I saw the doctor today, and now have a diagnosis: my stomach doesn't empty properly. The doctor thinks I had an infection at some point and that led to this problem, technically called gastroparesis. It usually hits diabetics and some cancer patients, but there is a tiny percentage of people who get it following an infection, including, apparently, me.
I'm on a new drug to treat it, Reglan. The list of side effects (including dizziness, drowsiness, depression, suicidal ideation) is scary -- obviously I will have to pay attention to these things. If the dizzy/drowsy thing happens, I simply can't take it, because, you know, I have a life and it's not as if I can just give up driving.
Reglan, or metoclopramide, crosses the blood-brain barrier which is why it can cause these screwy side-effects. There's a drug available in Canada, Domperidone, that has much the same effect, but doesn't cross the barrier, and so has far fewer side effects. The only problem is, the FDA hasn't approved it -- and my g/e doc has no idea why they haven't. Apparently it's not difficult to get, though.
DH is highly skeptical that this is going to work: Oh, so you'll just go on this medication for 3 months and then you'll be fine? Right. I can see his point. I'm also concerned about the side effects, always thinking about that cost-v-benefit equation. How much is this really going to help to stop my acid reflux? The doctor suspects some muscle weakness in the ring muscle at the top of my stomach, but it's a chicken/egg situation: the slow emptying is stressing the ring muscle, so if the emptying improves, maybe the muscle can get better and that will help, too.
Possibly the worst thing about this new drug is that I'm supposed to take it 30 minutes before I eat, 3 times a day. I do not eat on anything even remotely like a schedule, and now I'm supposed to figure out when I'm eating, subtract 30 minutes from that, and remember to take this stuff? Breakfast and supper shouldn't be too difficult, but lunch is always going to be a problem. At least it doesn't interfere with any other medications or supplements (at least not the ones I'm taking.)
In the meantime, I've got two different acid-blockers to try out as well. This is going to take a little while to figure out. I took one at dinner and felt a little spacy, but I had been feeling exhausted all day. Am I just tired, or is it the new meds? We'll see what happens tomorrow.