I've been diagnosed with hiatal hernia and gerd and lately my breathing problems got a lot worse. what are my options and best course of action?

GERD-related asthma?: About a third of chronic gerd suffers have an asthma-like presentation, and about a third of asthmatics have gerd. As such, many asthmatics show significant benefit from acid reducers when used over time. Shortness of breath however can result from many causes that have nothing to do with gerd, so get checked asap, especially if your breathing problem is progressive.

GERD: If your symptoms are not controlled by medication and you are getting episodes of aspiration which may be the cause of your breathing issues, you may be a good candidate for anti-reflux surgery which is done laparoscopicly and involves wrapping the stomach around the lower part of the esophagus creating a valve. The hiatal hernia also gets fixed during this surgery.