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- Archimonde
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I also went back to the ENT who took my tonsils out and he has ordered a cat scan of the sinuses just to make sure we aren't missing any fungal ball or new abnormality that could be causing the Mucus. He also did a strobe test and saw mucus sticking to my vocal chords so at least he knows I'm not crazy. He thinks the reflux is causing the mucus and he told me that new literature has come out which is realy validating the ENT stance that Acid and Bile salt reflux both damge the oral/nasal pharynx and can lead to a whole host of symptoms.
As strange as it sounds, there is a certain satisfaction in ruling out possible causes and not having to stress about those areas. I no longer worry about my teeth or tonsils and I have a feeling that my sinuses will be checked off the list as well. I believe that the new equation (for me ) is this:
Mucus = halitosis. GERD = Mucus. thus GERD = HALITOSIS because it is always true (for me) that NO Mucus = NO Halitosis.
So it makes sense that I am currently focusing on reducing the GERD and clearing the mucus to help minimize the halitosis. Unfortunatly the GERD will never go away without surgery for a defective LES but the mucus can be helped by staying hydrated and using a personal steam inhaler to help thin it out. I have also stopped taking anything more than 20mg of PPI medication because anyhing more realy dries that mucus and makes it smell.
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Appeals were denied for the LINX procedure so I am going to get the fundoplication done. It turns out that not only would I have to pay the implant cost for the linx, but also all hospital bills and diagnostic studies after implantation. I simply can't afford that.
To that end, I saw a surgeon yesterday and just need to call the scheduler on Monday. To say I am nervous would be an understatement. There have plenty of success stories in terms of GERD reduction but plenty of horror stories as well. The surgeon told me that the megadose PPI medication will not stop the progression of Barret's esophagus and that the stomach contents washing out of the stomach continues to damage the tissue. This is like getting a sunburn in the same spot over and over and could lead to cancer if not fixed.
I did learn something else as well. When you have a hiatal hernia, part of the stomach is forced through the diaphragm and that part is where the LES valve is. The pressure generated in the stomach is what keeps the valve open. He told me that the LES valve is not a particularly strong valve to begin with, so a hernia will almost always cause it to relax open allowing reflux material to splash up and out of the stomach.
The goal of surgery is to pull the hernia back down through the diaphragm and wrap the top of the stomach around the esophagus to seal it in. Stitches are placed on the wrap and diaphragm to keep everything in place.
I told him about my fears with the wrap coming undone and he told me that he hasn't seen that since he started using new stitches that aren't made of silk. He told me that the surgery is meant to be permanent and shouldn't fail within 10 years like my original GI doctor told me.
This thing has two very troubling side affects. The first is that I will no longer be able to burp. Gas has only one way to get out and you can guess how..
The second is when I get a stomach virus or food poisoning, I have to go to the nearest ER and have my stomach pumped via NG tube. This is because I will no longer be able to vomit either. The fundus is responsible for the involuntary wretching response and since it is wrapped around the esophagus it will actually clamp down more so that even a little vomit has no chance of getting out. Failure to get the stomach pumped could lead to a rupture.
The good news (if you want to call it that) is that the surgery can be undone or redone if ever needed. No anatomy is actually dissected or removed so cutting the stitches will undo the wrap. Also, I will no longer be taking any acid blocking medication and the esophagus will finaly have a chance to heal and repair the damaged tissue.
I don't really know if what impact this will have on halitosis. Besides traditional GERD, I have what I believe to be LPR and I have read a couple of fundoplication threads on another forum where people have been completely cured of throat mucus, sinus infections, mouth ulcers, acid taste and other reflux related symptoms. However, I have also read threads where this surgery had little to know impact on LPR symptoms but did relieve traditional GERD symptoms.
I hope that I will see some improvement in the quality of my breath. This whole thing started years ago with an acid taste in my mouth and a very dry throat. It arrived after a night of very violent vomiting due to food poisining. My breath had a meat smell to it and would smell like whatever I just ate hours before. It could be that the hernia formed due to the vomiting but who knows. The halitosis has evolved over the years to include tonsil stones, constant mucus and fecal breath. I believe the mucus is responsible for the increase in the severity of the halitosis and the formation of the stones. I also believe that the mucus has occured because the body is trying to protect itself from the reflux material coming up the throat and the sinus tissue is inflammed for the same reason.
I just want to say here that I am not getting this done to cure halitosis. In my case this surgery has been recomended by three seperate doctors and I have been putting it off for years. The surgery is to fix the reflux and help mitigate the chances of getting esophageal cancer from Barret's. Do I hope the halitosis magically dissappears? yes!!! Am I optimistic that it will? No. I do expect that it will improve though but if it doesn't, at least I can rule out reflux as a cause.
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- Master
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- Master
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Sinus CT Scan - All Clear - Check
Dentist Examination - "Gums very good" - Check
Endoscopy - Check - H Pylori Negative
Post nasal space cyst removed - Check
Wisdom Teeth Extraction - Check
Mouth Swab Clear - Check
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- Master
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Not sure what to make of all this untill I attempt to eat something so I will update then.
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- Master
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- Master
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- Joined: Sun Feb 28, 2010 4:44 am
I have not had any episodes of reflux or throat burning so I believe the surgery is working.
Oddly enough, I am still able to muster an occasional burp but it comes from the upper throat and not the stomach. The wrap needs to heal and I need to start eating solid foods before getting a true sense of what progress has been made with regards to GERD and halitosis.
Can you pls post or PM me a link to the thread? Because I also have LPR and I'm interested in this.NOTANYMORE wrote:Surgery is scheduled for first week in May. I was seriously thinking of backing out but today I ate a candy bar (which I don't usualy do) only to burp it all up in a pool of chocolatey vomit. I take that as my bodies way of telling me to take the chance.
Also, congrats on your surgery! I hope this will be your cure.
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- Master
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I will post another update when I am completely off the pain meds.
i do wonder if certain allergies are to blame for PND and maybe the PND magnifies stink in some cases or carries the bacteria?
did you ever have nasal odor?
Sinus CT Scan - All Clear - Check
Dentist Examination - "Gums very good" - Check
Endoscopy - Check - H Pylori Negative
Post nasal space cyst removed - Check
Wisdom Teeth Extraction - Check
Mouth Swab Clear - Check
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- Master
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- Advanced
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