Hunting for Answers

Hands on the steering wheel and eyes on the road, Brent Walsh can’t stop his mind from racing. The 32-year-old from Roseau, Minn., heads south to Thief River Falls, Minn., hoping the surgeon he’s heard about will be able to cure his lifelong, severe heartburn.

But it seems too good to be true: The answer just one hour from home? In the past three years, Brent has traveled hundreds of miles searching for help -- and encountering roadblocks:

* His local doctor recommended a specialist in Grand Forks, N.D., -- two hours away.

* The specialist administered tests, confirming that Brent had severe GERD -- Gastroesophageal Reflux Disease. He definitely qualified for anti-reflux surgery, but would have to travel to Minneapolis to get it -- seven hours away.

* In Minneapolis, doctors again told Brent he had severe GERD. Surgery could be done, but would involve several pre-surgery appointments. With a 3-year-old daughter and a fulltime job, Brent wondered how he’d manage it. And what if he had problems after surgery? A surgeon so far away seemed unworkable.

Brent pops another Rolaid and keeps driving south. Thief River Falls is just a few miles away…

Unexpected expertise

“Very amazing,” says Brent, recalling that first appointment with Dr. David Gutierrez at Sanford Thief River Falls Clinic. “I was impressed with his straightforward answers to questions.” Brent first heard about Dr. Gutierrez from his supervisor at work, who had excellent results with anti-reflux surgery.

A surgeon who joined Sanford in 2008, Dr. Gutierrez gained expertise in laparoscopic (minimally invasive) surgery during his training in the early 2000s. Today he’s the only surgeon in northern Minnesota performing laparoscopic anti-reflux surgery.

Says Dr. Gutierrez: “Many people would be eligible for this surgery, but they don’t realize it’s available locally -- and they don’t realize it can now be done using a minimally invasive approach.”

Typical candidates already take prescription GERD medications. “If you’ve been on those medications for a while and your life would be intolerable without them, you should be investigated,” says Dr. Gutierrez. “Medication masks the symptoms of GERD, but surgery treats it definitively.”

Dr. Gutierrez reviewed Brent’s medical history and tests. He listened as Brent described his constant struggles:

* Popping Rolaids -- typically three packs a day

* Waking up at night because of discomfort

* Peeling off a film of acid that formed on the back of his tongue

* Trying to get rid of excess saliva

* Taking daily prescription medication to block the acid

* Pushing away half-eaten meals because of immediate heartburn

Brent was also concerned about his increased risk for esophageal cancer. Tests indicated he had Barrett’s esophagus with dysplasia -- a pre-malignant condition. “That’s what bothered me most,” says Brent. “I could’ve lived with the constant hassle of heartburn, but the increased cancer risk? No.”

Successful surgery, careful recovery

Last summer Brent underwent the minimally invasive anti-reflux procedure at Sanford Thief River Falls Medical Center. Technically called gastric fundoplication, the surgery involved wrapping the top part of the stomach around the base of the esophagus. This created a valve mechanism to prevent reflux -- the back-up of stomach acids into the esophagus. Dr. Gutierrez also repaired a hiatal hernia -- a frequent finding in people with GERD.

After one night in the hospital and four days’ rest at home, Brent was able to return to work at Central Boiler. He closely followed Dr. Gutierrez’ orders, including a liquid diet the first two weeks, then a gradual transition to solid foods. He also took care in lifting so he wouldn’t hinder healing.

Dr. Gutierrez stresses the cooperation of patients in ensuring the best possible outcome, particularly if surgery involved hernia repair. “Avoiding strenuous activity for several weeks after the surgery will minimize the chances of hernia recurrence,” he says. “That’s important because a second surgery in the same area is always more difficult due to scar tissue formation."

A life-changing difference

Every day, every hour, Brent appreciates the benefits of anti-reflux surgery. “It’s unbelievable that after all these years I’m able to enjoy a glass of orange juice -- or a glass of beer. And I love Mexican food -- tacos, jalapenos, chilies,” he says. “I haven’t had heartburn one time since my surgery. No more pushing away half-eaten meals, no more Rolaids, no more prescription medication. It’s really neat! Other people need to know about this option.”

An avid outdoorsman, Brent even noticed the difference during last fall’s hunting season -- his first without being plagued by acid reflux.

“Before, I was constantly fidgeting while I was in the deer stand -- reaching for Rolaids, spitting, or trying to find a Kleenex. Now I can be totally still,” he says. “This surgery was a life-changer. I eat better. I sleep better. I live better.”