Patients of Dr. David Gutman

Align? That must be something new as I have not heard of yet. He has me taking 60mg of Dexilant. It's a 24hr pill. It seems to help. When I wake up in the morning that is when I notice my symptoms more. They are never the same on any given day. One day its throat clearing. one day it's post nasal drip, on another day hoarseness. Some days all three or some days none. I never know what to expect.
I can't believe some idiot doctor overdosed you! NOOOOOOO Your joking? Who would have thought such a thing! LOL That's what happened to me before I saw Gutman. Some doctor had me on so much acid suppressing meds it was crazy. I stopped using them for a year or so just to test the waters. I did the diet thing, apple cider etc. You know the rest. The endoscopy confirmed what I always thought. My conclusion as to what is going to happen will be based on the biopsies. My guess is no matter what, I will need some sort of surgery. I can't just leave the inlet patches. There are so many different types of surgery out there. Step 1. get diagnosed properly and have all tests taken. 2. See what comes back. 3. Make a choice. Long term meds or surgery with possibility of no more meds.
Dr. Gutman did tell me it takes at least a couple of months for meds to work. I had more globus when I first started as well. Give it some time. He said it's a good sign that the Dexilant is working. His concern was that I would show no signs of any relief. With that said, he said surgery would work for me.

I looked up the SITZ marker test. Looks super simple. Swallow a pill and five days later come in and get a bunch of xrays. It's used mainly for people with chronic consitpation to check for motility of the bowels not the esophagus.
Don't worry about the endo. It's easy. I slept through all three of mine. I did fight the doctor during the second one but knew nothing of it. That's why I had to have three. ;)

Nick:
Thanks for all the info. I will be sure to check these things out. The endoscopy should be a breeze. I had three of them and slept through the entire thing. I hope you have the Russian lady who put me to sleep as she was such a doll. She was cracking up as I thought I was under and hearing things. It turned out it was only the tubes for oxygen. I must have been so tired that I started dosing off and thought I was out cold. LOL! When I woke up I had no idea what the F anyone was even saying. Not to worry! This is the first step in the right direction and you will be able to take it from there. You mention something about a pill getting stuck???? Are you having the Bravo done? Never had the SITZ test. Good luck with everything tomorrow and let us know how you make out. Who would have thought that a book called "Dropping Acid" would be about acid reflux. Back in the day it would have been more like Blotter or LSD. LOL!!!!

Michele,
I should have mentioned, the Align is actually a Probiotic, not medicine.
So of course I was doing really great the last coupla days, no reflux, throat great! Then Blammo, I'm getting stressed tonite because of the test, and of course the acid hits! Thanks everyone for all your support and for reassuring me that the test isn't such a Big Deal! I know you're right, I'll wake up and be like, did they do the test yet? And that will be that! SITZ test is for motility. You swallow a pill and then every coupla days you get x-rays to see how far along it has passed through your system. He didn't mention anything about the Bravo. My husband Loves the title of the book, "Dropping Acid" it's such a clever play on words. Dr. Koufman is attributing the LPR more to pepsin than acid. She says that the acid activates the pepsin, however it is the pepsin that has embedded itself into the tissue, that does the damage. The acid is simply a catalyst. Very interesting and it truly makes lots of sense. I will definitely let you all now how things go tomorrow! Thanks again for all the support! We really should meet for lunch!

It works real good.
That's what the doctor called it when he told me what was happening. I think it's called propenal? I woke up quick from it though with no grogginess. The versed left me groggy.

ask for valium. that helped me when I was scared.

hey, thanks. i have some serious anxiety/ depression, but i always have my whole life. yeah, i guess i'll take the other tests, we'll see what happens. thanks again.

So sorry to hear all of this from both of you. I luckily have no fear, so I count my blessings. I am sure this will all work out for Nick. I am seeing Gutman next week, so will keep you posted on outcome. I am off to go skiing for a while. Not sure what kind of reception for my Wi-Fi but will try and check in.

Be well.

LIC

joy: wow, i think we are in the same boat with the anxiety issues! my problem is i am even too anxious to take meds! Koo-Koo! i know!
michele: hope you have fun skiing! i haven't been in 15 years! used to go to camelback all the time! good luck with dr. gutman!

I am also from Long Island and a patient of Dr. Gutman.  Yes, he is nice and he will take time to explain things to you, even on the phone, which most doctors won't do.  Only thing I'm puzzled by is why he didn't press me to try the PPI's longer because I read that with LPR, meds can take a lot longer to have an effect than GERD.  So I would have expected him to tell me to take it a min of 2 months before quitting or trying a stronger dose.  When he gave me the stronger med and stronger twice day dosing, the side effects of heart palpitations and diarrhea made me quit meds altogether. I don't trust meds at all anyway, which he knows, but maybe I would have tried the less intense meds longer if that was what it took was more time.

Plus I haven't been able to find anyone that had the surgery with him.  I have passed every test to have esophyx with him and Dr Nishimura, well every gastro test, but they are making me get cardiac clearance bec the heart palps continue without taking meds. I was hoping to find that Dr. Nishimura was listed somewhere as a top doc also like Castle Connely, but I see no such reference about him anywhere.  Only person saying he's so great is his own staff.  I see Dr. Gutman's site saying he is a top doc, but wondering why his partner is not listed anywhere as such so that is making me uncomfortable.  Also, article I read said TIF works only 56% of the time, wondering where people saw 80%, I guess I have to do more pubmed reading maybe, and that was mainly talking about GERD.  I don't even know that there is a single study looking at the success rate of TIF/esophyx in LPR. I do not trust what any doctors claim their own personal success rate is because I think they mostly make it up or think of it in their head from memory and aren't actually keeping track of every patient in some sort scientific fashion.  Because they'd have to be keeping track of every patient every few months and keeping detailed written records and I think if they are not getting paid to do that, then they are not doing it.  They might assume if the patient doesn't call, oh well then they're doing fine.  UH no, I know for me I don't bother call all the docs that haven't helped me with a problem, I just look for the next thing to try, next doctor to see and so on.

So I was supposed to have esophyx soon, but now I have a few more questions as in how are they tabulating the success rate, are they keeping actual records because then I want see some sort of proof.  And can I speak to one of their former patients with LPR that had it done and is 6 to 12 mos post op?  Lots of docs say oh patient privacy, I can't let you do that, well if I'm offering to give out my contact info to the patient to contact me, then patient privacy my butt bec I'm agreeing to give them my info and then they have a choice if they want speak to me.  So I want see what he says when I ask for these things. Because so far you two are all I've found that see the same doctor and neither of you have had the procedure.

I do agree he takes more time to talk to you than any other doc and that is somewhat comforting, but I also like to see some proof of the success rate and speak/email with someone that had the procedure specifically with them. I would have liked to seen Dr Shawn Garber, but he doesn't take my insurance.

I'm not thrilled that South Nassau where the surgery is done is rated 2 out of 4 stars per some website I came across, but maybe that is meaningless? I think hospitals never really have great ratings and always have areas where they need to improve, hospitals are difficult to run and it said that each doctor working there affects the ratings.  Hopefully if I go fwd with this, I will only be there less than 24 hrs.

So with LPR, everything takes longer to work, meds, surgeries.  The throat takes much longer to heal from the acid damage than esophagus so the throat may contiue to hurt a long time and you know how when your throat is sore, certain foods make it burn more, citrus fruits, berries, salad dressing, alcohol, etc. So if I do go fwd with esophyx, even if just out of desperation and I use Dr. Gutman and Nishimura if only because I can use my health insurance, then I will wait 6 to maybe even 8 mos to see if it works, I won't consider it a failure at less than 6 mos and maybe I will request a post op bravo to prove it, but then my insurance would have to be willing to pay for it.

Well so much for talking with other patients of Dr Gutman. I'm pretty fed up with him, I think I started seeing him 2 years ago or maybe even longer and far he's done nothing for me other than bunch of tests. I've never been told the proper information on how to take meds and finally had to start reading medical studies and figuring out for myself what i need to try. I should have gotten that from the doctor, not from doing my own research. So far I'm disgusted with all the money I spent on him to still have to do my own research. He was having me try to get cleared for surgery without ever really having properly tried the meds bec he never told me how to properly take the meds for LPR. And he has GERD himself and he can't even help himself, talking about losing weight, I've seen him for long time and I don't see weight loss so someone is going to tell me to change my life and habits and whatnot and go thru horrible surgery, someone who can't even resolve his own issues with his own GERD. He doesn't even go for the surgery for himself, but I should trust him and his not top doctor partner to do surgery on me, right. So I finally do what I should have done, my own research, and see that I need to try a twice daily dosing of a PPI for at least four months before I can say one way or the other if it works, but when he gave me an rx, he let me say it didn't work after only few weeks, maybe as few as 2, I don't remember exactly, but I know he didn't say no no, don't worry, you need try it for 10 to 12 more weeks before you will know. Seems crazy to me that it should take so long to stop the acid, but I read to give it 12 to 16 weeks in 2 studies done so I guess I can make myself do it because I don't think they would have even been able to clear this with my insurance without being able to show my insurance that I tried the meds in the proper dosing and for proper length of time. I think they might be the only doctors in my plan around here doing esophyx, which is problem since they don't like me and I don't like them, but maybe there are other esophyx docs, I could try the website, bec at this point I don't trust the Gutman, Nishamura team. I don't even trust esophyx at the moment yet either as all the studies I've read were on GERD, not LPR and I read a success rate as low as 56%. I have not been able to speak to one person with LPR that was glad they did esophyx. I'm looking into one other thing I read about, stretta, anyone heard of it? Don't be fooled by doctors that seem nice, that doesn't mean they're doing you any good, I've spent 2 years now letting acid eat away my throat and vocal chords and don't think he's losing any sleep over it at night.

LPR is a tricky thing to treat because it's so different from the standard GERD.
I had LPR/silent reflux and it took three years of higher doses of PPIs and H2 blockers combined before they threw up their hands and said maybe the surgery will help, but there's no garentee on it.
It has helped me though.