Back where I started; incurable LPR after all

Are you open to the Nissan?

@eric I would take anything at this point to cure my symptoms, but if given the choice, I would try the LINX first; at least it's reversible.

@ Andy Yes I have normal levels in daytime for the most part, but elevated-moderate levels at night. Amitrptyline didn't help; it doesn't stop the post nasal drip central to my breathing issues.

Daxter if your impedance has shown that you have reflux outside of the normal range and or a weak LES, I would be asking questions as to why surgery hasn't been offered? Ask for a second opinion.
My very first ph study was only literally just outside of the normal range, my LES is weak and the first surgeon didn't hesitate to offer surgery. Funnily enough after my first surgery my deemeester sciore was higher than before surgery!
As it stands though, I really think LPR is a very difficult disease to cure. Some get some relief from surgery but from my experience LPR quite often is still there after surgery. I've had 2 fundoplications and I still have terrible symptoms. I totally understand your frustration and sadness at dealing with this.

I really would push to see another consultant. If you have had abnormal amounts of reflux and a higher than normal deemester score despite a normal LES then it needs to be acknowledged that you are refluxing. A normal valve isn't a contraindication to surgery.

Dexter I had a normal LES in my manometry as well, but it was the pH test which confirmed LPR. What was your demeester score? Also what type of pH test did you get? Because the old style of catheter test, and the Bravo can't give the information needed to confirm LPR. The Restech is not the gold standard for pH, so you have been mislead if they have told you it is. The one you need to have done is the 24-hr impedance pH test, it gives much more indepth information and it detects ALL reflux events, not just acidic ones.

Have you seen an ENT? They might find another cause for your symptoms unrelated to reflux. As for the surgery, it does seem odd that you would be discounted for having a normal LES, what normally excludes people is motility issues, and even then they can usually still qualify for a partial wrap. I myself have a very cautious GI who has tried every measure possible to stop me having to have surgery and we have now reached the end of the road. He has 99% confidence that I have LPR, but because of that 1% he still wants me to get thoroughly checked out by an ENT. He said that while the LPR caused the initial symptoms, there is a small chance the reflux could be under control but there are other factors like post-nasal drip, allergies, infections etc. which could have exacerbated and prolonged the damage to my sinuses and upper airways.

It sounds like I will end up needing to have surgery anyway, but if there is even the slightest chance it could be something else, I want to know because otherwise I will stay symptomatic and have to deal with a tough recovery from a surgery that may have been unneccessary. So just keep in mind that reflux may have caused the problem, something else could be continuing it.

I was exactly where you are a couple of months ago, actually right up until yesterday really, I knew medication wasn't helping, I was (still am) miserable because I can't breathe properly, I feel like I'm drowning all the time, the sinus pain is constant now and I was 100% adamant that surgery was the only way I was going to get relief, which may still be the case. What got me through it was making sure I did everything humanly possible to follow all the instructions for GERD and LPR in relation to diet, lifestyle changes and give every medication he prescribed a chance, they take about 2 months to see effects esp if you do have LPR. That way I knew when I went back to see him this time I had given it the best shot of working.

My advice, get more opinions, do more tests if you have to. Don't stop until you find someone who is going to help you. But also remember to keep an open mind to what they say, even if you are 100% certain it is LPR, be willing to at least hear them out if they have another theory about what the issue is.

Great advice jenagade.
Think it's great that everyone can talk, discuss and share their knowledge and experience via this.
It was actually another member on here that recommended the impedance test. After ph study and bravo coming back completely "normal" after my first fundo I pushed for impedance which showed abnormal amounts of reflux to my throat. I will forever be thankful to the tips and advice and kindness I have been shown by fellow members.
Helps to know I'm not alone.