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Old 02-11-2006, 01:37 PM   #1
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Elga HB User
Nexium and problems breathing

Hello,
I did not want to hijack hanaroad's post my question is similar so I started a knew thread.

I had been taking Pariet (rabeprapole sodum, ppi) 20 mg 2 times a day as prescribed by my doctor for the past 5 months for LPR. It helped with some of my symptoms but I still had problems breathing normaly and a very sore throat and tongue.

I just came back for a gastro enterologist which switches my meds to Nexium 40mg 2 times a day. (schedualed me for tests also).

What surprised me is that just after taking them for one day my breathing has been improved a lot. I thought it could not be possible as my doctor told me that I would have to wait at least a month to see some effect.

Has anyone experienced such a fast recovery or should I think my breathing problems where not related.....thanks for answering

 
Old 02-12-2006, 07:12 AM   #2
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Re: Nexium and problems breathing

Elga,

My shortness of breath improved greatly in just one day of PPI therapy as well. Of course, it continued to improve at a slower rate with continued therapy, but I also had that immediate positive effect. Skylar

 
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Old 02-12-2006, 06:21 PM   #3
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Re: Nexium and problems breathing

I had been on Nexium 1x per day for about 4 months before being diagnosed specifically with LPR. I had no relief from the 40 mg per day. The day I was diagnosed with LPR, my ENT told me to simply go up to 2 pills per day (80 mg). I stopped coughing 20 minutes after I took my first double dose. I can't tell you what disbelief I had when the ENT told me I my problems would go away with the higher dose. I thought she was nuts, but she was 100% right, god bless her. I still have to be careful with what I eat and drink, but now it's about 3 1/2 years later, and I'm still doing well. One of my best friends began having sympoms of LPR this year (she's also 32) and after 6 weeks of her not feeling well, and finally being able to define her sympoms, I gave her 2 of my nexium. She took them, and stopped coughing after 20 minutes. She went to the ENT the next day for a scope and he confirmed massive redness around the larynx. Thank goodness my friend didn't have to suffer longer than the 6 weeks. I know all too well what this disease can do to one's head and soul.

 
Old 02-12-2006, 10:55 PM   #4
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hanaroad HB User
Re: Nexium and problems breathing

Quote:
Originally Posted by aswander
I know all too well what this disease can do to one's head and soul.
I can't tell you how much I relate to the above. I have been suffering for years to the point of utter desperation (and depression). As I read the replies to my "I'm new here post" I began to have even more hope.

I've just "googled" LPR as I had no idea what it was. I believe that could be exactly what I have and with the breakthrough I seem to have had just by simply taking 2 prilosec OTC a day instead of 1, I'm wondering what might happen if I went to 2 nexiums?

Anyway, I guess I should go back to see a doc, though after years of seeing many DRs, everything from MDs to naturopaths, I had lost hope that they could be of any help. And, after years of seraching and researching on my own for a cause or solution as to why I can't breathe, why I have this awful taste in my mouth all the time, constant post-nansl drip, etc... I think, thank God in heaven, that I may be on to something here. I never really felt like I had classic "heartburn" symptoms but as I read about this "LPR" thing, those symptoms seem to be right on the money.

So, can anyone here recommend what type of Dr would be of the most help at this point? An ENT? A gastro?

Thanks for your help.

Steve in Seattle
(wishing I was on the road to Hana)

 
Old 02-13-2006, 07:19 PM   #5
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aswander HB Useraswander HB User
Re: Nexium and problems breathing

Steve,

An ENT can confirm LPR by scoping you. Though it sounds uncomfortable, it really isn't that bad - and I have it done 2x a year. He will first numb your nose and airways with a spray. Then he inserts a wire with a miniature camera attached to one end up your nose and down your throat. I know this sounds awful - but with the numbing spray it really isn't that bad - just a little weird! He will be able to view your larynx and throat on a TV monitor. Typically, a red and swollen larynx is confirmation of LPR - it indicates that the acid has gotten beyond your esophagous, all the way into your throat.

You can also go to a gastro, but they usually don't have the camera on a wire equipment, and strangely enough, many aren't familiar with LPR. Gastros also like to perform endoscopies, which are procedures where you are knocked out (usually in a hospital), and they scope you, but lower (in the esophagous) and take biopsies to check for cell damage caused by acid. (They are looking for Barrett's esophagous and cancer). It's an outpatient procedure, with no recovery time - once you wake up, you should be good to go. If you do have LPR (you will know if you respond to PPI treatment), you might want to schedule an endoscopy with a gastro if you have had the condition for a long time and are concerned about esophageal damage. But I'd start with the ENT.

If you are going to a local ENT, even the ENT may not be familiar with LPR, as many aren't. Most ENTs are able to recognize that a reddened and swollen larynx is likely the result of acid reflux, but what they often don't know is that the protocol for treating LPR is a little different from GERD - the 2 PPIs per day for LPR vs the 1 PPI per day for GERD. Sometimes, it's good to educate your doctor. The Official Journal of the American Academy of Physician Assistants published a nice article , "Lyngopharyngeal reflux—It’s not GERD" some time ago, which is very helpful and was given to me by my own doctor when I was diagnosed.

You asked about taking Prilosec vs. Nexium. Everybody responds differently, but there does seem to be some consensus on this board that Nexium may be the most effective PPI for LPR, and unfortunately, the most expensive and the least likely to be covered by insurance - unless you have good insurance. But I personally have tried Protonix, Prilosec, Prevacid and Nexium, and only Nexium worked for me. Luckily, it worked great! My symptoms went away in 20 minutes. I did switch to Prilosec for 3 months when it went OTC, and my symptoms began coming back very badly. So I tried 2 Prilosec a day, then 4, then 6, and eventually I was taking 8 Prilosec a day (for about a week) and then gave up and went back to Nexium. As soon as I restarted the Nexium, my symptoms promptly cleared up. I never tried Aciphex though - and a lot of people on this board take it. I'm not tempted, as I have good insurance and a great response with Nexium.

In the meantime, the quickest way to see if you have LPR, is to ask your Primary Care Physician for a couple of day's worth of Nexium samples. Take 2 per day, and see if you respond to it. Just remember - doing it that way might interfere with the ENT scope, if your larynx begins recovering. I think it still takes a few weeks for most of the redness and swelling to go away.

 
Old 02-13-2006, 09:42 PM   #6
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hanaroad HB User
Re: Nexium and problems breathing

Thanks for the reply aswander. I was thinking the same thing in regards to going to my primary and just trying the double dose of nexium. I'm a little reluctant as he was skeptical a few years ago when I first brought up the possible GERD connection to my shortness of breath. He did prescribe the nexium though and also, perhaps he's more educated now on the issue.

You've probably already covered this but, do you take both nexium at the same time, in the morning for example, or twice daily?

Thanks for your responses and advice.

Steve

 
Old 02-14-2006, 04:36 PM   #7
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aswander HB Useraswander HB User
Re: Nexium and problems breathing

Hi Steve,

Yes, I take my Nexium together in the morning. This is clearly an area of debate on this board - but I say that you should just experiment until you find what works for you. I have also tried splitting them up, which did not work well for me. It was my doctor, and ENT who sees LPR every day, who told me to take them together, and I think she was right.

The only downside is that Nexium only lasts about 17 hours. But 10 PM or so, I'm beginning to cough a little again. I usually stop coughing if I lie down, but I suspect I really need another 2 Nexiums at bedtime, which my insurance won't pay for (as they already pay for 2 nexiums a day). Instead, if the coughing is bad, I take 2 Ranititide at bedtime, a total of 300 mg. Ranitidine is the same medications that's in Tagamet and Xantac, sold OTC. Ranitidine is just the pharmaceutical generic equivalent. When I take it, it usually helps a little bit. My father-in-law has chronic GERD, and when Nexium gave him dry mouth, his doctor switched him to a 300 mg dose of Ranitidine every day, and that's helped him extremely well with no side effects.

 
Old 02-14-2006, 08:33 PM   #8
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Re: Nexium and problems breathing

Thanks aswander. Unfortunately, my insurance won't cover nexium. I have good insurance but I've opted for a very high deductible the last couple of years due to rising premiums (I pay for it) and any presrciptions are out of pocket for me at this point.

None the less, if nexium can bring an end to this long frustrating journey, it will be well worth it. I'll just have to work a little harder (hopefully without increased stress ). I'll let you know how it turns out. Thanks again for your time and advice.

Steve

 
Old 02-15-2006, 05:07 AM   #9
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aswander HB Useraswander HB User
Re: Nexium and problems breathing

Steve,

If you pay out of pocket in the U.S., Nexium (via your average drugstore, for ex) costs $719.95 for 180 40 mg pills. You'd be taking 60 a month, so that's 3 months worth, for about $240 a month. Could be worse.

Via Canadian online pharmacies, you can get 84 40mg pills for $220. It's a little bit of a savings - and it is legal to buy from Canada still, I believe. I know you can go to Canada and bring back about 6 months worth of drugs for your own personal use.

Another option, which I don't know as much about, is that a generic form of Nexium is available in Canada and also sold in some of the onlie pharmacies. The generic is called Esomeprazole Magnesium Trihydrate, and is made by Sun Pharma. 100 40mg pills costs about $158.

I've never tried the generics before, but I'd be tempted if my insurance changed.

 
Old 02-15-2006, 06:21 AM   #10
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ADGrant HB User
Re: Nexium and problems breathing

Quote:
Originally Posted by hanaroad
Thanks aswander. Unfortunately, my insurance won't cover nexium. I have good insurance but I've opted for a very high deductible the last couple of years due to rising premiums (I pay for it) and any presrciptions are out of pocket for me at this point.

None the less, if nexium can bring an end to this long frustrating journey, it will be well worth it. I'll just have to work a little harder (hopefully without increased stress ). I'll let you know how it turns out. Thanks again for your time and advice.

Steve
Is two Prilosec OTCs a day not working for you? They would cost around $40 a month.

 
Old 02-15-2006, 08:39 AM   #11
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hanaroad HB User
Re: Nexium and problems breathing

Quote:
Originally Posted by ADGrant
Is two Prilosec OTCs a day not working for you? They would cost around $40 a month.
AD, see my recent post, "I'm new-here's my story". Yes, the 2 prilosec OTCs greatly improved my shortness of breath, almost immediately. I started taking them about 10 days ago. The last few days have not been as good, though I've been under a lot of stress at work so that may be the issue of course.

While my shortness of breath has seen dramatic improvment, I still have the awful bitter taste in my mouth, post nasal, some soreness and low voice endurance. Yesterday I decided to try 4 prilosecs 2 x daily. I've decided to try that for a while to see how things go. From what I've now read about LPR, apparently it takes 3-6 months of treatment for things to heal up.

Before I came to this board I had never heard of LPR but now after reading info on the web and info here, I'm all but convinced this is the problem. That's what is leading my desire to try the double dose of Nexium as it sounds like its the "cadilac drug" to treat this condition. But with the costs so high, I'm not sure I can afford it, partcularily if I'm on it long term.

Soooo, I think I'll try the prilosec route for now and then perhaps try the generic nexium that Aswnader has mentioned here if that does not seem to be relieving the other symptoms.

Thanks again for all you replies.

Steve

 
Old 02-15-2006, 09:46 AM   #12
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ADGrant HB User
Re: Nexium and problems breathing

Quote:
Originally Posted by hanaroad
AD, see my recent post, "I'm new-here's my story". Yes, the 2 prilosec OTCs greatly improved my shortness of breath, almost immediately. I started taking them about 10 days ago. The last few days have not been as good, though I've been under a lot of stress at work so that may be the issue of course.

While my shortness of breath has seen dramatic improvment, I still have the awful bitter taste in my mouth, post nasal, some soreness and low voice endurance. Yesterday I decided to try 4 prilosecs 2 x daily. I've decided to try that for a while to see how things go. From what I've now read about LPR, apparently it takes 3-6 months of treatment for things to heal up.
Make sure you time your doses correctly. PPIs need active acid production in order to work correctly. You need to give them some time to work too of course. You should also try all the "lifestyle" stuff (basically bland food and water, loose clothes, raise the bed etc).

 
Old 02-16-2006, 08:37 AM   #13
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Elga HB User
Re: Nexium and problems breathing

Thanks for all the responses and differents infos.

I just came back from my family doctor and told him about the gastro dr. that switch my pariet 20mg twice a day to Nexium 40 mg twice a day. What surprised me is that he said it was the same dosage, that a Pariet 20 mg equals a Nexium 40mg. So in reality I was not taking a higher dosage, I was just take a different med. He also said that Nexium was the best med available for GERD or LPR

Finally, I'm still surprised with my one day recovery for the breath problems. The other problems are not solved. The burning tongue, the soare throat, the burning oesophageus (sorry for my spelling). I hope they eventually do.

My doctor also schedualed me to see a ¨pneumologis¨just in case because he and the gastro doctor don't seem to think the breathing problems are from GERD LPR...

 
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