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So, what's a guy have to do to get LINX around here?

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GERD & Acid Reflux
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Posted 4/12/2016 10:33 PM (GMT 0)
Anyone have insight into what makes someone a good candidate for the LINX surgery?

For the past 8 months, I've been suddenly thrust into the world of GERD. Although I would rate my case as moderate, it's also only been moderately responsive to medication and positive changes in weight, diet, and habits. Many days I'm quickly exhausted and I know the GERD has a role in that. And other times, just the thought of physical activity makes my stomach turn - sports, running, biking, hunting, all things that I enjoy frequently in the snow free months. Even moving larger items around the house is out of bounds for me on some days. I often have chest pain and uneasiness, shoulder pain, nausea, upper airway irritation, and overall just don't feel very good. And the "medication shuffle" I've been doing with my GI's office is not helping much either. The PPI's help me to not feel like creeping death, but I still wouldn't say I feel great. And if I'm going to rely on such a strong medication, change my diet and habits, I want to see RESULTS. I'm not even 30 yet, but the PA at my specialist's office (who is always who I see) acts like it's no big deal and I should be accepting of the new life GERD has handed me. Frankly, I find it unacceptable. I don't want to go on a strong and possibly dangerous medication for decades and have a "meh" feeling life to show for it, if there are other options available.

When I asked the PA about surgical options, she just kind of shrugged my question off and mumbled something about fundoplifications only being reserved for severe cases. I know their hospital network provides LINX surgery, but I didn't want to come off like a jerk and grill her about it. But I have seen quite a few cases online where people have the device placed and feel like a whole new person. I realize that nothing is a sure bet, but I'm just so irritated that it's not even on the table for me to have the additional tests and see if it's an option. My wife and I have great insurance and money isn't an issue. I've had a barium series and upper endoscopy, but no PH probe or manometry, and I believe those would be the other pieces of the puzzle. Aside from GERD, I'm 100% healthy, no chronic conditions, no medications, perfect candidate for surgery in the general sense, and this surgery seems to have few complications and a high success rate.

So, what do I need to make my medical team get serious about this with me? Is there a certain amount of pain and suffering one needs to demonstrate to be considered? Do I just need to be a particularly squeaky wheel? Please, before anyone says "you need to discuss this with your doctor," I'm here saying I've tried and they don't take me seriously. I need to know why.
Posted 4/13/2016 12:12 AM (GMT 0)
Hey Doc, welcome to our forum. You are having a rough time-- the symptoms are upsetting and certainly interrupt your life. I have a family member who had the Linx implant four years ago. She had the same tests you mentioned and then some additional ones that determine if the valve is opening and closing and how long time wise the valve stays open. The tube goes down the nose and usually stays 24 hours. You probably know all of this anyway. The doctors do have a set of criteria that must be met before they will do the implant. The criteria is on Google and surgeons want to feel assured that you are a good candidate and that will get help from it.

The Linx is implanted around the esophagus after carefully measuring its size and it goes above the vagus nerve on one side and under on the other side. They must be cautious of placement to avoid erosion. This is considered major surgery even if it is of short duration and through a port in the abdomen. They make it sound real easy.

While my friend has received improvement in symptoms ( as compared to prior to implant) she still experiences heartburn, concerned about erosion, nausea, unable to gain weight, still must eat very slowly giving the device time to open with each bolus of food. Yes, she eats very healthy since implant, cooks at home only, cannot drink coffee, beer, carbonated, tomatoes, spicy stuff. As the surgeon said , having the device surgery is not a license to eat anything, but must now eat like you should have been eating before implant.

She is giving serious thought to having the device removed. As we have all read this appears to be very safe and helpful device for many patients and my response here is not meant to be negative but to let you know that the doctors are wise to be cautious.

Perhaps you could consider adding an H2 to your medication regime. Also, please be aware of the rebound effect if you stop taking or cut back on your PPI meds. That is very real and your symptoms can get worse as the stomach produces more acid. Try alkaline water. Try occasional baking soda in water (watch out sodium). Put the head of you bed on blocks to keep contents in the stomach. Sleep on your left side is helpful. Yes, it makes you anxious and angry over how you feel. Please know that stress definitely doesn't help matters. We've lived through it and are still living through it. Please stay with the forum and let us know how you progress. We aren't docs but we appreciate the advice and thoughts of the members. Wish you well. Kindly. Pay
Posted 4/13/2016 12:17 PM (GMT 0)
I know you are frustrated, but you've only had your symptoms for 8 months. Unfortunately, sometimes it takes a longer amount time to find a resolution to your symptoms. You said that you consider your symptoms to be moderate, and surgery of any kind is usually reserved for severe cases. Have you considered going somewhere for a second opinion, a different medical team may have a whole different outlook on your treatment.

Sharon
Posted 4/14/2016 2:01 PM (GMT 0)
Have you talked with an actual doctor? You only mentioned a PA.

Several of the symptoms you mentioned are heart symptoms. Being overweight makes you vulnerable in that area too. I would highly recommend getting checked by a cardiologist. You'd need a clearance from one before any stomach surgery anyway.

I totally agree with Sharon. A lot of us have GERD or other stomach and esophagus problems for 20 years, or more, before getting surgery. Surgery is a last resort! Try everything else first! LINX is not what my surgeons do anymore anyway. They try out everything as it gets invented - university setting, research. It should always be up to the doctors to choose what treatment, including types of surgery, is right for each patient.

Why haven't your doctors sent you for the rest of the tests? You need to ask a doctor, not the PA.
Posted 4/15/2016 4:02 AM (GMT 0)
You need the testing done. That will help narrow down options. You can't get surgery without the 4 tests. I recently went through the rest of the testing after a decade of dealing with reflux to find out that my LES valve works fine and my ph study revealed normal reflux. So I'm exploring other avenues as to why I am still dealing with this crap. I just started acupuncture and my GI is exploring different nerve drugs. I still take Zantac OTC which helps somewhat. These digestive issues are tricky. I also believe I could have SIBO.
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