Multiple Problems - Increase dose of Nexium?

I have bad reflux disease (GERD) and take 40mg of Nexium a day to keep it under control.  I had been taking Ultram (tramadol) for a ruined knee (osteoarthritis) and started to vomit every day.  After tapering off the Ultram, it stopped.  I think the Ultram has caused more "sphincter"(sp?) valve problems.  The Nexium is not working as well.  When recently put on antibiotics, my GERD really got worse, and I got esophageal spasms (very painful).  I'm going in for surgery tomorrow to have my parotid (salivary) gland removed (has a tumor on it).  I know the ENT doctor wants to give me Vicodin for pain.  I sure don't want to vomit from pain medicine after just having surgery on my neck!

Would it be harmful or helpful to take a larger dose of Nexium (maybe 60mg instead of 40mg) for awhile to try to calm my GERD down?  I don't have insurance and my surgery tomorrow is going to be very painful financially.  Having surgery for my GERD is just not an option right now.

I would really appreciate any input.  Thank you.

Sue