I’ve been dealing with chronic reflux for about 8 mos now. On PPIs and they don’t seem to do much. But once I get away from my typical routine of work/dadding then all the symptoms vanish, even to the point of being able to eat foods that are not good for reflux: spicy things, tomatoes, a bit of coffee. In my case, this is absolutely a downstream symptom of something mind-body. Already been scoped and got a diagnosis of visceral hypersensitivity, which is medical speak for “nerves in esophagus are too sensitive.”
The question of why is out of scope.
In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
I’ve made some life changes (new job) to see what happens here. But I also have to be prepared for the possibility that it doesn’t fix it. Been working through The Body Keeps The Score as well.
Looking forward to seeing what the author discusses here.
This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :)
I have shared my experience with others and it helped them too
Edit - Changed the link, had posted something else by mistake
How did you implement this? I can't figure out what these instructions in the article mean: "Exercises of dry swallowing in the bridge posture lasted for 4 weeks and were performed ten times per day (Fig. 2). The exercise was performed with 10-s intervals between swallows."
Does this mean that total number of daily dry swallows in bridge position was 10 or 10 times 10 (100)?
You get in the bridge position. And then swallow, wait 10 seconds, and swallow again. So total of 10 times, I'm not sure if I could have kept up with it if I had to swallow 100 times :)
Thanks for this - it looks interesting, I'm planning on giving it a try for my low level reflux that's been bothering me for over a decade (but always had other health issues that seemed higher priorities to try to address).
> In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.
I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief
[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.
Western medicine “can’t treat stress” but Eastern medicine definitely claims to be able to. But then so do various nebulous “alternative medicines”. Another comment mentioned deep meditation as being effective, and I believe there are a number of studies that have shown it to have actual effect. I’ll add another tried and true stress cure but with a twist. Exercise has consistently been shown to help reduce stress, but I find that you have to pick an activity that’s different than what you normally do, e.g. if you’re a runner, try swimming or tennis. The goal is to actually raise the stress level while exercising by doing something unfamiliar and therefore more challenging. In my experience, if the exercise is too relaxed or routine, it doesn’t allow your mind to disengage from the other stressors that are causing symptoms. Of course, all this is pure anecdata from an internet rando.
This is false. Therapy is designed to do just this and it’s readily available in different modalities that have been trialed and studied. You can book an appointment with a therapist today and start working on techniques to build stress resilience and stress handling techniques
> but Eastern medicine definitely claims to be able to. But then so do various nebulous “alternative medicines”.
Much of the allure of so-called Eastern medicines is the feeling that it’s ancient, semi-secret knowledge that is mysteriously superior to modern medicine. There are a lot of herbal medicines that kind of do something, but the effects are small and often prone to rapid tolerance build up and side effects. A large part of the efficacy is getting the patient to believe that the medicine and/or practices are a cure for their ills. Feeling like you’re tapping in to a mysterious ancient solution to stress will encourage a very strong placebo effect, which can actually reduce the stress.
Similarly, when we do randomized trials of medicines for depressive disorder it’s incredible how much the placebo group improves. When people have been told they’re receiving a treatment, it usually helps to some extent even if the treatment does nothing at all!
I don't think the allure of Eastern medicine has much to do with a feeling that it's ancient or secret. It's pretty normal here in Taiwan to go to a TCM clinic here in Taiwan for various treatments, including stress. The practitioners have degrees and certifications for it.
I can't say how much is placebo, but there isn't really anything mysterious about it.
The ancient and mysterious part is the idea that it’s based on wisdom passed down through generations and herbal concoctions, as opposed to synthetic medicines tested in RCTs. This is precisely what draws a lot of people to it, and why it falls in the category of alternative medicine.
It’s actually very interesting that many of the herbal compounds they use do have some quantifiable biological activities. So it’s not all placebo, but you’ll also discover that many of the herbs being sold don’t contain the ingredients they claim, don’t contain enough active ingredients to do anything, or might even be contaminated.
I once asked some doctor friends what things they’ll never do after seeing the consequences in their patients. One of the most surprising answers, to me, was that they avoided TCM and Avurvedic medicines. Apparently they see a lot of people come in with elevated liver enzymes or signs of kidney problems and discover that some TCM or Ayurvedic herbal remedy is causing the damage. Discontinuing the supplement can stop the damage. This happens with megadoses of other supplements too, especially some of the things peddled to gym bros. However, TCM and Ayurvedic supplements seem to catch people by surprise because they assume it’s safer.
> it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly.
Thanks for the edit that added this. Very similar experience as this.
It's BS that IC ladders top out at quasi-management roles, but perhaps part of the issue is believing that professional growth is as tidy as a FAANG career ladder (since most companies just copy them wholesale), and that not reaching those rungs reflects on me in any way.
It feels a bit taboo to say, but I believe not everyone can flex into management easily, even part-time. I'm alright at it, but it clearly isn't long-term sustainable.
This was years ago now and I came to complete peace and acceptance with it. I don't view it as complete BS tbh. Here is how I look at it:
First of all, there ARE more steps on top of the IC ladder. They are really really exclusive though in our industry. A large company needs thousands of managers, but only a dozen or so those positions. Half those people are really smooth talkers, and the other half are truly remarkable human beings. You can set it as a challenge to yourself to shadow and follow in that direction. It might take you another 10 or 20 years and it might never happen.
The reason I don't view it as BS is because there is a limit on the amount of value a single person can generate. At the end of the day "managers" are viewed as force multipliers. Their job is to direct and control the output of 10 people. A great manager can 2x or 3x the productivity of their team compared to just 10 aimless people with no accountability or structure. Paying that person 2x or 4x is justified. Your entire career in management, from M1 -> CEO is all about trying to convince the one above you that you are a bigger force multiplier than others in your position. That's basically your job.
As an IC, you need to be someone who has had a track record of founding and delivering multiple highly profitable products/business/features/etc. Otherwise, you did, in fact, hit a ceiling of sorts.
From FAANG prospective, for an IC there is a sweet spot between their technical seniority, output vs burnout, and their compensation expectations/asks.
Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.
>But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine
This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits.
A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.
I'd be fine with that if the posturing didn't go along with unnecessary medication and the lack of suggestions to search for treatment somewhere better equipped.
Hey, I just wanted to let you know that I have the _exact_ same issue as you since 2 years. It was much worse than what you described 2 years ago. Now it's just very annoying.
The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.
The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).
I wish you all the best and thank you so much for sharing.
If you mean the Buddhist meditation: I joined a local group a few years ago. I wasn't super serious about the practice until I saw how directly it can improve my life. Even now it's hard to find this much time every day.
For me, the two big things that help are losing weight and reduced anxiety. When either are high the problem is noticeable when both are low it’s gone.
Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.
The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space
I had this for years. Then I took vitamin K2 (about 50mcg per day I think), and after a few months it went away. No idea why, though. Anyway, happy that I can drink coffee again :)
For me intermittent fasting after 6pm and small diet changes fixed my acid reflux. PPI were not helping and making things worse. I actually took Betaine HCI supplements to fix digestive issues after PPIs.
I had this for about a year, and it really only went away when I quit my job. It wasn't even a particularly demanding job, but I guess the lifestyle + the fact that I felt I was wasting my life away might have played a role. Nothing else is really different.
I have had near-debilitating non-GI physical symptoms when it was time to leave a job in the past. I might just be bad at responding to those before it gets to be a five alarm fire.
Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!
Most people are familiar with the Peter Principle where it talks about people rising to their level of incompetence.
But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
All of my reflux went away last year when I started tirzepatide via my Zepbound prescription. I was having horrible heartburn daily and it’s just completely gone. I used to take tums and omeprazole literally daily, now it’s basically never.
I seem to have something very similar going on. I'm on the early end of trying to understand it. Coffee was the first indicator because it'd ruin my day to drink some. I hope the best for us.
Lots of anecdotal cures here, but I'll add Aloe Vera gel to the mix since it seems to help* both soothe/recover/prevent the return of my reflux symptoms for long periods of time.
I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.
FYI, The Body Keeps The Score is full of misinformation, and is alternately ignored and criticized by other psychiatrists
> The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019).
Just a sidenote: GERD can lead to Barrett's Esophagus (precancerous changes in tissue), and erosive damage to the esophagus can accumulate over time and abruptly become life threatening. After decades of terrible GERD, my father nearly died from exactly such an undetected gastric bleed, losing 11/12 of his blood (which doctors replaced as it coursed out) before an emergency-medicine team finally found and sealed the rupture.
He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.
I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.
Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.
If this came to pass, the population would be stripped of dignity pretty much en masse. We need to feel competent, useful, and connected to people. If people feel they have nothing left, then their response will be extremely ugly.
I think the thing I have the most difficulty with in this discussion is that it seems virtually unthinkable to stop taking semi-anonymous ratings seriously? I know there will be intense loss aversion to such a crazy idea.
But sometimes the comment section is just a bunch of people with axes to grind.
I agree. This is exemplified by social media’s constant refrain to join “the conversation.” The subtext is you joining in to talk about what’s relevant, which, of course, ends up being the current talking points of the world/your niche.
In this way, social media can be almost unbearably lonely for me. So many people corralled to talk about that which gets them Internet Points. But they seem like they’re right there.
Concrete example is I’m trying to learn how to build a tone for djent metal, which is a highly syncopated guitar sound that needs special considerations from your signal chain to achieve a distorted, highly staccato (at times) clear tone. I find a lot of discussion when it was fresh (2010-2015) but have difficulty getting much discussion on it nowadays because it’s not seen as fresh. Is it because it is somewhat niche? Absolutely. But even the people that are into it are much less enthused. It’s like the info has to be dug up vs being easily passed around.
Older books seem perfectly content not to try to hook you within the first few pages. Keep at it. I read Crime and Punishment recently and it is quite slow to start, but was rewarded by the depth of characterization that is present.
Also if you want to read classic books I highly recommend getting the most accessible translation/version you can find. The material is often dense enough without the style of writing making things harder. But this sometimes means paying for one vs finding it on Gutenberg.
I remember reading Jules Verne and similar books from my mums library at 10y. First 50 pages were excruciatin and it applied to most classic books. However Verne was special at making them boring.
OTOH I remember Velocity from Dean Koontz, picked up on an airport (as an adult), which I didn't put back until landing and having to leave the plane. Somebody on HN once commented that these days books are much more like current TV shows, action packed and full of cliff hangers.
Definitely grab them from Standard Ebooks. Not as huge a selection as Gutenberg, obviously, but still several lifetimes worth of reading, and the quality is way higher.
> We get it, so many HN and Tech folks have thrown in the towel and given up on changing anything within their own lives, or within the lives of others.
It’s hilarious to read such defeatist takes on the current state of things on a site called Hacker News. The classical definition of a hacker was someone who wielded tech to circumvent power imbalances in whatever form.
Now I fear we have plenty of technologists that are happy to use tech to further cement and centralize existing power structures. IMO, this has been brewing for the past ten years or so, where technologists wrongly believe they have an in to this power just because they work for a FAANG.
You are labor. Where you work does not matter. So long as you need to work, you are labor. And there’s nothing wrong with that! Doctors are finding out this same lesson.
The way out is to build ventures that don’t involve the capital class. Autonomy and independence are worthy goals to strive for.
Tech still is rife with temporarily not-yet-founders who cling to not rocking the boat.
What do you do when the boat capsizes?
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