My Battle With Silent Reflux

My name is Andy Manning.  I am a Baptist preacher in South Louisiana.  This is the story of my battle with silent reflux.

On November 16, 2017, at the age of 37, at woke up with shortness of breath.  I could breathe, but I felt like I wasn't getting enough air.  I felt like I needed to take a deep breath, but I couldn't.  We went to the emergency room, where the doctor took an x-ray of my chest and lungs.  She didn't see anything wrong with me, and suggested that I might be struggling with anxiety.  However, she did notice a spot on my lungs, so she sent me to have it checked out further.  But alas, those tests came back negative.  Still, the shortness of breath lingered.  It never subsided.  I went to my family doctor for help, who prescribed an inhaler for asthma, but it didn't help.  By this time I was getting more and more anxious, wondering what was wrong with me.  Was I dying?  Why couldn't the doctors figure out what was wrong with me?  Did I have cancer, or some other deadly disease?  When the inhaler did not work, the doctor put me on an antibiotic, but that didn't solve the problem, and I grew more worried.  By this time, I didn't realize it, but I was suffering from severe anxiety attacks.  I was already short of breath, but the anxiety was making it even harder to breathe, and to sleep, to sit still, and to concentrate at work.  That caused me to be even more anxious, as I was worried that I wouldn't be able to continue to work and provide for my family in such a state.

On December 23 we gathered with family at my parent's house for Christmas, but I was absolutely miserable.  I felt like I was suffocating.  Every breath took great effort.  Being inside with the heat on made me feel like I was smothering.  I knew I was breathing in, but it didn't feel like it.  It's like my body didn't feel like it was getting any air.  I couldn't sit still and relax.  So every ten minutes or so I had to go outside for a walk to get some cool, fresh air, but this only slightly helped.  The whole family was laughing, enjoying the food, playing games, and I was in the lowest place in my life physically and mentally.  Eventually we went home where I felt a little better, but along with my troubled breathing I was having trouble falling asleep.  As the anxiety and shortness of breath prevented me from sleeping, I grew even more anxious.  I have a wife and six children depending on me.  I have an entire church that needs me.  How could I hold down a job if I couldn't sleep at night?  The best thing for a sick body is rest, but I couldn't sleep.  I was too anxious and uncomfortable.

On Christmas Eve, we got together at my mother-in-law's house with my brother-in-law and his family.  But before they made it to town from Fort Worth, I was having intense chest pains.  Fearing that I might be having a heart attack, I called my registered nurse friend, who recommended that I go to the emergency room.  So, on Christmas Eve I spent the evening in the hospital.  I was glad to be there because I knew they were going to do a lot of tests and hopefully figure out what was wrong with me.  They checked my heart, my lungs, my appendix, but everything looked great.  There was nothing wrong with me, which was both encouraging and discouraging.  It was encouraging to know that I wasn't dying; and it was encouraging to rule some things out.  But it was discouraging because they didn't know why I felt like I was dying!  However, the doctor did suggest that I might have acid reflux, which can cause heartburn and the sensation of chest pains.  He prescribed some stomach medication -- proton pump inhibitors and H2 blockers -- and instructed me to stay away from spicy and acidic foods.  Not an easy thing to do, especially at Christmas time, but I felt so bad that I was willing to do anything.  

Over the next couple of days my symptoms continued, which led to anxiety attacks, making my breathing even worse, which intensified the anxiety attacks, which made my breathing worse, etc.

I tried to Google "shortness of breath," but that led nowhere because it led everywhere.  There were just too many possible reasons for shortness of breath for me to figure anything out.

Later in the week between Christmas and New Years Day, I was able to get in to see my family doctor again.  He didn't know what was causing my shortness of breath, but he did think I was suffering from anxiety attacks, which was the first time that idea entered my mind.  I never had an anxiety attack before.  I never struggled with anxiety.  But when I looked up the symptoms, it made sense.  He prescribed Zoloft and Xanax, different types of anxiety medications.  That was embarrassing because I didn't think devoted Christians should struggle with anxiety and depression, or need to rely upon these kinds of drugs to cope.  Zoloft was the long term strategy, but since it takes three to four weeks to kick in, Xanax was prescribed to help me calm down until them.  And it did.  I was finally able to relax and to sleep.  My breathing seemed to improve a little, but only because my anxiety was subsiding, not my throat getting better.

My doctor and I decided to try several different avenues, still trying to figure out what was causing my shortness of breath.  First, I was sent to a gastroenterologist (stomach doctor), who scheduled me for an esophageal acid monitoring procedure.  They put me to sleep, placed a monitor inside my esophagus, and had me wear a little receiver box on my waist for a few days to capture the information collected by the monitor.  The test monitored the acid in my esophagus.  When the test came back, it showed that I did have acid reflux, but it was not severe.  The doctor did however keep me on my stomach medication and wanted to keep seeing me.

Second, my family doctor sent me to get an ultrasound on my chest and throat area, since it felt like something inside of me was obstructing my air flow.  The ultra sound only discovered one thing, which was a spot on my thyroid.  Perhaps a nodule was pushing on trachea, affecting my breathing.  So, that sent me to the endocrinologist (thyroid doctor).  The endocrinologist did another ultrasound on my throat, and did not think it was obstructing my breathing.  However, he did do a biopsy to determine if the nodule was malignant.  After waiting a week for the results, the test came back indeterminate because they did not get collect enough cells in the biopsy.  So, I had to endure a second biopsy, but that test also came back indeterminate.  So, the endocrinologist decided not to do a third biopsy, but to just see me in a year to keep an eye on the nodule.  

A third route to determine the cause of my throat problems was to schedule me for a pulmonary function test.  This would determine if I had asthma.  For this test I had to get inside of a large machine and do a lot of blowing into a tube with all my might.  The test determined that it was possible that I might have a slight case of asthma, so I then needed to schedule an appointment with a pulmonologist (lung doctor).  This may sound horrible to asthmatics, but I was hoping that I had asthma so that we could then move on with the proper treatments and start feeling better.  The pulmonologist performed another pulmonary function test and determined that I probably did not have asthma.  Over the course of the next couple of months he prescribed different asthma medications, but when none of it helped me, he determined I no longer needed to see him.

A fourth route was to send me to a psychologist for "talk therapy," but after one visit I wasn't at all impressed.  By this time my anxiety was under control because of the Zoloft medication, but my throat and breathing were still bothering me the same.  It felt like there was something in my throat, obstructing my breathing.  Anxiety may have made my breathing worse, but I concluded that it was not the cause of my throat problems.  I didn't schedule any more visits with the counselor.  

Fifth, my doctor sent me to see the otolaryngologist (ear, nose, and throat doctor).  This doctor took one look at my throat and diagnosed me with Laryngopharyngeal reflux disease (LPR), also known as silent reflux.  It is a form of acid reflux, but it is called "silent" because the patient doesn't experience the typical heartburn, but instead is plagued with a plethora of throat problems.  After doing much research on my own, this finally made sense.  I had all the symptoms.  Breathing problems, sore throat, hoarseness, problems swallowing, the sensation of something being caught in the throat, etc.  So, the doctor kept me on the stomach medications, and recommended that I change my eating habits.  He also saw that I had a deviated septum, which makes it harder to breathe through the nose, and recommended surgery.  He re also recommended that I try speech therapy, as it was possible that I had been using my larynx (voice box) incorrectly, which could also cause hoarseness and other throat problems.  

I decided to have the septoplasty to correct my deviated septum.  At this point, I was so miserable with my breathing that I was willing to do anything that might give me some relief.  The evening after the surgery, my nose wouldn't stop bleeding, but was gushing blood.  So, my wife rushed me to the hospital where the doctor worked to stop the bleeding.  This was extremely painful since I had just endured surgery.  After spending the night in the hospital I was released.  Eventually my wounds healed, and having the septoplasty turned out to be a good decision.  It opened up my nasal passages and helped me to breathe easier.  However, my throat issues were still plaguing me.  

I started seeing a speech therapist on a regular basis, and they had me doing all kinds of speaking exercises during the week.  I usually did these during my commute to work so that no one else would have to listen to me.  But after a about a year of therapy, and no noticeable improvements, I decided to stop.

Ever since the ENT doctor diagnosed me with silent reflux, I made drastic lifestyle changes recommended by silent reflux experts.  I stopped leading worship in church, since I found that singing irritated my throat and made things worse.  I had to choose between preaching and singing, so I choose preaching and had to rely more upon others in the church for the singing.  Second, I bought a mattress wedge specifically designed for reflux.  It raises your upper body about six inches to help prevent acid from coming into your throat.  Many people suffer the worst from acid reflux during the night while lying down.  Third, I loosened my belt to decrease the pressure around my waist.  Fourth, I didn't lie down for three hours after eating.  Fifth, I changed my diet, cutting out acidic, spicy, and fatty foods, which is just about everything, and definitely everything good!  My diet was the same every day.  For breakfast, I ate oatmeal made with almond milk, steal cut oats, brown sugar, cinnamon, a banana, and a piece of cantaloupe or watermelon on the side (every other kind of fruit is too acidic).  For lunch and supper I ate a mixture of black beans, corn, and diced chicken breast seasoned with salt.  Fifth, I started drinking only alkaline water and nothing else -- no coffee, tea, sodas, juices, etc.  The hardest thing to give up was my morning coffee, but it really wasn't that hard because I was desperate to feel better.  Sixth, I changed my toothpaste to get away from mint, which is very acidic.  

It's been over four years since I started my battle with silent reflux, and while I'm not completely healed, I have come a long way.  There are many days when my throat barely gives me any problems.  I've noticed that the stricter I am with my diet, the better I feel.  Silent reflux is a chronic disease, which means there is no quick fix, and in fact may be something you have to battle with for the rest of your life.  The improvements in my throat and breathing have been sure, but very slow.  In fact, the progress is so slow that it can be hard to determine if you are improving.  But given enough time, improvement is noticeable.

Eventually I dropped the stomach medications because I didn't think they were helping, and I learned about the destructive long term side effects they can have on the body.  That is a decision I do not regret.  As for the anxiety medication (Zoloft and Xanax), I only took Xanax for the first few weeks until the Zoloft kicked in, and then I stopped taking it because I have read that it can be very addictive.  My goal with the Zoloft has been to get off of it when my silent reflux was completely healed, but I recently changed my mind.  As I said, I don't know if I will ever feel completely healed; silent reflux may be something I have to battle for the rest of my life.  But I don't want to be on Zoloft for the rest of my life.  So, this past Thursday I started the weaning process -- a four-week journey of slowing decreasing the medication until I'm completely off of it.  

It's been said that "what doesn't kill you makes you stronger."  That's certainly been the case as I've battled silent reflux.  

1. I learned about anxiety, and anxiety attacks, and anxiety medications.  I am much more understanding and sympathetic with people who battle with anxiety and depression and who take medication.  
2. I learned to rely upon others in ministry.  I used to lead worship and preach, and had a difficult time delegating the worship to others.  But when I could no longer sing, I was forced to share the load, and it has led to many people in the church stepping up, growing, and developing their talents and skills.  
3. I have much less confidence in the medical field.  There are some diseases that are very difficult to diagnose, and even more difficult to treat.  Sometimes the only solution is to change your lifestyle, and then progress can be extremely slow, if any.  
4. I learned a lot about my body.  Before all of this I didn't know the difference between an endocrinologist and an  otolaryngologist.  I didn't know the difference between breathing problems caused by asthma (trouble breathing out), and silent reflux (trouble breathing in).  I'm embarrassed to say that I didn't know the difference between my larynx, esophagus, and trachea.  
5. I learned a lot about the correct way to speak and sing through speech therapy.  
6. I learned why it is so important to never be without good health insurance.  In my entire life I never needed much healthcare until all of this happened.  
7. I also understand the idea of suicide better.  When I was at my lowest point, suffering from both anxiety attacks, sleeplessness, and breathing problems, I had suicidal thoughts for the first time in my life.  I never considered committing suicide, but for the first time I could understand why some people commit suicide.  When physical or emotional pain are so bad, and nothing helps, suicide can seem like the best way to find relief.  
8. I have much more sympathy for people with breathing issues, and for those with other kinds of chronic diseases.  In fact, I didn't know the definition of a chronic disease until all of this.  I better understand that there are many people who are suffering in misery, pain, and torment, with no relief in sight.  My heart breaks for these people.
9. Last but not least, I have become an expert on silent reflux.  It's all about lifestyle -- cutting acid, eating healthy, getting in shape, etc. 

If you think you may have silent reflux, I'd be happy share my experience and advice with you, so please don't hesitate to reach out to me.  Relief is possible.  Don't give up.