Hiatal Hernia

JRNJ

Anyone have a hiatal hernia after DIEP or that got worse from DIEP? or just have one unrelated to cancer? I have a lump in my throat when I swallow, trouble breathing, tired, headache. It showed up on two CT scans, 10/2019 and 1/2021. I felt the lump during radiation and didn't know what it was, and it went away 3 weeks after radiation. 9 months later I had DIEP. Three months later the symptoms got really bad. Makes sense that DIEP would shove your stomach into your esophagus. Did you have surgery? Did it work? How long was the recovery? I scheduled a trip rafting in the Grand Canyon on 8/20 for my family and don't know if I can have surgery before that and be recovered in time. And if I wait until after the trip, I'll be miserable the whole time.

SpecialK

jrnj - I did not have DIEP, but long before breast cancer I had a significant hiatal hernia and GERD. I never had heartburn, rather had esophageal spasms, and actually had a pretty complete cardiac workup because this felt like chest pain. None of that indicated the real problem, which came to light in the workup after I aspirated a caustic antibiotic that burned my esophagus. For the previous several years I also had simultaneous cases of aspiration pneumonia. I am fairly petite and had back to back pregnancies - which as you noted above with regard to your DIEP - pushed my stomach up, but I suspect a congenital aspect as well - my DD has the same issues. I did have a laparoscopic Nissen fundoplication surgery in 1995. Generally, this surgery has a long success rate - it did for me, pretty much solved the problem. I’m sorry you are experiencing this, it can be uncomfortable.Is there a specific surgery that is being recommended for you?

JRNJ

Thanks for the feedback SpecialK. I was also thinking it probably started with pregnancy, as I am also petite and had my kids late, they are 14 and 16, I am 55. Long story short, my symptoms got really bad about 6 weeks ago and I thought I had thyroid cancer. I had a thyroid nodule biopsy 2 weeks ago, benign, yay, and a throat swallow test scheduled for 6/30 and won't see the ENT until 7/7. While using Dr. Google for throat swallow test, the light bulb went off. I have two CT scans that show I have a hiatal hernia, and no Dr. has ever discussed it with me. I had an emergency CT in January after DIEP because I couldn't breath, so they were focused on the fluid in my lungs, and all my Drs. suck. My kidney stone was also on that scan, no one told me, and in April made 3 trips to urgent care and emergency room to find that out. So I am 95 % sure that is my problem. I don't really have heartburn either, just a little bit. I hope it's not throat cancer. My main concern now, aside from cancer, is I scheduled a trip rafting in the Grand Canyon on 8/20 for family and don't know if I can have surgery before that. And if I wait until after, I'll be miserable the whole time. Do you remember how fast the recovery was?

SpecialK

jrnj - I wonder if you have Barrett’s esophagitis that is causing irritation? Glad the thyroid nodule is benign - my DH just had a thyroid US because he has hypothyroid but his meds were not keeping him in range and he was hoarse. His nodule is benign, fairly small, and he also had his vocal chords scoped. Turns out he has Hashimoto’s and his hoarseness is eased with increased thyroid meds. He is being treated by an oncological endo, which I insisted on - and set up. I wanted a one stop shop if there was an issue. She has been very thorough. As far as the recovery from the surgery, mine was complicated by two things. Within 24 hours I developed aspiration pneumonia and was kept in the hospital with a high fever and shortness of breath. Once that was treated I had difficulty with eating. With this surgery sometimes when you swallow food the stomach releases a bubble and there is a moment when the food and bubble pass each other. It can be uncomfortable and it usually only lasts a couple of weeks and then the process figures itself out. It lasted months for me and I lost enough weight that I dropped to about 95 lbs. I wonder if you can be treated with somethingin the interim and have the surgery right when you get back from rafting? My BIL is a gastroenterologist and I can ask him about the normal recovery for that procedure if you would like. It’s also possible there are newer and better surgical techniques that have an easier recovery. Hope so!

JRNJ

SpecialK, thanks for the tip on oncological endo, I didn't know that was a thing. My head is spinning, second guessing myself again, maybe it's cancer..... Had a gyn appointment today, he thought the thyroid was swollen, although the ENT didn't think the thyroid was causing my problem. I know I have the hiatal hernia, it was on my January CT scan. Maybe I have two problems. I'll just have to wait and wait...., throat swallow test 6/30, dr appointment 7/7.

JRNJ

SpecialK, So the good new is doesn't look like I have thyroid or throat cancer and probably not thyroid disease either. I have been taking pepsid, and sleeping with my head up, and I stopped my letrozole. I did feel a little better, and slept better, except for the annoying lump feeling when I swallow won't go away. The swallow test shows I have a "cricopharyngeal bar" in my throat, which apparently is caused by the hiatal hernia/silent acid reflux I have that none of my drs. told me was on my CT scans for 2 years, that is either caused or worsened by dmx, radiation and DIEP. ENT said today, it is not bad enough to do risky throat surgery and to see a GI dr. for the hiatal hernia. Why didn't someone tell me that 2 years ago when it first appeared or even last year when I complained about the lump during radiation!!!! And NO recommendations for my misery. That's what you get when you call a dr. and can get in that day. And now that I read your response again, wish I had noticed the word "gastroenterologist". I thought the ENT would do the surgery. I waited weeks for this test just to be told to see a gastro. Ugg!!! But thanks for the advice. Did you have the throat lump feeling when you swallowed?

SpecialK

jrnj - that is good news! I will also say that I existed with the GERD issue for a long time due to several military moves, vacillating symptoms, the negative cardiac workup, and being a busy mom of toddlers with a husband who was never home. The true nature of the problem was not uncovered for quite a while, and yes, it was frustrating - just what you have also experienced. After seeing the GI doc there was additional waiting as they wanted to try some meds first to see if that helped - I was given Rx omeprazole. After 6 months of that I was considered "maximally medically managed" and became a candidate for the lap Nissen procedure. There was a diagnostic workup for that as well including a 24 hour PH probe and an endoscopy to see if my esophagus needed dilation - fun times! There was some question about whether I also had some dysphagia that was complicating things, and I still have issues swallowing - particularly large pills - even after surgery. I tend to now take any meds with a spoonful of pudding or applesauce or they will dissolve too high and make me feel sick. I just had surgery in June for a ruptured implant and had to take an antibiotic for three weeks - large pill!

JRNJ

SpecialK, I was afraid of that, that even when I see a GI they'll say what you said, no surgery yet. 6 months, that's ridiculous. I made some calls today and the good Drs. are booked til September. I'm so miserable, but just need to accept my misery. I could have started this process so much sooner if someone read my reports properly. I asked the ENT for dilation and he said he doesn't do that for my condition. I did a swallow test wed and he stuck the scope down my nose yesterday, yuck. Sorry about the implant. I originally had tissue expanders that got infected and I was in the hospital on iv antibiotics. I hate antibiotics. Switched the plan to DIEP. They are a little too small and flat, but I might have phase II when I feel better. You also confirmed my fear that fixing the hernia won't reverse the throat damage. That's what I read also. I'll have to find another ENT after the GI.

FarAwayToo

I have hiatal hernia, it was there long before breast cancer.

Mine is of sliding type, and it actually "slides down" or whatever it does, but I go through periods of zero symptoms, they may last for years. Then something triggers the "slide up" (a heavy meal, a bloating episode, anything that pushes my stomach up) and I will be miserable for months. I found this exercise helps:

ctmbsikia

Hi. I don’t have a hiatal hernia but was just diagnosed with a Schatzki’s ring after an emergency endoscopy for food impaction. Hope you don’t mind if I hang with y’all for a bit to learn about these differentGI issues. I go back in a month.

SummerAngel

I have a hiatal hernia and eosinophilic esophagitis (mild), but my only symptom is nausea. Not that nausea is okay, it can actually be pretty miserable, but GERD seems worse.