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Surgery for sagging palate may help

 (The Spokesman-Review)
(The Spokesman-Review)
Peter Gott United Media

Dear Dr. Gott: I’m 60 and my husband is 65. My snoring keeps him awake. We don’t choose to have separate bedrooms. What can I do?

Dear Reader: See an otolaryngologist. You may need surgery for a sagging palate. Or a sleep study may be in order. The specialist will be able to advise you about how to proceed and what treatment may be necessary.

To give you related information, I am sending you a copy of my Health Report “Sleep/Wake Disorders.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title.

Dear Dr. Gott: My elderly wife suffers from severe acid reflux, leading to left arm pain and jaw discomfort. None of our medics have been able to provide her relief. They have prescribed Nexium, Prevacid, Prilosec and other medicines, without beneficial effects. I would appreciate any comments on this problem.

Dear Reader: I assume from your four-sentence note that your wife is experiencing abdominal and chest discomfort that is unrelieved by the usual medications for acid reflux.

Rather than adding to the list of ineffective remedies, I would like to branch out. Here’s why.

The nerves from the stomach and the heart tend to be carried to the brain in the same bundles. Thus, the brain may not be able to differentiate pain originating in the upper intestine from that stemming from the heart. This is the reason that patients with heartburn may incorrectly assume they are having a heart attack, or patients having a heart attack may incorrectly blame “indigestion” as a cause of their pain.

By now, you can see where I’m going with this. Although your wife may have correctly been diagnosed with acid reflux in the past, I am concerned that her present symptom may have another source. In my opinion, she should be tested for angina and coronary artery disease, using blood and stress tests or even a coronary angiogram performed by a cardiologist.

Therefore, my advice is:

1) Check with your wife’s primary care physician, who can organize and coordinate the investigations.

2) Request a referral to a cardiologist.

3) If all the cardiac examinations are normal, refer her to a gastroenterologist for possible endoscopy, a test that enables the specialist to view your wife’s upper intestinal tract to make sure that she doesn’t have “Barrett’s esophagus,” pre-malignant lesions in the area where the esophagus joins the stomach.

But, before subjecting her to an invasive procedure, work through the cardiologist. Her symptoms should not be ignored.

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