🎯Three Content Types · One Force Field
Every square belongs to one of three content types — not three levels you climb. Track progress in your Course and Skills Lab.
📘 Learn It Content type
Concepts to absorb.
🛠 Live It Content type
Daily skills and habits.
📣 Share It Content type
Teach, advocate, carry forward.
🛡️Your Force Field — 16 Squares
Deeper detail lives in the Prepared Patient GERD course.
What GERD Actually Is
Chronic backflow of stomach acid into esophagus. Affects ~20% of US adults.
Learn ItHow PPIs Work
Block acid production. Most effective long-term acid suppression.
Learn ItSpot Cardiac Mimics
Crushing chest pain + sweating + jaw/arm pain = 911, not antacid.
Learn ItCommon Triggers
Caffeine, alcohol, chocolate, citrus, mint, fatty/spicy foods, late eating.
Learn ItAnatomy
Lower esophageal sphincter relaxes inappropriately. Hiatal hernia common.
Learn ItMed Approach
PPIs daily or on-demand. H2 blockers for breakthrough. Antacids occasional.
Live ItWhen to Scope
Alarm symptoms: dysphagia, weight loss, bleeding, age + new symptoms.
Live ItLifestyle Tweaks
Elevate head of bed, no eating within 3 hr of bed, avoid triggers, weight loss.
Live ItLong-Term PPI Risks
Vitamin B12, magnesium, bone density, kidney — discuss balance.
Live ItMake Every Visit Count
Bring symptom log, trigger log, current meds.
Live ItYour Care Team
PCP, sometimes GI, sometimes surgeon for refractory cases.
Live ItSymptom Apps
GERD diaries help identify your triggers.
Live ItInsurance + Cost
Most PPIs generic. Endoscopy generally covered.
Live ItTeach & Mentor
Patients confuse GERD with cardiac — share when to worry.
Share ItAdvocate
Push for medication coverage and access to GI care.
Share ItResearch & Trials
Newer surgical options, novel acid blockers, microbiome research.
Share ItThree things to learn before you actually need them.
Workflow lives in the Prepared Visit Tool. Trackers in your Course.
Which door do I use?
GERD is mostly manageable. The ladder helps you tell reflux from cardiac emergencies.
Handle at home
- Manageable baseline reflux
- On PPI or H2 blocker as needed
- Avoiding trigger foods
Log it. Stay on meds. Avoid bedtime eating.
Call the office / message the portal
- Reflux symptoms worsening
- Running low on PPI
- Side effects from long-term acid suppression
- New trigger you can’t identify
Same day. Med review or workup may be needed.
Urgent / Acute care
- Difficulty swallowing or food sticking
- Weight loss without trying
- Persistent chest discomfort
- Blood in vomit or black stools
Urgent care. May need endoscopy.
ER NOW / call 911
- Crushing chest pain with sweating, shortness of breath, jaw or arm pain — could be cardiac
- Vomiting blood or black stools
- Severe difficulty swallowing
- Sudden severe abdominal pain
Call 911. Don’t assume chest pain is reflux until cardiac is ruled out.
How to describe a new symptom in 30 seconds
What is it?
Plain words.
How bad?
0-10.
When did it start?
Time + what you were doing.
What made it worse?
Movement · food · meds.
What helped?
Even a little.
What else was new?
Fever · med · supplement · stress. The forgotten detail often shifts the diagnosis.
“Heartburn 4 days in a row, a 6, started after I went off my PPI when it was on backorder, worse lying down, sitting up and antacid help a little, and I’ve been more stressed this month.”
Questions worth asking
Four for every patient, every condition, every visit:
- “Could this be a side effect of one of my medications, a supplement, or something else I’m doing — and should we change that?”
- “Would any non-drug therapy help — physical therapy, meditation, rest, ice or heat?”
- “If I can’t afford this medication or this test, can we talk about samples, alternatives, or a social worker who can help?”
- “What should I be watching for between now and my next visit — and when do I handle it myself, when do I call your office, when do I go to urgent care, and when do I go to the ER?”
Questions specifically for GERD:
- “Am I on the right acid-suppression regimen — PPI, H2, on-demand?”
- “Do I need endoscopy — have I had one recently?”
- “What are my specific food triggers?”
- “Long-term PPI risks — what are they and how do we balance?”
- “Am I a candidate for surgery (fundoplication, LINX)?”