At some point, when your lungs are affected by reflux, the surgery is the only answer. Believe me, my PCP and asthma doctors were tearing their hair out trying to keep me breathing. I coughed constantly. I remember my daughter in law, who is a PA kept telling me that I had to do something...that I shouldn't be coughing that much. My lungs were making tons of mucous, and it had to be coughed out. It was not good.
At one point, when I got gastritis from an antibiotic, my reflux got so bad that I was hospitalized for a week, on IV steroids. This, when I was on top dose PPI and top dose inhaled steroids. Even prednosone didn't do a bit of good.
My PCP told me that my situation was life-threatening, and refered me to a thorasic surgeon himself. The surgeon did tests and on the recommendation of my PCP, whom he respected, said I was a good candidate for surgery.
I took the test results back to my GI doc, and he did the PH monitor again. My reflux levels were a little higher (mind you, my reflux was never horrible...but it doesn't take much to get lungs going). He told me I could continue treating the reflux with medication (which wasn't working) or he could refer me to a surgery, which he did.
I agree with your doctor who said that nobody can guarantee anything. The reason they've ruled out all those other things with testing is to narrow down the probability that it's reflux that is causing your problems. With me, it wasn't that easy. I do have asthma and allergies, which definitely muddied the waters.
My surgeon told me that "If the lung issues were caused by reflux, the surgery [would] help me. That, of course was the big "IF" that kept the GI doc from refering me. However, I was at the end of my rope. I couldn't continue the way I was.
I understand your desire to choose the best time to be recovering after surgery. Mine was toward the end of February, which is a good time..after the holidays, but before summer!
Good luck with your decision!
This is a great place to be as you make that decision. There are lots of post-Nissen members who can help you work thorugh things.