Doctor prescribes, pharmacist says TOO much.

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chaoticme
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Date Joined Aug 2011
Total Posts : 137
   Posted 8/10/2011 5:05 PM (GMT -6)   
I went to my GI doctor today as I woke with a huge burning lump in my throat and upper chest. I was at wit's end.

He asked me the usual questions and then prescribed Pantoprazole Sod Dr 40 mg Tab (PPI) once a day. He said if I didn't get relief I should consider surgery.

(about the surgery, I have an abdominal mesh due to a T.R.A.M. flap in 1992 and would be scared to death if I had surgery.)

Here's the kicker, he told me to continue taking Zegerid 40 mg, plus a total of 60 mg Pecid Complete per day and Gaviscon 1 oz 4 x day in ADDITION to the new scrip, pantoprazole. I thought this was a tremendous amount of anti-acid and asked told the pharmacist all that I was taking. She said this is far too much anti-acid and to call my doctor. She couldn't tell me to get off of it but did say she'd take the Gaviscon but stop the Pepcid Complete. The PPIs combined are 80 mg per day which isn't out of the norm for some people.

When I was at my doctor's office in July, I noticed he appeared to be on something. He's been a wonderful doctor and in practice for over 30 years but he's going through cancer right now and from what I gathered, he's been living on borrowed time. And today he didn't seem as out of it but I could definitely tell he was on something, probably pain medicine. I know he isn't a druggie.

I'm really torn over this and am pretty apprehensive about continuing to see him. It would break my heart to leave him but I have to think of my well being.

I'm going to stop the Pepcid Conplete but will not call his office. I really think I should stop going to him. It would be difficult to tell him the pharmacist says he's wrong.

This isn't helping my anxiety! What would you do?

Thank you kindly,

God bless,
Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

sk55
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Date Joined Jun 2011
Total Posts : 225
   Posted 8/10/2011 8:45 PM (GMT -6)   
If you have throat symptoms that usually means max dose ppi . If you are worried go see two different GI docs. You can make an imformed decision after that.

I would be listening to doc before a pharmacist.

KatherineG
Regular Member


Date Joined Jun 2011
Total Posts : 96
   Posted 8/11/2011 11:57 AM (GMT -6)   
I have LPR and doses for that are higher.  I am on 80 mg total PPI per day and 1 Zantac 150 at night.
 
If I read your e-mail correctly you are also on 80 mg total PPI per day and 1 Pepcid, supplementing with Gaviscon.
 
Reflux with throat symptoms typically results in higher meds.
 
sk55 makes a good point, it never hurts to get a second opinion.
 
Have you had an endoscopy done?  Or, have you had EN&T check out your throat symptoms?

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/12/2011 5:45 PM (GMT -6)   
Yes, Katherine, I've been scoped last year and treated for ulcers. Additional scope showed they were healed.

I only started this throat problem about a week ago. I'm scheduled to see my GI doctor in three weeks.

I haven't seen an ENT for this current throat issue. I'm on a total of 80 mg PPI per day, two 40 mg Pepcid Complete in the AM and one at bedtime and an ounce of Gaviscon four times a day.


I'm scheduled to see my PCP this Monday for my semi-annual checkup and labs.


Thank you KatherineG and sk55.

God bless,
Cme

KatherineG
Regular Member


Date Joined Jun 2011
Total Posts : 96
   Posted 8/13/2011 9:25 AM (GMT -6)   
Good luck with your upcoming appt. I hope you get it figured out.

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/13/2011 10:02 AM (GMT -6)   
Thank you Katherine.

I spent 85% of the night in the bathroom. So much so that I was beginning to dehydrate.

I called the nurse line and was told the meds were "excessive" and to contact my doctor within the next hour or go to the ER. My PCP's associate was on call. He said what I was taking was far too much medicine and to only take 40 mg PPI, stop the Gaviscon and Pepcid Complete immediately and to drink Gator-aid and soup, and if the diarrhea didn't stop by noon or if I became weaker to go to the ER. Then he says it's more than likely the Gaviscon is the culprit.

I started the Gator-aid immediately. It's been a couple of hours since then and I think I'm a bit better. I'm tempted to continue the 80 mg PPI but I don't want to dehydrate. So I have until this evening to decide.

Thankfully I will see my PCP on Monday and get his opinion re the meds. If he says the same as the pharmacist, nurse and physician did, I'm changing my G.I. doctor. Personally I love him dearly but my health is at stake.

Do you know the absolute max dosage of PPI's?

God bless,
Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

KatherineG
Regular Member


Date Joined Jun 2011
Total Posts : 96
   Posted 8/13/2011 11:25 AM (GMT -6)   
I don't know the max for PPIs but I have read and heard of people taking 80 mg per day. I take 80 mg per day right now for LPR. However, I believe my Dr. plans to reduce it after a few months.

Sorry you are having a tough time.

Good luck, Monday. Keep us posted.

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/13/2011 12:17 PM (GMT -6)   
Katherine, do you take anything besides the PPI? What do you do for the breakthrough pain? I can't say it's 'breakthrough pain' for me as it's constant. And also, how long were you on before you had relief?

I'm also posing this question to Chuck. As you can both tell, I'm at wit's end and now this dehydration issue is taking its toll on my nerves.

Thank you.

God bless,
Cme

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/13/2011 12:19 PM (GMT -6)   
Sorry, I'm asking Chuck T. I don't know if there are more than one Chucks so I thought I better get the names straight.

Thanks, Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

Chuck T
Regular Member


Date Joined May 2011
Total Posts : 143
   Posted 8/13/2011 12:58 PM (GMT -6)   
I would recommend you both give 60 mg of dexilant a try. It is the only thing that helped my throat. Unfortunately I'm having some GI problems on it so not sure where to go from here. Also, when your throat acts up, chew up a tums, take a sip of water, gargle it and spit it out. I have gaviacon and carafate. Usually don't take the gaviacon too much, and am on the carafate for gastritis.

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/13/2011 4:46 PM (GMT -6)   
I'll ask my PCP on Monday about the Dexilant.

I spoke earlier today to a my regular pharmacist. He said the PPI, Zegerd, is the best one to take and that I shouldn't take 80 mgs, that I shouldn't take the Pepcid Complete but the Gaviscon PRN is okay. I know he isn't an MD but frankly I think I've been overly medicated with 2 different PPIs plus the amount of the two antacids. Thus far the two pharmacist, an MD, an RN and an RN/nurse practitioner all said the same thing. I have to go with the majority.

I'm drinking Pedialyte instead of the Gator aid due to the sodium content in GA.

I definitely feel for you and understand how you feel. I hope you will feel better soon. GI problems are just awful and in my case accompany GERD.

I'll try the tums. I appreciate the information.

God bless,
Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

KatherineG
Regular Member


Date Joined Jun 2011
Total Posts : 96
   Posted 8/13/2011 6:21 PM (GMT -6)   
Hi Cme,

Well, I'm on protonix 80 mg/day and 1 zantac 150 at night. Currently, I'm trying not to take much else other than some supplements and the occasional tums. I have used Gaviscon and it seems to help but I did not want to take it everyday. I do get breakthrough pain but I try to just chew on a tums or two and wait it out.

I've only been on the high dose since early August. Before I was on 40 mg protonix/day and 2 Zantac 150.

ChuckT,

I'll look into the dexilant. Thanks!

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/13/2011 8:38 PM (GMT -6)   
Hi chaoticme,

Sorry you're having so many problems.

I can just tell you what I took before my surgery:

40mg PPI (Protonix) morning and before dinner. (80mg total)
300mg Zantac at bedtime

My asthma doctor even added 300mg Zantac in the morning to the above for a while.

I had no noticeable side effects from these, and I did take them for a long time. My problem was that my reflux caused havoc with my lungs, and my asthma and family doctors were very concerned that I keep the acid production down.

Good luck getting things straightened around.
Hope you feel better.
Denise

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/14/2011 3:30 PM (GMT -6)   
Thank you Denise, KatherineG, ChuckT and sk55.

I'm going to grill my PCP tomorrow. I'm sure he'll send me to different GI doc.

I will ask him about 80 mg of PPI. The doctor I spoke with that told me I was taking too much meds...well, I don't like him frankly and he has the JC complex.

I want to try the dexilant. I'm so desperate I'd try cow-patties if I thought it would help!

Any and everything I eat sends acid to my throat after about 2 hours. It's so bad that I hardly notice the stomach!

If this keeps up I don't know what I'm going to do. It has got to be eating my insides up! I've even developed what looks like a blister in my throat. What next???

Thank you so much for your support, all of you. I don't have anyone who can relate. You are all angels to spend you time trying to help me.

Thank you so very much! May God richly bless you for your kindness.

Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/14/2011 3:37 PM (GMT -6)   
PS... ChuckT, I tried the tums to no avail. :o(
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/14/2011 8:33 PM (GMT -6)   
Good luck Cme! yeah

It's good that you're going to discuss this with your PCP.
I hope you find a great GI doc to work with. It's important!

Take care,
Denise

Chuck T
Regular Member


Date Joined May 2011
Total Posts : 143
   Posted 8/15/2011 7:45 AM (GMT -6)   
CME
Keep in mind that it will probably take a few months for the Dexilant to work. I am also getting a lot of lower abdominal pain on it (or at least I hope thats whats causing it, and not something more serious). I hope it works out for you!

Chuck

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/15/2011 1:36 PM (GMT -6)   
I'm back from seeing my PCP. (I love him dearly.) I didn't have to ask him about Dexilant. When I told him about the different PPIs my GI doctor had tried, he suggested Dexilant 60 mg. I was even given 2 weeks worth of samples to hold me until I get the (90 day supply) order from my mail-order drug provider comes in. I just hope the insurance company doesn't squawk!

I asked if I could take a Dexilant today since I had already taken a Zegerid. He said, "Want me to get you a glass of water?" He also drew 3 tubes of blood to check B12, calcium, D and all my routine labs.

It's been four hours since I took the Dexilant. I am nauseated with a capital N! ChuckT, did you get nauseous when you started taking it? I hope your abd pain goes away soon. I pray for all of you everyday.

I plan on keeping Pedialyte on hand because, God-willing, I will stay on this medicine. I must get some relief and if it means tummy ache, nausea, poops...well, guess I just won't wander too far from home.

I've lost 14 lbs in the past month and I must start eating again. I started thinking..."hmmm, I hurt if I eat, hurt if I don't eat, so...eat"! I came home and fixed a romaine salad with a chopped up boiled egg and bits of boiled chicken, added about a 1/2 tablespoon of Vinaigrette dressing and ate the whole thing.

I've eaten carbs, the bad ones, for weeks now and don't know how I'll handle my normally healthy diet again. I ate veggies, both cooked and raw, fruits, nuts and grains, whole wheat, beans, brown rice, small amounts of baked chicken and fish etc. I'm a bit afraid to eat much fiber now.

I know we all react differently to food but would you mind telling me some of the thing you can safely eat?

Thank you so much for all the good thoughts and suggestions!

God bless,
Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/15/2011 7:17 PM (GMT -6)   
Hi Cme,

I would assume you've got an irritated esophagus and stomach if you're hurting when you eat. I would suggest being careful to eat things that are fairly smooth and won't irritate on their way down or when the stomach does it's mashing thing when doing its digesting job.

Just a thought.

Any irritation of the upper GI takes a long time to heal. It's just a fact of life. The medication in conjunction with careful eating and PATIENCE to wait while things heal, will eventually do the trick. It just takes time.

Good luck! Hope you begin to feel better soon.
Denise

chaoticme
Regular Member


Date Joined Aug 2011
Total Posts : 137
   Posted 8/16/2011 6:19 PM (GMT -6)   
Thank you Denise. I will take you good advise and change my attitude. I've been too depressed for months now. I think coming here to this site has helped me tremendously! You and the other people have been so kind and helpful.

about two or so hours after eating, burning slowly begins in my upper esophagus then reaches the throat. It's really strange as I almost never experience heartburn. I think I'd prefer it to this throat pain.

I perused several HW resources and found the list of AR friendly foods, printed it out and put it on my breakfast table.

By God's grace, I felt better today. I went grocery shopping and even cleaned my kitchen windows! Today was my second dose of Dexliant and I'm wondering if this is why I felt better than I have in a long time. Of course I've been taking Zegerid for a few weeks so maybe I just needed to change things a bit.

I could feel the burning itching to start all day. I bought some soy milk and sipped on it. It didn't hurt me so I added it to the AR friendly foods list. I also added hot Chamomile tea.

My niece (nurse practitioner) told me to add 1/2 to 1 tsp of ground ginger to food stuffs. I added 1/2 tsp and a tablespoon of raw honey to a breakfast of rolled oats. Not very appetizing but it was healthy and the throat behaved rather well even though the burning was lurking.

Again thank you kindly!

God bless,
Cme
Specific (cancer) phobia, depression, GAD, fibro, hypertension, GERD

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/16/2011 6:59 PM (GMT -6)   
Hi Cme,

I'm glad you had a better day. Believe me, I understand the frustration of what you're experiencing. I've had many experiences with gastritis and esophagitis, and I know how hard it is. Hang in there. It will get better, but it just takes time. Be very careful with your eating, so you don't re-irritate your tissue. It sounds like your list is exactly the right way to go, and will be helpful in choosing your foods wisely.

It's good you've joined us. This is a place you can come where people understand.
Keep your chin up. It's just something you'll have to work through. The better your attitude, the easier it will be on you.

Take care!
Denise
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