I want to start a post about
my experience with LPR (Laryngopharyngeal Reflux) and Nissen Fundoplication.
For several years now, I have been, by and large, atypical when it comes to having any of the traditional symptoms of acid reflux: copious amounts of acid coming up into my mouth, heartburn, etc.
For as long as I can remember, I have had the following symptoms: continuous postnasal drip, thick mucous in my throat, coughing, wheezing from time to time, and hoarseness that has grown progressively worse.
So, I have made the rounds to a variety of specialists: ENT's, GI's, Allergist's, Laryngologists, etc.
It seems that anytime I would eat something, I would get all of this mucous in my throat and I would begin to become progressively hoarser and hoarser. I attributed this to having year round allergies and went to an allergist for the second time in my life. The allergist quickly put me on a series of allergy shots, prescribed a sinus medicine, encouraged me to do saline nasal rinses, and use Mucinex. However, after dutily doing all of this, I still continued to have major mucosal production and I was still hoarse.
Some of my other symptoms included getting a runny nose while eating and hearing a 'gurgling' sound at the back of my throat. From time to time, I would experience 'traditional' reflux and feel food or beverages coming back up into my mouth.
The worst offenders in terms of food were green peppers and onions.
five years ago, I changed primary care doctors and began to see a physician who practices medicine from his home and he does not accept medical insurance. I found him to be one of THE most approachable physicians who took 2.5 hours to complete a physical. During my physical, I gave him a complete list of my 'disparate' and seemingly 'unconnected' symptoms and he told me that he thought that I was suffering from acid refux. I was a bit incredulous because I have never suffered from the traditional symptoms of the disease.
So, I set out on my own and found a GI to whom I explained all of my symptoms. This GI had the bedside manner of a rock and agreed to do an upper and lower endoscopy. I went to the hospital on the prescribed day and underwent the procedure. I then underwent a 48 hour BRAVO test. The doctor told me that he would contact me with a 'firm' diagnosis. Weeks went by and I never heard anything from him and I mentioned it to my family one night at dinner. My youngest son said, "Dad, the doctor did call and said that you had 'significant' reflux.'. " I was dumbounded that a physician would disclose a diagnose for an adult patient to a 12 year old!
I lost all confidence in this GI and decided to go see a Laryngolgist (voice specialist). He diagnosed me with 'Spasmodic Dysphonia' and told me that it was 'incurable' and could only be treated with botox injections into my vocal cords. I reluctantly agreed to have the injections but I told the doctor to use the weakest dose as I was suspicious that this was the correct diagnosis.
To make a long story short, I completely lost the ability to talk and could not even whisper after 24 hours. I was told that I would regain my voice in a week. Seven days went by and I was mute. Two weeks passed and I was mute. Then three, then four, five, six weeks. So, I e-mailed the Laryngologist totally panicked because I could barely whisper. He told me to make an appointment to see him which I did.
At my next appointment with the Laryngologist, he told me that I might be suffering from 'Muscle Tension Dysphonia' and that I should consider going to the Mayo Clinic or to a Voice Center at Vanderbilt University.
I began speech therapy at that point in time and it helped a little. I later found another Laryngologist who was more experienced through a friend. This Laryngologist told me that I definitely did not have Spasmodic Dysphonia, but Muscle Tension Dysphonia and prescribed two visits with a speech therapist. Not once did he inquire about
I went to the Speech Therapist and the therapy helped up to a certain point except that I continued to experience hoarseness.
Fast forward to 2013 - A friend of mine commented on the poor condition of my voice and I decided to go back to my trusted primary care physician. This time, I asked him to 'coordinate' my care with the GI of his choosing and recommend a surgeon. Before I knew it, I was scheduled to have an upper endoscopy, a 24 hr PH test, and a swallowing study.
The upper endoscopy provided tremendous insight as to why none of the PPI inhibitors or natural products were helping my voice: I had a 'gaping' lower esphogeal sphincter. Basically, he said that my stomach, my throat, and my voicebox were basically one 'cavity' instead of separate entities.
Then the 24 hr pH test revealed that I had had 82 episodes of acid reflux during this time frame. I wore a monitor that revealed a ph as low as 1.9 at times which is highly acidic!
Finally, I completed the swallowing study - this was worse then the worst form of torture. I won't even go into all of the details here.
After completing these three tests, I finally was able to get an appointment with a surgeon. He explained the Nissen Fundoplication surgery to me and spent about
30 minutes answering all of my questions.
I am scheduled to have the Nissen Fundoplication this Friday, October 18th. I can't say that I have ever looked forward to surgery except in this case.
I plan on keeping a log like many of you have to help others learn more about
this surgery. Hopefully, someone reading this blog will benefit from my experience - especially if you are suffering from unexplained hoarseness that never goes away.
One thing that I have learned about
the medical establishment is this: doctors don't communicate with one another. I am so glad that I found a primary care physician who has excellent diagnostic abilities and made me think outside of the box. Otherwise, I would be trying the same old things and never improving.
Post Edited (Mr. Matt) : 10/23/2013 9:01:08 AM (GMT-6)