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Suggest treatment for non-erosive reflux disease and GERD

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Posted on Mon, 18 May 2015
Question: Where to begin... I was a healthy child until 17 at which I developed ITP. After months of steroid tx at Northwestern, I was unable to get platelets up over 40K. They did laproscopic surgery, took my spleen, weaned me off the steroids and I went back to school.

I then developed allergies at 18- never an issue before, environmental and food. At 29, I had my first daughter, c-section. My second came at 31, also c-section. During the second pregnancy I was put on bed rest due to HBP. I explained to my OB that my BP was normal at my internist, and only occasionally spiked. Those spikes came with extreme sweating, nightmares, heart palpitations, headaches and flushing. I delivered my second daughter via c-section at 31 and my BP was 220/200. I was calm.

A year after my daughter was born, all the symptoms got worse. The bounding pulse in my neck kept me awake at night. My internist told me I was anxious, I had a stressful life as a traveling executive and 2 young kids and of course, gave me and SSRI and clonopin. After complaining of lower back pain on my right side, and me telling my internist about car accidents and my childhood as an athlete, did he order an xray. The Xray showed something, they suspected gall stones or constipation. The CT scan showed a 7cm lesion on my right adrenal.

The lesion proved to be a Pheochromocytoma- 10.2 cm when it was removed in January 2009 at U of XXXXXXX Here we are 6 years later and the symptoms of the pheo remain. I've had a sleep study, cardio work ups, endo appts at NW and U of XXXXXXX and no one can figure out why I have regular PVCs, why my BP spikes to 180/120 on a regular basis and my resting HR is 100.

My OB did endometrial ablation and tubal ligation at 37 due to a failed IUD and heavy periods. Now I have a swollen lymph node in my right armpit.

With the recent Obama care help, and I moved from XXXXXXX to XXXXXXX I'm having a tough time getting my annual scans to check for another pheo. I have BCBS PPO, access to all specialists, and it took 5 months to get an annual check up at UT Southwestern.

I also explained to my new internist in TX that I have developed stomach issues. Heartburn, feeling full after the smallest of meals (usually a 1/2 chicken breast and lettuce), I have a chronic cough that my allergist is blaming on allergy induced asthma- more meds and an inhaler now. I had a colonoscopy and endoscopy that I was AWAKE for. My GI rolled me back to my husband and said, "wow, she's not a cheap date", as the local meds couldn't knock me out.

I'm sure this reads like I'm a hypochondriac, but clearly I'm not. ITP and a pheo? I have better chances of winning 2 state lotteries. I don't want any of this. I want answers and my life back.

What do I have to say to get my next endo, with whom I see in XXXXXXX at UT Southwestern in a week to do a full body MRI/CT? Are there not enough symptoms? Why hesitate when I can pay out of pocket or insurance can pay? I deserve to live a full life- my 7 and 9 year old kids need a healthy Mom. My husband and kids don't even notice when I vomit anymore with the fatigue, chronic cough, and heartburn. "Oh, Mom will be fine." I hide what I can from them, but enough is enough.

I understand a full body scan can reveal false positives of many things... but haven't I "earned" one by now? After dozens of specialists, sleep study, endocronologists, cardiologists, internists, OBGYNs, GI, and so on and so on. I'm tired of doctors, no offense, I was pre-med with neuroscience until they took my spleen and developed allergies that gave me a monthly sinus infection. Thank goodness those are gone with sinus surgery to drain my sinuses.

Any advice you can give would be fantastic. No one understands what it's like to feel sick every minute of everyday. I do not have thyroid issues, as that has also been scanned and I have bi-annual blood labs.

BTW, I feel that this site is the beginning of the future of medicine. It won't be long until we all have a wearable monitor developed with Google or someone that can scan and inject insulin to diabetics when needed. My cell phone talks to my TV and my FitBit records my movement.... it's only a matter of time.

To whomever reads this novel.... thank you. I'm searching for help in every avenue available to me.

XXXX
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Answered by Dr. Noble Zachariah (2 hours later)
Brief Answer:
Hope the following helps

Detailed Answer:
Hello Ms XXXX,
Thank you very much for posting this eye opener for me. It shows our helplessness as doctors to help our patients feel better. I understand what you have been through and am amazed by the high spirit you keep.
Your present problem is due to a condition called Nonerosive reflux disease in which you have symptoms of GERD but there are no signs at endoscopy. See if the following helps you.
Avoid all acidic and spicy food, aerated and caffeinated beverages, raise the head end of your bed by 6 inches, go to bed on an empty stomach (your last food / drink should be 2 hrs before bed time , take a prokinetic like Metoprolol and a PPI like Omeprazole before bed.
Have you had an ambulatory blood pressure monitoring? It would help to know the fluctuations in your blood pressure through out the 24-hour period and help you understand whether it is related to any activity or stress. If your BP is normal or accountable to some stressful activity, then you might have a respite in your hunt for a pheochromocytoma recurrence.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2320 Questions

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Suggest treatment for non-erosive reflux disease and GERD

Brief Answer: Hope the following helps Detailed Answer: Hello Ms XXXX, Thank you very much for posting this eye opener for me. It shows our helplessness as doctors to help our patients feel better. I understand what you have been through and am amazed by the high spirit you keep. Your present problem is due to a condition called Nonerosive reflux disease in which you have symptoms of GERD but there are no signs at endoscopy. See if the following helps you. Avoid all acidic and spicy food, aerated and caffeinated beverages, raise the head end of your bed by 6 inches, go to bed on an empty stomach (your last food / drink should be 2 hrs before bed time , take a prokinetic like Metoprolol and a PPI like Omeprazole before bed. Have you had an ambulatory blood pressure monitoring? It would help to know the fluctuations in your blood pressure through out the 24-hour period and help you understand whether it is related to any activity or stress. If your BP is normal or accountable to some stressful activity, then you might have a respite in your hunt for a pheochromocytoma recurrence.