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120 MG of dexilant a day?

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Posted 8/14/2015 8:11 PM (GMT 0)
So I called my gastro on Tuesday due to my medicine not working. Well today I still hadn't heard back so I called again. Then I got a call back today and the nurse or whoever it was says the dr hasn't responded to my message. I'm due for a refill Monday and I don't want to spend 250.00 dollars on Mede that don't work. So I was told by the woman who was crunching away on chips to go ahead and take 2 60 mg pills of dexilant a day. My concern is 1) I weigh 84 pounds isn't that a high dose? 2) insurance has refused to even allow twice a day so what happens on day 15 when I am out? Even if they allowed it it would cost 500 a month. I feel like adding to an already high dose isn't going to help me I just want to try something else.
Posted 8/14/2015 10:07 PM (GMT 0)
PPIs are not the fix to what is causing your reflux. These medications are only meant to treat symptoms and sometimes do not even do that. If you are not getting relief from Dexilant 60mg, you will not get relief on 120mg either. Sadly, GI doctors just want to throw medication at the problem instead of finding out what is causing the problem

Have you been tested for H. Pylori, delayed gastric emptying, and food sensitivities? All three of these things should have been completely ruled out before ever prescribing a PPI. It's much more convenient for the doctors to write these prescriptions then to actually find the source of your problem.

If the GI doctors are not interested in finding what is causing your reflux, you might want to consider seeing a qualified naturopathic doctor.
Posted 8/14/2015 11:55 PM (GMT 0)

CAGU said...
If you are not getting relief from Dexilant 60mg, you will not get relief on 120mg either.


Sorry, but this is just nonsense.

When taking one dose of Dexilant, the first half of the dose is released immediately whereas the second half is released about four to five hours later.
If your insurance won't cover Dexilant twice a day and paying yourself is too expansive, you could discuss with your doc about taking a high dose of a conventional PPI splitted into three times a day.
Posted 8/15/2015 12:00 AM (GMT 0)

CAGU said...
PPIs are not the fix to what is causing your reflux. These medications are only meant to treat symptoms and sometimes do not even do that. If you are not getting relief from Dexilant 60mg, you will not get relief on 120mg either. Sadly, GI doctors just want to throw medication at the problem instead of finding out what is causing the problem

Have you been tested for H. Pylori, delayed gastric emptying, and food sensitivities? All three of these things should have been completely ruled out before ever prescribing a PPI. It's much more convenient for the doctors to write these prescriptions then to actually find the source of your problem.

If the GI doctors are not interested in finding what is causing your reflux, you might want to consider seeing a qualified naturopathic doctor.

I have requested food testing and not one doctor seems to think it's necessary. I was never tested for gastric emptying and was tested for H Pyloria.
Posted 8/15/2015 12:57 AM (GMT 0)
Hi Lawchick

I would definitely get tested for delayed gastric emptying. You do not have to be vomiting to have delayed gastric emptying. There are many people who have this that are dealing with serious GERD/LPR issues. If your GI doctor will not order the test, have your primary care physician order the test. Food sensitivities is another thing which should be ruled out. Your allergist can test you for food items. Sorry you are going through this. It's sad they are just throwing medication at your problem.
Posted 8/15/2015 3:33 AM (GMT 0)
Hi Lawchick,
I just had this conversation with my son's new gastroenterologist! My son was up to 80mg of prilosec, and then he was switched to 60mg of Dexilant. He has been on it 3 months. It did help the GERD heartburn, but he continues to have regurgitation and a whole bunch of other LPR symptoms. We started going to a new gastro last month and he said, if you are on a high dose of PPI and it's not helping, then it is almost certain that it is not ACID reflux. My son apparently has acid GERD, and also non-acid LPR. He was unable to do the dual impedance ph test.We are going for a 24 hr restech dx-pH test that doesn''t go all the way down your throat. It measures not only acid and non-acid liquid that refluxes up past the larynx, but also acid and pepsin vapor that can be the cause of LPR. It is supposed to be a reliable indicator of LPR, however not many doctors seem to know about it.We will see what it says. I don't know if this helps, but the gastro had said if we wanted to add zantac 150 at night to cover the break thru period of the dexilant we could try it. It didn't work for us, but it may be worth it to try(and the H2 blockers are much cheaper OTC than more pricey prescriptions). Good luck.
Posted 8/15/2015 1:13 PM (GMT 0)
I tried Zantac at night and it didn't help. I am also starting to think I have silent aspiration. When I eat liquids sometimes I get this feeling for a short second that I almost drowning it's scary but I have no urge to cough and it does go away. On my last barium it showed I aspirated and had no reaction.
Posted 8/15/2015 9:45 PM (GMT 0)

LAWCHICK said...
So I called my gastro on Tuesday due to my medicine not working. Well today I still hadn't heard back so I called again. Then I got a call back today and the nurse or whoever it was says the dr hasn't responded to my message. I'm due for a refill Monday and I don't want to spend 250.00 dollars on Mede that don't work. So I was told by the woman who was crunching away on chips to go ahead and take 2 60 mg pills of dexilant a day. My concern is 1) I weigh 84 pounds isn't that a high dose? 2) insurance has refused to even allow twice a day so what happens on day 15 when I am out? Even if they allowed it it would cost 500 a month. I feel like adding to an already high dose isn't going to help me I just want to try something else.

I find this unacceptable. I generally do not follow the advice of nursing staff when it comes to my medications unless they can show me something in writing from the doctor. Dexilant is a very expensive PPI. I was 60mg once a day at one point and found it very effective, but that story is for another time.

Is it possible to go see your GI doctor as a walk in? Sometimes they will see you if you tell them it's urgent and that you're willing to wait. Your doctor, who I know is busy, should get back to you within a reasonable period of time. I generally give mine a few days, but if it's longer than a week, than I'm on the phone calling them everyday until I get to speak to them.

Push to speak to your GI doctor or call them and see if you can't go in to see your doctor asap. Tell them that the medication isn't working and you're not keen on the idea of anyone but your doctor giving you advice on your medications. Otherwise it may be time to find another GI doctor. You've been on PPIs for a long time and if you're not getting relief then in my opinion, something is not right.

Since your insurance limits your medication, tell them you want to consult with your doctor to see if there is a less expensive alternative, there are many other PPIs that he or she can put you on.

I'm not sure what you're eating now but a puree diet might be necessary for awhile to allow your esophagus time to heal. I'm currently on one right now.
Posted 8/21/2015 5:36 PM (GMT 0)

Peabs said...

LAWCHICK said...
So I called my gastro on Tuesday due to my medicine not working. Well today I still hadn't heard back so I called again. Then I got a call back today and the nurse or whoever it was says the dr hasn't responded to my message. I'm due for a refill Monday and I don't want to spend 250.00 dollars on Mede that don't work. So I was told by the woman who was crunching away on chips to go ahead and take 2 60 mg pills of dexilant a day. My concern is 1) I weigh 84 pounds isn't that a high dose? 2) insurance has refused to even allow twice a day so what happens on day 15 when I am out? Even if they allowed it it would cost 500 a month. I feel like adding to an already high dose isn't going to help me I just want to try something else.

I find this unacceptable. I generally do not follow the advice of nursing staff when it comes to my medications unless they can show me something in writing from the doctor. Dexilant is a very expensive PPI. I was 60mg once a day at one point and found it very effective, but that story is for another time.

Is it possible to go see your GI doctor as a walk in? Sometimes they will see you if you tell them it's urgent and that you're willing to wait. Your doctor, who I know is busy, should get back to you within a reasonable period of time. I generally give mine a few days, but if it's longer than a week, than I'm on the phone calling them everyday until I get to speak to them.

Push to speak to your GI doctor or call them and see if you can't go in to see your doctor asap. Tell them that the medication isn't working and you're not keen on the idea of anyone but your doctor giving you advice on your medications. Otherwise it may be time to find another GI doctor. You've been on PPIs for a long time and if you're not getting relief then in my opinion, something is not right.

Since your insurance limits your medication, tell them you want to consult with your doctor to see if there is a less expensive alternative, there are many other PPIs that he or she can put you on.

I'm not sure what you're eating now but a puree diet might be necessary for awhile to allow your esophagus time to heal. I'm currently on one right now.

Thanks for your reply. I have an apt with a new doctor the first week of September since my Gastro never got back to me about this. I am thinking about filing a complaint to the medical board. His lack of care has really set me back.
Posted 8/21/2015 5:50 PM (GMT 0)
Unfortunately, there are some GI doctors (and GPs) who don't take GERD (and it's causes) very seriously. Some have gone so far as to say things like "it's all in your head". I actually prefer going to a GI doctor who has had their own bout with GERD or something along those things so that they can at least understand how bad it can get.

I fired my first GI doctor because he overbooked his appointments and rushed me in and out of his practice. Sorry, I know you're busy, but I'm also a customer, a human being, not just a number or a patient. BAM! You're fired.

My 2nd GI doctor was actually pretty good, but he was convinced that my esophagitis had nothing to do with my esophageal spasms. Even when I showed him literature online that showed there was a direct link between our digestive system and our heart he pretty much blew it off! Every time I'd get a spasm it would irritate my vagal nerve and cause my heart to race (also known as SVT in my specific case).

After interviewing several GI doctors I finally settled on my third GI doctor. Right now it's too early to tell, but so far so good. She's not hassling me for not taking my PPIs as I'm trying a 90 day experiment to see if I can heal naturally. I'm on my 2nd month so it's too early to tell.

I'm glad to see that you have an appointment with a new doctor.
Posted 8/24/2015 3:05 AM (GMT 0)
Hi Peabs, I read most of your post. Are you still taking PPI or any meds (H2 blocker/Tums) right now. How far are you with your 90 day experiment? Please share. I wean myself gradually for PPI since July 24. The H2 blocker/Zantac around 5 days I think. I sometimes feel the pain of acid rebound. Rolaids helped on days I really have the acid attack. I'm trying to wean totally. I am still on a strict diet (steamed rice, fish and selected veggies). Few times I eat out and boom, feel that acidity again. Even eating steamed fish and rice, but a lot of stuff is on restaurant food.
To reiterate my post, My acidity was triggered from taking antibiotics, all my test results were normal. I was rushed to emergency last June14 and all test were done and all are normal. (Praise God).
I don't know how long to be on this strict diet and when I can be back to normal. Focusing on my recovery but still weak to be back to work.
Posted 8/24/2015 1:26 PM (GMT 0)

Tu Wang said...
Hi Peabs, I read most of your post. Are you still taking PPI or any meds (H2 blocker/Tums) right now. How far are you with your 90 day experiment? Please share. I wean myself gradually for PPI since July 24. The H2 blocker/Zantac around 5 days I think. I sometimes feel the pain of acid rebound. Rolaids helped on days I really have the acid attack. I'm trying to wean totally. I am still on a strict diet (steamed rice, fish and selected veggies). Few times I eat out and boom, feel that acidity again. Even eating steamed fish and rice, but a lot of stuff is on restaurant food.
To reiterate my post, My acidity was triggered from taking antibiotics, all my test results were normal. I was rushed to emergency last June14 and all test were done and all are normal. (Praise God).
I don't know how long to be on this strict diet and when I can be back to normal. Focusing on my recovery but still weak to be back to work.

I have opted not to take any medications during my 90 day experiment.  I'm nearing the end of my 2nd month so I have one more month to go.  I don't advise anyone else to do this because I made this decision after consulting my nutritionist and my GI doctor and for my specific situation, I have decided to do this by adhering to a strict, all-natural diet.  My current diet is extremely restrictive, but it's slowly starting to get results.

Since my Lower Esophageal Sphincter is normal, I am working on the theory that my gastritis and esophagitis was caused by years of a bad diet, eating late at night before going to bed, and drinking heavily on weekends.  I ignored my heartburn for years and I paid the price. 

I've decided for the first 90 days to only eat about 7 to 8 basic foods and nothing else and all these foods would be organic and all natural.  This will give me the nutrient dense foods that I need in order to heal as well as give my body the time it needs to heal. 

As far as going out to eat, remember that the majority of restaurants use MSG, even many of the ones that say they don't because sometimes the food already comes with it or it's in their sauces and marinades.  For this reason alone I rarely go out to eat, but when I do I only go to places that serve sushi, wild caught fish, or organic foods. 

If your GERD was triggered by taking antibiotics then hopefully you are taking a probiotic supplement.  If you're not sensitive to dairy then drinking organic kefir and/or eating organic greek yogurt (sugar free) would be a good source.  My personal favorites though are fermented vegetables.  A word of caution though, you'll want to start off in small amounts and slowly increase your intake. 

Posted 8/24/2015 7:51 PM (GMT 0)
Thank you Peabs. I am taking probiotics now. Yakult after each meal even half a bottle and a supplement at night. This had helped me so far. If I was more strict on the diet (eating out) I would not need the Rolaids. That's good to know that sushi is good. I'm just scared to eat raw. But if it did worked for you, it's worth a try as well as the fermented vegetables.
During this 2 months with no medications, with your strict diet, how are you feeling?. Are you taking supplements? I been taking Vitamin D per my doctor's advise and seems to help. I'm on my 6 days and some days I'm ok but sometimes I have a little discomfort during this journey of recovery.

God bless.
Posted 8/24/2015 8:50 PM (GMT 0)

Tu Wang said...
Thank you Peabs. I am taking probiotics now. Yakult after each meal even half a bottle and a supplement at night. This had helped me so far. If I was more strict on the diet (eating out) I would not need the Rolaids. That's good to know that sushi is good. I'm just scared to eat raw. But if it did worked for you, it's worth a try as well as the fermented vegetables.
During this 2 months with no medications, with your strict diet, how are you feeling?. Are you taking supplements? I been taking Vitamin D per my doctor's advise and seems to help. I'm on my 6 days and some days I'm ok but sometimes I have a little discomfort during this journey of recovery.

God bless.

I look for sushi places that have high ratings (think Yelp, Zagat, etc.) and I also pay close attention to the sushi chef preparing my food.  Does he wash his hands when he's supposed to?  Does he handle my fish properly?  

I can understand why some people are afraid of eating raw fish, however, if the sushi chef / owner of the restaurant do things correctly, they prep the fish so it is very clean and has very little bacteria on it.  I have found sushi one of the safest foods to eat, but I make sure I order it at a place that makes food safety and cleanliness a high priority.   If sushi still scares you, you can eat wild caught fish by grilling it or cooking it in a pan.  I prefer to cook mine over the bbq or if I cook it in a pan, I use a little bit of coconut oil.

As far as how I'm feeling, that's a little tough to answer because on my good days I feel pretty good.  On my bad days I few awful.  I guess it's suffice to say that I'm feeling much better than I did when I started my 90 day food experiment.  When I went to the ER in June, the pain was so bad I could barely see straight.  At least now, the pain I'm feeling, while constant, is manageable and no longer interferes with my work. 

The first two weeks after my trip to the ER were the most difficult.  And I didn't start feeling better until around the 6th week.  So you'll need to give it time.   darn the esophagus takes a long freakin' time to heal.  I'm hoping to feel well enough by the end of December so I can have a couple glasses of my favorite red wine.  Until then, I'm just drinking water, coconut water, and certain home made teas.  Ok, ok.....sometimes I'll drink grape juice and pretend it's wine lol.

Regarding Vitamin D did the doctor say anything about getting sun exposure?  I bring this up because my own GP advised me to get 15-20 minutes of sunlight everyday, making sure 30-40% of my body was in the sun.  You can get a day's worth of vitamin d and then some with that amount of sun exposure.  Just a thought.

Here are some informative articles about obtaining the vitamin D you need from the sun:

http://articles.mercola.com/sites/articles/archive/2012/09/29/sun-exposure-vitamin-d-production-benefits.aspx

http://health.usnews.com/health-news/family-health/heart/articles/2008/06/23/time-in-the-sun-how-much-is-needed-for-vitamin-d

http://articles.mercola.com/sites/articles/archive/2012/03/26/maximizing-vitamin-d-exposure.aspx

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