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Hello Dr. Safhafi.....it’s Your “friend” Missy....I Thought I’d Close My
Question: Hello Dr. Safhafi.....it’s your “friend” Missy....I thought I’d close my other discussion with you and consult you about another issue, so that you would be given credit for another query (not to mention the fact that you were so incredibly kind in going above and beyond with answering my prior question, which led into discussion over other health concerns)!
I am not an overly religious person, but I do believe in God. I feel as though a higher power has had a hand in connecting me with you via this platform, and you have truly been like a guardian XXXXXXX to me! Your kind words and reassurances, not to mention your terrific personality, have been a godsend to me.
You had asked about how I am faring with my anxiety. The short answer is, I am coping and able to maintain my obligations, but the dastardly health worries are always front and center in my mind on a daily basis. I am currently taking duloxetine and also .5 mg of alprazolam once daily, which certainly help. I’ve also been seeing a therapist for two years now, and I have a stack of self-help anxiety books on my coffee table (which I have yet to have the time to break open and read). I’ve purchased a package of massages at a local spa, and my hubby and I try our best to walk three miles a night, weather permitting. I also have two girlfriends who I met in an online anxiety forum, both of whom live in other states; although we’ve never met in person, we aren’t in regular contact via texting and serve as a voice of reason for one another when our health anxiety flares.
I think the origin of my anxiety is a perfect storm of nature, nurture and classic overthinking. My dad, who passed away 13 years ago, was an incredibly intelligent man with encyclopedic knowledge and a photographic memory. I could only dream to be as intelligent as him, but I did inherit the “overthinking” gene from him most definitely! He used to tell me, “Miss....sometimes I think I’d rather go through life being stupid and happy” (don’t take that the wrong way!). One thing my dad did not like to do on a regular basis was visit his doctor. When I was in my early twenties and still living at home, he had classic symptoms of a heart attack but refused to call 911 or go to the hospital. Of course, he waited three days before he finally relented and went to the hospital and sure enough, had had a heart attack. He had successful triple bypass surgery, but by waiting too long he sustained a lot of damage to his heart muscle and ultimately passed away from cardiac arrest years later (I am just so grateful he was able to walk me down the aisle and see my boys being born). There were various other times he was ill and refused to get medical attention as well. Hence, my first reaction when I have a health worry is to consult my doctor(s).
I am an attorney and as you can imagine, law school trained me to pick apart situations, analyze, research applicable law and apply the same to the circumstances at hand. I think the medical student “wanna be” part of me does the exact same thing with my health concerns and worries. But as we both know, I am NOT medically trained and NOT a doctor, so my over analyzing of these health worries is undoubtedly “over the top” lol! By the way, I handle estate administration in my work, so I am literally dealing with “death” on a daily basis...not in a medical sense certainly, but in working with the decedents families and their frail emotions, combined with facilitating the disposition of the decedent’s worldly possessions. No wonder the reality of death is in the forefront of my mind. Not to mention that I am a total empath and tend to feel and take on other people’s worries and emotions. And I wonder why my body is tensed up and twitching lol! I loved your Star Trek example...I wasn’t a Trekkie but had a huge crush on Captain XXXXXXX and loved every single episode (especially the one those little furry ball animals that kept multiplying lol). I think I need to be more like Mr. Spock with his rational thinking devoid of emotion!
One last thing to share that I know has a huge hand in my health anxiety. I shared in my prior query to you about my MS worry back in 2002 through 2005; well? The neuro I visited in 2005 went so far as to diagnose me with probable MS based upon my clinical symptoms, even in the absence of sclerotic lesions on my brain and spine MRIs. He wanted to proceed with a lumbar puncture and interferon treatments and that is when I called a big halt to everything. That same year, in 2005, I had chest pain and had a stress test done, which picked up on some elevated pulmonary artery pressures. So my PCP referred me to a pulmonologist, who proceeded to inform me that I fit the criteria for a diagnosis of it being “primary pulmonary hypertension” and if that was the case, my lifespan would be on average another two and a half years! My sons were three and seven years old at the time and all that I could do was cry. He sent me for a sleep study, CT scan of lungs and ventilation-perfusion test. Based upon some mild bronchiecstasis found, he said that may possibly be the cause of it, which would make it less likely to be pulmonary hypertension. Fast forward to 2017 , at which time my PCP sent me for an echocardiogram....guess what? My pulmonary pressure was totally within normal range.
So as you have probably garnered, I think I have a handle on the various factors behind my anxiety, which is primarily focused on health worries. I can function on a daily basis and to the outside world no one would guess I have such turmoil inside my head. As they say, acknowledging the problem is the first step. Now I just have to explore and find some techniques which will be successful in helping me squelch this nasty monster!!
To answer your questions, XXXXXXX is about a forty five minute drive from here, and yes, sometimes we let our snow just sit. Back in November of 2014 we had a storm that dumped SEVEN FEET of snow! We had no choice but to let that sit. We were snowed in for close to a week. I hope you and your family stayed safe and toasty warm during this little snowstorm we’re having (and I hope your kiddos decided to stay close to home)! And I got a nice little nap in today.
You are truly not only an incredible physician, but an incredible person with a huge heart. Sending you all my thanks and gratitude for not only listening, but for truly HEARING me!!
I am not an overly religious person, but I do believe in God. I feel as though a higher power has had a hand in connecting me with you via this platform, and you have truly been like a guardian XXXXXXX to me! Your kind words and reassurances, not to mention your terrific personality, have been a godsend to me.
You had asked about how I am faring with my anxiety. The short answer is, I am coping and able to maintain my obligations, but the dastardly health worries are always front and center in my mind on a daily basis. I am currently taking duloxetine and also .5 mg of alprazolam once daily, which certainly help. I’ve also been seeing a therapist for two years now, and I have a stack of self-help anxiety books on my coffee table (which I have yet to have the time to break open and read). I’ve purchased a package of massages at a local spa, and my hubby and I try our best to walk three miles a night, weather permitting. I also have two girlfriends who I met in an online anxiety forum, both of whom live in other states; although we’ve never met in person, we aren’t in regular contact via texting and serve as a voice of reason for one another when our health anxiety flares.
I think the origin of my anxiety is a perfect storm of nature, nurture and classic overthinking. My dad, who passed away 13 years ago, was an incredibly intelligent man with encyclopedic knowledge and a photographic memory. I could only dream to be as intelligent as him, but I did inherit the “overthinking” gene from him most definitely! He used to tell me, “Miss....sometimes I think I’d rather go through life being stupid and happy” (don’t take that the wrong way!). One thing my dad did not like to do on a regular basis was visit his doctor. When I was in my early twenties and still living at home, he had classic symptoms of a heart attack but refused to call 911 or go to the hospital. Of course, he waited three days before he finally relented and went to the hospital and sure enough, had had a heart attack. He had successful triple bypass surgery, but by waiting too long he sustained a lot of damage to his heart muscle and ultimately passed away from cardiac arrest years later (I am just so grateful he was able to walk me down the aisle and see my boys being born). There were various other times he was ill and refused to get medical attention as well. Hence, my first reaction when I have a health worry is to consult my doctor(s).
I am an attorney and as you can imagine, law school trained me to pick apart situations, analyze, research applicable law and apply the same to the circumstances at hand. I think the medical student “wanna be” part of me does the exact same thing with my health concerns and worries. But as we both know, I am NOT medically trained and NOT a doctor, so my over analyzing of these health worries is undoubtedly “over the top” lol! By the way, I handle estate administration in my work, so I am literally dealing with “death” on a daily basis...not in a medical sense certainly, but in working with the decedents families and their frail emotions, combined with facilitating the disposition of the decedent’s worldly possessions. No wonder the reality of death is in the forefront of my mind. Not to mention that I am a total empath and tend to feel and take on other people’s worries and emotions. And I wonder why my body is tensed up and twitching lol! I loved your Star Trek example...I wasn’t a Trekkie but had a huge crush on Captain XXXXXXX and loved every single episode (especially the one those little furry ball animals that kept multiplying lol). I think I need to be more like Mr. Spock with his rational thinking devoid of emotion!
One last thing to share that I know has a huge hand in my health anxiety. I shared in my prior query to you about my MS worry back in 2002 through 2005; well? The neuro I visited in 2005 went so far as to diagnose me with probable MS based upon my clinical symptoms, even in the absence of sclerotic lesions on my brain and spine MRIs. He wanted to proceed with a lumbar puncture and interferon treatments and that is when I called a big halt to everything. That same year, in 2005, I had chest pain and had a stress test done, which picked up on some elevated pulmonary artery pressures. So my PCP referred me to a pulmonologist, who proceeded to inform me that I fit the criteria for a diagnosis of it being “primary pulmonary hypertension” and if that was the case, my lifespan would be on average another two and a half years! My sons were three and seven years old at the time and all that I could do was cry. He sent me for a sleep study, CT scan of lungs and ventilation-perfusion test. Based upon some mild bronchiecstasis found, he said that may possibly be the cause of it, which would make it less likely to be pulmonary hypertension. Fast forward to 2017 , at which time my PCP sent me for an echocardiogram....guess what? My pulmonary pressure was totally within normal range.
So as you have probably garnered, I think I have a handle on the various factors behind my anxiety, which is primarily focused on health worries. I can function on a daily basis and to the outside world no one would guess I have such turmoil inside my head. As they say, acknowledging the problem is the first step. Now I just have to explore and find some techniques which will be successful in helping me squelch this nasty monster!!
To answer your questions, XXXXXXX is about a forty five minute drive from here, and yes, sometimes we let our snow just sit. Back in November of 2014 we had a storm that dumped SEVEN FEET of snow! We had no choice but to let that sit. We were snowed in for close to a week. I hope you and your family stayed safe and toasty warm during this little snowstorm we’re having (and I hope your kiddos decided to stay close to home)! And I got a nice little nap in today.
You are truly not only an incredible physician, but an incredible person with a huge heart. Sending you all my thanks and gratitude for not only listening, but for truly HEARING me!!
Hello Dr. Safhafi.....it’s your “friend” Missy....I thought I’d close my other discussion with you and consult you about another issue, so that you would be given credit for another query (not to mention the fact that you were so incredibly kind in going above and beyond with answering my prior question, which led into discussion over other health concerns)!
I am not an overly religious person, but I do believe in God. I feel as though a higher power has had a hand in connecting me with you via this platform, and you have truly been like a guardian XXXXXXX to me! Your kind words and reassurances, not to mention your terrific personality, have been a godsend to me.
You had asked about how I am faring with my anxiety. The short answer is, I am coping and able to maintain my obligations, but the dastardly health worries are always front and center in my mind on a daily basis. I am currently taking duloxetine and also .5 mg of alprazolam once daily, which certainly help. I’ve also been seeing a therapist for two years now, and I have a stack of self-help anxiety books on my coffee table (which I have yet to have the time to break open and read). I’ve purchased a package of massages at a local spa, and my hubby and I try our best to walk three miles a night, weather permitting. I also have two girlfriends who I met in an online anxiety forum, both of whom live in other states; although we’ve never met in person, we aren’t in regular contact via texting and serve as a voice of reason for one another when our health anxiety flares.
I think the origin of my anxiety is a perfect storm of nature, nurture and classic overthinking. My dad, who passed away 13 years ago, was an incredibly intelligent man with encyclopedic knowledge and a photographic memory. I could only dream to be as intelligent as him, but I did inherit the “overthinking” gene from him most definitely! He used to tell me, “Miss....sometimes I think I’d rather go through life being stupid and happy” (don’t take that the wrong way!). One thing my dad did not like to do on a regular basis was visit his doctor. When I was in my early twenties and still living at home, he had classic symptoms of a heart attack but refused to call 911 or go to the hospital. Of course, he waited three days before he finally relented and went to the hospital and sure enough, had had a heart attack. He had successful triple bypass surgery, but by waiting too long he sustained a lot of damage to his heart muscle and ultimately passed away from cardiac arrest years later (I am just so grateful he was able to walk me down the aisle and see my boys being born). There were various other times he was ill and refused to get medical attention as well. Hence, my first reaction when I have a health worry is to consult my doctor(s).
I am an attorney and as you can imagine, law school trained me to pick apart situations, analyze, research applicable law and apply the same to the circumstances at hand. I think the medical student “wanna be” part of me does the exact same thing with my health concerns and worries. But as we both know, I am NOT medically trained and NOT a doctor, so my over analyzing of these health worries is undoubtedly “over the top” lol! By the way, I handle estate administration in my work, so I am literally dealing with “death” on a daily basis...not in a medical sense certainly, but in working with the decedents families and their frail emotions, combined with facilitating the disposition of the decedent’s worldly possessions. No wonder the reality of death is in the forefront of my mind. Not to mention that I am a total empath and tend to feel and take on other people’s worries and emotions. And I wonder why my body is tensed up and twitching lol! I loved your Star Trek example...I wasn’t a Trekkie but had a huge crush on Captain XXXXXXX and loved every single episode (especially the one those little furry ball animals that kept multiplying lol). I think I need to be more like Mr. Spock with his rational thinking devoid of emotion!
One last thing to share that I know has a huge hand in my health anxiety. I shared in my prior query to you about my MS worry back in 2002 through 2005; well? The neuro I visited in 2005 went so far as to diagnose me with probable MS based upon my clinical symptoms, even in the absence of sclerotic lesions on my brain and spine MRIs. He wanted to proceed with a lumbar puncture and interferon treatments and that is when I called a big halt to everything. That same year, in 2005, I had chest pain and had a stress test done, which picked up on some elevated pulmonary artery pressures. So my PCP referred me to a pulmonologist, who proceeded to inform me that I fit the criteria for a diagnosis of it being “primary pulmonary hypertension” and if that was the case, my lifespan would be on average another two and a half years! My sons were three and seven years old at the time and all that I could do was cry. He sent me for a sleep study, CT scan of lungs and ventilation-perfusion test. Based upon some mild bronchiecstasis found, he said that may possibly be the cause of it, which would make it less likely to be pulmonary hypertension. Fast forward to 2017 , at which time my PCP sent me for an echocardiogram....guess what? My pulmonary pressure was totally within normal range.
So as you have probably garnered, I think I have a handle on the various factors behind my anxiety, which is primarily focused on health worries. I can function on a daily basis and to the outside world no one would guess I have such turmoil inside my head. As they say, acknowledging the problem is the first step. Now I just have to explore and find some techniques which will be successful in helping me squelch this nasty monster!!
To answer your questions, XXXXXXX is about a forty five minute drive from here, and yes, sometimes we let our snow just sit. Back in November of 2014 we had a storm that dumped SEVEN FEET of snow! We had no choice but to let that sit. We were snowed in for close to a week. I hope you and your family stayed safe and toasty warm during this little snowstorm we’re having (and I hope your kiddos decided to stay close to home)! And I got a nice little nap in today.
You are truly not only an incredible physician, but an incredible person with a huge heart. Sending you all my thanks and gratitude for not only listening, but for truly HEARING me!!
I am not an overly religious person, but I do believe in God. I feel as though a higher power has had a hand in connecting me with you via this platform, and you have truly been like a guardian XXXXXXX to me! Your kind words and reassurances, not to mention your terrific personality, have been a godsend to me.
You had asked about how I am faring with my anxiety. The short answer is, I am coping and able to maintain my obligations, but the dastardly health worries are always front and center in my mind on a daily basis. I am currently taking duloxetine and also .5 mg of alprazolam once daily, which certainly help. I’ve also been seeing a therapist for two years now, and I have a stack of self-help anxiety books on my coffee table (which I have yet to have the time to break open and read). I’ve purchased a package of massages at a local spa, and my hubby and I try our best to walk three miles a night, weather permitting. I also have two girlfriends who I met in an online anxiety forum, both of whom live in other states; although we’ve never met in person, we aren’t in regular contact via texting and serve as a voice of reason for one another when our health anxiety flares.
I think the origin of my anxiety is a perfect storm of nature, nurture and classic overthinking. My dad, who passed away 13 years ago, was an incredibly intelligent man with encyclopedic knowledge and a photographic memory. I could only dream to be as intelligent as him, but I did inherit the “overthinking” gene from him most definitely! He used to tell me, “Miss....sometimes I think I’d rather go through life being stupid and happy” (don’t take that the wrong way!). One thing my dad did not like to do on a regular basis was visit his doctor. When I was in my early twenties and still living at home, he had classic symptoms of a heart attack but refused to call 911 or go to the hospital. Of course, he waited three days before he finally relented and went to the hospital and sure enough, had had a heart attack. He had successful triple bypass surgery, but by waiting too long he sustained a lot of damage to his heart muscle and ultimately passed away from cardiac arrest years later (I am just so grateful he was able to walk me down the aisle and see my boys being born). There were various other times he was ill and refused to get medical attention as well. Hence, my first reaction when I have a health worry is to consult my doctor(s).
I am an attorney and as you can imagine, law school trained me to pick apart situations, analyze, research applicable law and apply the same to the circumstances at hand. I think the medical student “wanna be” part of me does the exact same thing with my health concerns and worries. But as we both know, I am NOT medically trained and NOT a doctor, so my over analyzing of these health worries is undoubtedly “over the top” lol! By the way, I handle estate administration in my work, so I am literally dealing with “death” on a daily basis...not in a medical sense certainly, but in working with the decedents families and their frail emotions, combined with facilitating the disposition of the decedent’s worldly possessions. No wonder the reality of death is in the forefront of my mind. Not to mention that I am a total empath and tend to feel and take on other people’s worries and emotions. And I wonder why my body is tensed up and twitching lol! I loved your Star Trek example...I wasn’t a Trekkie but had a huge crush on Captain XXXXXXX and loved every single episode (especially the one those little furry ball animals that kept multiplying lol). I think I need to be more like Mr. Spock with his rational thinking devoid of emotion!
One last thing to share that I know has a huge hand in my health anxiety. I shared in my prior query to you about my MS worry back in 2002 through 2005; well? The neuro I visited in 2005 went so far as to diagnose me with probable MS based upon my clinical symptoms, even in the absence of sclerotic lesions on my brain and spine MRIs. He wanted to proceed with a lumbar puncture and interferon treatments and that is when I called a big halt to everything. That same year, in 2005, I had chest pain and had a stress test done, which picked up on some elevated pulmonary artery pressures. So my PCP referred me to a pulmonologist, who proceeded to inform me that I fit the criteria for a diagnosis of it being “primary pulmonary hypertension” and if that was the case, my lifespan would be on average another two and a half years! My sons were three and seven years old at the time and all that I could do was cry. He sent me for a sleep study, CT scan of lungs and ventilation-perfusion test. Based upon some mild bronchiecstasis found, he said that may possibly be the cause of it, which would make it less likely to be pulmonary hypertension. Fast forward to 2017 , at which time my PCP sent me for an echocardiogram....guess what? My pulmonary pressure was totally within normal range.
So as you have probably garnered, I think I have a handle on the various factors behind my anxiety, which is primarily focused on health worries. I can function on a daily basis and to the outside world no one would guess I have such turmoil inside my head. As they say, acknowledging the problem is the first step. Now I just have to explore and find some techniques which will be successful in helping me squelch this nasty monster!!
To answer your questions, XXXXXXX is about a forty five minute drive from here, and yes, sometimes we let our snow just sit. Back in November of 2014 we had a storm that dumped SEVEN FEET of snow! We had no choice but to let that sit. We were snowed in for close to a week. I hope you and your family stayed safe and toasty warm during this little snowstorm we’re having (and I hope your kiddos decided to stay close to home)! And I got a nice little nap in today.
You are truly not only an incredible physician, but an incredible person with a huge heart. Sending you all my thanks and gratitude for not only listening, but for truly HEARING me!!
Brief Answer:
MISSY! So glad you took the TRIBBLE to write back so soon! ;)
Detailed Answer:
I hope my obtuse reference to Star Trek's The Trouble with Tribbles in the title didn't escape your keen Eagle Eye!...Or should I say, "Legal Eye!" HAHA!
Missy! You're back so SOON? LOL.....I must admit that signing off on the last note was done with a bit of trepidation and a smidge of ambivalence on my part because I didn't know how to try and figure out your status on things down the road. So imagine my XXXXXXX to find another query in my mailbox- almost like finding a $20.00 XXXXXXX in my pocket! LOL....
And again, I must thank you for your hypergenerously distributed compliments. I wish I were so deserving, but they are truly kind words that I graciously accept. Hope I can REALLY help in some meaningful way with this new set of questions....here goes
Let's see if we can brainstorm a bit to bring some fresh ideas to bear upon the problems you're describing having to do with overly nervous symptoms. I must repeat that you should not feel at all isolated in what or how you're feeling. It is felt by so many people...likely even people near and dear to you....in fact, there are doctors and nurses that suffer from these problems as curious as that may sound! I'm sure it wouldn't XXXXXXX you if I told you that one of the most affected subgroups of folks suffering from what was referred to as HYPOCHONDRIASIS in antiquity (meaning up to about 10 years ago before terms became politically corrected) were MEDICAL STUDENTS. If one wished to really see feelings of anxiety played out in individuals on a day to day basis...over an ever changing landscape of maladies (which didn't exist in the average student) to include every common and rare disease known to man then, all they would need to do is to watch medical students reading their anatomy, physiology, embryology, and pathology texts. Med students are forever diagnosing in themselves and their classmates every disease they're being tested on only to discover (perhaps to their amazement and relief) that once the test was over...they would miraculously be cured of their LUPUS, ALZHEIMER'S, and yes, ALS. Only, their relief was short lived since the next set of infirmities they needed to become expert at were precisely the ones they would next begin feeling...diabetes, angina, impotence, bowel and bladder problems, and of course, MORE ALZHEIMER's (since they couldn't remember what they needed for that last blasted test! LOL!!).
There I go rambling again, but my point Missy dear is that what you describe is clearly something many, many folks deal with who are very intelligent, highly motivated to be well, who worry about how things would be at home with their children, spouses, friends, and work feeling that they either almost certainly have...or are developing, X, Y, or Z.
I read with great interest your CLOSE ENCOUNTERS of the WORST kind when you apparently ran into either very bad clinicians, very unscrupulous clinicians, or a combination of both! I hate to denegrate colleagues but unfortunately, I don't have a whole lot of faith in community based private physicians....and to some extent, even academician physicians since even nowadays, hospitals (teaching and otherwise) are grading the productivity and value of doctors on staff by not only how many referrals are sent to them from the outside but also how much revenue they can generate for the institution. On the private side, physicians are continuously looking for revenue streams that are higher and potentially LONGER IN DURATION (i.e. chiropractors, physical and other types of counselors/therapists, ACUPUNCTURISTS, etc) and I'm sorry to say that in my opinion I think it is as likely as not (how's that for a legal phrase from someone who despises having to do anything but medicine! HA!) that you were being shanghai'ed to do unnecessary tests.....the guy with the MS scam should have his medical diploma stuffed in his mouth like an old sock and he should be on the first shuttle mission to XXXXXXX ...don't need yahoo's like him practicing medicine.....he almost put you on potentially dangerous medications for no reason?? Or did he think you'd be so happy that finally SOMEONE diagnosed you with what you knew you had all along.....how easy would that have been for him to keep you coming back every 2-3 months for another prescription, take 5 minutes to tell you everything was stable, and who'd be any the wiser....that is reportable behavior in my opinion to the Board. If he wasn't being just flat out UNETHICAL in his management plan for you...then, the only other explanation is that he is incompetent as a neurologist and probably should be banned from treating or diagnosing MS patients....and damn likely lots of other types of patients! I apologize if he was on your list of "caring or well intentioned physicians"...I have no respect for anybody who ignores their responsibility to either ask for help when necessary or keeping up with guidelines and diagnostic approaches to diagnose patients.
Remember this please for future medical exams, tests, laboratory values, or any type of other diagnostic testing.....in the VAST MAJORITY of cases....things are considered abnormal when numbers are literally HIGHLY OVER or HIGHLY UNDER the lab limits....you know what I mean? Example, if the pulmonary artery pressure is measured as 22 or 23 mm Hg and the lab limits say, 8-20mm.....we really wouldn't begin to think of the number obtained on measurement as being TRULY abnormal until it hits at least 25mm. Or 30mm. when doing physical activity. And even then, depending on my index of clinical suspicion I might choose to bring the patient back on another day and rerun tests to see how reproducible results are....or add confirmatory tests FIRST before all the nonsense you were told and had to have time to think about until it was finally decided that you didn't really have PPH in the first place....really? I mean, REALLY?? What kind of medical curriculum on bedside manner did he take...and what grade did he score? I can only guess!
So RECAP: 1. Lab tests (blood work or diagnostics) are generally considered CLINICALLY SIGNIFICANT if numbers are at least 20-30% over or under normal limits.
2. An automatic corollary to the above point is that even if the numbers come out to be SIGNIGFICANTLY abnormal there should be CLINICALLY RELEVANT SIGNS AND SYMPTOMS present in the patient. PULMONARY HYPERTENSION without evidence of congestion in either the lungs or the heart is a BIG RED flag that should be further investigated before just labeling someone just because the numbers say so.....make sense?
3. So, please tell me what PROACTIVE steps your therapist has given you in the 2 years you've been seeing them to try and get ahead of this problem. I totally believe that you can hold it together to be functional.....most people do....unless they are in the 3 or 4 standard deviations of the populations that are so off to the right on the Bell Shaped Curve that they are fully dysfunctional.....what techniques have you discovered or have been suggested to you.
4. AND, listen to this for a minute young lady.....I get how some of the close shaves you've had with medical Yahoo's so I can understand why you can be UNTRUSTING when docs tell you things as well as how that could be fueling your health anxiety....but I'm not sure I see where the ORIGIN of your feelings of anxiety are rooted....I'm not certain that the underlying cause has been unearthed yet from what you've told me....has it? I am having trouble linking your father's troubles with his heart to precipitating overly anxious feelings in your case....Have there been any other episodes of health problems of a life/death nature either in yourself or in a close friend or family that goes farther back perhaps than you can readily remember?
BTW, the kids stayed home...by their own choice....Daddy's so PROUD of their consideration of consequences! LOL......
Await to hear more about how you guys weathered the storm and hear some more of your thoughts.....
MISSY! So glad you took the TRIBBLE to write back so soon! ;)
Detailed Answer:
I hope my obtuse reference to Star Trek's The Trouble with Tribbles in the title didn't escape your keen Eagle Eye!...Or should I say, "Legal Eye!" HAHA!
Missy! You're back so SOON? LOL.....I must admit that signing off on the last note was done with a bit of trepidation and a smidge of ambivalence on my part because I didn't know how to try and figure out your status on things down the road. So imagine my XXXXXXX to find another query in my mailbox- almost like finding a $20.00 XXXXXXX in my pocket! LOL....
And again, I must thank you for your hypergenerously distributed compliments. I wish I were so deserving, but they are truly kind words that I graciously accept. Hope I can REALLY help in some meaningful way with this new set of questions....here goes
Let's see if we can brainstorm a bit to bring some fresh ideas to bear upon the problems you're describing having to do with overly nervous symptoms. I must repeat that you should not feel at all isolated in what or how you're feeling. It is felt by so many people...likely even people near and dear to you....in fact, there are doctors and nurses that suffer from these problems as curious as that may sound! I'm sure it wouldn't XXXXXXX you if I told you that one of the most affected subgroups of folks suffering from what was referred to as HYPOCHONDRIASIS in antiquity (meaning up to about 10 years ago before terms became politically corrected) were MEDICAL STUDENTS. If one wished to really see feelings of anxiety played out in individuals on a day to day basis...over an ever changing landscape of maladies (which didn't exist in the average student) to include every common and rare disease known to man then, all they would need to do is to watch medical students reading their anatomy, physiology, embryology, and pathology texts. Med students are forever diagnosing in themselves and their classmates every disease they're being tested on only to discover (perhaps to their amazement and relief) that once the test was over...they would miraculously be cured of their LUPUS, ALZHEIMER'S, and yes, ALS. Only, their relief was short lived since the next set of infirmities they needed to become expert at were precisely the ones they would next begin feeling...diabetes, angina, impotence, bowel and bladder problems, and of course, MORE ALZHEIMER's (since they couldn't remember what they needed for that last blasted test! LOL!!).
There I go rambling again, but my point Missy dear is that what you describe is clearly something many, many folks deal with who are very intelligent, highly motivated to be well, who worry about how things would be at home with their children, spouses, friends, and work feeling that they either almost certainly have...or are developing, X, Y, or Z.
I read with great interest your CLOSE ENCOUNTERS of the WORST kind when you apparently ran into either very bad clinicians, very unscrupulous clinicians, or a combination of both! I hate to denegrate colleagues but unfortunately, I don't have a whole lot of faith in community based private physicians....and to some extent, even academician physicians since even nowadays, hospitals (teaching and otherwise) are grading the productivity and value of doctors on staff by not only how many referrals are sent to them from the outside but also how much revenue they can generate for the institution. On the private side, physicians are continuously looking for revenue streams that are higher and potentially LONGER IN DURATION (i.e. chiropractors, physical and other types of counselors/therapists, ACUPUNCTURISTS, etc) and I'm sorry to say that in my opinion I think it is as likely as not (how's that for a legal phrase from someone who despises having to do anything but medicine! HA!) that you were being shanghai'ed to do unnecessary tests.....the guy with the MS scam should have his medical diploma stuffed in his mouth like an old sock and he should be on the first shuttle mission to XXXXXXX ...don't need yahoo's like him practicing medicine.....he almost put you on potentially dangerous medications for no reason?? Or did he think you'd be so happy that finally SOMEONE diagnosed you with what you knew you had all along.....how easy would that have been for him to keep you coming back every 2-3 months for another prescription, take 5 minutes to tell you everything was stable, and who'd be any the wiser....that is reportable behavior in my opinion to the Board. If he wasn't being just flat out UNETHICAL in his management plan for you...then, the only other explanation is that he is incompetent as a neurologist and probably should be banned from treating or diagnosing MS patients....and damn likely lots of other types of patients! I apologize if he was on your list of "caring or well intentioned physicians"...I have no respect for anybody who ignores their responsibility to either ask for help when necessary or keeping up with guidelines and diagnostic approaches to diagnose patients.
Remember this please for future medical exams, tests, laboratory values, or any type of other diagnostic testing.....in the VAST MAJORITY of cases....things are considered abnormal when numbers are literally HIGHLY OVER or HIGHLY UNDER the lab limits....you know what I mean? Example, if the pulmonary artery pressure is measured as 22 or 23 mm Hg and the lab limits say, 8-20mm.....we really wouldn't begin to think of the number obtained on measurement as being TRULY abnormal until it hits at least 25mm. Or 30mm. when doing physical activity. And even then, depending on my index of clinical suspicion I might choose to bring the patient back on another day and rerun tests to see how reproducible results are....or add confirmatory tests FIRST before all the nonsense you were told and had to have time to think about until it was finally decided that you didn't really have PPH in the first place....really? I mean, REALLY?? What kind of medical curriculum on bedside manner did he take...and what grade did he score? I can only guess!
So RECAP: 1. Lab tests (blood work or diagnostics) are generally considered CLINICALLY SIGNIFICANT if numbers are at least 20-30% over or under normal limits.
2. An automatic corollary to the above point is that even if the numbers come out to be SIGNIGFICANTLY abnormal there should be CLINICALLY RELEVANT SIGNS AND SYMPTOMS present in the patient. PULMONARY HYPERTENSION without evidence of congestion in either the lungs or the heart is a BIG RED flag that should be further investigated before just labeling someone just because the numbers say so.....make sense?
3. So, please tell me what PROACTIVE steps your therapist has given you in the 2 years you've been seeing them to try and get ahead of this problem. I totally believe that you can hold it together to be functional.....most people do....unless they are in the 3 or 4 standard deviations of the populations that are so off to the right on the Bell Shaped Curve that they are fully dysfunctional.....what techniques have you discovered or have been suggested to you.
4. AND, listen to this for a minute young lady.....I get how some of the close shaves you've had with medical Yahoo's so I can understand why you can be UNTRUSTING when docs tell you things as well as how that could be fueling your health anxiety....but I'm not sure I see where the ORIGIN of your feelings of anxiety are rooted....I'm not certain that the underlying cause has been unearthed yet from what you've told me....has it? I am having trouble linking your father's troubles with his heart to precipitating overly anxious feelings in your case....Have there been any other episodes of health problems of a life/death nature either in yourself or in a close friend or family that goes farther back perhaps than you can readily remember?
BTW, the kids stayed home...by their own choice....Daddy's so PROUD of their consideration of consequences! LOL......
Await to hear more about how you guys weathered the storm and hear some more of your thoughts.....
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
MISSY! So glad you took the TRIBBLE to write back so soon! ;)
Detailed Answer:
I hope my obtuse reference to Star Trek's The Trouble with Tribbles in the title didn't escape your keen Eagle Eye!...Or should I say, "Legal Eye!" HAHA!
Missy! You're back so SOON? LOL.....I must admit that signing off on the last note was done with a bit of trepidation and a smidge of ambivalence on my part because I didn't know how to try and figure out your status on things down the road. So imagine my XXXXXXX to find another query in my mailbox- almost like finding a $20.00 XXXXXXX in my pocket! LOL....
And again, I must thank you for your hypergenerously distributed compliments. I wish I were so deserving, but they are truly kind words that I graciously accept. Hope I can REALLY help in some meaningful way with this new set of questions....here goes
Let's see if we can brainstorm a bit to bring some fresh ideas to bear upon the problems you're describing having to do with overly nervous symptoms. I must repeat that you should not feel at all isolated in what or how you're feeling. It is felt by so many people...likely even people near and dear to you....in fact, there are doctors and nurses that suffer from these problems as curious as that may sound! I'm sure it wouldn't XXXXXXX you if I told you that one of the most affected subgroups of folks suffering from what was referred to as HYPOCHONDRIASIS in antiquity (meaning up to about 10 years ago before terms became politically corrected) were MEDICAL STUDENTS. If one wished to really see feelings of anxiety played out in individuals on a day to day basis...over an ever changing landscape of maladies (which didn't exist in the average student) to include every common and rare disease known to man then, all they would need to do is to watch medical students reading their anatomy, physiology, embryology, and pathology texts. Med students are forever diagnosing in themselves and their classmates every disease they're being tested on only to discover (perhaps to their amazement and relief) that once the test was over...they would miraculously be cured of their LUPUS, ALZHEIMER'S, and yes, ALS. Only, their relief was short lived since the next set of infirmities they needed to become expert at were precisely the ones they would next begin feeling...diabetes, angina, impotence, bowel and bladder problems, and of course, MORE ALZHEIMER's (since they couldn't remember what they needed for that last blasted test! LOL!!).
There I go rambling again, but my point Missy dear is that what you describe is clearly something many, many folks deal with who are very intelligent, highly motivated to be well, who worry about how things would be at home with their children, spouses, friends, and work feeling that they either almost certainly have...or are developing, X, Y, or Z.
I read with great interest your CLOSE ENCOUNTERS of the WORST kind when you apparently ran into either very bad clinicians, very unscrupulous clinicians, or a combination of both! I hate to denegrate colleagues but unfortunately, I don't have a whole lot of faith in community based private physicians....and to some extent, even academician physicians since even nowadays, hospitals (teaching and otherwise) are grading the productivity and value of doctors on staff by not only how many referrals are sent to them from the outside but also how much revenue they can generate for the institution. On the private side, physicians are continuously looking for revenue streams that are higher and potentially LONGER IN DURATION (i.e. chiropractors, physical and other types of counselors/therapists, ACUPUNCTURISTS, etc) and I'm sorry to say that in my opinion I think it is as likely as not (how's that for a legal phrase from someone who despises having to do anything but medicine! HA!) that you were being shanghai'ed to do unnecessary tests.....the guy with the MS scam should have his medical diploma stuffed in his mouth like an old sock and he should be on the first shuttle mission to XXXXXXX ...don't need yahoo's like him practicing medicine.....he almost put you on potentially dangerous medications for no reason?? Or did he think you'd be so happy that finally SOMEONE diagnosed you with what you knew you had all along.....how easy would that have been for him to keep you coming back every 2-3 months for another prescription, take 5 minutes to tell you everything was stable, and who'd be any the wiser....that is reportable behavior in my opinion to the Board. If he wasn't being just flat out UNETHICAL in his management plan for you...then, the only other explanation is that he is incompetent as a neurologist and probably should be banned from treating or diagnosing MS patients....and damn likely lots of other types of patients! I apologize if he was on your list of "caring or well intentioned physicians"...I have no respect for anybody who ignores their responsibility to either ask for help when necessary or keeping up with guidelines and diagnostic approaches to diagnose patients.
Remember this please for future medical exams, tests, laboratory values, or any type of other diagnostic testing.....in the VAST MAJORITY of cases....things are considered abnormal when numbers are literally HIGHLY OVER or HIGHLY UNDER the lab limits....you know what I mean? Example, if the pulmonary artery pressure is measured as 22 or 23 mm Hg and the lab limits say, 8-20mm.....we really wouldn't begin to think of the number obtained on measurement as being TRULY abnormal until it hits at least 25mm. Or 30mm. when doing physical activity. And even then, depending on my index of clinical suspicion I might choose to bring the patient back on another day and rerun tests to see how reproducible results are....or add confirmatory tests FIRST before all the nonsense you were told and had to have time to think about until it was finally decided that you didn't really have PPH in the first place....really? I mean, REALLY?? What kind of medical curriculum on bedside manner did he take...and what grade did he score? I can only guess!
So RECAP: 1. Lab tests (blood work or diagnostics) are generally considered CLINICALLY SIGNIFICANT if numbers are at least 20-30% over or under normal limits.
2. An automatic corollary to the above point is that even if the numbers come out to be SIGNIGFICANTLY abnormal there should be CLINICALLY RELEVANT SIGNS AND SYMPTOMS present in the patient. PULMONARY HYPERTENSION without evidence of congestion in either the lungs or the heart is a BIG RED flag that should be further investigated before just labeling someone just because the numbers say so.....make sense?
3. So, please tell me what PROACTIVE steps your therapist has given you in the 2 years you've been seeing them to try and get ahead of this problem. I totally believe that you can hold it together to be functional.....most people do....unless they are in the 3 or 4 standard deviations of the populations that are so off to the right on the Bell Shaped Curve that they are fully dysfunctional.....what techniques have you discovered or have been suggested to you.
4. AND, listen to this for a minute young lady.....I get how some of the close shaves you've had with medical Yahoo's so I can understand why you can be UNTRUSTING when docs tell you things as well as how that could be fueling your health anxiety....but I'm not sure I see where the ORIGIN of your feelings of anxiety are rooted....I'm not certain that the underlying cause has been unearthed yet from what you've told me....has it? I am having trouble linking your father's troubles with his heart to precipitating overly anxious feelings in your case....Have there been any other episodes of health problems of a life/death nature either in yourself or in a close friend or family that goes farther back perhaps than you can readily remember?
BTW, the kids stayed home...by their own choice....Daddy's so PROUD of their consideration of consequences! LOL......
Await to hear more about how you guys weathered the storm and hear some more of your thoughts.....
MISSY! So glad you took the TRIBBLE to write back so soon! ;)
Detailed Answer:
I hope my obtuse reference to Star Trek's The Trouble with Tribbles in the title didn't escape your keen Eagle Eye!...Or should I say, "Legal Eye!" HAHA!
Missy! You're back so SOON? LOL.....I must admit that signing off on the last note was done with a bit of trepidation and a smidge of ambivalence on my part because I didn't know how to try and figure out your status on things down the road. So imagine my XXXXXXX to find another query in my mailbox- almost like finding a $20.00 XXXXXXX in my pocket! LOL....
And again, I must thank you for your hypergenerously distributed compliments. I wish I were so deserving, but they are truly kind words that I graciously accept. Hope I can REALLY help in some meaningful way with this new set of questions....here goes
Let's see if we can brainstorm a bit to bring some fresh ideas to bear upon the problems you're describing having to do with overly nervous symptoms. I must repeat that you should not feel at all isolated in what or how you're feeling. It is felt by so many people...likely even people near and dear to you....in fact, there are doctors and nurses that suffer from these problems as curious as that may sound! I'm sure it wouldn't XXXXXXX you if I told you that one of the most affected subgroups of folks suffering from what was referred to as HYPOCHONDRIASIS in antiquity (meaning up to about 10 years ago before terms became politically corrected) were MEDICAL STUDENTS. If one wished to really see feelings of anxiety played out in individuals on a day to day basis...over an ever changing landscape of maladies (which didn't exist in the average student) to include every common and rare disease known to man then, all they would need to do is to watch medical students reading their anatomy, physiology, embryology, and pathology texts. Med students are forever diagnosing in themselves and their classmates every disease they're being tested on only to discover (perhaps to their amazement and relief) that once the test was over...they would miraculously be cured of their LUPUS, ALZHEIMER'S, and yes, ALS. Only, their relief was short lived since the next set of infirmities they needed to become expert at were precisely the ones they would next begin feeling...diabetes, angina, impotence, bowel and bladder problems, and of course, MORE ALZHEIMER's (since they couldn't remember what they needed for that last blasted test! LOL!!).
There I go rambling again, but my point Missy dear is that what you describe is clearly something many, many folks deal with who are very intelligent, highly motivated to be well, who worry about how things would be at home with their children, spouses, friends, and work feeling that they either almost certainly have...or are developing, X, Y, or Z.
I read with great interest your CLOSE ENCOUNTERS of the WORST kind when you apparently ran into either very bad clinicians, very unscrupulous clinicians, or a combination of both! I hate to denegrate colleagues but unfortunately, I don't have a whole lot of faith in community based private physicians....and to some extent, even academician physicians since even nowadays, hospitals (teaching and otherwise) are grading the productivity and value of doctors on staff by not only how many referrals are sent to them from the outside but also how much revenue they can generate for the institution. On the private side, physicians are continuously looking for revenue streams that are higher and potentially LONGER IN DURATION (i.e. chiropractors, physical and other types of counselors/therapists, ACUPUNCTURISTS, etc) and I'm sorry to say that in my opinion I think it is as likely as not (how's that for a legal phrase from someone who despises having to do anything but medicine! HA!) that you were being shanghai'ed to do unnecessary tests.....the guy with the MS scam should have his medical diploma stuffed in his mouth like an old sock and he should be on the first shuttle mission to XXXXXXX ...don't need yahoo's like him practicing medicine.....he almost put you on potentially dangerous medications for no reason?? Or did he think you'd be so happy that finally SOMEONE diagnosed you with what you knew you had all along.....how easy would that have been for him to keep you coming back every 2-3 months for another prescription, take 5 minutes to tell you everything was stable, and who'd be any the wiser....that is reportable behavior in my opinion to the Board. If he wasn't being just flat out UNETHICAL in his management plan for you...then, the only other explanation is that he is incompetent as a neurologist and probably should be banned from treating or diagnosing MS patients....and damn likely lots of other types of patients! I apologize if he was on your list of "caring or well intentioned physicians"...I have no respect for anybody who ignores their responsibility to either ask for help when necessary or keeping up with guidelines and diagnostic approaches to diagnose patients.
Remember this please for future medical exams, tests, laboratory values, or any type of other diagnostic testing.....in the VAST MAJORITY of cases....things are considered abnormal when numbers are literally HIGHLY OVER or HIGHLY UNDER the lab limits....you know what I mean? Example, if the pulmonary artery pressure is measured as 22 or 23 mm Hg and the lab limits say, 8-20mm.....we really wouldn't begin to think of the number obtained on measurement as being TRULY abnormal until it hits at least 25mm. Or 30mm. when doing physical activity. And even then, depending on my index of clinical suspicion I might choose to bring the patient back on another day and rerun tests to see how reproducible results are....or add confirmatory tests FIRST before all the nonsense you were told and had to have time to think about until it was finally decided that you didn't really have PPH in the first place....really? I mean, REALLY?? What kind of medical curriculum on bedside manner did he take...and what grade did he score? I can only guess!
So RECAP: 1. Lab tests (blood work or diagnostics) are generally considered CLINICALLY SIGNIFICANT if numbers are at least 20-30% over or under normal limits.
2. An automatic corollary to the above point is that even if the numbers come out to be SIGNIGFICANTLY abnormal there should be CLINICALLY RELEVANT SIGNS AND SYMPTOMS present in the patient. PULMONARY HYPERTENSION without evidence of congestion in either the lungs or the heart is a BIG RED flag that should be further investigated before just labeling someone just because the numbers say so.....make sense?
3. So, please tell me what PROACTIVE steps your therapist has given you in the 2 years you've been seeing them to try and get ahead of this problem. I totally believe that you can hold it together to be functional.....most people do....unless they are in the 3 or 4 standard deviations of the populations that are so off to the right on the Bell Shaped Curve that they are fully dysfunctional.....what techniques have you discovered or have been suggested to you.
4. AND, listen to this for a minute young lady.....I get how some of the close shaves you've had with medical Yahoo's so I can understand why you can be UNTRUSTING when docs tell you things as well as how that could be fueling your health anxiety....but I'm not sure I see where the ORIGIN of your feelings of anxiety are rooted....I'm not certain that the underlying cause has been unearthed yet from what you've told me....has it? I am having trouble linking your father's troubles with his heart to precipitating overly anxious feelings in your case....Have there been any other episodes of health problems of a life/death nature either in yourself or in a close friend or family that goes farther back perhaps than you can readily remember?
BTW, the kids stayed home...by their own choice....Daddy's so PROUD of their consideration of consequences! LOL......
Await to hear more about how you guys weathered the storm and hear some more of your thoughts.....
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Sanghafi! Thank you as always for your kind and insightful reply! Yes, I most definitely had some close encounters of the worst kind lol with the prior neurologist and pulmonologist i had seen. Those are experiences which I will most certainly never forget and I truly believe they had a hand in my health anxiety. It was so enlightening to hear your perspective, as a physician, on those doctors’ ”diagnoses” and lack of bedside manner.
With regard to my father’s heart issues, I believe his delay in seeking medical attention while having a heart attack (and on other occasions as well) is likely a reason why I feel compelled to run, not walk (lol) to my doctors when I begin to stress or worry over an ache or pain or anything unusual.
In terms of my therapist, I truly like her ALOT and I am very comfortable with her, but truth be told, I don’t always feel as though I am leaving my sessions with sufficient tools for dealing with it in a constructive way. My sessions primarily feel like a nice opportunity to talk about my worries or anxiety du joir, but I oftentimes wish there was more of a CBT focus. As I am sure you can understand, it would be hard to break off a relationship with a therapist after having invested so much time and mental energy over the past two years talking about my whole life, background, and fears and worries. I think perhaps I may subtly ask her to see if we can focus on more concrete strategies.
I had mentioned I sometimes visit an online anxiety forum, and the moderators recommend a wonderful book on anxiety written by an Australian psychologist, Dr. XXXXXXX Weekes. Obviously there is much more to it, but her basic premise is that fighting the anxiety and trying to squelch it only gives it more power. Rather, she advocates allowing the anxiety to come without giving it any reaction; acknowledge that it is there, but let it flow through you without giving it any reactive power. The idea is akin to a person struggling in the water while swimming...the more energy expended fighting the waves, the more likely that person is to drown; floating along with the waves is bound to have a more successful outcome. I think I’ll re-read that book as a refresher!
Well, our time is almost out, so I just want to thank you again for all of the kindness and caring you have given me. You have truly made me feel much more at peace in many respects, and for that I am so very grateful!
With regard to my father’s heart issues, I believe his delay in seeking medical attention while having a heart attack (and on other occasions as well) is likely a reason why I feel compelled to run, not walk (lol) to my doctors when I begin to stress or worry over an ache or pain or anything unusual.
In terms of my therapist, I truly like her ALOT and I am very comfortable with her, but truth be told, I don’t always feel as though I am leaving my sessions with sufficient tools for dealing with it in a constructive way. My sessions primarily feel like a nice opportunity to talk about my worries or anxiety du joir, but I oftentimes wish there was more of a CBT focus. As I am sure you can understand, it would be hard to break off a relationship with a therapist after having invested so much time and mental energy over the past two years talking about my whole life, background, and fears and worries. I think perhaps I may subtly ask her to see if we can focus on more concrete strategies.
I had mentioned I sometimes visit an online anxiety forum, and the moderators recommend a wonderful book on anxiety written by an Australian psychologist, Dr. XXXXXXX Weekes. Obviously there is much more to it, but her basic premise is that fighting the anxiety and trying to squelch it only gives it more power. Rather, she advocates allowing the anxiety to come without giving it any reaction; acknowledge that it is there, but let it flow through you without giving it any reactive power. The idea is akin to a person struggling in the water while swimming...the more energy expended fighting the waves, the more likely that person is to drown; floating along with the waves is bound to have a more successful outcome. I think I’ll re-read that book as a refresher!
Well, our time is almost out, so I just want to thank you again for all of the kindness and caring you have given me. You have truly made me feel much more at peace in many respects, and for that I am so very grateful!
Hi Dr. Sanghafi! Thank you as always for your kind and insightful reply! Yes, I most definitely had some close encounters of the worst kind lol with the prior neurologist and pulmonologist i had seen. Those are experiences which I will most certainly never forget and I truly believe they had a hand in my health anxiety. It was so enlightening to hear your perspective, as a physician, on those doctors’ ”diagnoses” and lack of bedside manner.
With regard to my father’s heart issues, I believe his delay in seeking medical attention while having a heart attack (and on other occasions as well) is likely a reason why I feel compelled to run, not walk (lol) to my doctors when I begin to stress or worry over an ache or pain or anything unusual.
In terms of my therapist, I truly like her ALOT and I am very comfortable with her, but truth be told, I don’t always feel as though I am leaving my sessions with sufficient tools for dealing with it in a constructive way. My sessions primarily feel like a nice opportunity to talk about my worries or anxiety du joir, but I oftentimes wish there was more of a CBT focus. As I am sure you can understand, it would be hard to break off a relationship with a therapist after having invested so much time and mental energy over the past two years talking about my whole life, background, and fears and worries. I think perhaps I may subtly ask her to see if we can focus on more concrete strategies.
I had mentioned I sometimes visit an online anxiety forum, and the moderators recommend a wonderful book on anxiety written by an Australian psychologist, Dr. XXXXXXX Weekes. Obviously there is much more to it, but her basic premise is that fighting the anxiety and trying to squelch it only gives it more power. Rather, she advocates allowing the anxiety to come without giving it any reaction; acknowledge that it is there, but let it flow through you without giving it any reactive power. The idea is akin to a person struggling in the water while swimming...the more energy expended fighting the waves, the more likely that person is to drown; floating along with the waves is bound to have a more successful outcome. I think I’ll re-read that book as a refresher!
Well, our time is almost out, so I just want to thank you again for all of the kindness and caring you have given me. You have truly made me feel much more at peace in many respects, and for that I am so very grateful!
With regard to my father’s heart issues, I believe his delay in seeking medical attention while having a heart attack (and on other occasions as well) is likely a reason why I feel compelled to run, not walk (lol) to my doctors when I begin to stress or worry over an ache or pain or anything unusual.
In terms of my therapist, I truly like her ALOT and I am very comfortable with her, but truth be told, I don’t always feel as though I am leaving my sessions with sufficient tools for dealing with it in a constructive way. My sessions primarily feel like a nice opportunity to talk about my worries or anxiety du joir, but I oftentimes wish there was more of a CBT focus. As I am sure you can understand, it would be hard to break off a relationship with a therapist after having invested so much time and mental energy over the past two years talking about my whole life, background, and fears and worries. I think perhaps I may subtly ask her to see if we can focus on more concrete strategies.
I had mentioned I sometimes visit an online anxiety forum, and the moderators recommend a wonderful book on anxiety written by an Australian psychologist, Dr. XXXXXXX Weekes. Obviously there is much more to it, but her basic premise is that fighting the anxiety and trying to squelch it only gives it more power. Rather, she advocates allowing the anxiety to come without giving it any reaction; acknowledge that it is there, but let it flow through you without giving it any reactive power. The idea is akin to a person struggling in the water while swimming...the more energy expended fighting the waves, the more likely that person is to drown; floating along with the waves is bound to have a more successful outcome. I think I’ll re-read that book as a refresher!
Well, our time is almost out, so I just want to thank you again for all of the kindness and caring you have given me. You have truly made me feel much more at peace in many respects, and for that I am so very grateful!
Brief Answer:
Missy my dear....MY APOLOGIES for taking this long to answer
Detailed Answer:
One would be hard pressed to detect how happy I was to see a response back from you by the length of time it has taken me to respond...My apologies. Yesterday was absolutely insane with stuff to get accomplished....mostly administrative duties....thank you for your patience my dear.
It's really disturbing to hear stories such as you've described since it is so far off center of where physicians are supposed to be aspiring toward that sometimes...ignorance in knowledge is simply not an adequate explanation...I'm sure it's the same in your profession..I could tell you my own stories that should be sufficient to light up any number of "anxiety" laden feelings when it comes to mistreatment and downright malfeasance when it comes to attorneys. Except in my case, I don't know that I would necessarily say "legal anxiety" sets in so much as it is just cynicism for a system we teach our kids is democratic when in fact there are so people entrusted from behind the bench to those representing clients who demonstrate anything BUT.....So does HYPER-cynicism toward a societal system (e.g. Legal) based on poor behavior by attorneys and judges constitute analogous sentiments to what so many folks feel when it comes to Health Anxiety as a direct result of poor (even egregious and intentional) behavior or treatment on a Health Professional's part? Perhaps, but again, I digress....
I wouldn't interpret your overly cautious attitudes regarding your health as a manifestation of feelings of anxiety.....that part of it is what most doctors probably wish MORE PATIENTS would do....the old "stitch in time saves nine rule...." but I guess when one goes beyond that point after being given the "all is well" signal..well, that is where Health Anxiety may actually begin....Of course, that is also assuming that the doctor giving the ALL CLEAR signal is someone of repute and someone who has earned your trust and confidence.
And what you say of your therapy sessions is what I hear mostly from my patients regarding, "nice people to talk to, kind, empathetic, understanding, good listeners" but at the end of the day those anxious feelings are still there the next time around and patients find themselves still using their own means of dealing with them. So, where's the THERAPY? I 100% agree and wish I could address that aspect of things....but then, I'd be accused of overstepping my bounds as a neurologist and stepping on the toes of "experts."
I think the key to effectively dealing with Health Anxiety issues is to apply DESENSITIZATION techniques which as you correctly point out are best discussed and learned through COGNITIVE BEHAVIORAL THERAPY. I think patients need to be able to PRACTICE what they are taught by good CBT folks. I've never heard of patients being given HOMEWORK to perform regarding their sessions. In other words, being given actual case vignettes of other people let's say....who are exhibiting overt signs of health anxiety.....how about doing something like...."OK Missy, I want you to take these 3 cases home with you and before our next session....I want you to read them, think about them, and tell me if you think they are exhibiting signs of Health Anxiety....." I think that sort of EXERCISE and that sort of LEARNING HOW TO RECOGNIZE in others...what one may have can be an alternative method to DESENSITIZES a person to the NOISE that comes in......Remember, how I told you that our brains are constantly flooded, second by second by sensory input, some from internally and some externally.....it's the RIGHT PARIETAL lobe's job to ignore that sensory input unless it's relevant. For instance, ,can you feel the pressure your GLUTEI are sensing against the chair you are sitting in? Does it hurt? Is it uncomfortable? Or had you not been aware of it until I just drew your attention to it..perhaps to a point where you just readjusted yourself in the seat.......I just did in mine! HAHAHA!
The question becomes how to know when to filter out things like muscle twitches, from feelings of numbness on the skin, or other weird sensations, etc. without always calling up worst case scenarios......the other side of that coin is knowing when there are legitimate things happening that need rapid and immediate attention or intervention...viz a viz....your dad's evolving heart attack...
I always tell patients (about their long lists of medications). If you don't know what a medication is being used for in your body, and you can't wholeheartedly agree that is is doing you GOOD....REAL GOOD.....have a talk with your doctor to find out what exactly you'd be missing if you were to eliminate that from the regimen? If the doctor can honestly tell you that the medication is germane and essential to your well being then, fine...keep taking it.....if there is any doubt or hesitation on the doctor's part to tell you the answer to the aforementioned question....I'd voice a motion to get rid of it from the list..... Remember, the body was designed and in most cases (probably in yours...though I don't know your full story) intended to go an entire lifetime without the need for artificial chemicals, colorings, sweeteners, and syrups. Good nutrition, good exercise, good mental perspectives and coping mechanisms to ward off evil spirits (and idiots) around you....are the BEST prescriptions that a person can fill for good health and maintenance thereof.....don't you think?
I absolutely agree with your wanting your therapist to give you more concrete ideas and TECHNIQUES on how to deal with these issues. Tell her you'd like to see her ROCK OUT on you.....ya know what I mean? It's kinda like the case of that pianist in the corner of a smokey bar who comes in night after night playing his sets, all the usual and regular stuff....because that's what the manager wants or likes.....wouldn't you love to hear him/her.....just once, change it up? XXXXXXX XXXXXXX XXXXXXX style, Balls to the Walls.....GREAT BALLS O' FIRE....and just make the joint rock out....then, you'll know that they person's got spunk...chops, whatever....and I think that's where you should go with your therapist......or find someone who is recognized in CBT and can give you those HANDS ON ways of confronting situations that you can recognize as things to ignore vs. things to address....make sense
And I am totally aware of the philosophy of XXXXXXX Weekes....not hers personally mind you, but the notion of going the other direction of allowing feelings of anxiety to play out sometimes and letting the person themselves find their own points of moderation. I think that's very much like letting a child hold their breath because they're mad....you've done that with your kids, haven't you? Well, frankly I think that's a behavior that kids used to do in the dark ages....I don't recall any of my kids using that behavior to try and get their ways....but whatever it was....so long as they weren't threatening or trying to go lie down in the middle of a busy intersection as a way of revolting against authority....I would just turn off their whining and bitching.....sooner or later the episode ends....and soon enough the behavior actually extinguishes.....
Notice that during all of OUR conversations and responses so far....I don't think I've once told you NOT TO investigate your symptoms on the internet, I never once told you that you were being absolutely ridiculous in not accepting authoritative opinions that such and such was the case....case closed....I think if you feel more comfortable looking things up, ,questioning diagnoses, etc.....that's great....I support that....I'll do everything I can to support my case....you as an attorney know better than I how to support yours....and hopefully, we can meet in the middle! LOL......
I would say that is a very good approach to dealing with Health Anxiety in this day and age of such open information......As a violinist who did teach students at one time I found that when a pupil was tense with the instrument and was holding the scroll of the instrument with a death grip, trying to get the elbow underneath, chin in place, etc. etc. the last thing in the world that the student would do to a command of RELAX....would be to relax! How many years it took me to figure that out...I have no clue....how many years it took me to realize that about myself when I played and even still play......I found that the best way to handle students and posture was to make sure, first that I was demonstrating all the proper and correct elements...both visually as well as how they could feel that my wrist was loose, my chin was not grabbing the chinrest that tightly, my elbow was not so far under that I was trying to touch my opposite ear with my contralateral epicondyle, etc. etc. Second, allow the student to hold the instrument how they would and then, make minor adjustments to what they were doing....I wouldn't speak about what I was doing...I'd just do it....and then, we'd repeat the process...not too many times in one day...but just enough so that I knew they had gotten a sufficient amount of visual and tactile stimulation on the topic and could feel themselves FINDING the comfortable position....I would definitely correct mistakes and did not allow mistakes to persist while playing.....make sense?
I think a similar if not identical parallel to Health Anxiety can be drawn from learning how to play a violin! LOL! Do you play an instrument....perhaps you can relate to that example.....and as you said before Missy....Now, "our time is almost out"...literally there is a clock ticking above this query that is down to 1 minute before it zero's out...meaning I've been typing continuously for 60 minutes! Write back.....but only if it makes you feel better! I'll try to pare down the response to a cool 30 minutes next time! HAHA!!
Be well!
Missy my dear....MY APOLOGIES for taking this long to answer
Detailed Answer:
One would be hard pressed to detect how happy I was to see a response back from you by the length of time it has taken me to respond...My apologies. Yesterday was absolutely insane with stuff to get accomplished....mostly administrative duties....thank you for your patience my dear.
It's really disturbing to hear stories such as you've described since it is so far off center of where physicians are supposed to be aspiring toward that sometimes...ignorance in knowledge is simply not an adequate explanation...I'm sure it's the same in your profession..I could tell you my own stories that should be sufficient to light up any number of "anxiety" laden feelings when it comes to mistreatment and downright malfeasance when it comes to attorneys. Except in my case, I don't know that I would necessarily say "legal anxiety" sets in so much as it is just cynicism for a system we teach our kids is democratic when in fact there are so people entrusted from behind the bench to those representing clients who demonstrate anything BUT.....So does HYPER-cynicism toward a societal system (e.g. Legal) based on poor behavior by attorneys and judges constitute analogous sentiments to what so many folks feel when it comes to Health Anxiety as a direct result of poor (even egregious and intentional) behavior or treatment on a Health Professional's part? Perhaps, but again, I digress....
I wouldn't interpret your overly cautious attitudes regarding your health as a manifestation of feelings of anxiety.....that part of it is what most doctors probably wish MORE PATIENTS would do....the old "stitch in time saves nine rule...." but I guess when one goes beyond that point after being given the "all is well" signal..well, that is where Health Anxiety may actually begin....Of course, that is also assuming that the doctor giving the ALL CLEAR signal is someone of repute and someone who has earned your trust and confidence.
And what you say of your therapy sessions is what I hear mostly from my patients regarding, "nice people to talk to, kind, empathetic, understanding, good listeners" but at the end of the day those anxious feelings are still there the next time around and patients find themselves still using their own means of dealing with them. So, where's the THERAPY? I 100% agree and wish I could address that aspect of things....but then, I'd be accused of overstepping my bounds as a neurologist and stepping on the toes of "experts."
I think the key to effectively dealing with Health Anxiety issues is to apply DESENSITIZATION techniques which as you correctly point out are best discussed and learned through COGNITIVE BEHAVIORAL THERAPY. I think patients need to be able to PRACTICE what they are taught by good CBT folks. I've never heard of patients being given HOMEWORK to perform regarding their sessions. In other words, being given actual case vignettes of other people let's say....who are exhibiting overt signs of health anxiety.....how about doing something like...."OK Missy, I want you to take these 3 cases home with you and before our next session....I want you to read them, think about them, and tell me if you think they are exhibiting signs of Health Anxiety....." I think that sort of EXERCISE and that sort of LEARNING HOW TO RECOGNIZE in others...what one may have can be an alternative method to DESENSITIZES a person to the NOISE that comes in......Remember, how I told you that our brains are constantly flooded, second by second by sensory input, some from internally and some externally.....it's the RIGHT PARIETAL lobe's job to ignore that sensory input unless it's relevant. For instance, ,can you feel the pressure your GLUTEI are sensing against the chair you are sitting in? Does it hurt? Is it uncomfortable? Or had you not been aware of it until I just drew your attention to it..perhaps to a point where you just readjusted yourself in the seat.......I just did in mine! HAHAHA!
The question becomes how to know when to filter out things like muscle twitches, from feelings of numbness on the skin, or other weird sensations, etc. without always calling up worst case scenarios......the other side of that coin is knowing when there are legitimate things happening that need rapid and immediate attention or intervention...viz a viz....your dad's evolving heart attack...
I always tell patients (about their long lists of medications). If you don't know what a medication is being used for in your body, and you can't wholeheartedly agree that is is doing you GOOD....REAL GOOD.....have a talk with your doctor to find out what exactly you'd be missing if you were to eliminate that from the regimen? If the doctor can honestly tell you that the medication is germane and essential to your well being then, fine...keep taking it.....if there is any doubt or hesitation on the doctor's part to tell you the answer to the aforementioned question....I'd voice a motion to get rid of it from the list..... Remember, the body was designed and in most cases (probably in yours...though I don't know your full story) intended to go an entire lifetime without the need for artificial chemicals, colorings, sweeteners, and syrups. Good nutrition, good exercise, good mental perspectives and coping mechanisms to ward off evil spirits (and idiots) around you....are the BEST prescriptions that a person can fill for good health and maintenance thereof.....don't you think?
I absolutely agree with your wanting your therapist to give you more concrete ideas and TECHNIQUES on how to deal with these issues. Tell her you'd like to see her ROCK OUT on you.....ya know what I mean? It's kinda like the case of that pianist in the corner of a smokey bar who comes in night after night playing his sets, all the usual and regular stuff....because that's what the manager wants or likes.....wouldn't you love to hear him/her.....just once, change it up? XXXXXXX XXXXXXX XXXXXXX style, Balls to the Walls.....GREAT BALLS O' FIRE....and just make the joint rock out....then, you'll know that they person's got spunk...chops, whatever....and I think that's where you should go with your therapist......or find someone who is recognized in CBT and can give you those HANDS ON ways of confronting situations that you can recognize as things to ignore vs. things to address....make sense
And I am totally aware of the philosophy of XXXXXXX Weekes....not hers personally mind you, but the notion of going the other direction of allowing feelings of anxiety to play out sometimes and letting the person themselves find their own points of moderation. I think that's very much like letting a child hold their breath because they're mad....you've done that with your kids, haven't you? Well, frankly I think that's a behavior that kids used to do in the dark ages....I don't recall any of my kids using that behavior to try and get their ways....but whatever it was....so long as they weren't threatening or trying to go lie down in the middle of a busy intersection as a way of revolting against authority....I would just turn off their whining and bitching.....sooner or later the episode ends....and soon enough the behavior actually extinguishes.....
Notice that during all of OUR conversations and responses so far....I don't think I've once told you NOT TO investigate your symptoms on the internet, I never once told you that you were being absolutely ridiculous in not accepting authoritative opinions that such and such was the case....case closed....I think if you feel more comfortable looking things up, ,questioning diagnoses, etc.....that's great....I support that....I'll do everything I can to support my case....you as an attorney know better than I how to support yours....and hopefully, we can meet in the middle! LOL......
I would say that is a very good approach to dealing with Health Anxiety in this day and age of such open information......As a violinist who did teach students at one time I found that when a pupil was tense with the instrument and was holding the scroll of the instrument with a death grip, trying to get the elbow underneath, chin in place, etc. etc. the last thing in the world that the student would do to a command of RELAX....would be to relax! How many years it took me to figure that out...I have no clue....how many years it took me to realize that about myself when I played and even still play......I found that the best way to handle students and posture was to make sure, first that I was demonstrating all the proper and correct elements...both visually as well as how they could feel that my wrist was loose, my chin was not grabbing the chinrest that tightly, my elbow was not so far under that I was trying to touch my opposite ear with my contralateral epicondyle, etc. etc. Second, allow the student to hold the instrument how they would and then, make minor adjustments to what they were doing....I wouldn't speak about what I was doing...I'd just do it....and then, we'd repeat the process...not too many times in one day...but just enough so that I knew they had gotten a sufficient amount of visual and tactile stimulation on the topic and could feel themselves FINDING the comfortable position....I would definitely correct mistakes and did not allow mistakes to persist while playing.....make sense?
I think a similar if not identical parallel to Health Anxiety can be drawn from learning how to play a violin! LOL! Do you play an instrument....perhaps you can relate to that example.....and as you said before Missy....Now, "our time is almost out"...literally there is a clock ticking above this query that is down to 1 minute before it zero's out...meaning I've been typing continuously for 60 minutes! Write back.....but only if it makes you feel better! I'll try to pare down the response to a cool 30 minutes next time! HAHA!!
Be well!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Missy my dear....MY APOLOGIES for taking this long to answer
Detailed Answer:
One would be hard pressed to detect how happy I was to see a response back from you by the length of time it has taken me to respond...My apologies. Yesterday was absolutely insane with stuff to get accomplished....mostly administrative duties....thank you for your patience my dear.
It's really disturbing to hear stories such as you've described since it is so far off center of where physicians are supposed to be aspiring toward that sometimes...ignorance in knowledge is simply not an adequate explanation...I'm sure it's the same in your profession..I could tell you my own stories that should be sufficient to light up any number of "anxiety" laden feelings when it comes to mistreatment and downright malfeasance when it comes to attorneys. Except in my case, I don't know that I would necessarily say "legal anxiety" sets in so much as it is just cynicism for a system we teach our kids is democratic when in fact there are so people entrusted from behind the bench to those representing clients who demonstrate anything BUT.....So does HYPER-cynicism toward a societal system (e.g. Legal) based on poor behavior by attorneys and judges constitute analogous sentiments to what so many folks feel when it comes to Health Anxiety as a direct result of poor (even egregious and intentional) behavior or treatment on a Health Professional's part? Perhaps, but again, I digress....
I wouldn't interpret your overly cautious attitudes regarding your health as a manifestation of feelings of anxiety.....that part of it is what most doctors probably wish MORE PATIENTS would do....the old "stitch in time saves nine rule...." but I guess when one goes beyond that point after being given the "all is well" signal..well, that is where Health Anxiety may actually begin....Of course, that is also assuming that the doctor giving the ALL CLEAR signal is someone of repute and someone who has earned your trust and confidence.
And what you say of your therapy sessions is what I hear mostly from my patients regarding, "nice people to talk to, kind, empathetic, understanding, good listeners" but at the end of the day those anxious feelings are still there the next time around and patients find themselves still using their own means of dealing with them. So, where's the THERAPY? I 100% agree and wish I could address that aspect of things....but then, I'd be accused of overstepping my bounds as a neurologist and stepping on the toes of "experts."
I think the key to effectively dealing with Health Anxiety issues is to apply DESENSITIZATION techniques which as you correctly point out are best discussed and learned through COGNITIVE BEHAVIORAL THERAPY. I think patients need to be able to PRACTICE what they are taught by good CBT folks. I've never heard of patients being given HOMEWORK to perform regarding their sessions. In other words, being given actual case vignettes of other people let's say....who are exhibiting overt signs of health anxiety.....how about doing something like...."OK Missy, I want you to take these 3 cases home with you and before our next session....I want you to read them, think about them, and tell me if you think they are exhibiting signs of Health Anxiety....." I think that sort of EXERCISE and that sort of LEARNING HOW TO RECOGNIZE in others...what one may have can be an alternative method to DESENSITIZES a person to the NOISE that comes in......Remember, how I told you that our brains are constantly flooded, second by second by sensory input, some from internally and some externally.....it's the RIGHT PARIETAL lobe's job to ignore that sensory input unless it's relevant. For instance, ,can you feel the pressure your GLUTEI are sensing against the chair you are sitting in? Does it hurt? Is it uncomfortable? Or had you not been aware of it until I just drew your attention to it..perhaps to a point where you just readjusted yourself in the seat.......I just did in mine! HAHAHA!
The question becomes how to know when to filter out things like muscle twitches, from feelings of numbness on the skin, or other weird sensations, etc. without always calling up worst case scenarios......the other side of that coin is knowing when there are legitimate things happening that need rapid and immediate attention or intervention...viz a viz....your dad's evolving heart attack...
I always tell patients (about their long lists of medications). If you don't know what a medication is being used for in your body, and you can't wholeheartedly agree that is is doing you GOOD....REAL GOOD.....have a talk with your doctor to find out what exactly you'd be missing if you were to eliminate that from the regimen? If the doctor can honestly tell you that the medication is germane and essential to your well being then, fine...keep taking it.....if there is any doubt or hesitation on the doctor's part to tell you the answer to the aforementioned question....I'd voice a motion to get rid of it from the list..... Remember, the body was designed and in most cases (probably in yours...though I don't know your full story) intended to go an entire lifetime without the need for artificial chemicals, colorings, sweeteners, and syrups. Good nutrition, good exercise, good mental perspectives and coping mechanisms to ward off evil spirits (and idiots) around you....are the BEST prescriptions that a person can fill for good health and maintenance thereof.....don't you think?
I absolutely agree with your wanting your therapist to give you more concrete ideas and TECHNIQUES on how to deal with these issues. Tell her you'd like to see her ROCK OUT on you.....ya know what I mean? It's kinda like the case of that pianist in the corner of a smokey bar who comes in night after night playing his sets, all the usual and regular stuff....because that's what the manager wants or likes.....wouldn't you love to hear him/her.....just once, change it up? XXXXXXX XXXXXXX XXXXXXX style, Balls to the Walls.....GREAT BALLS O' FIRE....and just make the joint rock out....then, you'll know that they person's got spunk...chops, whatever....and I think that's where you should go with your therapist......or find someone who is recognized in CBT and can give you those HANDS ON ways of confronting situations that you can recognize as things to ignore vs. things to address....make sense
And I am totally aware of the philosophy of XXXXXXX Weekes....not hers personally mind you, but the notion of going the other direction of allowing feelings of anxiety to play out sometimes and letting the person themselves find their own points of moderation. I think that's very much like letting a child hold their breath because they're mad....you've done that with your kids, haven't you? Well, frankly I think that's a behavior that kids used to do in the dark ages....I don't recall any of my kids using that behavior to try and get their ways....but whatever it was....so long as they weren't threatening or trying to go lie down in the middle of a busy intersection as a way of revolting against authority....I would just turn off their whining and bitching.....sooner or later the episode ends....and soon enough the behavior actually extinguishes.....
Notice that during all of OUR conversations and responses so far....I don't think I've once told you NOT TO investigate your symptoms on the internet, I never once told you that you were being absolutely ridiculous in not accepting authoritative opinions that such and such was the case....case closed....I think if you feel more comfortable looking things up, ,questioning diagnoses, etc.....that's great....I support that....I'll do everything I can to support my case....you as an attorney know better than I how to support yours....and hopefully, we can meet in the middle! LOL......
I would say that is a very good approach to dealing with Health Anxiety in this day and age of such open information......As a violinist who did teach students at one time I found that when a pupil was tense with the instrument and was holding the scroll of the instrument with a death grip, trying to get the elbow underneath, chin in place, etc. etc. the last thing in the world that the student would do to a command of RELAX....would be to relax! How many years it took me to figure that out...I have no clue....how many years it took me to realize that about myself when I played and even still play......I found that the best way to handle students and posture was to make sure, first that I was demonstrating all the proper and correct elements...both visually as well as how they could feel that my wrist was loose, my chin was not grabbing the chinrest that tightly, my elbow was not so far under that I was trying to touch my opposite ear with my contralateral epicondyle, etc. etc. Second, allow the student to hold the instrument how they would and then, make minor adjustments to what they were doing....I wouldn't speak about what I was doing...I'd just do it....and then, we'd repeat the process...not too many times in one day...but just enough so that I knew they had gotten a sufficient amount of visual and tactile stimulation on the topic and could feel themselves FINDING the comfortable position....I would definitely correct mistakes and did not allow mistakes to persist while playing.....make sense?
I think a similar if not identical parallel to Health Anxiety can be drawn from learning how to play a violin! LOL! Do you play an instrument....perhaps you can relate to that example.....and as you said before Missy....Now, "our time is almost out"...literally there is a clock ticking above this query that is down to 1 minute before it zero's out...meaning I've been typing continuously for 60 minutes! Write back.....but only if it makes you feel better! I'll try to pare down the response to a cool 30 minutes next time! HAHA!!
Be well!
Missy my dear....MY APOLOGIES for taking this long to answer
Detailed Answer:
One would be hard pressed to detect how happy I was to see a response back from you by the length of time it has taken me to respond...My apologies. Yesterday was absolutely insane with stuff to get accomplished....mostly administrative duties....thank you for your patience my dear.
It's really disturbing to hear stories such as you've described since it is so far off center of where physicians are supposed to be aspiring toward that sometimes...ignorance in knowledge is simply not an adequate explanation...I'm sure it's the same in your profession..I could tell you my own stories that should be sufficient to light up any number of "anxiety" laden feelings when it comes to mistreatment and downright malfeasance when it comes to attorneys. Except in my case, I don't know that I would necessarily say "legal anxiety" sets in so much as it is just cynicism for a system we teach our kids is democratic when in fact there are so people entrusted from behind the bench to those representing clients who demonstrate anything BUT.....So does HYPER-cynicism toward a societal system (e.g. Legal) based on poor behavior by attorneys and judges constitute analogous sentiments to what so many folks feel when it comes to Health Anxiety as a direct result of poor (even egregious and intentional) behavior or treatment on a Health Professional's part? Perhaps, but again, I digress....
I wouldn't interpret your overly cautious attitudes regarding your health as a manifestation of feelings of anxiety.....that part of it is what most doctors probably wish MORE PATIENTS would do....the old "stitch in time saves nine rule...." but I guess when one goes beyond that point after being given the "all is well" signal..well, that is where Health Anxiety may actually begin....Of course, that is also assuming that the doctor giving the ALL CLEAR signal is someone of repute and someone who has earned your trust and confidence.
And what you say of your therapy sessions is what I hear mostly from my patients regarding, "nice people to talk to, kind, empathetic, understanding, good listeners" but at the end of the day those anxious feelings are still there the next time around and patients find themselves still using their own means of dealing with them. So, where's the THERAPY? I 100% agree and wish I could address that aspect of things....but then, I'd be accused of overstepping my bounds as a neurologist and stepping on the toes of "experts."
I think the key to effectively dealing with Health Anxiety issues is to apply DESENSITIZATION techniques which as you correctly point out are best discussed and learned through COGNITIVE BEHAVIORAL THERAPY. I think patients need to be able to PRACTICE what they are taught by good CBT folks. I've never heard of patients being given HOMEWORK to perform regarding their sessions. In other words, being given actual case vignettes of other people let's say....who are exhibiting overt signs of health anxiety.....how about doing something like...."OK Missy, I want you to take these 3 cases home with you and before our next session....I want you to read them, think about them, and tell me if you think they are exhibiting signs of Health Anxiety....." I think that sort of EXERCISE and that sort of LEARNING HOW TO RECOGNIZE in others...what one may have can be an alternative method to DESENSITIZES a person to the NOISE that comes in......Remember, how I told you that our brains are constantly flooded, second by second by sensory input, some from internally and some externally.....it's the RIGHT PARIETAL lobe's job to ignore that sensory input unless it's relevant. For instance, ,can you feel the pressure your GLUTEI are sensing against the chair you are sitting in? Does it hurt? Is it uncomfortable? Or had you not been aware of it until I just drew your attention to it..perhaps to a point where you just readjusted yourself in the seat.......I just did in mine! HAHAHA!
The question becomes how to know when to filter out things like muscle twitches, from feelings of numbness on the skin, or other weird sensations, etc. without always calling up worst case scenarios......the other side of that coin is knowing when there are legitimate things happening that need rapid and immediate attention or intervention...viz a viz....your dad's evolving heart attack...
I always tell patients (about their long lists of medications). If you don't know what a medication is being used for in your body, and you can't wholeheartedly agree that is is doing you GOOD....REAL GOOD.....have a talk with your doctor to find out what exactly you'd be missing if you were to eliminate that from the regimen? If the doctor can honestly tell you that the medication is germane and essential to your well being then, fine...keep taking it.....if there is any doubt or hesitation on the doctor's part to tell you the answer to the aforementioned question....I'd voice a motion to get rid of it from the list..... Remember, the body was designed and in most cases (probably in yours...though I don't know your full story) intended to go an entire lifetime without the need for artificial chemicals, colorings, sweeteners, and syrups. Good nutrition, good exercise, good mental perspectives and coping mechanisms to ward off evil spirits (and idiots) around you....are the BEST prescriptions that a person can fill for good health and maintenance thereof.....don't you think?
I absolutely agree with your wanting your therapist to give you more concrete ideas and TECHNIQUES on how to deal with these issues. Tell her you'd like to see her ROCK OUT on you.....ya know what I mean? It's kinda like the case of that pianist in the corner of a smokey bar who comes in night after night playing his sets, all the usual and regular stuff....because that's what the manager wants or likes.....wouldn't you love to hear him/her.....just once, change it up? XXXXXXX XXXXXXX XXXXXXX style, Balls to the Walls.....GREAT BALLS O' FIRE....and just make the joint rock out....then, you'll know that they person's got spunk...chops, whatever....and I think that's where you should go with your therapist......or find someone who is recognized in CBT and can give you those HANDS ON ways of confronting situations that you can recognize as things to ignore vs. things to address....make sense
And I am totally aware of the philosophy of XXXXXXX Weekes....not hers personally mind you, but the notion of going the other direction of allowing feelings of anxiety to play out sometimes and letting the person themselves find their own points of moderation. I think that's very much like letting a child hold their breath because they're mad....you've done that with your kids, haven't you? Well, frankly I think that's a behavior that kids used to do in the dark ages....I don't recall any of my kids using that behavior to try and get their ways....but whatever it was....so long as they weren't threatening or trying to go lie down in the middle of a busy intersection as a way of revolting against authority....I would just turn off their whining and bitching.....sooner or later the episode ends....and soon enough the behavior actually extinguishes.....
Notice that during all of OUR conversations and responses so far....I don't think I've once told you NOT TO investigate your symptoms on the internet, I never once told you that you were being absolutely ridiculous in not accepting authoritative opinions that such and such was the case....case closed....I think if you feel more comfortable looking things up, ,questioning diagnoses, etc.....that's great....I support that....I'll do everything I can to support my case....you as an attorney know better than I how to support yours....and hopefully, we can meet in the middle! LOL......
I would say that is a very good approach to dealing with Health Anxiety in this day and age of such open information......As a violinist who did teach students at one time I found that when a pupil was tense with the instrument and was holding the scroll of the instrument with a death grip, trying to get the elbow underneath, chin in place, etc. etc. the last thing in the world that the student would do to a command of RELAX....would be to relax! How many years it took me to figure that out...I have no clue....how many years it took me to realize that about myself when I played and even still play......I found that the best way to handle students and posture was to make sure, first that I was demonstrating all the proper and correct elements...both visually as well as how they could feel that my wrist was loose, my chin was not grabbing the chinrest that tightly, my elbow was not so far under that I was trying to touch my opposite ear with my contralateral epicondyle, etc. etc. Second, allow the student to hold the instrument how they would and then, make minor adjustments to what they were doing....I wouldn't speak about what I was doing...I'd just do it....and then, we'd repeat the process...not too many times in one day...but just enough so that I knew they had gotten a sufficient amount of visual and tactile stimulation on the topic and could feel themselves FINDING the comfortable position....I would definitely correct mistakes and did not allow mistakes to persist while playing.....make sense?
I think a similar if not identical parallel to Health Anxiety can be drawn from learning how to play a violin! LOL! Do you play an instrument....perhaps you can relate to that example.....and as you said before Missy....Now, "our time is almost out"...literally there is a clock ticking above this query that is down to 1 minute before it zero's out...meaning I've been typing continuously for 60 minutes! Write back.....but only if it makes you feel better! I'll try to pare down the response to a cool 30 minutes next time! HAHA!!
Be well!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Saghafi! Words cannot express how grateful I am to you for taking the time to respond to my queries! I truly feel as though I have found a new friend in this world to turn to in times of questions or doubts with my health, and that is truly priceless! It goes without saying that you are extraordinarily intelligent and I completely agree with all of your perspectives on the issues we've discussed! In my opinion, I think you should consider writing a book -- I'm not quite sure of an exact subject matter for the same lol -- but you have so much wisdom and so much to share (along with your wonderful sense of humor and obvious talent for writing) that would be inordinately helpful to our fellow human beings!!
You have made me feel so much better, not only in my current health worries (muscle twitching and rare nasal papilloma), but also in my more generalized battle with anxiety. You have given me some fresh and wonderful perspectives upon the same, and I know for a fact that I will consult your responses for some time to come as a reminder of a physician's perspective on how the mind should ideally respond when a new symptom arises!
BTW, I have absolutely no musical talent whatsoever, but my husband's grandfather was a piano teacher, and my mother-in-law and her brother were incredible accordian players! I think my older son inherited some of the musical genes, as he is a wonderful guitar player. He has what I believe to be an "old soul" and is an avid lover of all musical genres -- particularly jazz (great for creating new brain synapses!!). He knows more about jazz and all of the famous musicians than anyone I know, and he is an absolutely AVID collector of vinyl records -- yep, just what you and I grew up listening to! So nice to hear music in that warm and lovely form, as opposed to the "computerized" digital versions of the same!
As an update, as I mentioned, the neuro whom I visited ordered a creatine kinase test, EMG study, and MRI of the brain. I am still waiting for insurance pre-authorization for the brain MRI, but I did receive the results of the creatine kinase labs -- my reading was smack dab in the middle of the normal parameters. I went for the EMG a few days ago (I didn't find it to be painful or uncomfortable at all -- I guess I have a high tolerance for pain!). As you know all too well, the first part was conducted by the technician and for the second part, a neurologist came in and did the actual testing of my muscles with the needle insertions. He was a delightful doctor and was so interesting to speak with during the testing. Essentially, he told me that I have the nerves and muscles of a teenager -- wow -- that worked wonders in making me feel better about the twitching. The only reading which was "off" was something to do with the nerve in my carpal tunnel area being a bit slower; he showed me something showing the corresponding muscle reaction was strong, so he was not concerned one iota about that finding. He believes the twitching to be benign fasciculations. Since I've gone that far, I will most likely proceed to have the brain MRI if my insurance approves the same. Quick question on that note -- if perchance I am able to get it scheduled withing the next few days, there is no problem having it done a few days before my surgery next Wednesday under general anesthesia, is there? The neuro ordered the MRI without contrast.
I also received all of the results of my pre-op testing, which made me feel better as well. My EKG was perfect, as was all of the blood work. The chest x-ray did pick up on some minimal opacity in my left lower lobe and mentioned it could be atelactasis; when I visited the PA at my PCP yesterday for the pre-op approval, she said that is a typical finding and nothing to be concerned about -- she listened to my lungs and all were clear, even down to the lower lobe area (I attached copies of my reports).
I hope that your day is a bit less hectic than yesterday -- it's always nice to have a bit more "breathing room" during the work day.
And I hear we may be due for another snow storm this weekend......ugh!! This better not happen on next Wednesday, the day of my surgery! I am ramped up and eager to get that little stinker papilloma out of my nose!
Have a wonderful day Dr. Saghafi :) :)
You have made me feel so much better, not only in my current health worries (muscle twitching and rare nasal papilloma), but also in my more generalized battle with anxiety. You have given me some fresh and wonderful perspectives upon the same, and I know for a fact that I will consult your responses for some time to come as a reminder of a physician's perspective on how the mind should ideally respond when a new symptom arises!
BTW, I have absolutely no musical talent whatsoever, but my husband's grandfather was a piano teacher, and my mother-in-law and her brother were incredible accordian players! I think my older son inherited some of the musical genes, as he is a wonderful guitar player. He has what I believe to be an "old soul" and is an avid lover of all musical genres -- particularly jazz (great for creating new brain synapses!!). He knows more about jazz and all of the famous musicians than anyone I know, and he is an absolutely AVID collector of vinyl records -- yep, just what you and I grew up listening to! So nice to hear music in that warm and lovely form, as opposed to the "computerized" digital versions of the same!
As an update, as I mentioned, the neuro whom I visited ordered a creatine kinase test, EMG study, and MRI of the brain. I am still waiting for insurance pre-authorization for the brain MRI, but I did receive the results of the creatine kinase labs -- my reading was smack dab in the middle of the normal parameters. I went for the EMG a few days ago (I didn't find it to be painful or uncomfortable at all -- I guess I have a high tolerance for pain!). As you know all too well, the first part was conducted by the technician and for the second part, a neurologist came in and did the actual testing of my muscles with the needle insertions. He was a delightful doctor and was so interesting to speak with during the testing. Essentially, he told me that I have the nerves and muscles of a teenager -- wow -- that worked wonders in making me feel better about the twitching. The only reading which was "off" was something to do with the nerve in my carpal tunnel area being a bit slower; he showed me something showing the corresponding muscle reaction was strong, so he was not concerned one iota about that finding. He believes the twitching to be benign fasciculations. Since I've gone that far, I will most likely proceed to have the brain MRI if my insurance approves the same. Quick question on that note -- if perchance I am able to get it scheduled withing the next few days, there is no problem having it done a few days before my surgery next Wednesday under general anesthesia, is there? The neuro ordered the MRI without contrast.
I also received all of the results of my pre-op testing, which made me feel better as well. My EKG was perfect, as was all of the blood work. The chest x-ray did pick up on some minimal opacity in my left lower lobe and mentioned it could be atelactasis; when I visited the PA at my PCP yesterday for the pre-op approval, she said that is a typical finding and nothing to be concerned about -- she listened to my lungs and all were clear, even down to the lower lobe area (I attached copies of my reports).
I hope that your day is a bit less hectic than yesterday -- it's always nice to have a bit more "breathing room" during the work day.
And I hear we may be due for another snow storm this weekend......ugh!! This better not happen on next Wednesday, the day of my surgery! I am ramped up and eager to get that little stinker papilloma out of my nose!
Have a wonderful day Dr. Saghafi :) :)
Hello Dr. Saghafi! Words cannot express how grateful I am to you for taking the time to respond to my queries! I truly feel as though I have found a new friend in this world to turn to in times of questions or doubts with my health, and that is truly priceless! It goes without saying that you are extraordinarily intelligent and I completely agree with all of your perspectives on the issues we've discussed! In my opinion, I think you should consider writing a book -- I'm not quite sure of an exact subject matter for the same lol -- but you have so much wisdom and so much to share (along with your wonderful sense of humor and obvious talent for writing) that would be inordinately helpful to our fellow human beings!!
You have made me feel so much better, not only in my current health worries (muscle twitching and rare nasal papilloma), but also in my more generalized battle with anxiety. You have given me some fresh and wonderful perspectives upon the same, and I know for a fact that I will consult your responses for some time to come as a reminder of a physician's perspective on how the mind should ideally respond when a new symptom arises!
BTW, I have absolutely no musical talent whatsoever, but my husband's grandfather was a piano teacher, and my mother-in-law and her brother were incredible accordian players! I think my older son inherited some of the musical genes, as he is a wonderful guitar player. He has what I believe to be an "old soul" and is an avid lover of all musical genres -- particularly jazz (great for creating new brain synapses!!). He knows more about jazz and all of the famous musicians than anyone I know, and he is an absolutely AVID collector of vinyl records -- yep, just what you and I grew up listening to! So nice to hear music in that warm and lovely form, as opposed to the "computerized" digital versions of the same!
As an update, as I mentioned, the neuro whom I visited ordered a creatine kinase test, EMG study, and MRI of the brain. I am still waiting for insurance pre-authorization for the brain MRI, but I did receive the results of the creatine kinase labs -- my reading was smack dab in the middle of the normal parameters. I went for the EMG a few days ago (I didn't find it to be painful or uncomfortable at all -- I guess I have a high tolerance for pain!). As you know all too well, the first part was conducted by the technician and for the second part, a neurologist came in and did the actual testing of my muscles with the needle insertions. He was a delightful doctor and was so interesting to speak with during the testing. Essentially, he told me that I have the nerves and muscles of a teenager -- wow -- that worked wonders in making me feel better about the twitching. The only reading which was "off" was something to do with the nerve in my carpal tunnel area being a bit slower; he showed me something showing the corresponding muscle reaction was strong, so he was not concerned one iota about that finding. He believes the twitching to be benign fasciculations. Since I've gone that far, I will most likely proceed to have the brain MRI if my insurance approves the same. Quick question on that note -- if perchance I am able to get it scheduled withing the next few days, there is no problem having it done a few days before my surgery next Wednesday under general anesthesia, is there? The neuro ordered the MRI without contrast.
I also received all of the results of my pre-op testing, which made me feel better as well. My EKG was perfect, as was all of the blood work. The chest x-ray did pick up on some minimal opacity in my left lower lobe and mentioned it could be atelactasis; when I visited the PA at my PCP yesterday for the pre-op approval, she said that is a typical finding and nothing to be concerned about -- she listened to my lungs and all were clear, even down to the lower lobe area (I attached copies of my reports).
I hope that your day is a bit less hectic than yesterday -- it's always nice to have a bit more "breathing room" during the work day.
And I hear we may be due for another snow storm this weekend......ugh!! This better not happen on next Wednesday, the day of my surgery! I am ramped up and eager to get that little stinker papilloma out of my nose!
Have a wonderful day Dr. Saghafi :) :)
You have made me feel so much better, not only in my current health worries (muscle twitching and rare nasal papilloma), but also in my more generalized battle with anxiety. You have given me some fresh and wonderful perspectives upon the same, and I know for a fact that I will consult your responses for some time to come as a reminder of a physician's perspective on how the mind should ideally respond when a new symptom arises!
BTW, I have absolutely no musical talent whatsoever, but my husband's grandfather was a piano teacher, and my mother-in-law and her brother were incredible accordian players! I think my older son inherited some of the musical genes, as he is a wonderful guitar player. He has what I believe to be an "old soul" and is an avid lover of all musical genres -- particularly jazz (great for creating new brain synapses!!). He knows more about jazz and all of the famous musicians than anyone I know, and he is an absolutely AVID collector of vinyl records -- yep, just what you and I grew up listening to! So nice to hear music in that warm and lovely form, as opposed to the "computerized" digital versions of the same!
As an update, as I mentioned, the neuro whom I visited ordered a creatine kinase test, EMG study, and MRI of the brain. I am still waiting for insurance pre-authorization for the brain MRI, but I did receive the results of the creatine kinase labs -- my reading was smack dab in the middle of the normal parameters. I went for the EMG a few days ago (I didn't find it to be painful or uncomfortable at all -- I guess I have a high tolerance for pain!). As you know all too well, the first part was conducted by the technician and for the second part, a neurologist came in and did the actual testing of my muscles with the needle insertions. He was a delightful doctor and was so interesting to speak with during the testing. Essentially, he told me that I have the nerves and muscles of a teenager -- wow -- that worked wonders in making me feel better about the twitching. The only reading which was "off" was something to do with the nerve in my carpal tunnel area being a bit slower; he showed me something showing the corresponding muscle reaction was strong, so he was not concerned one iota about that finding. He believes the twitching to be benign fasciculations. Since I've gone that far, I will most likely proceed to have the brain MRI if my insurance approves the same. Quick question on that note -- if perchance I am able to get it scheduled withing the next few days, there is no problem having it done a few days before my surgery next Wednesday under general anesthesia, is there? The neuro ordered the MRI without contrast.
I also received all of the results of my pre-op testing, which made me feel better as well. My EKG was perfect, as was all of the blood work. The chest x-ray did pick up on some minimal opacity in my left lower lobe and mentioned it could be atelactasis; when I visited the PA at my PCP yesterday for the pre-op approval, she said that is a typical finding and nothing to be concerned about -- she listened to my lungs and all were clear, even down to the lower lobe area (I attached copies of my reports).
I hope that your day is a bit less hectic than yesterday -- it's always nice to have a bit more "breathing room" during the work day.
And I hear we may be due for another snow storm this weekend......ugh!! This better not happen on next Wednesday, the day of my surgery! I am ramped up and eager to get that little stinker papilloma out of my nose!
Have a wonderful day Dr. Saghafi :) :)
Brief Answer:
Look at that Missy--Response in 40% of the time from last time!
Detailed Answer:
See that? I told you that I'd do better the next time around! LOL.....How are doing this evening...or rather this morning? Are you up perchance? Well, if you are I'll bet it's not like I am...got this tub of SALTED CARAMEL ice cream that I'm targeting for total annihilation by the time I finish talking with you! HA! And boy is my daughter going to be MAD when she realizes for probably the UMTEENTH time in her life that there's really nowhere in this house that one can hide food from me...especially something that has to be frozen like ice cream. Oh, you can put things on top, around....one might even think about hiding something WITHIN something something else.....but that's only because I've taught everyone MY tricks of the trade. It's tough to outfox the Fox...n'est ce pas? ROFL! It was wonderful to read your comments, along with with your insightful and cogent statements and philosophies.....First of all, again, I graciously accept your compliments on how you've found my comments relevant but honestly, I must insist that it's all in a day's work for me...and I absolutely enjoy helping you BECAUSE you are so well versed in what's going on...and no matter whether you feel that you're a bit over the top here and there....you should know that you are much better, much calmer, and much easier to speak to about these things than (and this is true) virtually anyone I can remember in recent history....If I put pen to paper to come out with any type of book...will you be my attorney to make sure I don't get taken to the cleaners? What should we write about? You as a learned and successful professional with great insight into what you're all about would make as much of an important contribution to a book or compilation series as I could. The audience wants to connect with someone who's got real world experience facing and dealing with their situations....I've got a few scattered ideas...but my dear...you would knock 'em dead...we could take the show on the road with your husband's grandpappy who could tickle the ivories with some Cole XXXXXXX ..and I'll bring my ax to sling a few riffs...One day, if we meet please remind me and I'll tell you about my initiation into jazz...me, a classically trained conservatory product being taught by XXXXXXX Orchestra violinists as well as some of the most well known violin conservatory teachers and composers in the U.S....oh I fought it alright..downright even scoffed at the very idea that anybody inventing things out of their head were even close to the world of legitimate musicians...but then, it started to come and I realized I wasn't attracted to it initially, because I didn't understand it but more to the point, "I COULDN'T DO IT!" And that was scary...So what's the next way to poopoo something you can't do? Just minimize it and make sure the world is aware of your opinion that it's really not that important of an activity at all! But then, I opened up...became a bit more flexible, and now have to almost control myself when playing in orchestras...NOT to start embellishing and disassembling music that I'm reading since everyone IS SUPPOSED to be playing the same thing! LOLLOLOL! BTW, this caramel ice cream doesn't have very long to live outside my stomach....I just can't stop taking swaths of it out of the bucket....
But I digress.....and I like it! HA!
I did look at your labs and they're beautiful....I even tried to find something wrong with them....but dang it...I couldn't...excepting for that little line of ATELECTASIS in the lung...but I'll bet you credits to Navy beans that if you got either another more sensitive scan such as an MRI that the area thought to represent minor deflation or collapse were just artifact....what tips me off is the description of the area appearing rather linear in nature as opposed to a "regional pocket".....anyhow....there's absolutely no reason for you to redo these studies....
If you were to ever have any more bloodwork done in the future (and it were me giving the orders) I might request you get some THYROID workup done (FT4 and TSH) as well as B12, homocysteine, methylmalonic acid, Vitamin D, folate, and Magnesium, Free Magnesium, and Magnesium in RBC, calcium, ionized calcium, parathormone, and potassium. This would (at least for me) constitute very nearly the perfect metabolic profile in a person with the symptoms you've got of the muscle twitches and other things..... I was smiling when reading about the awesome bedside manner your electromyographer had with you.....How cool is that to find someone like him doing a test that usually is very time consuming and has docs trying to BEAT THE CLOCK....but not in this colleague's case.....please send him my regards....he's an all too rare find....as we've both mentioned and understand.
And let me answer your question too before I forget.....there should be NO TIMING ISSUES between having had the EMG/NCV performed and any surgical or other interventional procedure you are to have done.....
I wish I could say I had more breathing space today....but as you can surmise by the fact that I'm enjoying myself with you tonight at 2:30AM, twas not the case , Alas....but that's OK....that is the life I signed up for.....my longest continuous # hrs. awake and working as a result of necessity as well as the fact who the Hell did we have to complain to 30 years ago when MEN were expected to be MEN...not sniveling, snot nosed, little brats that can't enough ways to lessen and lessen their loads of cases....oh could we get into a discussion on this topic now......But I REALLY digress.....
It's going to get down into single digits tonight and stay there for a few days.....you guys should be in line with us so you'll get it.....but then, as far as precipitation you may get a bigger BANG due to the Lake! I HOPE you don't.....crossing all superior and inferior digits bilaterally.
Oh, and I like the idea of BENIGN FASCICULATIONS.....I"ve written an actual poem about BFS as it's abbreviated....This may make it into the book we're going to write! LOLOLOLOL.....lemme see if I can find it and attach it to this note...I think you'll get a kick out of it! Hang on...be right back....... And the ice cream is DEAD in the bucket....delicious in my stomach....it never had a chance....and now I feel terrible about the fact that my daughter will be looking for her tub of ice cream...and she'll know EXACTLY who got to it! HA!
This was published Sept 16, 2014 Enjoy my dear and I look forward to hearing more about what is going on with your situation and if you get any of the above recommended tests done, etc. :)
1 min. 48 seconds on the clock up top to finish.....Can he do it? LOL!!
An Ode to Benign Fasciculation Syndrome (BFS)- sung in the style of Dr. Seuss' GREEN EGGS and HAM.
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
Dariush Saghafi, MD
Sept. 16, 2014
3 seconds left to spare!!!!!
Look at that Missy--Response in 40% of the time from last time!
Detailed Answer:
See that? I told you that I'd do better the next time around! LOL.....How are doing this evening...or rather this morning? Are you up perchance? Well, if you are I'll bet it's not like I am...got this tub of SALTED CARAMEL ice cream that I'm targeting for total annihilation by the time I finish talking with you! HA! And boy is my daughter going to be MAD when she realizes for probably the UMTEENTH time in her life that there's really nowhere in this house that one can hide food from me...especially something that has to be frozen like ice cream. Oh, you can put things on top, around....one might even think about hiding something WITHIN something something else.....but that's only because I've taught everyone MY tricks of the trade. It's tough to outfox the Fox...n'est ce pas? ROFL! It was wonderful to read your comments, along with with your insightful and cogent statements and philosophies.....First of all, again, I graciously accept your compliments on how you've found my comments relevant but honestly, I must insist that it's all in a day's work for me...and I absolutely enjoy helping you BECAUSE you are so well versed in what's going on...and no matter whether you feel that you're a bit over the top here and there....you should know that you are much better, much calmer, and much easier to speak to about these things than (and this is true) virtually anyone I can remember in recent history....If I put pen to paper to come out with any type of book...will you be my attorney to make sure I don't get taken to the cleaners? What should we write about? You as a learned and successful professional with great insight into what you're all about would make as much of an important contribution to a book or compilation series as I could. The audience wants to connect with someone who's got real world experience facing and dealing with their situations....I've got a few scattered ideas...but my dear...you would knock 'em dead...we could take the show on the road with your husband's grandpappy who could tickle the ivories with some Cole XXXXXXX ..and I'll bring my ax to sling a few riffs...One day, if we meet please remind me and I'll tell you about my initiation into jazz...me, a classically trained conservatory product being taught by XXXXXXX Orchestra violinists as well as some of the most well known violin conservatory teachers and composers in the U.S....oh I fought it alright..downright even scoffed at the very idea that anybody inventing things out of their head were even close to the world of legitimate musicians...but then, it started to come and I realized I wasn't attracted to it initially, because I didn't understand it but more to the point, "I COULDN'T DO IT!" And that was scary...So what's the next way to poopoo something you can't do? Just minimize it and make sure the world is aware of your opinion that it's really not that important of an activity at all! But then, I opened up...became a bit more flexible, and now have to almost control myself when playing in orchestras...NOT to start embellishing and disassembling music that I'm reading since everyone IS SUPPOSED to be playing the same thing! LOLLOLOL! BTW, this caramel ice cream doesn't have very long to live outside my stomach....I just can't stop taking swaths of it out of the bucket....
But I digress.....and I like it! HA!
I did look at your labs and they're beautiful....I even tried to find something wrong with them....but dang it...I couldn't...excepting for that little line of ATELECTASIS in the lung...but I'll bet you credits to Navy beans that if you got either another more sensitive scan such as an MRI that the area thought to represent minor deflation or collapse were just artifact....what tips me off is the description of the area appearing rather linear in nature as opposed to a "regional pocket".....anyhow....there's absolutely no reason for you to redo these studies....
If you were to ever have any more bloodwork done in the future (and it were me giving the orders) I might request you get some THYROID workup done (FT4 and TSH) as well as B12, homocysteine, methylmalonic acid, Vitamin D, folate, and Magnesium, Free Magnesium, and Magnesium in RBC, calcium, ionized calcium, parathormone, and potassium. This would (at least for me) constitute very nearly the perfect metabolic profile in a person with the symptoms you've got of the muscle twitches and other things..... I was smiling when reading about the awesome bedside manner your electromyographer had with you.....How cool is that to find someone like him doing a test that usually is very time consuming and has docs trying to BEAT THE CLOCK....but not in this colleague's case.....please send him my regards....he's an all too rare find....as we've both mentioned and understand.
And let me answer your question too before I forget.....there should be NO TIMING ISSUES between having had the EMG/NCV performed and any surgical or other interventional procedure you are to have done.....
I wish I could say I had more breathing space today....but as you can surmise by the fact that I'm enjoying myself with you tonight at 2:30AM, twas not the case , Alas....but that's OK....that is the life I signed up for.....my longest continuous # hrs. awake and working as a result of necessity as well as the fact who the Hell did we have to complain to 30 years ago when MEN were expected to be MEN...not sniveling, snot nosed, little brats that can't enough ways to lessen and lessen their loads of cases....oh could we get into a discussion on this topic now......But I REALLY digress.....
It's going to get down into single digits tonight and stay there for a few days.....you guys should be in line with us so you'll get it.....but then, as far as precipitation you may get a bigger BANG due to the Lake! I HOPE you don't.....crossing all superior and inferior digits bilaterally.
Oh, and I like the idea of BENIGN FASCICULATIONS.....I"ve written an actual poem about BFS as it's abbreviated....This may make it into the book we're going to write! LOLOLOLOL.....lemme see if I can find it and attach it to this note...I think you'll get a kick out of it! Hang on...be right back....... And the ice cream is DEAD in the bucket....delicious in my stomach....it never had a chance....and now I feel terrible about the fact that my daughter will be looking for her tub of ice cream...and she'll know EXACTLY who got to it! HA!
This was published Sept 16, 2014 Enjoy my dear and I look forward to hearing more about what is going on with your situation and if you get any of the above recommended tests done, etc. :)
1 min. 48 seconds on the clock up top to finish.....Can he do it? LOL!!
An Ode to Benign Fasciculation Syndrome (BFS)- sung in the style of Dr. Seuss' GREEN EGGS and HAM.
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
Dariush Saghafi, MD
Sept. 16, 2014
3 seconds left to spare!!!!!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Look at that Missy--Response in 40% of the time from last time!
Detailed Answer:
See that? I told you that I'd do better the next time around! LOL.....How are doing this evening...or rather this morning? Are you up perchance? Well, if you are I'll bet it's not like I am...got this tub of SALTED CARAMEL ice cream that I'm targeting for total annihilation by the time I finish talking with you! HA! And boy is my daughter going to be MAD when she realizes for probably the UMTEENTH time in her life that there's really nowhere in this house that one can hide food from me...especially something that has to be frozen like ice cream. Oh, you can put things on top, around....one might even think about hiding something WITHIN something something else.....but that's only because I've taught everyone MY tricks of the trade. It's tough to outfox the Fox...n'est ce pas? ROFL! It was wonderful to read your comments, along with with your insightful and cogent statements and philosophies.....First of all, again, I graciously accept your compliments on how you've found my comments relevant but honestly, I must insist that it's all in a day's work for me...and I absolutely enjoy helping you BECAUSE you are so well versed in what's going on...and no matter whether you feel that you're a bit over the top here and there....you should know that you are much better, much calmer, and much easier to speak to about these things than (and this is true) virtually anyone I can remember in recent history....If I put pen to paper to come out with any type of book...will you be my attorney to make sure I don't get taken to the cleaners? What should we write about? You as a learned and successful professional with great insight into what you're all about would make as much of an important contribution to a book or compilation series as I could. The audience wants to connect with someone who's got real world experience facing and dealing with their situations....I've got a few scattered ideas...but my dear...you would knock 'em dead...we could take the show on the road with your husband's grandpappy who could tickle the ivories with some Cole XXXXXXX ..and I'll bring my ax to sling a few riffs...One day, if we meet please remind me and I'll tell you about my initiation into jazz...me, a classically trained conservatory product being taught by XXXXXXX Orchestra violinists as well as some of the most well known violin conservatory teachers and composers in the U.S....oh I fought it alright..downright even scoffed at the very idea that anybody inventing things out of their head were even close to the world of legitimate musicians...but then, it started to come and I realized I wasn't attracted to it initially, because I didn't understand it but more to the point, "I COULDN'T DO IT!" And that was scary...So what's the next way to poopoo something you can't do? Just minimize it and make sure the world is aware of your opinion that it's really not that important of an activity at all! But then, I opened up...became a bit more flexible, and now have to almost control myself when playing in orchestras...NOT to start embellishing and disassembling music that I'm reading since everyone IS SUPPOSED to be playing the same thing! LOLLOLOL! BTW, this caramel ice cream doesn't have very long to live outside my stomach....I just can't stop taking swaths of it out of the bucket....
But I digress.....and I like it! HA!
I did look at your labs and they're beautiful....I even tried to find something wrong with them....but dang it...I couldn't...excepting for that little line of ATELECTASIS in the lung...but I'll bet you credits to Navy beans that if you got either another more sensitive scan such as an MRI that the area thought to represent minor deflation or collapse were just artifact....what tips me off is the description of the area appearing rather linear in nature as opposed to a "regional pocket".....anyhow....there's absolutely no reason for you to redo these studies....
If you were to ever have any more bloodwork done in the future (and it were me giving the orders) I might request you get some THYROID workup done (FT4 and TSH) as well as B12, homocysteine, methylmalonic acid, Vitamin D, folate, and Magnesium, Free Magnesium, and Magnesium in RBC, calcium, ionized calcium, parathormone, and potassium. This would (at least for me) constitute very nearly the perfect metabolic profile in a person with the symptoms you've got of the muscle twitches and other things..... I was smiling when reading about the awesome bedside manner your electromyographer had with you.....How cool is that to find someone like him doing a test that usually is very time consuming and has docs trying to BEAT THE CLOCK....but not in this colleague's case.....please send him my regards....he's an all too rare find....as we've both mentioned and understand.
And let me answer your question too before I forget.....there should be NO TIMING ISSUES between having had the EMG/NCV performed and any surgical or other interventional procedure you are to have done.....
I wish I could say I had more breathing space today....but as you can surmise by the fact that I'm enjoying myself with you tonight at 2:30AM, twas not the case , Alas....but that's OK....that is the life I signed up for.....my longest continuous # hrs. awake and working as a result of necessity as well as the fact who the Hell did we have to complain to 30 years ago when MEN were expected to be MEN...not sniveling, snot nosed, little brats that can't enough ways to lessen and lessen their loads of cases....oh could we get into a discussion on this topic now......But I REALLY digress.....
It's going to get down into single digits tonight and stay there for a few days.....you guys should be in line with us so you'll get it.....but then, as far as precipitation you may get a bigger BANG due to the Lake! I HOPE you don't.....crossing all superior and inferior digits bilaterally.
Oh, and I like the idea of BENIGN FASCICULATIONS.....I"ve written an actual poem about BFS as it's abbreviated....This may make it into the book we're going to write! LOLOLOLOL.....lemme see if I can find it and attach it to this note...I think you'll get a kick out of it! Hang on...be right back....... And the ice cream is DEAD in the bucket....delicious in my stomach....it never had a chance....and now I feel terrible about the fact that my daughter will be looking for her tub of ice cream...and she'll know EXACTLY who got to it! HA!
This was published Sept 16, 2014 Enjoy my dear and I look forward to hearing more about what is going on with your situation and if you get any of the above recommended tests done, etc. :)
1 min. 48 seconds on the clock up top to finish.....Can he do it? LOL!!
An Ode to Benign Fasciculation Syndrome (BFS)- sung in the style of Dr. Seuss' GREEN EGGS and HAM.
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
Dariush Saghafi, MD
Sept. 16, 2014
3 seconds left to spare!!!!!
Look at that Missy--Response in 40% of the time from last time!
Detailed Answer:
See that? I told you that I'd do better the next time around! LOL.....How are doing this evening...or rather this morning? Are you up perchance? Well, if you are I'll bet it's not like I am...got this tub of SALTED CARAMEL ice cream that I'm targeting for total annihilation by the time I finish talking with you! HA! And boy is my daughter going to be MAD when she realizes for probably the UMTEENTH time in her life that there's really nowhere in this house that one can hide food from me...especially something that has to be frozen like ice cream. Oh, you can put things on top, around....one might even think about hiding something WITHIN something something else.....but that's only because I've taught everyone MY tricks of the trade. It's tough to outfox the Fox...n'est ce pas? ROFL! It was wonderful to read your comments, along with with your insightful and cogent statements and philosophies.....First of all, again, I graciously accept your compliments on how you've found my comments relevant but honestly, I must insist that it's all in a day's work for me...and I absolutely enjoy helping you BECAUSE you are so well versed in what's going on...and no matter whether you feel that you're a bit over the top here and there....you should know that you are much better, much calmer, and much easier to speak to about these things than (and this is true) virtually anyone I can remember in recent history....If I put pen to paper to come out with any type of book...will you be my attorney to make sure I don't get taken to the cleaners? What should we write about? You as a learned and successful professional with great insight into what you're all about would make as much of an important contribution to a book or compilation series as I could. The audience wants to connect with someone who's got real world experience facing and dealing with their situations....I've got a few scattered ideas...but my dear...you would knock 'em dead...we could take the show on the road with your husband's grandpappy who could tickle the ivories with some Cole XXXXXXX ..and I'll bring my ax to sling a few riffs...One day, if we meet please remind me and I'll tell you about my initiation into jazz...me, a classically trained conservatory product being taught by XXXXXXX Orchestra violinists as well as some of the most well known violin conservatory teachers and composers in the U.S....oh I fought it alright..downright even scoffed at the very idea that anybody inventing things out of their head were even close to the world of legitimate musicians...but then, it started to come and I realized I wasn't attracted to it initially, because I didn't understand it but more to the point, "I COULDN'T DO IT!" And that was scary...So what's the next way to poopoo something you can't do? Just minimize it and make sure the world is aware of your opinion that it's really not that important of an activity at all! But then, I opened up...became a bit more flexible, and now have to almost control myself when playing in orchestras...NOT to start embellishing and disassembling music that I'm reading since everyone IS SUPPOSED to be playing the same thing! LOLLOLOL! BTW, this caramel ice cream doesn't have very long to live outside my stomach....I just can't stop taking swaths of it out of the bucket....
But I digress.....and I like it! HA!
I did look at your labs and they're beautiful....I even tried to find something wrong with them....but dang it...I couldn't...excepting for that little line of ATELECTASIS in the lung...but I'll bet you credits to Navy beans that if you got either another more sensitive scan such as an MRI that the area thought to represent minor deflation or collapse were just artifact....what tips me off is the description of the area appearing rather linear in nature as opposed to a "regional pocket".....anyhow....there's absolutely no reason for you to redo these studies....
If you were to ever have any more bloodwork done in the future (and it were me giving the orders) I might request you get some THYROID workup done (FT4 and TSH) as well as B12, homocysteine, methylmalonic acid, Vitamin D, folate, and Magnesium, Free Magnesium, and Magnesium in RBC, calcium, ionized calcium, parathormone, and potassium. This would (at least for me) constitute very nearly the perfect metabolic profile in a person with the symptoms you've got of the muscle twitches and other things..... I was smiling when reading about the awesome bedside manner your electromyographer had with you.....How cool is that to find someone like him doing a test that usually is very time consuming and has docs trying to BEAT THE CLOCK....but not in this colleague's case.....please send him my regards....he's an all too rare find....as we've both mentioned and understand.
And let me answer your question too before I forget.....there should be NO TIMING ISSUES between having had the EMG/NCV performed and any surgical or other interventional procedure you are to have done.....
I wish I could say I had more breathing space today....but as you can surmise by the fact that I'm enjoying myself with you tonight at 2:30AM, twas not the case , Alas....but that's OK....that is the life I signed up for.....my longest continuous # hrs. awake and working as a result of necessity as well as the fact who the Hell did we have to complain to 30 years ago when MEN were expected to be MEN...not sniveling, snot nosed, little brats that can't enough ways to lessen and lessen their loads of cases....oh could we get into a discussion on this topic now......But I REALLY digress.....
It's going to get down into single digits tonight and stay there for a few days.....you guys should be in line with us so you'll get it.....but then, as far as precipitation you may get a bigger BANG due to the Lake! I HOPE you don't.....crossing all superior and inferior digits bilaterally.
Oh, and I like the idea of BENIGN FASCICULATIONS.....I"ve written an actual poem about BFS as it's abbreviated....This may make it into the book we're going to write! LOLOLOLOL.....lemme see if I can find it and attach it to this note...I think you'll get a kick out of it! Hang on...be right back....... And the ice cream is DEAD in the bucket....delicious in my stomach....it never had a chance....and now I feel terrible about the fact that my daughter will be looking for her tub of ice cream...and she'll know EXACTLY who got to it! HA!
This was published Sept 16, 2014 Enjoy my dear and I look forward to hearing more about what is going on with your situation and if you get any of the above recommended tests done, etc. :)
1 min. 48 seconds on the clock up top to finish.....Can he do it? LOL!!
An Ode to Benign Fasciculation Syndrome (BFS)- sung in the style of Dr. Seuss' GREEN EGGS and HAM.
If it twitches while in song,
If it twitches but it's strong,
If it twitches, twitches,
Twitches, TWITCHES ALL night long.
If it twitches here or there,
If it twitches everywhere,
Yet the fibers do not rustle,
When you go to make a muscle.
And you've been to Doctor 1,
And you've been to Doctor 2,
And you've been to Doctor 3,
But they all just look at you!
And you've done your labs,
Your sticks, your jabs,
And those painful EMG's
To be told you're fine,
You're good- Go home
An allergy to Cheese?
So finally, you arrive at home
And those muscles twitch no less.
Think back to what your Granny said,
"Dear Child- it's BFS!"
Dariush Saghafi, MD
Sept. 16, 2014
3 seconds left to spare!!!!!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Saghafi! Just when I thought you were one of the kindest people in this oftentimes crazy world of ours, I learned that you surreptitiously ate your daughters salted caramel ice cream!?!!! Haha truth be told I have done the exact same to my sons on numerous occasions. They always know because I eat it right out of the carton (it tastes better that way!) and they see the spoon imprints in it. Here in Western New York we have a brand called “Perry’s Ice Cream” with a multitude of incredible gourmet flavors. In homage to our XXXXXXX Sabres hockey team they have a flavor called “Let’s Dough Buffalo” with creamy vanilla, huge chunks of chocolate chip cookie dough and swirls of
chocolate fudge. Heavenly! You must try it is you ever make it over this way...have you ever visited Niagara Falls?
You are so incredibly talented not to mention extraordinarily intelligent. I loved your orchestra story...I literally picture you trying to stifle yourself and resist the urge to break away into a “bring the house down” over-the-top solo!!!
You could definitely become a successful author if you venture into the literary realm. If your book ends up being of a medical subject matter, you can count on me to provide voluminous and entertaining examples of some super duper crazy health worries, most of which were ignited by the dastardly “Dr. Google”!
On that note, I don’t want to monopolize your valuable time on this site, but as a quick update, I had my brain MRI yesterday and of course, will be waiting anxiously on proverbial pins and needles for the reaults;
I have a follow up with the neuro in a week and a half, but I am sure the surgery for my nasal papilloma next week will keep me occupied in the meantime.
I hope you are enjoying your weekend and can manage to squeeze in some much-deserved relaxation time!
chocolate fudge. Heavenly! You must try it is you ever make it over this way...have you ever visited Niagara Falls?
You are so incredibly talented not to mention extraordinarily intelligent. I loved your orchestra story...I literally picture you trying to stifle yourself and resist the urge to break away into a “bring the house down” over-the-top solo!!!
You could definitely become a successful author if you venture into the literary realm. If your book ends up being of a medical subject matter, you can count on me to provide voluminous and entertaining examples of some super duper crazy health worries, most of which were ignited by the dastardly “Dr. Google”!
On that note, I don’t want to monopolize your valuable time on this site, but as a quick update, I had my brain MRI yesterday and of course, will be waiting anxiously on proverbial pins and needles for the reaults;
I have a follow up with the neuro in a week and a half, but I am sure the surgery for my nasal papilloma next week will keep me occupied in the meantime.
I hope you are enjoying your weekend and can manage to squeeze in some much-deserved relaxation time!
Dr. Saghafi! Just when I thought you were one of the kindest people in this oftentimes crazy world of ours, I learned that you surreptitiously ate your daughters salted caramel ice cream!?!!! Haha truth be told I have done the exact same to my sons on numerous occasions. They always know because I eat it right out of the carton (it tastes better that way!) and they see the spoon imprints in it. Here in Western New York we have a brand called “Perry’s Ice Cream” with a multitude of incredible gourmet flavors. In homage to our XXXXXXX Sabres hockey team they have a flavor called “Let’s Dough Buffalo” with creamy vanilla, huge chunks of chocolate chip cookie dough and swirls of
chocolate fudge. Heavenly! You must try it is you ever make it over this way...have you ever visited Niagara Falls?
You are so incredibly talented not to mention extraordinarily intelligent. I loved your orchestra story...I literally picture you trying to stifle yourself and resist the urge to break away into a “bring the house down” over-the-top solo!!!
You could definitely become a successful author if you venture into the literary realm. If your book ends up being of a medical subject matter, you can count on me to provide voluminous and entertaining examples of some super duper crazy health worries, most of which were ignited by the dastardly “Dr. Google”!
On that note, I don’t want to monopolize your valuable time on this site, but as a quick update, I had my brain MRI yesterday and of course, will be waiting anxiously on proverbial pins and needles for the reaults;
I have a follow up with the neuro in a week and a half, but I am sure the surgery for my nasal papilloma next week will keep me occupied in the meantime.
I hope you are enjoying your weekend and can manage to squeeze in some much-deserved relaxation time!
chocolate fudge. Heavenly! You must try it is you ever make it over this way...have you ever visited Niagara Falls?
You are so incredibly talented not to mention extraordinarily intelligent. I loved your orchestra story...I literally picture you trying to stifle yourself and resist the urge to break away into a “bring the house down” over-the-top solo!!!
You could definitely become a successful author if you venture into the literary realm. If your book ends up being of a medical subject matter, you can count on me to provide voluminous and entertaining examples of some super duper crazy health worries, most of which were ignited by the dastardly “Dr. Google”!
On that note, I don’t want to monopolize your valuable time on this site, but as a quick update, I had my brain MRI yesterday and of course, will be waiting anxiously on proverbial pins and needles for the reaults;
I have a follow up with the neuro in a week and a half, but I am sure the surgery for my nasal papilloma next week will keep me occupied in the meantime.
I hope you are enjoying your weekend and can manage to squeeze in some much-deserved relaxation time!
Brief Answer:
Seen Niagra Falls? Surely you jest! LOL
Detailed Answer:
Oh my, YES....I (We) have visited the Falls countless times. I'll even wager that you and I may have passed each other as children in tow with our parents on either the Horseshoe side or in the Gorges when it was fashionable in the 60's and 70's to take kids for a day of fun on the Maid of the Mist, the Spanish Trolley Car, and then, to eat atop the rotating restaurant at a time when parents only needed their drivers' licenses and for the little rugrat to only have to bear a resemblance to the couple in order to cross the border! LOL.... Niagara was our honeymoon destination in 1992 (did we pass you then, when we were OLDER KIDS??) though ours wasn't nearly the event of XXXXXXX Kent's when he took Lois up to the Newlywed suite. Recall that rather embarrassing scene? Having to try and explain why your hand doesn't burn when it sits inside a firepit for 10 seconds? I mean, really....didn't it seem that he actually kept his hand fixed on the burning coals before Lois pulled him back??? LOL!
Well, shifting gears for a moment-- I hope you're satisfied....you made me feel so shamed at having burgled my daughter's ICE CREAM the other night when we were chatting;made even worse by the fact that she has yet to even say anything to me about not finding her 1/2 gallon tub that I will just have to get her 4 pints of Hagen Daaz tomorrow or perhaps she can have 3 pints and 1 for me; on 2nd thought, let's make it 2 and 2 OK? ROFLMAO!!
You however, have far too much the conscience to be a good thief. The secret my dear is to NOT LEAVE any evidence when committing to the deed. You're leaving spoon tracks.
Just eat the blood tub and be done with it or at least smooth out the crevasses before replacing the lid. This then, makes it decidedly more difficult for anybody to accuse you of robbing anything and prompts the rest to think that perhaps, their memories as to how much ice cream was actually left for another day is somehow altered. Perhaps, from the brain freeze they feel when they themselves eat DIRECTLY from the carton!
Funny that XXXXXXX has Perry's Ice Cream and XXXXXXX has Pierre's Ice Cream....
But tell me true...what did you think of one of MY tastiest choices of ice creams that have ever been made by man.....which came out of none other than XXXXXXX Trump's THE APPRENTICE?
Do you recall Trace Adkin's MAPLE MACADAMIAN MASH UP? It was manufactured by DISH Ice Cream exclusively for WALGREEN's. I was so hooked on that flavor that I would walk into Walgreen's stores and literally instruct cashiers to FILL UP MY CART with every last pint of that flavor "before anybody gets hurt!" I'd threaten managers with lodging complaints at Headquarters if I failed to receive immediate notifications following new store shipments! I really needed therapy during those crucial months.....I was having a hard time remembering the standard doses of many common medications I prescribed to my patients for a variety of illnesses simply because visions of MAPLE MACADAMIANS danced in my head...that a Country Western Superstar was able to come up with.....my goodness....but I survived....!
But I once again DIGRESS by your leave Milady and thoroughly enjoyed the trip down memory XXXXXXX that you invited me to take with you.... :)
You've not IN THE LEAST monopolized my time with your questions and comments. To the contrary, you've provided many more reasons for insight further on my part of just how incredibly functional, varied, and normal the mind of a person wrestling with this thing we call Health Anxiety can be AND IS, to be sure. And by the way, I still maintain (though lacking in expertise in this field) that you are likely NOT NEARLY as far down the track as the vast majority of folks I've interacted with who suffer from the same sorts of complaints. Furthermore, I believe you demonstrate many excellent qualities and tools at your disposal to tweak the machine just enough to turn some of that obsession off long enough to catch your breath and get away from all that overly concerns you when it comes to your health. I'm not just saying that either but rather truly believe you are well enough versed in yourself as well as the ins and outs of what health anxiety is all about so that you really can implement effective and long term strategies to climb out of the hole...which is not as deep as you think....
My Dept. Chair once made a broad statement to us as residents, "There is nothing bad about information and there is no such thing as ever having learned TOO MUCH information about the universe around you so long as it's factual according to the best science we have at the moment." I wasn't crazy about him as an attending and didn't think he was appropriate for teaching residents in training due to his "holier than thou attitude" but that is one POSITIVE statement he made that I shant forget any time soon....and it's already been 20 years since I heard it directly from him....soooooo....you're becoming aware essentially of a lot of information....and as we say to each other these in the spirit of coolness, "It's ALL GOOD!" LOL!
You should really not feel as if you're crossing into forbidden territory or putting your hand awkwardly into the cookie jar atop highest shelf in the kitchen just because you had the motivation, curiosity, and intelligence to know how to look up data in the first place.....
Where you may make more inroads into how you feel about that information you've mined is by bringing it to someone who can assimilate it more relevantly to your situation by virtue of being an authoritative expert (one you trust and have a good working relationship). And then, learning and believing in what that person either tells or SHOWS you about the information (i.e. imaging or electrical studies or other objective measures). Of course, experts are fallible (don't get me started on some of the examples I was using the other night! LOL)...and therefore, it is your obligation as a thinking and concerned human being to question things you don't understand or things you still can't get perspective on if it just doesn't make sense. I actually will reprimand patients who feel it is their DUTY as GOOD PATIENTS to question NOTHING and not to speak up when they feel ambivalent. They somehow convince themselves they're the ignorant ones in the situation and the doctor can't possibly be wrong in his/her way of thinking.....Nothing can be further from the truth Missy.....
If I ever have the honor and pleasure of meeting you then, please remind me to explain why a former primary school classmate always comes to mind (who's also an attorney) when it comes to explaining to patients how they should ask questions of doctors. I call it just being XXXXXXX KACIC to the doctor. Just pull out the XXXXXXX KACIC persona and let it shine through.....doctors may not like it...in fact, most will surely become internally molested when a patient pulls a XXXXXXX KACIC on them. Some may even feel EMASCULATED as physicians since they may not know how to adequately respond to someone who obviously has done a bit more reading than they in the past 24 hrs. on a certain disease or condition! HA! I never assume that I know more about a patient's disease state at any given moment compared to the patient themself...especially if I'm dealing with someone I know has an insatiable and unquenchable thirst for the latest on whatever condition they possess. As another attending once told me...."beware of the motivated ditch digger who wishes to overcome his/her state of unwellness and who ALSO scored at least 850 on their SAT's! HOW TRUE is that statement? Worst feeling in the world to have one's IGNORANCE called out on the rug due to one's own pride by someone armed with indisputable facts, fresh off the research press!
And so once again, I commend you on how you've handled yourself and the person that YOU ARE my dear. I'm certain your MRI will be just fine as will be your EMG/NCV studies. I would love to continue following your story and perhaps, have a hand in helping you navigate some more uncharted territory with you as it applies to the twitching problems, the anxiety issues (though others are so much more expert than I in that realm), and I want to know that all went well getting the papilloma removed. I think you're doing the right thing getting it removed.
I hope you guys don't get nailed as badly as I fear we will with the cold snap this week and I'd like to invite you to share when you might be coming to Cleveland? Did I tell you that some poll or inquest was recently done showing us to be 5th in the nation as far as NIGHT LIFE was concerned? And we're also either 13th or 19th in the country as far as STAYCATION destinations. I'm not sure if it's really such an honor to be on the top of that list- to me that would more aptly correlate to amount of financial burden one is feeling as opposed to feeling so elevated to choose HOME over anywhere else to in order to satisfy the main goal of any vacation which is, "GET AWAY FROM IT ALL..."---don't you think?
Once again, as we close on this message I wish you all the very best Missy with surgery, and everything else. You're doing AWESOME in my opinion and will do marvelously well (in large part based upon how much you love sneaking ice cream out of the bucket and leaving spoon marks!)....so says Dr. D's Crystal Ball...! :0
Be well!
Seen Niagra Falls? Surely you jest! LOL
Detailed Answer:
Oh my, YES....I (We) have visited the Falls countless times. I'll even wager that you and I may have passed each other as children in tow with our parents on either the Horseshoe side or in the Gorges when it was fashionable in the 60's and 70's to take kids for a day of fun on the Maid of the Mist, the Spanish Trolley Car, and then, to eat atop the rotating restaurant at a time when parents only needed their drivers' licenses and for the little rugrat to only have to bear a resemblance to the couple in order to cross the border! LOL.... Niagara was our honeymoon destination in 1992 (did we pass you then, when we were OLDER KIDS??) though ours wasn't nearly the event of XXXXXXX Kent's when he took Lois up to the Newlywed suite. Recall that rather embarrassing scene? Having to try and explain why your hand doesn't burn when it sits inside a firepit for 10 seconds? I mean, really....didn't it seem that he actually kept his hand fixed on the burning coals before Lois pulled him back??? LOL!
Well, shifting gears for a moment-- I hope you're satisfied....you made me feel so shamed at having burgled my daughter's ICE CREAM the other night when we were chatting;made even worse by the fact that she has yet to even say anything to me about not finding her 1/2 gallon tub that I will just have to get her 4 pints of Hagen Daaz tomorrow or perhaps she can have 3 pints and 1 for me; on 2nd thought, let's make it 2 and 2 OK? ROFLMAO!!
You however, have far too much the conscience to be a good thief. The secret my dear is to NOT LEAVE any evidence when committing to the deed. You're leaving spoon tracks.
Just eat the blood tub and be done with it or at least smooth out the crevasses before replacing the lid. This then, makes it decidedly more difficult for anybody to accuse you of robbing anything and prompts the rest to think that perhaps, their memories as to how much ice cream was actually left for another day is somehow altered. Perhaps, from the brain freeze they feel when they themselves eat DIRECTLY from the carton!
Funny that XXXXXXX has Perry's Ice Cream and XXXXXXX has Pierre's Ice Cream....
But tell me true...what did you think of one of MY tastiest choices of ice creams that have ever been made by man.....which came out of none other than XXXXXXX Trump's THE APPRENTICE?
Do you recall Trace Adkin's MAPLE MACADAMIAN MASH UP? It was manufactured by DISH Ice Cream exclusively for WALGREEN's. I was so hooked on that flavor that I would walk into Walgreen's stores and literally instruct cashiers to FILL UP MY CART with every last pint of that flavor "before anybody gets hurt!" I'd threaten managers with lodging complaints at Headquarters if I failed to receive immediate notifications following new store shipments! I really needed therapy during those crucial months.....I was having a hard time remembering the standard doses of many common medications I prescribed to my patients for a variety of illnesses simply because visions of MAPLE MACADAMIANS danced in my head...that a Country Western Superstar was able to come up with.....my goodness....but I survived....!
But I once again DIGRESS by your leave Milady and thoroughly enjoyed the trip down memory XXXXXXX that you invited me to take with you.... :)
You've not IN THE LEAST monopolized my time with your questions and comments. To the contrary, you've provided many more reasons for insight further on my part of just how incredibly functional, varied, and normal the mind of a person wrestling with this thing we call Health Anxiety can be AND IS, to be sure. And by the way, I still maintain (though lacking in expertise in this field) that you are likely NOT NEARLY as far down the track as the vast majority of folks I've interacted with who suffer from the same sorts of complaints. Furthermore, I believe you demonstrate many excellent qualities and tools at your disposal to tweak the machine just enough to turn some of that obsession off long enough to catch your breath and get away from all that overly concerns you when it comes to your health. I'm not just saying that either but rather truly believe you are well enough versed in yourself as well as the ins and outs of what health anxiety is all about so that you really can implement effective and long term strategies to climb out of the hole...which is not as deep as you think....
My Dept. Chair once made a broad statement to us as residents, "There is nothing bad about information and there is no such thing as ever having learned TOO MUCH information about the universe around you so long as it's factual according to the best science we have at the moment." I wasn't crazy about him as an attending and didn't think he was appropriate for teaching residents in training due to his "holier than thou attitude" but that is one POSITIVE statement he made that I shant forget any time soon....and it's already been 20 years since I heard it directly from him....soooooo....you're becoming aware essentially of a lot of information....and as we say to each other these in the spirit of coolness, "It's ALL GOOD!" LOL!
You should really not feel as if you're crossing into forbidden territory or putting your hand awkwardly into the cookie jar atop highest shelf in the kitchen just because you had the motivation, curiosity, and intelligence to know how to look up data in the first place.....
Where you may make more inroads into how you feel about that information you've mined is by bringing it to someone who can assimilate it more relevantly to your situation by virtue of being an authoritative expert (one you trust and have a good working relationship). And then, learning and believing in what that person either tells or SHOWS you about the information (i.e. imaging or electrical studies or other objective measures). Of course, experts are fallible (don't get me started on some of the examples I was using the other night! LOL)...and therefore, it is your obligation as a thinking and concerned human being to question things you don't understand or things you still can't get perspective on if it just doesn't make sense. I actually will reprimand patients who feel it is their DUTY as GOOD PATIENTS to question NOTHING and not to speak up when they feel ambivalent. They somehow convince themselves they're the ignorant ones in the situation and the doctor can't possibly be wrong in his/her way of thinking.....Nothing can be further from the truth Missy.....
If I ever have the honor and pleasure of meeting you then, please remind me to explain why a former primary school classmate always comes to mind (who's also an attorney) when it comes to explaining to patients how they should ask questions of doctors. I call it just being XXXXXXX KACIC to the doctor. Just pull out the XXXXXXX KACIC persona and let it shine through.....doctors may not like it...in fact, most will surely become internally molested when a patient pulls a XXXXXXX KACIC on them. Some may even feel EMASCULATED as physicians since they may not know how to adequately respond to someone who obviously has done a bit more reading than they in the past 24 hrs. on a certain disease or condition! HA! I never assume that I know more about a patient's disease state at any given moment compared to the patient themself...especially if I'm dealing with someone I know has an insatiable and unquenchable thirst for the latest on whatever condition they possess. As another attending once told me...."beware of the motivated ditch digger who wishes to overcome his/her state of unwellness and who ALSO scored at least 850 on their SAT's! HOW TRUE is that statement? Worst feeling in the world to have one's IGNORANCE called out on the rug due to one's own pride by someone armed with indisputable facts, fresh off the research press!
And so once again, I commend you on how you've handled yourself and the person that YOU ARE my dear. I'm certain your MRI will be just fine as will be your EMG/NCV studies. I would love to continue following your story and perhaps, have a hand in helping you navigate some more uncharted territory with you as it applies to the twitching problems, the anxiety issues (though others are so much more expert than I in that realm), and I want to know that all went well getting the papilloma removed. I think you're doing the right thing getting it removed.
I hope you guys don't get nailed as badly as I fear we will with the cold snap this week and I'd like to invite you to share when you might be coming to Cleveland? Did I tell you that some poll or inquest was recently done showing us to be 5th in the nation as far as NIGHT LIFE was concerned? And we're also either 13th or 19th in the country as far as STAYCATION destinations. I'm not sure if it's really such an honor to be on the top of that list- to me that would more aptly correlate to amount of financial burden one is feeling as opposed to feeling so elevated to choose HOME over anywhere else to in order to satisfy the main goal of any vacation which is, "GET AWAY FROM IT ALL..."---don't you think?
Once again, as we close on this message I wish you all the very best Missy with surgery, and everything else. You're doing AWESOME in my opinion and will do marvelously well (in large part based upon how much you love sneaking ice cream out of the bucket and leaving spoon marks!)....so says Dr. D's Crystal Ball...! :0
Be well!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Seen Niagra Falls? Surely you jest! LOL
Detailed Answer:
Oh my, YES....I (We) have visited the Falls countless times. I'll even wager that you and I may have passed each other as children in tow with our parents on either the Horseshoe side or in the Gorges when it was fashionable in the 60's and 70's to take kids for a day of fun on the Maid of the Mist, the Spanish Trolley Car, and then, to eat atop the rotating restaurant at a time when parents only needed their drivers' licenses and for the little rugrat to only have to bear a resemblance to the couple in order to cross the border! LOL.... Niagara was our honeymoon destination in 1992 (did we pass you then, when we were OLDER KIDS??) though ours wasn't nearly the event of XXXXXXX Kent's when he took Lois up to the Newlywed suite. Recall that rather embarrassing scene? Having to try and explain why your hand doesn't burn when it sits inside a firepit for 10 seconds? I mean, really....didn't it seem that he actually kept his hand fixed on the burning coals before Lois pulled him back??? LOL!
Well, shifting gears for a moment-- I hope you're satisfied....you made me feel so shamed at having burgled my daughter's ICE CREAM the other night when we were chatting;made even worse by the fact that she has yet to even say anything to me about not finding her 1/2 gallon tub that I will just have to get her 4 pints of Hagen Daaz tomorrow or perhaps she can have 3 pints and 1 for me; on 2nd thought, let's make it 2 and 2 OK? ROFLMAO!!
You however, have far too much the conscience to be a good thief. The secret my dear is to NOT LEAVE any evidence when committing to the deed. You're leaving spoon tracks.
Just eat the blood tub and be done with it or at least smooth out the crevasses before replacing the lid. This then, makes it decidedly more difficult for anybody to accuse you of robbing anything and prompts the rest to think that perhaps, their memories as to how much ice cream was actually left for another day is somehow altered. Perhaps, from the brain freeze they feel when they themselves eat DIRECTLY from the carton!
Funny that XXXXXXX has Perry's Ice Cream and XXXXXXX has Pierre's Ice Cream....
But tell me true...what did you think of one of MY tastiest choices of ice creams that have ever been made by man.....which came out of none other than XXXXXXX Trump's THE APPRENTICE?
Do you recall Trace Adkin's MAPLE MACADAMIAN MASH UP? It was manufactured by DISH Ice Cream exclusively for WALGREEN's. I was so hooked on that flavor that I would walk into Walgreen's stores and literally instruct cashiers to FILL UP MY CART with every last pint of that flavor "before anybody gets hurt!" I'd threaten managers with lodging complaints at Headquarters if I failed to receive immediate notifications following new store shipments! I really needed therapy during those crucial months.....I was having a hard time remembering the standard doses of many common medications I prescribed to my patients for a variety of illnesses simply because visions of MAPLE MACADAMIANS danced in my head...that a Country Western Superstar was able to come up with.....my goodness....but I survived....!
But I once again DIGRESS by your leave Milady and thoroughly enjoyed the trip down memory XXXXXXX that you invited me to take with you.... :)
You've not IN THE LEAST monopolized my time with your questions and comments. To the contrary, you've provided many more reasons for insight further on my part of just how incredibly functional, varied, and normal the mind of a person wrestling with this thing we call Health Anxiety can be AND IS, to be sure. And by the way, I still maintain (though lacking in expertise in this field) that you are likely NOT NEARLY as far down the track as the vast majority of folks I've interacted with who suffer from the same sorts of complaints. Furthermore, I believe you demonstrate many excellent qualities and tools at your disposal to tweak the machine just enough to turn some of that obsession off long enough to catch your breath and get away from all that overly concerns you when it comes to your health. I'm not just saying that either but rather truly believe you are well enough versed in yourself as well as the ins and outs of what health anxiety is all about so that you really can implement effective and long term strategies to climb out of the hole...which is not as deep as you think....
My Dept. Chair once made a broad statement to us as residents, "There is nothing bad about information and there is no such thing as ever having learned TOO MUCH information about the universe around you so long as it's factual according to the best science we have at the moment." I wasn't crazy about him as an attending and didn't think he was appropriate for teaching residents in training due to his "holier than thou attitude" but that is one POSITIVE statement he made that I shant forget any time soon....and it's already been 20 years since I heard it directly from him....soooooo....you're becoming aware essentially of a lot of information....and as we say to each other these in the spirit of coolness, "It's ALL GOOD!" LOL!
You should really not feel as if you're crossing into forbidden territory or putting your hand awkwardly into the cookie jar atop highest shelf in the kitchen just because you had the motivation, curiosity, and intelligence to know how to look up data in the first place.....
Where you may make more inroads into how you feel about that information you've mined is by bringing it to someone who can assimilate it more relevantly to your situation by virtue of being an authoritative expert (one you trust and have a good working relationship). And then, learning and believing in what that person either tells or SHOWS you about the information (i.e. imaging or electrical studies or other objective measures). Of course, experts are fallible (don't get me started on some of the examples I was using the other night! LOL)...and therefore, it is your obligation as a thinking and concerned human being to question things you don't understand or things you still can't get perspective on if it just doesn't make sense. I actually will reprimand patients who feel it is their DUTY as GOOD PATIENTS to question NOTHING and not to speak up when they feel ambivalent. They somehow convince themselves they're the ignorant ones in the situation and the doctor can't possibly be wrong in his/her way of thinking.....Nothing can be further from the truth Missy.....
If I ever have the honor and pleasure of meeting you then, please remind me to explain why a former primary school classmate always comes to mind (who's also an attorney) when it comes to explaining to patients how they should ask questions of doctors. I call it just being XXXXXXX KACIC to the doctor. Just pull out the XXXXXXX KACIC persona and let it shine through.....doctors may not like it...in fact, most will surely become internally molested when a patient pulls a XXXXXXX KACIC on them. Some may even feel EMASCULATED as physicians since they may not know how to adequately respond to someone who obviously has done a bit more reading than they in the past 24 hrs. on a certain disease or condition! HA! I never assume that I know more about a patient's disease state at any given moment compared to the patient themself...especially if I'm dealing with someone I know has an insatiable and unquenchable thirst for the latest on whatever condition they possess. As another attending once told me...."beware of the motivated ditch digger who wishes to overcome his/her state of unwellness and who ALSO scored at least 850 on their SAT's! HOW TRUE is that statement? Worst feeling in the world to have one's IGNORANCE called out on the rug due to one's own pride by someone armed with indisputable facts, fresh off the research press!
And so once again, I commend you on how you've handled yourself and the person that YOU ARE my dear. I'm certain your MRI will be just fine as will be your EMG/NCV studies. I would love to continue following your story and perhaps, have a hand in helping you navigate some more uncharted territory with you as it applies to the twitching problems, the anxiety issues (though others are so much more expert than I in that realm), and I want to know that all went well getting the papilloma removed. I think you're doing the right thing getting it removed.
I hope you guys don't get nailed as badly as I fear we will with the cold snap this week and I'd like to invite you to share when you might be coming to Cleveland? Did I tell you that some poll or inquest was recently done showing us to be 5th in the nation as far as NIGHT LIFE was concerned? And we're also either 13th or 19th in the country as far as STAYCATION destinations. I'm not sure if it's really such an honor to be on the top of that list- to me that would more aptly correlate to amount of financial burden one is feeling as opposed to feeling so elevated to choose HOME over anywhere else to in order to satisfy the main goal of any vacation which is, "GET AWAY FROM IT ALL..."---don't you think?
Once again, as we close on this message I wish you all the very best Missy with surgery, and everything else. You're doing AWESOME in my opinion and will do marvelously well (in large part based upon how much you love sneaking ice cream out of the bucket and leaving spoon marks!)....so says Dr. D's Crystal Ball...! :0
Be well!
Seen Niagra Falls? Surely you jest! LOL
Detailed Answer:
Oh my, YES....I (We) have visited the Falls countless times. I'll even wager that you and I may have passed each other as children in tow with our parents on either the Horseshoe side or in the Gorges when it was fashionable in the 60's and 70's to take kids for a day of fun on the Maid of the Mist, the Spanish Trolley Car, and then, to eat atop the rotating restaurant at a time when parents only needed their drivers' licenses and for the little rugrat to only have to bear a resemblance to the couple in order to cross the border! LOL.... Niagara was our honeymoon destination in 1992 (did we pass you then, when we were OLDER KIDS??) though ours wasn't nearly the event of XXXXXXX Kent's when he took Lois up to the Newlywed suite. Recall that rather embarrassing scene? Having to try and explain why your hand doesn't burn when it sits inside a firepit for 10 seconds? I mean, really....didn't it seem that he actually kept his hand fixed on the burning coals before Lois pulled him back??? LOL!
Well, shifting gears for a moment-- I hope you're satisfied....you made me feel so shamed at having burgled my daughter's ICE CREAM the other night when we were chatting;made even worse by the fact that she has yet to even say anything to me about not finding her 1/2 gallon tub that I will just have to get her 4 pints of Hagen Daaz tomorrow or perhaps she can have 3 pints and 1 for me; on 2nd thought, let's make it 2 and 2 OK? ROFLMAO!!
You however, have far too much the conscience to be a good thief. The secret my dear is to NOT LEAVE any evidence when committing to the deed. You're leaving spoon tracks.
Just eat the blood tub and be done with it or at least smooth out the crevasses before replacing the lid. This then, makes it decidedly more difficult for anybody to accuse you of robbing anything and prompts the rest to think that perhaps, their memories as to how much ice cream was actually left for another day is somehow altered. Perhaps, from the brain freeze they feel when they themselves eat DIRECTLY from the carton!
Funny that XXXXXXX has Perry's Ice Cream and XXXXXXX has Pierre's Ice Cream....
But tell me true...what did you think of one of MY tastiest choices of ice creams that have ever been made by man.....which came out of none other than XXXXXXX Trump's THE APPRENTICE?
Do you recall Trace Adkin's MAPLE MACADAMIAN MASH UP? It was manufactured by DISH Ice Cream exclusively for WALGREEN's. I was so hooked on that flavor that I would walk into Walgreen's stores and literally instruct cashiers to FILL UP MY CART with every last pint of that flavor "before anybody gets hurt!" I'd threaten managers with lodging complaints at Headquarters if I failed to receive immediate notifications following new store shipments! I really needed therapy during those crucial months.....I was having a hard time remembering the standard doses of many common medications I prescribed to my patients for a variety of illnesses simply because visions of MAPLE MACADAMIANS danced in my head...that a Country Western Superstar was able to come up with.....my goodness....but I survived....!
But I once again DIGRESS by your leave Milady and thoroughly enjoyed the trip down memory XXXXXXX that you invited me to take with you.... :)
You've not IN THE LEAST monopolized my time with your questions and comments. To the contrary, you've provided many more reasons for insight further on my part of just how incredibly functional, varied, and normal the mind of a person wrestling with this thing we call Health Anxiety can be AND IS, to be sure. And by the way, I still maintain (though lacking in expertise in this field) that you are likely NOT NEARLY as far down the track as the vast majority of folks I've interacted with who suffer from the same sorts of complaints. Furthermore, I believe you demonstrate many excellent qualities and tools at your disposal to tweak the machine just enough to turn some of that obsession off long enough to catch your breath and get away from all that overly concerns you when it comes to your health. I'm not just saying that either but rather truly believe you are well enough versed in yourself as well as the ins and outs of what health anxiety is all about so that you really can implement effective and long term strategies to climb out of the hole...which is not as deep as you think....
My Dept. Chair once made a broad statement to us as residents, "There is nothing bad about information and there is no such thing as ever having learned TOO MUCH information about the universe around you so long as it's factual according to the best science we have at the moment." I wasn't crazy about him as an attending and didn't think he was appropriate for teaching residents in training due to his "holier than thou attitude" but that is one POSITIVE statement he made that I shant forget any time soon....and it's already been 20 years since I heard it directly from him....soooooo....you're becoming aware essentially of a lot of information....and as we say to each other these in the spirit of coolness, "It's ALL GOOD!" LOL!
You should really not feel as if you're crossing into forbidden territory or putting your hand awkwardly into the cookie jar atop highest shelf in the kitchen just because you had the motivation, curiosity, and intelligence to know how to look up data in the first place.....
Where you may make more inroads into how you feel about that information you've mined is by bringing it to someone who can assimilate it more relevantly to your situation by virtue of being an authoritative expert (one you trust and have a good working relationship). And then, learning and believing in what that person either tells or SHOWS you about the information (i.e. imaging or electrical studies or other objective measures). Of course, experts are fallible (don't get me started on some of the examples I was using the other night! LOL)...and therefore, it is your obligation as a thinking and concerned human being to question things you don't understand or things you still can't get perspective on if it just doesn't make sense. I actually will reprimand patients who feel it is their DUTY as GOOD PATIENTS to question NOTHING and not to speak up when they feel ambivalent. They somehow convince themselves they're the ignorant ones in the situation and the doctor can't possibly be wrong in his/her way of thinking.....Nothing can be further from the truth Missy.....
If I ever have the honor and pleasure of meeting you then, please remind me to explain why a former primary school classmate always comes to mind (who's also an attorney) when it comes to explaining to patients how they should ask questions of doctors. I call it just being XXXXXXX KACIC to the doctor. Just pull out the XXXXXXX KACIC persona and let it shine through.....doctors may not like it...in fact, most will surely become internally molested when a patient pulls a XXXXXXX KACIC on them. Some may even feel EMASCULATED as physicians since they may not know how to adequately respond to someone who obviously has done a bit more reading than they in the past 24 hrs. on a certain disease or condition! HA! I never assume that I know more about a patient's disease state at any given moment compared to the patient themself...especially if I'm dealing with someone I know has an insatiable and unquenchable thirst for the latest on whatever condition they possess. As another attending once told me...."beware of the motivated ditch digger who wishes to overcome his/her state of unwellness and who ALSO scored at least 850 on their SAT's! HOW TRUE is that statement? Worst feeling in the world to have one's IGNORANCE called out on the rug due to one's own pride by someone armed with indisputable facts, fresh off the research press!
And so once again, I commend you on how you've handled yourself and the person that YOU ARE my dear. I'm certain your MRI will be just fine as will be your EMG/NCV studies. I would love to continue following your story and perhaps, have a hand in helping you navigate some more uncharted territory with you as it applies to the twitching problems, the anxiety issues (though others are so much more expert than I in that realm), and I want to know that all went well getting the papilloma removed. I think you're doing the right thing getting it removed.
I hope you guys don't get nailed as badly as I fear we will with the cold snap this week and I'd like to invite you to share when you might be coming to Cleveland? Did I tell you that some poll or inquest was recently done showing us to be 5th in the nation as far as NIGHT LIFE was concerned? And we're also either 13th or 19th in the country as far as STAYCATION destinations. I'm not sure if it's really such an honor to be on the top of that list- to me that would more aptly correlate to amount of financial burden one is feeling as opposed to feeling so elevated to choose HOME over anywhere else to in order to satisfy the main goal of any vacation which is, "GET AWAY FROM IT ALL..."---don't you think?
Once again, as we close on this message I wish you all the very best Missy with surgery, and everything else. You're doing AWESOME in my opinion and will do marvelously well (in large part based upon how much you love sneaking ice cream out of the bucket and leaving spoon marks!)....so says Dr. D's Crystal Ball...! :0
Be well!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Saghafi -- you put a smile on my face every single time I read your responses!! I wanted to respond with some light-hearted comments, but I actually just picked up the disc of my brain MRI scan at the neuro's office today, and much to my chagrin, they would not give me a written report to go along with it. So, knowing me, I plug the CD into my computer here at work and am frantically trying to interpret it for anything ominous looking! As you are aware, the CD consists of almost 200 images, but if I attach some of what appear to be the "main" ones, would you be able to take a look and tell me if there is anything worrisome (I don't have my follow up appt with the neuro for another week)? As I mentioned, I did have a brain MRI back in 2003 which showed "a single, non-specific 3mm high signal lesion in the subcortical white matter of the left frontal-parietal lobe" and nothing further. I also had a repeat brain MRI in 2005 which showed "minimal white matter changes, non-specific in a patient this age". Thanks again immensely for being there for me!! Missy
PS my surgery for my sinonasal papilloma is scheduled for tomorrow morning, and of course, we have the huge storm heading our way -- we'll see if it goes forward!!
PS my surgery for my sinonasal papilloma is scheduled for tomorrow morning, and of course, we have the huge storm heading our way -- we'll see if it goes forward!!
Dr. Saghafi -- you put a smile on my face every single time I read your responses!! I wanted to respond with some light-hearted comments, but I actually just picked up the disc of my brain MRI scan at the neuro's office today, and much to my chagrin, they would not give me a written report to go along with it. So, knowing me, I plug the CD into my computer here at work and am frantically trying to interpret it for anything ominous looking! As you are aware, the CD consists of almost 200 images, but if I attach some of what appear to be the "main" ones, would you be able to take a look and tell me if there is anything worrisome (I don't have my follow up appt with the neuro for another week)? As I mentioned, I did have a brain MRI back in 2003 which showed "a single, non-specific 3mm high signal lesion in the subcortical white matter of the left frontal-parietal lobe" and nothing further. I also had a repeat brain MRI in 2005 which showed "minimal white matter changes, non-specific in a patient this age". Thanks again immensely for being there for me!! Missy
PS my surgery for my sinonasal papilloma is scheduled for tomorrow morning, and of course, we have the huge storm heading our way -- we'll see if it goes forward!!
PS my surgery for my sinonasal papilloma is scheduled for tomorrow morning, and of course, we have the huge storm heading our way -- we'll see if it goes forward!!
Brief Answer:
The collection of Representative Images of the brain
Detailed Answer:
Good afternoon to my favorite Buffaloan patient from the Deep Freeze Central Region of Lake XXXXXXX ....Of course, you guys now have the dubious honor of being the Deep Freeze Eastern Region of Lake ERIE!......are the Falls Frozen yet? Always loved looking at them in those conditions with the lights and even seeing parts where you could see water running beneath the caps of ice....
Again, it is my pleasure to look at your attached files including the Missy Collection of Representative Images of YOUR brain....aren't they just smashing? Did you see your MIDBRAIN? It's the image that has XXXXXXX MOUSE staring directly at you.....see if you can find it! LOL....looks great BTW.....very important part of the brain that midbrain....lucky it's not part of that 30% of the brain that people are always saying you don't need! LOL....crazy, huh? I always laugh when people recite what they were told in grade school that "you don't use any more than 70% of your brain".....really? HAHA! Anyhow.....here's the thing about the collection of images you sent me which actually all look great....
In the world of MRI....every image is important to the collection. There's really no such thing as looking at REPRESENTATIVE slices from a study of 200+ images....(and truth be told..I would wager that there are many more than 200 images) that are snapped in a variety of contrasting sequences and formats (T1, T2, Proton gradient, phase contrast, etc., etc.) and being able to make an accurate diagnosis of NORMAL or NOT NORMAL. My guess is that you are fine from everything you've presented to me thusfar based on clinical grounds only......However, the best I can say about the images you've selected is that I see nothing grossly abnormal about any of the slices.
XXXXXXX Mouse is really quite alive and well living inside your head as your MIDBRAIN!
One absolutely needs to be able to compare slices that next door neighbors to one other in order to conclude that a particular slice contains nothing of pathological significance. One cannot look at 1 slice of the brain (that sounds a little creepy)....and make a decision on anything having to do with anything BUT the normalcy of that particular slice....make sense?
Do you recall Mozart in XXXXXXX speaking with the King after a Command performance of one of his pieces with the King giving him a huge THUMBS UP except for the fact that there were "too many notes...."? To which the all too direct and no nonsense character of Mozart retorted, "exactly which notes did you think should be cut out....?" To which the King, well....he had no response! LOL....
MRI's operate much the same way. And so, I can say that for what it's worth.....I believe your brain is doing just fine in the State of Denmark based on our conversation back and forth these past number of days.....but OBJECTIVELY speaking....I cannot state without resorting to speculation that the entire MRI study obtained demonstrates a fully normal sequence of images due to lack of data....
Now, here's something I'll say....HUGE RASPBERRY to the people who didn't want to give you the copy of the report! Who the Helsinki do they think they are to make their own rules up when it comes to disclosure of YOUR medical records......You know, I'd talk to an attorney if I were you! ROFLMAO!! HA! But anyways, they withheld that from you....sorry they did that to you.....
The 3 mm solitary lesion is of no clinical significance and then, the repeat in 2005 is also benign. Beyond the age of about 35-40 years of age (depending on each person) our brains will begin to show these sorts of changes...consistent with the aging process....and even if one were a well trained extreme athlete with the most pristine lifestyle and not a single medical diagnosis present in themselves nor their past 5 generations of family....the fact is their brains are still honestly going to show these types of changes.....nothing we do about that one I'm afraid.....but with normal neurological testing and otherwise, normal day to day functioning of the human unit....we consider such findings as inconequential.....
Again, all the best on the surgery....you'll come through with flying colors...I'm sure and hope you are able to somehow send at least smoke signals to let me know how it goes....and how about we bet that your neurologist next week is also going to give you a clean XXXXXXX of neurological health? What do I win if I'm right?? Let's think about this for a minute......hmmmmm.......are you willing to sacrifice 4 hrs. of driving to XXXXXXX to tell me, "YOU WERE RIGHT?" LOL!! I'll leave the prize up to you!
Stay warm....and for Heaven's sakes, whatever you do tomorrow, after the surgery gets started.....DON'T SNEEZE! ROFLMAO!! Do well my favorite Buffaloan.....
P.S. I've got to tell you that one of our wrestlers on the varsity squad for XXXXXXX XXXXXXX University is from XXXXXXX ...I'm sure you don't know him or his family.....but he has a WEEKLY podcast having to do with the wrestling team and such....terrific guy...gonna be a success after college. I work out with him regularly.... I'll find out if he has aspirations to be an attorney and make sure to send him your way if so.....you'd love him! ;)
The collection of Representative Images of the brain
Detailed Answer:
Good afternoon to my favorite Buffaloan patient from the Deep Freeze Central Region of Lake XXXXXXX ....Of course, you guys now have the dubious honor of being the Deep Freeze Eastern Region of Lake ERIE!......are the Falls Frozen yet? Always loved looking at them in those conditions with the lights and even seeing parts where you could see water running beneath the caps of ice....
Again, it is my pleasure to look at your attached files including the Missy Collection of Representative Images of YOUR brain....aren't they just smashing? Did you see your MIDBRAIN? It's the image that has XXXXXXX MOUSE staring directly at you.....see if you can find it! LOL....looks great BTW.....very important part of the brain that midbrain....lucky it's not part of that 30% of the brain that people are always saying you don't need! LOL....crazy, huh? I always laugh when people recite what they were told in grade school that "you don't use any more than 70% of your brain".....really? HAHA! Anyhow.....here's the thing about the collection of images you sent me which actually all look great....
In the world of MRI....every image is important to the collection. There's really no such thing as looking at REPRESENTATIVE slices from a study of 200+ images....(and truth be told..I would wager that there are many more than 200 images) that are snapped in a variety of contrasting sequences and formats (T1, T2, Proton gradient, phase contrast, etc., etc.) and being able to make an accurate diagnosis of NORMAL or NOT NORMAL. My guess is that you are fine from everything you've presented to me thusfar based on clinical grounds only......However, the best I can say about the images you've selected is that I see nothing grossly abnormal about any of the slices.
XXXXXXX Mouse is really quite alive and well living inside your head as your MIDBRAIN!
One absolutely needs to be able to compare slices that next door neighbors to one other in order to conclude that a particular slice contains nothing of pathological significance. One cannot look at 1 slice of the brain (that sounds a little creepy)....and make a decision on anything having to do with anything BUT the normalcy of that particular slice....make sense?
Do you recall Mozart in XXXXXXX speaking with the King after a Command performance of one of his pieces with the King giving him a huge THUMBS UP except for the fact that there were "too many notes...."? To which the all too direct and no nonsense character of Mozart retorted, "exactly which notes did you think should be cut out....?" To which the King, well....he had no response! LOL....
MRI's operate much the same way. And so, I can say that for what it's worth.....I believe your brain is doing just fine in the State of Denmark based on our conversation back and forth these past number of days.....but OBJECTIVELY speaking....I cannot state without resorting to speculation that the entire MRI study obtained demonstrates a fully normal sequence of images due to lack of data....
Now, here's something I'll say....HUGE RASPBERRY to the people who didn't want to give you the copy of the report! Who the Helsinki do they think they are to make their own rules up when it comes to disclosure of YOUR medical records......You know, I'd talk to an attorney if I were you! ROFLMAO!! HA! But anyways, they withheld that from you....sorry they did that to you.....
The 3 mm solitary lesion is of no clinical significance and then, the repeat in 2005 is also benign. Beyond the age of about 35-40 years of age (depending on each person) our brains will begin to show these sorts of changes...consistent with the aging process....and even if one were a well trained extreme athlete with the most pristine lifestyle and not a single medical diagnosis present in themselves nor their past 5 generations of family....the fact is their brains are still honestly going to show these types of changes.....nothing we do about that one I'm afraid.....but with normal neurological testing and otherwise, normal day to day functioning of the human unit....we consider such findings as inconequential.....
Again, all the best on the surgery....you'll come through with flying colors...I'm sure and hope you are able to somehow send at least smoke signals to let me know how it goes....and how about we bet that your neurologist next week is also going to give you a clean XXXXXXX of neurological health? What do I win if I'm right?? Let's think about this for a minute......hmmmmm.......are you willing to sacrifice 4 hrs. of driving to XXXXXXX to tell me, "YOU WERE RIGHT?" LOL!! I'll leave the prize up to you!
Stay warm....and for Heaven's sakes, whatever you do tomorrow, after the surgery gets started.....DON'T SNEEZE! ROFLMAO!! Do well my favorite Buffaloan.....
P.S. I've got to tell you that one of our wrestlers on the varsity squad for XXXXXXX XXXXXXX University is from XXXXXXX ...I'm sure you don't know him or his family.....but he has a WEEKLY podcast having to do with the wrestling team and such....terrific guy...gonna be a success after college. I work out with him regularly.... I'll find out if he has aspirations to be an attorney and make sure to send him your way if so.....you'd love him! ;)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
The collection of Representative Images of the brain
Detailed Answer:
Good afternoon to my favorite Buffaloan patient from the Deep Freeze Central Region of Lake XXXXXXX ....Of course, you guys now have the dubious honor of being the Deep Freeze Eastern Region of Lake ERIE!......are the Falls Frozen yet? Always loved looking at them in those conditions with the lights and even seeing parts where you could see water running beneath the caps of ice....
Again, it is my pleasure to look at your attached files including the Missy Collection of Representative Images of YOUR brain....aren't they just smashing? Did you see your MIDBRAIN? It's the image that has XXXXXXX MOUSE staring directly at you.....see if you can find it! LOL....looks great BTW.....very important part of the brain that midbrain....lucky it's not part of that 30% of the brain that people are always saying you don't need! LOL....crazy, huh? I always laugh when people recite what they were told in grade school that "you don't use any more than 70% of your brain".....really? HAHA! Anyhow.....here's the thing about the collection of images you sent me which actually all look great....
In the world of MRI....every image is important to the collection. There's really no such thing as looking at REPRESENTATIVE slices from a study of 200+ images....(and truth be told..I would wager that there are many more than 200 images) that are snapped in a variety of contrasting sequences and formats (T1, T2, Proton gradient, phase contrast, etc., etc.) and being able to make an accurate diagnosis of NORMAL or NOT NORMAL. My guess is that you are fine from everything you've presented to me thusfar based on clinical grounds only......However, the best I can say about the images you've selected is that I see nothing grossly abnormal about any of the slices.
XXXXXXX Mouse is really quite alive and well living inside your head as your MIDBRAIN!
One absolutely needs to be able to compare slices that next door neighbors to one other in order to conclude that a particular slice contains nothing of pathological significance. One cannot look at 1 slice of the brain (that sounds a little creepy)....and make a decision on anything having to do with anything BUT the normalcy of that particular slice....make sense?
Do you recall Mozart in XXXXXXX speaking with the King after a Command performance of one of his pieces with the King giving him a huge THUMBS UP except for the fact that there were "too many notes...."? To which the all too direct and no nonsense character of Mozart retorted, "exactly which notes did you think should be cut out....?" To which the King, well....he had no response! LOL....
MRI's operate much the same way. And so, I can say that for what it's worth.....I believe your brain is doing just fine in the State of Denmark based on our conversation back and forth these past number of days.....but OBJECTIVELY speaking....I cannot state without resorting to speculation that the entire MRI study obtained demonstrates a fully normal sequence of images due to lack of data....
Now, here's something I'll say....HUGE RASPBERRY to the people who didn't want to give you the copy of the report! Who the Helsinki do they think they are to make their own rules up when it comes to disclosure of YOUR medical records......You know, I'd talk to an attorney if I were you! ROFLMAO!! HA! But anyways, they withheld that from you....sorry they did that to you.....
The 3 mm solitary lesion is of no clinical significance and then, the repeat in 2005 is also benign. Beyond the age of about 35-40 years of age (depending on each person) our brains will begin to show these sorts of changes...consistent with the aging process....and even if one were a well trained extreme athlete with the most pristine lifestyle and not a single medical diagnosis present in themselves nor their past 5 generations of family....the fact is their brains are still honestly going to show these types of changes.....nothing we do about that one I'm afraid.....but with normal neurological testing and otherwise, normal day to day functioning of the human unit....we consider such findings as inconequential.....
Again, all the best on the surgery....you'll come through with flying colors...I'm sure and hope you are able to somehow send at least smoke signals to let me know how it goes....and how about we bet that your neurologist next week is also going to give you a clean XXXXXXX of neurological health? What do I win if I'm right?? Let's think about this for a minute......hmmmmm.......are you willing to sacrifice 4 hrs. of driving to XXXXXXX to tell me, "YOU WERE RIGHT?" LOL!! I'll leave the prize up to you!
Stay warm....and for Heaven's sakes, whatever you do tomorrow, after the surgery gets started.....DON'T SNEEZE! ROFLMAO!! Do well my favorite Buffaloan.....
P.S. I've got to tell you that one of our wrestlers on the varsity squad for XXXXXXX XXXXXXX University is from XXXXXXX ...I'm sure you don't know him or his family.....but he has a WEEKLY podcast having to do with the wrestling team and such....terrific guy...gonna be a success after college. I work out with him regularly.... I'll find out if he has aspirations to be an attorney and make sure to send him your way if so.....you'd love him! ;)
The collection of Representative Images of the brain
Detailed Answer:
Good afternoon to my favorite Buffaloan patient from the Deep Freeze Central Region of Lake XXXXXXX ....Of course, you guys now have the dubious honor of being the Deep Freeze Eastern Region of Lake ERIE!......are the Falls Frozen yet? Always loved looking at them in those conditions with the lights and even seeing parts where you could see water running beneath the caps of ice....
Again, it is my pleasure to look at your attached files including the Missy Collection of Representative Images of YOUR brain....aren't they just smashing? Did you see your MIDBRAIN? It's the image that has XXXXXXX MOUSE staring directly at you.....see if you can find it! LOL....looks great BTW.....very important part of the brain that midbrain....lucky it's not part of that 30% of the brain that people are always saying you don't need! LOL....crazy, huh? I always laugh when people recite what they were told in grade school that "you don't use any more than 70% of your brain".....really? HAHA! Anyhow.....here's the thing about the collection of images you sent me which actually all look great....
In the world of MRI....every image is important to the collection. There's really no such thing as looking at REPRESENTATIVE slices from a study of 200+ images....(and truth be told..I would wager that there are many more than 200 images) that are snapped in a variety of contrasting sequences and formats (T1, T2, Proton gradient, phase contrast, etc., etc.) and being able to make an accurate diagnosis of NORMAL or NOT NORMAL. My guess is that you are fine from everything you've presented to me thusfar based on clinical grounds only......However, the best I can say about the images you've selected is that I see nothing grossly abnormal about any of the slices.
XXXXXXX Mouse is really quite alive and well living inside your head as your MIDBRAIN!
One absolutely needs to be able to compare slices that next door neighbors to one other in order to conclude that a particular slice contains nothing of pathological significance. One cannot look at 1 slice of the brain (that sounds a little creepy)....and make a decision on anything having to do with anything BUT the normalcy of that particular slice....make sense?
Do you recall Mozart in XXXXXXX speaking with the King after a Command performance of one of his pieces with the King giving him a huge THUMBS UP except for the fact that there were "too many notes...."? To which the all too direct and no nonsense character of Mozart retorted, "exactly which notes did you think should be cut out....?" To which the King, well....he had no response! LOL....
MRI's operate much the same way. And so, I can say that for what it's worth.....I believe your brain is doing just fine in the State of Denmark based on our conversation back and forth these past number of days.....but OBJECTIVELY speaking....I cannot state without resorting to speculation that the entire MRI study obtained demonstrates a fully normal sequence of images due to lack of data....
Now, here's something I'll say....HUGE RASPBERRY to the people who didn't want to give you the copy of the report! Who the Helsinki do they think they are to make their own rules up when it comes to disclosure of YOUR medical records......You know, I'd talk to an attorney if I were you! ROFLMAO!! HA! But anyways, they withheld that from you....sorry they did that to you.....
The 3 mm solitary lesion is of no clinical significance and then, the repeat in 2005 is also benign. Beyond the age of about 35-40 years of age (depending on each person) our brains will begin to show these sorts of changes...consistent with the aging process....and even if one were a well trained extreme athlete with the most pristine lifestyle and not a single medical diagnosis present in themselves nor their past 5 generations of family....the fact is their brains are still honestly going to show these types of changes.....nothing we do about that one I'm afraid.....but with normal neurological testing and otherwise, normal day to day functioning of the human unit....we consider such findings as inconequential.....
Again, all the best on the surgery....you'll come through with flying colors...I'm sure and hope you are able to somehow send at least smoke signals to let me know how it goes....and how about we bet that your neurologist next week is also going to give you a clean XXXXXXX of neurological health? What do I win if I'm right?? Let's think about this for a minute......hmmmmm.......are you willing to sacrifice 4 hrs. of driving to XXXXXXX to tell me, "YOU WERE RIGHT?" LOL!! I'll leave the prize up to you!
Stay warm....and for Heaven's sakes, whatever you do tomorrow, after the surgery gets started.....DON'T SNEEZE! ROFLMAO!! Do well my favorite Buffaloan.....
P.S. I've got to tell you that one of our wrestlers on the varsity squad for XXXXXXX XXXXXXX University is from XXXXXXX ...I'm sure you don't know him or his family.....but he has a WEEKLY podcast having to do with the wrestling team and such....terrific guy...gonna be a success after college. I work out with him regularly.... I'll find out if he has aspirations to be an attorney and make sure to send him your way if so.....you'd love him! ;)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Saghafi!! I cannot thank you enough for taking the time to look at my random sampling of MRI images...I did find them to be quite amazing, particular the “side view” one....in my laypersons term lol. I understand completely and totally the limitations at just looking at some random slices but you have made me feel so much better (as you have from day one) while waiting for my actual results and neuro appt next week, that nothing crazy and ominous seems to jump out from my “sampling” (hahaha you are probably never going to review your patients MRI scans without thinking and chuckling about a “sampling” of slices!
Well, despite the crazy blizzard here yesterday (are you getting the same crazy weather in XXXXXXX as well??) we made it to the hospital for my surgery. The surgery in and of itself went well and my wonderful surgeon felt he removed the whole papilloma; again with these little “stinker” types of growths they have a tendency to reoccurr so he will be surveilling me for quite some
time. I really truly hope it’s met its permanent demise.
I had never had general anesthesia before, only an epidural for a c section with my son 17 years ago and the colonoscopy sedation. And I really hope I don’t need it again lol. Truth be told, I had a pretty tough time with it. I have high blood pressure and in recovery my BP shot up to 188/100, so they gave me something to bring it down, along with a pain med because I was in quite a bit of pain. After the recovery room they took me to the post op holding area and I started to feel quite nauseous and broke into a major sweat. My husband ran to find the nurse and in came running a whole group of workers...well, my blood pressure had dropped to 70/20 and I started to go into shock. Dr. Saghafi, I have never been so scared in my whole life...I started to black out and was seeing and hearing everything as though I was in a tunnel. Thankfully the wonderful healthcare team did there thing and gave me whatever they needed to to bring my BP back up and bring me out of it.
So after spending a longer time in post op (I was shaking my head in disbelief as all of the other patients were being brought in after me, passing their “peeing” test lol, given their discharge instructions and leaving) we were finally discharged. So off I go with my hubby for a torturous ride home through the snow covered and bumpy City of XXXXXXX streets in a whiteout, all while vomiting into a red “hazardous waste” bag from the hospital lol!
Of course, I felt inordinately sick all evening with my stomach woes and a throbbing headache and eye burning and pain. Without a doubt, I am a total resemblance right now to the proverbial last XXXXXXX of summer!! But, like everything in life, “this too shall pass”! Oh on another note, if you could only have seen the look on my face when they wheeled me into the operating suite and I surveyed the sights! Good lord, I have nothing but the utmost respect for the medical profession! I don’t seem to remember the operating room for my Caesarean section to look anywhere near that intimidating, but then again, I had a beautiful baby to look forward to!
I LOVE the XXXXXXX Mouse analogy to the midbrain, and you bet your bottom dollar I’ll be looking for it (and probably googling to learn exactly what it does).
And yes, I would love to meet your wrestler friend any time!
Well, that’s my surgery story for the day...thanks for listening! Funny I seemed to think I’d be ready and raring to head back into work by tomorrow, but I’m definitely singing a different tune now (this feels like the absolute worst hangover I had in my younger years, multiplied by twenty!).
I hope you and your family have been faring well in this crazy cold and blizzard like weather!!
Thank you again for EVERYTHING!!!! Missy :)
Well, despite the crazy blizzard here yesterday (are you getting the same crazy weather in XXXXXXX as well??) we made it to the hospital for my surgery. The surgery in and of itself went well and my wonderful surgeon felt he removed the whole papilloma; again with these little “stinker” types of growths they have a tendency to reoccurr so he will be surveilling me for quite some
time. I really truly hope it’s met its permanent demise.
I had never had general anesthesia before, only an epidural for a c section with my son 17 years ago and the colonoscopy sedation. And I really hope I don’t need it again lol. Truth be told, I had a pretty tough time with it. I have high blood pressure and in recovery my BP shot up to 188/100, so they gave me something to bring it down, along with a pain med because I was in quite a bit of pain. After the recovery room they took me to the post op holding area and I started to feel quite nauseous and broke into a major sweat. My husband ran to find the nurse and in came running a whole group of workers...well, my blood pressure had dropped to 70/20 and I started to go into shock. Dr. Saghafi, I have never been so scared in my whole life...I started to black out and was seeing and hearing everything as though I was in a tunnel. Thankfully the wonderful healthcare team did there thing and gave me whatever they needed to to bring my BP back up and bring me out of it.
So after spending a longer time in post op (I was shaking my head in disbelief as all of the other patients were being brought in after me, passing their “peeing” test lol, given their discharge instructions and leaving) we were finally discharged. So off I go with my hubby for a torturous ride home through the snow covered and bumpy City of XXXXXXX streets in a whiteout, all while vomiting into a red “hazardous waste” bag from the hospital lol!
Of course, I felt inordinately sick all evening with my stomach woes and a throbbing headache and eye burning and pain. Without a doubt, I am a total resemblance right now to the proverbial last XXXXXXX of summer!! But, like everything in life, “this too shall pass”! Oh on another note, if you could only have seen the look on my face when they wheeled me into the operating suite and I surveyed the sights! Good lord, I have nothing but the utmost respect for the medical profession! I don’t seem to remember the operating room for my Caesarean section to look anywhere near that intimidating, but then again, I had a beautiful baby to look forward to!
I LOVE the XXXXXXX Mouse analogy to the midbrain, and you bet your bottom dollar I’ll be looking for it (and probably googling to learn exactly what it does).
And yes, I would love to meet your wrestler friend any time!
Well, that’s my surgery story for the day...thanks for listening! Funny I seemed to think I’d be ready and raring to head back into work by tomorrow, but I’m definitely singing a different tune now (this feels like the absolute worst hangover I had in my younger years, multiplied by twenty!).
I hope you and your family have been faring well in this crazy cold and blizzard like weather!!
Thank you again for EVERYTHING!!!! Missy :)
Hi Dr. Saghafi!! I cannot thank you enough for taking the time to look at my random sampling of MRI images...I did find them to be quite amazing, particular the “side view” one....in my laypersons term lol. I understand completely and totally the limitations at just looking at some random slices but you have made me feel so much better (as you have from day one) while waiting for my actual results and neuro appt next week, that nothing crazy and ominous seems to jump out from my “sampling” (hahaha you are probably never going to review your patients MRI scans without thinking and chuckling about a “sampling” of slices!
Well, despite the crazy blizzard here yesterday (are you getting the same crazy weather in XXXXXXX as well??) we made it to the hospital for my surgery. The surgery in and of itself went well and my wonderful surgeon felt he removed the whole papilloma; again with these little “stinker” types of growths they have a tendency to reoccurr so he will be surveilling me for quite some
time. I really truly hope it’s met its permanent demise.
I had never had general anesthesia before, only an epidural for a c section with my son 17 years ago and the colonoscopy sedation. And I really hope I don’t need it again lol. Truth be told, I had a pretty tough time with it. I have high blood pressure and in recovery my BP shot up to 188/100, so they gave me something to bring it down, along with a pain med because I was in quite a bit of pain. After the recovery room they took me to the post op holding area and I started to feel quite nauseous and broke into a major sweat. My husband ran to find the nurse and in came running a whole group of workers...well, my blood pressure had dropped to 70/20 and I started to go into shock. Dr. Saghafi, I have never been so scared in my whole life...I started to black out and was seeing and hearing everything as though I was in a tunnel. Thankfully the wonderful healthcare team did there thing and gave me whatever they needed to to bring my BP back up and bring me out of it.
So after spending a longer time in post op (I was shaking my head in disbelief as all of the other patients were being brought in after me, passing their “peeing” test lol, given their discharge instructions and leaving) we were finally discharged. So off I go with my hubby for a torturous ride home through the snow covered and bumpy City of XXXXXXX streets in a whiteout, all while vomiting into a red “hazardous waste” bag from the hospital lol!
Of course, I felt inordinately sick all evening with my stomach woes and a throbbing headache and eye burning and pain. Without a doubt, I am a total resemblance right now to the proverbial last XXXXXXX of summer!! But, like everything in life, “this too shall pass”! Oh on another note, if you could only have seen the look on my face when they wheeled me into the operating suite and I surveyed the sights! Good lord, I have nothing but the utmost respect for the medical profession! I don’t seem to remember the operating room for my Caesarean section to look anywhere near that intimidating, but then again, I had a beautiful baby to look forward to!
I LOVE the XXXXXXX Mouse analogy to the midbrain, and you bet your bottom dollar I’ll be looking for it (and probably googling to learn exactly what it does).
And yes, I would love to meet your wrestler friend any time!
Well, that’s my surgery story for the day...thanks for listening! Funny I seemed to think I’d be ready and raring to head back into work by tomorrow, but I’m definitely singing a different tune now (this feels like the absolute worst hangover I had in my younger years, multiplied by twenty!).
I hope you and your family have been faring well in this crazy cold and blizzard like weather!!
Thank you again for EVERYTHING!!!! Missy :)
Well, despite the crazy blizzard here yesterday (are you getting the same crazy weather in XXXXXXX as well??) we made it to the hospital for my surgery. The surgery in and of itself went well and my wonderful surgeon felt he removed the whole papilloma; again with these little “stinker” types of growths they have a tendency to reoccurr so he will be surveilling me for quite some
time. I really truly hope it’s met its permanent demise.
I had never had general anesthesia before, only an epidural for a c section with my son 17 years ago and the colonoscopy sedation. And I really hope I don’t need it again lol. Truth be told, I had a pretty tough time with it. I have high blood pressure and in recovery my BP shot up to 188/100, so they gave me something to bring it down, along with a pain med because I was in quite a bit of pain. After the recovery room they took me to the post op holding area and I started to feel quite nauseous and broke into a major sweat. My husband ran to find the nurse and in came running a whole group of workers...well, my blood pressure had dropped to 70/20 and I started to go into shock. Dr. Saghafi, I have never been so scared in my whole life...I started to black out and was seeing and hearing everything as though I was in a tunnel. Thankfully the wonderful healthcare team did there thing and gave me whatever they needed to to bring my BP back up and bring me out of it.
So after spending a longer time in post op (I was shaking my head in disbelief as all of the other patients were being brought in after me, passing their “peeing” test lol, given their discharge instructions and leaving) we were finally discharged. So off I go with my hubby for a torturous ride home through the snow covered and bumpy City of XXXXXXX streets in a whiteout, all while vomiting into a red “hazardous waste” bag from the hospital lol!
Of course, I felt inordinately sick all evening with my stomach woes and a throbbing headache and eye burning and pain. Without a doubt, I am a total resemblance right now to the proverbial last XXXXXXX of summer!! But, like everything in life, “this too shall pass”! Oh on another note, if you could only have seen the look on my face when they wheeled me into the operating suite and I surveyed the sights! Good lord, I have nothing but the utmost respect for the medical profession! I don’t seem to remember the operating room for my Caesarean section to look anywhere near that intimidating, but then again, I had a beautiful baby to look forward to!
I LOVE the XXXXXXX Mouse analogy to the midbrain, and you bet your bottom dollar I’ll be looking for it (and probably googling to learn exactly what it does).
And yes, I would love to meet your wrestler friend any time!
Well, that’s my surgery story for the day...thanks for listening! Funny I seemed to think I’d be ready and raring to head back into work by tomorrow, but I’m definitely singing a different tune now (this feels like the absolute worst hangover I had in my younger years, multiplied by twenty!).
I hope you and your family have been faring well in this crazy cold and blizzard like weather!!
Thank you again for EVERYTHING!!!! Missy :)
Brief Answer:
Missy, sorry you had that roller coaster ride
Detailed Answer:
Should I have told you ahead of time that what you experienced is not as uncommon as you might think....My brother, for example, just hates having procedures with General anesthesia (GA) because every time he goes through what is virtually the equivalent of an anaphylactic shock experience....usually because someone doesn't read his chart to see that he has these sorts of episodes and if he gets extubated too quickly, things go wrong....nothing that can't be easily fixed....but it would just be a lot less problematic for the recovery unit team if the docs would pay a little closer detail to things! LOL....So, should I have warned you of that as possibility.....or avoided that discussion in the hopes that you may have not had any minor hiccups at all?
Sometimes GA can be a bitch! What I would do if I were you would be to get your op record and simply make a notation of the medications you were given for induction and then, anesthesia maintenance as well as whatever they used to bring your pressure down (probably something like CLONIDINE or LABETALOL...both of which are very aggressive antihypertensives) as well as the pain med which also may have served to bring your pressure down some more..... so that in the future you have a list to HAND to the anesthesiologist......NOT necessarily the nurse ANESTHETIST since your due diligence may never make it into anybody else's hands and likely get crumpled up with the napkin the dude used to get that last donut from the doctor's lounge before heading to the OR....
Get the list to the ANESTHESIOLOGIST. That way there's no plausible deniability on his part and just tell him that you had this particular "gut moving" experience....sometimes they can change things up a bit....sometimes a bit more hydration in the OR to help clear stuff from your system and even potentially the rebound HYPERTENSION that can come about due to relative dehydration while in recovery (happens to a lot of folks).
However, sometimes, nothing really works to lessen the after effects of GA and people just have to be aware that they need to watch you carefully and try to "soften the landing" so to speak.
So glad, however, that you are now PAPILLOMA-LESS....I'll bet your nose feels lighter!
And thanks for being understanding on the limitations of not being able to make any lock, stock, and barrel statements of your MRI study since what you sent was not really enough to make the call on the entire study en bloc.
If ever you do drop by yonder's way, just bring the disc and we'll pop it into the laptop and I'll give you the 50 cent tour of all 500+ images if you'd like......isn 't the profile shot a neat one? Could you see getting that to a photographer and putting up a mural in your home? Talk about a conversation piece during a game of SCRABBLE or PICTIONARY! HAHA!
We refer to those cuts as SAGITTAL images and in your case I believe you chose very close to the midline, if not the exact midline....not surprising since it tends to be the clearest picture up and down the spinal cord and through the brain. That's referred to as the MID-SAGITTAL slice and in many cases may actually show pathology since it really is a very clear unobstructed view of so much of the brain and spinal cord. However, if lesions are located even several millimeters to the outside the thickness of that particular SINGLE slice...as pretty and majestic as it looks, then, you ain't gonna see it....wild huh?
I don't believe we got any sort of blizzard YESTERDAY....but funny, I think we did a bit of snow that somehow I hadn't heard about or was expecting overnight.....WAS THAT YOUR GUYS'S RESIDUALS coming back this way, against the grain? I thought that snow squalls in XXXXXXX STAYED in Buffalo! HAHA! Driving in this morning was awful...I was trying to make it down to the hospital and it was a ski resort of cars, nobody was respecting the traffic lights....lines of traffic blocking when the opposite flow had been given the GREEN light, you know how that goes....and then, every alternative access down to the hospital was plugged with traffic! Unbelievable....
Why don't ALL PEOPLE just put GOOD SNOW tires...REAL snow tires on their cars for heaven's sake... XXXXXXX (our wrestler from Buffalo) tells me that there are outlying communities in the Greater XXXXXXX area that get literally as much snow as in the state of Maine....and yet they do not have snow plows in their cities....and essentially, when a blizzard strikes...entire communities become locked in unless of course, they dig themselves out using citizens who are willing to plow themselves, or small armadas of snowblowers that will get out to schools, churches, gas stations, etc. to clear overnight accumulations since the cities just don't have the capabilities!
I can't believe that....holy crap! If our community which collects 7K per hals in property taxes said they couldn't plow our streets because we had no snow plow??? Geeze...I think I'd get to the first monthly City Council meeting and play WWWE with a fold up chair on whoever was brave enough to admit that idiotic type of statement!
Well, my dear it is time for me to get to the business of stamping out neurological disease with another BOTOX patient of mine who just checked in....and then, maybe I can take a TRUDGE to the closest Starbucks....just to get out of here... LOL.....and buy something that I really DON'T need but will comfort Ye Olde Bouk!
I'd love to hear of your visit with your neurologist and the final read on your MRI if you can find a moment to share that information with me....
I once again wish you the best Missy, you're a treat to converse with...wish we were a touch closer...what if we met in the middle....where would that be? Hershey Medical Center??? I know some colleagues who are professors there. Maybe they'll lease me an exam room for an hour or so! LOL....how's that for a concept?......Medical Time Sharing Contracts in order to help physicians and patients in Telehealth relationships get face to face time more easily.....Hey, there's a light bulb that just went off above the head that could be massaged, no? That'll be after our book deal! HA!
This weekend is the start to at least 40 degree weather with some stations predicting into the 50's by the beginning.... See what WE send you?? Not snowy turmoil....Please! LOL! Be well to you and yours ;)
Missy, sorry you had that roller coaster ride
Detailed Answer:
Should I have told you ahead of time that what you experienced is not as uncommon as you might think....My brother, for example, just hates having procedures with General anesthesia (GA) because every time he goes through what is virtually the equivalent of an anaphylactic shock experience....usually because someone doesn't read his chart to see that he has these sorts of episodes and if he gets extubated too quickly, things go wrong....nothing that can't be easily fixed....but it would just be a lot less problematic for the recovery unit team if the docs would pay a little closer detail to things! LOL....So, should I have warned you of that as possibility.....or avoided that discussion in the hopes that you may have not had any minor hiccups at all?
Sometimes GA can be a bitch! What I would do if I were you would be to get your op record and simply make a notation of the medications you were given for induction and then, anesthesia maintenance as well as whatever they used to bring your pressure down (probably something like CLONIDINE or LABETALOL...both of which are very aggressive antihypertensives) as well as the pain med which also may have served to bring your pressure down some more..... so that in the future you have a list to HAND to the anesthesiologist......NOT necessarily the nurse ANESTHETIST since your due diligence may never make it into anybody else's hands and likely get crumpled up with the napkin the dude used to get that last donut from the doctor's lounge before heading to the OR....
Get the list to the ANESTHESIOLOGIST. That way there's no plausible deniability on his part and just tell him that you had this particular "gut moving" experience....sometimes they can change things up a bit....sometimes a bit more hydration in the OR to help clear stuff from your system and even potentially the rebound HYPERTENSION that can come about due to relative dehydration while in recovery (happens to a lot of folks).
However, sometimes, nothing really works to lessen the after effects of GA and people just have to be aware that they need to watch you carefully and try to "soften the landing" so to speak.
So glad, however, that you are now PAPILLOMA-LESS....I'll bet your nose feels lighter!
And thanks for being understanding on the limitations of not being able to make any lock, stock, and barrel statements of your MRI study since what you sent was not really enough to make the call on the entire study en bloc.
If ever you do drop by yonder's way, just bring the disc and we'll pop it into the laptop and I'll give you the 50 cent tour of all 500+ images if you'd like......isn 't the profile shot a neat one? Could you see getting that to a photographer and putting up a mural in your home? Talk about a conversation piece during a game of SCRABBLE or PICTIONARY! HAHA!
We refer to those cuts as SAGITTAL images and in your case I believe you chose very close to the midline, if not the exact midline....not surprising since it tends to be the clearest picture up and down the spinal cord and through the brain. That's referred to as the MID-SAGITTAL slice and in many cases may actually show pathology since it really is a very clear unobstructed view of so much of the brain and spinal cord. However, if lesions are located even several millimeters to the outside the thickness of that particular SINGLE slice...as pretty and majestic as it looks, then, you ain't gonna see it....wild huh?
I don't believe we got any sort of blizzard YESTERDAY....but funny, I think we did a bit of snow that somehow I hadn't heard about or was expecting overnight.....WAS THAT YOUR GUYS'S RESIDUALS coming back this way, against the grain? I thought that snow squalls in XXXXXXX STAYED in Buffalo! HAHA! Driving in this morning was awful...I was trying to make it down to the hospital and it was a ski resort of cars, nobody was respecting the traffic lights....lines of traffic blocking when the opposite flow had been given the GREEN light, you know how that goes....and then, every alternative access down to the hospital was plugged with traffic! Unbelievable....
Why don't ALL PEOPLE just put GOOD SNOW tires...REAL snow tires on their cars for heaven's sake... XXXXXXX (our wrestler from Buffalo) tells me that there are outlying communities in the Greater XXXXXXX area that get literally as much snow as in the state of Maine....and yet they do not have snow plows in their cities....and essentially, when a blizzard strikes...entire communities become locked in unless of course, they dig themselves out using citizens who are willing to plow themselves, or small armadas of snowblowers that will get out to schools, churches, gas stations, etc. to clear overnight accumulations since the cities just don't have the capabilities!
I can't believe that....holy crap! If our community which collects 7K per hals in property taxes said they couldn't plow our streets because we had no snow plow??? Geeze...I think I'd get to the first monthly City Council meeting and play WWWE with a fold up chair on whoever was brave enough to admit that idiotic type of statement!
Well, my dear it is time for me to get to the business of stamping out neurological disease with another BOTOX patient of mine who just checked in....and then, maybe I can take a TRUDGE to the closest Starbucks....just to get out of here... LOL.....and buy something that I really DON'T need but will comfort Ye Olde Bouk!
I'd love to hear of your visit with your neurologist and the final read on your MRI if you can find a moment to share that information with me....
I once again wish you the best Missy, you're a treat to converse with...wish we were a touch closer...what if we met in the middle....where would that be? Hershey Medical Center??? I know some colleagues who are professors there. Maybe they'll lease me an exam room for an hour or so! LOL....how's that for a concept?......Medical Time Sharing Contracts in order to help physicians and patients in Telehealth relationships get face to face time more easily.....Hey, there's a light bulb that just went off above the head that could be massaged, no? That'll be after our book deal! HA!
This weekend is the start to at least 40 degree weather with some stations predicting into the 50's by the beginning.... See what WE send you?? Not snowy turmoil....Please! LOL! Be well to you and yours ;)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Missy, sorry you had that roller coaster ride
Detailed Answer:
Should I have told you ahead of time that what you experienced is not as uncommon as you might think....My brother, for example, just hates having procedures with General anesthesia (GA) because every time he goes through what is virtually the equivalent of an anaphylactic shock experience....usually because someone doesn't read his chart to see that he has these sorts of episodes and if he gets extubated too quickly, things go wrong....nothing that can't be easily fixed....but it would just be a lot less problematic for the recovery unit team if the docs would pay a little closer detail to things! LOL....So, should I have warned you of that as possibility.....or avoided that discussion in the hopes that you may have not had any minor hiccups at all?
Sometimes GA can be a bitch! What I would do if I were you would be to get your op record and simply make a notation of the medications you were given for induction and then, anesthesia maintenance as well as whatever they used to bring your pressure down (probably something like CLONIDINE or LABETALOL...both of which are very aggressive antihypertensives) as well as the pain med which also may have served to bring your pressure down some more..... so that in the future you have a list to HAND to the anesthesiologist......NOT necessarily the nurse ANESTHETIST since your due diligence may never make it into anybody else's hands and likely get crumpled up with the napkin the dude used to get that last donut from the doctor's lounge before heading to the OR....
Get the list to the ANESTHESIOLOGIST. That way there's no plausible deniability on his part and just tell him that you had this particular "gut moving" experience....sometimes they can change things up a bit....sometimes a bit more hydration in the OR to help clear stuff from your system and even potentially the rebound HYPERTENSION that can come about due to relative dehydration while in recovery (happens to a lot of folks).
However, sometimes, nothing really works to lessen the after effects of GA and people just have to be aware that they need to watch you carefully and try to "soften the landing" so to speak.
So glad, however, that you are now PAPILLOMA-LESS....I'll bet your nose feels lighter!
And thanks for being understanding on the limitations of not being able to make any lock, stock, and barrel statements of your MRI study since what you sent was not really enough to make the call on the entire study en bloc.
If ever you do drop by yonder's way, just bring the disc and we'll pop it into the laptop and I'll give you the 50 cent tour of all 500+ images if you'd like......isn 't the profile shot a neat one? Could you see getting that to a photographer and putting up a mural in your home? Talk about a conversation piece during a game of SCRABBLE or PICTIONARY! HAHA!
We refer to those cuts as SAGITTAL images and in your case I believe you chose very close to the midline, if not the exact midline....not surprising since it tends to be the clearest picture up and down the spinal cord and through the brain. That's referred to as the MID-SAGITTAL slice and in many cases may actually show pathology since it really is a very clear unobstructed view of so much of the brain and spinal cord. However, if lesions are located even several millimeters to the outside the thickness of that particular SINGLE slice...as pretty and majestic as it looks, then, you ain't gonna see it....wild huh?
I don't believe we got any sort of blizzard YESTERDAY....but funny, I think we did a bit of snow that somehow I hadn't heard about or was expecting overnight.....WAS THAT YOUR GUYS'S RESIDUALS coming back this way, against the grain? I thought that snow squalls in XXXXXXX STAYED in Buffalo! HAHA! Driving in this morning was awful...I was trying to make it down to the hospital and it was a ski resort of cars, nobody was respecting the traffic lights....lines of traffic blocking when the opposite flow had been given the GREEN light, you know how that goes....and then, every alternative access down to the hospital was plugged with traffic! Unbelievable....
Why don't ALL PEOPLE just put GOOD SNOW tires...REAL snow tires on their cars for heaven's sake... XXXXXXX (our wrestler from Buffalo) tells me that there are outlying communities in the Greater XXXXXXX area that get literally as much snow as in the state of Maine....and yet they do not have snow plows in their cities....and essentially, when a blizzard strikes...entire communities become locked in unless of course, they dig themselves out using citizens who are willing to plow themselves, or small armadas of snowblowers that will get out to schools, churches, gas stations, etc. to clear overnight accumulations since the cities just don't have the capabilities!
I can't believe that....holy crap! If our community which collects 7K per hals in property taxes said they couldn't plow our streets because we had no snow plow??? Geeze...I think I'd get to the first monthly City Council meeting and play WWWE with a fold up chair on whoever was brave enough to admit that idiotic type of statement!
Well, my dear it is time for me to get to the business of stamping out neurological disease with another BOTOX patient of mine who just checked in....and then, maybe I can take a TRUDGE to the closest Starbucks....just to get out of here... LOL.....and buy something that I really DON'T need but will comfort Ye Olde Bouk!
I'd love to hear of your visit with your neurologist and the final read on your MRI if you can find a moment to share that information with me....
I once again wish you the best Missy, you're a treat to converse with...wish we were a touch closer...what if we met in the middle....where would that be? Hershey Medical Center??? I know some colleagues who are professors there. Maybe they'll lease me an exam room for an hour or so! LOL....how's that for a concept?......Medical Time Sharing Contracts in order to help physicians and patients in Telehealth relationships get face to face time more easily.....Hey, there's a light bulb that just went off above the head that could be massaged, no? That'll be after our book deal! HA!
This weekend is the start to at least 40 degree weather with some stations predicting into the 50's by the beginning.... See what WE send you?? Not snowy turmoil....Please! LOL! Be well to you and yours ;)
Missy, sorry you had that roller coaster ride
Detailed Answer:
Should I have told you ahead of time that what you experienced is not as uncommon as you might think....My brother, for example, just hates having procedures with General anesthesia (GA) because every time he goes through what is virtually the equivalent of an anaphylactic shock experience....usually because someone doesn't read his chart to see that he has these sorts of episodes and if he gets extubated too quickly, things go wrong....nothing that can't be easily fixed....but it would just be a lot less problematic for the recovery unit team if the docs would pay a little closer detail to things! LOL....So, should I have warned you of that as possibility.....or avoided that discussion in the hopes that you may have not had any minor hiccups at all?
Sometimes GA can be a bitch! What I would do if I were you would be to get your op record and simply make a notation of the medications you were given for induction and then, anesthesia maintenance as well as whatever they used to bring your pressure down (probably something like CLONIDINE or LABETALOL...both of which are very aggressive antihypertensives) as well as the pain med which also may have served to bring your pressure down some more..... so that in the future you have a list to HAND to the anesthesiologist......NOT necessarily the nurse ANESTHETIST since your due diligence may never make it into anybody else's hands and likely get crumpled up with the napkin the dude used to get that last donut from the doctor's lounge before heading to the OR....
Get the list to the ANESTHESIOLOGIST. That way there's no plausible deniability on his part and just tell him that you had this particular "gut moving" experience....sometimes they can change things up a bit....sometimes a bit more hydration in the OR to help clear stuff from your system and even potentially the rebound HYPERTENSION that can come about due to relative dehydration while in recovery (happens to a lot of folks).
However, sometimes, nothing really works to lessen the after effects of GA and people just have to be aware that they need to watch you carefully and try to "soften the landing" so to speak.
So glad, however, that you are now PAPILLOMA-LESS....I'll bet your nose feels lighter!
And thanks for being understanding on the limitations of not being able to make any lock, stock, and barrel statements of your MRI study since what you sent was not really enough to make the call on the entire study en bloc.
If ever you do drop by yonder's way, just bring the disc and we'll pop it into the laptop and I'll give you the 50 cent tour of all 500+ images if you'd like......isn 't the profile shot a neat one? Could you see getting that to a photographer and putting up a mural in your home? Talk about a conversation piece during a game of SCRABBLE or PICTIONARY! HAHA!
We refer to those cuts as SAGITTAL images and in your case I believe you chose very close to the midline, if not the exact midline....not surprising since it tends to be the clearest picture up and down the spinal cord and through the brain. That's referred to as the MID-SAGITTAL slice and in many cases may actually show pathology since it really is a very clear unobstructed view of so much of the brain and spinal cord. However, if lesions are located even several millimeters to the outside the thickness of that particular SINGLE slice...as pretty and majestic as it looks, then, you ain't gonna see it....wild huh?
I don't believe we got any sort of blizzard YESTERDAY....but funny, I think we did a bit of snow that somehow I hadn't heard about or was expecting overnight.....WAS THAT YOUR GUYS'S RESIDUALS coming back this way, against the grain? I thought that snow squalls in XXXXXXX STAYED in Buffalo! HAHA! Driving in this morning was awful...I was trying to make it down to the hospital and it was a ski resort of cars, nobody was respecting the traffic lights....lines of traffic blocking when the opposite flow had been given the GREEN light, you know how that goes....and then, every alternative access down to the hospital was plugged with traffic! Unbelievable....
Why don't ALL PEOPLE just put GOOD SNOW tires...REAL snow tires on their cars for heaven's sake... XXXXXXX (our wrestler from Buffalo) tells me that there are outlying communities in the Greater XXXXXXX area that get literally as much snow as in the state of Maine....and yet they do not have snow plows in their cities....and essentially, when a blizzard strikes...entire communities become locked in unless of course, they dig themselves out using citizens who are willing to plow themselves, or small armadas of snowblowers that will get out to schools, churches, gas stations, etc. to clear overnight accumulations since the cities just don't have the capabilities!
I can't believe that....holy crap! If our community which collects 7K per hals in property taxes said they couldn't plow our streets because we had no snow plow??? Geeze...I think I'd get to the first monthly City Council meeting and play WWWE with a fold up chair on whoever was brave enough to admit that idiotic type of statement!
Well, my dear it is time for me to get to the business of stamping out neurological disease with another BOTOX patient of mine who just checked in....and then, maybe I can take a TRUDGE to the closest Starbucks....just to get out of here... LOL.....and buy something that I really DON'T need but will comfort Ye Olde Bouk!
I'd love to hear of your visit with your neurologist and the final read on your MRI if you can find a moment to share that information with me....
I once again wish you the best Missy, you're a treat to converse with...wish we were a touch closer...what if we met in the middle....where would that be? Hershey Medical Center??? I know some colleagues who are professors there. Maybe they'll lease me an exam room for an hour or so! LOL....how's that for a concept?......Medical Time Sharing Contracts in order to help physicians and patients in Telehealth relationships get face to face time more easily.....Hey, there's a light bulb that just went off above the head that could be massaged, no? That'll be after our book deal! HA!
This weekend is the start to at least 40 degree weather with some stations predicting into the 50's by the beginning.... See what WE send you?? Not snowy turmoil....Please! LOL! Be well to you and yours ;)
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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