LPR Update (important to read for LPR sufferers)

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strat923
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Date Joined Jul 2012
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   Posted 7/14/2012 2:55 AM (GMT -6)   
I posted a 2000 word essay about my situation 10 months ago, as "jacket923" but I forgot my login info so i just created a new account. Hopefully one of you can dig up the post, I'm not really familiar with how this website works anymore (I guess thats a good thing...).

My "LPR" is 100% gone. Zilch. Nada. Nothing. I had one of the worst documented cases my ENT had ever seen. I went from almost being mute and my throat burning like hell for 4 years to now returning to my career as a singer within the past couple of months.

Of course, if you read my old post, you will see that I didn't have LPR. And neither do some of you who are reading this. I could go on and on about why this is but let me just sum it up in the words of the one person in the world who knows best....I was reading a paper or a blog from the hands-down best laryngologist in the world (I think he lives in Seattle or Portland, I can't remember its been 6 months. He runs the best laryngology fellowship in America).

He said something to the effect of: "LPR is not to my knowledge a real condition, or at least it is not one that is as common as my fellow Doctors seem to think it is.. For all patients who have severe vocal problems attributed to LPR, I have always found that it is nerve irritation or neuropathy or some sort of other mysterious neurological condition. There is little to no evidence for "LPR" being the sole cause of severe vocal dysfunction, and ENT doctors should stop treating it that way."

------Like I said, I paraphrased the above, but thats essentially what he said.

If you have any questions for me don't hesitate to ask. Best wishes to you all.

Post Edited (strat923) : 7/14/2012 2:58:52 AM (GMT-6)


drtinsac
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Date Joined Apr 2012
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   Posted 7/14/2012 3:25 AM (GMT -6)   
Obviously, people want to know what your actual problem was and what the solution was. Why you have withheld that says something about your motivation for posting your message. If you are here to help, then help.

strat923
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Date Joined Jul 2012
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   Posted 7/14/2012 3:34 AM (GMT -6)   
What? Thats what the first paragraph was referencing, if someone or a moderator could find an archived post so I didn't have to type it again. Do you think I'm posting for attention? Anonymously? No, I'm posting because its incredibly saddening to see people being miserable and some even on the verge of suicidal thoughts over a disease that in some cases isn't even real.

Edit: If anyone actually has any questions then I'll try to answer them from the best of my experiences. I think thats the first time I have ever been attacked for writing out long posts when I could be doing other things. Seeing as there aren't that many people who take the time to come back after they are healthy again.

Post Edited (strat923) : 7/14/2012 3:39:43 AM (GMT-6)


DOGGBONES
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   Posted 7/14/2012 5:50 AM (GMT -6)   
I'll cut to the case....You had one of the worst cases of LPR and now your symptoms are 100% gone. So what was done to cure you! This is not an attack, but you offered no treatment. Please post what you did to cure yourself.

strat923
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   Posted 7/14/2012 6:09 AM (GMT -6)   
Ok, I came back cause I had checked my old email account and saw messages asking for an update. So I obliged. I saw you bumped the thread thanks for finding it. But yea basically I was treated for nerve damage/hypersensitivity with amitriptyline.

And JPT, I know I came off kind off crass in that regard, so I should elaborate on what I failed to do earlier. There are tons of people who have normal tests within the standard deviation of gastroenterology & upper airway tests (I forgot the name) but are still diagnosed with LPR. This post was more directed at those people in that they should look into being treated for neuropathy. The people that have absolutely no medical proof that they have reflux.

Also JPT, for you interest and I don't know if this concerns you or not.......but I went from burping 400 times (honestly) a day to 1 time a day after I was on the amitriptyline. I had the feeling of steaming hot air constantly rising up and hitting my throat. So who knows, I am not a doctor and am not trying to be one. I am just simply saying that if someone got a 2 week Rx of a neuropathic pain medication it could make a difference in their life. It could not. But its worth a shot, because LPR symptoms are hell.

Post Edited (strat923) : 7/14/2012 6:14:10 AM (GMT-6)


DOGGBONES
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   Posted 7/14/2012 7:22 AM (GMT -6)   
JPT,
 
Calm down?????? You have completely lost me? My post wasn't over the top, nor was it attacking anyone, so I'm not sure were you're coming from?
 
Just to clarify I was responding to strat923 post not your comments, however I do appreciate you pointing out I missed the "h" in chase.
 
I have seen your "linx" post, and wish you all the best.

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 7/14/2012 8:04 AM (GMT -6)   
jacket923 - I had not seen your other thread and I realize now that one has great and specific information about your cure. The first post in this thread did not suggest that the solution was provided in the other thread. I thought the other thread was the most common thread around here, where people lay out their story of symptoms as they try to figure things out. Then it was as if you were coming here and saying you had laid out all your issues in another thread, go read it for details, and now you are 100% cured. Then "Any questions?"

Anyways, you can always just write in that original thread, it's still working fine, and it's usually best to post an update in the same thread since in that one, you were already doing so much better even in the first post.

strat923
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Date Joined Jul 2012
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   Posted 7/14/2012 8:48 AM (GMT -6)   
agreed drtinsac, that probably would have been the better route.

strat923
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Date Joined Jul 2012
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   Posted 7/14/2012 8:56 AM (GMT -6)   
And JustPassingThrough, I just wanted to clarify again that I also had abnormal amounts of vaporized reflux that felt like it was destroying my throat. So while LPR could be the correct term, it may be 100% caused by a nerve problem. As it was with me. But I don't know your situation obviously.

Edit: And also one last thing, that I think is pretty important. If a section of your vagus nerve is acting up, then your upper esophageal sphincter (not a doctor...but i think thats right) may be out of whack. Which means that NORMAL amounts of reflux that are would irritate it anyways. So getting a nissen or linx or esophyx would be futile IF that was the case. Which, as I addressed in my old post, is what is happening to thousands of LPR patients after the placebo effect time span passes.

Post Edited (strat923) : 7/14/2012 9:03:36 AM (GMT-6)


Carrie48
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Date Joined Mar 2010
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   Posted 7/14/2012 9:39 AM (GMT -6)   
I looked up that drug you are talking about. Here is the description:

Amitriptyline is used for a number of medical conditions including: depressive disorders, anxiety disorders, attention deficit hyperactivity disorder, migraine prophylaxis, eating disorders, bipolar disorder, post-herpetic neuralgia, and insomnia.

Amitriptyline is used in ankylosing spondylitis for pain relief. It is also used as a preventive for patients with recurring biliary dyskinesia (sphincter of Oddi dysfunction).

Amitriptyline is also used in the treatment of nocturnal enuresis in children.

Amitriptyline may be prescribed for other conditions such as cyclic vomiting syndrome post-traumatic stress disorder (PTSD), chronic pain, tinnitus, chronic cough, carpal tunnel syndrome (CTS), fibromyalgia, vulvodynia, interstitial cystitis, male chronic pelvic pain syndrome, irritable bowel syndrome (IBS), diabetic peripheral neuropathy, neurological pain, *******laryngeal sensory neuropathy********, chronic fatigue syndrome and painful paresthesias related to multiple sclerosis. Typically lower dosages are required for pain modification of 10 to 50 mg daily.[6]

A randomized controlled trial published in June 2005 found that amitriptyline was effective in functional dyspepsia that did not respond to a first-line treatment (famotidine or mosapride


I just popped into hear and saw this thread. I don't know much about LPR and all this stuff, but I know I've been having issues and I have lyme disease. I do believe that somehow my nerves are affecting my body and contributing to all of this. I take .25 to .5 Xanax each night and I swear, after I take it, I feel so much better. I would like to post another thread on this (xanax use). Thanks.
DX with Lyme and Erlichosis in January 2010. January-August: Biaxin and Amoxicillian. September 2011 - ? on Rifampin and Zithromax. Symtpoms mostly neuro and have 20 small lesions on brain.

Nickles
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Date Joined May 2011
Total Posts : 296
   Posted 7/14/2012 9:57 AM (GMT -6)   
Hi everyone,

I used amytryptilline for 10 months and never noticed a difference. I originally started with a small dose, but my Gastro told me to increase the dose. I never noticed any improvement. This was back in 2007 or 2008. That was my experience with it. I know the doctor meant good, but nothing ver helped.

My symptoms are most similar to LPR.

Incognito
Regular Member


Date Joined Jun 2012
Total Posts : 45
   Posted 7/14/2012 2:42 PM (GMT -6)   
I've been diagnosed with reflux based on my reaction to PPI drugs.

My symptoms are chronic cough, loss of voice, constant need to clear my throat, occasional hiccups and burping. I've been previously treated for a gastric ulcer in my childhood. Confirmed allergy.

- methacholine asthma test negative(!)
- gastroscopy showed no aesophegal inflammation
- bronchoscopy and biopsy showed no lung cancer, no infection, nothing
- I ordered pepsin test JPT talked about, no pepsin in my lungs.
- PPI drugs seemed to help for first few days, now the cough is back.

Any other ideas? My doctor pretty much gave up on me. I'm mostly unable to work, it affects my social life, I'm absolutely SICK of it cry

strat923
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Date Joined Jul 2012
Total Posts : 10
   Posted 7/14/2012 5:04 PM (GMT -6)   
Incognito, you might want to read this:

http://www.fauquierent.net/cough.htm

I'm not trying to claim that everyone with LPR will be helped by amitriptyline, as Nickles shows that isn't the case. All I am saying is that I had textbook LPR, and now after self-regulated speech therapy (vocal frys morning and night) and amitriptyline I'm back to normal.

Incognito
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Date Joined Jun 2012
Total Posts : 45
   Posted 7/14/2012 6:21 PM (GMT -6)   
Thank you for your reply.

I am really desperate and would try anything if there is a chance it will help, but I have no idea how could I convince my doctor to try amitriptyline.

Do you still take this drug or you don't need to anymore?

strat923
New Member


Date Joined Jul 2012
Total Posts : 10
   Posted 7/14/2012 8:20 PM (GMT -6)   
I still am taking it as I'm going through speech therapy and singing lessons. Once I get a feel that its gone for good, I will try to taper off. Even if I can't 25 mg of Amitriptyline a day is not a big deal, the drug is 60 years old and has a great safety record to my knowledge.

And if you can't get your doctor to Rx you something to try, bring that article. It is written by Christopher Chang, a young Otolaryngologist from Yale with a fellowship in laryngology. If your doctor wouldn't respect you enough to listen and give something a try out of desperation, then get a different doctor.

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 7/14/2012 9:20 PM (GMT -6)   
Strat. Clearly you're here to help, sorry I overreacted earlier, you know how this condition makes life in general frustrating.

I'll be seeing my ENT doc in another 8 weeks and at that time, he mentioned we'd try a tricyclic antidepressant such as amitriptyline. He did not mention possible dosage, but from the articles I've read, they mention a "non mood altering dose". From reading about amitryptyline today, the doses are listed as 10-25mg a day. Did your doc start you with a lower dose, or did you go right to 25mg?

Did you happen to have a sour bitter taste as one of your symptoms? I have read papers on refractory GERD where they mention an antidepressant (visceral pain modulator) for people with bitter taste on PPIs.

strat923
New Member


Date Joined Jul 2012
Total Posts : 10
   Posted 7/15/2012 12:02 AM (GMT -6)   
I started at 25 mg. I believe that when people take amitriptyline (or took...elavil is old) for depression they take somewhere around 150 mg. So 25 mg is still pretty low.

As for my symptoms, I can't say I had a sour bitter taste or the feeling of actual 100% pure LIQUID acid reaching my throat. My symptoms were in general:

Burping 200-300 times daily
Constant feeling of hot air coming up my esophagus
Globus
Loss of Voice
Burning throat

Carrie48
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Date Joined Mar 2010
Total Posts : 638
   Posted 7/15/2012 9:49 AM (GMT -6)   
Strat:

I think but am not sure that I might have LPR too. I have been having chest pain - like a tightness in my chest. My GI sent me to a pulminory doctor who did an xray (normal) and then a breathing test which showed early asthma. I'm a 50 year old woman with no history of this. However, I feel like everything my lungs start up is right after I feel like I'm having an episode of reflux....I'm just not sure. I don't feel the typical heartburn but a general discomfort in my chest along with a bloated - gassy feeling in my stomach and then comes the burping. I have noticed some sound breaks (very few times though) in my voice. Does this sound like LPR to you?

Also, I had an endoscopy but everything was normal..? I have no issues at all at night. However, I do take .25-.5 mg of xanax at night for sleeping. PPI's don't help - I've tried them. I'm also thinking it might be IBS and it's causing a lot of gas which is in-turn causing gas into my esophogus. I just don't know....so confusing.
DX with Lyme and Erlichosis in January 2010. January-August: Biaxin and Amoxicillian. September 2011 - ? on Rifampin and Zithromax. Symtpoms mostly neuro and have 20 small lesions on brain.

strat923
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Date Joined Jul 2012
Total Posts : 10
   Posted 7/15/2012 9:57 AM (GMT -6)   
The thing is, and this is the important part. I have never had heartburn a day in my life. Never. I had no respiratory symptoms. I just had the symptoms listed above and insane amounts of Post-Nasal Drip. So people with my exact, or near exact, symptoms but without ANY heartburn, have a very good chance of having something other than abnormal reflux causing their problem.

And thats what the doctor who fixed me said as well. He said he has stopped putting "LPR" patients through surgery if they have not had their symptoms significantly resolved with PPIs and diet change. So when he saw a patient like me, a skinny 21 year old who had cycled through all 5 PPI's, he just flat out told me I didn't have reflux when he walked in the room and that it wasn't up for discussion. Of course I thought he was a @$#@ at the time, but....he ended up being right.

Carrie48
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Date Joined Mar 2010
Total Posts : 638
   Posted 7/15/2012 10:06 AM (GMT -6)   
Well...I told my doctor that the PPI's were making me worse and giving me reflux (when I take them they stop my digestion and cause me a huge lump in my throat) and he said "then you don't have acid".... I just don't know what to do about all of this. I've been on a 5-day Juice fast (with today being my 5th day)...trying to reset my digestion. So frustrating. I'm glad you have found something that works for you. That is great.

Also, I have lyme disease with a lot of nerve involvement. Sometimes I think that my vagus nerve is also being involved in all of this and it has my "timing" off or something if that makes sense... Geezo....
DX with Lyme and Erlichosis in January 2010. January-August: Biaxin and Amoxicillian. September 2011 - ? on Rifampin and Zithromax. Symtpoms mostly neuro and have 20 small lesions on brain.

strat923
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Date Joined Jul 2012
Total Posts : 10
   Posted 7/15/2012 10:09 AM (GMT -6)   
Yea that's unfortunately where it gets complicated, because other health problems can probably make curing one all together (especially a neurological one) more difficult. I had no other health problems, so just taking the amitriptyline just kind of cured me and that was that. Best wishes though, just keep trying new things and getting second opinions.

Incognito
Regular Member


Date Joined Jun 2012
Total Posts : 45
   Posted 7/15/2012 6:18 PM (GMT -6)   
I'm going to obtain this drug in 3 days. I've read about it, about the possible side effects and it doesn't seem any worse than PPIs which I used to take already. I'm out of options anyway so gonna try it.

Kittycatz
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Date Joined Jul 2012
Total Posts : 6
   Posted 7/15/2012 6:44 PM (GMT -6)   
Hi

I'm not sure if i am in the right place so if not i apologise and if you can please direct me to the correct place/thread.

I have been recently diagnosed with esophigitis stage 1, gastritis and indeterminate colitis. I take 20mg of lamaprozole twice a day which helps somewhat but not completely and have just started suppositries one at night. I am hoping I can get some advice please?

1 are these all linked as they are all in the gi tract
2 what does indeterminate colitis mean?

Thank you for your help


2 what does indeterminate colitis mean?

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 7/15/2012 8:54 PM (GMT -6)   
You are not in the right place-- go here:
www.healingwell.com/community/default.aspx?f=45

and then "Post new topic"

e1wlpr
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Date Joined May 2011
Total Posts : 5
   Posted 7/17/2012 2:36 AM (GMT -6)   
Hi everyone:  just wanted to add my story.  I'm still experimenting on myself and have had some success.  I too find LPR one big mystery.
 
My LPR history started in July 2009.  It was a nightmare getting diagnosed.  I don't know how I held on to my sanity due to severe unbearable pain.  But when it was finally diagnosed it continued to be a nightmare as nothing worked for me.  I had every test you can think of.  They started with antibiotics for H-Pylori.  Tests showed that I had an acid score of 40.  They started with the lower level PPI's.  They didn't work.  They slowly introduced other PPIs.  I soon found myself on the highest dose of the purple pill for 6 weeks when I came down with a severe case of pnuemonia that wouldn't go away.  My legs felt like lead weights.  It was a nightmare...horrible pain, pnuemonia and my limbs starting to give out on me.  How I continued to work and functioned was due to sheer embarrasement that I didn't want people to know how sick I was and that I had lost control of my body.  The throat/head/neck/ear/cheek pain was torture.  I found out when ENT scoped me that I was burnt to a crisp on my vocal chords.  I had lost my voice as well.  I couldn't talk but a few seconds.  But that was secondary to the severe unbearable pain.
 
When I got pnuemonia the GI said he was sending me to surgery as the medications weren't working on me.  I finally got to the two surgeons, one said if the PPIs didn't work that I only had a 50/50 chance of success. She strongly discorage me from having surgery.  The other Thorastic Dr felt I had a 95% of success.  I had the fundoplicaiton surgery as I was terrified of being on PPIs and I just wanted to get out of pain and fix the problem.  To my horror I came out of surgery 10x worse and began a slow, painful, diblilating decline.  There were no answers.  In the mean time, I moved due to a retirement.  I laid in bed in excruciating pain and lost 1-2 lbs a day.  This lasted about 5 months. When the new Drs saw me they thought I was making it all up.  To be honest the new GI treated me with disgust.  By this time it felt like I had 5 balls in my throat and I was steadily getting worse.  I developed pain radiating down my arms and legs.  I suspect it was the nerves from the throat being burnt so severely that it radiating down my extrementies.
 
I also didn't even bother to tell my Drs, as I was so distraught and they didn't believe me anymore, that I developed incontinence and all my joints hurt.  I couldn't lift my arms to shower or put on clothes or comb my hair.  I couldn't function and going out to eat with my husband was torture as I was in excruciating pain.  My Drs sent me straight to mental health.  So my family thought it was all in my head too.  I was like a burn patient only the burn was inside my throat and it was unrelenting.
 
My GI finally got me into the new ENT and he confirmed my throat was in bad shape.  He said he had to do a biopsy.  I demanded a new GI.  I did not want the former GI who treated me with distain.  The new GI sat in front of me and said quietly that they believed me now, that I was burned to a crisp but they didn't know what to do.  They tried one medication that burnt me to death 100% more.  I felt that if I didn't wake up it would be ok.  The pain was off the chart.  They took me off it and put me on Carafate.  It gave me maybe 10% help but I found myself swallowing oodles of bottles of Gaviscon to no avail.
 
I slowly began to take over my treatment.  The GI didn't fight me on it as she was at a loss as to how to help me.  I began large doses of probiotics and when the GI saw that it helped me she gave me a prescription for medical probiotics.  I took them at 900 Billion per packet and I took 4 packets a day. My GI said it was safe to do.  The probiotics gave me a 30% improvement.  I was still in pain but little better.  I stayed this way for 7 months.  Still horribly miserable with pain but able to get up and function, but I worked hard to hide my pain with my family.
 
7 months later my Gi and the Head Regional GI told me that they were going to cut me loose and turn me over to the ENT as they could no longer do anything for me...what a horrible thing to experience.  To be in pain and have the Drs say they can do nothing more.
 
My ENT made it clear to me that he would only check my throat and that there was no advice he could give me.  He in fact only wanted to check me for 6 months.  I insisedt that it continue.  I wanted to keep getting at least my condition monitored and having my throat scoped and that it be documented in my chart.
 
I came home that lonely day in August 2011 and was so despondent and angry, I said to myself I'm going to research everything and try to find somehting to help myself...
 
I typed into the web, "what strengthens muscles?" and up popped a few articles on Vit D.  What I read felt logical and I decided that it was worth the try.  I researched the best D to take and I immedately emailed my primary and asked for a D lab test for my level.  I was not as bad as some people I've read about but I knew I had avoided the sun for 40 years since I was a young women.  I never went in the sun and had for the 1st time in 40 years been in the sun for the 4 months prior to my D lab test.  I suspected D could help me.
 
So in Aug 2011 I began my experiment on myself as I had nothing to lose.  Within two days I felt a decent improvement...and each month following I have improved slowly and steadily.  The joint pain disappeared.  The incontienence disappeared.  The swelling of my ankles and wrists disappered.  My legs got stronger.  I finally slept throught the night for the first time in 2 1/2 years.  The LPR was not an overnight improvement but it was slow and steady.  It has been 11 months and my diet is almost normal.  I only avoid raw onions and anything with tomatoes.  I have no more severe pain.
 
My ENT has checked me in Oct 2011 and May 2012 and when he saw me in Oct 2011 he said the spo,t that was burnt to a crisp, that he biopsied, was compeltely healed but that my upper throat was still angry looking.  He asked me what I was doing and he noted in my chart I was taking Vit D3 drops.  In May 2012 he said my throat was less red/angry looking.  I see him again in the fall of 2012.
 
LPR has slowly disappeared.  I only have small wisps of it occasionally and since summer started I have felt the wisps almost just about disappeared.  It's just a very faint vague feeling.  A great deal of the time I don't feel any LPR.  If I didn't know I had LPR I would think I had a little plugged up ear once in awhile.
 
What I would like to share with you all is that Vit D help me so much.  Am I cured?  I can't quite call it that...at least not yet.  I don't feel it will ever be cured but I have managed to help myself more than any Dr, medication, or surgery could.   I feel that because I'm in the sun every day now and taking Vit D3 that I'm better.  But I feel that I still have to see how I am doing when winter comes.  It could return when the sun's rays are weaker.  But I have quality of life now.
 
Another point, on the last Aug 2011 visit with the Head Regional GI, when I pressed him for answers to my questions as to what I had, he said he thought I had a nuerological problem and that my vagus nerve may be causing my problems.
 
I have never had GERD.  I only burned in my throat.  And now I'm so much better with Vit D3.  I test every 3 months and I have gotten my Vit D score up to 65.  It's been a very difficult process but I'm relieved to have Vit D3 to help me manage this horrible anatomical illness.  I still privately am terrified that it will return but at least I have hope.  I thought I would die from this and I was plannning my final documents.
 
I will never forget how terrible my Drs treated me.  I will never forget how they put me on psych drugs telling me I had stress.  I was so defeated that I gave up fighting.  All I could keep telling them was that I was burning to death.  It was the most depressing thing to be in so much pain and have Drs treat me silently with distain for brining them a problem they couldn't figure out.  The last set of Drs told me there was no such thing as LPR.  But they couldn't tell me what I had.  And they wouldn't give me a referral outside of my HMO to see experts.  It truly was an eye opening experience to see what happens when one has a chronic problem.  So I have become my own Dr and I have developed my own treatment plan.  And my HMO continues to take my premium every month.  Its like being in the twilight zone. 
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