New and unsure of next step

If money is an issue as you say, don't schedule an appointment with your ENT.  He can't really help you.  I've been this route...and all it does is cost money, cause you to wait longer to get scheduled with a GI, go through the initial office visit, etc.  Your ENT can write prescriptions for you, but that's about all.  He can't schedule the tests you need.

When you say the upper GI was "normal", how much was looked at during this exam?  In terms of efficiency, this would have been a perfect time to do the Bravo pH study, and killed two birds with one stone, so to speak.  Did the doctor do biopsies to test for eosinophilc esophagitis?

The lump you describe is likely a cricopharyngeal spasm, which is a common occurrence when LPR symptoms first manifest.  LPR is a more complex form of GERD with atypical symptoms (there are a whole bunch of odd symptoms attributed to LPR, which can make it difficult to diagnose without proper tests -- the ones you describe are among them), and is caused when the reflux passes both the LES and the pharyngeal sphincters.  I have been struggling with LPR myself, as have many other members here on this board.

Sleeping on a wedge is helpful, although, unfortunately, it doesn't do much for LPR except keep the bulk of the acid away from your throat.  Six inches is recommended, but in my experience, twelve inches is better. 

Another problem with LPR is the aerosolization of the stomach acid, and this vapor can travel and accumulate on soft tissues in the throat.  If you can, I would stick with antacids and H2 blockers for now, because they are cheaper than PPIs.  Unfortunately, if you use H2 blockers regularly, you will probably reach a point when you develop a tolerance for them and they no longer work.  This is when you should make the move towards PPIs.  If you can tolerate PPIs, these may serve you well, although they do nothing to stop the non-acid components of reflux that can burn throat tissues as well.

There are a lot of good people here who can listen, and offer their support when needed.  Best of luck!

-Bruce

  The upper GI I had was a a basic barium swallow. I drank the chalky liquid and the radiologist watched it travel through me while I shifted positions when he directed. When they said it looked OK/normal, they really didn't give me much detail and I didn't know what to ask. The PCP had wanted to do a GB ultrasound along with the barium test at first, but I delayed that one due to my time and money concerns. My mom thinks I should have the PCP schedule this before year's end, but I just don't think it is my gallbladder. Of course, I'm not a doctor though I feel like I have tried to over-think this whole thing to death as it affects my daily life.  I do know that the Pepcid helps, but I feel best when I take the 20mg once a day without a break and I haven't done that consistently. I am not sure if it will help the throat issues because those just started about 2 1/2 weeks ago.  I just elevated the bed, so maybe that will help.

 I feel like I frustrate the doctors because it is hard for me to do multiple tests and follow-up. Since my issues have been more chronic than acute, I feel guilty getting my husband to take off unnecessarily, but my relatives are too old to handle my son anymore.  It really helps to talk it over with people who have been down this same road. I can't tell you how much I appreciate it!