Posted 2/20/2013 6:39 PM (GMT 0)
Hello all! I lurked for awhile, but decided to join the community to (hopefully) contribute information (once I get some), and perhaps receive advice. I have been having issues for awhile, so here's my story.
I never really had GERD/reflux/digestive problems for most of my life. The only exception to this was self-diagnosed gastritis when I was in my late teens and early twenties. It manifested as a burning, gnawing feeling in my mid-to-upper abdomen/back and would usually be helped by starchy foods and chamomile tea. I took ranitidine twice daily for awhile and that also kept it at bay. My problems went away for awhile but returned once I started taking Prozac (the lowest dosage) in 2010. It seems like this drug triggered something in me and I found myself constantly fearful of getting the "gastritis" pain again (so, I had to take chamomile tea with me EVERYWHERE, which was annoying once I was 2 hours into a night class and my drink was cold and gross! :) )
In December 2010, I had the worst pain of my entire life (and I had migraines for most of my childhood and teenage years). It felt like the pain from before except worse, this horrible, gnawing pain (pain level 15 out of 10--seriously), accompanied by nausea, sweating, shivering, and being unable to find a comfortable position. This lasted about three hours and I was then just left with a feeling of bruising inside my stomach. This also went away a week or so later. I went to my doctor who suspected gallbladder, but my blood tests and ultrasound were normal (except for an ovarian cyst). She wanted me to get a HIDA scan but at that point my severe pain was pretty much gone and I had classes and college things to worry about. I ended up stopping the Prozac about a year later because the mild "gastritis" pains were really getting on my nerves.
Everything was pretty normal until around the first of this year. For a few days prior to that, I had been getting random, slight and short-lasting pain to the right of my bellybutton (felt like a muscle was being tugged on). Nothing seemed to trigger it except I think that drinking alcohol made it worse (champagne for the new year--not very much). I had been drinking about one margarita a day for a few days prior to New Year's Eve. I generally am NOT a big drinker, as alcoholism runs in the family. The few drinks I had from around Dec 25th until Jan 2nd were I think the only drinks I had in over a year. Anyways, the pain seemed to somehow correlate with drinking, so I stopped that.
On the 2nd, the pain started but then suddenly turned into a sharp "twisting" kind of pain. After that, the pain would travel to anywhere it pleased. I'd get pain in my upper right abdomen, upper left, lower abdomen, pelvic region, in my back a few times..the pain varied from 2-4/10.
I started a Z-Pak on Jan 4, as a preventative (my boyfriend had mono and his tonsils got really messed up, so they wanted to ensure that I wouldn't develop tonsillitis or bacterial strep).
Sometime between Jan 2nd and before the antibiotics were done, I started getting really bloated and nauseous. I would eat half a sandwich and I felt like I went on a binge. I was still getting in enough calories, probably around 1200-1400 a day, so I wasn't worried. However, this was accompanied by some ridiculous constipation. To this day, since then, the only time I haven't been constipated or had major issues with bowel movements is when I took Milk of Magnesia for two days. That worked. I also took one dose of Metamucil which acted as a laxative for some odd reason.
My amazing doctor stopped practicing a few months ago, so I went in to see the nurse practitioner at her old office. The NP was convinced that it was my gallbladder acting up, and she insisted that I get the HIDA before anything else. Now, I will admit to having some reservations about the HIDA scan. First, I'm extremely claustrophobic and the idea of laying completely still for long periods of time makes me sick. Second, apparently the CCK that they use to contract the gallbladder can make you really ill, which scares me. But I went in to get it done. Unfortunately, they were extremely unprofessional at the hospital I was scheduled to get it done at, and I ended up not being able to go through with it. (That's a story on its own..essentially, they tried to put me in an MRI tube and then told me that nobody would be watching or listening and that if I needed help, I could "try yelling" and someone "might" hear me. That was too much for me.) I made an appointment with a GI specialist.
On Feb 2, I was sitting down, not eating or drinking or anything. Just sitting, and I was laughing. This laugh turned into a deep cough (which is typical of me). After I was done coughing, I felt like I had a swelling or lump in my throat. I also found that drinking or eating made me feel like I was choking. I went to my student health center the next day and the RN on duty said I probably had something stuck in my throat and gave me a Pepcid pill. This did nothing. That night, I went to an urgent care facility and they took a neck x-ray. They saw nothing so the doctor said "neck sprain" and that was that.
On the 4th, I went back to my health center to see an NP. She didn't even do any diagnostics or physical examination, and said simply that I had somehow messed up my trachea and to drink lots of cold water. I went home to try cold water and it made me feel so much worse. I made an appointment at my old doctor's office and saw the NP there. She said acid reflux. She prescribed muscle relaxers and Dexilant. At this point, I should reiterate that I could no longer swallow solids, including pills, so I couldn't take either of these.
On the 5th, I had my appointment with the GI specialist. She said she didn't really know and it could be an ulcer, GERD, candida..she scheduled me for an endoscopy and called me in a sublingual PPI (I think Prevacid or Prilosec). My insurance wouldn't cover it and it was going to be way expensive, which I really can't afford. So I did not pick them up.
On the 6th, I managed an appointment with an ENT specialist. He did the scope through my nose and into my throat and said everything looked fine. No irritation, nothing caught, and my vocal cords were working okay. He said maybe a throat strain and prescribed steroids. Which I couldn't swallow. I saw another doctor sometime between the 6th and the 12th (I can't remember the date) and she said it was acid reflux and anxiety.
On the 8th, I called my health center again and told them that nothing was changing and I needed to see someone again. They told me that they wouldn't see me because there's nothing else they could do. Finally, they scheduled me an appointment with the visiting physician. I saw him the next week and he also did not do a physical exam. He said he didn't know (but hinted that he thought it was psychological) and scheduled me for a modified barium swallow. I did the swallow on the 18th and they said it came back normal. The speech pathologist who was present basically said she didn't know, but suggested GERD and that I should just work up to solid foods, as well as take my medicine. Which I honestly physically cannot do.
So at that point I basically decided to go all out and do what I could to see if it was acid reflux or GERD. I bought kefir and coconut water, which I have read can be extremely beneficial. I sipped on the coconut water and I didn't notice a difference. I had a sip of kefir.
That night (still the 18th), I drank a protein shake around 7:15p. Around 7:30, I started getting intense chest pains, which went up to my jaw and down my arms (mainly pain on the right side). It was kind of a crampy pain but very severe (6-8/10) and I couldn't sleep all night as a result. I thought maybe it was acid so I sat up for a very long time to see if it would help at all. No dice. The next morning (around 7a on the 19th) I went to my health center to see what they thought. The RN on duty was the same one who gave me a Pepcid before, and because my temp was normal, she said that I was fine and that it was all psychological. She told me that counseling would be the only cure. Well, as protocol, they have to send me to the ER, so I went by ambulance.
At the ER, my BP was okay but elevated (about 140/90 generally), my heart monitor was fine, chest x-ray fine, heart echo was fine, bloodwork was fine, but my EKG had some abnormality. Inverted T waves or something like that? He wants me to get a nuclear stress test done, which I still have to schedule. They gave me a Xanax and sent me on my way. The Xanax made me sleep, which was great. When I woke up, the chest pains had gone down somewhat but I was still having problems with walking and standing (felt like I was going to pass out if I walked, like all the blood was rushing to my head). I ate a protein shake and some mashed potatoes yesterday. After eating, my chest got really tight and I started feeling like I wasn't getting in enough air. I was, because I didn't pass out or anything. But it felt extremely uncomfortable. I took a Klonopin and went to sleep.
When I woke up this morning, the chest pain is mostly gone but I still have the intense chest tightness/trouble breathing. I have this weird dry cough that keeps occurring, especially when I try to breathe in deeply. I feel sore, like when you hold your breath and you have kind of a burning feeling in your chest.
My endoscopy is the 27th, which I am hoping will give me some answers. In the meantime, my question is--do any of these symptoms sound familiar in terms of GERD or acid reflux? I have done some research on esophageal spasms, which I think I may have had/be currently having. It is my understanding that a modified barium swallow won't show this, but a barium swallow will?
Basically, I'm trying to figure out how to survive until my endoscopy. I know that ibuprofen, steroids, Klonopin/Xanax, chocolate (protein shakes), and cold drinks/food can all trigger reflux and spasms. But, if I'm having some weird asthma thing, steroids can help. If I'm having swelling or inflammation of the chest wall, ibuprofen can help. And generally, Klonopin helps. I don't want to be taking medicines that are going to make my reflux worse, but I don't know if it's reflux!
My diet:
I was on Atkins for two weeks in December. I was on Atkins before for a year and I had no issues with it. My only issue this time was that I experienced constipation and some leg cramps.
Otherwise, my diet was usually things like Chinese take-out, tuna sandwiches, fish sticks, turkey sandwiches, rotisserie chicken and mashed potatoes..I didn't eat a terrible amount of cheese, milk, etc though I did eat yogurt daily. I took a daily Vitamin D supplement, fish oil, and usually a multi-vitamin.
Since the beginning of February, I am on a liquids-only diet. I get in 300-400 calories a day, and it's all in the form of protein shakes, yogurt bars, fudge bars, or applesauce (I crush up my Klonopin and put it in applesauce). Yes, I feel weak and disgusting all of the time because I'm not getting in enough calories and it's all sweet-tasting things. I've tried broth, but for some reason I cannot drink it. I choke. Even when it's room temperature. Frustrating. Last night I had mashed potatoes, which have been the most solid thing I've eaten in almost a month.
The only medicine I take now is Klonopin. .5mg, as needed. I took it once or twice a day for a week, now I'm at one every few days. I've always dealt with anxiety, and I understand how it manifests in myself. I can physically relax my entire body, but the throat and chest symptoms remain. I honestly don't think it's caused by anxiety, but I do think that my anxiety makes it worse.
I'm still horribly constipated, but I feel less pain from it now that I'm on liquids only. Also, my abdominal pain has subsided quite a bit since switching to 400 calories daily of liquids.
I've tried:
Mylanta (made me feel like I have hair in the back of my mouth?)
Klonopin/Xanax (calmed me but symptoms remained)
Liquid ibuprofen (nothing)
Ice water (no no no no no)
Warm chamomile (helps somewhat)
Warm compress (no effect)
Cold compress (no effect)
Liquid Mucinex (maybe slightly beneficial, but not really)
I'm a 24-year old female, overweight (but losing rapidly--about a pound a day), with no family history of heart or reflux issues. My mother gets "winter asthma." I get bronchitis about once a year, which I had last fall. I am a college student. My current lifestyle is sedentary, as moving makes me feel like I'm dying. I miss a lot of class because of these issues. I am frustrated that nobody seems to take it seriously (no doctor seems to care about the weight loss and the lack of calories--health center doc said, "Oh, you know you'll gain that all back, right?" Thanks). I went from having clear, frequent urination to urinating 2-3 times a day and it's so ridiculously yellow. (Sorry for this info, but I'm getting really frustrated with my apparent dehydration.)
I'm hungry all the time but I can't eat much. I'm terrified of getting the chest pains again (if I touch my chest right now, it feels bruised for some reason).
Does anybody have any advice? Any OTC acid reducers I could try, preferably in liquid form? Anybody ever experience this stuff?
Sorry for the extremely long post! I wanted to include all details so that hopefully someone will be able to help me figure out what it could or couldn't be, since doctors seem to be guessing and my endoscopy isn't until the 27th. Thank you for any help!