RE: questions and concerns

November 19, 2002

Sorry you aren't feeling so hot, Tess, but I'm glad that you'll be

seeing your rheumatologist and getting your Remicade Thursday. I hope

you get speedy relief.

No, I don't think it's terrible to look for a new PCP. Your health is

more important than possibly hurt feelings. You have to feel comfortable

with each and every physician and believe that he or she is working with

you to help you achieve the best health possible.

The procedure you are talking about for your eyes is called " punctal

occlusion. " It involves plugging the puncta in your eyes. Puncta are

tiny openings in your eyelids which lead to the drainage canals which

allow the liquid to leave the surface of your eyes; this is not where

tears are produced.

" Punctal occlusion " from VisionsEyeHealth.com:

http://www.visionseyehealth.com/Punctalocclusion.html

An editorial on punctal occlusion from the AMA:

http://archopht.ama-assn.org/issues/v117n3/ffull/eed80010.html

Here's a very good article entitled " Insulin Resistance Syndrome " from

the American Academy of Family Physicians:

http://www.aafp.org/afp/20010315/1159.html

How long have you had a diagnosis of diabetes? How long have been using

insulin? Are you Type 1 or 2?

[ ] questions and concerns

> Hi...I'm seeing my rheummy Thursday and having my Remicade. My knees

> and feet are painful which has not been as bad as my hands, wrists and

> shoulders. It takes me a few seconds to get my bearings when I stand,

> like my legs, feet don't quite know what to do. My eyes are not doing

> well, and swallowing is troublesome. I fell asleep on the couch for 2

> hours tonight while Em was watching TV. When I awoke, she said

> everytime I swallowed while sleeping it looked like I was having to

> force it down, and my face grimaced.

>

> When the Dr. tried the biopsy, she said my fibroids are 'huge' and

> shaped her fingers like the size of an orange. I have been having a

> difficult time with bowel movements, and wonder if the herniated disks

&

> fibroids are interfering with that process.

>

> I really liked my PCP a lot, but over the past few months I've really

> felt that she isn't as aggressive with some health issues as what I

> need. I've talked to her about the obesity...she wasn't for surgery

at

> all, but didn't follow up my questions and concerns regarding other

> kinds of help. Also, my diabetes...my numbers are good and my HA1C

has

> been in the 6's for about 3 years which is great. However, I'm

hearing

> so much about 'insulin resistance' contributing to morbid obesity I

> don't understand why we haven't addressed getting me off insulin. She

> is in her late 50's and trained in Romania, very conservative. I feel

> sort of bad, but I decided to try another PCP who is much younger and

> trained at OHSU in Portland. Do you think that's awful? When I called

> to change PCP's they asked what was wrong with Dr. Boboia and I told

> them nothing...I liked her very much but I think we have some

> philosophical differences.

>

> I'm going to weigh myself Thursday, and I'm scared. I'm doing pretty

> well, but that gain a few weeks ago has made me nervous. However, I

> didn't throw in the towel...still writing down my food, stopping at

8pm,

> etc. I really have pretty good energy from about an hour or two after

I

> get up until mid, late afternoon when I just am so exhausted.

>

> Have been a bit sad today...crying often. My rheummy talked with me

> about plugging my tear ducts. I hope this isn't a dumb question, but

> does that stop your ability to cry? I think I'd emotionally implode

if

> I couldn't cry. Sometimes you just gotta.

>

> Love You All...

>

> Tess

November 19, 2002

Tess,

Have you been back to the doctor that took out your tonsils? Is your throat

sore or feel swollen?

I¹m not sure what to think about the fibroids causing constipation. I can

see how it could

restrict the movement of your intestines if the fibroids are pushing up

against your intestines. Please mention this to your doctor and don¹t let

the constipation continue.

As far as seeing another doctor, I think it¹s a great idea if you think your

current doctor is not being aggressive enough. It has nothing to do with

your feelings for the doctor. You need someone that will address your

concerns.

Glad you didn¹t throw in the towel with your diet. We all have backslides

and that is to be expected. Just get back on that horse as they say. I

hope your efforts will be rewarded on Thursday.

a

> Hi...I'm seeing my rheummy Thursday and having my Remicade. My knees

> and feet are painful which has not been as bad as my hands, wrists and

> shoulders. It takes me a few seconds to get my bearings when I stand,

> like my legs, feet don't quite know what to do. My eyes are not doing

> well, and swallowing is troublesome. I fell asleep on the couch for 2

> hours tonight while Em was watching TV. When I awoke, she said

> everytime I swallowed while sleeping it looked like I was having to

> force it down, and my face grimaced.

>

> When the Dr. tried the biopsy, she said my fibroids are 'huge' and

> shaped her fingers like the size of an orange. I have been having a

> difficult time with bowel movements, and wonder if the herniated disks &

> fibroids are interfering with that process.

>

> I really liked my PCP a lot, but over the past few months I've really

> felt that she isn't as aggressive with some health issues as what I

> need. I've talked to her about the obesity...she wasn't for surgery at

> all, but didn't follow up my questions and concerns regarding other

> kinds of help. Also, my diabetes...my numbers are good and my HA1C has

> been in the 6's for about 3 years which is great. However, I'm hearing

> so much about 'insulin resistance' contributing to morbid obesity I

> don't understand why we haven't addressed getting me off insulin. She

> is in her late 50's and trained in Romania, very conservative. I feel

> sort of bad, but I decided to try another PCP who is much younger and

> trained at OHSU in Portland. Do you think that's awful? When I called

> to change PCP's they asked what was wrong with Dr. Boboia and I told

> them nothing...I liked her very much but I think we have some

> philosophical differences.

>

> I'm going to weigh myself Thursday, and I'm scared. I'm doing pretty

> well, but that gain a few weeks ago has made me nervous. However, I

> didn't throw in the towel...still writing down my food, stopping at 8pm,

> etc. I really have pretty good energy from about an hour or two after I

> get up until mid, late afternoon when I just am so exhausted.

>

> Have been a bit sad today...crying often. My rheummy talked with me

> about plugging my tear ducts. I hope this isn't a dumb question, but

> does that stop your ability to cry? I think I'd emotionally implode if

> I couldn't cry. Sometimes you just gotta.

>

> Love You All...

>

> Tess

>

November 19, 2002

on 11/19/02 2:26 AM, tess_northwest@... at tess_northwest@...

wrote:

> Have been a bit sad today...crying often. My rheummy talked with me

> about plugging my tear ducts. I hope this isn't a dumb question, but

> does that stop your ability to cry? I think I'd emotionally implode if

> I couldn't cry. Sometimes you just gotta.

I asked a related question on my Fuchs' Friends list, because several people

who have dry eyes talked about having their tear ducts plugged to help the

problem. I, too, thought the tears came from the tear ducts. Here is the

answer that I received:

" Tears are produced in the tear glands in the eye lids. Tear ducts

(normally) drain the excess tears away from the eyes, and are located

in the inner corner of eye (near the nose). When you have have dry

eyes, the tear ducts drain too many of the tears away.

" The tear ducts drain into the nasal passage, and that's why you have

a 'sniffly' nose when you have a hard cry. "

Hope this helps.

Sue in NC

November 19, 2002

Thanks ((((((((((Sue))))))))))

Love....

Tess

November 19, 2002

Hi a...I met with my new PCP today and was really impressed. We

mostly talked about diabetes...we did touch on other things. She said

she wished she had at least 30 minutes scheduled to get to know me...I

told her I had asked for a " get to know me " appointment as I have so

many issues. The scheduler said that wasn't done. Dr. Brown said to

tell them to schedule me for 30 and if they give me any grief to tell

them to talk to her. We did talk a good 20 minutes. And they scheduled

me for another 30!

My cholesterol is just a bit high, so I told her I was trying to get

oatmeal in more often. She thought that was great and suggested I get

some more omega fatty acids in...I just ordered the Wild Salmon from the

co-op...should come anytime.

I'm going to talk more extensively to my gyn about the fibroids. My ENT

said my throat looks beautiful, " like the Grand Canyon! "

Thanks for all your loving concern and helpfulness.

Hugs...

Tess

November 19, 2002

Hi ...thanks for all the great information. I was diagnosed Type 2

diabetes in 1990. I started on insulin in 91. Since adding Actos to

the mix, I have dropped my insulin from over 300 units a day to about

100. I saw my new PCP today she seems great, and up on all the new

things. She does say that my using insulin will fight against weight

loss, but since my diabetes is in such good control, she wants to first

approach weight loss without lessening the insulin. She also said that

my weight loss so far is evidence that losing weight can be done on

insulin even if it takes a bit longer, and for me please not to compare

myself to folks who have had gastric bypass as it is apples & oranges.

She was very encouraging. She also said as more weight comes off we may

be able to gradually lessen the insulin.

Love...

Tess

November 19, 2002

That's great, Tess! I'm so glad you like your new doctor. I think you made

a good decision to find a more aggressive, up to date doctor.

Sending love and (((((((((((((((((((((((lots of

hugs))))))))))))))))))))))))))

Carol

Re: [ ] questions and concerns