My Experience with the LINX Procedure

After years of chronic GERD, Barrett’s esophagus, and sinus headaches, I decided to get the LINX procedure. Here is my experience with the LINX surgery and my recovery from day 1 to 5 months!

This post is a little bit different than my normal recipe post! I’ve posted several of my health experiences and surgery recoveries on my website, so I decided to do a post about my most recent surgery (and hopefully my last): my LINX procedure for chronic GERD.

About 5 months ago, I had surgery to repair a mild hiatal hernia and to install the LINX device. The first few days were pretty rough, and my surgery was really not timed well since I had this done shortly after some unexpected, stressful events in our family life.

But I made it through, I’ve recovered, and I’m going to share my surgery story with you!

This post is not meant to replace medical advice by your doctor or other qualified medical professional! If you have questions if this procedure is right for you, please contact your doctor since I cannot give out medical advice. I can only share with you what my experience has been.

I’ll also add that these disclaimers (like the one above) might seem annoying to see throughout the post, but they are necessary for me to include in health-related posts.

My chronic GERD, Barrett’s, and sinus headaches

A couple years ago, I discovered that my chronic sinus headaches were partly caused by acid reflux coming up into my lower sinuses. My headaches were progressively getting worse, and during allergy season they were so severe I could barely function, and nothing seemed to touch them, even after taking Ibuprofen, Flonase, sinus meds (which hurt my stomach), and my nightly combo of Singulair plus Claritin.

At their worst, my headaches would spread into my neck and shoulders making it hurt to even turn my head or lay my head on my pillow to sleep.

I knew I had dealt with reflux before from the previous endoscopies I had done. I had already had a couple of endoscopies before that resulted in a diagnosis of GERD and Barrett’s esophagus, but I didn’t realize that my chronic reflux was causing severe headaches until I went to an ENT who did a quick nasal scope in his office and diagnosed me with erosion in my lower sinuses from chronic GERD.

After this appointment, I started taking Prilosec daily and my headaches started going away! I was able to finally have some relief for my increasingly severe headaches and I was actually able to reduce and finally eliminate the Singulair I had been taking for several years. I had noticed that the Singulair was resulting in mental health side effects for me and I was eager to get off of it.

I took Prilosec for about a year following that appointment and while I liked that the severity of my headaches were reduced, I knew that Prilosec wasn’t meant to be a long term solution. There are numerous long term side effects, none of which I wanted especially potential cognitive problems.

Since I’m only in my 30s, I didn’t want to be on a PPI (proton pump inhibitor) like Prilosec for the next 50 or more years. While medications can be incredibly beneficial, they often come with so many side effects, that I try to avoid taking them as much as possible.

Each time I started to try and get off of the Prilosec, my headaches and my nagging cough would come back. I tried using natural reflux supplements, we elevated the head of our bed so I slept at an angle, I changed my diet even more than I had done previously.

These things helped, but I still had regular reflux and headaches that were just being managed by Prilosec but as soon as I’d try going off of it, they’d come back.

The following year after my appointment with my ENT, I finally went to see an internal medicine doctor about my chronic reflux. I used to see a gastroenterologist but I wasn’t happy with his treatment, so I had to find someone completely new to see.

We ended up doing another endoscopy (my 3rd one) to assess how things were looking with my GERD. I still had mild Barrett’s esophagus which seemed to have improved since I had started taking Prilosec, and they took biopsies and fortunately there were no pre-cancer cells.

My doctor explained that because I have Barrett’s esophagus, I would have to get routine endoscopies every 3 years to keep tabs on it. He said I’d basically have to take PPI medication the rest of my life to keep it from progressing into potential esophageal cancer. Obviously taking meds forever was not something I wanted to do.

He also explained that meds like Prilosec will only manage GERD and Barrett’s esophagus, by reducing the acid, but it will not reverse it. It will only keep the disease from progressing. He said that Barrett’s isn’t just caused by acid, but also things like non-acid stomach fluids that contain digestive enzymes. Prilosec reduces the acid in your stomach, but there can still be other damaging fluid coming up even if it’s not acidic.

We also discovered from my endoscopy that the Prilosec I was taking for months had resulted in me now having stomach polyps. They biopsied the polyps and said they are non-cancerous, and they’re from the Prilosec (which is apparently pretty common), but the polyps won’t go away even once I stop taking it.

My doctor also said that I had a small hiatal hernia, and that I may naturally have a more loose lower esophageal sphincter in my stomach than other people.

The doctor said that if I don’t want to worry about the chance of esophageal cancer, then surgery is something to consider doing and since I’m still young and already have Barrett’s, it might be good to do to prevent potential cancer from developing.

Bottom line was that I was either going to have to take medication long term or get surgery.

LINX® consultation and testing

My doctor told me about a fairly new procedure using a LINX magnetic ring device to help with GERD. He said that it is has been shown to actually reverse Barrett’s esophagus (unlike medication), so it’s a good long term solution for reflux. And most people who have the LINX procedure don’t have to be on reflux medication anymore.

The LINX device is a ring of magnets held together by titanium wires. The LINX magnetic ring helps to close the esophageal sphincter and prevents acid and stomach fluid from coming back up and damaging the esophagus, but it still allows food and water to pass through when you swallow. You are also supposed to still be able to burp and vomit, which is not possible with some other traditional stomach surgeries for GERD.

I thought about it for several months, and finally decided to look into the procedure seriously about 6 months after my endoscopy. My doctor told me about 2 great stomach surgeons who do the LINX procedure, so I picked one that was closer to me and went for a consultation.

In order to determine if I was a good candidate for the Linx procedure, they had to run a series of tests. I had to do a 24 hour esophageal pH study where I had a sensor sit in my throat for 24 hours and it was attached to a device that read the pH in my throat throughout the 24 hours.

It was neat seeing the pH change over the course of the day, but it wasn’t very comfortable. Fortunately it was for only 24 hours. I didn’t go out since I had tape stuck to my face. Since my doctor was in another town, I took it out on my own and mailed it back to them in a pre-paid box they gave me.

They also had to check my esophageal motility to make sure that my esophagus muscles worked well enough to push food through the LINX device to my stomach. We did an esophagram and I swallowed a marshmallow dipped in barium solution during an x-ray to see how well it was moved down my esophagus into my stomach.

We also did an x-ray test drinking a fizzy barium solution, then laying down in various sleeping positions (on my back, sides, etc.) and they’d measure how much of it would come back up out of my stomach. I had quite a bit of reflux coming into my throat when I was laying down on the x-ray table.

The stomach doctor told me that smokers and tobacco users have more fragile and brittle tissues and sometimes the Linx device will actually wear through the esophagus wall. They usually don’t do the Linx procedure for people who are heavy tobacco users.

We also reviewed a few other options for reflux surgeries, like the Nissen fundoplication, but these other options don’t last as long and they tend to loosen or go back to normal after a while so the LINX surgery has better outcomes for patients. The LINX device *should* last a lifetime. I say should because it’s a fairly newer device and they don’t yet have long term studies for it past 10 years.

They also told me that because the LINX device is magnetic, you can’t go into really strong MRI machines over a certain Tesla (most regular MRIs are fine). It doesn’t pull the magnets out of your body (I was imagining a Twilight Zone episode haha), it just reverses the polarity of the magnets and makes them ineffective.

After your surgery, they give you a card to carry with you that tells people that you have an implanted metal magnetic device so you can give this card to medical providers if you have an upcoming MRI. I’m not sure yet if the LINX device sets off airport scanners yet or not.

After all my testing, they determined that I was a good candidate for the Linx procedure if I wanted to get it done. My new doctor said that they’d also repair my hiatal hernia which would correct about 50% of my symptoms by itself, and the LINX device would help correct the rest of my symptoms.

So almost exactly 2 years after my initial diagnosis from the ENT, I had a hiatal hernia repair and LINX device implantation to manage chronic GERD and to reverse Barrett’s esophagus.

About a month or so before my surgery I had switched from Prilosec to Pepcid since I was starting to have an increase in distension and swelling in my stomach area that I suspected was from the Prilosec.

My hiatal hernia surgery and LINX surgery recovery timeline

If you’ve read my other surgery posts, you’ll be familiar with how I write up the recovery portion of my posts. They’re a little bit of a journal where I check in as I’m recovering to write something through each stage of surgery recovery.

I started writing up my recovery a few days after my surgery was done, I was frankly too miserable in the first 2-3 days to write anything at first.

Please note that I am sharing my personal experience. Every surgery/health experience is unique and different for each person. This isn’t intended to be a guideline, I’m just sharing how things went for me.

One of the biggest things with recovery from the LINX surgery is the regular eating. You have to be committed to the recovery eating process where you have to eat a bite of something solid every hour you are awake for the first 3 weeks, then every 2 hours for 2 weeks. Then switching to eating 5 to 6 moderate meals a day for several months.

They don’t want people to go more than about 3 hours without eating something to keep the scar tissue down, so this is not something you can do intermittent fasting with (or fasting in general) after surgery.

This is extremely important to prevent excess scar tissue building up around the LINX device. You want some scar tissue so that it is held in place, but too much scar tissue can build up if you are not eating a bite of food every hour religiously. It can get to the point where no food will pass and people sometimes have to get an endoscopy to expand it open again.

The doctor said about 1/3 of people end up having to get the endoscopy to expand the scar tissue around the device because swallowing solid food is painful, so they eat soft foods only and the scar tissue keeps building until they have to get it surgically resolved with an endoscopy.

Fortunately I did not have to do this! I stuck with my eating regularly and my recovery went smoothly.

Here’s the timeline of my LINX surgery recovery!

Day 1 and 2

Ok, so I was pretty miserable the first 2 to 3 days.

I did not do well with my anesthesia at all after surgery. Normally I do pretty well with it when they make adjustments for my nausea, but this time I had a hard time waking up from anesthesia (which rarely happens to me), and I still had nausea even after they added anti-nausea meds to my IV and anesthesia.

The anesthesiologist added tons of meds to my anesthesia (she told me she’d add extra stuff for my nausea) and it knocked me on my butt for most of the day. I struggled so hard to wake up from surgery, to move, and get dressed since this was an outpatient procedure. It was completely out of the ordinary for me.

As a result, it took me a lot longer to wake up and get out of the hospital and get home. I slept most of the afternoon at home. I was pretty much out of it for almost the entire rest of that day.

The doctor told me that I didn’t have to eat anything the same day as my surgery if I didn’t want to, but I had to start my bite every hour the very next day.

They also gave me a spirometer to breathe with 10x every hour.

It hurts to take deep breaths (thanks to the hiatal hernia repair on my diaphragm), so using the spirometer is hard and hurts. I’m not quite getting it done 10x per hour.

My chest and shoulders hurt badly. I know it’s referred pain from my diaphragm due to the air they add for laparoscopic surgeries (pain meds never seem to touch that). My diaphragm pain probably won’t resolve as quickly as the pain from the excess air in my abdomen.

Since they are trying to reduce the use of opioids, there were no narcotics. My meds are Tylenol, Mobic, and Gabapentin. I was glad initially that they didn’t give me narcotics since I don’t handle them well, but the amount of pain I’m in I kind of wish I had gotten some stronger pain relief.

Moving around a lot or trying to lay flat results in stabbing shoulder/chest pain and spasms that makes it hard to breath until it passes (the worst pain usually takes 2-5 minutes to dissipate).

The morning after my surgery, I tried to eat some food and ate part of a salad and some coffee. Even though it wasn’t a ton of food, I think that was too much food for my stomach to handle at the moment because my chest and shoulder pain was horrible after I ate and then sat down. I think my stomach was pushing on my diaphragm causing more pain than I was already experiencing.

Making a mental note not to try and eat an actual meal yet (even if it’s small) until my pain improves.

I ended up with 5 laparoscopic incisions for this surgery, each about 1/4 to 1/2 inch each and all above my belly button this time (my other abdominal surgeries were below my belly button).

Day 3

My pain has improved quite a bit the latter part of day 2 and during day 3 today, but I still had quite a bit of shoulder pain this morning. I didn’t sleep well last night and was too uncomfortable to sleep very well in the early morning so I ended up waking up early, taking my pain medicine, then going back to sleep in our recliner.

Sleeping in a recliner for the first few days has been a staple with pretty much all of my surgeries, especially my abdominal surgeries.

So far I’m not experiencing much dysphagia (food getting stuck in the throat), but the doctor said the dysphagia would progressively get worse, peak during weeks 2 and 3, then improve after that. I just have to push through any pain with swallowing and continue to take solid food every hour while I’m awake until the 3 week mark, then I can move to eating something every 2 hours for 2 weeks.

I have noticed that when I feel like I need to burp, my stomach really hurts. I think the air bubbles pressing up against the top of my stomach makes it hurt.

I have to make sure that I’m not eating too much at once or my stomach gets uncomfortable, but this should get better over time.

I’ve been noticing some dizziness, not sure if it’s from not being able to eat enough or as much as I normally eat.

Day 6

Feeling much better now, the first 3 days were pretty brutal pain-wise, plus I don’t think the gabapentin I took at night helped. I’m pretty sure the gabapentin made me feel loopy and dizzy the next day.

I am mentally and physically struggling with not being able to eat the same volume of food. I feel a little lightheaded and blah since I’m not able to eat full meals like I’m used to and I don’t think I’m getting enough to eat throughout the day.

It doesn’t take much food at all for me to feel full (maybe just 1/4 or 1/3 cup), but I’m trying to keep my bites and snacks balanced with plenty of protein and fruits and veggies as well. But I’ve also been trying to add some high calorie things in as well (like nuts) to keep my calorie intake up.

My stomach is itching a lot right now, I’m having an allergic reaction to the steri-strips they used to close my incisions. I am allergic to adhesives since my 2nd surgery several years ago, and this has happened after previous surgeries. I should hopefully be able to take the tape off my incisions in a few days because the itching is driving me crazy.

Day 8

I was able to take my steri-strips off my incisions yesterday thankfully. My incisions are itchy and inflamed from the adhesives, but removing the allergen (the adhesive) is half the battle, so now I can work on getting my body to calm the reaction.

I’m able to eat a bit more food at one time the past couple days, which is great! Still not the same volume of food as before, but much better than the first few days after surgery. I’m feeling much better with more nutrients in my system.

So far I haven’t had dysphagia except taking a large magnesium supplement pill this morning. I’m not sure if I swallowed it wrong or with too much water with air, but that is the first time I had the dysphagia they described to me before my procedure: feeling like something is stuck and it won’t go down, and that you might regurgitate it.

I worked through it and it did eventually do down, but it was a very unpleasant few minutes. Fortunately I haven’t had that happen with food yet. I am trying to follow their advice to eat smaller bites of food and chew very thoroughly.

I have been struggling with pretty severe sinus headaches yesterday and today, I think I’m catching my husband’s cold. Trying to add in some vitamin C and D and plenty of water to keep it from getting worse.

Weeks 2 to 3

As the doctor promised, I noticed that my dysphagia got worse between 2 and 3 weeks. It still wasn’t horrible, but I noticed that I couldn’t take huge gulps of water or it would feel “stuck”. And I noticed that I couldn’t drink a ton of water before my food had gone down fully or it creates so much pressure in my esophagus, it’s really uncomfortable.

I just have to slowly breathe through it and walk around a bit until it passes.

So far, I haven’t been able to burp much, which is a little frustrating since any air in my stomach ends up staying too long then going the other way, but I’m hoping this will resolve with time. Because of this, I have been avoiding anything that will create excess air in my stomach (like sparkling water or soda) and foods that bother my stomach and create excess gas or air.

I have been forgetting sometimes to eat every hour, but I usually don’t forget too long and it usually doesn’t go past 1 1/2 hours at a time since my brain keeps reminding me about it since it’s developed that habit.

Other than that, I haven’t had too many problems so far. I probably should have used my spirometer more often than I have been, so I’ve been trying to expand my chest and take deep breaths to help stretch my diaphragm (this is especially important since I work so much at my desk and admittedly don’t have great posture…).

I follow up with the doctor or physician’s assistant at 3 weeks from my LINX surgery to see how things are going and how I’m recovering.

Week 3 follow up with my doctor + Week 4

I followed up with the physicians assistant for my 3 week follow up appointment and everything went well. My dysphagia is already starting to improve and I was released to move to eating something every 2 hours instead of every hour after my visit.

The doctor did tell me that they want to do an endoscopy in 3 years to see how everything is doing with my Barrett’s esophagus, so I will be in again for that in 3 years.

After this appointment, I’m also able to switch from eating a bit of solid food every hour to eating a bite of solid food every 2 hours.

I was also released to activity as tolerated, so I could return to workouts depending on how I was feeling with them. I did have scar tissue buildup under my incisions, so they told me to massage my scars to help break that up and flatten out my surgery scars.

I’ve noticed some pulling on my abdominal muscles, so I need to start stretching those out as well in addition to massaging the scars to help reduce scar tissue. My gym is closed this week for deep cleaning and maintenance (which they do every year) so that was bad timing to be released to full activity!

Moving past week 3 and into week 4, my dysphagia is improving. I still have to be careful with starchy or dry foods, but I can tell it’s getting better, which is making me happy!

I am also increasing my volume of eating close to where I was before. Not quite there, but close. I still need to focus on protein and veggies first regardless of my volume anyway since I feel better when I do that anyway.

4 months post surgery

I had my LINX procedure on April 7th, and it’s August 29th today, so I’m currently almost 5 months out from surgery.

So far everything has been great! My eating volume is pretty much back to normal now, I don’t have any issues with food or pills sticking anymore unless it’s something very dry and starchy and I eat too much of it at once.

I struggled with getting back to my workout routine due to lots of stress and things this spring and early summer, but I’m getting back into a solid workout routine again and have been doing some running and core exercises and have had no issues or discomfort with the LINX device at all, which was one of my concerns going into the surgery.

I’ve noticed that when I’m working out and I take a larger drink of water, it takes a bit longer to go down than when I normally drink water. It might be that I’m taking a larger drink of water than usual, and that I have more tension in my diaphragm when I’m trying to take a drink. But this is pretty minor and not anything I find super bothersome.

I notice that my ab muscles need more stretching since this was my 4th abdominal surgery. But regular exercise helps a lot with that to keep my muscles loose and from getting too many adhesions from scar tissue. After my appointment, they had told me to do some scar massage, so I did that usually in the shower and that helped quite a bit with scar tissue and flattening my scars. I need to continue doing that and stretching my ab muscles regularly to keep adhesions away.

I’m loving that I don’t have to take Tums in the middle of my workouts. I would often get reflux in the middle of my workouts while I was running or doing anything horizontal (planks, crunches, etc.) and I previously had to keep a bag of Tums in my gym bag to keep the acid down while I was working out. I just tossed that bag of Tums this morning when I was looking through my bag, one thing in there I was really happy to get rid of!

We were able to get rid of the elevation in the head of our bed, so our bed is level now (my husband really disliked having the bed elevated).

I am able to burp now, and I don’t have as much air in my stomach as I did the first couple weeks after my surgery. I don’t think I realized how much burping actually helps your stomach until you can’t actually do it anymore. So I’m grateful I’m able to burp again haha!

My headaches are much better now, I still have them when my allergies kick up, but I feel like they are much more manageable now. I can manage them well with sinus rinses and ibuprofen rather than having to take multiple allergy meds. I’m currently only taking Claritin each day for allergies, and very occasionally Flonase but I really don’t have to use that much at all anymore.

Since my fall allergies are starting up, I’m noticing more sinus headaches and pain again, so I’m trying to manage those with regular sinus rinses that seem to help quite a bit. But I know for sure now that it’s from seasonal allergies and not reflux erosion. I’m hoping as my sinuses continue to heal, my allergies will be less bothersome next allergy season.

Overall, the procedure was worth it for me even though I was pretty miserable the first few days after my surgery and I had to be pretty vigilant about recovery. Early on I wondered if it was going to be worth the pain and discomfort, but now that I’m past those initial weeks of discomfort, I’m glad I got this LINX surgery done.

Since I have to do a 3 year follow up endoscopy to check on things, I’m excited to see how my Barrett’s esophagus is healing up after this procedure!

My tips for the LINX® procedure

Here are a few things that seemed to help my recovery after my LINX surgery.

Reminder: these are things that worked for me and should not replace medical advice from your doctor!

• Soothe your stomach: a heating pad can help soothe your stomach after surgery. Just make sure to check with your doctor about this in case you have special considerations with your health history, medication, etc. Some gentle pressure like from a weighted blanket is nice, too. I used a clay bead microwaveable heating pack that both heats and provides some weight.
• Focus on healthier solid foods: since you need to eat solid food for your hourly bite of food (liquids, smoothies, and soft foods don’t count!), focus on healthier solid foods like apples, carrots, cucumbers, and protein especially when you can’t get much food at first. I bought some Duke’s meat sticks to include with my bites so I made sure to get enough protein.
• Add nutrient-dense food if you’re not getting enough to eat: if you can’t fit much food in your stomach at first and you’re feeling underfed, add some high calorie and nutrient dense foods like nuts to your diet. You may have to avoid nut butters since those will probably be difficult to get down without lots of sticking/dysphagia.
• Trust the process: I mentioned I was pretty miserable the first 2 days and wasn’t sure if it was worth it at first. But trust the process and commit to the recovery plan, and communicate with your doctors and nurses to make the most of your recovery and results.

My biggest advice is to stay prepared with proper snacks at all times. If you are traveling or running errands, be prepared by bringing snacks with you wherever you go so you can stay on schedule no matter where you’re at. Try to avoid places where food is prohibited for very long so you can take your hourly bite of food when you need it without delaying too long.

It can be inconvenient at first, but the 1 bite every hour phase only lasts a few weeks, so it will go by quickly. My go-to snack after surgery was baby carrots since they were easy to carry around, not messy, and they’re healthy.

My doctor and nurses also warned me about relying too much on sugary foods (like granola bars) for my hourly bites. If you do include snack bars or bites, make sure you’re eating 1 bite each hour rather than the entire bar each hour, which can add up.

One thing I did was try to rotate what I included in my bites so I was getting a balance of nutrients since I couldn’t fit much in my stomach at once for the first week. So one hour I’d have baby carrots, the next hour Duke’s meat sticks, the next hour a small meal (what I could stomach), etc. Or I’d combine a bite of carrot and a bite of meat stick to keep things balanced with protein and veggies.

Our cost for the LINX® procedure

The facility I went to for my surgery provided a very precise breakdown of our medical charges for my procedure in my online patient portal (which was really nice, no ambiguities).

This is just showing what our bill was for the procedure, this is not meant to be a guide to what your procedure may cost.

My surgery included a mild hiatal hernia repair, so the prices may be different depending on what other procedures are also done, who a person’s doctor is, where in the country they had the surgery, their type of insurance, etc.

I think my bill was a little bit higher than it could have or should have been because they charged for the extra time spent in recovery due to my anesthesia being so ridiculously bad. They gave me way too much medication: the anesthesiologist told my husband they gave me “everything but the kitchen sink” to help with nausea. And it resulted in me being extremely groggy, dizzy, still nauseated, and delaying our leaving the facility, which actually cost us extra money because I guess they charge for extra time you spend in recovery.

To be honest, I was really shocked by how much the procedure cost. My emergency surgery in 2018 that included a robot-assisted laparoscopy with 2 surgeons, and a 3 day hospital stay actually cost about the same (or a bit less) than this procedure. So this final pre-insurance bill really took me by surprise. There’s no way I could have had this done if we didn’t have good health insurance that covered this.

Here’s a general breakdown of our final bill for the procedure:

• Pharmacy: $3,745.88
• Operating room: $12,990.00
• Recovery Room: $2,505.00
• Anesthesia: $2,949.00
• Medical/surgical supplies: $17,948.30 (of this, $14,187.50 was the actual Linx device)
• Physician and assistant bills: $9,411.60
• Total before insurance: $49,549.78
• Insurance covered: $46,675.38
• Out of pocket for surgery: $2874.40

This is just for the surgery itself and doesn’t include the testing prior to the surgery or the follow-up visits after the procedure.

If you have questions about my experience with my surgery, you can leave a comment or reach out on social media. However please know that I can’t provide medical advice about whether this may or may not be the right procedure for you!