When I’m not learning new origami folds or getting caught in a stupor over why my toenails are so long my days have a steady routine:
- Get up and take a walk for a half hour
- Eat breakfast
- Work for about 3-4 hours, mostly on administrative stuff
- Eat lunch and take another walk
- Make a list of what I want to get done for the next day and stew over it for 20 minutes or so
- Devote my last block of the day towards whatever’s salient at the time.
- Eat dinner/work out/call friends and family
- Read or work on something nerdy. (Just ordered this on Amazon…….HOT).
On January 13th I rolled out of bed in my blue Adidas soccer shorts, bare chested and picking the sleep dust out of my eye, with nothing that’d suggest the day was going to be any different.
Little did I know the esophagus gods had something different in mind.
When I got to step 4 in my daily routine I hurried over to Green Zebra grocery to pick up some tofu stir fry and mindlessly gnoshed it down while I pored over the morning’s details in my head.
15 minutes after my meal a marble sized pocket of gas started making its way up my throat, turning my mouth into an exhaust pipe of General Tso’s flavored hot air.
I didn’t think much of it……..until it happened again. This time with a little more burn and intensity. I shrugged this gastrointestinal moment off too, thinking it couldn’t be THAT serious.
Until it happened again. More intense.
By now a half hour or so had passed and it hurt to swallow and my trachea felt like it had a cooling fan at the bottom of it, blowing hydrochloric acid through it and into my mouth.
After futilely downing a handful of digestive enzymes in the bathroom of Fred Meijer’s, I made my way over to GoHealth to see if they had something more powerful to make the pain go away.
Me: I need to get help with my throat……it’s not working. I think it’s acid reflux.
Nurse Guy: Sure. Just fill this form out and I’ll be right with you.
Me: I’m not sure how much longer I can go on like this. If you could make this as quick as possible, that’d be great.
Nurse Guy: Okay, I’m going to need you to take this. It’s a GI Tonic, it’ll numb your throat and quench the inflammation that’s going on inside your stomach now.
Me: God, it hurts to swallow.
Nurse Guy: Just kill it. The more you wait the worse it’ll get.
Me: I feel like this is going to kill me. Wish me luck.
I start cocking my head back and groaning loudly, with my eyes rolling back into my skull. A little pool of saliva is forming in my mouth from the lack of swallowing.
My stomach tightens.
The lymph nodes start to swell. Bigger. And bigger. Until finally…….
I look down on the floor and can see my face in the reflection of the undigested tofu that just came back up. I feel better.
Doctor: Yeah, so I think you might have something a little worse than acid reflux. I’m going to send you to the ER at Emmanuel.
Me: Sure. If you think that’ll make this stop then whatever you say.
Fun Times In The Emergency Room
I’ve never been to the emergency room to get help for myself before.
My impression of them is probably heavily influenced by shows like Grey’s Anatomy or ER, since I figured it was a place where really good looking people valiantly slay dragons and resuscitate people from the brink of death.
I was a bit letdown when I realized the place I was in reminded me more of the DMV than anything I’d seen on TV. Lots of cranky people idly waiting in line, with frumpy bureaucrats at the front desk telling you what you can’t do.
After getting checked in I’m excused to the waiting room, given a barf bag, and told it’ll be approximately 3-4 hours.
My limbs are going numb from the pain in my stomach, HOW ON EARTH CAN I WAIT THAT LONG?!
By now I’m going on almost 90 minutes of scorching pain at the bottom of my throat and have spit up almost a quart of saliva since my head spins every time I swallow. It doesn’t help my mood that many of the people here apparently use the emergency room as their daycare center whenever they get a tummy ache.
I had a mild sense of disbelief when I was lying in my corner with my barf bag, moaning with slurred speech to numb the pain in my throat……..and here are these little Nancies showing up because they have a fever that was making them feel a little weak.
CRY ME A RIVER!
I guess that’s the difference between having a Cadillac plan and a Health Savings account.
I stand up and walk around with my barf bag, letting the spittle that’s gathering in my mouth occasionally siphon off into it so it doesn’t spill over. I’m careful not to make too strong of a spitting motion so I don’t aggravate the muscles in the back of my mouth.
After an hour passes my stomach has finally had enough and force vomits some more of its contents out to see if that’ll help. I feel better for about 5 minutes, until the acid creeps up, up, up, starting the cycle over again.
After another two hours of this I’m starting to feel weak from having to withstand the little acid bombs that are going off inside my stomach. It’s hard for me to stand and I have to lean against the wall to prop myself up.
I lurch over to the front desk to ask the receptionist how long it’ll be before I get to enter. 3 hours. My spot in line went from 5th to 8th. Apparently there were some people in ICU that had to get shuttled over because it was a busy night over there.
By now my stoic approach towards my throat was beginning to wane and I sulk over to a chair in the lobby, figuring it’d be best if I’m sitting down in the event of a collapse.
The Real Doctor I Needed To See
After I sit down, the lady sitting next to me is feeling chatty and starts up a conversation with me, even though I’m pretty sure I have the charisma of a radish by now.
Lady: Boy, I was feeling sorry for you over there. Are you going through acid reflux?
Me: Thanks, and yeah I think so.
Lady: I get ulcers very badly sometimes and there are some pills you can take for that you know.
Me: Oh yeah? What do you take?
Lady: It’s called Zantac. I carry them with me all the time in case my stomach flares up. Because when it does the pain is unbearable.
Me: Where do you get these?
Lady: Pretty much anywhere. You can buy them over the counter. In fact, I might have some in my purse. Let me check….
……oh, here they are!
Do you want to try one?
Me: You know, if this doesn’t work it’s really not going to sound very good when I tell people that I took an unmarked pill from a stranger that I met in the Emergency Room.
Lady: (Chuckling), oh I know! But trust me you’re fine sweetie. I think it might really help.
She hands me an unmarked blue pill:
Seriously questioning the wisdom of what I’m about to do, I march to the bathroom to get some water. I figure this can’t be any worse than waiting in the ER for another 3 hours.
I cross my fingers, throw my head back and swallow.
In 15 minutes I feel fine. It’s like nothing ever happened.
Me: Wow! I feel awesome!
Lady: Yeah, you sound a lot better! The color is coming back to your face too. I can tell already that you’re just about healed up.
Me: So what’s this stuff called again?
Lady: Zantac. You want some extra?
Me: Yeah sure, it can’t hurt.
She hands me a few more from her purse.
Me: You know, the Doctor at told me there’s no way I could’ve had heartburn, and it would’ve taken me at least 5 hours before I got to see someone in the ER. I think the person I was really meant to see was you. You’ve really been a blessing.
Lady: (Chuckles), oh anytime. I felt so sorry for you over there. I wasn’t sure if you were going to make it or not.
Me: (Thinking) — You know, I’m not even sure if it makes sense for me to be here any longer. I feel great and I don’t know if sitting here for another 3 hours would do any good.
Lady: They’ll probably just give you a Zantac.
Me: Yeah, that’s what I was thinking. I have a high deductible plan and will be paying with an HSA, so this’ll probably be paid for with cash.
Lady: Oh yeah, then I’d definitely go. You don’t want a $2,000 tablet of Zantac.
Me: No, I don’t think I do. There are much more amusing things I’d rather waste my money on.
I collect my jacket, thank my Good Samaritan again for her medical advice, and take a taxi back home.
The Follow Up Plan: What Next?
My Zantac pill was a life saver in the moment, but before I decided on a treatment plan for my heartburn I wanted to get a good picture of what was actually going on.
Will taking a Zantac regularly stop what’s causing my stomach from turning into an inferno in the first place, or is it merely a fire extinguisher?
Here’s what I found:
- Antacids are useful for quenching immediate pain, but depleting your stomach of its ability to produce acid can have dangerous long term consequences. All animals have acid in their stomach for a reason.
- The true root of the problem is the spout at the bottom of your esophagus. It’s supposed to stay shut. When it opens acid creeps in and you get heart burn. The prominence of the leaky spout in heartburn is indisputable.
- A leaky spout is exacerbated by increased intraabdominal pressure, which raises the chances stomach acid will get into your esophagus when the spout flops open.
- Increased intra-abdominal pressure is caused by bacterial overgrowth in the stomach.
- Bacterial overgrowth in the stomach is caused by a reduction in stomach acid, which allows the contents of your small intestine to spill into your tummy.
- Reduced stomach acid, at its root, is an inflammation issue.
- When you have heartburn the overall acidity of your stomach is not important because any acid will cause you intense pain since your esophagus is not equipped for an acidic environment. So heartburn isn’t really affected by having too much or too little acid in the moment.
The Way Forward
Part of the issue with heartburn is simply mechanical, which requires mechanical measures to fix. Sleep upright, keep your weight down, and get surgery if things get really bad.
Lifestyle interventions should focus on getting your stomach acid under control. Which coincidentally enough means increasing the acidity of your stomach, not decreasing it.
Luckily this is easy to fix.
I used the following supplement stack since my incident and haven’t had any issues since.
Here’s why this works:
Betaine HCL: The important part is the HCL, which stands for hydrochloric acid, which is the same acid that lines your stomach. Betaine HCL capsules are a simple and easy way to increase the acid content of your stomach. This is also why acetic acid is good for people with GERD. I take it in the morning, although the timing probably isn’t that important. Betaine is also helpful for the body, but not because it helps with heartburn. It’s a metabolite of glycine and is used in the methylation cycle. So taking Betaine HCL might have a side benefit of improved cognitive function.
Digestive Enzymes: When your stomach’s acidity is too high many of its enzymes won’t become active because they can only do so at low pH. Taking digestive enzymes will allow your food to be properly broken down in your stomach even if you don’t have an adequate pH to activate the enzymes necessary to digest your food. Take 30 minutes before eating and make sure it contains pepsin, an HCL activated enzyme that helps break down protein.
Licorice Root: Taking licorice root for heart burn is an old wive’s tale that happens to be true. Licorice is a powerful anti-bacterial and it helps scrub your stomach of the unwanted stuff. Helpful to take before a meal with your digestive enzymes.
I’ve been doing this for 49 days and so far so good.
Of course I have no way of knowing if my GERD non-occurrence is because of the stack or just because, but all of these are safe and have a solid foundation for why they’d work.
Take it for what it’s worth.
Now if you’ll excuse me……..I have a pot of red alarm chili stewing in the kitchen with my name on it.