I had a similar situation to yours, however my lungs were far worse than yours are now. That was a progressive deterioration over probably 5 years. At one point in that progression, I'm sure I was like you, but things just went downhill as time went on.
My lungs were very unhealthy, and my PCP pushed very hard for surgery. My GI doc dragged his feet for 5 years while my asthma doc and PCP tried to keep me breathing. GI doctors don't really understand how a very little amount of reflux can affect lung health.
500mcg Advair is a very high dose. Before my surgery, I was on 240mcg 4 puffs twice a day (along with Serevent and Singular) and my lungs were so bad that I was taking nebulizer treatments with Xopenex (like Albuterol) several times a day.
Post surgery, I am on 115/21 Advair, 2 puffs twice a day, and my lungs are great. I do have allergies and asthma unrelated to reflux. Before my surgery, my doctors couldn't control my asthma even with prednosone, inhaled steroids, etc...I was on such high doses of steroids that I now have permanent problems (thin skin that tears and bruises extremely easily). I just wish I'd had the courage to push my GI doc to refer me to a surgeon much earlier. I could have avoided so much illness and discomfort, and I could bump into something without requiring steri strips and bandaids. My skin has no protective ability.
Nobody can promise that surgery will solve your problems. Noone promised me, either. That's why my GI doc was so hesitant to send me to a surgeon. He was afraid I'd have the surgery without any improvement to my lungs. My PCP and asthma doctors disagreed. They wanted me to have the surgery. Many tests and many years, along with many letters from my PCP, finally led to my GI doc offering a surgical consult.
I know that there are no guarantees. I know I many at some point need a redo surgery. Still, for some of us, there is no choice. It's a risk we must take. I, for one, am glad I took the risk. The reward has been great. I just wish I hadn't waited so long.
Good luck with your decision!
Here is the link to my early recovery journal:
Words of wisdom by Eckhart Tolle:
"Whatever you fight, you strengthen, and what you resist, persists.”
“Worry pretends to be necessary but serves no useful purpose”
“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”