Laparoscopic Fundoplication

[Sparky]

Yeah... Say that five times real fast..:cool:

I had one (Laparoscopic Fundoplication) done in 1998 in order to correct GERD. I have had no problems with the surgery or the GERD since. Now that I am going through the process of enlisting in the National Guard, it seems that it may be a problem. The first review of the records regarding the surgery has determined that I am disqualified from service, let alone the 18E MOS I wish to pursue. They sent the records up to the next level for review, but if the next level agrees it means a "permanent disqualification from service" according to my recruiter.

The 40-501 says, "History of surgical correction for GERD within 6 months is disqualifying". However, mine was done ten years ago. While waiting for the records from the hospital, I went to my personal physician to get a note saying that it shouldn't be a problem. When I told him what was going on he laughed and wrote that I am better now, having had the surgery, than if I hadn't gotten the GERD corrected.

My question is; would this type of surgery put my teammates at risk in the field if I got cleared and made it through the stresses of selection and the Q course?
I have some knowledge about the procedure, but won't pretend I have any idea of the things the body is put through in the field. I don't want to pursue something that would endanger the lives or health of others, but don't want to just give up without being certain that I have no place in the Guard or the 5/19th.

Thank you for any response,
Sparky

P.S. Here is a website that describes the procedure: http://www.laparoscopyhospital.com/lap_fundo.htm

[Red Flag 1]

Sparky,

In looking at your problem, there are several things to consider: 1): your best advice on this site will come from Doc T and SwatSurgeon, I am but a lowley anesthesia guy. 2): The reason you had the surgery in the first place can recurr...that it has not is great news for you!...in that recurrence is possible, you are asking the US Military to share in the liability of dealing with said recurrence, no matter how long you have been symptom free. 3): No matter what your MOS, be it 11B or 18X...when you go down (your fault, their fault no-ones fault), someone else has to fill the hole and still do their job...this can compromise mission success...eight to ten other people (minimum) will then be responsible for you care and wellbeing.

I wish you the best. Consider the "Bigger Picture" as you think of all this.

RF 1

[Sparky]

Thank you for the response RF 1. The reason I got the procedure done was to prevent chronic heart burn and the risk of cancer and esophageal ulcers that go with it. I have to be honest with you, I don't see heart burn really bringing me down or stopping me from fighting. :) It was always annoying at best, but never stopped me or slowed me down while doing anything. I could still run five minute miles, still played high school football, and still wrestled in high school.

[RichL025]

Rather silly, and I encourage you to keep pushing your request up the appropriate channels until it reaches a person with knowledge of what's going on.

Six months is reasonable because most serious complications from lap nissen will show up during that time (sooner, actually), if you have done well with it for 10 years now, it should not be an issue.

I know several active duty soldiers (including one of our senior surgeons who just retired) who had a lap nissen done for refractory GERD. After acute recovery, there is no reason whatsoever where a lap nissen could endanger you or your teammates in the future.

Red Flag is right in pointing out that your heartburn may recur unfortunatly - there is good 10-year data out there that shows that a fair number of people with nissens will eventually need to be back on medicine to control reflux. However, it tends to be much lower doses of medicine that is needed than if you never had the surgery in the first place. And a requirement to take PPIs (heartburn medicine) is hardly a disqualifier or something that will affect your ability to function in a field environment.

Also be advised - there is no data out there that shows that the nissen reduces your cancer risk. People THINK it does, but no one has been able to prove it. We know that people with complications from severe reflux are at a higher risk of esophageal cancer, and that a properly done nissen improves reflux, but no one has proven a nissen reduces cancer.

Good luck, and I encourage you to keep trying to get your waiver approved.

[Sparky]

RichL025,

I was afraid I was missing something in this whole thing. I thought that perhaps the folks at MEPS new something that I did not. It was very encouraging to hear that others in the service have had the same surgery as I have. My mom is a nurse and the only thing she could think of is that they may have trouble with an NG tube. However, I thought that if I could swallow food, an NG tube shouldn't be too much trouble.

Thank you also for the warning regarding esophageal cancer. It was my impression that my chances would be at least reduced if not eliminated. It will be something for me to keep a watch on and even further incentive to quit chewing tobacco.

At this point my hope is that if the second round of doctors disqualifies me, I can take it to a further level. However, until I get to that bridge I guess I will keep training as if I am still going to join up.:lifter

Thank you again for the replies, Red Flag 1 and RichL025.

Sparky