You didn't mention much about other eating and sleeping habits so this may not apply or you may already know it. However, the Ivor Lewis surgery removes the sphincter muscle that keeps food from coming up into the esophagus, especially when laying down or sleeping. If I don't sleep with my head & back elevated, and/or I eat within 2-3 hours before bed, it is usually a disaster with coughing, choking and burning. I also really have to watch the foods I eat -- which can make things worse. I think it is different with everyone, but I have problems when I eat things like fried foods, heavy tomato content, oranges, or anything with orange juice in it. I also seem to have trouble when I eat things with real heavy sugar content (like one of my favorites -- caramel milkshakes). Also, it sometimes seems to create a lot of mucus coming from somewhere, enough to choke on, and will certainly give me problems at night with bile coming up. I have had to really pay attention to what I eat, and how I react to it, and try to learn. And I will often go for a long time without problems so I'll be feeling brave or careless, and eat something I shouldn't -- and almost always regret it. Hope this helps.

Forgot to respond to the Prilosec/Nexium question. I have been using Nexium and have been pretty happy that it seems to work. Also, I was surprised at some things that have caffeine, so I really have to watch that. For instance, even "decaffeinated" coffee has more caffeine remaining in it than chocolate does.

I had taken Prilosec for almost ten years before being diagnosed with EC, but became resistant to Prilosec and three weeks before surgery was switched to Pantoprazole, 40 mg once a day.

Pantoprazole works reasonably well but once in a while I will still have an episode of reflux, particularly if I scoot off of my foam wedge when asleep. If I inhale any acid when asleep it will cause flem and a bad cough for some time. When that happens, the first thing I do is take some liquid antacid and then drink water which helps.

I am thinking that the adjustable bed may be the answer to acid reflux, as noted in another post.

Prilosec (Omeprazole) and Pantoprazole along with Nexium are acid production inhibitors, but work through different paths, so one may work better than another.

I had to take several anti nausea drugs for quite some time and still take Ondansetron at a full year after surgery. I do not tolerate Reglan as an anti nausea drug. Although it controls my nausea, it makes me very jittery and unable to sleep well.

I'll chime in here. My hubby had his surgery 11/21/11. He was released from hospital without any prescriptions and still, to this day, only pops a Pepcid if he has a bit of heartburn. Not every night. He also sleeps flat on his back. Vomiting has never been an issue for him but he definitely does produce a lot more phlegm now.

One thing our chemo nutritionist told us is that chemo makes most people lactose intolerant and this can be in the form of gastric upset or the production of extra phlegm. Mike has pretty much cut dairy out of his diet now, except for cheese, and it has really made a difference for him. Dan, I'm wondering if chemo did the same thing to you (you mentioned milkshakes...)?

Mike eats an orange, some cashews and V8 juice for breakfast every morning and has done so, without fail, since the day he came home from hospital. Orange for the Vitamin C, cashews for the protein, and V8 for the veggies. He calls it his "breakfast of champions". We have switched to half-caff coffee now as full-caff was causing him some dumping syndrome issues. Other than quitting smoking (before surgery), coffee is really the only thing he has drastically reduced. He now only has a max of three cups a day.

I think Dan is right - everyone is different.

Margi ... I believe the chemo has effected my tolerance for dairy products. I haven't completely eliminated them (I still eat a lot cheese, butter & ice cream), but I think my ability to handle a lot of milk and ice cream has been reduced.

Just wanted you to know that I'm thinking about your wife and you. She sounds like a wonderful, strong woman! After I retired from teaching at the secondary level, I had an opportunity to watch first grade teachers in action. They do an amazing job, bordering on magic! Sending good thoughts your way!