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Update and Gastroparesis Questions

by "Peter" <peter@[EMAIL PROTECTED] > Oct 31, 2007 at 06:05 PM

Howard,

I am still suffering like a dog and I am not having a good time with the
new 
gastro who found the ulcers and retained food when he scoped me, and 
therefore couldn't do my bravo placement.  On my three week revisit things

didn't go to good and he got pissy with me.  I am having a gastric
emptying 
test tomorrow because he is concerned about possible gastroparesis.  I
took 
reglan for 3 weeks after the EGD and it did nothing at all to help my 
burning, and he agreed to me stopping it since I was already getting
slight 
hand jitters.  I also told him I wanted to drop from nexium 40 mg BID to 
prilosec 20 mg BID since I thought the nexium was causing gas type pain 
between my shoulder blades and in my chest, and making my throat sore (as
I 
have re****ted previously).  The pain stopped between the shoulder blades
but 
I still burn like hell and I am screwed.

He also started alluding to the "psychosomatic corner" that Vanny just 
mentioned in another post, and that got me upset.  I told him my problems 
are pathological and everything was okay until the PPI's stopped working. 
Damn it I have been suffering since June.  He told me I was hyper (no 
kidding, I live in constant pain) and mentioned the old 
amitriptyline/nortriptyline crap and said he would only prescribe 25 mg at

bedtime, which is far below the usual dose of three times daily (since he 
was not my primary care doc).  I knew that wouldn't do anything since I
have 
taken them before, and they constipate me immediately, but I will try 
anything out of desperation, and agreed to the Rx.

The tricyclic anti-depressants (which are also have off label usage for 
various pain syndromes) are notorious for side effects and have 
anti-cholenergic type effects that constipate you and cause urine
retention. 
*But* yet he wanted me to get the gastric emptying scan since he suspects 
gastroparesis could be causing part of the problem.  I took one 
nortriptyline first night and immediately got constipated (my bowels have 
been fine).  IMO he should not have prescribed it since it is 
contraindicated for gastroparesis and could skew the test I am having 
tomorrow.  I haven't taken any more of the nortriptyline and may not take
it 
because he agreed to scope me at 8 weeks from the last EGD to check on the

ulcers, and if I take the nortriptyline it may cause food retention again.

I told him I thought the food retention he saw during the EGD may have
been 
caused by a valium I took the night before.

He also said he doesn't want to do the bravo now and I told him that is
why 
I went to him and I needed to verify acid reflux if I was to consider the 
surgery.  Now I am really depressed after going to Dr. Marohn at Johns 
Hopkins, and now this.  He said even if the Bravo did show acid reflux it 
wouldn't matter and he doesn't think I should have the surgery.  I don't 
understand or agree with his logic.  He is a young doctor (fellow****p in 
2003), but I believe he is hung up on the "old school" attitude you 
mentioned in regard to "people who don't do good on the pills don't do
good 
with the surgery".

Howard, this is so depressing and I can't get anyone to help me.  Let me
ask 
you a couple of questions.

If my gastric emptying scan shows delayed emptying, which is gastroparesis

(basically treated with reglan), and if the reglan doesn't help (which it 
didn't, and your not suppose to take it long term anyway even if it did 
help), then couldn't a lap nissen still stop the burning above the LES. 
How 
would gastroparesis cause heartburn or other types of burning in the 
esophagus, chest, throat, tongue, nose, face (which I have).  I know it's 
coming from my stomach either acidic or basic or both.  It is really
messing 
up my lungs and my mucous and coughing are increasing.

You told me once before you didn't know the vehicle for abnormal
esophageal 
motility (which I also have) causing burning pain.  Could you try to
explain 
how gastroparesis can cause burning types of pain.

 Thanks Howard...Pete
 




 2 Posts in Topic:
Update and Gastroparesis Questions
"Peter" <pet  2007-10-31 18:05:56 
Re: Update and Gastroparesis Questions
"Howard McCollister&  2007-11-01 06:11:02 

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tan12V112 Fri Nov 21 15:40:02 CST 2008.