Tag Archives: LPR

That old chestnut, if you have your health you have everything!

That old chestnut, if you have your health you have everything!

Yesterday was my medical test day.  I’m pretty much talking soup to nuts … what with EKG’s, lots of blood work and then an afternoon at Mt. Sinai Hospital getting hundreds of pictures taken of my esophagus and stomach from the “inside” view.

Sheesh.  It was enough to make me heave, which I’m proud to say I didn’t, but having been prone on a surgical table for 45 minutes with lots of tubes, IV lines and the like, I do have pains in odd places today that are inexplicable such as the weird spot on my left jaw and the sore in my mouth just below my lip on the right side.

Hiatal Hernia, Credit: Medicine.net

Things are mostly okay with a few surprises — such as a Hiatal Hernia and some funny looking inflammation in my stomach.

For those *not* in the know (such as myself twelve hours ago), a Hiatal Hernia is when part of the stomach pushes through the diaphragm into the space were the esophagus passes through to the stomach.

According to the Mayo Clinic’s website, “Your diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a Hiatal Hernia.” (Link)

Many patients who have been diagnosed with a Hiatal Hernia (such as myself) don’t exhibit any particular symptoms other than GERD (Gastroesophageal Reflux Disease) and may only discover that they have a hernia after undergoing an Endoscopy. (An Endoscopy is a surgical procedure which entails a GI specialist viewing your esophagus through a tube that passes through the esophagus and the stomach all the way to the small intestine.  It is also known as an Upper GI Endoscopy.)

The diagnosis of a Hiatal Hernia is also found in patients who have Barrett’s Esophagus — and such is the case with me.

For those who’ve never heard of Barrett’s Esophagus, “it is a condition in which the cells of your lower esophagus become damaged, usually from repeated exposure to stomach acid. The damage causes changes to the color and composition of the esophagus cells.” (Mayo Clinic Link.) The process, known as “metaplasia” actually changes the cells from the normal ones found in the esophagus to the type of cells normally found in the intestines!  To quote some more from the Mayo Clinic write-up, “A diagnosis of Barrett’s esophagus can be concerning because it increases the risk of developing esophageal cancer. Although the risk of esophageal cancer is small, monitoring of Barrett’s esophagus focuses on periodic exams to find precancerous esophagus cells. If precancerous cells are discovered, they can be treated to prevent esophageal cancer.”

Acid Reflux, Credit: Greater Baltimore Medical Center

GERD is the usual precursor to Barrett’s Esophagus.  In my case, the thinking is that I’ve had this for many years, but because my symptoms were not related to the classic heartburn of old Alka Seltzer commercials, but rather as sore throats and coughs, what I had always thought were seasonal allergies turned out to be LPR or Laryngopharyngeal Reflux Disease.  In other words, discomfort in my throat, not my stomach!

Often called “silent reflux” this particular permutation of gastric reflux is often linked to GERD as well as a risk factor for developing Barrett’s Esophagus and other Esophageal conditions. As well, Hiatal Hernias are also often seen in GERD and LPR patients.  (LPR Link)

All of these conditions require diagnosis, treatment and follow-up by skilled GI and ENT specialists and should be taken seriously.

There are also important steps that patients such take to help mitigate the discomfort and risks associated with these conditions.  Changes included the following suggestions:

– If you smoke, quit.

– If you are overweight, commit to returning to a normal weight for your height and body type.

– If you don’t exercise on a regular basis, you should strongly consider starting.

– Avoid the “no-no” foods:  Soda/carbonated beverages (even club soda), alcoholic beverages, chocolate, mints, citrus fruits/drinks/juices, spicy foods, tomato-based products, caffeine, fried foods, high fat foods, refined flours/sugars, highly acidic foods.

– Eat small meals/snacks 5-6 times per day, instead of 3 large meals.  This helps to digest food faster, especially if you eat one type of food at a time rather than loading up with lots of different foods as once.

– Try to take a walk after eating. A twenty-minute “constitutional” should do it. This really aids the digestive process.

– Stop eating 3-4 hours before lying down/going to bed

– Invest in a wedge pillow (gradual include to 6 inches) and use this for sleeping at night.

Also realize, that you can affect the outcome of your own health — and while things may not return to perfect, your commitment to yourself and doing what you can to help yourself, really does make a difference.




Getting back in the swing!

Getting back in the swing!

Whether it’s perfecting your left hook or flexing your mind (as in keeping a “daily” blog) – getting back to a regular regimen is tough going when you’ve been away from it for a while!

Having stepped into the gym on Saturday for the first time in three weeks was a case in point.  I’m nursing sore abs, a creaky shoulder and a mindset that is less focused on perfecting the minute shifts of tuned-up training, than just getting to the gym at all.

So my job is to push my momentum, meaning, getting myself back on a weekly gym schedule that *builds* rather than maintains!  I’m also trying to talk myself out of the neat excuses for not going such as, “I’ll be out of town on Saturday” or “I’m tired” or “it’s raining out” … you know the drill!

I can say the same for writing!  When I don’t write every day I get out of the habit — so, starting today, I am bound and determined to get back on the writing stick!  And yes, I’ll even give myself some slack for having finished up my degree, et alia, but a daily blog is just that, a daily blog.  That means putting fingers to the keyboard with a mindset that can get past the range of reasons *not* to do something.

Meanwhile, it’s 2012 and I’m already over three weeks behind in getting my resolutions in order for the year!  So here goes!

1.  Write a daily entry for Girlboxing!

2.  Gain more strength, endurance and flexibility. Being in my late 50s means I need resistance training and a lot of it to keep my bones strong.  I also need to do more aerobic training, and yoga.  That means getting back to a training schedule that has me doing at least one thing a day and on some days all three!

3.  Eating better!  Yikes.  This one is tough.  Having been diagnosed with LPR (Laryngeal Pharyngeal Reflux) and GERD (Gastric Esophageal Reflux Disease) PLUS having Barrett’s Esophagus (the cells in the esophagus near the gastric junction actually CHANGE due to acid erosion), I’ve been living a low-acid/low-fat life!  What I have to get to, however, is better balance in selecting meals and foods and how they are combined.  This one is a tough to sort out – and I’ll actually do a column on it sometime soon, suffice to say that I’m getting there.  I’ve lost nearly 25 pounds since the change in my eating regimen in July 2011, now the trick is to go the rest of the way (another 10 pounds), while continuing to build muscle (which has suffered as late) so that when I eventually meet my goal, I’ll be a healthy and toned – rather than depleted and weak.

4.  The next project:  now this is the tough one!  I’m thinking book and just have to move into the space by DOING rather than angsting about it.  And therein lies the sticky problem: getting to the DOING part.  Again, it’s a matter of starting and once in the habit continuing the process until it is concluded.  Easier said than done?  No, probably not ‘cause we all have goals that we set and follow.  It’s that pesky issue of getting started!

What it all comes down to for the year:  Doing!

So, day one in my reforecast New Year means putting the fingers to the keyboard to say thanks so much to my Girlboxing friends for listening and HAPPY NEW YEAR!!!

And how nice that it happens to coincide with the Chinese celebration of the Year of the Dragon!


Getting “back”

Getting “back”

I worked out hard on Saturday — giving it my all so to speak through my sweet 16.  I even got Len laughing when he asked me if I’d eaten my Wheaties!  Mostly it felt great to sweat and to realize that my stamina was such that I could start to maintain speed — not to say that I was rabbiting through all 16 rounds, but the four with Len felt right except perhaps for the last part of the fourth round when I could feel myself flagging.

Back on the double-ended bag after coasting a round I did forge through with speed again — all of which is allowing me to officially proclaim to myself that my goal of gaining some conditioning is finally being met!

For a 50-something out of shape person, knowing that one can get pretty much “back” to conditioning at the six months mark of training is excellent. I can actually throw myself into a jog without dying and when it comes to gym time finally finding some speed is a truly remarkable feeling.  Len even had a little bit of a wince when I threw a left jab at his body followed by the right to the pad — and not that I’m necessarily evil or anything, but that little tiny push back made me feel like a million bucks.

On top of all of this, I finally had a diagnosis for the coughing!  It runs out its something called Laryngopharyngeal Reflux or LPR.  Often called the “silent” reflux, symptoms and signs include coughing, thick mucous at the back of the throat, “postnasal” drip, throat irritations/throat clearing and even sore throats that seem to resolved after a day or two.

The mechanical action is the acid from the stomach backs into the esophagus through the upper esophageal sphincter.  For people who suffer from heartburn, the acid hangs around in the esophagus, however, with LPR the acid actually backs up into the voice box and the back of the throat.  Hence the symptoms!

I went in for a scope of my nasal passages and throat and low and behold, what we found was an enlarged larynx that showed evidence of having had LPR for some time. In speaking with the doctor, he told me that patients do indeed experience breathing problems upon exertion — and that is one of the reasons patients seek medical attention.

As for treatment — the primary one is a change in diet with several huge no-no’s:

  • caffeine, cola beverages, citrus beverages and mints, alcoholic beverages, particularly at night, cheese, fried foods, eggs and chocolate.
  • no eating a minimum of three hours prior to bedtime — and no large meals at night.
  • a primary diet of green veggies and non-acid forming fruits (60%)
  • weight loss.

I’m also being put on something call a proton pump inhibitor (PPI) — a class of medications that essentially prevents the stomach from forming acids.

I still have a few more tests to undergo to rule out a few things, but figure the diagnosis is pretty solid — now it’s just up to me to give up coffee, tea and chocolate 😦 while noting that a mostly veggie diet will certain aid in my weightloss campaign.

For more information on LPR, here are a couple of sites.