Posted 7/27/2012 7:48 PM (GMT 0)
Sid:
I have had sinus problems all of my life, and developed problems with Gerd 15 years ago, when I was pregnant with my daughter. I have found that they most definitely contribute to each other.
Following the birth of my daughter, I had a couple of Gerd-free years. Then, it returned just as I began working a very stressful job as an in-home family counselor. At that point, I was spending a great deal of time in environments where there was cigarette smoke, as many of our clients did. I was also probably drinking far too much coffee, as I was putting in long hours, and spending a lot of time behind the wheel. I began having symptoms much as you were describing, with the coughing (both day and night), asthmatic symptoms (lots of wheezing), accompainied by severe reflux. I had to undergo a number of tests, and was treated for both bronchitis and sinus infection, and I believe they put me on Tagamet for awhile. The sinus symptoms subsided for awhile, but the tagamet did not seem to help much. Then the same bronchitis and asthma symptoms returned two more times. At that point, I was referred to a GI doctor, who ran yet more tests. A PH test revealed that I had 10 times the amount of stomach acid of the average person. An endoscopy showed that I had a huge hiatal hernia. This doctor was reluctant to do surgery, as he felt that it would not help since the stomach acid was so high. He started me on Prilosec, 40mg per day, and recommended the usual dietary and lifestyle changes. This helped, but the problems were not totally under control. So this was increased to 80 mg. At this time, the relationship between PPI's and Osteoporosis was not known, at least not to the general public. I continued to take this for probably about a year, then, the symptoms returned again. I asked my MD for a referral to Medical School about 11/2 hours from here to be evaluated for possible surgery.
The doctors at the University Hospital seemed stunned that I had not been considered for surgery much sooner. After having yet another battery of tests run, I was finally scheduled for surgery 3 months from that time. The wrap went well. I felt better right away. I can't remember all of the instructions, but I remember being on a soft diet for a few days following my release. I was also on a five pound lifting restriction, I believe, for about 4 weeks. Nothing was said about lifting restrictions following that.
I had about 7 GERD-free and PPI free months following that. Then, I began having problems again, along with difficulty swallowing. I was also having sinus problems at the time. The doctor at the University Hospital saw me, dialated my esophagus, and asked if I had sinus problems. He then commented that the drainage contained a lot of white cells, which were irritating to the esophagus. This is the first time that anything had been mentioned to me about the coorelation, although I had suspected it. It made perfect sense. He commented to me that I might want to talk to my MD about going on Claritan.
The Claritan seemed to help a bit for awhile, but then did not seem to help. I now wonder if another med was interfering with it, as I was taking either prozac or effexor. I also had to be put on Nexium, 40 mg, as the dialation did not seem to be of much help. This was soon increased to 80 mg, as 40mg was not of much help. I had also been laid off my job because of state budget cuts, and opened an in-home childcare center, so I was lifting regularly. My daughter was also 4-5 years old at the time, so I'm sure that I was still lifting her more than I should have. I continued taking the 80 mg of nexium until 2-3 years ago, when they started talking more about it's long-term side effects.
about 5 years ago, I had an endoscopy performed by a local surgeon, and he commented that my wrap had slipped a bit. He said that I might want to consider having it redone. However, there was no one locally who does this, and the doctor at the University has now left his position. The closest place to have this corrected would now be in Omaha, which is all the way across the state of Iowa from me. Considering the pre-surgical testing, the surgery itself, and the follow-ups, this would mean a number of long trips for us, and a major hassle. At that point, I decided that I would either have to have it done, or find a way to live with it. I chose the latter, at least for the time being.
I have had a long standing battle with my weight. I find losing it nearly impossible no matter how much I diet and I do exercise daily, sometimes for 1-2 hours. I think a big part of my problem is that I take lyrica for fibromyalgia, and this prevents me from losing. I have also read that Nexium will do this. I have been able to lose about 15 lbs, which has helped. I find that even a couple of pounds can make a difference in the way that I feel. However, I need to lose a lot more. I have cut back a great deal on the amount of coffee that I drink. Although I have not been able to completely give up caffeine, I try to limit myself to 1-3 cups daily. If I drink much more than this, I have problems. I also have to limit carbonated soft drinks. I can drink Sprite on occasion, but no more than about 3 times per week. I find that I do not tolerate artifical sweetners well. Dietary triggers seem to vary between people with GERD. Greasy, oily foods really bother me. I have had to totally give up foods that I love such as spaghetti, and pizza because of the tomato sauces with the spices. However, I can sometimes tolerate certain Mexican foods? Sometimes, there is no rhyme or reason. I have to avoid citrus fruits and juices because of the acids. I cannot tolerate alcohol at all. Rich foods and sweets also seem to be triggers. Many medications can also make a difference in GERD. I cannot tolerate anything related to Motrin, so I have to be careful with the pain relievers that I take. Many of the antibiotics that are prescribed for sinus or other infections can also be irritating to GERD (I cannot take Doxycycline or Augmentin). They can also upset the intestinal flora, which can lead to problems later on. We also need to carefully watch the vitamins that we take, as they can be irritating. I was having many problems during the night recently, as you were describing. I would wake up choking with burning in the back of my throat that would not go away. I was having sinus headaches and nasal congestion daily. I finally made the association that it was the fish oil that I had started taking at about the time that the symptoms started.
There are a number of things that anyone can do that help control sinus problems. I think that what has helped me more than anything was replacing our living room carpet 3 years ago. Dust also bothers me, so I have to be careful about this, including making sure that our furnace and air conditioner filters are changed regularly. Wind bothers me, so I try to limit my time outdoors on very windy days. I also use saline nasal wash twice daily, or more often if I am having symptoms. Also, on bad days, I take Zertec. This seems to be the sinus/allergy medication that helps me the most.
Much of what needs to be done to control these problems we have do do on our own. Many of the medications that we take either contributes to the problems, or creates to additional ones. I now have osteopenia from the long term use of PPI's, and am trying to wean myself off of the Nexium so that I can take Pepcid or Zantac instead. I believe that the more that we can do to control our problems through diet, exercise, and other lifestyle changes, the better off we will be.
I wish you luck with your situation.