i'm currently taking nexmezol 40mg in the morning before breakfast.will i have to take nexmezol permanently or will my condition heal over time?" Hiatal hernia repair in laparoscopic adjustable gastric banding and laparoscopic Roux-en-Ygastric bypass: a national database analysis. If you need to have an open surgical procedure, the recovery time will be longer and you may need to stay in the hospital for several days. Other Classes: 600/593, 604/45, 604/118 ... Hiatal hernia repair is needed in a large number of patients suffering from esophagitis. Hernia repair is a therapeutic procedure to fix the protrusion. Currently, there's no pricing information for Hiatal Hernia Surgery procedures at King's College Hospital, as all prices are … Wassenaar EB, Mier F, Sinan H, Petersen RP, Martin AV, Pellegrini CA, et al. Hiatal hernia has often been called the "great mimic" because its symptoms can resemble many disorders. Med. However, there is no guarantee that a hernia will not recur, even if preventative steps are taken. Wassenaar EB, Mier F, Sinan H, Petersen RP, Martin AV, Pellegrini CA, et al. Emergent repair is indicated in patients with uncontrolled bleeding, obstruction, volvulus, strangulation, perforation and respiratory compromise. A hiatal hernia occurs when a small part of your stomach pokes through a hole in the wall of your diaphragm. If you have acid reflux, your doctor may suggest medications to treat those symptoms, including: Fifty-three consecutive patients underwent Hill hiatal hernia operation for esophageal reflux. I recently had a Lap Hill Hiatal Hernia Repair on Dec. 2nd for complications with GERD leading to Barrett's Esophagus. 43334: Thoracotomy repair of Paraesophageal hernia without mesh. As such, the best course of action is a carefully held discussion between patient and surgeon on the risks and benefits of elective repair versus watchful waiting. Routine elective repair … Hiatal hernia … Dr. Dasari has performed numerous hernia repair procedures and is one of the top hernia surgeons in Centennial Hills. The most common is called a sliding hiatal hernia. Originally, Dr. Hill recommended the placement of anchoring sutures through the median arcuate ligament. These tests or procedures include: 1. The sliding type hiatal hernia (Type I) is the most common. Dr. Dasari may recommend a hiatal hernia repair if you are suffering from symptoms associated with hiatal hernia. Gastroparesis results from abnormal gastro … Not so much with this surgery. Sliding hernia … I had a "Hill Repair" on 5/19/2021 with Rasa Zarnegar out of Weill Cornell in NYC. A very large paraesophageal hernia could potentially cause back pain, but this is not a common symptom. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. Boyle JT, Altschuler SM, Nixon TE, et al. GERD occurs when the esophageal sphincter does not close properly and causes acid reflux. Any symptomatic hiatal hernia should be considered for surgical repair, including Type I hernias that are associated with GERD .The symptomatic hernia should be repaired especially if there are obstructive symptoms or volvulus [].Anemia can occur in up to 20% of patients with paraesophageal hernias, especially in the presence of Cameron’s lesions, and should also be an indication for repair … The condition manifests in two ways: The sliding kind . Patients should be optimized for surgery with careful attention to their … 2009 Apr 3. . If you want, I can send you the detailed article my doctor gave me about the Hill repair. Hiatal hernia is of two types: Sliding hiatal hernia: Most common type of hiatal hernia where the stomach slides in and out of the hiatus. Patients who do not experience reflux but have other symptoms associated with their hiatal hernia should consider hernia repair. A hernia may develop in various parts of the body, most commonly in the region of the … The safety of biologic mesh for laparoscopic repair of large, complicated hiatal hernia… The repair includes restoration of the gastroesophageal junction (GEJ) with posterior anchoring and reconstruction of the gastroesophageal flap-valve mechanism (GEV). 5. Try this amazing Gerd, Hernias, And Hiatal Hernia N180 Stokke quiz which has been attempted 577 times by avid quiz takers. https://www.sciencedirect.com/science/article/pii/S2212097113700517 The surgery was easy and painless. Most people with hiatal hernias are asymptomatic. Results of the Hill antireflux operation. Note how the hiatal hernia is larger than it appeared in the assessments. Contemp Surg 1994; 44:13. 2014; 24: 377-384. Dr. Dasari may recommend a hiatal hernia repair if you are suffering from symptoms associated with hiatal hernia. Type I (sliding hiatal hernia): A portion of the stomach slides in and out of the hiatus. Incarcerated hiatal hernia (rare; observed only with paraesophageal hernia) The physical examination usually is unhelpful. K40 Inguinal hernia. Hill LD, Kraemer SJ, Aye RW, et al. If you are suffering from symptoms of a hiatal hernia, please call Rolling Hills Medical today to schedule a consultation about your options for hiatal hernia repair. Soricelli E, Basso N, Genco A, Cipriano M. Long-term results of hiatal hernia mesh repair and antireflux laparoscopic surgery. Do you struggle with acid reflux, anxiety, upper abdominal pain, or feel like food sits like a rock in your stomach? Fifty-two patients underwent laparoscopic repair of a type III hiatal hernia. Diagnosing a Hiatal Hernia Download Article Ask your doctor about an esophagram. Then I started getting severe stomach pain and regurgitation and acid reflux again. Certain conditions may predispo… It's not always clear why this happens. Weight lifting, either as a sport or as part of … You can email your mailing address to me at mrgeecue@msn.com. Your diaphragm is the muscle that controls breathing and is located in your abdomen. Dr. Dasari is affiliated with Centennial Hills Hospital within the Valley Health System to provide his patients the very best Outpatient and Inpatient surgical care nearest them. Background: The open Hill repair for gastroesophageal reflux disease and hiatal hernia is remarkably durable, with a median 10-year reoperation rate of only 3% and satisfaction of 93%. The hiatal hernia will not spontaneously resolve and they will usually get bigger with time. Even though this is my first surgery ever, I typically like to think that I have a high pain tolerance. The Hill Repair is an operation designed to restore the function of the antireflux barrier. Hiatal … I will definitely go for any surgery if I needed in future. Known for its acidic nature, ironically it produces an alkaline effect in the … Indigestion, heartburn, and constant burping are symptoms common with a sliding hiatal hernia and should be investigated and treated immediately. Dr. Grinberg did a great job with my Hernia repair… Laparotomy repair of Paraesophageal hernia with mesh: 36.74. Recurrence of Hiatal Hernia: Perhaps one of the most obnoxious of all hiatal hernia surgery risks is the knowledge that it may not be a permanent solution. This type is the most common and usually causes gastroesophageal reflux disease (GERD). Here’s an update on my health and stomach issues for everyone who has followed. Patients’ symptoms, clinical presentations and hiatal hernia type drive the selection of the most appropriate workup for hiatal hernia. View the actual hiatal hernia repair with a concomitant TIF procedure, referred to in the interview segments above, by Drs. Gastroparesis or delayed gastric emptying is a poorly understood medical disorder. Conclusion: From our data, and in terms of association with GERD, the Hill classification was slightly stronger compared to the axial length of a hiatal hernia, but we could not verify that the Hill classification was superior as a predictor. The Hill repair for correction of hiatal hernia and surgical management of gastroesophageal reflux disease is defined as a cardia calibration plus posterior gastropexy. It permanently relieves your hiatal hernia … Hermreck AS, Coates NR. A laparoscopic Nissen fundoplication (LNF) is the standard procedures to repair a hiatal hernia. Hiatal hernias come in several varieties and sizes. You also might also be surprised at how common they are. Short esophagus was determined from the operative record. The use of surgical mesh for the repair of large hiatal hernias still remains controversial. Ramadan Abdel Meguid. Obes Surg. Repair will help prevent complications such as bleeding, intestinal disruption, strangulation and the like. I had a complication 2 weeks post opt with a bowel obstruction. The Hill repair is best defined as restoration of the gastroesophageal anti-reflux barrier 4 by reducing the hernia and anchoring the gastroesophageal junction via its normal attachment to the pre-aortic fascia, thereby re-creating the gastroesophageal valve. 4. Short esophagus was determined from the operative … I recovered from that I was feeling great for months. Heartburn — it's been a part of your … 33.66: 43333. Open hiatal hernia repair can be used on all types of hernias, including ventral, inguinal, femoral and incisional hernias. Hiatal hernia. Recurrence of Hiatal Hernia: Perhaps one of the most obnoxious of all hiatal hernia surgery risks is the knowledge that it may not be a permanent solution. 36.31: 43335. The exact cause of hiatal hernias is unknown. The procedure was robotic assisted (da Vinci) and took around three hours. Hiatal Hernia Treatment. Surg Endosc. Hiatal Hernia Symptoms . This type of hiatal hernia happens when your hernia is the result of a sliding motion, which happens during periods of increased pressure on your abdominal cavity. The Hill repair for correction of hiatal hernia and surgical management of gastroesophageal reflux disease is defined as a cardia calibration plus posterior gastropexy. In 1836, hiatal hernia was first clearly described by Brightx1Account of a remarkable misplacement of the stomach. The repair of hiatal hernia, is a medical procedure carried out for correcting the breathing muscle in the stomach, which is commonly known as the diaphragm. This is the more common type of hernia. Hiatal Hernia: To Conclude. If a hiatal hernia is present, bulging may be seen around the esophagus stomach junction. Hill classification is superior to the axial length of a hiatal hernia for assessment of the mechanical anti-reflux barrier at the gastroesophageal junction Authors Ida Hansdotter1, Ove Björ2, Anna Andreasson3,4, Lars Agreus4, Per Hellström5, Anna Forsberg6, Nicholas J. Talley7, Michael Vieth8, Bengt Wallner1 Institutions … 2011 Nov 16. The sliding hernia may progress to a rolling hernia. The procedure … Nguyen and Chang. According to one study, 60% of people will have a hiatal hernia … 1, 2 Although respiratory symptoms are a recognized consequence of PEH, they are often overlooked or attributed to another cause. If Dr. Dasari diagnoses a paraesophageal hernia, it will require a repair. Also explore over 7 similar quizzes in this category. I chose this surgeon and operation due to the favorable side effect profile, minimal dissection, and use of … No waiting. There are generally no symptoms of hiatal hernia, and it is incidentally discovered when a person is … The surgery was pretty rough for me and I'm still a pretty young guy (32). The advantages of this approach include the fact that a primary closure of the diaphragm is virtually always possible. Laparoscopic repair is the most common procedure. Since then, it has become an accepted or even preferred method to repair uncomplicated paraesophageal hernias. During a Hill repair, the hiatal hernia is fixed by bringing the stomach back through the opening in the diaphragm and lessening the opening in the diaphragm at the esophagus. Sliding hiatal hernias are those in which the junction of the esophagus and stomach, referred to as the gastro- esophageal junction, and part of the stomach protrude into the chest. The bend at the opening of the stomach, known as the … I had no pain and did not require opioids. Complications of hiatal hernia may include the following: 1. When to have it repaired. Hi all. Closing the hole in your diaphragm muscle. Hi professionalism. A relatively small hernia will permit the … Surg Endosc. Soricelli E, Basso N, Genco A, Cipriano M. Long-term results of hiatal hernia mesh repair and antireflux laparoscopic surgery. No long-term data exist for the laparoscopic Hill repair (LHR). Nissen fundoplication with hiatal hernia repair is the most reliable and most effective treatment of GERD or acid reflux disease. Surg Endosc. … Upper endoscopy.Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope… Patients with Type II-IV Hiatal hernias should consider surgical repair, especially if they have symptoms. In this procedure the protruding organ is first placed in the correct position. I was able to walk a mile immediately post-op and went hiking nine days later. King's College Hospital, located in Denmark Hill, Greater London, United Kingdom offers patients Hiatal Hernia Surgery procedures among its total of 391 available procedures, across 32 different specialties . Surgery can repair a hiatal hernia by pulling your stomach back into the abdomen and making the opening in the diaphragm smaller. For hernias which are asymptomatic, the literature is conflicting. I had a 10cm parasophagol hiatal hernia repaired in December and anti acid reflux surgery . Sliding hiatal hernia: Hiatal hernias are categorized as being either sliding or para-esophageal. Sorted by Best Match 25 miles from Oxon Hill, MD Hernia Repair … Relationship of hiatal hernia to endoscopically proved reflux esophagitis. A Hiatal Hernia is when the stomach extends up into the chest through an opening in the diaphragm. Fifty-two patients underwent laparoscopic repair of a type III hiatal hernia. Methods This study is a single-institution retrospective chart review of prospectively collected data for consecutive patients undergoing PEH repair from … Laparoscopic repair of giant hiatal hernias, also known as paraesophageal hernias, is indicated for individuals with a symptomatic type II or III paraesophageal hiatal hernia. X-ray of your upper digestive system.X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. Possible complications of Laparoscopic Nissen Fundoplication and hiatus hernia repair will be discussed with you by your surgeon: Recurrent hiatus hernia or slippage of the wrap (uncommon) Injury to lung and pneumothorax (uncommon) Wound infection (uncommon) Bleeding (uncommon) Need for … A weak spot or other abnormal opening in a body wall permits part of the organ to bulge through. I had hernia repair surgery by Dr V, Dronsky. Please Note: You may not embed one of our images on your web page without a link back to our site. Hiatal Hernia Repair (Laparoscopic) What Is a Hiatal Hernia? In brief terms, the Hill Repair does three things. Surgeons make every attempt to both repair the hernia as well as prevent its recurrence. Hiatal Hernia. We wished to evaluate the long-term effectiveness of the laparoscopic Hill repair in the treatment of type III hiatal hernia. Laparoscopic Cruroplasty and Nissen fundoplication is the procedure of choice for repair of a hiatal hernia. If so, you may have a hiatal hernia. For type II-IV hiatal hernias, the literature also supports repair of those hernias which are symptomatic. Surgery of huge hiatal hernia. The Hill repair … A procedure to repair the hiatal hernia and create a properly function GEJ was developed by Dr. Lucius Hill, and is known as the Hill repair. When the pressure lessens, your stomach returns to its … The safety of biologic mesh for laparoscopic repair of large, complicated hiatal hernia. The crura of diaphragm originate from the anterior surface of the first four lumbar vertebrae on the right and L2–L3 on the left to insert anteriorly into the transverse ligament of the central … (310) 789-2103 Menu. 2 ... You may also have a Hill repair, which is a procedure where the top part of the stomach, before it becomes the esophagus, is anchored to the back of the abdomen, strengthening the anti-reflux mechanism. A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. My chest hurts and I have … 1, 3, – 6 Respiratory symptoms can include shortness of breath, but also … It occurs when the gastroesophageal junction (GEJ), along with a leading portion of the gastric cardia, slides through the esophageal hiatus into the mediastinum. If you or your loved one is suffering from such a condition, then visit us for expert consultancy and treatment. A hiatal hernia occurs when the upper part of the stomach bulges through this small gap into your chest. The symptomatology can range from just chest pain in the less severe types to respiratory and hemodynamic compromise … More than 95% of all hiatal hernias are of this type. The advantages of laparoscopy are well known, including Excellent timing. Assess the wave-like motion (propulsive function) of the esophagus Laparoscopic Cruroplasty and Nissen fundoplication is the procedure of choice for repair of a hiatal hernia. Sliding hernia: In a sliding hiatal hernia, the stomach and the section of the esophagus that joins the stomach slide up into the chest through the hiatus. I definitely don't have reflux any more but in the first week or so I lost around … Hiatal hernia results from the translocation of intra-abdominal contents from their usual position into the thorax. The most common pains related to a paraesophageal hernia are chest … "i've been diagnosed with a 2-3 cm hiatal hernia with reflux esophagitis. If you don’t have any symptoms, you might not need treatment. Hiatal hernia surgery is a surgical procedure to repair and return the stomach to its normal location and is normally performed when the symptoms are severe or it did not respond well to other treatments. During a Hill repair, the hiatal hernia is fixed by bringing the stomach back through the opening in the diaphragm and lessening the … This is done by using sutures and a special surgical mesh to reinforce the damaged area after the organs are put into proper position. No esophageal lengthening procedures were performed. I had a robotic Hill repair ten days ago for refractory LPR (cough, globus, reactive airway disease) and am still symptomatic; however, the frequent, nasty belching and regurgitation after/during meals have been completely abrogated. A hiatal hernia is defined as an enlarged opening at the point where the esophagus goes through the diaphragm. Authors . The use of laparoscopy to repair paraesophageal hernias began with the first laparoscopic cases in the early 1990s. Surgery is an effective way to treat a hiatal hernia, with a 90–95 percent success rate in relieving symptoms such as acid reflux and GERD. includes the Hill repair, popularized by Dr Lucius Hill in Seattle, WA. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. Our team of surgeons specialize in Hernia treatment and surgery. The procedure is also very safe with less than 1% complication rate. Hiatal hernia is a common condition and commonly affects people over 50 years of age. Types of hiatal hernia: There are two main types of hiatal hernias: 1- sliding and, 2- paraesophageal (next to the esophagus). The junction may reside permanently in … If you are … The esophageal sphincter is the lower muscle of the esophagus. 2. Sliding hiatal hernias can cause GERD symptoms. The normal gastroesophageal junction (GEJ) is a highly competent barrier against reflux … Find Top Doctors who perform Hernia Repair near Oxon Hill, MD. Hiatal hernias can be mild and asymptomatic or they can become large and produce heartburn. adj., adj her´nial. submitted 19. Hill classification is superior to the axial length of a hiatal hernia for assessment of the mechanical anti-reflux barrier at the gastroesophageal junction Authors Ida Hansdotter1, Ove Björ2, Anna Andreasson3,4, Lars Agreus4, Per Hellström5, Anna Forsberg6, Nicholas J. Talley7, Michael Vieth8, Bengt Wallner1 Institutions Institutions are listed at the end of article. Excellent results. The weakened portion of the body is then strengthened to prevent future occurrences. 2009 Apr 3. . Alex. Hiatal hernia is caused by obesity, being pregnant, age, or thinning of the phrenoesophageal membrane. Stage 1 – The First Week Diet Post Hiatal Hernia Repair Surgery: For the first few days following the surgery for hiatal hernia, the patient must be given only liquid and semi-liquid diets such as water, low fat and unflavoured milk, fruit juice, pureed and finely strained soups, ice cream, jelly, custard, tea or coffee that … A hiatal hernia is a condition where the top half of your stomach pops into your chest cavity, using an opening in your diaphragm. J. HILL; LUCIUS D. Primary Class: 600/561. Lenox Hill Surgeons is a state of the art facility in New York City. Indigestion, heartburn, and constant burping are symptoms common with a sliding hiatal hernia and should be investigated and treated immediately. This article provides some information about this medical condition, along with the surgical procedures to rectify it and the complications or risks that are involved with the same. The open Hill repair is our preferred approach in patients with large type III and type IV hernias involving 75% to 100% of the stomach and significant esophageal shortening, which either does not reduce or only minimally reduces during witnessed preoperative barium studies. However, there is no guarantee that a hernia will not recur, even if … spleen, colon, liver) displaced into the chest should be repaired urgently. Paraesophageal hernia: Symptomatic paraesophageal hiatal hernia is an indication for surgery. Laparoscopic repair Paraesophageal hernia with mesh: 50.37. Hiatal hernias are located in the diaphragm where the esophagus joins the stomach and they typically cause heartburn and reflux. Dig Dis Sci 1979; 24:311. Use Apple Cider Vinegar. I received films showing results of my repair. The hernia occurs when a part of the stomach pushes through the hiatus (part of the digestive system that connects stomach to the esophagus). With the right lifestyle changes and simple home remedies, hiatal hernia can be curbed. Some of them are discussed below. A simple self-massage can help get relief from the symptoms of hiatal hernia. You can find more information on our website, or call us at 646 … Mending the valve at the bottom of your oesophagus. Elective repair … But a hiatal hernia might be caused by: Age-related changes in your diaphragm; Injury to the area, for example, after trauma or certain types of surgery; Being born … JAMES G. Pleasant mannerism, explained the procedure well, right upfront about what to expect. You can reach our Hernia Doctor and his team at 424-250-8699 Wright RA, Hurwitz AL. Introduction We compared clinical and objective outcomes of combined Nissen-Hill hybrid (HYB) to Nissen fundoplication (LNF) for repair of paraesophageal hernia (PEH). Surgeons make every attempt to both repair the hernia as well as prevent its recurrence. No esophageal lengthening procedures were performed. If Dr. Dasari diagnoses a paraesophageal hernia, it will require a repair. Background: The open Hill repair for gastroesophageal reflux disease and hiatal hernia is remarkably durable, with a median 10-year reoperation rate of only 3% and satisfaction of 93%. Our top doctors at our Los Angeles Hernia Center provide hiatal hernia surgery and repair to patients from Beverly Hills and all over. The LES pressure is calibrated to the correct range using … Dr. Nguyen exposes the area to be worked on, similar to a Nissen fundoplication, so the bio-degradable … View/Print Full Issue Return to Issue. A hiatal hernia is often discovered during a test or procedure to determine the cause of heartburn or chest or upper abdominal pain. Persistent symptoms, in particular those related to the mechanical effects of paraesophageal hernia, eventually will result … In 1963, the French surgeon André Toupet described a semifundoplication to be used in hiatus hernia repair and as a complement to Heller myotomy. In 1967, Hill reported a procedure consisting of calibration of the lower esophageal sphincter and posterior fixation of the gastroesophageal junction to the median arcuate ligament. Hiatus repair: Early-stage hiatal hernia can be taken on by reducing the size of the hiatus, which is the opening in the diaphragm that allows the esophagus to pass through on its way to the stomach. http://facebook.com/PreOp and https://preop.comPatient Education CompanyYour doctor has recommended that you undergo surgery to repair a hiatal hernia. It corrects the hiatel hernia, creates a flap valve at the junction of the esophagus and stomach, and tightens the valve itself. More specific functional and morphological studies such as pH testing, PTF, and CT scan should be used case by case depending on the hernia … 43332: Laparotomy repairof Paraesophageal hernia without mesh. Between 10 and 80% of the population has a sliding hiatal hernia. Although paraesophageal hernia was once considered an immediate indication for surgical repair, the role of surgery in this operation is changing and patients receive treatment appropriate to their complaints. A laparoscopic repair of hiatal hernia and reflux, called Nissen Fundoplication, is very effective in most patients. To improve the function of the valve in the GEJ, the esophageal membranes of the GEJ are anchored to the connective tissue surrounding the heart using sutures. This surgery requires general anesthesia and a short stay in the hospital. A sliding hiatal hernia will not cause back or epigastric pain like a paraesophageal hernia can. Normally, the large muscle that separates the abdomen and chest (diaphragm) has a small opening (hiatus) through which the esophagus passes before connecting to the stomach. When the upper part of the stomach pushes through the opening in the diaphragm that the esophagus passes through — and into the chest cavity — this is known as a hiatal hernia or hiatus hernia. Laparoscopic Hill repair. The Hill repair is a transabdominal repair and is the only repair that firmly anchors the GE junction in the abdomen to the strong crural musculature and underlying preaortic fascia. I have had GERD and acid reflux my whole life and it was mainly caused by this sliding hiatal hernia.Years of stomach acid bubbling up into my esophagus has turned into me also having Barrett’s … They can be categorized into type I-IV which implies varying gradations of herniation. Paraesophageal hiatal hernia (PEH) is associated with a wide variety of upper gastrointestinal symptoms. Unlike the hernias described above, which occur when the intestine protrudes through the abdominal wall, hiatal hernias occur when the stomach protrudes thorough the diaphragm into the chest. repair of a type I hiatal hernia in the absence of reflux disease is not indicated. For elective HH repair we advocate the use of UGI series, EGD and HRM as first line pre-operative tests. K40.10 Bilateral inguinal hernia, with gangrene, not... K40.11 Bilateral inguinal hernia, with … Patients that have paraesophageal hernia which allows the fundus to be displaced into the chest above the GE junction or patients with other abdominal organs (e.g. Laparoscopic Repair of Hiatal Hernia Introduction The esophageal hiatus is an elliptical opening in the diaphragmatic muscular portion. Late symptomatic follow-up and a satisfaction questionnaire were completed in 71% … Testimonials. Thoracotomy repair of Paraesophageal hernia … The surgery was extremely easy. Crossref ; PubMed; Scopus (9) Google Scholar], and occasionally may trigger painful dysphagia. hiatal hernia: [ her´ne-ah ] the abnormal protrusion of part of an organ or tissue through the structures normally containing it. Intermittent bleeding from associated esophagitis, erosions (Cameron ulcers), or a discrete esophageal ulcer, leading to iron-deficiency anemia 2. Awhile ago in an earlier post, I briefly mentioned under going testing to get my hiatal hernia examined for potential surgery.
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