I have been suffering from GERD for about 15 years. I have had 2 unsuccessful laparoscopic surgeries to repair my hiatal hernia and no valve from my esophagus into my stomach. I have been on every medication for this problem and finally when Nexium came out, that worked, but I had to take 3 a day. I am down to 2 a day now, and my reflux is coming back no matter what I eat. My insurance company wants me on a less expensive med but they don't work at all for me and every year I have to fight to get the Nexium. My dilemma is whether to have another surgery - different surgeon - and see if that works. I am 66 and don't want to have to worry about this as I age. Any suggestions?