From: john schweinfurth
To: VOCALIST <vocalist>
Subject: Re: Singer with Hiatal Hernia
Send reply to: VOCALIST <vocalist>

On Fri, 17 Dec 1999 09:04:47 -0500, VOCALIST wrote:

> Hello Again!
>
> The producer of our successful local opera company has a hiatal hernia
which she has self-managed for some time. It, and accompanying acid reflux
disease, have become so painful that she has difficulty singing. She has
been advised to have surgery and is concerned about possible effect on her
ability to sing.
>
> 2. Would a medical professional care to comment on the different
procedures
> and any effect on her ability to sing?
> Laura Sharp

Laura,

She should not consider surgery until she has had MAXIMAL medical therapy.
Among the things she should consider, priolosec or prevacid for a minimum of
6 weeks, dietary changes (no sugars or simple starches, no fried or fatty
foods, no caffeine, chocolate, or alcohol, etc.) no eating within 3 hours of
bedtime, raise the head of the bed up on blocks or phone books (if she lives
in a large city), drinking >64 oz water a day.

The ideal surgery is a laparoscopic (surgery done with endoscopes through
VERY small incisions) Nissen fundoplication which wraps the top of the
stomach around the esophagus to 'tighten' up the 'valve' between the two.

It's extremely rare to have to go straight to surgery before trying
non-surgical therapy.

Hope this helps.

John M. Schweinfurth, MD
Laryngology and Professional Voice Care
Assistant Professor
Vanderbilt University
Nashville, TN
(615) 322-6180





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