Keep trying. Jump through the hoops as long as it takes. It sounds to me like you need something and acupuncture is useless. carafate only helps a few people. Take the ppi twice a day or whatever it takes. Maybe one of the newer 24-hour products will help a little. Surgery is a last resort, is not fun and leaves side effects.
I had to jump through hoops for 4 1/2 months even with a traumatic paraesophageal hernia - life threatening if it would roll and strangulate. I had a completely open LES and a weak swallow from polio, and they still made me do test after test after test.
I did figure out that my particular actual reflux (nothing to do with the acid production) was caused by food intolerances. I kept a food log, eliminated the trigger foods, and was able to control the refluxing. Despite this I still needed surgery, and would rather have been able to avoid it.