Prostate enlargement sufferers: Alpha blockers can relax the LES

I mentioned in a previous post that my new set of health issues is having an enlarged prostate (BPH). If you suffer from it, you know there are not so fun symptoms you have to deal with. The worst is a weak pee stream. If your condition gets bad enough, it can progress to the point that you can't pee at all. Then it's catheter time.

So I had extra incentive to figure the problem out. I take a regimen of herbal supplements that help, to a degree. I'm not back to anything resembling normal flow, but it keeps the pipes running, at least. I basically scared myself into seeking a prescription from my doctor. The standard starter drug in most cases is FloMax, a so-called alpha blocker. Alpha blockers work by  relaxing certain muscles, and helping small blood vessels remain open. This improves blood flow and also reduces blood pressure. It helps BPH sufferers by relaxing muscles down there so pee is easier.
It has some drawbacks. One of the biggest problems is it does not deliver the medicine gently- which means when it takes effect, your blood pressure drops quickly, and it can make you dizzy or feel faint. Some people actually do faint when taking an alpha blocker. That's a pretty bad scene to say the least. You don't want to be driving a car when this stuff kicks in.

As readers of this blog know, I have a history of suffering from severe vertigo due to a still-mysterious inner ear problem. I am already prone to dizziness, so this was a side effect I really didn't want to have. So my doc suggested Doxazosin, another Alpha blocker which achieves the same result but is easier to "titrate-" that is, apply in graduated doses until you reach the level you need. I started taking this pill a few months ago.

Another drawback is it makes you feel sluggish and- dare I say it- dumb. For at least a four-hour period, every day that I took this stuff, it made me feel sluggish, sleepy, and out of it. I would not be quite ready with a clever pun like I would be before this stuff. and most evenings consisted of coming home, eating dinner and slinking off to bed without saying much at all.

To help alleviate this, I started taking my dose before going to bed, figuring I would be sleepy when I am already sleeping, and more with it. Let me introduce you to drawback #2: paradoxically, you feel more tired and out of it while at the same time you have problems sleeping. Insomnia, That's right. Such a cruel side effect since the drug already zonks you. To not let you rest on top of that? Suffice to say on some days while taking this stuff, I wasn't 100% what I was doing all the time. I was artificially spaced out and sleep deprived at the same time.

But the most "fun" side effect of all was a total surprise. And you don't see this mentioned a lot unless you find the comments of someone who experienced it. Along with all the other things it relaxes, it also relaxes the Lower Esophogeal Sphincter (LES)- the muscle that keeps stomach acid from splashing into your esophagus. So yeah, my throat is re-injured thanks to this evil drug.

So I am back on the low-acid regimen- the Koufman diet, eating really small meals and sleeping with my head raised. Ugh.

Since I have stopped taking it, I have gone from constant reflux- a bubbling you can feel happening all the time, which basically feels like hell has taken up residence in your stomach- to just days spendt dealing with the throat damage. Throat lozenges. Chomping on DGL tablets and Gaviscon.  That's where I am now.

I really controlled, mild diet does seem to prevent pain most of the time, but it's not easy to maintain. Plus this time I can really see what Jamie Koufman said about nerves. The actual damage may be happening anymore, but the throat is very sensitive to anything that might normally cause damage, even if it isn't, because the nerves have been damaged as well. Convincing them to calm down is hard, and the last time I had to do it, it took nearly a year.

So if you are someone like me who is dealing with BPH and LPR issues at the same time, be very wary of alpha blockers. It could set you back, like it did me.

New Health Challenge: Prostate health

So, I was diagnosed with BPH- benign prostatic hyperplasia. Just for a convenient guideline, 50% of 50-year-old men have it, and 80% of 80-year-old-men have it. It doesn't necessarily lead to cancer; in fact, there are some lifestyle changes that can slow down or even prevent its development. Apparently there isn't hard evidence that the symptoms of BPH can be reversed, so basically once you develop it, it's more or less a matter of managing the symptoms.

What causes it? Once again, Science is inconclusive, but evidence suggests the Standard American Diet, lack of exercise and being overweight- the western office worker trifecta- is the main culprit. In a nutshell, the SAD diet produces inflammation, and acidifies the urine. Both situations irritate the prostate and cause the cells to grow. Eventually the urethra, which is right next to it, is  crowded to the point that it becomes harder to completely evacuate when you pee. This can result in nasty, painful infections. It can also eventually lead to impotence. Yay.

There are official treatments for the symptoms. The pills involve relaxing muscles and spawning a dieuretic effect. Both can have adverse reactions which can lead, paradoxically, to the same symptoms caused by BPH. So I am going to try to manage this with diet and exercise. Foodwise, the basic strategy is eating in the Mediterranean and Asian foodways. Stay tuned!