In my last post – Hellers Myotomy Recovery – The First 24 hours – I detailed my post operative experiences up to and including my discharge from hospital 24 hours after the operation. In this post I will try to describe the first week of my recovery.
In the hours leading up to discharge, I had managed to eat some jelly and ice cream for breakfast, and picked at some vegetable lasagne for lunch. Drinking seemed to be fine but I was still nervous about eating anything solid, having really struggled with swallowing during the weeks leading up to the operation. Anyway, there didn’t seem to be much that I considered soft on the hospital lunch menu. However, what I did eat and drink was going down and staying down. That felt really good.
Physically I was feeling pretty good considering what had been done to me the previous day. My stomach muscles were a bit sore and they restricted my movement and my breathing quite a bit. It meant that coughing was quite painful and to be avoided as much as possible! However, I was able to walk, albeit very slowly, and get around the ward. When it came to dressing I was relieved to find I could put on the clothes I had been dressed in the previous morning. However, putting on my shoes was a different matter. I could get them on to my feet but there was no way I could bend down to do up the laces! Luckily, the nurse was happy to oblige.
Ready to go home
I was now ready to leave. My wife arrived to take me home and we walked out of the ward and towards the lift. It was two floors down to the lower ground level from where we walked along a corridor to the exit for the car park. A couple of times I asked my wife to slow down as I couldn’t keep up. This was a first for us as she is normally the one asking me to slow down.
Once outside the hospital building there were some steps to navigate to get down to the car park. It was surprising that these weren’t too hard on my stomach muscles. Getting into the car was a different matter, though. I had to brace myself using my arms and lower my bottom into the seat making sure my core was locked and not twisting or flexing. My wife drove home very carefully, making sure she didn’t make any sudden manoeuvres. She had taken the precaution of bringing a cushion for me to hold on my lap to protect my stomach.
The recovery starts here
Soon I was back home and following the surgeon’s instructions to take it easy and not lift anything heavy for the first 2 weeks and then to gradually get back to normal after that. He also told me not to drive for 2 weeks.
Initially I was very reliant on my wife to do lots of things that I would normally have done. She had to drive our daughter to the station each morning, so she could catch the train to London where she works, and pick up her again in the evening. She also had to load and unload the dishwasher as I couldn’t bend down and pick anything up. However, as I had moved the bins to the end of the driveway before I when into hospital, she was spared the job of wheeling the bins around to the front of the house on collection day.
During the first 4 days I could still feel the effects of the anaesthetic. I lacked energy and my movement was still quite restricted. However, my breathing did improve quite quickly. I was able to fully utilise my asthma inhaler and cough up the mucous that had collected in my lungs since the operation. Initially I was taking a combination of codeine and paracetamol every 4 hours, but quickly moved to one dose of codeine at bed time and paracetamols only when I was feeling uncomfortable.
On day 3, I decided to accompany my wife when she drove to Heathrow Airport to pick up our daughter who had been to Cologne for the weekend. I was nervous about being in the car, but realised that she needed my support. Again I held a cushion in my lap to protect my stomach from sudden movements. I was pleased I had gone as I knew I would have to be a passenger in a car again 2 days later when I had a Cardiology appointment at the hospital.
My stomach has shrunk
I don’t know whether achalasia has shrunk my stomach or whether it has been made smaller by the Nissen Fundoplication. I suspect that it is a combination of the two. After the operation I started eating small soft meals, as that was all I could manage before feeling full. It soon became clear that I’m wasn’t even eating enough to maintain my weight. So I then added in a snacks between meals to make up the difference.
What was most worrying during the first week was that I had 3 episodes of discomfort caused by wind or over eating. In each case the symptoms lasted for up to an hour and I found it difficult to find a position where I was comfortable. Eventually I learnt that the only position that gave any relief was sitting on the edge of the bed, or a chair, with my head in my hands and my elbows on my knees!
Things start getting a lot better
From day 5 onwards I started noticing a rapid improvement including my asthma control. I had a lot more energy and was able to do lot more for myself. In addition to making cups of tea and coffee for myself, I was now wanting to prepare my own food. I also noticed that my concentration levels were improving. I hadn’t put on any weight but I was enjoying the feeling of eating real food again and benefiting from the nutrition it was giving me.
On day 5 itself I attended an appointment with a Consultant Cardiologist at Frimley Park Hospital. This was a follow up to my original Atrial Fibrillation diagnosis in December and a subsequent 24 hour heart monitor recording performed at the end of January. The consultant explained that the Atrial Fibrillation was intermittent and only showed up on the recording during the first 2 hours of sleep. That explained why in the recent ECG’s it had not shown up at all. He said that he expected to see an improvement in the general health of my heart once the disruption and inflammation caused by the HM operation had subsided. He, therefore, scheduled another 24 hour heart monitor recording for the end of May and told me he would see me after that to reassess things.
So now I’ve learnt that achalasia had not only made my asthma worse but it probably caused me to have atrial fibrillation. As atrial fibrillation is a major cause of stroke, achalasia was therefore, in all likelihood, responsible for the mini stroke I had in August 2015. So now I’ve had the Hellers Myotomy, I am extremely optimistic that my quality of life will improve significantly and I’ll be able to do most of the things I used to do before I had my stroke 18 months ago.