NCCP 's - Debbie's Article- Chest pains, heartburn, acid reflux, spasm pains, NCCPs...

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 Debbie's Article

 

Chest pains, heartburn, acid reflux, spasm pains, NCCPs.... what

the heck is all of this stuff anyway????

 

(aka:  Debbi's Dissertation on Dysfunctional Dysphagia

Diagnoses)

 

Here's some info I've put

together on differences between " heartburn " and the " chest

pains/spasm pains "  that are related to achalasia.  The official

medical term that I've found for the " spasm pain " is

" NCCP "  or Non Cardiac Chest Pain.  There are multiple terms

used for " heartburn " including:  acid indigestion, acid reflux,

GERD/GORD, etc.

 

In my pre-achalasia days, I would have " indigestion/heartburn "

once in a while (after a particularly large, fatty, acidic meal, etc.),

maybe once or twice a year.  I would have that nasty acid taste in my

mouth when I burped, and a hot/burning sensation in the area of my

breastbone.  While not particularly comfortable, it wasn't an

excruciating, debilitating pain, and taking some Tums or other

antacid would neutralize it and both the taste and the discomfort would go

away.

 

When I had my first NCCP, I had been having problems swallowing for a

few years but hadn't yet been diagnosed with anything, and I had no

clue that the pain was related to my swallowing problems.  I thought

the pain was some gawd-awful gas pains -- felt like something was stabbing

me from the inside out!  The pain seemed to start in the ribs and almost

squeeze my chest with searing pain that seemed to shoot up into my neck,

too. (note: everyone can experience NCCPs in varying degrees and in

various parts of the body, including stomach, chest, shoulders, neck, back,

jaw, tongue, teeth, and roof of the mouth.)  I lived alone at the time,

and I drove to a convenience store and bought three rolls of Rolaids and ate

two whole rolls.  That didn't have any effect at all, and it took a couple

hours for the pain to go away. 

 

Another time, I have a distinct memory of standing in the kitchen

holding onto the countertop and just WAILING at the top of my lungs because it

hurt so bad, and my knees buckling from the pain.  My wailing turned into

one big repetitious prayer: " Please, Lord, Please, Lord, Make It Stop,

Lord, I Can't Take It Anymore, Lord, Please, Lord, I Need You To Please Help

Me! " over and over and over again while sobbing.  This was almost a

decade ago and I don't know how long it went on, but I'm thinking that it was

well over an hour of that constant wailing.  Boy, those were the days,

huh?  ;o)

 

For people whose doctors believe that NCCPs are an

" atypical " (not normal) symptom for achalasia patients, point

them in the direction of this informal

poll here on our group:

achalasia/surveys?id=1037310

The poll is now closed, so who knows how many more would be added to it

if it were still accepting votes.  If you scroll down to the end, 38

people reported that they have these " spasms " , and 5 people reported

that they don't have spasms.  So out of 43 people who answered the poll,

88% have spasms and 12% don't have spasms.  Doesn't sound like a

" rare " or " atypical " symptom, does it? 

 

In another poll (

achalasia/surveys?id=1011383 ) of people

who went to the Emergency Room due

to extreme chest pains, 2 were given intravenous Valium, 3 were given Demorol

or other narcotic injection, and 7 were given no treatment whatsoever.... isn't

that sad?  58% of the people who were in such severe pain that they went

to the E.R. were given NO TREATMENT at all!!!  That is SO unnecessary!!!!

 

Here's some info that I

copied from an old post of mine -- if your doctor will bother to do some simple

web searches, he'll see that calcium channel blockers, nitroglycerine, and

anti-depressants are all documented ways to treat NCCP in people with

esophageal disorders!  Maybe if you print it out and show it to him, he'll

be willing to offer you some help in dealing with this.  

 

=============================================

 

Here's some basic info that

I've posted in the past -- different things work for different people, so it's

basically just an experiment to find what works for your own particular

situation.

 

Here are some different coping methods to try:

 

-- Swallowing something warm or something cold (in my case, I chug warm

--not hot-- water as fast as I can).

 

-- CCB medication (calcium channel blockers) -- when I'm having NCCPs, I

prick the shell of a nifedipine capsule and squirt it under my tongue.  It

absorbs into the bloodstream under the tongue (this is called a

" sub-lingual " medication, meaning under-tongue) and relaxes smooth

muscle tissue (which is what the esophagus is made up of).  You can also

just swallow the capsule, but since we have trouble swallowing in the first

place, I've found the under-the-tongue method works best (then you just

swallow when you've held it there as long as you can and your saliva requires a

swallow).  Unfortunately, it can also lower your blood pressure (usually

only a problem if you already have low BP to begin with) and cause a headache

afterwards -- some people experience this, some don't.  CCB's can also be

tried in the " slow release " formula as a preventative to having NCCPs

start in the first place.

 

-- Nitroglycerin medication -- works in much the same way as the CCB

mentioned above, and can also be taken sublingually for fast relief.

 

-- Certain anti-depressant and anti-convulsant medications -- some

people don't have NCCPs when on these types of medications, believed to be a

function of the medicine's effect on serotonin in the brain (antidepressants

such as Nortryptaline, Amitryptaline, Imipramine and Trazodone have been

studied; Neurontin is being studied in a similar way for " phantom limb

pain " in amputees, etc.)  People in the group have had luck with

Paxil, Ativan, Nortryptaline, etc.  The dosage needed in this case is

generally lower than the dosage that is normally used to treat depression.

 

-- L'Argnine supplements -- some people have found these relieve NCCP

symptoms.

 

-- If symptoms are debilitating and none of the methods above help, you

may need a narcotic pain reliever, but definitely try all the options above

first, b/c if you're on narcotics you can't drive, work, etc., and the vast

majority of people can find relief in a way that doesn't involve narcotics.

 

=============================================

 

In the last few years I've taken three different drugs that affect

serotonin (one of which isn't considered to be an anti-depressant medication,

but which does have a serotonin effect nonetheless); any time I was on one of

those drugs, my NCCPs have either disappeared entirely, or been nearly

eliminated. And each time I discontinued a serotonin-effect drug, the NCCPs

started up again within a month's time.  One member here who was in the

E.R. repeatedly for debilitating NCCPs finally had a doctor prescribe a

low-dose daily antidepressant; her NCCPs have been eliminated.... no more pain,

no more narcotics, no more trips to the hospital. 

 

There are soooooooooooo many things that can be done to reduce NCCPs,

but doctors don't even bother to TRY to find a solution for us.  I say let

THEM curl up in a fetal position making plea-bargain deals with their Maker at

3:00 in the morning just ONCE, and you can bet your booty that they'll find a

solution REAL fast!!!  :oP

 

------------------------------------------

 

________________________________

________________________________

From: bigbrillohead <imahockeymom@...>

achalasia

Sent: Tuesday, April 17, 2012 12:18 PM

Subject: Re: NCCP 's ....have a question about son (has had

Achalasia since he was 6yrs old)

 

Two questions:

1. What type of med does the doc want to put your son on?

2. Have you read my " famous " NCCP post and discussed it with your son and his

doctor?

Debbi in Michigan

>

> My son will be 17 in Aug. He had a Heller myotomy when he was 6. Been

getting NCCP's for years. He's not on any meds. GI doc wants to put him on

something. He is going to scope him and do a biopsy of lining of the E. this

summer ..,....just wondering

> What others thought?? son doesn't want to be on any meds

>