3months post Ivor Lewis

[Deeedals]

3 months post Ivor Lewis. Does anyone else wake up choking and vomiting ?

[telford-hiker]

Hi..sounds awful..are you on lansoprazole for acid ..and are you sleeping at a elevated position,ie 2/3 pillows or wedge pillow..I have mistakenly turned over on my stomach and an awful acid has crept up and produced an awful acid ..which burns and makes me cough and feel sick,but only on 2 occasions..

[Deeedals in reply to telford-hiker]

Hi, nice to hear from you. Yeah I’m on Lansoprazole twice a day.I have an electric bed, that’s not the problem so much, although like you it happens occasionally. The problem is if I doze off sitting on the sofa.

[telford-hiker in reply to Deeedals]

Yes ..10 mins after a meal I find myself dropping off..I think my body is using my energy to digest ..but not long enough for me to get food down so to speak ..so starts to come back ,where I awake with a jolt before it comes back up…so to speak 🤷🏻‍♂️😂

[telford-hiker in reply to telford-hiker]

I’m not very good at explaining things …so sorry ..I drop off..before food has digested ..then it starts to come back up

[Deeedals in reply to telford-hiker]

Yes that’s exactly what I mean and I’m now getting paranoid that I’ll inhale and get pneumonia or choke to death 😱

[telford-hiker in reply to Deeedals]

I think best try and stay awake for at least an hour after eating..until it’s digested enough,,even if you have to walk about the house slowly..or even eat a little less ,..hope this helps

[Molly14]

Hi - I tend to eat standing up and always go for a walk straight after - helps the food go down better - so you don’t get it coming up - all the best

[strangetimes]

It's taken me several years ! to find that taking omeprazole (40mg) in the morning before food makes a huge difference .

I'm not sure why it's suggested that we take in the evening .

[Cavalier3 in reply to strangetimes]

Yes my GP told me to take 40mg in a morning too.. I’m 6 months post IL and don’t have a problem with acid at all x

[Cavalier3]

Hi Deeedals, yes this did happen to me in the first few months but it was after I’d eaten pasta and once with tomato skins. I avoid both now. I’m 6 months post op now. I still eat regular small meals and I sit for at least 30 minutes after I’ve eaten. I take Omeprazole 40mg an hour before I eat every morning and touch wood I don’t have a problem at all now with acid. It’s scary when it happens and you feel like your choking but it will get better as your body adjusts and you discover what foods don’t agree with you anymore xx

[FKM100]

He, Dee. I take Omeprazole 2x per day - 20 mg am and pm - so I have the best of both worlds.

In the beginning I found I had to be very careful not to go to bed on a full 'stomach' (what's left of it), so I made it a rule not to eat after 3pm. I did this for about six months, but I don't have to be quite so strict any more, as long as whatever I eat later in the day is very light and digestible (plain yoghurt, or something like that).

I still have my main meal at about 2:00/2:30 pm though - not in the evening. And I often chew antacid lozenges and take Gaviscon if I am worried about reflux.

[Mauser1905]

Ita perfectly normal recovery theme. Most have experienced this and three or six months is way too early for the new normal tk set in or for the patient to start setting in it.

The body is still adjusting and will keep doing it for months if not years.

Practical advice given above is valid in regards to sleeping positioning steep slope, not having meals 3 hours prior to bed, finding regular sleep routine. You can also try pop corn or crispy toasted bread in the night when the choking feeling comes.

Remember acid is not your problem, simply the new GI system is trying to work itself out. Give it some time please.

I am personally against any PPI's on regular prescription for oesophagectomy survivors, and especially the majority elder age groups. For obvious reasons.

You can try gaviscon advance formula to soothe the throat during such episodes but not a regular prescription.

[Hidden]

Hi Deeedals, I am 65 also and coming up to 7 years post op and still suffer very nasty bouts of what I can only refer to as bile reflux, I have also been having some slight problems with heartburn (even though still on 40 mgs of omeprazole daily) just recently and my consultant has suggested 10 ml of Gaviscon liquid just before going to sleep which has helped the heartburn but also in doing some research I have discovered that Gaviscon Advance actually can stop the pepcid in bile and calm the effect of an attack. I now get it on prescription and it works really well to supress and/or quell the nasty bile issues I was getting. The only other advice I can offer is (as I'm sure you may already be aware) be very careful of how much fat you ingest any time after about 7 or 8 pm as I've found this to my own 'watershed' as I normally go to sleep at between 1 or 2 am. I now find myself reading every label as to the fat and saturated fat content in everything I eat after that time in the evening and am still surprised how much fat is it the most innocent looking things and of course the fat will compound throughout the day and as we do need a certain amount of fat you can't cut it out altogether. In watching my fat intake as the clock ticks on throughout the evening and snacking on fruit and low fat or fat free food such as yogurt as an example and with the dose of Gaviscon before bed most nights I sleep completely horizontal with no issues at all. If I do wake in the morning with that awful noxious taste and burning throat I can normally recall where I slipped up normally something like a bowl of cereal with skimmed milk, sometimes I just can't help myself and 9 times out of 10 will get away with it but it depends on how much fat I've taken in during the day of course. I really hopes this helps.

[Mauser1905 in reply to Hidden]

Hello Dadable,

Sleeping horizontally flat can exaggerate the reflux (acid or bile) as post surgery there is nomore LES. Relying only on peristalsis of the oesophagus is insufficient to naturally protect further damage from reflux.

40mg PPI+Gavison liquid daily @ 65 age. please keep an eye on the bone brittleness and calcium levels within the body as any bone fracture at this combination would be very challenging.

Had GP/GI Cons not asked you to take lifestyle measures to reduce the reliance on the PPI and other medications, such as sleeping up on an incline and others?

[Deeedals in reply to Mauser1905]

Yes I have an electric bed, so I sleep elevated but I think I slip down through the night . What is LES? I am on lansoprasole twice daily too .

[Mauser1905 in reply to Deeedals]

Hi Deedals, the above was meant for Dadable based on his comment contents. Apologies if it confused you.

opa.org.uk/opa-sleep-advice/ This is a sleep health advice

opa.org.uk/bed-wedge-specia... using discount code from OPA you get approx 25 GBP off.

opa.org.uk/tips-for-managin... this is mainly for acid reflux associated symptoms but majority of it will apply to reflux post oesophageal cancer surgery.

LES or LOS is lower esophgaeal sphinchter, which basically is a muscle valve at the junction between the oesophagus and the stomach. If you have had surgery for Oesophageal cancer then you may not have this anymore in your body.

lanso is a PPI as well.

gravity will pull you down be it electric bed or otherwise. some people have tried a particular material type for sleepwear and the bedsheet which grips their bodies more onto the fabric and resists sliding down to greater extent. There are comments in past threads on this forum as I am unable to recall the name of the fabric off my head.

you may try putting a gripy cushion just under your bottoms whilst sleeping which may stop you sliding down, as long as the cushion has good grip on the bedsheet!

[Kentishred in reply to Deeedals]

If you have a single electric bed you could make what my grandmother ( a nurse) called a donkey really just a pillow wrapped in a sheet and tucked in at upper thigh hight. It might help you.

[Hidden in reply to Mauser1905]

Hi Mauser, no I'm fine really and yes the GP has tried getting me down to 20mg PPI daily and the acid reflux became a bigger problem than ever the bile was so I like many others has to resign myself to that fact. As regards sleeping horizontally I sleep fine most nights and am one of the few apparently, it's only if I 'break the rules' that I have an issue. The Gaviscon was a suggestion from the MDT at Leicester Royal Infirmary because the PPI's aren't doing as good a job as they once were and upping the dose is not something I'd be happy with. #the Gaviscon unlike most people that take a dose after every meal I can't really do that anyway as I graze all day so It's just something I do before going to bed and it works really well plus as I discovered it is a quick block on bile after an attack, not Gaviscon normal or double action only advance has the ability to stop the Pepcid in bile. Anyway thanks for the advice but I sleep fine laying down and really have no major issues as such these days I was just trying to give some feedback to Deeedals.

[Molly14]

Hi - I’m 6yrs post op and tried every way to sleep there is - I would cough and cough - the only place I get a nights sleep is the sofa - bolt upright - nothing to eat after 8pm and gaviscon advance before bedtime - I prop the end of the sofa with pillows and then feet up - no sliding down - not ideal but then things aren’t ideal after an oesophagectomy - been sleeping happily like this for years now - hope you find things that work for you - all the best x