Many of our members have seen a primary care physician, been diagnosed with GERD, and then put on long-term proton pump inhibitor (PPI) medication. Most never give it a second thought. This is what made Howard’s story so interesting to us. Until he had a “chance” endoscopy and learned that he had Barrett’s esophagus, he might have continued on the PPI path like so many others. But once diagnosed, Howard took full control, did his research, and made the best decision for one person – himself. This is his story.
A few weeks ago we received a nice email from Howard, one of our members living in the beautiful Southwest. Howard wasn’t a typical candidate for GERD; low BMI, non-smoker, and in excellent condition from riding his bicycle over 200 miles every week. However, when we read his email to Laura, we just knew there would be a good story to share – and we were right!
“Hey Laura, just want to let you know that I had the hybrid procedure done in Phoenix on September 5th by Dr. Jon King. He was able to fix my hiatal hernia and do the TIF procedure. He mentioned to me before the surgery that he needed to look inside first to determine if the TIF procedure could be done. If not, he would have done the Nissen procedure. So far so good; I’m just starving. Thanks for giving me his name and number. Howard”
Early GERD Symptoms Suggested Something Was Wrong
About 7-years ago, Howard’s heartburn changed from periodic and manageable to frequent and severe. “When I’d eat chili and drink beer, or go to bed directly after eating, I’d have heartburn,” Howard told RefluxMD. His family doctor told him not to worry about it, that it was just heartburn, and to take Tums. But Howard’s symptoms continued to be “horrible, just horrible,” he said, and he started having regurgitation at night: “It hit me so bad, and I really didn’t know what it was.” So Howard decided to do some research on the Internet and figured out that he had acid reflux.
Two years later, Howard learned more about his condition after a routine diagnostic procedure. “Since I had a colonoscopy scheduled, my GI doctor decided to also do an endoscopy procedure. He found that I had really bad acid reflux and prescribed Omeprazole. I was to take it everyday and he told me that it wouldn’t do me any harm.”
Learn more: What you should know before taking PPIs
But Howard was skeptical and continued to research his symptoms. He soon became concerned about what he was learning about PPIs. “I found out that it causes problems like osteoporosis.” So Howard asked his doctor about this and was once again told that it was safe to take the medicine; his GI assured him that it wouldn’t cause him any problems. But five years later Howard had a bone density scan and it showed that he had osteopenia on his hip and some osteoporosis. He told us that he “blames this on the medication.”
Things Get Worse on PPI Therapy as Confirmed by an Endoscopy Procedure
“I went for my 5-year colonoscopy and endoscopy last year. When I woke up, they said that I had severe damage to my esophagus. They did an endoscopy procedure with a biopsy, and the biopsy came back with Barrett’s esophagus. My doctor told me that I would need to see him again in two years. When I got the biopsy report in the mail, I did more research online and thought, “What’s this? He wants to see me in a few years? So I went back to my doctor and asked what the heck is going on?” Frustrated, Howard knew he was on his own.
“I’m the one that got online and did the research on treatments. I went to the doctor and asked him about RFA (radiofrequency ablation of Barrett’s esophagus) and if he knew of anyone in the area who could do this for me.” They found a specialist who was able to provide the ablation therapy for Howard in three sessions. According to Howard, it was quick and painless. “It was pain free; you just need to go on a diet for a few days.” Each session was only 15 minutes and after those treatments, Howard was diagnosed as free from Barrett’s esophagus.
Learn more: RF Ablation for Barrett’s Esophagus
Antireflux Surgery to Avoid any Future Complications
But Howard knew that there is a higher risk of people with Barrett’s getting esophageal cancer, and he wanted to make sure that his didn’t come back. “I didn’t just have damage – I had severe damage. The word cancer scares the hell out me, like it does everybody else, and I didn’t want to take any chances. I thought that being in the ‘high category’ sounded pretty risky and I wanted to keep learning. I felt better reading about individuals having the TIF or Nissen procedure and that 90-95% were happy 10 years after it was done. So my deciding to have the surgery was a no brainer.”
Learn more: GERD Treatment: Procedures At-A-Glance
After evaluating surgeons in his area, Howard decided to travel over 3-hours to see a GERD expert in Phoenix. “I just did not feel comfortable with the local surgeon’s lack of experience in these types of procedures, so I went to see Dr. Jon King in Phoenix, who was a surgeon recommended by RefluxMD.”
Dr. King wanted Howard to make his own decisions. “He gave me the options. He put them in front of me, told me what I had and what he could do for me and basically said it was my call.” According to Howard, Dr. King drew everything out with a magic marker on a white board. When Howard decided on the hybrid procedure (TIF), the doctor agreed that it was a good call. There are more side effects with a Nissen Fundoplication and Howard wanted the least minimally invasive step. If the TIF didn’t work, he could have the Nissen procedure in the future.
One Month After Surgery: All is Good
Howard is happy with all of his decisions. “I’m still healing up, but doing pretty good. I asked Dr. King how will I know if it was successful and he said, ‘Oh, you’ll know.’ It’s been 3 ½ weeks with a diet of soft foods, and so far I am having no problems. No severe exercise for another 3 weeks, and I guess I will really know in 5 weeks when I can have a beer – and on December 5th, when the 12 week program is over, and I can have green and red chilies. I’ll let you know!” Good for you Howard!
Howard’s Advice for Others with Acid Reflux Disease
We always like to ask what our members would do differently and how they would advise others. Howard wants people to start with getting “a couple of opinions. If your primary care physician says not to worry about it, go and look it up on the Internet, and find the right doctor even if you have to go out of town.” He also thinks that people on PPIs should find out about surgical options even if they are feeling symptom free. Not one to mince words he said, “Don’t sit on your easy chair all the time, eating anything you want, and don’t kid yourself about those medications!” Thanks, Howard, and thank you, Dr. Jon King and the great team at the Estrella Surgical Group, for allowing Howard the opportunity to evaluate all his treatment options and make the best choice for himself.