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Medical Forum / General / Cardiology / April 2008Plueral effusion
First of all my husband has chronic afib (takes Coumadin) and had a quadruple bypass 4 years ago. He's 77. PCP discovered fluid around my husband's left lung in early November during a routine exam. She put him on an antibiotic in case it was pneumonia. It wasn't. Since then he's had many tests (CT Scan, thorasentesis, echocardiagram, stess test, x-rays). He's seen a pulmonologist who was stumped but didn't think it was serious. After the echo the cardiologist was very surprised to hear that there was still fluid since he saw nothing in the echo. He did see that at some time in the past, probably around the time of the bypass, he'd had a very small heart attack. It was so small that it does not show up on an EKG. Also there was no damage at all. He did a stress test just to cover all bases and it was fine. When the cardio examined him he could hear the fluid and suggested Lasix. After a month on Lasix the fluid is basically unchanged. His cardiologist is convinced the fluid has a cardiological basis. He said a blood vessel in his neck was slightly enlarged and this along with the small heart attack could be affecting the pressure in the heart which could cause the fluid. The cardio says he's really not concerned since all of the serious possibilities have been ruled out and thinks that since there are no bothersome symptoms he should continue the Lasix and just watch it. My husband feels fine. No symptoms. Is it unusual for a plueral effusion to be such a mystery? > First of all my husband has chronic afib (takes Coumadin) and had a > quadruple bypass 4 years ago. He's 77. [quoted text clipped - 27 lines] > > Is it unusual for a plueral effusion to be such a mystery? It is actually quite common for post-bypass (CABG) cardiac patients to have a left-sided pleural effusion after their surgery. In our collective clinical experience, this happens in the majority of folks and does not cause symptoms as in your husband's case. Typically, it spontaneously disappears but can either persist or recur when there is either atrial fibrillation or congestive heart failure. Suggested reading: Heart Vessels. 2007 Jan;22(1):16-20. On-line link to full-text PDF of the above citation: http://www.springerlink.com/content/p451188g25gw5775/fulltext.pdf Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 22, 10:11 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote:It is actually quite common for post-bypass (CABG) cardiac patients to have a left-sided pleural effusion after their surgery. << The heart is on the left side and the blood spill causes the effusion .. the high iron blood spill. "100 times more ferritin in the pleural fluid" J Clin Pathol. 1985 July; 38(7): 818-824. PMCID: PMC499311 Copyright notice Pleural fluid ferritin concentrations in human disease. M Klockars, T Weber, P Tanner, P E Hellström, and T Pettersson Abstract The concentration of ferritin was measured in the pleural fluid of 108 patients with pleural effusions. In all groups of patients the ferritin concentration was higher in pleural fluid than in serum. The greatest differences, with up to 100 times more ferritin in the pleural fluid, were found for patients with rheumatoid pleurisy, malignant effusions, and empyema. In patients with non-malignant inflammatory pleural effusions the concentration of ferritin in pleural fluid correlated significantly with other pleural fluid indices of inflammation: there was a positive correlation with lactate dehydrogenase activity and a negative correlation with concentrations of glucose and complement components C3 and C4. Ferritin was detected immunocytochemically only in the macrophages found among the pleural fluid cells. Our study shows that large amounts of ferritin accumulate locally in the pleural cavity in certain types of pleural inflammation. The accumulation is probably partly the result of increased local reticuloendothelial system activity. Determination of the concentration of ferritin in pleural fluid may provide corroborative information for differential diagnosis and may further our understanding of the pathogenetic events that lead to the perpetuation of inflammatory activity in pleural effusions. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=499311 Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > > First of all my husband has chronic afib (takes Coumadin) and had a > > quadruple bypass 4 years ago. He's 77. [quoted text clipped - 56 lines] > > - Show quoted text - > On Mar 22, 10:11 am, "Andrew B. Chung, MD/PhD"<heartdo...@emorycardiology.com> wrote:It is actually quite common for > [quoted text clipped - 107 lines] > > > - Show quoted text - Hi Tom, Not being a medical person I have only a vague idea what this article is saying. Wouldn't the ferritin have been identified in the fluid after the thorasentesis? All tests on the fluid were negative. His doctors agree that this is not related to the problem after the bypass. Chest x-ray 6 months after CABG showed no fluid. Where there is overeating, there will tend to be iron overload. Therefore, it remains smarter to simply eat less, down to the right amount: http://HeartMDPhD.com/BeSmart A simple parable to help promote understanding: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > Andrew, in the Holy Spirit, boldly wrote: > [quoted text clipped - 111 lines] > > > > - Show quoted text - On Mar 24, 11:32 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > Where there is overeating, there will tend to be iron overload. > [quoted text clipped - 134 lines] > > > > - Show quoted text - Where there is Chung there will tend to be lies, twisted truth, made up cow stories and medical misinformation. satan via a sockpuppet (corporeal demon) hissed like a sissy: > Andrew, in the Holy Spirit, boldly wrote: > [quoted text clipped - 11 lines] > Where there is Chung there will tend to be lies, twisted truth, made > up cow stories and medical misinformation. Not for the discerning. Bottom line: You remain the liar who is the source of all lies as described in the Bible: http://HeartMDPhD.com/Liarsatan May we, who are Jesus' disciples, continue to rebuke you at each GOD- given opportunity as GOD desires: http://HeartMDPhD.com/Convicts/Rebukesatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow alt.atheism on 26 Mar 2008: Behold, in amazement and wonder, Chung's girlfriend: http://www.youtube.com/watch?v=7TJLOGI2Odc http://HeartMDPhD.com/Whinersatan is still http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow alt.atheism on 26 Mar 2008: > http://HeartMDPhD.com/Whinerchung Andy and Mags Sitting in a tree K.I.S.S.I.N.G. http://www.youtube.com/watch?v=zS24UUU4LsI  SignatureDavid Silverman D.B.E. BAAWA aa #2208 Lord Mayor of Dis Lawful copyright holder of the term "Earthquack". Holder of rights to the stage musical "The Shining". Not authentic without this signature. http://HeartMDPhD.com/Whinersatan is still a http://HeartMDPhD.com/Sissysatan who remains http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow alt.atheism on 26 Mar 2008: > http://HeartMDPhD.com/Whinersatan > > is still a http://www.youtube.com/watch?v=Ff9vlPD10YM&feature=related SignatureDavid Silverman D.B.E. BAAWA aa #2208 Lord Mayor of Dis Lawful copyright holder of the term "Earthquack". Holder of rights to the stage musical "The Shining". Not authentic without this signature. http://HeartMDPhD.com/Fakersatan is still http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow Chung once again shows his below statement is the one true thing he said. "I realize I can't begin to refute anything said here, so I'll simply post meaningless links to nonsense I spewed earlier." Chung http://groups.google.com/group/alt.flame.jesus.christ/browse_thread/thread/76885 6a9f7a454a8# On Mar 26, 8:03 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Fakersatan > [quoted text clipped - 71 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow http://HeartMDPhD.com/Squirmingsatan Chung - the goof that keeps giving. On Mar 26, 8:24 pm, "Andrew > http://HeartMDPhD.com/Squirmingsatan "I realize I can't begin to refute anything said here, so I'll simply post meaningless links to nonsense I spewed earlier." Chung http://HeartMDPhD.com/ARF Satanist Android Chung wrote: Nothing of any value. Smiler, The godless one a.a.# 2279 Satanist Android Chung wrote: Nothing of any value. Smiler, The godless one a.a.# 2279 > Satanist Android Chung wrote: Nothing of any value. Smiler, The godless one a.a.# 2279 > Android Chung wrote: Nothing of any value. Smiler, The godless one a.a.# 2279 http://HeartMDPhD.com/LoveLesssatan Satanist Android Chung wrote: Nothing of any value. Smiler, The godless one a.a.# 2279 http://HeartMDPhD.com/LoveLesssatan On Mar 26, 2:22 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > satan via a sockpuppet (corporeal demon) hissed like a sissy: > [quoted text clipped - 97 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow As they say - takes one to know one big fella! http://HeartMDPhD.com/TruthBeatssatan On Mar 28, 4:39 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/TruthBeatssatan ;-) You can't handle the truth. Satan is not debating you via Usenet. You are delusional. http://HeartMDPhD.com/DepressedSockPuppet On Mar 28, 4:45 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/DepressedSockPuppet ;-) Wrong again! You must certianly be projecting your own depression. Get help. http://HeartMDPhD.com/Despairingsatan On Mar 29, 11:51 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Despairingsatan Wrong again....... Your despair is obvious to all. http://HeartMDPhD.com/DepressedSockPuppet On Mar 30, 4:49 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/DepressedSockPuppet Dream on. http://HeartMDPhD.com/Flounderingsatan On Mar 28, 4:39 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/TruthBeatssatan On Mar 22, 11:10 am, ironjustice <teamtan...@hotmail.com> wrote: The heart is on the left side and the blood spill causes the effusion .. the high iron blood spill. << "Release of hemoglobin during cardiopulmonary bypass procedures impacts associated implications" Am J Physiol Lung Cell Mol Physiol 294: L161-L174, 2008. First published November 30, 2007; INVITED REVIEW Pathogenesis of the systemic inflammatory syndrome and acute lung injury: role of iron mobilization and decompartmentalization Anna L. Lagan, Daniel D. Melley, Timothy W. Evans, and Gregory J. Quinlan Department of Critical Care Medicine, Imperial College School of Medicine, Royal Brompton Hospital, London, United Kingdom Changes in iron homeostatic responses routinely accompany infectious or proinflammatory insults. The systemic inflammatory response syndrome (SIRS) and the development of acute lung injury (ALI) feature pronounced systemic and lung-specific alterations in iron/heme mobilization and decompartmentalization; such responses may be of pathological significance for both the onset and progression of acute inflammation. The potential for excessive iron-catalyzed oxidative stress, altered proinflammatory redox signaling, and provision of iron as a microbial growth factor represent obvious adverse aspects of altered in vivo iron handling. The release of hemoglobin during hemolytic disease or surgical procedures such as those utilizing cardiopulmonary bypass procedures further impacts on iron mobilization, turnover, and storage with associated implications. Genetic predisposition may ultimately determine the extent to which SIRS and related syndromes develop in response to such changes. The design of specific therapeutic interventions based on endogenous stratagems to limit adverse aspects of altered iron handling may prove of therapeutic benefit for the treatment of SIRS and ALI. systemic inflammatory response; hemolysis; oxidative stress -------------------------------------------------------------------------------- Address for reprint requests and other correspondence: G. J. Quinlan, Dept. of Critical Care Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, UK (e-mail: g.quinlan@imperial.ac.uk) doi:10.1152/ajplung.00169.2007 1040-0605/08 $8.00 Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > On Mar 22, 10:11 am, "Andrew B. Chung, MD/PhD"<heartdo...@emorycardiology.com> wrote:It is actually quite common for > [quoted text clipped - 109 lines] > > - Show quoted text - How are you doing Mr. Assy Mc Chung!!! I see by turning to your Web Site that you're OBESE!!! Be hungry... be healthy... be hungrier... be anorexic. Bondservant to the KING of kings and anorexic LORD of lords. Obsessive Compulsive Disorder... VISIT MR. Mc CHUNG'S CAT HOUSE: http://www.jackanapes.ws/2pdcat_2.html SignatureBubba Do Wah Ditty > Smarter to eat less, be anorexic:.... >> First of all my husband has chronic afib (takes Coumadin) and had a >> quadruple bypass 4 years ago. He's 77. On Mar 22, 1:11 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > > First of all my husband has chronic afib (takes Coumadin) and had a > > quadruple bypass 4 years ago. He's 77. [quoted text clipped - 54 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow The CABG was four years ago. At the time he had a lot of problems with pleural effusion. He had to go back to the hospital twice to be drained, but again that was four years ago. He's had the afib for over 40 years and has been in constant afib for the past five years. Neither the cardiologist nor the pulmonary specialist think he has congestive heart failure. If he does there are no other symptoms. > Andrew, in the Holy Spirit, boldly wrote: > > [quoted text clipped - 46 lines] > > The CABG was four years ago. So noted. Since you write that he is asymptomatic with his current left pleural effusion, it is possible that there has been some all these years. > At the time he had a lot of problems > with pleural effusion. He had to go back to the hospital twice to be > drained, but again that was four years ago. Again, it is possible that it never completely went away. > He's had the afib for over 40 years and has been in constant afib for > the past five years. Then the atrial fibrillation would be a possible explanation for the problems with the pleural effusion after the CABG requiring drainage x2 and possible persistence of a lesser amount over the past few years. > Neither the cardiologist nor the pulmonary specialist think he has > congestive heart failure. If he does there are no other symptoms. The physical findings of distended neck veins and abnormal lung sounds by his cardiologist would be consistent with possible congestive heart failure especially in someone who has had a heart attack especially in the setting of presbycardia, which predisposes folks to diastolic dysfunction. Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 22, 10:24 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > > Andrew, in the Holy Spirit, boldly wrote: > [quoted text clipped - 86 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow I suspect that you are correct about congestive heart failure. I think that the cardiologist probably doesn't want to scare us by using the term since if it is CHF it is extremely mild. As for fluid following the CABG, he had a chest x-ray about 6 months later and it was clear. If he has had any fluid in the lungs since then it had to be very small because he sees the PCP and cardio every 6 months and they heard nothing until November. As a matter of fact the cardio saw him 2 weeks before the PCP heard the fluid. The cardio didn't hear it, so it accumulated pretty quickly. I think what we're hoping for right now is for the doctor to say - we've ruled out anything serious, it doesn't bother you, we'll keep an eye on it but don't worry about it. My husband has really been through the ringer these past 5 months. > Andrew, in the Holy Spirit, boldly wrote: > > > Andrew, in the Holy Spirit, boldly wrote: [quoted text clipped - 92 lines] > > My husband has really been through the ringer these past 5 months. Then it is possible that his blood pressure has not been as well controlled and this can lead to worsening heart function. Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 23, 1:51 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > > Andrew, in the Holy Spirit, boldly wrote: > > > > Andrew, in the Holy Spirit, boldly wrote: [quoted text clipped - 107 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow He has never had high blood pressure but now that he's on the Lisinopril it is even lower - generally about 118/70. Before the Lisinopril it was about 130/75. Again, the Lisinopril was given to him for kidney function. > Andrew, in the Holy Spirit, boldly wrote: > > > Andrew, in the Holy Spirit, boldly wrote: [quoted text clipped - 99 lines] > He has never had high blood pressure but now that he's on the > Lisinopril it is even lower - generally about 118/70. Optimal is 115/75. > Before the Lisinopril it was about 130/75. Suboptimal. > Again, the Lisinopril was given to him for kidney function. Either pre-diabetes (IR/MetS) or frank diabetes (for which ACE Inhibitors such as lisinopril are given to preserve kidney function) also worsens heart function. Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 23, 8:27 pm, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > > Andrew, in the Holy Spirit, boldly wrote: > > > > Andrew, in the Holy Spirit, boldly wrote: [quoted text clipped - 123 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Hmmm, I didn't know lisinopril can worsen heart function. Anyway, that's not causing the fluid. The fluid appeared weeks before he was put on lisinopril. He does take various other meds: Coumadin, Toporol, Cardizem, Zocor. > Andrew, in the Holy Spirit, boldly wrote: > > > Andrew, in the Holy Spirit, boldly wrote: [quoted text clipped - 114 lines] > > Hmmm, I didn't know lisinopril can worsen heart function. Not the lisinopril but the insulin resistance (IR/MetS) or frank diabetes (for which the lisinopril is given) cause worsening heart function. Otoh, the anti-inflammatory effects of lisinopril result in better control of blood glucose thereby working to improve heart function. Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > On Mar 23, 8:27 pm, "Andrew B. Chung, MD/PhD" > <heartdo...@emorycardiology.com> wrote: [quoted text clipped - 130 lines] > put on lisinopril. He does take various other meds: Coumadin, > Toporol, Cardizem, Zocor. Jane, beware Chung is a mentally ill man. Although he went to medschool and residency, he was fired for substandard care from the only employed position he had, after 3 months, in Fla several years ago. His mental illness which manifests itself with bizarre, delusional diet advice and a rigid fixation on his own idiosyncratic interpretation of Christianity make him unfit to function normally in society or to be a competent physician. He has no admitting privileges or verifiable practice. He spends his days trolling the internet. He has given you some specific medical advice. He is under investigation from the Georgia Medical Board. Be sure to consult your own physicians. If you are unsure about the care and advice given to your husband, seek a second opinion from a physician who can examine your husband, take a thorough history and review all old medical records. Chung is a mentally ill, narcissistic, man who doesn't practice evidence-based medicine. He will lie to you about, " in our clinical experience" but that doesn't mean he has any recent clinical experience or colleagues. http://HeartMDPhD.com/CrazySockPuppet of http://HeartMDPhD.com/Crazysatan who remains http://HeartMDPhD.com/Liarsatan and http://HeartMDPhD.com/Wimpsatan and http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 8:41 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/CrazySockPuppet > [quoted text clipped - 83 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow See? Chung thinks that he is some sort of persecuted Jesus figure himself. He thinks that anyone on the internet who questions him is Satan. Is this who you want giving advice to your husband Jane? http://HeartMDPhD.com/Convicts/Beatensatan is still http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 8:56 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Convicts/Beatensatan > [quoted text clipped - 71 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Chung, you make this way too easy to discredit you. You make your own case, LOL. And no, LOL is not written despair. That is your own delusional interpretation. Everyone else knows what I mean and interprets it in its common usage way. I can back up anything I've said with third party, factual, objective, independent sources. You can't do the same. On Mar 24, 10:51 am, yamant... > Chung thinks that he is some sort of persecuted Jesus figure himself. > He thinks that anyone on the internet who questions him is Satan. Is > this who you want giving advice to your husband Jane? And no doctor is going to give medical advice to a person on a usenet group. Doctors may discuss cases on sites like Sermo, but never will give advice to a sight unseen patient - if a doctor does, run away as fast as you can. You need to actual see a doctor who can talk with you and actually exam you to get any meaningful answer. http://HeartMDPhD.com/CrazySockPuppets of http://HeartMDPHD.com/Crazysatan who remains http://HeartMDPhD.com/Convicts/Beatensatan and http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 9:05 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/CrazySockPuppets > [quoted text clipped - 79 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Like shootin' fish in a barrel, I tell ya. LOL http://HeartMDPhD.com/Convicts/Beatensatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 9:26 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Convicts/Beatensatan > [quoted text clipped - 67 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Jane, I rest my case. Get advice from a real doctor; not delusional, dysfunctional Chung. http://HeartMDPhD.com/Convicts/Beatensatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 11:34 am, Chung, > Hunger is wonderful: > Yes, hunger is our knowledge of good versus evil that Adam and Eve > Andrew B. Chung .... > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords..... Such are the warped machinations of Chung's delusional mind, On Mar 24, 9:26 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Convicts/Beatensatan > [quoted text clipped - 67 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Hey Chung troll, I shot your <>< http://HeartMDPhD.com/Idioticsatan is http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Mar 24, 9:39 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > http://HeartMDPhD.com/Idioticsatan > [quoted text clipped - 71 lines] > Lawful steward ofhttp://EmoryCardiology.com > A latter-day disciple of the KING of kings and LORD of lords.http://HeartMDPhD.com/HolySpirit/DiscipleNow Don't look under your bed or in the closet late at night, Chung. Satan might be there waiting for you. http://HeartMDPhD.com/DepressedSockPuppet of http://HeartMDPhD.com/Despairingsatan who remains http://HeartMDPhD.com/Doomedsatan <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow |
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