GERD - and it isn’t about comforting Aunt Geordie coming for a visit. By Celeste Cooper

Boy, what a day to revisit GERD, right? The day after Thanksgiving can translate into "need to know" for those who suffer from Gastro-Esophageal-Reflux-Disease. 

What is GERD?

Gastroesophageal reflux (GER) becomes GERD when symptoms are consistently present for more than a couple of times a week, you should be assessed by a physician. The specialist in this field is called a gastroenterologist or the “GI doc.”

What happens?

We have two tube-like structures that make their way through our neck. The passageway of food from the mouth to the stomach is a tube-like structure called the esophagus which is located behind the second structure, the trachea or breathing tube. When there is a problem with the esophagus, we experience symptoms of heartburn, sour taste, burning, soreness or hoarseness in the throat, nausea, regurgitation, problems swallowing, and sometimes even severe chest pain, but never assume your pain is GERD until you have been properly diagnosed with a test called an EGD (esophagogastroduodenoscopy), and heart problems have been ruled out. The symptoms of GERD and other problems such as esophageal spasm and hiatal hernia can mimic heart pain. Always err on the side of caution.

“Reflux” of stomach acid occurs because the gate (sphincter) at the lower end of the esophagus fails. Normally, this lower gate (LES) relaxes to let food pass into the stomach where special acids continue the digestive process.  When the gate/sphincter, which is normally a tight muscle, becomes floppy or opens for no reason, acid and/or food regurgitate back into the esophagus and can make it all the way back to the mouth. This can cause permanent damage, because those acids belong in the stomach and can cause erosion when it strays from its home, the stomach. When GERD is present, unlike pleasant and nurturing Aunt Geordie, it is no fun. I imagine right now you at least have a roll of antacids in your purse or pocket.

On Sharecare.com (my other home), Dr Mehmet Oz has a short demonstrative video that shows you exactly what happened in GERD. You can watch it here.

Why does the sphincter stop working?

Sphincter dysfunction can be the result of heredity, life-style choices, or myofascial pain syndrome. Some patients are more susceptible to this, such as those with connective tissue disorder, diseases that cause restriction of the esophagus, hypermobility syndromes causing laxity, certain neurological conditions, and patients with muscle dysfunction. 

What should we avoid?

We can only focus on what we can change, such as healthier lifestyle choices that affect or worsen GERD. We should not overeat; limit acid forming foods (fried, greasy, spicy or inflammation producing), drinks (such as caffeine and carbonated beverages) and alcohol. We should learn more about what supplements and medications might aggravate GERD; avoid smoking; and limit exercise that creates gravitational reflux, such as jumping, aggressive jogging or Yoga poses, such as the downward facing dog.  

What can we do?

Sleeping with your upper body at a slight angle (head higher than your waist) can help prevent acid reflux by gravitational flow. (Try putting four inch blocks under the head of your bed frame.) Learn about and use an anti-inflammatory diet, eat small frequent meals, and exercise regularly by walking or doing T’ai Chi to improve digestions. There are also supplements, such as ginger and medications that can help treat GERD, so if you have symptoms, discuss them with your doctor.

If you have myofascial pain syndrome, you could be at an increased risk of having esophageal problems. According to Travell and Simons knotted up pieces of muscle fiber, called myofascial trigger points (MTrPs) can cause or contribute to GERD. Remember the sphincter is made of muscle and abdominal and chest muscles completely surround the digestive system.  Trigger points in the area can also mimic symptoms of costochondritis (chest wall pain) and cause esophageal spasm which is diagnosed by symptoms and a test called an esophageal manometry. So, be sure to feel around your chest and abdomen for tender areas and see if you have unusual, painful lumps. 

November is awareness month for Gastro-Esophageal-Reflux-Disease

Excerpt:Twisting of the upper body, slumping over a keyboard, not using proper body mechanics when doing activities, walking or sleeping; lifting too much weight, excessive reaching, a cold or cough, trauma, surgery, improper breathing techniques (chest or shallow breathing), overuse of unconditioned muscles, carrying a baby, backpack, or heavy purse, any activity that causes heavy breathing (exercise or anxiety), arm movement (such as swimming, tennis, racquet ball, golf, weight lifting, or bowling when you are not used to it), can be aggravating factors for the development of TrPs in the chest wall. Metabolic disorders and other conditions such as CFS and GWS can also make TrPs more difficult to treat.

Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN and Jeff Miller, PhD Available at Amazon, Barnes and Noble, and all major online retail stores.

(Signature line appended October 2018)

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Editorial Review by Jean Hall at Readers Favorites just in for SUMMER DEVOTIONS of the Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain Series by Celeste Cooper, RN and Jeff Miller, PhD

Readers Favorite Book Review

Broken Body, Wounded Spirit: 

Balancing the See-Saw of Chronic Pain

SUMMER DEVOTIONS

by Jean Hall, here.

Chronic pain can drag you down but there are ways to lift yourself up. Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain by Celeste Cooper, RN, offers sublime encouragement and innovative tips for healing. Ninety-two daily readings have a beautiful or peaceful photograph to accompany a famous quote or words of wisdom. This book is called Summer Devotions which is a season for growth in nature and, hopefully, in your life and health.

There may be deep meaning in the experience of chronic pain which goes beyond invisible and nagging symptoms. There is a Chinese proverb which says, "The gem cannot be polished without friction, nor man perfected without trials." The hidden gem of value within ourselves can be understood by practicing meditation, breathing deeply, or focusing on prayer. Topics for Summer Devotions include: Ten tips for overcoming depression, focusing on outcomes instead of obstacles, suggestions for visualization, finding your inner strength, better nutrition, and spirituality.

Registered nurse Celeste Cooper and her co-author psychologist Jeff Miller, PhD, don't minimize the experience of chronic pain and they show many ways to find balance in your life and health. The quotes and coping methods have both Eastern and Western sources. The author clearly speaks from her own personal experience and this gives the text credibility and heart. Each day's devotion has just enough information to widen your horizons without getting bogged down. Celeste Cooper urges the reader to cope and to find meaning in difficult circumstances.

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The reviewer for Reader's Favorite, Jean Hall, did an excellent job in capturing the essence of what we offer our readers who are struggling to manage and cope with chronic pain. It is obvious that her review was based on her experiences with the information, tools and tips we wish all of our readers to explore.

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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website, http://TheseThree.com

Reviews, availability, and information on Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection

Review from Goodreads, here. Tami Says:

Based upon my own personal experiences, I know that getting that Fibromyalgia and/or Chronic Fatigue Syndrome diagnosis is difficult. Saying that you hurt all over for no particular reason, that you just can’t seem to get out of bed each morning, that you could sleep for days and still be tired, or that you feel like you are thinking through several layers of cotton just tends to confuse most doctors. Even though there is nothing new about these conditions and there are a growing number of individuals suffering from them, few doctors know much about Fibromyalgia, Chronic Fatigue Syndrome, or Myofascial Pain. Diagnosis, even if your doctor believes you, can take months or even years. Then, once diagnosed, there is no set treatment options leaving us with the primary responsibility of finding options that ease our suffering. 

Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain is the book that I wish I could have been given when I started this journey. I highly recommend it to anyone who thinks they might have Fibromyalgia, Chronic Fatigue Syndrome, or Myofascial Pain. This multifunctional book will educate you while reminding you that you are not alone. 

Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain begins by explaining the similarities and differences between the three conditions. Many doctors and most of the literature tend to lump these together because the symptoms are very similar. Nonetheless, the root cause may not necessarily be the same which definitely suggests different treatment strategies. 

Next, the book tells us how to talk to our doctor. How to explain our symptoms: their location, the intensity and the duration, knowing our rights and when to find another doctor. This is important as after repeated testing and specialist visits, we all start to wonder if the pain is in our head. However, it is at this point that we need to stand up for ourselves and find appropriate healthcare specialists.

The final sections are for after the diagnosis. Things like finding support, educating yourself, and figuring out what treatment options might be useful to you. There are also some invaluable tips on living, getting through your day, reworking relationships, and understanding the emotional aspects of these conditions.

More about the book can be found here.  

Available at:

• Inner Traditions, Bear and Company, (Publisher, imprint Healing Arts Press) here.
• Amazon.com, here. 
•    Kindle, here.
• Barnes and Noble, here.
•    Nook Book, here. 
• Booktopia, here.
• Google Books, here.
• Simon and Schuster, here.
• Amazon UK, here.
• Amazon Canada, here.
• Amazon India (free shipping), here.
• Australian Amazon Associate (note: you will need to type in the book title), here.
• Alibris Books, here.
• ebay, here. 
• Abe Books, here.
• Kobo ebooks, here.

For many diseases in our world, we are finally learning the treatments using only allopathic or only homeopathic remedies are seldom the best approach in and of themselves. Much of the confusion has come from the polarized arguments of both sides attempting to defend their points of view, but like most truths the answers are often found in the middle ground, hence “integrative medicine.” I found this book, at 448 pages, to be very comprehensive and I highly recommend it for anyone searching for a balanced approach for the treatment of these diseases.

~Dhara Lemos, Lotus Guide

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Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website, http://TheseThree.com

Out with the Old in with the New: Not so much. Diagnosing Fibromyalgia

There has been a great deal of criticism regarding the 2010 Preliminary Proposed Criteria for Fibromyalgia, here, and The Modification of the American College of Rheumatology, here. Besides my own concerns reported on in a blog titled A Comprehensive Review on the Proposed and Modified Diagnostics for Fibromyalgia, here, you might be interested in seeing what other clinicians an researchers have to say:

 

• Enhancing the Diagnosis and Assessment of Fibromyalgia by Lesley M. Arnold, MD, here.
• A report and opinion on the preliminary guidelines for the  clinical diagnostic criteria for fibromyalgia by Robert Bennett, MD, here.
• Drs Bennett & Clauw Debate Abandonment of Tender Point Test in Revised FM Diagnostic Criteria, here.
• The Scientific Basis for Understanding Pain in Fibromyalgia by Robert Bennett MD, FRCP, here. 

 

In July of 2012, the SSA ruled to include Fibromyalgia in the listing of impairments, here. As an RN, this expert  was thrilled that the SSA has the good sense to use the 1990 criteria and require a physical exam, something the authors of the new criteria say is not necessary. As always, functional impairment must be documented using tools such the Residual Functional Capacity Questionnaire by Dr. Robert Bennett. The new diagnostic criteria, proposed but in use by some, falls short of assessing patients for clinical trials and in helping them obtain disability benefits. You can read more about pain and disability here. 

 

Many study results are skewed because common comorbid conditions are not ruled out, the number one culprit is myofascial pain syndrome (MPS), which is known as the great imitator. Research suggests it is one of the main peripheral pain generators to the centralization (amplification) of pain in fibromyalgia. It is also prevalent in other overlapping conditions, such as bruxism, restless leg syndrome, migraine, bladder and bowel dysfunction, chronic fatigue syndrome, TMJ and piriformis syndrome. The presence of MPS can also explain some of the unexplained symptoms of swelling and neuropathy. This is exactly the type of comment I submitted to the FDA on the upcoming “Public Meeting on Fibromyalgia Patient-Focused Drug Development” on December 10, 2013, here. 

 

There is no doubt that fibromyalgia may play a role in neuro, endocrine, and immune function because of the upset in the command center of the brain and possibly a broken mechanism in the brain for interpreting pain messages, but to get clear untainted research, we need good diagnostic criteria, which will only come about when all these other things are considered and leaving out a physical exam is no way to go about it.

 

Is it any wonder we seem to be chasing the monkey around the barrel?

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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website, http://TheseThree.com

Did you know? – Smoothies, health, and you by Celeste Cooper

When dealing with chronic pain issues, it is sometimes difficult to prepare meals, but here is a healthy breakfast or snack solution if you have a blender.

Ingredients:

Use fresh and/or frozen fruits and vegetables on hand. Keep in mind that for some an anti-inflammatory choice is a smart selection, particularly if you are subject to irritable bladder, GERD or other digestion problems, immune deficiencies or conditions that create inflammation.

Keep it balanced:

Protein powder (or if you are gluten intolerant, use the protein substitute of your choice.

Special considerations:

Apples are considered to be a low acidic fruit in their raw form. They are abundant in pectin, a natural substance that soothes the stomach and absorbs acid, so they are actually creating an alkaline environment when digested.  They are a great source of vitamin C, and have phosphorous, iron, antioxidants and flavanoids, and they are high in fiber. 

“An apple a day keeps the doctor away.”

Because apples are high in fiber, they are also a good choice for those of us who take medications that cause constipation or experience alternating constipative/diarrhea irritable bowel syndrome.

Tip! The peeling of an apple is important too, but it is also a great source of accumulated pesticides. Therefore, wash your apple (or other fruits and vegetables with edible peelings) by sprinkling on some baking soda, wet your hands and massage the apple, then rinse thoroughly.

Want to know more about flavanoids?  They are discussed in “Summer Devotions” and nutrition tracking is discussed in the “Fall Devotions” of Broken Body, Wounded Spirit: Balancing the See-Saw of Chronic Pain. Many tracking tools are included in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: the Mind-Body Connection. You can read more “About the Books” at http://TheseThree.com

Did you know?

Did you know that you can freeze a whole banana and use it later? Yes, it is true, and you can cut off what you need and easily remove the peeling. Not only do they add flavor, a banana also adds fiber, protein, vitamin B6, vitamin C, potassium, manganese, magnesium, folate, riboflavin, niacin, vitamin A, and iron. There is a reason they are considered as a baby’s first food.

Green leafy vegetables, such as spinach, broccoli, kale, red (my personal favorite) and green romaine lettuce, are packed with fiber and are a great source of vitamins and minerals.

The more colorful the better, because bright colors mean they are loaded with antioxidants, which fight cellular oxidative stress apparent in both fibromyalgia and CFS/ME.

Carrots are known as the eye health veggie. Raw carrots are loaded with fiber and a great source of thiamin, niacin, vitamin B6, Folate, manganese, vitamin A, vitamin C, vitamin K and potassium.

Tip! Cleaning vegetables with a weak vinegar solution will help fight any lingering bacteria.

If you have left over colorful bell peppers, zucchini, cucumbers, etc., throw those in too. Any colorful fruit or vegetable that your body tolerates is a good choice.

*If you are sticking to a low acid forming diet, check to see if ingredients are “acid forming” foods. They can be acidic, but that does not mean they create an acidic environment in your body.  This topic is outside the source of this particular blog. 

I have found by using fresh and frozen fruits and vegetables it makes the smoothie like drinking a nutritious shake. Add water, milk, almond milk, soy milk, whichever you prefer, for the consistency you like and enjoy vitamins the old fashion way with a modern twist!

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All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com, here, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy, here. You can read more educational information and about her books on her website, http://TheseThree.com