PPI Stepdown pt 2.5

I went out yesterday and got some things to try for the ongoing PPI stepdown. I picked up:
– aloe juice
– more probiotics (I’ve added these to my daily supplements.)
– alkaline water
– Gaia Gas and Bloating tea with similar herbs as Ibrogast (caraway, fennel, chamomile, star anise, licorice, peppermint)
– Target brand Pepcid Complete (calcium, magnesium and 10mg famotidine)

The Lil Tummy was pretty well behaved yesterday, but I got a little GERD-y in the late afternoon, so I took a Pepcid chew. Worked immediately and I felt fine. I did not drink any wine last night to get a good read on what Lil Tummy was up to. You’re not supposed to drink alcohol with oral famotidine, but there are not as many restrictions for the antacid/famotidine chews. I took another one before bed, since I’d had two nights in a row of horrible GERD.

IT WORKED!!

I slept well and had zero GERD all night. I hope that this will continue to work for me. I’d like to NOT take it daily in any case, because famotidine has its own list of fucking side effects and interactions that I’d like to avoid. But it’s a good start at living a GERD free existence. Even if I have it sometimes, I really don’t want to take any drugs daily other than my supplements.

Here’s to hoping that I’ll be drug free SOON!

PPI Stepdown pt 2

OMG. Terrible. I’ve been taking only one half a 20mg esomeprazole at bedtime for a week. Now I have breakthrough GERD randomly all day. For the last two nights, a couple of hours after I go to bed, I’m awakened by my stomach trying to crawl out my throat. I feel strangled and have a coughing fit. This is GERD at its worst. I have to go sit up on the sofa and eat TUMS until it stops, which is usually an hour or so.

I’ve got ranitidine and famotidine (these are H2 blockers) on hand and I’m heading to CVS and Sprouts for a variety of other products to try. Eating a handful of TUMS just ain’t cutting it.

My ability to eat has also been compromised. I can eat about 1/3 less than before I dropped the PPI. While annoying to get the foamies (what we call it when our VSG tummies get too full), I do need to lose about 10#, so THAT I’ll tolerate. I’m back to about 1/2-2/3 cup capacity with this GERD irritation. I got the foamies and was pretty sick after eating a small couscous stuffed pepper last night, so I’ll have to be very careful.

But basically, I am miserable 24 hrs a day right now. As I knew would happen w/out PPIs. ::sob::

I’ve added probiotics to my supplement regimen and I’m looking for something called Iberogast (STW-5) liquid to try as well. (Amazon is pricey, I’ll check Sprouts.) I am aware of aloe juice and will get some.

I hope I can live through this and Lil Tummy will self regulate. If nothing works, I’ll be forced to go back on PPIs. I can’t live like this indefinitely – I *do* need to sleep and eat!

Despite all this bullshit, I’m still hopeful I can get off PPIs. I really think if Lil Tummy has time to adjust, it’ll be OK. I’ve never in my life had any sort of stomach issue, so I hope I can get that back. I’ll post more as I implement various things.

PPI Stepdown

I’ve been on PPIs (Nexium, esomeprazole) since my VSG surgery in 2016. My four year anniversary is coming up and I really don’t want to continue on PPIs. They are prescribed liberally and people are on them for YEARS, just like me, but now we’re starting to see some of the longterm problems of taking a PPI (Proton Pump Inhibitor) such as H Pylori, malabsorption of minerals and even kidney damage. This article is a good round up of all that PPIs can damage. You can’t just stop taking a PPI because of rebound GERD that is worse than the original. The proton pumps (digestive acid) go into overdrive without the inhibitor – which is what’s happened the last two times I attempted to get off PPIs.

I’ve been having more and more issues with the PPI in the last year. I started having intense histamine reactions to random foods a few months ago, so I found a histamine blocker (Seeking Health Histamine Block is AWESOME!) that worked. I had to take it daily to keep the reactions from happening. When I researched it, guess what was the culprit? Yep. PPI.

Next, I started having leg cramps. I know that PPIs retard mineral absorption, and after some research, I confirmed that the PPI was likely interfering with potassium as well as calcium and magnesium. So I got a potassium supplement.

THEN, I realised that the list of things I was taking to OFFSET the damn PPI was getting longer and longer. It made no sense to keep adding more and more supplements to offset a drug that has known issues for long term use.

So, I began my step down from 1.5 tablets a day (1 20mg in the morning and a half tab before bed; 30mg/day) about six weeks ago. First I moved the time I took the single pill to evenings so it would peak while I am asleep. Breakthrough GERD is worse at night when you’re laying down. I dropped the second dose entirely. This worked pretty well, there were random bouts of GERD at random times, but it was OK for the most part.

Last week, I changed to half a tab at 9pm ONLY. So far, so good. I still have random bouts of GERD that have no pattern. I can chew a few TUMS to tame them down. I have a bed wedge, which has helped with the occasional night time breakthrough GERD. But it’s the same as the one dose was, so I’m encouraged.

I’ll stick with the half tab for a few more weeks, then I’ll attempt ZERO PPI. It’ll work or it won’t. I’m hopeful that it will work and I can get by with random bouts of GERD that can be handled with TUMS. Or perhaps I can go back to an H2 blocker (Tagamet, etc.) at night if necessary. The H2s have far fewer side effects than the PPIs.

I hope I can be rid of PPIs once and for all. They are TERRIBLE for you.

I will post again with the results of the end of PPIs.

Almost Four Years!

Esomeprazole image courtesy Shutterstock.

It’s been almost four years since my VSG surgery. It feels like a lifetime ago. Lots of crap has happened since then: my car died, so I got a new car, Nick’s job ended, pub project failed, and now we are recovering.

I’ve been taking Nexium (esomeprazole) daily since my VSG surgery in May 2016. After the healing period, I discovered that I had HORRIBLE GERD if I didn’t take some sort of PPI. They had me on Prilosec (omeprazole) after surgery, but it was giving me the absolute worst side effects, so I knew I couldn’t keep taking it. I tried H2 blockers (Tagamet, etc.), but they didn’t work well for me. So I ended up on esomeprazole, twice a day, a full 20mg tablet in the morning and a half tab before bed. I have been doing this for almost four years.

While I have zero GERD while on this PPI, I have a multitude of other issues to deal with. The only physical side effect I’ve had from the get-go is diarrhea. However, PPIs affect absorption of vitamins and minerals, not to mention that they are seeing kidney damage start to crop up with people who have been on it for years. The nature of how a PPI works prohibits the absorption of calcium in particular, but it basically messes up absorption of everything.

I’ve been taking supplements to try to offset the affects of esomeprazole. I’ve been taking these things for four years:
– a good quality multivitamin
– calcium/magnesium supplement
– Vit D + K supplement
– Vit B supplement
– selenium
– CoQ10

Things have been mostly fine until recently. I suddenly started having histamine reactions. They were sparse at first, but have become an almost daily occurrence. So I started taking a histamine blocker (actually a DAO supplement) to get these reactions under control. I also started having leg cramps regularly, so I added potassium to my supplements. These extra supplements helped, but…

THEN I started to realise that ALL THESE THINGS are side effects of the PPI. I did some research and sure enough, the PPI can alter the digestion of histamines, therefore causing these reactions. I already knew about the prevention of minerals being absorbed. So I decided that what needs to happen is getting off these terrible PPIs and therefore not having all these side effects. NOT TO MENTION the other things that are happening to me long term, that I’m not even aware of, such as kidney damage and gods know what. Pubmed abstract on kidney damage. An often reposted paper by Dr Al Aly of the VA St Louis.

So, last week, I began my attempt to get off the PPI. I dropped the night time dose and moved my whole tablet dose to 5pm. By moving the whole tablet dose, the meds peak during the night and wear off in the late afternoon, when I am upright and less susceptible to heartburn. So far, so good. I’ve had some issues with break through heartburn late in the day, but nothing too terrible.

In my attempts to get off the PPI in the past, I think I’ve moved too fast. This time I’m going to stay at this dose for a month, then try knocking it down to a half pill only at night for a month, then off. I think (hope!) the key to getting off a PPI with little rebound GERD is going slowly to wean off. I hope my altered stomach can figure it out and allow me to get back to normal. ::fingers crossed::

The thing about PPIs is that the amount of the dose is irrelevant as far as absorption goes. Taking 20mg or 60mg still blocks absorption of nutrients due to the lack of digestive acids which are needed to break down foods. So I MUST be off them completely. EVERYONE should be off them, really. Doctors do not know or care to tell patients that long term PPI use is VERY bad for them. It’s easier to prescribe a PPI and be done with it. I know, as a PPI user, that yes, they do work to keep GERD at bay, but at what cost?? I really wish Drs would STOP prescribing shit to people to fix a symptom without even a thought about long term issues! Statins are another drug that is prescribed liberally without one whit of concern about the LONG LIST of interactions they have.

I’ll post here again when I step down to a half pill at night. I hope I can get off the PPI for good and I hope these posts can help others get off them, too. PPIs are not a long term solution, despite Drs prescribing them that way. Take control of your health! Research every drug you are prescribed! I guarantee you that your Dr has NOT. I hope I’ll have good news in a couple of months!

VSG Anniversary coming up!

On May 16, it will be two years since my Vertical Sleeve Gastrectomy in Mexico. I’ve not posted here or at YouTube in quite some time, simply because I am very stable and not much has changed. I hit a hard plateau at 180 pounds which translates to size 12 jeans (actually like a half size below that) and 12-14 dress. I’m fine with that. Without surgery, I’ll never get rid of the belly flab, and I’ve decided against tummy tuck surgery. It is HORRIBLE to recover from and I just don’t have time for that shit. Or the money, honestly. And there are things like Spanx to deal with it!!

In addition to that, Nick’s 45th birfday is May 10. It’s a Thursday, so I’m not sure what we’ll do.

And, of course, we’ve got the pub thing ongoing. I’ve been working on the menu, trying not to FREAK OUT that there is no real estate available.

And on top of all this, my friend Kenny dropped dead of a heart attack on Friday April 13, so that has been rough. Friday 13 has always been a good day for me, but now, not so much. Sigh. He was my age, too. He had untreated heart issues and literally dropped dead. At least he didn’t suffer. The memorial was yesterday and of course: it sucked. His wife Carole has stage 4 ovarian cancer, so it’s all just really terrible. Sigh.

So, as you can see, the VSG anniversary is not very important to me with all this other stuff going on. I’m still grateful I did it and I still feel FABULOUS, and I still recommend it if you’ve been struggling with your weight your whole life like I did. It is absolutely worth it. Save yourself the agony of US healthcare and just go to Mexico. You, too, can have a new life in 4 days and $5000. Fuck your insurance company and their bullshit “plan” that forces you through hoops for a year then offers you no follow up care. Just DO IT.

I think I will lose that last 10# when I am crazy busy with the pub. I did lose 5# when I was working 7 days a week there for a month. But whatever, I’m not dieting and I’m not getting plastic surgery, so it is what it is. I’m happy with the way I look in clothes, so it’s all good. :)

I’d like to wish Nick a Happy Birfday in advance and myself a happy VSG anniversary!