Seriously consider acid reflux. Chest pain, pain radiating down an arm, and joint pain are all symptoms. Not all acid reflux is expressed as heartburn.
The medication for acid reflux is very safe, and using it works as an indirect diagnosis of the problem. If the medication works, you know she has reflux, if it doesn't, it's somehing else.
There are 4 prescription PPIs (proton-pump inhibitors) available. The smallest unit of acid is a bare Hydrogen proton. By partially inhibiting the production of these protons/ions, you reduce the concentration of acid in the stomach and the throat. The 4 prescription PPIs are Nexium, Aciphex, Prevacid, and Protonix. Nexium is the "latest and greatest" and most people with severe reflex at the GERD board are on Nexium or Aciphex.
Most doctors will prescribe 1 pill a day but most don't know that severe reflux requires 2 doses a day. The best way to begin reflux therapy is to start at the 2 pills a day dose because you want to get it under control ASAP. Some people get some nausea/lethargy with PPIs so discontinue them if it's significant. (I've been on 2 Nexium a day for 3.5 years with no problems at all). Nexium is metabolized the best by most patients.
If the 2 Nexium provide noticeable relief within 1 week, keep going with the 2 doses until relief plateaus. Then switch down to 1 pill a day and see if that works for maintenance.
Looking for some advice.
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