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Medical Forum / Diseases and Disorders / Sinusitis / December 2007sinus condition?
i've been having a runny nose all day and now my head is starting to hurt on the left side. the pain grows each time i bend or sneeze. this has happened many times before but i havent really done anything about it and simply toughed it out. it usually goes away in a couple of days, but then starts again.. there's no schedule, like almost every month. there's also a painful sensation in my nose, like some kind of boil.. after googling i got chronic rhinitis and something about polyps? i know i'm allergic to dust and have had breathing problems in the past, chest congestion. it sucked and i lost a lot of sleep as it always happened at night. but i dont know what this all is.. thinking i should see a doctor. my mom usually applies some balm thing if the headache is too much, sort of almost get feverish but i'm too preoccupied with other things to care, dont know why. this is probably getting worse so i should do soething. > i've been having a runny nose all day and now my head is > starting to hurt on the left side. the pain grows each time [quoted text clipped - 16 lines] > too preoccupied with other things to care, dont know why. > this is probably getting worse so i should do soething. You might have some type of obstruction so I suggest an ENT to check out your sinuses. I have had all the x-rays and everything else. My nose still runs. I do not have any pain. I use a drying agent - Ipatropium Bromide. You can use up to 12 applications per day without any problem. I also use a steroid, Nasarel, for the inflammation. Good luck. Fred >> i've been having a runny nose all day and now my head is >> starting to hurt on the left side. the pain grows each time [quoted text clipped - 24 lines] > Good luck. > Fred thanks. right now i'm having a bad cough and again with the runny nose causing sleepping problems. > i've been having a runny nose all day and now my head is > starting to hurt on the left side. the pain grows each time [quoted text clipped - 13 lines] > but i dont know what this all is.. thinking i should see a > doctor. If you've been suffering like this for more than a few weeks, of course you should see a doctor.  SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >> i've been having a runny nose all day and now my head is >> starting to hurt on the left side. the pain grows each time [quoted text clipped - 16 lines] > If you've been suffering like this for more than a few weeks, of course > you should see a doctor. i know this will all get over in a couple of days like before so i should see one when its in this stage. the thing is after googling some more, its not exactly sinusitis, i constantly have clear mucous.. something allergy related i guess. rihinitis matches. >>> i've been having a runny nose all day and now my head is >>> starting to hurt on the left side. the pain grows each time [quoted text clipped - 21 lines] > sinusitis, i constantly have clear mucous.. something > allergy related i guess. rihinitis matches. If it's an allergy, you don't have to run to see an allergist right away. His allergy tests should detect what is giving you symptoms even when you're asymptomatic. There are a variety of medications you can try: Topical steroid sprays, Astelin antihistamine spray, etc. These require a prescription. If all you have is some kind of rhinitis, these kinds of medications may help. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > There are a variety of medications you can try: Topical steroid sprays, > Astelin antihistamine spray, etc. IIRC, all of these are preserved with Benzalkonium Chloride, known to be harmful to the sinuses with regular use. What do we do about this medical paradox? I know what /I/ do. I don't use any of them. WHEN ASKED this direct question, that IS the universal response of the ENT's that I've seen. Until I bring UP the BAK issue, though, they all recommend the same thing. I don't mean to challenge your recommendation, Steven, but rather to raise the issue again for discussion/ideas. I'm a product (AGAIN) of "Big Pharma fixes one thing and breaks yet another" (they theorize that the DPT vaccine caused this brachial neuritis ... an absolute b**ch of a thing to be dealing with....." I'm really starting to lose my faith in their methods, their processes, and their treatments. Of course, that does NOT mean that every internet cure WORKS, but ... I'm really losing my faith. Not for this post, but ... after two weeks at Mayo, I was astounded by how little they cared about "root cause," generally. There was virtually NO "holistic" approach to illness. Rather, each specialist recommended and prescribed, but the PCP there made NO apparent effort to "draw a line" through all the issues and see if something, or some couple of things, gave rise to the issues. I think most of us on this forum understand exactly what I mean. Many of us have also experienced the "short term gain for long term pain" issue in one way or another. I'm, medically, running scared right now, sitting on a handful of Rx's that I have no desire to fill. Beware BAK. It's a bad one ... with a decades-long history OF BEING a "bad one." All the best, Neil Neil, I recently got an email from the sinofresh people (I have no idea how I got onto their list) with breaking news that their product kills MRSA. It's basically saline with some essential oils AND BAK. I wrote them back, that I would never use a product in the nose that was toxic to cilia, especially when there were very viable alternative ciliary safe preservatives. I sent them one article, and wrote that there were many more. Your experience at Mayo sounds terrifying. A bunch of super specialists, none of whom see the whole picture, or want to take responsiblity for it. "Every time I've needed the health care system, it's never failed to disappoint me." A quote from a wonderful RNP, that continues to resonate. Judy On Dec 9, 12:46 pm, neil0...@yahoo.com wrote: > > There are a variety of medications you can try: Topical steroid sprays, > > Astelin antihistamine spray, etc. [quoted text clipped - 42 lines] > All the best, > Neil > Not for this post, but ... after two weeks at Mayo, I was astounded by > how little they cared about "root cause," generally. There was > virtually NO "holistic" approach to illness. Rather, each specialist > recommended and prescribed, but the PCP there made NO apparent effort > to "draw a line" through all the issues and see if something, or some > couple of things, gave rise to the issues. I understand this problem. There has been a near-extinction of the PCPs skilled in balancing the recommendations of specialists and helping a patient with juggling multiple conditions. I believe it has a lot to do with the rise of managed care and high-tech medicine; the specialists now use an array of high-tech tools that the PCP is unfamiliar with. All I can suggest is that you keep looking for a PCP who is a) board-certified in internal medicine and b) understands respiratory conditions and immunology. If you contact your state medical association, they can give you a bio of a prospective physician--the papers he has published in refereed journals, etc. Internal medicine is *supposed* to deal with "the whole adult patient". In my experience, being board-certified in internal medicine is a necessary but not sufficient condition for being a good PCP for someone struggling with one or more chronic illnesses. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I'm a product (AGAIN) of "Big Pharma fixes one thing and breaks yet > another" (they theorize that the DPT vaccine caused this brachial > neuritis ... an absolute b**ch of a thing to be dealing with....." > > I'm really starting to lose my faith in their methods, their > processes, and their treatments. Welcome to the club. > Of course, that does NOT mean that every internet cure WORKS, but ... > I'm really losing my faith. [quoted text clipped - 5 lines] > to "draw a line" through all the issues and see if something, or some > couple of things, gave rise to the issues. Because their diagnostic and treatment guidelines are bought, paid for and taught by big pharma. I don't know why anyone has to go to med school to follow the consensus cookbook any more. I'm so sorry you've come up against what I've been injured by my whole life, with dire consequences, too. Academic medicine is the worst, and community practitioners who dare to practice independent clinical judgment are frozen out and punished. > I think most of us on this forum understand exactly what I mean. Many > of us have also experienced the "short term gain for long term pain" > issue in one way or another. Without fail, in fact. Worst of it is, it's very rare that docs even recognized the most common side effects, much less the rarer ones, of the meds and treatments they rx. > I'm, medically, running scared right now, sitting on a handful of Rx's > that I have no desire to fill. Be very cautious, as you are. > Beware BAK. It's a bad one ... with a decades-long history OF BEING a > "bad one." Agreed. And so are steroids, BTW, in general, with BAK or not. They end up crippling your immune and anti inflammatory pathways, just what you don't need, long term. Susan > x-no-archive: yes > [quoted text clipped - 20 lines] > and taught by big pharma. I don't know why anyone has to go to med > school to follow the consensus cookbook any more. I'm not sure it's that, so much as it is the advent of managed care and extremely specialized high-tech medicine. After all, the specialists get inputs from "Big Pharma" too--but they have advanced treatment considerably. An ENT today can do a lot more than an ENT could 50 years ago. Whereas I've had PCPs tell me that they're washing their hands of me; because now that I'm into the CAT scan plus surgery treatment of my sinusitis, there's nothing more a PCP can do for me and I should just continue to see ENTs. A PCP who cannot interpret the radiologist's or ENT's report on my CAT scan, or my immunological workup, can't really do anything for me that the specialists couldn't already do; and he can't second-guess them and balance the various treatments. He just doesn't have the knowledge to be the balancing watchdog we want him to be. Plus there's no incentive for the PCP to get more knowledge. His job, as far as the managed care insurance companies are concerned, is just to be a "gatekeeper" that decides whether I need to see a specialist. And if so, to write a referral to the specialist. That's it. I'm really struck by how little the PCP's job has changed in the last 50 years. ENTs now have CAT scans, allergists now have immunological workups; but a typical PCP examination today is no different from what it was 50 years ago: Look in your ears, look up your nose, listen to your chest with a stethoscope, vital signs, that's about it. High-tech medicine has not come into the PCP's office. That's not an incentive for the best medical students to want to become PCPs either. So how can we expect a PCP who still does medicine the way it was done 50 years ago, to second-guess and balance the ultra-modern high-tech treatments of specialists who have access to all the latest advances? It's like calling an engineer who only knows vacuum tubes to diagnose what's wrong with your personal computer. The one area where the PCP's job has changed, is the one area which should NOT have changed: Allowing the PCP to prescribe psychotherapeutic drugs on his own without referral to a mental health professional. Again, managed care is partly responsible for this. Mental health care is expensive. The insurance companies are quite happy if the PCP just writes you a prescription for Prozac and sends you home. If with the Prozac you find out the hard way that you're bipolar, then s**t happens. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I'm not sure it's that, so much as it is the advent of managed care and > extremely specialized high-tech medicine. Oh, it's that. I'm assured of it by 4 close relatives currently practicing medicine. Who pays for CMEs? And buys off the academic medical whores to get them to recommend only their drugs for consensus guidelines. After all, the specialists > get inputs from "Big Pharma" too--but they have advanced treatment > considerably. An ENT today can do a lot more than an ENT could 50 years > ago. Whereas I've had PCPs tell me that they're washing their hands of > me; because now that I'm into the CAT scan plus surgery treatment of my > sinusitis, there's nothing more a PCP can do for me and I should just > continue to see ENTs. Managed care created the environment where doctors had no time to spend with patients if they wanted to stanch the loss of income. Pharma made it easier to see 5-8 patients per hour with consensus guidelines. No more thinking, analyzing, interpreting, researching, planning. Just test and rx. Susan > x-no-archive: yes > [quoted text clipped - 5 lines] > medical whores to get them to recommend only their drugs for consensus > guidelines. I'm not even talking about *treatment* yet, but *diagnosis*. A PCP skilled in internal medicine is supposed to be able to balance the various treatments by specialists against the various needs of the patient. It requires a PCP who can help set priorities--can he risk giving a patient certain painkillers for his arthritis, if the patient also has a history of peptic ulcer disease? If the patient's ENT blames GERD for the patient's sinusitis, but the gastroenterologist denies it, what should the patient do? > After all, the specialists >> get inputs from "Big Pharma" too--but they have advanced treatment [quoted text clipped - 8 lines] > it easier to see 5-8 patients per hour with consensus guidelines. No > more thinking, analyzing, interpreting, researching, planning. Isn't the rise of defensive medicine largely to blame for that? If a physician uses his own judgment, does something non-standard and gets it terribly wrong, he could be vulnerable to a malpractice lawsuit. (It's much harder to sue for malpractice if the physician followed all the standard treatment protocols, yet something went wrong anyway.) Plus, insurance companies may not pay for non-standard treatments. They have a list of things they pay for and a list they don't. I believe that's a major reason why I had such trouble finding an ENT willing to do sinus surgery on me. My CT scan had been negative, and two or three ENTs said that unless the CT scan showed real evidence of sinus disease, surgery wasn't indicated. I finally found an ENT who trusted my symptoms and history over the negative CT scan. He turned out to be right. But he and I agreed that doing surgery in the absence of positive results from medical tests involves risk--what if there had been major complications from the surgery, like blindness, and it had turned out to be unnecessary after all? Other ENTs were unwilling to take that risk. And my ENT told me he's seriously thinking of retiring early; he can't deal with the ever-present threat of malpractice lawsuits and the hefty malpractice premiums. Another example involves screening. It is now best medical practice for a man my age to have regular colonoscopy screening. Do you really think the pharma companies have bamboozled the doctors into doing colonoscopies? The only drugs used are ordinary anesthetic. Anyway, my health insurance company does NOT pay for colonoscopy screening. I have to pay out of pocket, every time. How can you expect "thinking, analyzing, interpreting, researching, planning" when the insurance companies won't pay for any of that? All that costs money. The mental health example I cited earlier is a good one. In psychology and psychiatry, you have to do a lot of "thinking, analyzing, and interpreting" of the patient's situation. Mental health treatment is still as much of an art as a science. That's why the insurance companies just want the doctor to put the patient on meds and get him out of the office. I had a friend who is an LICSW who works with abused children. The HMO told her that she gets exactly *two* visits with each abused child. If the child isn't well-adjusted by then, she should refer the child to an M.D. to put the kid on meds. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I'm not even talking about *treatment* yet, but *diagnosis*. A PCP > skilled in internal medicine is supposed to be able to balance the [quoted text clipped - 4 lines] > GERD for the patient's sinusitis, but the gastroenterologist denies it, > what should the patient do? Doctors receive CMEs from companies that have a vested interest in certain diagnostic guidelines and specific treatments. I'm discussing BOTH issues. Insurers, too, have shaped diagnostic protocols and limitations. > Isn't the rise of defensive medicine largely to blame for that? If a > physician uses his own judgment, does something non-standard and gets it > terribly wrong, he could be vulnerable to a malpractice lawsuit. (It's > much harder to sue for malpractice if the physician followed all the > standard treatment protocols, yet something went wrong anyway.) Defensive medicine is doing what the pharma and insurers have decided you all should be doing, in lockstep. > Plus, insurance companies may not pay for non-standard treatments. They > have a list of things they pay for and a list they don't. That's the way *they* influence outcomes and practices. > Another example involves screening. It is now best medical practice for > a man my age to have regular colonoscopy screening. Do you really think > the pharma companies have bamboozled the doctors into doing > colonoscopies? The only drugs used are ordinary anesthetic. Uh, no, that would be the medical equipment sellers. And the fact that insurers pay docs well for procedures and pay nothing for clinical practice/listening/thinking. > Anyway, my health insurance company does NOT pay for colonoscopy > screening. I have to pay out of pocket, every time. How can you expect > "thinking, analyzing, interpreting, researching, planning" when the > insurance companies won't pay for any of that? All that costs money. No sh.t. That's how they limit treatments and diagnoses to those they want to pay for. > The mental health example I cited earlier is a good one. In psychology > and psychiatry, you have to do a lot of "thinking, analyzing, and > interpreting" of the patient's situation. Mental health treatment is > still as much of an art as a science. So is clinical medicine, but it's been done away with. That's why the insurance > companies just want the doctor to put the patient on meds and get him > out of the office. I had a friend who is an LICSW who works with abused > children. The HMO told her that she gets exactly *two* visits with each > abused child. If the child isn't well-adjusted by then, she should > refer the child to an M.D. to put the kid on meds. You're making my point. Drug, equipment manufacturers and insurance companies decide what your doc will diagnose and treat, not medical science. Susan I think all have made excellent and coherent points, in all honesty. I also think there are LOTS more factors -- as yet un-raised -- at work here. Let me outline a couple of possibles: Intellectual laziness/medical prejudice. By design or by default, many docs begin to see things through a well-honed filter. The notion "If you hear hooves, think horses, not zebras" comes to mind. They go with what they know. If it does NOT fit readily with what they know, then it becomes an intellectual challenge, a time consuming venture, just plain /work/, or some combination of these and other factors. Not everybody gets energy from trying to solve complex medical puzzles. For some, we just become expensive to treat, and lower their hourly income. Which brings me to the 2nd point: a certain amount of .... call it greed, for lack of a better term. For many, complicated patients DON'T result in reimbursement that's commensurate with physician effort. For some, a little extra homework may be required that neither the patient nor the insurer will readily pay for. I do agree that BigPharma and the managed care environment (and, to a lesser degree, malpractice litigation (which from the little that I've learned through research ... just isn't as quantitatively big as so many would have us believe) HAVE had a radical impact on how MD's practice medicine. But Mayo, as an example, IIRC, is a not-for-profit, and their doctors are paid a fixed salary designed to be competitive with the free market. They are NOT compensated by the # of patients seen, or how quickly and cheaply they can push them out the door. BigPharma and its lobbying efforts vis-a-vis the FDA are, IMHO (as apart from IHMO) DO have a huge impact. Couple of Not Rocket Science examples: - clinical drug trials are NOT (IIRC) performed ON the intended audience. IOW, they don't test sinus meds on chronic sinus patients, or dry eye meds on dry eye patients. They randomize across the entire population. That's ridiculous on its face, to my way of thinking. The argument would be that it's impractical/cost-prohibitive to get a statistically significant random sample of ONLY chronic sinus suffers, dry eye patients, etc. But that, too, is ridiculous on its face. If there's enough market to compel BigPharma to invest in a drug, then there's enough market to get a statSig random sample OF people WITH that condition. BAK affects HEALTHY eyes and sinuses to a MUCH lesser degree than it does sinusitis sufferers with immotile cilia and dry eye patients with inadequate and unstable tear film. - Look at the prescribing insert for your favorite drug. Look at the sample size used in clinical testing. Now go play with an online sample size calculator. The trials involve NOWHERE NEAR enough bodies to result in anything approaching useful information to extrapolate across millions, EVEN IF they truly DID test only across people WITH that condition. - Only recently was a law passed that ALL trials had to be logged, and that ALL TRIALS -- success or failure -- had to be reported at their conclusion. Can you STAND it?? They were allowed to cherry pick, only reporting their successes. - No requirement to drill down on sub-groups (eg, those in whom the med produced a severe adverse effect). Not that /I/ know of, anyway. How cool would it be if they REALLY used data mining and analysis to create REAL "contraindications," perhaps even requiring lab work BEFORE you could take the drug. I just learned that anti-convulsants (they messed me up HARD) have clinically-demonstrated propensity to sharply lower levels of IgA, IgG and the IgG subclasses. Wow. If only I'd known. It's a multi factorial mess -- one for which I don't have a clue where you begin to fix it. Actually, I do. In talking to my women's health NP wife, I remarked at the efficacy of probiotics to resolve bacterial vaginosis, asking if she couldn't lobby for a protocol revision in her workplace, trying probiotics as 1st line, and antifungals ONLY if the probiotics failed. One small step for (wo)man ... one giant leap for (wo)mankind. Sorry for the ramble. Coffee, dontcha know.... > But Mayo, as an example, IIRC, is a not-for-profit, and their doctors > are paid a fixed salary designed to be competitive with the free > market. They are NOT compensated by the # of patients seen, or how > quickly and cheaply they can push them out the door. Aw, you're so cute when you're naive. :-) Academics in non-profits get their perqs, honoraria, and the Holy Grail; research grants from ... TAH DAH! Drug and equipment manufacturers. Trips to exotic locales to speak, to take CMEs, gifts, office lunches, you name it, they're bought. Susan > x-no-archive: yes > [quoted text clipped - 10 lines] > > Susan Oh, I don't disagree with /that/ at all. I saw countless drug reps milling around at Mayo. That comment was less about the insidious influence of BigPharma and more about the potentially relatively lesser insidious influence of managed care at not-for-profits. Emphasis on "relatively" and "lessER." Here's a blog maintained by a colleague. Health care is a disaster. http://hcrenewal.blogspot.com/ Judy who is board certified in family medicine--not internal medicine > x-no-archive: yes > [quoted text clipped - 48 lines] > > Susan On Dec 9, 12:46 pm, neil0...@yahoo.com wrote: > > There are a variety of medications you can try: Topical steroid sprays, > > Astelin antihistamine spray, etc. [quoted text clipped - 42 lines] > All the best, > Neil neil, sorry about all of it. no advice but much empathy. this whole thread is depressing - those of us struggling & trying to make the most responsible choices that we can already know all this, but still it's hard. i'm sitting here with doctors' bills & test appts & checking off various directions tried. hard to have hope & expectations for help. even harder when you're so miserable or in chronic pain - i'm desperate for just a tiny bit of relief to at least help the spirit. & yet i don't trust anything. so that didn't cheer you up any. & all the cute internet animals are on strike with the writers. ellen > sorry about all of it. no advice but much empathy. this whole thread > is depressing - those of us struggling & trying to make the most [quoted text clipped - 5 lines] > & yet i don't trust anything. so that didn't cheer you up any. & all > the cute internet animals are on strike with the writers. I just got home from my second wasted ENT appt in 5 mos. He assured me that C-T scans are 100%, without fail, guaranteed to catch every single case of sinus infection, and if it doesn't, I don't have it. He ignored the slight thickening in my frontal sinus, where my pain and drainage come from and said if I actually get an acute infection, I can come back and maybe get nebulized abx. I told him, "Maybe I've been reading the wrong research and shouldn't have paid $25 for the article comparing actual sinus outcomes with C-T imaging." I asked him what he knew about biofilms, he candidly said "nothing, really." This was an attempt by my inf. diseases doc to get my sinuses explored and cleaned out. Susan > x-no-archive: yes > [quoted text clipped - 24 lines] > > Susan crap. so sorry susan. ellen > On Dec 9, 12:46 pm, neil0...@yahoo.com wrote: > [quoted text clipped - 58 lines] > > ellen I definitely haven't stirred up a mug of holiday cheer. For that, I apologize. And I'm with ya', too. I'm sorry you're rolling into the holiday season with sinus misery, a handful of bills, a passel of appointments, and no clear answers. It's whiplash-inducing, isn't it: abx are great. No, they're no better than not. It's fungal. No, it's viral. Iran has nukes. No, they don't. You can never know which pitch to swing at, and -- just as you're SURE you've found The Answer ... you haven't. It's crazy-making, no doubt. It's also PTSD, hyper-vigilance making because WE know that WE can't blink, or they'll Rx something that ... might hurt us. But there's little downside in that for them. They cause symptoms ... then Rx yet ANOTHER drug for THOSE symptoms. What are your "go-to's," Ellen? Steam? Hot tea? Warm compresses? (sterilized) Humidifier? Meditation? Mine are sort of failing me at the moment. ALSO on strike, I guess. Take good care. Sometimes, out of these bitch sessions ... workable ideas DO come. If I didn't at least believe that a bit, I wouldn't vent so online ;-) > What are your "go-to's," Ellen? Steam? Hot tea? Warm compresses? > (sterilized) Humidifier? Meditation? [quoted text clipped - 4 lines] > ideas DO come. If I didn't at least believe that a bit, I wouldn't > vent so online ;-) My recent go tos, in desperation because my last good abx is failing me: 1) scrub down walls, floor, ceiling, every surface of my bathroom weekly with bleach or oxy cleaner to remove invisible but incredibly sinus flaring mold as yet unidentified. The bath is near my bed and it makes a hyooge diff. When I'm lazy and haven't bleached it, closing the bathroom door at night is just as good til I go in there. 2) I bought an AirDryr because it's cheaper than an AirFree, for my bathroom. May be helping, too soon to say for sure. I also moved my BigAss BlueAir between the bathroom and the bed, instead of on the other side of my room. 3) Irrigate with peroxide at least weekly; I seem to be doing better with the actually cleanable NeilMed bottle than with the impossible to sterilize Grossan, a biofilm farm if ever there was one. It's retired for good, it's a piece of junk, in my opinion. 4) Regular allergy shots; every doc used to comment on how incredibly inflamed my nasal passages were, even on Astelin and/or nasal steroids. Now they comment on how healthy and uninvolved looking they are, without fail, since going back to my old trusty allergist. Susan > x-no-archive: yes > [quoted text clipped - 32 lines] > > Susan Good stuff, Susan. Re: the peroxide... When I asked Mayo's guy about my fave's (Grapefruit Seed Extract and H2O2), he thought that both were an excellent idea, though he /did/ tend to agree with my PCP* that H2O2 might /better/ be used as a PRN thing .. because it's a powerful oxidant. I add the H2O2 about once a week now ... figuring that notion (too much = bad thing) makes some sense. I'm big on bleach. Bleach good. Neil *Now /former/ PCP, actually. I had the audacity to question an unreasonable charge on my bill and he sent me a 30-day term notice of doctor/pt relationship. True story. My NP wife was flabbergasted, and assumed he was /actually/ afraid of potential liability arising from the DPT vaccine and the brachial neuritis (I have zero energy to sue /anybody/ in this world). He charged $160 for summarizing the (one paragraph each) summaries of four different specialists. The "meta-summary" he created became a standing joke at Mayo. After a few chuckles, followed by "Can I see the original report, please?" I stopped presenting the meta-summary. Each doc required a total of about 1.75 minutes to review all four summaries in their original forms. > Good stuff, Susan. > [quoted text clipped - 7 lines] > I add the H2O2 about once a week now ... figuring that notion (too > much = bad thing) makes some sense. Neil, how did you come up with the GFSE as a tx? I'm interested. > I'm big on bleach. Bleach good. So's oxy cleaner; my bleach sensitive cleaning woman uses it, and it works for me, too, as long as she gets every inch of the bathroom. If she doesn't, I end up getting up at midnight to do it myself, due to congestion. > Neil > > *Now /former/ PCP, actually. I had the audacity to question an > unreasonable charge on my bill and he sent me a 30-day term notice of > doctor/pt relationship. True story. A$$hole! > My NP wife was flabbergasted, and assumed he was /actually/ afraid of > potential liability arising from the DPT vaccine and the brachial > neuritis (I have zero energy to sue /anybody/ in this world). He probably is. And also unwilling to work so hard at caring for someone. > He charged $160 for summarizing the (one paragraph each) summaries of > four different specialists. The "meta-summary" he created became a > standing joke at Mayo. After a few chuckles, followed by "Can I see > the original report, please?" I stopped presenting the meta-summary. > Each doc required a total of about 1.75 minutes to review all four > summaries in their original forms. I've never had anyone do that, much less charge for providing a summary or report. You're well rid of him. Susan > x-no-archive: yes > [quoted text clipped - 12 lines] > > Neil, how did you come up with the GFSE as a tx? I'm interested. First, just from general health (IIRC, fungal infections) research. But ... then ... from these: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSear ch=12165190&ordinalpos=19&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel .Pubmed_RVDocSum AND http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSear ch=12165191&ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel .Pubmed_RVDocSum If you stick "Grapefruit Seed Extract" into a PubMed search window ... many informative results appear. Seems to be a powerful, safe, and effective antimicrobial, good against bacteria, virus, AND fungus. Cheap, too! > > I'm big on bleach. Bleach good. > > So's oxy cleaner; my bleach sensitive cleaning woman uses it, and it > works for me, too, as long as she gets every inch of the bathroom. If > she doesn't, I end up getting up at midnight to do it myself, due to > congestion. I have a spray bottle that's got some mix of GSE, H2O2, and water. Maybe the best of both worlds, and without the nasal nastiness of bleach. > > *Now /former/ PCP, actually. I had the audacity to question an > > unreasonable charge on my bill and he sent me a 30-day term notice of [quoted text clipped - 19 lines] > > You're well rid of him. Agreed on all counts, though ... admittedly ... that wasn't my initial reaction to reading the letter :-) Neil, Your NP wife was right to be horrified. Some offices have standing charges for filling out forms: usually about $25. If I have to do a prolonged disability form, I have the patient come in, and we do it together. Why didn't he just release the consultants letters to you and you could present them: that would be about 25 cents a page (at most) to xerox. You should never terminate a patient without documentation of the reason, and you have to provide care and help them transfer care: otherwise that's abandonment. Stupidest thing I ever heard of: antagonist a patient who had a bad outcome from a vaccine you administered...Way to get sued. This person needs some risk/management remediation. I know you're too busy trying to deal with your medical conditions. But this adds insult to injury, IMO. My sister has sworn by grapefruit seed extract for years, and the Xlear people, who make a xylitol nose spray use it as their preservative, rather than BAK. I also agree that venting does help us come up with solutions, it's not just complaining. Judy On Dec 10, 6:09 pm, neil0...@yahoo.com wrote: > > x-no-archive: yes > [quoted text clipped - 63 lines] > Each doc required a total of about 1.75 minutes to review all four > summaries in their original forms. > Neil, > Your NP wife was right to be horrified. Some offices have standing [quoted text clipped - 4 lines] > could present them: that would be about 25 cents a page (at most) to > xerox. I actually provided the reports to him (my take-away from National Jewish). He, then, "summarized" them. You're exactly right, and/but -- given what I just mentioned -- it looks even worse ... to me. > You should never terminate a patient without documentation of the > reason, and you have to provide care and help them transfer care: > otherwise that's abandonment. He gave two things: - the standard form letter, recommending that I try "friends and acquaintances," or ... and then listed four local referral networks. I presume he met the letter of the law, and - the cover letter that included the following salient words: "Under the circumstances, since this is the way I practice medicine, and since it does not meet with your approval, I hereby am terminating our doctor-patient relationship." Yeah. I don't think he could have done it much more inelegantly without a great deal of thought. > Stupidest thing I ever heard of: antagonist a patient who had a bad > outcome from a vaccine you administered...Way to get sued. This person > needs some risk/management remediation. You're exactly right. Years ago, when I told my eye doc what the BAK did to my eyes, and showed him the electron microscopy, pathology reports, and preservative-induced ocular toxicity expert's narrative, he did exactly what "the book" tells you to do when "unforeseen consequences" arise. I suspected that's what he'd done, so I looked at the MedMal carriers' pages /about/ just such a thing. His response was, doubtless, rehearsed and textbook. It certainly was better received than this guy's approach. This doc did -- as you're implying -- the exactly wrong thing. I actually /thought/ about sending him a copy of the guidelines that MedMal carriers /provide/ to MD's for situations like this, and hinting that he had done exactly the wrong thing. Negative energy, though. Can't be bothered. Not today. > I know you're too busy trying to deal with your medical conditions. > But this adds insult to injury, IMO. Exactly right again. At the end of the day, though, sometimes a person who acts this way does you/me/us a favor. That's what I came to understand with a little reflection. > My sister has sworn by grapefruit seed extract for years, and the > Xlear people, who make a xylitol nose spray use it as their > preservative, rather than BAK. Ahh. Interesting. I haven't seen much downside in its use yet. Of course, in 15 years, it will be a "well-documented carcinogen" and "cytotoxic to mucous membranes" ;-) > I also agree that venting does help us come up with solutions, it's > not just complaining. > Judy Would somebody else like to take a turn, then? :-) Neil, I think I sent this to you, but I always return to it: I've worked with an NP who is brilliant, and she has always said: "Whenever I need the healthcare system, it never fails to dissapoint me." Unfortunately, I have to agree with her, and when, by chance, I find a special provider who really listens and problem solves, and doesn't get frustrated and turn on me with their frustration, I consider myself incredibly lucky. We just had our annual practice meeting: and we omitted the demographic slide that shows we're all getting older and new doctors aren't coming into the practice. I have a couple of providers: my allergist, my ENT and both can see retirement on their horizon, and it scares me. I was at a conference recently, and a colleague shared stories of a horrible, life threatening hospitalization. I shared my story of my daugther's travesty of a hospitalization: we both agreed we have PTSD, and it's not going away. This is not a global attack on health care, although it sounds like it. But there was a Newsweek article about a year ago discussing how health care providers are terrified of being on the receiving end of health care. I saved it. I still think that when we share information: biofilms, BAK, low dose macrolides, immunoglobulins. We empower ourselves. There's a great neurologist, Larry Robbins, and he publishes his text on headache for free on his website: www.headachedrugs.com. I emailed him about it, because I used to buy it, and he said he wants patients to inform their doctors. Good guys (and women) are out there. Guess I'll hold off on that adacel for now.... Judy On Dec 11, 5:40 pm, neil0...@yahoo.com wrote: > > Neil, > > Your NP wife was right to be horrified. Some offices have standing [quoted text clipped - 76 lines] > > Would somebody else like to take a turn, then? :-) > Neil, > I think I sent this to you, but I always return to it: I've worked > with an NP who is brilliant, and she has always said: "Whenever I need > the healthcare system, it never fails to dissapoint me." Hm. You defend your profession the way that I defend my male gender :-) It's an ongoing joke between my wife and me, too: I tell her how lucky she is that she doesn't need to be treated by people like herself (tongue-in-cheek, of course). > Unfortunately, I have to agree with her, and when, by chance, I find > a special provider who really listens and problem solves, and doesn't [quoted text clipped - 5 lines] > allergist, my ENT and both can see retirement on their horizon, and it > scares me. Also spot on. I was immediately aware that my amazingly bright ophthalmologist (that overlooked the BAK issue for too many years. Whoops) was my age (now, early 40's). I view(ed) that as a Very Good Thing. Lots of the people whose wisdom I've sought to tap ... on nearly any subject medical ... have -- as I found out -- since retired. A few of them, I chased nonetheless. Mostly, they were eager to help, if a tad rusty. > I was at a conference recently, and a colleague shared stories of a > horrible, life threatening hospitalization. I shared my story of my > daugther's travesty of a hospitalization: we both agreed we have PTSD, > and it's not going away. I have to assume that you mean this either with sincerity, or with more sincerity than you'd care to admit. I've described /that/ phenomenon to my wife, repeatedly, too: if I blink, they'll hurt me. It creates, in us, a medical hyper-vigilance that I think Susan would say is as damaging to the adrenals as steroids. Chronic fight-or-flight. Yes, it makes me much more threatening and worrisome and perceived- riskier to most physicians, but ... at the end of the day, my health matters more to me than his/her ego. Funny, that, huh? But it truly IS a PTSD thing. I actually sought out a local EMDR therapist on the premise that PTSD might explain some of what I've felt through all of this. Interesting that you raised that. > This is not a global attack on health care, although it sounds like > it. But there was a Newsweek article about a year ago discussing how > health care providers are terrified of being on the receiving end of > health care. I saved it. Back in the vision days, there was a website whose URL was a variant of "I Know Why Refractive Surgeons All Wear Glasses." As I met with more and more of these corneal/refractive types, it was a near- universal truth. Actions, as they say, speak louder...... > I still think that when we share information: biofilms, BAK, low > dose macrolides, immunoglobulins. We empower ourselves. Amen. > There's a great neurologist, Larry Robbins, and he publishes his > text on headache for free on his website:www.headachedrugs.com. > I emailed him about it, because I used to buy it, and he said he wants > patients to inform their doctors. Good guys (and women) are out there. I have to catch up on that other guy's med blog (that you just posted) first ;-) > Guess I'll hold off on that adacel for now.... You know as well as, or better than, any of us: risk-reward. IS there a DPT - IgG subclass connection?? Crap, I dunno. Interesting aside: watching rerun of "House" last night. Ailing senator had been treated, as a kid, with Phenytoin for childhood epilepsy. So goes the show, he was also an EBV carrier. Apparently, the mix can cause Chronic Variable Immune Deficiency Syndrome. I'm awaiting the Mayo results of the viral antibody tests for which I / fought/. Whether or not I have EBV, why couldn't the mix of DPT/ anticonvulsants (Neurontin ruined me), or ... whatever else ... produce, in larger numbers than we're now aware ... chronic immune dysfunction. Did I mention this one? If you Google (/PubMed) anticonvulsant and "IgG subclass deficiency" or, more broadly, any keywords to indicate immunosuppression, you quickly find out that these drugs smash our Ig* levels. It seems NOT to be dose/duration/gender dependent, NOR to recover upon cessation of treatment. Dunno' whether you've ever used one, but ... if not that ... what other drugs whose "mechanism of action is unknown" (scares the h*** out of me) might do likewise? More broccoli. Yeah. That's the ticket.... > I have to assume that you mean this either with sincerity, or with > more sincerity than you'd care to admit. [quoted text clipped - 3 lines] > that I think Susan would say is as damaging to the adrenals as > steroids. Chronic fight-or-flight. Yup. > Yes, it makes me much more threatening and worrisome and perceived- > riskier to most physicians, but ... at the end of the day, my health [quoted text clipped - 3 lines] > therapist on the premise that PTSD might explain some of what I've > felt through all of this. The whole stress over going to kiss yet another frog doctor, only to have him turn into an a$$hole doctor is something I have zero tolerance for, particularly after my Addisonian summer spent fixin' to die and being blown off by my former PCP, formerly the best doc I'd ever had. I just have such PTSD over that, that I got over my airplane phobia and went to LA to see a doc who, though not perfect, doesn't do that, though sometimes he seems to dismiss stuff, he never gives up pursuit of what's wrong. I had no fear of flying, which my husband was incredulous about; I finally realized it was because I felt so ill and hopeless that I just don't fear dying, even a horrible death. :-/ Susan Susan, You do have a way with words: love the frog metaphor. It is PTSD, and hyper-vigilance, and it's the old saying "Just because you're paranoid, doesn't mean they're not all out to get you." At the recent conference, a great lecture by an opthalmologist--who had NO drug company ties (the only one) admitted that very few opthalmologists will go for Lasik surgery, because they've seen all the disasters--as he went on to show slides gross enough that I had to look away at times.... Neil, I've never taken an anti-convulsant--but I take other meds, and wouldn't be surprised that IgG can be altered by medication. I hate House, because it's not how medicine really works, but lots of people love it, the portrayal of doctor as flawed, yet brilliant, misanthropic yet life saving. I was completely serious about the PTSD: my daughter is stable now, but we were caught in a medical nightmare, and no amount of advocating or research I did made any difference for a long time. I was so distraught, I couldn't even recognize the help when it was coming--my ENT recognized what was going on, a local neurologist tried to help--I ran up to Boston and discovered that the mecca had no answers. Ultimately, I did find some help, and she got better on her own, but I'm left with a profound distrust of the system. She hates most doctors now, and I can't blame her. She can sense a lousy provider in a heart beat. And, I always wait for the other shoe to drop... Crazy making. Judy > x-no-archive: yes > [quoted text clipped - 29 lines] > > Susan > Susan, > You do have a way with words: love the frog metaphor. LOL... it involved the use of my favorite word when discussing most physicians. I actually used "shithead" when describing a preteno or endiot to my former PCP. > It is PTSD, and hyper-vigilance, and it's the old saying "Just > because you're paranoid, doesn't mean they're not all out to get you." One of my all time favorite expressions! Of course, I had to keep it to myself when I was working with the mentally ill... :-D > At the recent conference, a great lecture by an opthalmologist--who > had NO drug company ties (the only one) admitted that very few > opthalmologists will go for Lasik surgery, because they've seen all > the disasters--as he went on to show slides gross enough that I had to > look away at times.... I've stayed away, and so has my husband. I read about the awfulness after an acquaintance had the surgery and developed nightmarish glare all the time, and severe depression as a result. > Neil, I've never taken an anti-convulsant--but I take other meds, > and wouldn't be surprised that IgG can be altered by medication. > I hate House, because it's not how medicine really works, but lots > of people love it, the portrayal of doctor as flawed, yet brilliant, > misanthropic yet life saving. Yeah, fantasy, the way Marcus Welby was, in a way. > I was completely serious about the PTSD: my daughter is stable now, > but we were caught in a medical nightmare, and no amount of advocating [quoted text clipped - 6 lines] > doctors now, and I can't blame her. She can sense a lousy provider in > a heart beat. She could just play the odds and bet on 99% to be lousy. > And, I always wait for the other shoe to drop... > Crazy making. It is. It's why I won't go see anyone for the most part, unless I've vetted them first. The ENT thing was annoying, but the least of my probs, so I didn't give a rat's a.s, and I got the pleasure of seeing him squirm. He did bring up nebulized abx, so it wasn't a total loss; I can take that back to my inf. diseases/former PCP doc. Susan On Dec 10, 5:08 pm, neil0...@yahoo.com wrote: > > On Dec 9, 12:46 pm, neil0...@yahoo.com wrote: > [quoted text clipped - 84 lines] > ideas DO come. If I didn't at least believe that a bit, I wouldn't > vent so online ;-) "go-to's?" all of the above & beyond & less. my mood tonight is as unstable & unpleasant as the rest of things that swing in & out of this poor old body. & as reliable as my 'go-to's.' better practical advice from everyone else, i'm sure. the crazy-making sends me to absurdist escapism. for tonight though: emmylou harris - the pearl (1st 4:00) http://www.youtube.com/watch?v=CywArYObn2U ellen > On Dec 10, 5:08 pm, neil0...@yahoo.com wrote: > [quoted text clipped - 96 lines] > > ellen then the next day comes & religious or not, you got to go for the gospel gal with the electric guitar. the great sister rosetta tharpe - up above my head: http://www.youtube.com/watch?v=JeaBNAXfHfQ ellen >>>> i've been having a runny nose all day and now my head is >>>> starting to hurt on the left side. the pain grows each time [quoted text clipped - 29 lines] > Astelin antihistamine spray, etc. These require a prescription. If all > you have is some kind of rhinitis, these kinds of medications may help. i've been having this regularly for few months now, it comes and goes in a few days, but occurs every month. before that i had chest congestion and breathing problems for years due to allergy. anyway i did see the family doctor, my mom was insisting since i have my exams day after and didnt want to take any chances. he said its sinusitis and gave me medicine for two days. well at least i know what i have. |
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