off work this year?
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itf56_2
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Quote itf56_2 Replybullet Posted: 15 Aug 2017 at 9:55pm
Originally posted by bobdigi

How long did you need off work this year?


If you mean last year when I had my Nissen it was 3 weeks but I could reasonably have gone back after maybe 2-2.5
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bobdigi
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Quote bobdigi Replybullet Posted: 15 Aug 2017 at 10:08pm
I just meant in general. I'm a self employed window cleaner and a little worried about not working. I was hoping for uner 1 month.
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