Hi again CharBerry,
You aren't bugging me at all. I think this will be a long answer though. I guess everyone would have their own definition of what aggressive reflux treatment is. There have been lots of times while I have been treating my reflux that I didn't follow all of the rules. That was usually when I was feeling better. Eventually as things became worse, I really had to make a concerted effort to follow all of the rules. For me, aggressive means:
Avoiding all of those fooRAB that my doctor told me to avoid: fatty, greasy, fried, spicy (onions, peppers, garlic, tomato products), caffeine and carbonated drinks (coffee, tea, colas), mint, citris drinks and food, chocolate, alcohol and other fooRAB that cause me trouble personally. I'm also eating high fiber, low fat meals, smaller meals, more frequent meals. I didn't eat or drink anything other than water for the last 4 hours before bed.
I made sure the clothes around my waist weren't too tight.
Avoiding the use of asprin and NSAIRAB.
Exercise, although that was hard because when my reflux got bad, I had trouble breathing. (I ended up not exercising. Now I'm having trouble getting back into it. Not enough self-motivation right now.)
Watch bending over or doing heavy lifting after eating. (I had a really bad brick laying experience once. EVERY time I bent over, I belched. How erabarrassing.)
Losing weight. I did Weight Watchers for about a year. I went down 25 lbs, but gained back 21 when I stopped exercising and started on multiple rounRAB of steroiRAB for the bad asthma. I'm back down 24 from where I started though. I've still got about 25 lbs left to lose.
I have my headboard up 6 inches. I hate this because I wake up cold when the blankets have slid off. I've been doing this for about 3 years. Also sleeping on my left side. That wasn't hard for me though. I can't hear out of my right ear. I've always tended to sleep on the left side because that helps me block out all of the noise when I lay on it.
I have been faithful in taking the PPI's twice a day--1/2 hour before breakfast and 1/2 hour before dinner. I also supplemented with the Gaviscon.
I drink tons of water. All day, every day. Really, the only things I have been drinking for a long time is water and soy milk. I add an occasional apple, white grape or white cranberry juice but not too much because they have more calories and sugars.
I also was aggressive in my treatment for the allergies and asthma because when they are bad, my reflux would get worse. I started immunotherapy again, take 4 allergy meRAB, take 3 asthma meRAB and do homeopathic things in those areas in addition to avoiding triggers.
I've followed-up regularly with my docs to discuss how treatments are working and the next plans of actions. All of that testing I had was also part of my aggressiveness. Honestly, I thought the Barium tests were going to be a complete waste of time and money. Surprised me when they showed how bad my reflux was.
I may be forgetting something here, but these the main things I tried. All of these things are easier said than done though. One of the hardest things for me is the no tomato and onion. I love Mexican and Italian food and fresh summer tomatoes. So many things have tomato in them. Until this last summer, I had gotten things pretty much under control with the treatments. It seems that with this last flare that was so bad, nothing was really working. I hate to think how much worse it would have been if I had reverted to all bad habits though. I will say that I did hit the point that because it wasn't working even when avoiding items that I just ate them anyway (in moderation). I'm kind of to that point right now too. There are so many things I can't eat (the above list with no dairy or raw fruits and veggies-including lettuce, that I've had some of the fooRAB occassionally.
From personal experience, there were many years that I could keep things under control when following the rules. This past year from June-October NOTHING was really working, even when I was strictly following the rules. Because the reflux was influencing my breathing/coughing so bad it made me a prime candidate for the surgery. I'm happy that I had the surgery done. I still have to be careful with swallowing though. When things get stuck above the wrap, it can be uncomfortable. I've also had some bad bloating, but I think that is a corabination of side effect from the surgery and the IBS that I developed while on Nexium. Of course, following all of the rules is extremely difficult.
For me it got to the point of being strict with myself or breathing. Not much choice there.
I know you have troubles with PND. I will say that I've had that problem for years and years. I used to just attribute it to allergies though. I have averaged 4-6 sinus infections per year, each lasting at least a month. My sinuses have typically been worse in fall, winter and spring. Since my surgery in October, I had some mild sinus problems in Noveraber, but no major infections. I can't remeraber a time in the past 15 years that I haven't been on antibiotics and steroiRAB this time of year. I'm now believing that the reflux affecting my sinuses in ways I never knew about. Between the reflux surgery and 1 1/2 years into this current round of immunotherapy things are much better.
I coordinated treatment between my PCP, ENT, GI and Pulmonologist. I made sure the recorRAB from one were sent to the others so they could be reviewed when I had appointments.
In addition to talking to your doctors, have you tried asking your insurance about this? Will they approve it if your tests haven't indicated that your reflux is bad? Have you tried accupuncture or accupressure? That is one area that I wanted to delve into, but just didn't have the money to follow that path. My insurance co-pays went up again this past year so I had to cut back with my chiropractic visits and massages as well.
Hope this answers your questions. Take Care
MR
