RLR
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Well, it can't be "every day" because a 10lb weight loss over 3 weeks, or 21 days, is slightly less than a half-pound per day and not too surprising or even considered remarkable in the midst of GI difficulties of the type being described.
I think one of the overriding concerns is that you feel convinced that something more serious is at hand, ie "to me this is not acid reflux." I'm constrained to point out that you're basing the range of possible symptoms of the disorder by your own past or own analysis. In every doctor-patient interaction, each must assume their role in order for the formula to work. It's important for you to understand that the mechanics which underlie reflux disorders are highly influential to certain types of stress. You and I go a considerable way back in discussing the actual nature of your difficulties and to date over several years, I don't believe we seen any expression of the type of health concerns you tend to become concerned about here.
About every two weeks or so, the outer-most thin lining of the intestinal tract breaks down and a new layer forms. The presence of significant GI disturbances like reflux can interfere with that process and aside from appetite depression, nutritional absorption can be affected to a mild extent as well. Realize that there are certain cells in your stomach and small intestine which produce natural bicarbonate and in the presence of significant acid production, the ability of the bicarbonate to successfully neutralize it becomes overwhelmed to a certain extent and can make its way past the corridor where it is typically inactivated, producing symptoms and a sense of general malaise and ill sensation.
You are far more resilient than you tend to believe, Richard. The human body undergoes a tremendous amount of adaptation throughout life and in most all instances, does an extremely efficient job without interference. With all the medical media which increases concerns that disease is rampant everywhere, it is common for persons to develop the sensation that an albatross circles overhead and that it's only a matter of time. The truth of the matter is that for reasons we don't yet understand, most all people who express significant health anxiety actually remain quite healthy throughout life, yet their concerns rival and often exceed those who worry less but yet fall victim to the very illnesses which emotionally plague the worried well.
The bottom line is that you can't out-guess mother nature and you can't spend a lifetime in apprehension of succumbing to serious illness or disease. For people with anxiety, they leave the logical boundaries of statistical probability and live with the notion that anything is possible and that the generation of compelling apprehension can somehow actually increase the risk of morbidity or mortality. This often occurs because people with anxiety permit the anchors which normally keep such notions in check to become free-floating and attach to any salient concern which happens to occur. They might read about a particularly alarming incident, such as the recent number of athletes experiencing sudden cardiac death, and by habituation internalize the event as actual proximity to risk in their own case, despite the logical fact that no such association exists at all. A loved one might pass away and the anxiety patient often develops proximal fears that their own life is in similar jeopardy.
As I've discussed many times on the forum, this type of fear is very unique in that the brain responds in a very archaic and predictable manner, producing physiological changes which only serve to accelerate and affirm fears that one's suspicions are potentially very accurate. The irony of such a perspective is that the usual patterns of self-confidence to separate fact from irrational fear becomes eroded and yet the anxiety patient exhibits increasing portrayals of confidence that their irrational fears are accurate, so much so that they even convince themselves on occasion that their condition is emergent in nature and that haste to the nearest emergency department is necessary to avoid risk to life.
I know that I've discussed this in a variety of contexts over the years and I wont belabor the point again here, but suffice it to say that in any instance of misdirection, the lights on the pathway back home need to be re-kindled on occasion.
You're going to be fine, Richard. The lymphocyte count is of no concern and there are many reasons for such a variability and none of which should be of any concern to you. Work closely with your doctor to get the reflux under control, refrain from second-guessing whether your medications are safe to consume and above all, take a deep breath and try to relax. You've a long life ahead and it's going to be a fairly boring journey if encapsulated within the context of apprehension.
A man languishes over the fact that he has no shoes until he meets the man with no feet.
Over the years, I've had many unfortunate occasion to see extremely sick people. Take serious contemplation of the fact that you're not one of them.
Best regards,
Rutheford Rane, MD (ret.)
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