Heartburn Support - Nose Bleeds from Pepcid

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Nose Bleeds from Pepcid

Preesi

2006-02-25, 4:39 pm

Do all Pepcid type drugs cause nose bleeds

--
preesi
~~~~~~~~~
Gay is just a label, Love is to the death...
~~~~~~~~~
My Websites and Favorite Links: http://tinyurl.com/yvw45
Yahoo/SidekickII Name: MissPreesi
Skype: Preesi

Vanny

2006-02-25, 6:23 pm

Preesi,

My apologies, but I did not have time the other day to write. Have a look at
www.drugs.com and www.rxlist.com for drug side effects and drug interations.

I have no personal experience with peptic ulcers, but a relative of mine was
treated for this disease. The only ways to establish that you have a peptic
ulcer is to go to a gastroenterologist and have gastroendoscopy done or to
wait until you start spewing up coffee granule type vomit.

For a peptic ulcer at a guess a low acid diet would be suitable. Google "low
acid diet"

Peptic ulcers are generally caused by H.pylori infection and this is not to
be taken lightly as it can cause cancer. H. pylori is eradicated by a
3-pronged treatment of two antibiotics and a proton pump inhibitor. Google
H. pylori treatment.

For further information do a directed search on:
PubMed: http://www.pubmedcentral.gov/
Medscape: www.medscape.com .
Free Medical Journals: http://www.freemedicaljournals.com/
Medical Hunt: http://www.hon.ch/MedHunt/
Medical World Search: http://www.mwsearch.com/
Medical Explorer: http://www.medexplorer.com/

V.

"Preesi" <preesi@comcast.net> schrieb im Newsbeitrag
news:8r6dnYh7w_rgQZ3Z4p2dnA@comcast.com...
Do all Pepcid type drugs cause nose bleeds

--
preesi
~~~~~~~~~
Gay is just a label, Love is to the death...
~~~~~~~~~
My Websites and Favorite Links: http://tinyurl.com/yvw45
Yahoo/SidekickII Name: MissPreesi
Skype: Preesi

Howard McCollister

2006-02-25, 6:23 pm

"Vanny" <VannySS2003@antispam.com> wrote in message
news:dtqndg$fod$1@newsreader3.netcologne.de...
> Preesi,
>
>
> For a peptic ulcer at a guess a low acid diet would be suitable. Google
> "low
> acid diet"

Bascially, that's an old wive's tale, just like the old erroneous concept
that emotional stress causes peptic ulcers. No particular diet has been
shown to cause peptic ulcers, nor has any diet been shown to heal them, with
the possible exception (widely disputed) that a diet high in soluble fiber
may speed healing. The evidence supporting this is marginal.

HMc

Preesi

2006-02-25, 6:23 pm

Vanny wrote:
> Preesi,
>
> My apologies, but I did not have time the other day to write. Have a
> look at www.drugs.com and www.rxlist.com for drug side effects and
> drug interations.
>
> I have no personal experience with peptic ulcers, but a relative of
> mine was treated for this disease. The only ways to establish that
> you have a peptic ulcer is to go to a gastroenterologist and have
> gastroendoscopy done or to wait until you start spewing up coffee
> granule type vomit.
>
> For a peptic ulcer at a guess a low acid diet would be suitable.
> Google "low acid diet"
>
> Peptic ulcers are generally caused by H.pylori infection and this is
> not to be taken lightly as it can cause cancer. H. pylori is
> eradicated by a 3-pronged treatment of two antibiotics and a proton
> pump inhibitor. Google H. pylori treatment.

I now think its just GERD, silent GERD...
I only have pain after I eat. I havent had pain in 3 hours.
Im calling my Dr on monday...

--
preesi
~~~~~~~~~
Gay is just a label, Love is to the death...
~~~~~~~~~
My Websites and Favorite Links: http://tinyurl.com/yvw45
Yahoo/SidekickII Name: MissPreesi
Skype: Preesi

Preesi

2006-02-25, 6:23 pm

So what about the Bloody Noses and Pepcid?

--
preesi
~~~~~~~~~
Gay is just a label, Love is to the death...
~~~~~~~~~
My Websites and Favorite Links: http://tinyurl.com/yvw45
Yahoo/SidekickII Name: MissPreesi
Skype: Preesi

Howard McCollister

2006-02-25, 6:23 pm

"Preesi" <preesi@comcast.net> wrote in message
news:OoydnU_ZGfsdd53ZnZ2dnUVZ_s6dnZ2d@comcast.com...
>
> So what about the Bloody Noses and Pepcid?
>

IIRC, it's listed as a possible adverse reaction to Pepcid, although I've
never seen it. I don't think it's listed in association with other proton
pump inhibitors.

HMc

Pete

2006-02-25, 6:49 pm

Howard McCollister wrote:
> "Preesi" <preesi@comcast.net> wrote in message
> news:OoydnU_ZGfsdd53ZnZ2dnUVZ_s6dnZ2d@comcast.com...
>
>
> IIRC, it's listed as a possible adverse reaction to Pepcid, although
> I've never seen it. I don't think it's listed in association with
> other proton pump inhibitors.
>
> HMc

Howard...I assume you meant to leave the word "other" out, since Pepcid is
an H2 blocker and no where near as powerful as the PPI's :-) ...Pete

Preesi

2006-02-26, 12:52 am

Howard McCollister wrote:
> "Preesi" <preesi@comcast.net> wrote in message
> news:OoydnU_ZGfsdd53ZnZ2dnUVZ_s6dnZ2d@comcast.com...
>
>
> IIRC, it's listed as a possible adverse reaction to Pepcid, although
> I've never seen it. I don't think it's listed in association with
> other proton pump inhibitors.
>
> HMc

Okay Ill switch...
BTW -- is there nausea with GERD?

--
preesi
~~~~~~~~~
Gay is just a label, Love is to the death...
~~~~~~~~~
My Websites and Favorite Links: http://tinyurl.com/yvw45
Yahoo/SidekickII Name: MissPreesi
Skype: Preesi

Howard McCollister

2006-02-26, 10:54 am

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"Preesi" <preesi@comcast.net> wrote in message
news:vrudnV0w6_ARhpzZRVn-vQ@comcast.com...
> Howard McCollister wrote:
>
> Okay Ill switch...
> BTW -- is there nausea with GERD?
>
>

Yes, Pete's correct. Pepcid is a different class of drug than the more
commonly used meds these days and I misspoke.

Yes, nausea is fairly common. Often it's related to alkaline reflux.
Sometimes it's related to the medication itself.

There is no question that the PPIs like Nexium are more effective at acid
suppression than the H2 blockers like Pepcid or Tagamet. They do have side
effects, however, and different PPIs have different side effects. Just
because Nexium might give you diarrhea doesn't mean that Prevacid will.

The treatment of GERD is all about controlling symptoms. If there is not
esophageal damage seen on EGD (Barrett's, stricture, esophagitis) then
lifestyle changes and medical treatment to suppress acid production in the
stomach is the appropriate choice *as long as that approach is controlling
the symptoms to the patient's satisfaction*. IF there is esophageal damage
from reflux, or if lifestyle changes/medication aren't controlling symptoms
(or both), then it's time to start thinking about surgical options.

Be aware that acid suppression with Pepcid or Nexium is only one component
of reflux treatment. Those drugs won't do anything to stop reflux of the
alkaline secretions from the stomach. Those secretions don't cause the pain
that acid does, but they still do damage to the lower esophagus. IOW,
medication doesn't stop reflux, it only changes the nature of the refluxate.

There can be several reasons why reflux symptoms go away, but if they do, it
doesn't mean that reflux still isn't occurring nor that there still isn't
ongoing esophageal damage.

HMc

Pete

2006-02-26, 5:54 pm

Howard McCollister wrote:
> "Preesi" <preesi@comcast.net> wrote in message
> news:vrudnV0w6_ARhpzZRVn-vQ@comcast.com...
>
> Yes, Pete's correct. Pepcid is a different class of drug than the more
> commonly used meds these days and I misspoke.
>
> Yes, nausea is fairly common. Often it's related to alkaline reflux.
> Sometimes it's related to the medication itself.
>
> There is no question that the PPIs like Nexium are more effective at
> acid suppression than the H2 blockers like Pepcid or Tagamet. They do
> have side effects, however, and different PPIs have different side
> effects. Just because Nexium might give you diarrhea doesn't mean
> that Prevacid will.
> The treatment of GERD is all about controlling symptoms. If there is
> not esophageal damage seen on EGD (Barrett's, stricture, esophagitis)
> then lifestyle changes and medical treatment to suppress acid
> production in the stomach is the appropriate choice *as long as that
> approach is controlling the symptoms to the patient's satisfaction*.
> IF there is esophageal damage from reflux, or if lifestyle
> changes/medication aren't controlling symptoms (or both), then it's
> time to start thinking about surgical options.
> Be aware that acid suppression with Pepcid or Nexium is only one
> component of reflux treatment. Those drugs won't do anything to stop
> reflux of the alkaline secretions from the stomach. Those secretions
> don't cause the pain that acid does, but they still do damage to the
> lower esophagus. IOW, medication doesn't stop reflux, it only changes
> the nature of the refluxate.
> There can be several reasons why reflux symptoms go away, but if they
> do, it doesn't mean that reflux still isn't occurring nor that there
> still isn't ongoing esophageal damage.
>
> HMc

For what its worth, long term use of PPI's can result in fundic polyps -
package inserts say about 4% incidence (I have them and don't know what I am
going to do). I can't live without them (the PPI's), and my prevacid
stopped working in 2004, and protonix didn't help either (currently taking
prilosec and it is working). Current gastro says my LES is not that bad,
but it is obviously allowing too much reflux (other gastros have said I have
a minor hiatal hernia - obviously). I'm sure that much of the older
population has a mild hiatal hernia, but maybe not bad enough to cause
discomfort or erosions in the esophagus. My esophagus is okay as long as I
am on the PPI's, and they are working.

There is no way I would entertain surgery of any kind and risk the danger of
messing up the vagus nerve. My last general surgeon (good guy but dropped
my insurance), told me hiatal hernia surgery is serious, and could be very
risky, and you might not be able to burp, or vomit afterward, and worst of
all you might have difficulty swallowing - no way. He said that colostomies
were a walk in the park compared to hiatal hernia surgery. I know they have
the newer endoscopic stuff today (not where I live), but still sounds risky
..

Preesi, I don't know if your interested or not, but the reason the PPI's
work way better than the H2 blockers is as follows [you can bet your doctor
won't tell you this :-)]. There are three main stimulators of acid in the
stomach (histamine, acetylcholine, and gastrin - which is the greatest of
the three I believe). The H2 blockers only block histamine, whereas the
PPI's block all three stimulators and are approx 10 times more effective for
talking purposes. They literally shut the acid off at the parietal cells in
the stomach, and raise the stomach ph significantly.

Currently, the only PPI that you can buy OTC is prilosec (20mg), and
therefore the prescription prilosec is only available in 10 mg and 40 mg.
So if you have insurance, it would probably be cheaper to get an Rx from
your doctor and purchase one of the PPI's that way, but they are quantity
limited (90 day supply) and you have to have your doctor's office call in to
a special number to get approval for longer term use. I would not recommend
taking any more than you need (eg, try 20 mg before 40 mg).

Also PPI's are basically not for long term use (although some of them may
have maintenance approval by the FDA for certain conditions), but doctors
have been prescribing them long term for many years now, and prilosec has
gone OTC (but it says not to take them for more than 14 days ... da da da
da). Before 1997 (approx), the FDA only approved them for 30 days, but the
ban was lifted. I just ran out of steam. For Preesi, I hope this helps.
For Howard, I hope it was reasonably accurate :-) ...Pete

Howard McCollister

2006-02-26, 5:54 pm

"Pete" <pete@nospam.net> wrote in message
news:12048aq5ln1qt76@corp.supernews.com...
> Current gastro says my LES is not that bad,

I assume then that you've had esophageal manometry...what is your resting
LES pressure?

>
> There is no way I would entertain surgery of any kind and risk the danger
> of messing up the vagus nerve.

An odd concern...that's an unusual complication in competent hands, and even
if it happens is generally not that big a deal.

> My last general surgeon (good guy but dropped my insurance), told me
> hiatal hernia surgery is serious, and could be very risky, and you might
> not be able to burp, or vomit afterward, and worst of all you might have
> difficulty swallowing - no way. He said that colostomies were a walk in
> the park compared to hiatal hernia surgery.

It sounds to me like your last general surgeon doesn't really know much
about it, doesn't do the operation, or doesn't do it well. And what a
bizarre comparison - colostomies and fundoplication. Performing a colostomy
is a rather trivial operation. You should get a second opinion from a more
skilled laparoendoscopic surgeon.

> Preesi, I don't know if your interested or not, but the reason the PPI's
> work way better than the H2 blockers is as follows [you can bet your
> doctor won't tell you this :-)]. There are three main stimulators of acid
> in the stomach (histamine, acetylcholine, and gastrin - which is the
> greatest of the three I believe). The H2 blockers only block histamine,
> whereas the PPI's block all three stimulators and are approx 10 times more
> effective for talking purposes. They literally shut the acid off at the
> parietal cells in the stomach, and raise the stomach ph significantly.
> For Howard, I hope it was reasonably accurate :-) ...Pete
>

Yes, reasonably accurate...but why should Preesi bet that her doctor won't
tell her any of that?

HMc

Pete

2006-02-27, 12:55 am

Howard McCollister wrote:
> "Pete" <pete@nospam.net> wrote in message
> news:12048aq5ln1qt76@corp.supernews.com...
>
> I assume then that you've had esophageal manometry...what is your
> resting LES pressure?

I can't get into the doctor stuff with you Howard. He was basing it on his
endoscopic examination, just like the other gastros (I have the pictures
indicating the hiatel hernia). I told you I have been to 75 doctors in my
life (and I have nothing to show for it). I have many medical problems
(gastro is just one). I went to Baltimore for a second gastro opinion in
2004 (I wrote you about this over a year ago at sci med), and got a 24 hour
ph and manometry and ended up with the worst brochitis in my life.

And the damn gastro where I live didn't even know how to read the 24 hour ph
graph, and didn't even know that it was in his chart (sent from Baltimore),
when I tried to ask him about my copy. It was a simple xy relationship of
ph versus time (I could read it real easy). He told me he'd have to look at
it later as he was fumbling through his chart looking for it - duh!! Right
now I need the bastard to check on my damn polyps once a year. So I can't
talk to you about going to any more doctors, plus I live by myself and don't
have anyone to help me except for one person. And he is the last gastro
where I live (been to the others) and is well respected, and from the old
school, but doesn't know a whole lot about 24 hour ph's and manometries,
since they don't do them in the hospital or facilities where I live.

>
>
>
>
> An odd concern...that's an unusual complication in competent hands,
> and even if it happens is generally not that big a deal.
>
>
>
> It sounds to me like your last general surgeon doesn't really know
> much about it, doesn't do the operation, or doesn't do it well. And
> what a bizarre comparison - colostomies and fundoplication.
> Performing a colostomy is a rather trivial operation. You should get
> a second opinion from a more skilled laparoendoscopic surgeon.

He is a fine doctor (and respected my right to do research), and probably
the best trauma surgeon where I live (there are only 7 general surgeons, and
I believe three of them are certified for trauma). He probably hasn't done
a whole lot of hiatal hernia surgeries, or fundo's if you wish, but I
queried him on it and what he told me is what I said. If there is a risk of
having difficulty swallowing after, forget it, and there are no guarantees
in surgery (I have had enough surgeries in my life).

And he was not comparing fundos to colostomies. I was the one who asked him
the question, just to get an order of magnitude of the risks between the
two.

>
>
>
> Yes, reasonably accurate...but why should Preesi bet that her doctor
> won't tell her any of that?

Howard...You are a doctor and are very knowledgeable, and I'm sure a fine
surgeon, but you ought to try going to doctors. There are few people on the
planet who have been to more doctors than me. Most of them will not tell
you anything unless you specifically ask, and then you get a lot of I don't
knows, which is fine if they don't know, but it happens too much. And they
don't even know who they are talking to (you are just a damn chart to them),
and they won't call you by your first name. And I can't stand it when they
get upset and disrespect my right to study my diseases/conditions, and if
you say too much they will dismiss you.

As far as Preesi's doctor not telling him what I wrote, if it's his primary
physician, I doubt he would even know what the three main stimulators of
stomach acid are, and even if he did know, he wouldn't waste the time in
trying to explain it.

>
> HMc

Vanny

2006-02-27, 10:57 am

Are you the Crohn's Pete that takes Molocure?

V.

"Pete" <pete@nospam.net> schrieb im Newsbeitrag
news:1204t382271ccb0@corp.supernews.com...
Howard McCollister wrote:
> "Pete" <pete@nospam.net> wrote in message
> news:12048aq5ln1qt76@corp.supernews.com...
>
> I assume then that you've had esophageal manometry...what is your
> resting LES pressure?

I can't get into the doctor stuff with you Howard. He was basing it on his
endoscopic examination, just like the other gastros (I have the pictures
indicating the hiatel hernia). I told you I have been to 75 doctors in my
life (and I have nothing to show for it). I have many medical problems
(gastro is just one). I went to Baltimore for a second gastro opinion in
2004 (I wrote you about this over a year ago at sci med), and got a 24 hour
ph and manometry and ended up with the worst brochitis in my life.

And the damn gastro where I live didn't even know how to read the 24 hour ph
graph, and didn't even know that it was in his chart (sent from Baltimore),
when I tried to ask him about my copy. It was a simple xy relationship of
ph versus time (I could read it real easy). He told me he'd have to look at
it later as he was fumbling through his chart looking for it - duh!! Right
now I need the bastard to check on my damn polyps once a year. So I can't
talk to you about going to any more doctors, plus I live by myself and don't
have anyone to help me except for one person. And he is the last gastro
where I live (been to the others) and is well respected, and from the old
school, but doesn't know a whole lot about 24 hour ph's and manometries,
since they don't do them in the hospital or facilities where I live.

>
>
>
>
> An odd concern...that's an unusual complication in competent hands,
> and even if it happens is generally not that big a deal.
>
>
>
> It sounds to me like your last general surgeon doesn't really know
> much about it, doesn't do the operation, or doesn't do it well. And
> what a bizarre comparison - colostomies and fundoplication.
> Performing a colostomy is a rather trivial operation. You should get
> a second opinion from a more skilled laparoendoscopic surgeon.

He is a fine doctor (and respected my right to do research), and probably
the best trauma surgeon where I live (there are only 7 general surgeons, and
I believe three of them are certified for trauma). He probably hasn't done
a whole lot of hiatal hernia surgeries, or fundo's if you wish, but I
queried him on it and what he told me is what I said. If there is a risk of
having difficulty swallowing after, forget it, and there are no guarantees
in surgery (I have had enough surgeries in my life).

And he was not comparing fundos to colostomies. I was the one who asked him
the question, just to get an order of magnitude of the risks between the
two.

>
>
>
> Yes, reasonably accurate...but why should Preesi bet that her doctor
> won't tell her any of that?

Howard...You are a doctor and are very knowledgeable, and I'm sure a fine
surgeon, but you ought to try going to doctors. There are few people on the
planet who have been to more doctors than me. Most of them will not tell
you anything unless you specifically ask, and then you get a lot of I don't
knows, which is fine if they don't know, but it happens too much. And they
don't even know who they are talking to (you are just a damn chart to them),
and they won't call you by your first name. And I can't stand it when they
get upset and disrespect my right to study my diseases/conditions, and if
you say too much they will dismiss you.

As far as Preesi's doctor not telling him what I wrote, if it's his primary
physician, I doubt he would even know what the three main stimulators of
stomach acid are, and even if he did know, he wouldn't waste the time in
trying to explain it.

>
> HMc

Howard McCollister

2006-02-27, 10:57 am

"Pete" <pete@nospam.net> wrote in message
news:1204t382271ccb0@corp.supernews.com...

> Howard...You are a doctor and are very knowledgeable, and I'm sure a fine
> surgeon, but you ought to try going to doctors. There are few people on
> the planet who have been to more doctors than me. Most of them will not
> tell you anything unless you specifically ask, and then you get a lot of I
> don't knows, which is fine if they don't know, but it happens too much.
> And they don't even know who they are talking to (you are just a damn
> chart to them), and they won't call you by your first name. And I can't
> stand it when they get upset and disrespect my right to study my
> diseases/conditions, and if you say too much they will dismiss you.
>
> As far as Preesi's doctor not telling him what I wrote, if it's his
> primary physician, I doubt he would even know what the three main
> stimulators of stomach acid are, and even if he did know, he wouldn't
> waste the time in trying to explain it.
>

Yeh, I don't go to doctors much, and my experience if I did is naturally
different than yours. Personally, I applaud your attention to your various
health conditions, but the communication difficulties you have is something
I can't relate to, nor do I perceive it in the patients that I see that come
from my various primary care partners in this particular medical community.
Nevertheless, I don't doubt that it exists around the country and I'm
sympathetic to your frustrations. I can't fix it for you though...I can only
influence a very limited part of the global medical community.

GERD is a complex disease process. Sadly, most gastroenterologists don't
understand it. This isn't surprising since it's not a medical condition -
it's a surgical condition whose only cure rests with surgery. And it is
indeed a cure, as opposed to simply treating the symptoms medically with
obviously variable success. Sometimes that symptomatic approach works,
sometimes it doesn't. The problem is that gastroenterologists tend to be
very unclear on where that line is and they don't really understand the
point that it's time to throw in the towel and refer the patient to a
surgeon.

As to surgeons, again the majority don't understand GERD. And, there are
many that do, but don't understand how to fix it or lack the skills to do it
well. It is indeed a difficult operation, but it's not THAT difficult. It
sounds like the surgeon you spoke to might be in that category, and this is
relatively common for doctors in that mid-50's age group. He grew up in a
world of open surgery, and advanced laparoscopic techniques are simply
beyond the skill set of many, many surgeons of that generation. I perceive
that what he was REALLY telling you is that he's not comfortable (or
capable) of a surgical solution to your problem, and therefore you shouldn't
have it done. I find it frustrating that so many patients are told that by
their surgeons and especially gastroenterologists, when their long-term
disabling reflux symptoms can be eliminated with a 45 minute operation and a
23 hour hospital stay.

My perspective.

HMc

Pete

2006-02-28, 12:54 am

Howard McCollister wrote:
> "Pete" <pete@nospam.net> wrote in message
> news:1204t382271ccb0@corp.supernews.com...
>
>
>
>
> Yeh, I don't go to doctors much, and my experience if I did is
> naturally different than yours. Personally, I applaud your attention
> to your various health conditions, but the communication difficulties
> you have is something I can't relate to, nor do I perceive it in the
> patients that I see that come from my various primary care partners
> in this particular medical community. Nevertheless, I don't doubt
> that it exists around the country and I'm sympathetic to your
> frustrations. I can't fix it for you though...I can only influence a
> very limited part of the global medical community.
> GERD is a complex disease process. Sadly, most gastroenterologists
> don't understand it. This isn't surprising since it's not a medical
> condition - it's a surgical condition whose only cure rests with
> surgery. And it is indeed a cure, as opposed to simply treating the
> symptoms medically with obviously variable success. Sometimes that
> symptomatic approach works, sometimes it doesn't. The problem is that
> gastroenterologists tend to be very unclear on where that line is and
> they don't really understand the point that it's time to throw in the
> towel and refer the patient to a surgeon.
>
> As to surgeons, again the majority don't understand GERD. And, there
> are many that do, but don't understand how to fix it or lack the
> skills to do it well. It is indeed a difficult operation, but it's
> not THAT difficult. It sounds like the surgeon you spoke to might be
> in that category, and this is relatively common for doctors in that
> mid-50's age group. He grew up in a world of open surgery, and
> advanced laparoscopic techniques are simply beyond the skill set of
> many, many surgeons of that generation. I perceive that what he was
> REALLY telling you is that he's not comfortable (or capable) of a
> surgical solution to your problem, and therefore you shouldn't have
> it done. I find it frustrating that so many patients are told that by
> their surgeons and especially gastroenterologists, when their
> long-term disabling reflux symptoms can be eliminated with a 45
> minute operation and a 23 hour hospital stay.
> My perspective.

Thank you Howard...I was afraid you were going to come back blasting at me
with both barrels, telling me I didn't know what I was talking about, but
you did not, and I appreciate your comments. I certainly would like to keep
our lines of communication open, and commend you for your dedication and
efforts in the sci.med group and in here, and my heart goes out to you for
that. There are very few doctors in the world like you, that will volunteer
their time to a newsgroup, like you do. There is a urologist in Madrid,
Spain (Dr. Sancha) who is becoming quite renown for his worldwide efforts in
PVP (what a nice man), and like you he is a kind and caring doctor who is
dedicated, and volunteers some of his time to a newsgroup. I would like to
clear up a couple things and maybe ask you a question or two. I am a
retired engineer and live by myself and don't have anyone to help me except
for one person, and I have multiple health problems.

- First I consider myself to be in the 99th to 100th percentile of all
patients going to doctors, pertaining to my medical knowledge. I'm not
bragging, I'm not like that - but I've been abused and insulted by doctors,
and don't like them in general, like I told you - and I have been studying
since my sarcoidosis diagnosis via thoracoscopy in 1992 - I was one of the
first patients in my area at the time to get the new video assisted surgery
for my lung biopsy. I could tell you stories on end about bad experiences
with doctors, who I feel should not be practicing medicine. You sound like
you may be old enough [10,000 colonoscopies :-)] to remember the black and
white TV show "Marcus Welby - MD". There are no more Marcus Welby's
anymore. It is all capitalistic dog eat dog today, and they are booking six
patients an hour now, which IMO is unacceptable. No personal (bedside
manner) contact with the patient, just get them in and out.

It makes me sick listening to conversations I hear in doctor's offices, and
to see people taking meds and don't know what they are taking (ie "I don't
know, the doctor gave them to me" - especially younger people - the older
people tend to be like that anyway, and may not even own a computer to do
their research). Most people who go to doctors don't do a lot of research,
but that has started to change with the advent of pc's.

But the problem is most doctors (IMO) aren't opened minded to that concept
(whether the doc is young or old). It has been written in many publications
that "us patients" have every right in the world to research our
diseases/conditions so we can ask intelligent questions and make informed
decisions. Any doctor who doesn't respect that right is a damn fool, and
shouldn't be practicing medicine. I understand you have to be somewhat
diplomatic when letting the doctor know you do research (and not make it
sound like you are questioning him or doubting him), but it is not always
easy, and in IMO most of them have primma donna attitudes and don't like it.
Hell, I had a Pakistani pulmonologist once who wouldn't listen to me, and
interrupt me, and not anwer my questions, and contradict himself, and
blindly write that my pulse/respiration were 70/18 everytime I went to him
(I found out when I got my records later), and I have tachycardia and my
heartbeat is always over 100 during the day. IMO that was incompetence. We
parted ways and it was not friendly. Unfortunately most practices these
days won't let you switch docs within the practice if you don't get along
with one of the docs (they have a bullshit reason for that which makes no
sense). So if you live in a small community where all the specialists are
in one or two groups, you can run out of doctors fast. It is not right.

- I would like to clear up what I think you may misperceive about my last
general surgeon. First of all he is not in his mid fifties (that is the new
gen surgeon that I just wrote you about in the sci.med group about the
colonoscopy prep). But I'm impressed that you remember "mid fifties" from
the sci.med group :-) . My last surgeon I mentioned, that told me the risks
associated with hiatal hernia surgery is a young man (early 40's), and one
of the few "good" doctors I have been to (but he dropped my insurance like I
told you). I was going to him for rectal problems (in 2002 and then again
in 2005).

I already said that he may not have done a lot of hiatal hernia surgeries
(and I know they don't do the latest stuff for GERD where I live - but they
do perform laparoscopic surgery), but I queried him on it, and he told me it
was serious and major, and the possible risk of having difficulty swallowing
was enough for me - I have too many other problems. I acknowledge what you
said about this, and I am not going back to Baltimore, for any more opinions
(I told you what happened last time). I have been to the damn so called
tertiary care centers three times now (Univ of Maryland and Johns Hopkins)
for three different problems and have nothing to show for it. Of course I
will grant you, if you need complex, or advanced high tech surgery of any
kind (they are using the da Vinci robot nowadays for various things, as I'm
sure you are aware), then you need to go to the bigger cities.

- Howard May I ask what state you practice in, and are you in a big city.
You mentioned having primary care partners. How big is your group and are
your partners all internists and you are the only surgeon, or is it huge
with many specialties. You seem to be very involved in gastroenterology
stuff (which is most of the general surgery areas in the abdomen anyway).
Do you treat patients as their gastroenterlologist (so to speak), and they
only go to you, and do not go to a gastro. The person who takes me for my
procedures has that relationship with her general surgeon, who is also a
female, which probably lends itself better to what I am asking. Also, do
you perform 24 hour ph's and manometries, or you just get the results from
them from a gastro facility that does them.

- Sorry this is off topic in this ng, but in closing let me ask you for
your opinion on the dreaded "dentate line" in the anal canal, since I have
had three hemorrhoidectomies in my life. I have been told by both a
colorectal surgeon and a general surgeon, and at least one gastro, and an
internist, that internal hemorrhoids don't pain, and there are no pain
sensors above the dentate line in the anal canal, and you can only feel
pressure above that point. My current gastro [the old timer I told you
about that didn't know how to read the 24 hour ph I got in Baltimore :-)],
told me that internal hemorrhoids *can* cause pain, and I didn't want to
argue with him (especially since I agree with him). And I am not talking
about prolapsed hemorrhoids, or external hemorrhoids, which no doubt pain.
I had my external hems lanced, and blood clots pulled out at least a dozen
times in the early 70's, right in the general surgeons office, took him
five minutes, shot of lidocaine and I was on my way - those days are gone -
everything is in the hospital or surgery center today, and the general
surgeons don't even have a damn anascope, so you have to go under gen
anesthesia just to get a rectal exam, which is overkill IMO.

Sorry I got carried away there. What is your opinion on the dentate line,
and internal hems paining. I say they do, based on my personal experiences,
and other people have told me the same. I have had chronic hemorrhoids much
of my life both internal, external, and prolapsed, and dare say I am
somewhat an expert on the subject. I say the internal ones can hurt also,
regardless of the dentate line, and what the textbooks say. It sure as hell
aint my imagination :-):-) .

Sorry this was so long Howard. Hope you got through it...Pete

Pete

2006-02-28, 12:54 am

Vanny wrote:
> Are you the Crohn's Pete that takes Molocure?

God no...I have enough problems :-):-)

[vbcol=seagreen]
>
> V.
>
>
> "Pete" <pete@nospam.net> schrieb im Newsbeitrag
> news:1204t382271ccb0@corp.supernews.com...
> Howard McCollister wrote:
>
> I can't get into the doctor stuff with you Howard. He was basing it
> on his endoscopic examination, just like the other gastros (I have
> the pictures indicating the hiatel hernia). I told you I have been
> to 75 doctors in my life (and I have nothing to show for it). I have
> many medical problems (gastro is just one). I went to Baltimore for
> a second gastro opinion in 2004 (I wrote you about this over a year
> ago at sci med), and got a 24 hour ph and manometry and ended up with
> the worst brochitis in my life.
>
> And the damn gastro where I live didn't even know how to read the 24
> hour ph graph, and didn't even know that it was in his chart (sent
> from Baltimore), when I tried to ask him about my copy. It was a
> simple xy relationship of ph versus time (I could read it real easy).
> He told me he'd have to look at it later as he was fumbling through
> his chart looking for it - duh!! Right now I need the bastard to
> check on my damn polyps once a year. So I can't talk to you about
> going to any more doctors, plus I live by myself and don't have
> anyone to help me except for one person. And he is the last gastro
> where I live (been to the others) and is well respected, and from the
> old school, but doesn't know a whole lot about 24 hour ph's and
> manometries, since they don't do them in the hospital or facilities
> where I live.
>
>
>
> He is a fine doctor (and respected my right to do research), and
> probably the best trauma surgeon where I live (there are only 7
> general surgeons, and I believe three of them are certified for
> trauma). He probably hasn't done a whole lot of hiatal hernia
> surgeries, or fundo's if you wish, but I queried him on it and what
> he told me is what I said. If there is a risk of having difficulty
> swallowing after, forget it, and there are no guarantees in surgery
> (I have had enough surgeries in my life).
>
> And he was not comparing fundos to colostomies. I was the one who
> asked him the question, just to get an order of magnitude of the
> risks between the two.
>
>
> Howard...You are a doctor and are very knowledgeable, and I'm sure a
> fine surgeon, but you ought to try going to doctors. There are few
> people on the planet who have been to more doctors than me. Most of
> them will not tell you anything unless you specifically ask, and then
> you get a lot of I don't knows, which is fine if they don't know, but
> it happens too much. And they don't even know who they are talking
> to (you are just a damn chart to them), and they won't call you by
> your first name. And I can't stand it when they get upset and
> disrespect my right to study my diseases/conditions, and if you say
> too much they will dismiss you.
>
> As far as Preesi's doctor not telling him what I wrote, if it's his
> primary physician, I doubt he would even know what the three main
> stimulators of stomach acid are, and even if he did know, he wouldn't
> waste the time in trying to explain it.
>

jmc

2006-02-28, 10:55 am

Suddenly, without warning, Pete exclaimed (28-Feb-06 3:51 AM):
> Howard McCollister wrote:

<snip long disserte on why Pete doesn't like doctors>
Sorry, Pete, but it was a bit long

[vbcol=seagreen]
>
> Sorry this was so long Howard. Hope you got through it...Pete
>

Gad. Don't ever come to England, it's even worse here. I've just had
my gp tell me, essentially, "sorry, we don't know why you have a chronic
cough, have a nice day!".

I also just found out she's lied to me, as a while back she told me that
NHS doctors don't even get to see the x-rays from hospital visits (had
em done most recently for my chest). Called the clinic yesterday as I'm
moving back out of the country (I'm American, posted to the UK), and
asked how I'd get my x-rays from the hospital. They have them there!

The other doctors in the clinic also have earned my ire, in different
ways. Though I can deal with the youngest, she hasn't been corrupted by
the system yet. They're all related: husband, wife, daughter.

And, they're really insulted if I do my own research - both the older
doctors get really huffy if I ask questions based on my research. And
don't you DARE question their diagnosis or suggested treatment!

Like when I went in with a severe, productive cough and they prescribed
amoxycillin (5 days) then proceeded to go through 3 other antibiotics
over the next two months when each didn't work - all without actually
trying to diagnose exactly what was wrong. Cough never stopped, and now
the cough/sore throat is worse again, no sleep last night and I'm home
sick writing long dissertations instead of getting some work done

(appt with thoracic doc in two weeks).

Dr. "Wife" still asks me each visit if I've had my gallbladder out yet.
I have stones, yes, but they are silent and I only get the lightest
tinge if I eat *really* bad - like a whopper and fries or something with
tons of saturated fat. I've changed to a healthier diet with more fiber,
as I know that helps. I also consulted with other doctors I have access
to, on a advice-only basis - he agreed I'm doing the right thing. But
still she asks, and insists it has to be removed *now*.

So, I have absolutely NO faith in most NHS doctors (I know some aren't
as bad as these). My private GP (cardio) is competent, but expensive.
Or is over $120 for a consultation (no procedures) now normal in the US
as well?

Pete, maybe you should make an appointment with Howard

heck, maybe I
should!

And, Howard, let me add my admiration to Pete's that you're willing to
get involved in these newsgroups. So few doctors do, and in our current
litigious, "it's always someone else's fault" country (yup, the US),
can't really blame them...

(I wish I could find a doctor that's like my cat's veterinarian:
Understands that I have some native intelligence, and some basic
knowledge, and doesn't 'talk down' to me. Gives me it straight, big
medical words and all

I respect and appreciate that, but haven't
found a doc for myself yet that'll do the same...)

jmc

Howard McCollister

2006-02-28, 10:55 am

"Pete" <pete@nospam.net> wrote in message
news:1207i58d5lg8a07@corp.supernews.com...
> Howard McCollister wrote:
>
> Thank you Howard...I was afraid you were going to come back blasting at me
> with both barrels, telling me I didn't know what I was talking about, but
> you did not, and I appreciate your comments. I certainly would like to
> keep our lines of communication open, and commend you for your dedication
> and efforts in the sci.med group and in here, and my heart goes out to you
> for that. There are very few doctors in the world like you, that will
> volunteer their time to a newsgroup, like you do. There is a urologist in
> Madrid, Spain (Dr. Sancha) who is becoming quite renown for his worldwide
> efforts in PVP (what a nice man), and like you he is a kind and caring
> doctor who is dedicated, and volunteers some of his time to a newsgroup.
> I would like to clear up a couple things and maybe ask you a question or
> two. I am a retired engineer and live by myself and don't have anyone to
> help me except for one person, and I have multiple health problems.
>
> - First I consider myself to be in the 99th to 100th percentile of all
> patients going to doctors, pertaining to my medical knowledge. I'm not
> bragging, I'm not like that - but I've been abused and insulted by
> doctors, and don't like them in general, like I told you - and I have been
> studying since my sarcoidosis diagnosis via thoracoscopy in 1992 - I was
> one of the first patients in my area at the time to get the new video
> assisted surgery for my lung biopsy. I could tell you stories on end
> about bad experiences with doctors, who I feel should not be practicing
> medicine. You sound like you may be old enough [10,000 colonoscopies :-)]
> to remember the black and white TV show "Marcus Welby - MD". There are no
> more Marcus Welby's anymore. It is all capitalistic dog eat dog today,
> and they are booking six patients an hour now, which IMO is unacceptable.
> No personal (bedside manner) contact with the patient, just get them in
> and out.
>
> It makes me sick listening to conversations I hear in doctor's offices,
> and to see people taking meds and don't know what they are taking (ie "I
> don't know, the doctor gave them to me" - especially younger people - the
> older people tend to be like that anyway, and may not even own a computer
> to do their research). Most people who go to doctors don't do a lot of
> research, but that has started to change with the advent of pc's.
>
> But the problem is most doctors (IMO) aren't opened minded to that concept
> (whether the doc is young or old). It has been written in many
> publications that "us patients" have every right in the world to research
> our diseases/conditions so we can ask intelligent questions and make
> informed decisions. Any doctor who doesn't respect that right is a damn
> fool, and shouldn't be practicing medicine. I understand you have to be
> somewhat diplomatic when letting the doctor know you do research (and not
> make it sound like you are questioning him or doubting him), but it is not
> always easy, and in IMO most of them have primma donna attitudes and don't
> like it. Hell, I had a Pakistani pulmonologist once who wouldn't listen to
> me, and interrupt me, and not anwer my questions, and contradict himself,
> and blindly write that my pulse/respiration were 70/18 everytime I went to
> him (I found out when I got my records later), and I have tachycardia and
> my heartbeat is always over 100 during the day. IMO that was
> incompetence. We parted ways and it was not friendly. Unfortunately most
> practices these days won't let you switch docs within the practice if you
> don't get along with one of the docs (they have a bullshit reason for that
> which makes no sense). So if you live in a small community where all the
> specialists are in one or two groups, you can run out of doctors fast. It
> is not right.
>
> - I would like to clear up what I think you may misperceive about my last
> general surgeon. First of all he is not in his mid fifties (that is the
> new gen surgeon that I just wrote you about in the sci.med group about the
> colonoscopy prep). But I'm impressed that you remember "mid fifties" from
> the sci.med group :-) . My last surgeon I mentioned, that told me the
> risks associated with hiatal hernia surgery is a young man (early 40's),
> and one of the few "good" doctors I have been to (but he dropped my
> insurance like I told you). I was going to him for rectal problems (in
> 2002 and then again in 2005).
>
> I already said that he may not have done a lot of hiatal hernia surgeries
> (and I know they don't do the latest stuff for GERD where I live - but
> they do perform laparoscopic surgery), but I queried him on it, and he
> told me it was serious and major, and the possible risk of having
> difficulty swallowing was enough for me - I have too many other problems.
> I acknowledge what you said about this, and I am not going back to
> Baltimore, for any more opinions (I told you what happened last time). I
> have been to the damn so called tertiary care centers three times now
> (Univ of Maryland and Johns Hopkins) for three different problems and have
> nothing to show for it. Of course I will grant you, if you need complex,
> or advanced high tech surgery of any kind (they are using the da Vinci
> robot nowadays for various things, as I'm sure you are aware), then you
> need to go to the bigger cities.
>
> - Howard May I ask what state you practice in, and are you in a big city.
> You mentioned having primary care partners. How big is your group and are
> your partners all internists and you are the only surgeon, or is it huge
> with many specialties. You seem to be very involved in gastroenterology
> stuff (which is most of the general surgery areas in the abdomen anyway).
> Do you treat patients as their gastroenterlologist (so to speak), and they
> only go to you, and do not go to a gastro. The person who takes me for my
> procedures has that relationship with her general surgeon, who is also a
> female, which probably lends itself better to what I am asking. Also, do
> you perform 24 hour ph's and manometries, or you just get the results from
> them from a gastro facility that does them.

My practice is a 25-doctor multispecialty group in a mostly rural
resort-type area of central Minnesota. I have 3 general surgery partners. We
do an extensive amount of advanced laparoscopic surgery, and in fact we
teach it to other surgeon from several midwestern states. We have
gastroenterologists we refer patients to 15 miles away in the next town when
necessary, but we don't sent them to gastrenterologists for surgical
problems, only for medical problems. We have a complete esophageal lab
including wireless ambulatory pH testing, conventional manometry and
impedance manometry and reflux testing.

>
> Sorry I got carried away there. What is your opinion on the dentate line,
> and internal hems paining. I say they do, based on my personal
> experiences, and other people have told me the same. I have had chronic
> hemorrhoids much of my life both internal, external, and prolapsed, and
> dare say I am somewhat an expert on the subject. I say the internal ones
> can hurt also, regardless of the dentate line, and what the textbooks say.
> It sure as hell aint my imagination :-):-) .
>

It's not the internal hemorrhoids that hurt, it's that the inflammatory
process from an inflammed internal hemorrhoid extends and stimulated nerves
that are close to the dentate line. You're right, internal hemorrhoids can
be, but aren't always, painful.

HMc

Vanny

2006-02-28, 12:52 pm

If you think Pete writes long essays, you'll change your mind when you get
me going on the subject of the competence of the medical profession.

Personally, I don't understand doctors. I also thought that the docs here in
Germany would be better than those in the UK. The speed of treatment is
obviously beyond compare, but there is something missing in the average
consultation. If I did my job like a lot of docs do theirs I would have been
sacked years ago.

I have been tired for years with Crohn's, mild heart failure and GERD and
repeatedly told my GP who said that I would probably just be tired for the
rest of my life. I also told her that I had intermittent diarrhoea, stomach
pain and intestinal blockages, the usual Crohn's arthritis and intermittent
eye problems. One really bad blockage lasted 24 hours (normally they lasted
between 2 and 8 hours) and I ended up with a section of intestine as hard as
rock (no, I am not exagerating). On that day I went to the local hospital
after having rung my doctor on her mobile phone at 07:00 (I waited until a
semi-civilised hour) and told her that I was concerned that my intestine
might perforate. She said that that would not happen but said that I should
go to the local accident and emergency for them to have a look because she
started surgery a couple of hours later.

I was incensed at the treatment I received at the hospital. The doc. (young,
tall, blond female) looked at me, decided that I was feigning it, did a 3
finger prod of the soft section of my abdomen and told me that there was
nothing wrong with me. I did not point to the section where the blockage was
because I was angry and I felt that it was not my job to tell her how to do
her job. I walked the 10 minutes back home, fuming, in a lot of pain and was
violently sick when I got in, which is always a good sign with a blockage
and indicates that things are resolving. In retrospect I should have
requested a second doctor to examine me because I was really ill and
intestinal perforation is a real risk in such a situation especially with
Crohn's.

I went in for surgery last Feb. 2005 after having had chronic pain since
Nov. 2002. The day before surgery my surgeon (the big boss) said to me the
blood tests, ultrasound examination and SBFT (small bowel follow through)
with barium had revealed absolutely nothing, but I said to the surgeon to
not having any qualms about opening me up because I knew that there was
something seriously wrong. As an aside, I actually felt as though I was
dying, but could not say that to any of the doctors because they would have
sectioned me on the spot. He also had to refashion the ileostoma (again),
which had retracted and stenosed and was contributing to the ileum
obstruction problems. The two senior surgeons spent over 5 hours just
cutting through adhesions and then over an hour cutting intestine out,
refashioning the ileostoma and generally clearing up. They removed a
conglomerate tumour of the ileum, the tissue of which was necrotising
because of restricted blood supply due to strangulation by adhesions. It
also had inactive Crohn's disease in it (one of my close companions in
life). The necrotising tissue was what was making me so ill.

The surgery was a success, although I ended up in intensive care twice. I
generally don't like coming round after an anaesthetic - a subconcious
desire to sleep for the rest of my life - and then I had a transfusion
reaction and was in for observation. Immediately after the op. I had out of
control diarrhoea, but this was interpreted as the operation being a
success. They discharged me after 16 days (and I wanted to go home). I was
so ill I could not hold myself upright. I had lost over 10 kg (starting
weight less than 55 kg) and my skin was hanging off me. I went to my GP 2-3
times a week and told her I had diarrhoea and was having to drink 5-6 litres
per day to and eat salt by the handfull (I had the crystalline salt and was
eating it like others eat peanuts) to prevent me from getting really
dehydrated. She did nothing. In the meantime I was back in the hospital to
have an abdominal abcess aspirated and told them I had diarrhoea. They
tested for pathogens, found nothing and discharged me. Eventually, I
requested that my GP refer me to my gastroenterologist. I went to my
gastroenterologist and told him. He said that diarrhoea with bag emptying
over 6 times a day was normal in an ileostomist (panproctocolectomy in 1993
for Crohn's colitis).

I went to a convalescent clinic in April, but had to leave after 4 days
because of suspected ovarian cancer, but it was actually a pelvic abcess
emptying through the vagina. I then had to be treated for several months for
an entero-vaginal fistula. In the clinic they had started doing tests and
measured my beta-carotine level at 15 mcg/ml (normal 150-1250 mcg/ml).
Unfortunately, this result was lost in the body of the 10 page report and
not highlighted in the suspected diagnoses. This was a major mistake.

In late May/early June I found a couple of papers on "high throughput
syndrome in Crohn's ileostomists" the treatment for which was the steroid
Entocort. I marched round the corner to my GP and requested this treatment,
which significantly helped me. Up to that point, March to May last year, I
was confined indoors and only staggered out to buy food. In early June some
4-5 days after starting Entocort I really picked up and the diarrhoea
lessened somewhat, but I was able to do more than lounge for days on end in
my pyjamas watching DVDs or playing the same computer game for 10 hours at a
time.

I asked my gynaecologist to provide me with a short statement for the
convalescent clinic and she totally screwed up and basically wrote that the
fistula that she was treating and that healed in early August and never
actually existed. I had to rewrite the letter (in German) as she dictated
corrections to me over the telephone. In September, I went back to the
convalescent clinic (German system is very good in this respect). They
measured my output and the doctor told me I was extremely ill. I did not
need a doctor to tell me that, but at least one doc was actually
acknowledging it. I had over 3 litres diarrhoea a day and between 120-180 g
fat was excreted per day. Pathogenic is over 12 g fat lost in the stool per
day. I was diagnosed as having severe steatorrhoea due to decompensated bile
salt loss. My beta-carotene level was 40 mcg/ml. However, it was some 8
months after the operation in Feb. in another hospital in a city adjacent to
my home town in Germany that I received the real diagnosis of short bowel
syndrome. I was parenterally fed there and I felt fantastic until I got
Pseudomonas aeruginosa sepsis.

Since Xmas I have been feeling increasingly run down - from being already
totally run down. I told my GP that I had the feeling that my body was just
shutting down. She said that that didn't happen and I was not to worry. It
was getting to the point where I again could not get out of the house (March
to May last year). I had already had eye problems and chronic exhaustion as
running symptoms and then I had started to develop neurological symptoms -
staggering, headaches, aching limbs, not being able to pick things up or
hand/wrist just giving way. I am fairly certain that some of my symptoms are
due to vitamin B12 deficiency. However, I cannot inject because I did this
three times the year before last and the third time I had anaphlactic shock
and collapsed. My blood levels look OK, but I do not think that I have any
reserves of anything in particular, which explains why I cannot walk very
far without having to sit down. I have been taking vitamin B12 sublingually,
but I still do not think that I am getting enough.

The Sunday before last I took things into my own hands and injected myself
with folic acid and low and behold I can see almost properly for the first
time in months. I am feeling significantly better and have been able to
venture out of the house nearly every day except for a couple of days where
I have overdone it on the preceding day. However, I still have sore calves,
arthritis in my hands and knees, abdominal pains, the occasional headache
and chronic tiredness, but I no longer have the feeling that my body is
shutting down.

I also think that my peritoneum has ripped away from the muscle/abdominal
wall because I was sitting having breakfast a week or so ago and I had
tremendous pains behind the last op. scar and I thought that it was going to
burst open. The whole episode lasted some 5-10 seconds and then nothing. The
area when prodded did not hurt. It is only now when I move that I have pain.

I could go on and on and on and on. The long and the short of it is that I
start work tomorrow (2 hours per day for the first 2 weeks) and that I have
negotiated with work that I can work from home until I feel fit enough to
travel. This probably won't happen this year, but who knows and I am raring
to go after a year written off sick.

I am really at a loss for words. I went for months without any appropriate
treatment and the only person that has had any ideas (not counting the
convalescent clinic that was really super) has been me. Had the various
doctors (perhaps 10 or so) I saw in that year really pulled out all the
stops or just used their heads I might have been able to go back to work 6
months or so ago, but it is my career that is shot to bits and not theirs so
that is all that matters.

It is so tiring dealing with doctors. As if it was not bad enough just being
ill.

Vanny

"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> schrieb im Newsbeitrag
news:46j6scFavns7U1@individual.net...
Suddenly, without warning, Pete exclaimed (28-Feb-06 3:51 AM):
> Howard McCollister wrote:

<snip long disserte on why Pete doesn't like doctors>
Sorry, Pete, but it was a bit long

I respect and appreciate that, but haven't
found a doc for myself yet that'll do the same...)

jmc

Pete

2006-02-28, 5:53 pm

>
> My practice is a 25-doctor multispecialty group in a mostly rural
> resort-type area of central Minnesota. I have 3 general surgery
> partners. We do an extensive amount of advanced laparoscopic surgery,
> and in fact we teach it to other surgeon from several midwestern
> states. We have gastroenterologists we refer patients to 15 miles
> away in the next town when necessary, but we don't sent them to
> gastrenterologists for surgical problems, only for medical problems.
> We have a complete esophageal lab including wireless ambulatory pH
> testing, conventional manometry and impedance manometry and reflux
> testing.

Sounds neat Howard - I wish you were here :-)

>
> It's not the internal hemorrhoids that hurt, it's that the
> inflammatory process from an inflammed internal hemorrhoid extends
> and stimulated nerves that are close to the dentate line. You're
> right, internal hemorrhoids can be, but aren't always, painful.

Thanks Howard...I will save this, like I save most of your other posts. But
if I tell another doctor that I read that, he would probably get mad at me
and say "well why do you bother coming to me then", or some smart XXX
equivalent, and "us patients" always have to be so careful how we word
things, or say things to doctors. Boy it really pisses me off :-) . I'm
sure I will be talking to you in the future (and look forward to it), and
maybe I will post some stuff on the 24 hour ph and manometry that I had in
Baltimore, that was a waste of time (and develeped serious bronchitis from
the probe), and never got to discuss the test results with anyone, since my
local gastro was useless, like I told you...Pete

> HMc

Pete

2006-02-28, 5:53 pm

> (I wish I could find a doctor that's like my cat's veterinarian:
> Understands that I have some native intelligence, and some basic
> knowledge, and doesn't 'talk down' to me. Gives me it straight, big
> medical words and all

I respect and appreciate that, but haven't
> found a doc for myself yet that'll do the same...)
>
> jmc

jmc...I totally agree with you. I am an animal lover of the first order,
and definitely like animals better than people, and especially doctors,
except for Howard of course - lol . Pets give you unconditional love, no
questions asked, and no bullshit - they are awesome. And they don't "talk
down" to you (as you said) like so many doctors do - boy I hate that.

I have studied several of my conditions for hundreds of hours over the
years - try studying the human immune system sometime, and then see how much
the average primary care physician (internist) knows about it. Hell, I
can't get any help from anyone on my serious immune deficiency, [got nothing
from infectious disease doc, or oncologist/hematologist (who was a real
XXXXXXX)]. Sorry, I don't want to get going again.

My vet for my two best friends (felix and onyx - both cats) is awesome. I
can talk to him and feel at ease, and not worry about being rushed, and ask
technical questions, etc, etc. I call him by his first name and he calls me
by my first name. I also call my dentists by their first name, but you
can't do that with MD's, even if you are old enough to be there father :-) .

I told my vet I wish my doctors were as nice as him and he just smiles. Out
of the approx 75 doctors I have been to in my life, there were less than
five that I really liked and felt comfortable talking to.

Jmc...I will remember that you, Preesi, and Vanny are ladies (I mistakingly
referred to Preesi as "he/him" in one of my replies to Howard - sorry
Preesi). And if you think that one post I just wrote was long - hell, I was
just getting started - lol . Take care :-) ...Pete

Pete

2006-02-28, 5:53 pm

Vanny...I read your story with interest, and my heart goes out to you. Did
you have someone helping you when you were going through all this (I assume
you must have). I am curious about you injecting yourself with folic acid.
How did you know how much to use and where did you get it from and what
about the needles, etc. This sounds very strange to me. If you don't want
to talk about it okay. I live by myself, and could lay here dead in my
house, and no one would know it, so if you live by yourself without any
family or friends to help, I know how you feel...Pete

Vanny

2006-03-01, 10:56 am

Hi Pete,

Like yourself I am on my own with no family and no relatives around. I had
help from a friend directly after I came out of hospital - she went shopping
for me twice and helped me make chicken soup and that was it. I have another
friend who takes me out for walks occasionally (I feel like a poodle), but
now he is having problems with his studies and, unfortunately, cannot help
him and he is unable to take me out due to time constraints.

The difficulty is that healthy people think that if they help you for a
couple of days then you will get better and the problem with chronic illness
is that that does not happen. It is an ongoing fight with bad days and
better days. This is extremely difficult for most healthy people to
understand and they get frustrated, think that we are blocking the healing
process and go away. When I look back on this year (2006 - just 2 months
worth) at everything that has happened to me I could fill a book with the
various symptoms and docs' visits.

I currently live in Germany (I am a Brit) and with respect to injecting
myself with vitamins I just went to my local pharmacist (the only one I go
to) and they advised me as to which preparation I should use and supplied me
with the needles, etc. It was as simple as that. Each country has its own
rules and regulations. I agree that it is a bit stupid because I am of the
opinion that these kind of things should be prescribed by doctors,
especially as an overdose of folic acid can cause convulsions. I had
side-effects - these were insomnia and a mild hyperactivity, which burnt out
pretty fast because I do not have the energy reserves to be hyper. However,
had I not acted without the doctors (I had addressed the subject of vitamin
supplementation with my doctor) then I would be in a diabolical state.

I should have injected myself a lot earlier, but because of the anaphylactic
shock to the vitamin B12 injection (a rare but documented side-effect) I was
a bit hesitant. I rationalised it in the end by realising that if I lay dead
in my flat for weeks on end, it would not be my problem.

Today is my first work day (2 hours for the first 2 weeks and thereafter
building up) and hopefully I will be able to perform. However, I do not
think that I will be able to work fulltime, at least not this year. I have
also found at work that some people (the nasty ones) take advantage of the
fact that one is ill and weak and not able to defend oneself properly.
Sometimes I think that I should play the lottery, win some money and then go
into early retirement. Mmm fat chance of that happening with my luck.

All the best,

Vanny

"Pete" <pete@nospam.net> schrieb im Newsbeitrag
news:1209ojemd2j5tfa@corp.supernews.com...
Vanny...I read your story with interest, and my heart goes out to you. Did
you have someone helping you when you were going through all this (I assume
you must have). I am curious about you injecting yourself with folic acid.
How did you know how much to use and where did you get it from and what
about the needles, etc. This sounds very strange to me. If you don't want
to talk about it okay. I live by myself, and could lay here dead in my
house, and no one would know it, so if you live by yourself without any
family or friends to help, I know how you feel...Pete

Pete

2006-03-01, 12:51 pm

>
> Today is my first work day (2 hours for the first 2 weeks and
> thereafter building up) and hopefully I will be able to perform.
> However, I do not think that I will be able to work fulltime, at
> least not this year. I have also found at work that some people (the
> nasty ones) take advantage of the fact that one is ill and weak and
> not able to defend oneself properly. Sometimes I think that I should
> play the lottery, win some money and then go into early retirement.
> Mmm fat chance of that happening with my luck.
>
> All the best,
>
> Vanny

Hi Vanny...I guess you don't need a prescription to get needles or
injectible folic acid in Germany. Doesn't the pharmacy have to at least
special order the folic acid?

May I ask how old you are and what kind of work you do. At least it was
good that they let you come back to work after being off so long. I retired
at age 49 (in 1996), since they were downsizing the department of defense
after the Berlin wall came down and the Russians became democratic (if you
want to believe that). I used to design ships for the U.S. Navy.

Take care and I wish you the best...Pete

Vanny

2006-03-03, 10:54 am

Hi Pete,

I am 45 and the pharmacist has to order most of my medicines, because I am
on the large packs of not so widely prescribed medicines. I ring up a few
hours in advance and they generally have the order by the afternoon or next
day at the latest.

If I retire early I will end up being a social case on invalidity benefit
because I still have 20 years to pay into my pension fund. I do not want to
go down that route untill it is absolutely necessary, which I thought it was
going to be prior to the folic acid injection.

I have reached a good compromise with my employer and they are not allowed
to get rid of me without dealing with the authorities because I am
registered disabled. It is German law and a pretty good one too, because I
have been despairing about my career over the last few months. The knowledge
that I will get backing from the authorities has prevented me from going
bananas. I have a social worker on my case who negotiated with my employer
on my behalf when I was too ill to do anything myself. The authorities are
going to pay for the set-up of a home office (we hope). If not I will pay.

All the best,

Vanny

"Pete" <pete@nospam.net> schrieb im Newsbeitrag
news:120br0u4nsso266@corp.supernews.com...
>
> Today is my first work day (2 hours for the first 2 weeks and
> thereafter building up) and hopefully I will be able to perform.
> However, I do not think that I will be able to work fulltime, at
> least not this year. I have also found at work that some people (the
> nasty ones) take advantage of the fact that one is ill and weak and
> not able to defend oneself properly. Sometimes I think that I should
> play the lottery, win some money and then go into early retirement.
> Mmm fat chance of that happening with my luck.
>
> All the best,
>
> Vanny

Hi Vanny...I guess you don't need a prescription to get needles or
injectible folic acid in Germany. Doesn't the pharmacy have to at least
special order the folic acid?

May I ask how old you are and what kind of work you do. At least it was
good that they let you come back to work after being off so long. I retired
at age 49 (in 1996), since they were downsizing the department of defense
after the Berlin wall came down and the Russians became democratic (if you
want to believe that). I used to design ships for the U.S. Navy.

Take care and I wish you the best...Pete

Pete

2006-03-22, 1:30 pm

Once again Vanny...my heart goes out to you. You still didn't tell me what
kind of work you do :-) . It must be some kind of office work, if they will
allow you to work at home, with a computer I assume (which sounds like a
good deal, and is ideal for you)...Pete

Vanny wrote:
> Hi Pete,
>
> I am 45 and the pharmacist has to order most of my medicines, because
> I am on the large packs of not so widely prescribed medicines. I ring
> up a few hours in advance and they generally have the order by the
> afternoon or next day at the latest.
>
> If I retire early I will end up being a social case on invalidity
> benefit because I still have 20 years to pay into my pension fund. I
> do not want to go down that route untill it is absolutely necessary,
> which I thought it was going to be prior to the folic acid injection.
>
> I have reached a good compromise with my employer and they are not
> allowed to get rid of me without dealing with the authorities because
> I am registered disabled. It is German law and a pretty good one too,
> because I have been despairing about my career over the last few
> months. The knowledge that I will get backing from the authorities
> has prevented me from going bananas. I have a social worker on my
> case who negotiated with my employer on my behalf when I was too ill
> to do anything myself. The authorities are going to pay for the
> set-up of a home office (we hope). If not I will pay.
>
> All the best,
>
> Vanny