Who to see?

Need some insight......

Since before surgery, I have had what I think is an acid reflux "attack".  I thought after surgery it would go away, but it hasn't.  It only happens about once every 6 weeks or so.  It's always at night, and I will wake up feeling like there is a ball of fire in the back of my throat.  It takes a long time for it to go away and is pretty painful while it's going on.  I do take OTC Prilosec at the suggestion of my bari surg PA, but this still happens.

My question is........should my bari program see me for this, or should I schedule an appointment with my PCP (who is a new one and doesn't understand WLS) or just try to get in with a gastro doc?

I also want to have some sort of test done to see what's going on with the size of my pouch.  I am considering Stomaphx and would like to know what's going on ahead of time.  The PA has been very reluctant to talk to me about any stretching, etc.  How can I get tests done without them?  

Any suggestions anyone has are appreciated.

PS-I can't find any patterns that make these "attacks" happen.  It doesn't seem to be related to what I eat or what time I eat, etc.  It's pretty random.

 My first thought was to see your bari surgeon.  But if they are reluctant to talk to you about your pouch size and their only solution to the acid was priolsec... I'd say try the new PCP first.  If he doesn't understand WLS, you're gonna have to work hard at educating him.  Take him as much written information as possible to bring him up to speed on your new anatomy, specific vitamin and med needs, etc. (I take my PCP some new medical journal report or article or whatever everytime I see him.)

But work with him to get in to see a gastro doc and also get an endoscope to check the size of your pouch AND your stoma (stoma stretching is worse than pouch stretching, so this is the most important part of the endoscope).  Then once you get the results from these tests you'll have some info to go back to your surgeon and get them to do what you need.

Good luck

If it were me, I would start with my PCP, but then again, I have a GREAT PCP (maybe you should try her, through UMHS, she was/is very WLS friendly).  

Before WLS, I had HORRIBLE reflux.  It got to the point that OTC did nothing for me.  Anyway, I eventually was prescribed Aciphex.  It really helped the reflux, but it wasn't until I was prescribed Protonix that the reflux was completely treated.  It was the ONLY thing that kept the reflux at bay, and I had reflux nightly, regardless of what I ate.  Sometimes, I even got it during the day for no reason!    

I hope you can get this taken care of soon!  Reflux sucks!  

I had reflux before WLS and was told having the surgery would completely clear it up. Wrong! Three days after I got home, I started having heartburn while I was on liquid protein. I had to go on a PPI, which at the time was Prevacid, and then I had to open up the capsules and gag down the little time-released thingies ... ugh! (they didn't have the strips then). But then I have Barret's esophagus (precancerous condition ... so that may be why I still have problems. I have to have EGDs every two years. I've graduated now to Nexium, because my condition hasn't improved at all.

I go to a GI doc who is very familiar with WLS and comments on the size of my pouch and stoma and everything. As for you, I'd recommend starting with your PCP; if you can't educate him/her, find a GI doc; you might ask the bariatric center for a recommendation.

Brenda,

I've been on Prilosec since surgery (I was on Acidphex prior to surgery), as a deterrent to  ulcers post op.  I did have a bit of a problem back in January...my gerd seemed to come back, but it was just for a few weeks...don't ask I don't know why.  Anyways, I went to my gastro, he was happy to talk to me about my options and seemed to have no problems w/ me having had gbs.

Good luck cause Tina's right, gerd sucks,

Edie

brenda- i'm sure it's from popcorn!!  hehehehehehehe

xo katie

Listen miss pot calling the kettle black!   I was going to say your hairball was from popcorn, but figured Jan had teased you enough LOL!!

HI Brenda-
Sorry you're having trouble...  I'm still taking prilosec - haven't stopped since the the surgery, and I know I still have problems b/c if I forget to take one, I'm dying...

Anyway, when I've been unhappy w/the reluctance from the PA (or anyone in the program), I've emailed them all - surgeon (include both of them), PA, NUT, Beth (the nurse), and even the office staff.  Outline the problems you're having, explain that you'd like them to work with you on this (both the refux and stomax question), but if they won't, ask if they'd suggest someone who would.  My guess is that this would get some type of response from them.  If not, at least you're no worse off, but you've given the surgeons a very clear message.  Good luck!!!

I did get a call from the program nurse yesterday.  She said Dr. B is on vacation for "a while" and she would email him and we'd have to wait and see what to do.  She said he'll probably just have me take 2 OTC Prilosec.

I also talked with the Admin. Assist. and she said she wanted to schedule me an appointment with the NUT.  I told her that one of the reasons I chose U of M is because I liked Patti, the original NUT.  She understood that I couldn't come in for appointments every time I had a question. Patti would take calls or emails and always answered right away.  I told her that I can't have time off of work to come in to discuss my diet.  She paused for a long time and then said "You don't have ANY time off?"  (I faxed over my Fitday logs for them to look at, and I went to my 3 year follow up in the Spring, so really it's just her giving me suggestions).  Uggghhh.

I'm getting kind of tired of dealing with them.

I know what you mean about Patti - she was really, really good.  Now when I have a question, I just get some canned answers about eating less, more veggies/fruit, etc.  Not terribly helpful.  I get the feeling she doesn't really understand WLS patients - might have been a better fit with the kids.  Uggghhh is right - sorry!

I hope Dr B has some more insightful info when he gets back.  (I have to hang on to some hope that he really is a god - with my crush and all...  [wink!]