Sorry I haven't been around to answer your questions! I'm back now, and I'll do my best!
First, asthma is a very challenging symptom, and its causes can be very murky and hard to pin down. Those of us with asthma have very reactive lungs, and it doesn't take much to get them going.
My asthma and PCP docs both want me to continue taking Protonix 40mg an hour before dinner. This is a proactive dose, to ensure that any errant reflux is treated so as not to cause a lung issue. Asthmatics have very sensitive, reactive lungs. I have also chosen to continue to sleep with the head of our bed elevated as well.
When my stomach acts up (I have a reactive stomach that is very sensitive, and I can get gastritis (fairly easily) every so often) take an additional PPI dose an hour before breakfast. This is mainly to protect my stomach from acid. I also add Carafate suspension when this happens. On the bright side, before my surgery, when I'd get these stomach/gastritis flares, they would result with horrible esophagitis that was so painful I couldn't eat anything other than egg custard. I was even hospitalized on one occasion when my stomach issues created untreatable, dangerous asthma.
If you have allergies, it is another piece of the asthma puzzle. My asthma doctor says this year has been particularly problematic for allergies/asthma with very high levels of pollen. I spent nearly every day outside while on vacation, and even though we had air conditioning and closed windows at night, it has taken me most of the week to stop coughing up gunk and get back to normal.
A Nissen fundoplication can help keep our reflux in much better control, but that doesn't mean you can never have a reflux episode that might cause you some trouble. It will not be anything close to what you experienced pre-surgery, but it's certainly possible to flare your stomach/reflux and cause your asthma to flare as well. Then there's the high pollen levels you've been bombarded with since April or May, when tree and grass pollens were both extremely high.
Your problem may be totally a result of pollen. I struggled with pollen allergies/irritation of my sinuses and lungs all spring and summer. I had trouble with my asthma as well, and ended up using a nebulizer, mid July, to help me cough things up. At that point, I suspected a lung infection, and headed to my PCP. He said my lower right lobe was very full, and I was treated with 10 days of Z-Pack. Once I took the 10 day treatment, my lungs were 100% again. I hate to take antibiotics, and I always wait and wait before I see someone, hoping things will clear on their own. I always wait too long, and suffer for no good reason. My allergy NP that I see says that with asthma, our lungs are compromised, and while "typical" people can generally heal/recover without treatment, we most often need help.
I don't think you need to worry for a moment that your wrap is damaged or slipped. What you're experiencing is pretty typical, I think. I hope I haven't bummed you out! Just sharing my own experiences.
People with typical GERD, get the surgery, and don't have to worry about the sensitivities that those of us with LPR/atypical symptoms have. Even tiny amounts of reflux can cause symptoms for us. It's just the cross we have to bear. That said, my post-Nissen improvements have been amazing, and I'm so thankful I had the surgery! I just wish I'd been smart and brave enough to get it sooner. I would have avoided some irreversible steroid damage that was caused by taking too many to keep my lungs going before surgery. Oh well...as they say, hindsight is 20-20!
Hang in there...do whatever you need to do to get things calmed down. You might need to stay inside more, to avoid the pollens out there, until things get feeling better.
Nissen Fundoplication 2/09
"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.”