Aryana,
I can't tell you what to do as that really is an individual thing, but I'm happy to share my experiences. LPR really is a tough condition with no "cure".
I was able to get my LPR under control for about 6 years on twice a day Prevacid. My primary symptom was a chronic cough. Of course, I have coughing as a symptom for my asthma and as a side symptom from allergies and frequent sinus problems. I've never been a "heartburn" person. When my coughing returned several years ago, that was when I went from once to twice a day on the Prevacid. For some reason the Solutab form worked best for me.
When things got bad about 1 1/2 years ago, I thought it was just my asthma. It was my Pulmonologist who helped determine, through my history, Barium testing, the pH testing, Manometry, etc... That my reflux had become life threatening because it was badly irritating my lungs and I was also aspirating the acid. It got to the point that I needed emergency treatment and was borderline for being admitted to the hospital. For about 8-9 months, I coughed almost non-stop and couldn't get a good breath.
Last summer, I switched PPI's once per month trying to find one that would work better. Even on two per day, none ended up helping. In fact, the Nexium gave me permenant IBS. I've become a bit anemic as well so I have constant digestive issues too. I try to avoid dairy, spicy, fatty, citrus, all raw fruits and veggies (no lettuce). I sleep with my bed on an incline as well. I also supplement with Gaviscon. (Too much of that can cause diarrhea to be worse though.)
With regarRAB to the cancer scare, I've had severe reflux diagnosed for about 7 years (think I had it long before but didn't realize it) and have absolutely no esophageal irritation. With LPR, the acid comes up to the throat so quickly, that most of the time, EGD's don't show damage. The problem with LPR is that it just takes a bit of acid to irritate the throat because it is so sensitive.
Have you tried other PPI's? You might find one that works better than your Nexium. For LPR, you should be on twice a day or on time-released Kapidex 60 mg.
When my LPR became so life threatening, I ended up going the surgical route with a Laproscopic Nissen Fundoplication. My coughing was gone when I woke up in the hospital and has remained gone since my procedure last October. I'd repeat this surgery in a heartbeat. I do still have serious acid production so I still take the Kapidex or Previcad x2 daily and watch my diet and lifestyle too. Per my GI, stopping the meRAB would mess my IBS up even more so I'm on the meRAB for life even after the surgery. The NF is not a 100% guarantee surgery, but from my research has a higher success if people are having breathing problems. I have had some bloating issues on and off post-surgery. I'm really not entirely sure if it is the NF or the IBS at this point. I cannot vomit either and have some intermittent nausea too so that can be unpleasant. I had a very experienced surgeon. I think that made all the difference. My wrap is tight enough that the acid isn't coming up, but I am able to belch occassionally to get a bit of air out. There are many posts on this board with people who aren't as happy with the wraps long term, but with my health issues, I think the side effects are outweighed by the being able to breathe again.
God bless,
Mountain Reader