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Acid Reflux / GERD Message Board


Acid Reflux / GERD Board Index


Hello, my name is Sam and I am a 27 year old male who has been struggling with a variety of issues for around 5 years. I will stick mostly to direct reflux-related issues for this post. I mostly want to get a few opinions on my case and also ask how I should proceed. First, I'll give my symptoms.

I started having an issue with having to clear my throat and constantly spitting out mucous around 5 years ago in college. Over time this evolved to also include having extremely uncomfortable burning sensations in my mouth and mild soreness in my throat. Soon, the burning sensations were pretty constant. I didn't know if was dry mouth, poor hygiene, or what. I greatly improved my oral hygiene but nothing helped. At some point I also started noticing more and more that I would nearly-regurgitate (up to about throat level) whatever I ate or drink most of the time, but I sort of got used to it and didn't think a lot about it since it didn't cause me direct pain. I pretty much never had heartburn unless I had some fast food immediately before bed. Fast forward a couple years and I finally started seeing an ENT and a Gastroenterologist since I had a job and my own insurance, and I was diagnosed with GERD. For the record, they have never said I had LPR, but I think it is fairly obvious LPR would be a more accurate diagnosis based on my symptoms and the data below. I have been on omeprazole for a few years but it doesn't really help the symptoms that bother me (regurgitations, nasal drip, throat clearing, and oral burning). I know the omeprazole is working to cut the acid though because my regurgitations taste different and I will get heartburn bounceback if I start missing doses (ironic that I had to start taking PPIs in order to start getting heartburn, haha).

Anyway, here is a summary of the tests I've had and some of the reasonings I'm using to make my case for surgery.

1) My ENT did a laryngoscopy and saw "interarytenoid thickening" which he said is consistent with reflux. He tried a few medical therapies on me (zantac and a couple different PPIs), but none helped my symptoms, so I eventually stopped.

2) I went to a Gastroenterologist and she also said it sounded like reflux. She ordered a bunch of tests over a very short period of time. I believe I did not start my any new medications until I had completed all of the tests. I will list them separately.

3) I had an EGD. There was nothing visually obvious except a mild gastric erythema. The biopsies came back negative for H. Pylori. The esophagus biopsy showed epithelial changes which are consistent with GERD.

4) I had liquid and solid gastric emptying studies. They showed mild reflux (although they state that the test wasn't designed to diagnose reflux). Otherwise these were normal.

5) I had a manometry. I don't have the record immediately available to me for some reason (I think Johns Hopkins is changing around their online portal and they aren't copied over yet). I had a hard time with this because I kept involuntarily swallowing and the doctor's report stated that this made some parts of the evaluation difficult. According to my memory though, if there was anything unusual in these tests, it was very mild.

6) I had the 24h pH and impedance monitoring test. This is the smoking gun for me. I will just copy the doctor's final impression for this one:
"This was an abnormal study. There was markedly abnormal
esophageal acid exposure throughout the study with a DeMeester Score of
134. Impedance showed abnormal reflux events, the bulk of which were
acidic. There was strong correlation between symptoms and reflux events."
Keep in mind that the pH test was done without any medications.

These are all the gastrological diagnostics that I have had done. Since that time (about 2 years), I have been taking omeprazole consistently just to reduce risk of further damage to my esophagus, but it is giving me zero resolution of my primary complaints. I am getting tired of the regurgitations, my mouth being on fire, all of my medications, and my other medical problems. Without going into too much detail (this post would literally a MINIMUM of 10x longer if I did), these include chronic pain, sleeping too much, fatigue, unrefreshing sleep, and mild psychiatric and social issues. The only one I will elaborate on is the sleep. I did have a sleep study very recently to evaluate for possible sleep apnea. It was found that I do not have sleep apnea. However, I did read the data and I found that I had many nighttime awakenings, and that I had spent a very large amount of time awake during the night. According to my perception, I only woke a couple times and then fell back to sleep almost instantly (this is normal for me). I was very surprised to see how much time I was staying awake, so I am wondering if this can be attributed to GERD since it is not a breathing issue. I also snore a lot, which I've read can be attributed to GERD.

Anyway, I have finally pretty much decided to get a laparoscopic Nissen fundoplication (I briefly considered some of the newer surgeries, but I've decided I'd much rather have the tried and true). I have currently scheduled an appointment with a gastroenterologist (a different one at Hopkins, my original one took way too long to see). It is currently 4 or 5 weeks away. I plan to recite this essay to them more or less, and expect to get the thumbs up for surgery. Is this basically how it goes? I was wondering if I could jump straight to it and schedule a surgeon consultation. Is this typically allowed, or do I need a GI thumbs up first? By the way I have a BCBS PPO for my insurance, so I can usually schedule consults whenever I want.

As a side note, a couple of months ago I got my nasal septum corrected as a total shot in the dark to see if it would help my constant throat clearing of mucous. It didn't help me at all. Hopefully it will at least help my winter nosebleeds though.

Thanks, Sam
[QUOTE=SammyCeee;5358217]Hello, my name is Sam and I am a 27 year old male who has been struggling with a variety of issues for around 5 years. I will stick mostly to direct reflux-related issues for this post. I mostly want to get a few opinions on my case and also ask how I should proceed. First, I'll give my symptoms.

I started having an issue with having to clear my throat and constantly spitting out mucous around 5 years ago in college. Over time this evolved to also include having extremely uncomfortable burning sensations in my mouth and mild soreness in my throat. Soon, the burning sensations were pretty constant. I didn't know if was dry mouth, poor hygiene, or what. I greatly improved my oral hygiene but nothing helped. At some point I also started noticing more and more that I would nearly-regurgitate (up to about throat level) whatever I ate or drink most of the time, but I sort of got used to it and didn't think a lot about it since it didn't cause me direct pain. I pretty much never had heartburn unless I had some fast food immediately before bed. Fast forward a couple years and I finally started seeing an ENT and a Gastroenterologist since I had a job and my own insurance, and I was diagnosed with GERD. For the record, they have never said I had LPR, but I think it is fairly obvious LPR would be a more accurate diagnosis based on my symptoms and the data below. I have been on omeprazole for a few years but it doesn't really help the symptoms that bother me (regurgitations, nasal drip, throat clearing, and oral burning). I know the omeprazole is working to cut the acid though because my regurgitations taste different and I will get heartburn bounceback if I start missing doses (ironic that I had to start taking PPIs in order to start getting heartburn, haha).

Anyway, here is a summary of the tests I've had and some of the reasonings I'm using to make my case for surgery.

1) My ENT did a laryngoscopy and saw "interarytenoid thickening" which he said is consistent with reflux. He tried a few medical therapies on me (zantac and a couple different PPIs), but none helped my symptoms, so I eventually stopped.

2) I went to a Gastroenterologist and she also said it sounded like reflux. She ordered a bunch of tests over a very short period of time. I believe I did not start my any new medications until I had completed all of the tests. I will list them separately.

3) I had an EGD. There was nothing visually obvious except a mild gastric erythema. The biopsies came back negative for H. Pylori. The esophagus biopsy showed epithelial changes which are consistent with GERD.

4) I had liquid and solid gastric emptying studies. They showed mild reflux (although they state that the test wasn't designed to diagnose reflux). Otherwise these were normal.

5) I had a manometry. I don't have the record immediately available to me for some reason (I think Johns Hopkins is changing around their online portal and they aren't copied over yet). I had a hard time with this because I kept involuntarily swallowing and the doctor's report stated that this made some parts of the evaluation difficult. According to my memory though, if there was anything unusual in these tests, it was very mild.

6) I had the 24h pH and impedance monitoring test. This is the smoking gun for me. I will just copy the doctor's final impression for this one:
"This was an abnormal study. There was markedly abnormal
esophageal acid exposure throughout the study with a DeMeester Score of
134. Impedance showed abnormal reflux events, the bulk of which were
acidic. There was strong correlation between symptoms and reflux events."
Keep in mind that the pH test was done without any medications.

These are all the gastrological diagnostics that I have had done. Since that time (about 2 years), I have been taking omeprazole consistently just to reduce risk of further damage to my esophagus, but it is giving me zero resolution of my primary complaints. I am getting tired of the regurgitations, my mouth being on fire, all of my medications, and my other medical problems. Without going into too much detail (this post would literally a MINIMUM of 10x longer if I did), these include chronic pain, sleeping too much, fatigue, unrefreshing sleep, and mild psychiatric and social issues. The only one I will elaborate on is the sleep. I did have a sleep study very recently to evaluate for possible sleep apnea. It was found that I do not have sleep apnea. However, I did read the data and I found that I had many nighttime awakenings, and that I had spent a very large amount of time awake during the night. According to my perception, I only woke a couple times and then fell back to sleep almost instantly (this is normal for me). I was very surprised to see how much time I was staying awake, so I am wondering if this can be attributed to GERD since it is not a breathing issue. I also snore a lot, which I've read can be attributed to GERD.

Anyway, I have finally pretty much decided to get a laparoscopic Nissen fundoplication (I briefly considered some of the newer surgeries, but I've decided I'd much rather have the tried and true). I have currently scheduled an appointment with a gastroenterologist (a different one at Hopkins, my original one took way too long to see). It is currently 4 or 5 weeks away. I plan to recite this essay to them more or less, and expect to get the thumbs up for surgery. Is this basically how it goes? I was wondering if I could jump straight to it and schedule a surgeon consultation. Is this typically allowed, or do I need a GI thumbs up first? By the way I have a BCBS PPO for my insurance, so I can usually schedule consults whenever I want.

As a side note, a couple of months ago I got my nasal septum corrected as a total shot in the dark to see if it would help my constant throat clearing of mucous. It didn't help me at all. Hopefully it will at least help my winter nosebleeds though.

Hi Sam,
I can empathize with you. I think that you can schedule an appointment with a surgeon. My last Nissen, I contacted a surgeon in another city and I had all of my test results sent to him. He performed my surgery three weeks after getting all of the results. The critical part is finding a surgeon who is an expert in performing Nissens. Just because a surgeon performs them does not mean that he/she is an expert. In the meantime you may want to elevate your headboard 5-6 inches, eat low acid food, try taking DGL licorice chewable tablets before meals and drink alkaline water with a ph of at least 8.
Lastly, you said that you did not get a diagnosis of LPR. My GI doctor did not believe that LPR exists and reading other information led me to think that may GIs do not recognize LPR.
Back for another followup (sorry I said I'd be back in a few days, I forgot/got lazy). Thanks for the advice and support.

I bought various brands of nutrition shakes like Ensure/Slimfast/etc. I ate a little yogurt and drank those almost exclusively for about a week. I bought some Senna and Colace and took them at night on May 21st, seemed to help because I passed my first stool (since my the surgery) fairly easily the next day. I have been taking my omeprazole off and on (couldn't make up my mind). For the first week, it didn't seem to a big difference either way. My swallowing became easier over that week and the pain in my shoulders had mostly gone away after about a week. I seemed to be recovering fairly quickly. On the night of May 26th I decided to test myself because I was having my followup the next day. I had a McFlurry, McChicken, and McDouble (cheeseburger). They went down fairly well actually, only mild difficulty swallowing. Not much in the way of heartburn, at least nothing too bad. I chose McDonald's partly because that is what used to give my heartburn back in college whenever I made latenight food runs. Despite my good recovery, I was still a little conerned about some things I was feeling. I still have reflux shortly after I eat, but as I said before, I just assumed this was stuff which was still working it's way into my stomach. I also had some tiny amount of burn which resembled heartburn, but it was hard to tell for sure if it was just surgical pain.

I had my followup on May 27th. The Dr reinforced my theory about the food coming up and the pain, he said the small "heartburn" pain was just because I am still healing and that food is likely to come up a little bit while it struggles to get into my stomach. He also surprised me by saying I could basically have whatever I wanted. He even encouraged me to try alcohol and carbonated beverages. He only caveated that I wait for carbonated beverages to fizz out a little and that I swallow only one bite at a time. He said that if I end up making myself throw up, I could tear wrap apart. I was surprised to hear him give me the thumbs up for carbonated beverages because the eating schedule they gave me said I shouldn't have them until week 12. He said that the schedule was the "old lady schedule" and that my recovery was way ahead of schedule.

When I left, it was around lunch time and I had a slice of pizza, frozen yogurt, and a soda. It seemed to go down fine. Later that night I had a little scare when I went to eat with my friends. I got a plate of garlic rolls to eat (I wasn't that hungry). I swallowed three separate bites of a roll, but I forgot to chew them thoroghly. I then started to feel a huge pressure in my chest (like the food was getting stuck). I drank some water, but it just made it worse and the stuff wouldn't go down. I sat there trying to swallow it, but I started coughing up the water. I went to the bathroom and threw up 3 separate times. Each time, one of my bites of the roll popped out. The first time it happened naturally and the next two times I induced vomiting. The vomiting wasn't very strong, the bites popped out pretty smoothly and easily (no retching or pain). I was a little worried, but I was pretty sure I only vomited my esophageal contents. Over the next few days, I ate more of a normal diet. I seemed to have more stuff lingering in my esophagus and sometimes I thought I tasted a little sour acid taste. I started to worry that the wrap may be damaged, but there was no pain and I still had difficulty swallowing ... so I assume it must be intact. It is pretty confusing.

Yesterday I had Chicken Pad Thai and I got some pretty bad heartburn. I'm pretty sure it was not simply surgical pain, it was pretty much textbook heartburn. I was pretty worried, but I still had difficulty swallowing it ... so I think the wrap must still be doing it's job to an extent. As I thought more about it, I realized later in the evening that I hadn't had any omeprazole for a couple of days. I now am hoping that the heartburn and extra stuff in my esophagus is just PPI bounceback. There are a few studies that show PPI withdrawal can cause upset stomach and heartburn for a couple of weeks even in NORMAL patients without GERD. So I am hoping that this will all go away once my body adjusts to having no omeprazole. However, to make the transition smoother, I started taking my omeprazole again this morning at a lower dose. I will try to taper off it. I am also going to scale back a little bit on the diet and try to avoid too many veggies and bread to help swallowing and avoid fatty food to help reduce acid production. Fingers crossed. I am debating giving the doctor a call and asking him about it, although he seemed somewhat dismissive of any possibility of acidic reflux at my followup.

Sam
[QUOTE=SammyCeee;5365302]Back for another followup (sorry I said I'd be back in a few days, I forgot/got lazy). Thanks for the advice and support.

I bought various brands of nutrition shakes like Ensure/Slimfast/etc. I ate a little yogurt and drank those almost exclusively for about a week. I bought some Senna and Colace and took them at night on May 21st, seemed to help because I passed my first stool (since my the surgery) fairly easily the next day. I have been taking my omeprazole off and on (couldn't make up my mind). For the first week, it didn't seem to a big difference either way. My swallowing became easier over that week and the pain in my shoulders had mostly gone away after about a week. I seemed to be recovering fairly quickly. On the night of May 26th I decided to test myself because I was having my followup the next day. I had a McFlurry, McChicken, and McDouble (cheeseburger). They went down fairly well actually, only mild difficulty swallowing. Not much in the way of heartburn, at least nothing too bad. I chose McDonald's partly because that is what used to give my heartburn back in college whenever I made latenight food runs. Despite my good recovery, I was still a little conerned about some things I was feeling. I still have reflux shortly after I eat, but as I said before, I just assumed this was stuff which was still working it's way into my stomach. I also had some tiny amount of burn which resembled heartburn, but it was hard to tell for sure if it was just surgical pain.

I had my followup on May 27th. The Dr reinforced my theory about the food coming up and the pain, he said the small "heartburn" pain was just because I am still healing and that food is likely to come up a little bit while it struggles to get into my stomach. He also surprised me by saying I could basically have whatever I wanted. He even encouraged me to try alcohol and carbonated beverages. He only caveated that I wait for carbonated beverages to fizz out a little and that I swallow only one bite at a time. He said that if I end up making myself throw up, I could tear wrap apart. I was surprised to hear him give me the thumbs up for carbonated beverages because the eating schedule they gave me said I shouldn't have them until week 12. He said that the schedule was the "old lady schedule" and that my recovery was way ahead of schedule.

When I left, it was around lunch time and I had a slice of pizza, frozen yogurt, and a soda. It seemed to go down fine. Later that night I had a little scare when I went to eat with my friends. I got a plate of garlic rolls to eat (I wasn't that hungry). I swallowed three separate bites of a roll, but I forgot to chew them thoroghly. I then started to feel a huge pressure in my chest (like the food was getting stuck). I drank some water, but it just made it worse and the stuff wouldn't go down. I sat there trying to swallow it, but I started coughing up the water. I went to the bathroom and threw up 3 separate times. Each time, one of my bites of the roll popped out. The first time it happened naturally and the next two times I induced vomiting. The vomiting wasn't very strong, the bites popped out pretty smoothly and easily (no retching or pain). I was a little worried, but I was pretty sure I only vomited my esophageal contents. Over the next few days, I ate more of a normal diet. I seemed to have more stuff lingering in my esophagus and sometimes I thought I tasted a little sour acid taste. I started to worry that the wrap may be damaged, but there was no pain and I still had difficulty swallowing ... so I assume it must be intact. It is pretty confusing.

Yesterday I had Chicken Pad Thai and I got some pretty bad heartburn. I'm pretty sure it was not simply surgical pain, it was pretty much textbook heartburn. I was pretty worried, but I still had difficulty swallowing it ... so I think the wrap must still be doing it's job to an extent. As I thought more about it, I realized later in the evening that I hadn't had any omeprazole for a couple of days. I now am hoping that the heartburn and extra stuff in my esophagus is just PPI bounceback. There are a few studies that show PPI withdrawal can cause upset stomach and heartburn for a couple of weeks even in NORMAL patients without GERD. So I am hoping that this will all go away once my body adjusts to having no omeprazole. However, to make the transition smoother, I started taking my omeprazole again this morning at a lower dose. I will try to taper off it. I am also going to scale back a little bit on the diet and try to avoid too many veggies and bread to help swallowing and avoid fatty food to help reduce acid production. Fingers crossed. I am debating giving the doctor a call and asking him about it, although he seemed somewhat dismissive of any possibility of acidic reflux at my followup.

Sam[/QUOTE]

Thanks for your thorough step by step analysis. I'm crossing my fingers for you, and hope it'll be all better soon. You made the right call by going back to being conservative in your healing. Take care!
Hi, sorry I haven't reported in a while. My recovery has been up and down, so I haven't felt like I hit a big milestone to share. I probably should be recovering faster, but I've made things more difficult for myself. I'd say the biggest things issues have been recurrent soreness in my chest/stomach as well as sharp pains in my abdomen/stomach. I think the soreness is largely due to overdoing things, particularly eating too much and too fast. I think it causes too much strain to the internally healing parts. My guess for the sharp pains in the abdomen is that it was trapped gas from swallowing air and carbonated beverages. It didn't really make much sense to have pains in my lower abdomen since obviously nothing was done there, so gas is my best guess. I also have bloating from overeating, but that is something I had prior to surgery as well. I'd say though after the surgery, bloating is more punishing. I stayed on my full dosage of meds because of the initial heartburn scare I had mentioned in my previous post (with the Pad Thai). Also, since I was still having all of the issues I mentioned above, I didn't want to add PPI bounceback acid to possibly make things even worse. Finally, I decided at some point that I wanted things to settle down and for the surgical soreness to be almost completely gone before I stopped my meds. That way, I will be able to more obviously feel if there is any acid working its way back up. I also started taking Gas-X as needed whenever I would drink something carbonated, have abdominal pain, and/or feel like I ate too fast. I feel like it helped a little bit with those issues, but it was hard to tell for sure.

As far as my doctor(s) go, my GI was from Hopkins, but not my surgeon. I don't know if we are allowed to post doctor names in public, but if you go to the Virginia Heartburn and Hernia Institute, you will see who my surgeon was. I think overall my experience was probably quite a bit above average in the grand scheme of things, but it wasn't perfect. The surgeon performs hundreds of these every year and based on the name of the clinic, I think you can guess that this is pretty much his specialty. He and his PA seem sharp and I had a very good impression of them on my first visit (I wonder though if this is because I heard what I wanted to hear). I'd say though that the doctor has a touch of arrogance. He seemed friendlier and more willing to listen and talk to me BEFORE the surgery, but in my followup appt. and during subsequent phone call he seemed a bit annoyed with me when I asked him more than a couple of questions. Overall, I would recommend them. Look at my previous postings to see my general feelings about the hospital itself. The hospital is Virginia Hospital Center, which is in a different place than the "Heartburn Institute" where I had my consult/followups. Let me know if you want me to go into more detail about the surgeon and/or hospital or if you have any more specific questions about them.

To summarize, I'd say that my biggest mistakes have been eating too fast, eating too much, and drinking carbonated beverages. Also, drinking alcohol too early on in the healing process was a mistake as well because it really burns when it's just sitting there in your esophagus trying to fight its way through the junction. I found that when I was doing these things, things would get much worse. I really wish the doctor would have scared me into following a stricter regimen rather than giving me the green light on everything after only 1 week. To be fair to him though, he probably didn't realize how little self-control I can have when it comes to food.

In the most recent stage of my recovery, I finally got fed up with myself after I lost my self control once again at a July 4th party. I decided at that point that I needed some changes. I've cut out carbonated beverages. I've cut down calories and I'm eating smaller meals. I've mostly cut out any sugary foods and beverages. I've maxed out my Colace and Senna, and I've added a little Miralax here and there. I'm drinking a lot of coffee to suppress my appetite and keep the bowels empty. I am still taking Gas-X as-needed. This is probably a dumb and unhealthy plan (so I'm not endorsing it in any way), but I'd gotten fed up with feeling bloated. I also want to lose weight and increase my motivation at work, hence the coffee. I've had a few small slip-ups, but I feel like this week has been much better. Since I need to get off omeprazole before my next visit, and since I haven't had legitimate heartburn for a while, I have cut down to only one dose per day. After another week or so, I will try cutting it out completely.

I think the surgery was a good idea. I do get some sensations that stuff wants to come up from my stomach. It's hard to explain and hard to tell exactly what I am feeling, but I THINK the new valve is pretty much doing it's job. What I do know is that I usually do not feel liquid coming up to my mouth/throat, unless I drink or eat too fast. I think this is just because all of that food is still fighting its way into my stomach and has nowhere to go but up. I have been trying to be more conscious of swallowing air. I found that it's a bit better to let beverages flow through your mouth and into your throat rather than sucking them up. It seems to reduce belching, which reduces the chances of any stuff coming all the way up. At this point, I am still optimistic that things will continue to improve.

Sam
[QUOTE=SammyCeee;5372276]Hi, sorry I haven't reported in a while. My recovery has been up and down, so I haven't felt like I hit a big milestone to share. I probably should be recovering faster, but I've made things more difficult for myself. I'd say the biggest things issues have been recurrent soreness in my chest/stomach as well as sharp pains in my abdomen/stomach. I think the soreness is largely due to overdoing things, particularly eating too much and too fast. I think it causes too much strain to the internally healing parts. My guess for the sharp pains in the abdomen is that it was trapped gas from swallowing air and carbonated beverages. It didn't really make much sense to have pains in my lower abdomen since obviously nothing was done there, so gas is my best guess. I also have bloating from overeating, but that is something I had prior to surgery as well. I'd say though after the surgery, bloating is more punishing. I stayed on my full dosage of meds because of the initial heartburn scare I had mentioned in my previous post (with the Pad Thai). Also, since I was still having all of the issues I mentioned above, I didn't want to add PPI bounceback acid to possibly make things even worse. Finally, I decided at some point that I wanted things to settle down and for the surgical soreness to be almost completely gone before I stopped my meds. That way, I will be able to more obviously feel if there is any acid working its way back up. I also started taking Gas-X as needed whenever I would drink something carbonated, have abdominal pain, and/or feel like I ate too fast. I feel like it helped a little bit with those issues, but it was hard to tell for sure.

As far as my doctor(s) go, my GI was from Hopkins, but not my surgeon. I don't know if we are allowed to post doctor names in public, but if you go to the Virginia Heartburn and Hernia Institute, you will see who my surgeon was. I think overall my experience was probably quite a bit above average in the grand scheme of things, but it wasn't perfect. The surgeon performs hundreds of these every year and based on the name of the clinic, I think you can guess that this is pretty much his specialty. He and his PA seem sharp and I had a very good impression of them on my first visit (I wonder though if this is because I heard what I wanted to hear). I'd say though that the doctor has a touch of arrogance. He seemed friendlier and more willing to listen and talk to me BEFORE the surgery, but in my followup appt. and during subsequent phone call he seemed a bit annoyed with me when I asked him more than a couple of questions. Overall, I would recommend them. Look at my previous postings to see my general feelings about the hospital itself. The hospital is Virginia Hospital Center, which is in a different place than the "Heartburn Institute" where I had my consult/followups. Let me know if you want me to go into more detail about the surgeon and/or hospital or if you have any more specific questions about them.

To summarize, I'd say that my biggest mistakes have been eating too fast, eating too much, and drinking carbonated beverages. Also, drinking alcohol too early on in the healing process was a mistake as well because it really burns when it's just sitting there in your esophagus trying to fight its way through the junction. I found that when I was doing these things, things would get much worse. I really wish the doctor would have scared me into following a stricter regimen rather than giving me the green light on everything after only 1 week. To be fair to him though, he probably didn't realize how little self-control I can have when it comes to food.

In the most recent stage of my recovery, I finally got fed up with myself after I lost my self control once again at a July 4th party. I decided at that point that I needed some changes. I've cut out carbonated beverages. I've cut down calories and I'm eating smaller meals. I've mostly cut out any sugary foods and beverages. I've maxed out my Colace and Senna, and I've added a little Miralax here and there. I'm drinking a lot of coffee to suppress my appetite and keep the bowels empty. I am still taking Gas-X as-needed. This is probably a dumb and unhealthy plan (so I'm not endorsing it in any way), but I'd gotten fed up with feeling bloated. I also want to lose weight and increase my motivation at work, hence the coffee. I've had a few small slip-ups, but I feel like this week has been much better. Since I need to get off omeprazole before my next visit, and since I haven't had legitimate heartburn for a while, I have cut down to only one dose per day. After another week or so, I will try cutting it out completely.

I think the surgery was a good idea. I do get some sensations that stuff wants to come up from my stomach. It's hard to explain and hard to tell exactly what I am feeling, but I THINK the new valve is pretty much doing it's job. What I do know is that I usually do not feel liquid coming up to my mouth/throat, unless I drink or eat too fast. I think this is just because all of that food is still fighting its way into my stomach and has nowhere to go but up. I have been trying to be more conscious of swallowing air. I found that it's a bit better to let beverages flow through your mouth and into your throat rather than sucking them up. It seems to reduce belching, which reduces the chances of any stuff coming all the way up. At this point, I am still optimistic that things will continue to improve.

Sam[/QUOTE]

Good luck Sam!
You've given me some hope that in the future I may be able to get the surgery. Kepp us posted and Godspeed!





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