Gastroesophageal reflux disease (GERD), or acid reflux as it is also known, doesn’t always manifest itself in ways that all the medical books say it does. Sometimes, as in my case, the diagnosis is elusive for several months. At which point the problem had grown so severe that esophagitis had developed. If allowed to go on for years it could have led to Barrett’s esophagus, a change in the esophagus which increases the risk of esophageal cancer.
My problems started about 6 months before my wedding date. It was a stressful time, with lots to do. The symptoms came on gradually. The first thing that I noticed was that I was having trouble swallowing. It seemed that there was always a lump in my throat. It grew noticeably uncomfortable over a period of about a week. The next thing that I noticed is that in the mornings before I got out of bed I would have a strange sensation in my chest, as if something was trying to explode out of my stomach up into my chest. I didn’t feel heartburn in the way that it is classically described-as just that, a burning sensation. I felt more pressure than anything. It was uncomfortable but when I got up and started moving around and got something in my stomach the feeling usually left for at least an hour or two. I wasn’t in too much pain at this point, I was simply uncomfortable. But being uncomfortable for more than a few days led to a visit with the doctor.
I told her all of my symptoms, along with the fact I was having some stress issues with planning a wedding and that some family and work problems were compounding it. She nodded as if she completely understood and stated that stress and anxiety was the cause of my physical problems. I agreed that everything did seem to be taking quite a toll on me lately. She prescribed Zoloft, giving me precise instructions on when and how to take it. I believed that this would solve my problems and help me get through the next few months, at which time I could work to get myself off of it. After two days on Zoloft I was a wreck. I couldn’t sleep, I didn’t feel like myself, and my heart felt like it was about to beat out of my chest all the time-not the rate but the sound of it. It was like a drum beating in my ears when I lay down to sleep. And it did nothing to solve my problems-either physical or emotional and mental. I gave myself a week and then went back to her, explaining I would like to try something else as the Zoloft didn’t seem to be working for me. She prescribed Lexapro. I had the very same reaction to the Lexapro. She then gave me Ativan, saying that I must be careful with it because it could be very habit forming but at least it would give me some instant relief for the time being so that the other medicines could begin to work. It gave relief all right. I felt so loopy I didn’t even trust myself to do anything. I felt completely uninhibited about everything, and I didn’t care about the fact I could hardly swallow. However, I was still feeling considerable pressure in my chest, and I didn’t want to eat anything anymore because it was too much trouble to feel so awful afterwards. I suspected that maybe my problems weren’t all mental-that maybe I was having some physical problems as well. And quite possibly those physical problems were serious and needed to be looked into further. I expressed my concerns to her and she wanted to try a wait and see approach. I wasn’t sure exactly what we were waiting on because each day my uncomfortability began to get worse. I decided that maybe I should try a different doctor and start fresh. I stopped taking the Ativan and scheduled an appointment with a new doctor.
The doctor sympathetically listened to my symptoms and all of the medication that I had tried. He agreed with me that there was something physical going on that must be addressed. Although stress can manifest itself in various ways in our body, he said that there was some reason I was feeling the increasingly intensified pressure in my chest. It had reached the point that I felt as if an elephant was sitting on my chest almost all the time and I was having difficulty swallowing all the time. He recommended that I go for an ultrasound of my thyroid and gave me Vioxx (this was obviously before the recall) because he believed that my thyroid had become inflamed. I went through with the testing, which showed nothing out of the ordinary so I stopped taking the Vioxx. It wasn’t working anyway.
I scheduled an appointment the day after the ultrasound results were sent back to the office. That particular doctor wasn’t in but a physician’s assistant was able to see me. Once again I explained my symptoms, which at this point had been growing considerably worse over the course of three months. I also felt like a broken record repeating the same thing I had been repeating for several months. She asked me to lie down on the examining table and began pressing down in certain spots on my chest. There was a spot that she pressed on that was so sore that I nearly came up off the table when she pressed on me. She looked at me and announced definitively “You have acid reflux and espophagitis.” My jaw dropped because I didn’t have any of the heartburn burning sensations that is so commonly associated with GERD. I had the pressure sensation that is less common. I was skeptical of her diagnosis until she wrote a prescription for Aciphex for me and I tried it. I gained almost instant relief. The pressure never completely went away but it did lessen. After about a week, however, the pain returned in full force. I had to make yet another visit to the office. This time she wrote a prescription for Prevacid twice a day. Apparently not every proton pump inhibitor GERD mediciation works the same way for each person so you might have to try a few out before you find your perfect match. The Aciphex worked but only partially and I had reached the point in my symptoms that anything was going to give some relief for a time. I began the Prevacid and within two weeks I was feeling like a brand new person. She sent me for an upper GI and I was diagnosed with moderate Gastro Esophageal Reflux Disease. I still had to take the medicine twice a day for several months to get my body back to normal, which was a fight with the insurance company but I was successful. By the time my wedding rolled around I was back to normal, taking the Prevacid only once a day.
It is amazing how reflux can show up in ways that don’t get covered in the news: the pressure in the chest and the lump in the throat. I even had a slight cough that seemed to linger for a long time, which I had chalked up to allergies. It was in fact part of the acid reflux. I am so glad that I switched doctors and found one who would take my complaints seriously enough to look further into it.