Re: Medical Opinions vs Facts

October 23, 2011

It is up to the PCP you end up with. From What I have gathered from 's story

is for about 4 years he was one the same path I am on. If VA was better at

understanding what PA was they should have DX him much sooner. In his case his

Dr was smart enough to know she was missing something. When the VA had a temp Dr

that was a hypertension specialist working there his Dr was smart enough to send

him to the expert.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of

value.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia

in

> > > > > > > > > women. They will also never mention that the estrogenic

properties

> > > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if

you

> > > > > > > > > look hard enough), yet in the three weeks I was on it, my

weight

> > > > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > > > way) went up five pounds. So my *opinion* that this drug's

side

> > > > > > > > > effects outweigh it's benefits *may* be of value to some

newbie who

> > > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I

could

> > > > > > > > > have skipped AVS and gone straight to surgery, even though I'm

a bit

> > > > > > > > > past 40, was not supported by any of the " facts " in the

research

> > > > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > > > the guidance I got via the *facts* presented in research

articles.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > --- In

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

October 23, 2011

And I for one try to encourage her to listen to her HTN Consultant!

>

> > Natalia,

> >

> > Micardis+Epler work well for you. Check this picture to see what they do and

find out if you need to block something else too:

> >

> > <image001.png>

> >

> > Click for details 1

> >

> > Max.

> >

> > Yes, my renin was low. But ACE and ARB always lowered my BP, although not

enough to the normal range.

> >

> > And now when I have spikes of BP around 200/100, the combinaton of Micardis+

eplerenon lower it much faster that only eplerenone.

> >

> > Thank you, .

> >

> > Natalia

> >

>

October 23, 2011

IMO, a PCP is responsible to recognize and treat most health issues. As Kenny

said, " know when to hold them and when to fold them! " A good example is

my wife who sees her PCP for most and a Cardoligist and Gynocologist for their

speciality fields.

In Dr. Webster's defense, she was not my PCP for 4 years before the referral. I

believe it was more like one year. I saw two different residents first. When

things weren't working I made (demanded) changes. I mean I screamed, I

hollared, I threatened and I finally hung up on a TT Nurse (after screaming

" nobody gives a sh_ _! " ) That got results but I only recommend it as a last

resort! I certainly got a call back, actually two, and was transfered from GMF

to WMF and a full fledged doctor with experience. I think that was the key that

allowed Dr. Webster to request the referral. A young resident is reluctant to

admit something is beyond their expertise and did you ever know a man to ask for

directions! (I highly recommend a female PCP, besides they have more compassion

and smaller fingers!)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of

value.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > For example - the research articles will

probably

> > > > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > > > exacerbate menstrual irregularities, or can cause

gynecomastia in

> > > > > > > > > > women. They will also never mention that the estrogenic

properties

> > > > > > > > > > may cause weight gain (plenty of anecdotal evidence of that

if you

> > > > > > > > > > look hard enough), yet in the three weeks I was on it, my

weight

> > > > > > > > > > (which under normal circumstances only fluctuates by a pound

either

> > > > > > > > > > way) went up five pounds. So my *opinion* that this drug's

side

> > > > > > > > > > effects outweigh it's benefits *may* be of value to some

newbie who

> > > > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I

could

> > > > > > > > > > have skipped AVS and gone straight to surgery, even though

I'm a bit

> > > > > > > > > > past 40, was not supported by any of the " facts " in the

research

> > > > > > > > > > articles. So I was able to choose to ignore his opinion, and

follow

> > > > > > > > > > the guidance I got via the *facts* presented in research

articles.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > --- In

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

October 23, 2011

I agree but we could argue that many patients are responsible for eating right, not smoking, exercising when possible and losing weight when possible. Many do not even try but then expect 100% perfect service. If I ate like I always should have....ie..low salt...then I still may have never had known I had PA and may have skipped alot of my lifes problems. No one can be always right, they can just tell you they are. Medicine has to cost as there is an over head no matter what some may think, but it has to be a 2 way street to be successfulSent from my Palm Pre on the Now Network from Sprint

IMO, a PCP is responsible to recognize and treat most health issues. As Kenny said, "know when to hold them and when to fold them!" A good example is my wife who sees her PCP for most and a Cardoligist and Gynocologist for their speciality fields.

In Dr. Webster's defense, she was not my PCP for 4 years before the referral. I believe it was more like one year. I saw two different residents first. When things weren't working I made (demanded) changes. I mean I screamed, I hollared, I threatened and I finally hung up on a TT Nurse (after screaming "nobody gives a sh_ _!") That got results but I only recommend it as a last resort! I certainly got a call back, actually two, and was transfered from GMF to WMF and a full fledged doctor with experience. I think that was the key that allowed Dr. Webster to request the referral. A young resident is reluctant to admit something is beyond their expertise and did you ever know a man to ask for directions! (I highly recommend a female PCP, besides they have more compassion and smaller fingers!)

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > I find both opinions, and facts to be of value.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > For example - the research articles will probably

> > > > > > > > > > never, ever mention that spiro's estrogenic properties can

> > > > > > > > > > exacerbate menstrual irregularities, or can cause gynecomastia in

> > > > > > > > > > women. They will also never mention that the estrogenic properties

> > > > > > > > > > may cause weight gain (plenty of anecdotal evidence of that if you

> > > > > > > > > > look hard enough), yet in the three weeks I was on it, my weight

> > > > > > > > > > (which under normal circumstances only fluctuates by a pound either

> > > > > > > > > > way) went up five pounds. So my *opinion* that this drug's side

> > > > > > > > > > effects outweigh it's benefits *may* be of value to some newbie who

> > > > > > > > > > comes here down the line.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > However. My HTN doctor's *opinion* that I could

> > > > > > > > > > have skipped AVS and gone straight to surgery, even though I'm a bit

> > > > > > > > > > past 40, was not supported by any of the "facts" in the research

> > > > > > > > > > articles. So I was able to choose to ignore his opinion, and follow

> > > > > > > > > > the guidance I got via the *facts* presented in research articles.

> > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > > --- In

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

October 23, 2011

Still history taking and listening has disappeared except for a few so the 2 way street is already like driving through new mexico - the road is blocked or divertedSent from my Palm Pre on the Now Network from Sprint