Laryngopharyngeal Reflux

[gja1000]

Originally Posted by judy

I also have GERD. I have changed my diet, but can still have coffee, tomatoes, chocolate, etc. I limit myself to two cups of coffee/day now. I discovered that no sweeteners in the coffee help. (???) I think everybody's foods to avoid differ. I have been taking nexium for years for it.

It took 2 years for a diagnosis because I didn't have any heartburn, etc, symptoms. It was all in the throat.l I couldn't talk for long, which was bad for a teacher. I would be exhausted at the end of the day from trying to use my voice.

I would say a few weeks after starting the nexium, I was a different person. I hope your doctor diagnoses you easily, and that your symptoms disappear as fast!

JUDY! You don't have GERD, you have Laryngopharengeal Reflux (LPR), the same thing I have!!! The most common symptom is voice problems - along with NO heartburn or other GERD symptoms. I don't have voice problems but I have all the other symptoms, (feeling something is in my throat all the time, coughing after meals, clearing the throat throughout the day).

The doctor visit went well, but I could tell the he (probably ~65 years old) didn't really know much of anything about LPR which is very common with doctors who don't stay current with the literature. And in fact the treatment is the same as GERD, with a few exceptions, (e.g., some people are so bad by the time they get diagnosed (see Judy's 2 year saga), they are REALLY bad by the time they get a diagnosis and the recommendation is to dose twice a day with Nexium, Protonics, etc).

The doctor gave me 10 days worth of samples of Aciphex to see if it helps and that is why I think he doesn't know anything about it. It is rare that it improves in that short amount of time. But, I know what it is and I am going to diligently watch my diet and take the meds and see what happens. I'll just call before the 10 days are up and say I am better (whether I am or not) and get an RX for it. Aciphex was on the list of recommended meds in the Journal of the American Medical Association article that I have which outlines the diagnosis and treatment of the condition - so I know the medicine is appropriate. I offered the article to the doctor, but he didn't take it - which is typical of older docs - they don't want you to tell THEM anything. I've never gone to him before, I go to his nurse practitioner whom is ALWAYS reading the latest research. But she is out on maternity leave, so I'll see her later.

I have been a tiny bit better today (less coughing) with just the dietary changes from yesterday and today.

[Janet]

I think I would be afraid to go to an old Dr... But since you know what you're dealing with I'm sure you are more comfortable. I know you already know this, but just be careful diagnosing yourself....you are loved so much!!!!

[judy]

What do you know? I have a different disease than I thought! I was probably diagnosed before the symptoms were common enough for doctors to know what I had. After all, it did take 2 years! Then a lot of Baby Boomers had these symptons, and more research was done. I forgot about the throat clearing. I think I still do it, especially after coffee, but am used to it.

As long as you are on the right medication, you should feel better very soon. Don't worry if this medication does not work. Not all the medication works on everyone. I began on one med, maybe Prilosec, and then that stopped working after a year or so. Nexium does the trick for me.

This doctor sounds annoying. I hope you don't have to find another one, and that you just take the medicine, and feel better.

[gja1000]

Thanks Judy, for the reminder that not every medicine works for everyone. Someone told me that Prilosec and Prevised do not work as well. I'm taking Aciphex and if it doesn't help, then I'll try Nexium. I won't have to change doctors, I will just have to wait till my nurse practitioner gets back from maternity leave. She's a good friend and a very good practitioner and when I give her the medical evidence on what meds/dosage works best, she will give it to me. I imagine she is more informed about LPR than the doctor is, because as you pointed out - it was an unknown when you were seeking a diagnosis years ago. She just graduated about 8 years ago, so she is much more likely to know about LPR.

[DianaB]

I'm glad that you're feeling better. Thank goodness you have an NP that you're comfortable with.

What is it with older doctors that don't listen? Thankfully my doctor is pretty young and I feel like she's pretty much on top of things. I have an appointment for next week to see her.

[gja1000]

Originally Posted by DianaB

I'm glad that you're feeling better. Thank goodness you have an NP that you're comfortable with.

What is it with older doctors that don't listen? Thankfully my doctor is pretty young and I feel like she's pretty much on top of things. I have an appointment for next week to see her.

Old doctors do not listen because they were not taught to listen. They were taught that they know what is best and their knowledge is superior to the patient's knowledge and preferences. That is the way medical education used to be, but it has changed to be more accepting of the information the patient gives. Also, younger doctors are trained to diagnose and manage conditions based on protocols from evidence-based practice. That is, they are trained to read the research and talk to the patients and treat them according to the best available evidence combined with patient preferences and idiocyncracies. The article that I had with me at the doctors office was the medical associations's accepted and published evidence-based protocol for treating my condition. Medical school did not used to teach that - so some older doctors rely on their "superior" knowledge. I have an endocrinologist that treats my low bone density and when I go to see her, I usually have research articles that I take to her and she usually has some for me. We respect each other's knowledge and she relies on the best evidence available to make treatment decisions.