Asthma, Reflux, Possible Surgery?

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caddyma1
New Member


Date Joined Jun 2014
Total Posts : 3
   Posted 6/18/2014 9:12 PM (GMT -6)   
Hey , I've been reading alot of peoples responses to gerd ...I'm needing some advice I'm a 56 yr old female normal weight Ialso have asthma .I have been on 30 mgs of prevacid 2 times a day for about 20 yrs in early march i had a severe viral infection in my chest and the drugs they put me on created the perfect gerd storm and have suffered extremely alot since then have had every test in the book besides having a small hiatel hernia all are normal so 3 weeks ago they put me on dexilant not much relief at all from that so today they changed it to 40 mgs 2 times aday of nexium so far no relief tonight .. they have been throwing around the idea of the surgery just curious if anyone has any ideas about this Thanks ahead of time

Edited to add title...

Post Edited By Moderator (dencha) : 6/19/2014 7:09:30 AM (GMT-6)


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 6/19/2014 8:42 AM (GMT -6)   
Hi caddyma1,

Welcome to Healing Well! Like you, I have asthma that was made worse by reflux. I had the Nissen fundoplication surgery in February 2009, and it has helped me tremendously.

I suffered with terrible, uncontrollable asthma for six years. My PCP constantly pushed me to have the surgery, but my GI doc was hesitant, because my reflux levels (DeMeester score) were never very high. I was pretty fearful of the surgery, so I didn't push as hard as I should have.

In the meantime, my lungs were so unhealthy, my PCP described them as "life-threatening". I was on a nebulizer several times a day, and coughed up tons of mucous. I was on high doses of inhaled (and intermittent oral) steroid with no noticable improvement in my lung condition. (In fact, I had very bad side effects from the steroids--I had adrenal insufficiency, and now have very thin skin that is fragile. It bruises and tears with a simple bump into something. I have to live with it, as they're no possibility of improvement in the condition.)

Finally, my PCP had had enough. He sent me to a surgeon himself, who did several more tests and because he trusted my PCP, said I was a good candidate for surgery. I took this information to my GI doc, and he FINALLY said, "a couple good reflux episodes a day could probably create problems for your lungs". You think? At that time he told me I could either continue just taking the medication (yeah, that was really working), or I could go see a surgeon that he recommended(no rush, he said). I made an appointment to see the surgeon, and had the surgery three weeks later.

After the three months it took my lungs to heal, I was 100% better. No more nebulizer, I now take a fraction of the inhaled steroids I took prior to surgery, and haven't had oral steroids in years. Now when I get a cold or sinus infection, my lungs aren't as bad, because they are generally healthier to begin with.

I have severe pollen allergies, and I'm very sensitive generally (reactive stomach, rosacea, asthma, etc), so I still get some asthma issues during bad allergy times, but now it's controllable with normal measures. I am so happy and healthy compared to my pre-Nissen condition!

Prior to my surgery, when I was put on an antibiotic, my stomach would react badly, I'd get increased reflux, painful esophagitis, and my asthma would become horrible. Now, if my stomach reacts to something, it stays in my stomach, and I don't get all those other painful and unhealthy reactions.

Once, prior to my surgery, I was put on Augmentin, and my stomach/reflux got so bad that my asthma put me into the hospital for a week on IV steroids. Even then, my lungs didn't improve completely. I was released to many weeks of healing at home.

What problems are you having? Is it stomach/esophagus pain, asthma symptoms, or both? If your stomach is painful, I'd suggest you ask for a prescription of Carafate Suspension. I have a reactive stomach, and keep it on hand always. It coats your esophagus and stomach, and helps with healing. It also can make you much more comfortable. And the effects can last up to six hours...much longer than liquid antacids. It's not an antacid, but simply coats that sensitive tissue and helps it heal/helps you feel better.


Be sure you're taking your PPIs properly, so you can get the most benefit from them. Here's a great article with information about how they work, and how to take them.
www.practicalgastro.com/pdf/January07/Jan07FrankArticle.pdf


Also, here's a link to my early Nissen fundoplication surgery recovery journal, so you get an idea of what one person's recovery looked like.
www.healingwell.com/community/default.aspx?f=45&m=2183443

This is a great forum to receive support and information from others who've, "been there, done that". I found it a month or so before my surgery, and it was so helpful that I decided to stick around and help others the way I was helped.

Hang in there!
Best wishes,
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

Post Edited (dencha) : 6/19/2014 7:47:02 AM (GMT-6)


caddyma1
New Member


Date Joined Jun 2014
Total Posts : 3
   Posted 6/19/2014 3:23 PM (GMT -6)   
Thank you Denise for your very informative response . I read your surgery blog wow you've had some struggles !! I'm on an antibiotic of zithromax 1 pill every other day always !! Due to a strange blood issue that drops my immunity its mostly preventative.. but now when ever I get sick usually 1 or 2 times a year I must go on much stronger antibiotics which preceded this recent event with my stomach .I have my asthma under control but I do take 5 mgs of prednisone a day and like you I have very thin skin which does concern em in the event of having surgery ! I refuse to let them do the bravo ph test as when you can basically only eat bread and water without getting acid reflux and all my other tests indicate that its gerd than I really cant bring myself to do that one . The manotry test was normal so surgery would be fine ...Im just so terrified of creating a worse situation than I'm already in .. As for the carafate thats kinda where they started with this mess but I just didnt use it that much. I appreciate all you had to say and your blog I get on the internet and freak myself out so bad thasts why I decided to reach out to Healingwell and try and get some reasonable advice !

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 6/19/2014 3:59 PM (GMT -6)   
Hi caddyma,

I had been on so many steroids before my surgery that my internal tissue was extremely fragile. My surgeon considered adding mesh as a strengthening agent, but since mesh can cause its own problems (eroding the esophagus with movement, etc.) he decided to add a few extra strengthening stitches to keep things in place.

I was coughing forcefully and nonstop during recovery, and I was fearful that the wrap stitches wouldn't hold, but they did just fine. Once my lungs recovered and healed, coughing stopped and I could reduce my steroid intake significantly. My adrenal gland has recovered, and the surgeon said that my internal tissue would improve once I wasn't getting high doses of steroids.

I did get a steroid boost for the surgery. I guess when you're on steroids for a long time, and have adrenal insufficiency, you can have problems with the stress of surgery, so they give you a boost of extra steroids to avoid that problem.

Why are you on daily steroids? Is it for your asthma? If that's the case, then I wouldn't call your asthma in control. Yes, it is responding to the steroids, but my asthma doc said that one round of steroids a year (just the 5 day starting high, then tapering immediately) is more steroid load on your body than a year of inhaled steroid. If you need to be on steroids for your lungs, then it's definitely time to take the plunge and go for the surgery. That's just plain not good for you, as I'm sure you know.

Wow. Having to be on antibiotics all the time would kill my stomach. I avoid them at all cost, but do tend to need them for that inevitable problem due to sinus, cold, or long periods of heavy pollens. I feel your pain...I dread taking antibiotics because of the number they do on my stomach. Z-pack seems to work the best for me as far as not irritating my stomach. Actually, Amoxicillin and Z-Pack seem to be the least irritating.

Are you saying the Carafate bothered you, or that you didn't take it? I know it's a challenge to take, but when my stomach gets reacting/irritated, it really makes a difference if I take it consistently...at least 3 doses a day.

The scary internet stories kept me from getting surgery, too. I could kick myself for waiting so long. My quality of life and health are so much better now. Did you read at the end of my journal the thoughts I wrote about the scary posts online? I've come to believe that most are due to people who haven't been prepared for the recovery, and think they'll deal with recovery symptoms forever.

It is very important to find a skilled/experienced Nissen surgeon. That surgery is an art form, and requires lots of practice to develop proper technique. The more experienced your surgeon, the better the outcome. Your attitude post-op is also critical. If you can surrender to the recovery, and follow its lead, you'll do much better. Those who try to fight it, rush it, and struggle against the reality of the recovery process have a hard time getting through it.

The first two weeks are the toughest, then peak swelling hits, which has some challenges. Once that clears, you're on your way. It takes six months for most of the healing and a year for the rest. It takes patience, but it's not all that bad. I was prepared for much worse. Actually, my reflux-related stomach/esophagus pain pre-Nissen was far worse in my opinion.

If you decide to go for it, we'll be here to provide you with support and information. Most often surgeons don't really know much about the recovery process. They do the surgery, follow up in a few weeks, then send you on your merry way. That's why it's so helpful to have a support group like the one here at Healing Well, to give you some advice, share their own experiences, and provide support and encouragement.

Good luck!
Best wishes,
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

Post Edited (dencha) : 6/19/2014 3:03:44 PM (GMT-6)


caddyma1
New Member


Date Joined Jun 2014
Total Posts : 3
   Posted 6/19/2014 4:38 PM (GMT -6)   
You've been so helpful my next appt with my GI is july 1st we're trying the nexium for a couple of weeks first ..but Im a little concern as I'm itching from it so far today .. but I was alittle bit on the dexilant too. so hoping the nexium works and I can avoid surgery but its not looking good at this point I appreciate you continued positivity Thank you

distantfrog
Regular Member


Date Joined Oct 2013
Total Posts : 33
   Posted 7/13/2014 12:56 AM (GMT -6)   
Hi Denise,
 
I haven't been on the blog for awhile and just came back recently.Was looking to find you as you had similar issues to mine and had surgery and seemed happy with it.
 
I had gerd for about 25 years but have been on various ppi's (mostly 1 x 40mg) for about 16 years.
 
Have had mild esophagitis and gastritis at least since diagnosed in 2010.Endoscopy in december 2013 said my stomach and duodenum were fine but no biopsies were taken.Gastritis was confirmed in 2012.
 
about 1 year ago i tried to ween off the ppi's over 1.5-2 months and then LPR symptoms started and never left.Went back on the ppi's as i was scared.Since then my throat is very dry during the night and i have to keep water at my bedside... 
January 2014 i tried again to ween off the ppi's as i was getting scary side effects from the pills i think anyways.Could not do it again due to persistent gastritis symptoms below chest bone.
 
about a week ago i think ashtma symptoms kicked in (never had them before or not chronic ones anyways) where my ears seem to block, runny nose and it's like "give me some fresh air".Never really had allergies before so i am pretty sure it's from the silent reflux.Plus i am winded at doing almost any exercise most of the time which is so hard for a 58 yer old non smoker who always thrived on exercise.Actually last few years i have't been able to play my racquet sports as i always wake up the next morning with plantar fasciatis and now i get it just from walking!I know that has to be a side effect of the ppi's.
 
Anyways i took the ph and manometry test last november and even if it showed that i have reflux about 1-2 hours after each meal,the amount of hits is not high and my demeester score is low so the doctors say i am not a good candidate for surgery. My LES pressure was at the low part of the range and my UES was dysfunctional.I have lost a lot of weight these past 2 years with anxiety and trying to find the right diet to hopefully ween off the ppi's.I went from 215 pds. 3 years ago to about 170 pounds right now for a 6 ft. 1 inch. frame.If this ashtma sticks around my quality of life will be terrible heading into retirement next year!
 
I read that nissen fundoplication improves lpr symptoms by about 70% on average.My docs tell me that surgery could make my symptoms worse and that concerns me.Unfortunately that way i am canadian and don't have $30 000 to get surgery in the States.If i had i think i would want the Lynx procedure as it looks less invasive than the nissen.Have you heard of the procedure called the "stretta" and if you do how are the comments on it?
 
I am moving to Montreal next year and i am wondering what it takes to convince a doctor to refer me for surgery?One concern for me are the strong cramps in the evening from gastritis.What happen if they wrap that piece of the stomach that is more inflamed where the cramps occur?Could you get infection or problems post surgery?
 
In the meantime i am trying the GAPS diet which is quite restrictive but needed to get healing in my opinion.No major success yet.I still get bad gastritis symptoms but less reflux so some improvements.
 
Just curious when you had your asthma pre surgery,how was your fitness level?Were you tired?In terms of energy level how did you feel after the surgery had healed?It's really hard on me to be so tired and winded these past two weeks. 
 
You talk about CARAFATE.Is that what they call SULCRAFATE in Canada and is a white chalky pill that serves to coat the stomach to prevent ulcers or other similar stomach issues?
 
Ok will leave it at that for now.Look forward to your comments and thanks for working on the blog.
 
Louis           
 
          
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