Yes, another Acid Reflux Thread

My apologies for the long explanation.

I’m in my late 20s and work as a Mate onboard various ships at sea. I stand a 12-hour watch, which consists of navigation, maneuvering the vessel, and doing paperwork. I also work a fair amount outside on deck doing tasks such as rigging deck cargo, carrying heavy items like ship stores, and maintenance (cleaning, operating, & inspection) of lifeboats and various deck equipment. While at work I can be called upon at any time to perform various safety and lifesaving functions for example firefighting, abandoning ship, and damage control. At home I also have a very physical and active life.

History of acid reflux
- Started getting acid reflux in High School at night just didn’t know that it was acid reflux.
- In 2003 after having heart burn at least 4 – 5 times a week I started on Prilosec OTC. Prilosec OTC it worked for a few weeks but decided to see a general Doctor and he proscribed Protonix 40 mg once a day
- My previous routine was to take one 40 mg tablet of Protonix before bed. Over the years if I had forgotten to take it every 24 hours I would usually get strong acid reflux within 36 hours of taking my last dose
- If eating within a couple of hours or eating a large meal before going to bed and I lie down the food travels up my esophagus into the back of my throat.
- Over the years while taking Protonix depending on when and what I eat I will have to take an antacid to calm the acid reflux. I’ve noticed that it was starting to occur more and more often.
- Last time I was at I work I noticed that I was taking the antacids more often then usual but was able to control it with antacids and once daily Protonix. Eventually the antacid/Protonix combination was not able to control the acid reflux. I increased my Protonix to two 40 mg tablets daily (12 hrs. apart) and have used the occasional antacid to try and calm the acid reflux unfortunately nothing is stopping it. The antacids usually just come back up my esophagus and into the back of my throat. I have cut back to a couple of small meals a day and try to consume just enough water to keep myself from getting dehydrated. When I do eat it gets pushed back into the lower part of my esophagus, with acid reflux, and belching (not large ones but many small ones). The amount of pain and discomfort is random
- Since returning home I went to a Gastrologist and she prescribed Zeroed (40 mg) at night and Protonix (40 mg) in the morning. I’m also scheduled for an Endoscope and Esophageal Manometry

I was diagnosed with hiatal hernia with scaring and damage in the lower esophagus. I try and avoid any type of surgery like the plague. I lead a very active life and my means of supporting myself require that I am mobile and not hampered by any physical limitations. My employer and the Coast Guard require that I pass stringent physicals every couple of years depending on license renewals, upgrades, etc. If I have any type of physical limitations I can easily loose my livelihood with very limited employment. My work and my home life are the exact opposite of someone that works at a desk.

I believe that my acid reflux has reached the point where I may not have a choice on to or not to have the surgery. I also have concerns of taking a PPI for the next 50 years. I would like to be able to have a life where I don’t have to sleep with my head 8” above my stomach, be able to lie on my side or stomach, and not have food and such back up esophagus all the time.

The biggest concerns I have over the surgery are loss of work due to length of recovery, unable to return to work due to not passing the physical, loss of my home life, and fear of complications at sea (i.e. sea sickness, picking up, pulling, pushing on heavy items, firefighting, etc.). I receive a day rate at work, i.e. every day onboard the ship I get paid every day I’m not on the ship I don’t get paid.

Just wanted to hear what everyone’s thoughts and onions are on what I should do.

So far this has been a great forum to hear what peoples stories of pre and post op.

Surprised I haven't had more responses especially with so many people on this Forum with similar problems as mine.

Anyway I just had the Esophageal Motility Study done this morning. I have to say that the difficulty of that test is way overdone. For anyone that has to have to say that the test is uncomfortable but it doesn't last for long. I'm not saying that I want to do it again but if I really really had to do it again I probably would.

I go in for another Endoscope tomorrow and from the looks of it, surgery may be an option for me.

I'm still really concerned about when and if I would be able to return to work after the surgery. From what it appears the surgery is a life changing operation.

M8: I have many of the same concerns you do.

What worries me about the standard Nissan surgery is not being able to burp or vomit ever again. That can't be good.

I work out 5 times a week, and I worry that strenuous exercise would damage the surgical work, or undo what was done.

I have an endoscopy scheduled for the 20th, so I guess I will find out more then.

I have only been on Prilosec 40MG for 5 weeks now, so it is still pretty early for me.

Re: Vomiting and Burping

I had the Nissen surgery three years ago and can burp and vomit.  It's not an automatic that you won't be able to do either.  Burping is definitely different than pre-Nissen..it is more at the whim of your stomach, but burp it does.  I had two stomach bugs in the last three years, and vomited both times.  The thing is that you should try to avoid vomiting, as it can be hard on your wrap.  I always keep anti-nausea drugs handy and took them as soon as I knew I was at risk.

 

Followed up with the doctor today. Bad News!! I have low esophageal motility so she rulled out the option of surgery.

She doesn't know why I have such bad reflux. The endoscopy showed that my esophagus doesn't have any scarring, looks completely normal, and I have a small (2 cm) Heital Hernia. She says everything about me is completely healthy and normal so once again she still doesn't know why I have such bad reflux because.

She also rulled out having an excessive amount of Acid because the combination of Protonix and Zegred has reduced my stomach acid to nothing. Every time I eat I can feel the food sit in my stomach and do nothing.

She changed my meds to 30 mg of Prevacid in the evening and 60 mg of Dexilant in the morning.

I just had a bowl of chicken noodle soup and once again I have acid all the way up the majority of esophagus.

Its really starting to be a pain. My diet is down to a beagle and 1/2 cup of oatmeal for breakfast followed by heart burn, turkey sandwich for lunch followed by heart burn, and soup or something similar for dinner once again followed by heart burn. This is starting to become really miserable. I'm young and hopefully have many years ahead of me. From the looks of it I'll be in pain 24/7 for the next 40 or 50 years. I'm dying for any type of solution.

Please if anyone has any suggestions please help!

Ok, a lot has happened between the last time I posted and now. It may take a couple of posts.

Went to a different Gastro to get a second opinion. New Doc said that surgery may still be an option but would have to be a 270 or 180 wrap instead of 360 but with a reduced wrap they are usually reduced results. He is waiting for the graphical results of my motility test to come in so he can make a better opinion because he only has the dictation. Interestingly enough the dictation said that I don't have week esophageal muscles but that they are slow if that makes sense.

The new Doc is also helping me get a referral to a specialist in esophageal surgeries located outside of my state. We've decided to put off the 24hr ph test till later but will definitely do it to confirm that its actually reflux because if it isn't reflux the surgery isn't going to help.

Ok, so after meeting with the 2nd Gastro the 1st Gastro had me do a ultrasound of my gallbladder and a chest x-ray. Durning the ultrasound they went ahead and did all of the organs in the area. The chest x-ray came back as normal but the ultrasound showed a cyst on my pancreas. Not much detail on what a cyst on the pancreas is or does but I'm lined up for a CT exam and blood work for enzymes.

My reflux is definitely still there after every meal but my meal options are starting to open more and I'm able to do many normal things that I enjoy.

I greatly appreciate everyone's help and assistance.