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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello Dr. Saghafi!! Guess who it is -- none other

Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2429 Questions

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Posted on Mon, 11 Mar 2019 in General Health
Question: Hello Dr. Saghafi!! Guess who it is -- none other than your friend from Western New York, Missy! Since I need to take a break from the ever-growing stacks of files on my desk, there's nothing I'd rather do at the moment than correspond with my favorite online doctor!

Some day you will need to share with me your secrets for having so much energy for not only your demanding profession, but also for your wonderful "side-gigs" of coaching wrestling and sharing your musical talent! Is it those Jolly Rancher candies?? Funny you mentioned those -- not too long ago I was speaking with a neighbor who had driven down to Florida nearly non-stop, and he mentioned that his secret to staying awake behind the wheel was sucking on Jolly Ranchers lmao! I think I'm definitely going to buy some next time I'm at the grocery store!

In all seriousness, I absolutely love the juxtaposition of your wrestling and musical pursuits -- you are without a doubt a true renaissance man! South Pacific was my father's ABSOLUTE favorite musical of all time! I remember him playing the vinyl record on the stereo when I was a young girl, listening to "Some Enchanted Evening" and of course, "I'm Gonna Wash that Man right out of my Hair"!! Brings back such wonderful memories! That is going to be an amazing performance for you to be a part of -- how exciting!

I cannot thank you enough for your thoughts on my therapy and progress with my health anxiety. I would say that I have undoubtedly made progress from where I was two and a half years ago -- back in Spring of 2016 I thought I would be able to function without being on cymbalta, and under my doctor's guidance, I weaned myself slowly off of it. Well. that did not go so well and I found myself quite nervous and agitated; the PA at my doctor's office suggested trying wellbutrin, which was a nightmare. It made me nearly manic, and extremely anxious -- while on it, I happened to see an article on Facebook about skin cancer and lo and behold, I convinced myself that I had basal cell skin cancer (I was wrong -- the little bumps on my face were merely sebaceous hyperplasia). Mind you, I had some degree of health anxiety since my teenage years, but the combination of being on the wrong medication and googling skin cancers (yes, there is LITERALLY a picture of a man online with only one-half of his face when you google "basal cell skin cancer" -- good lord!!) sent me into a complete tailspin at the time. Long story short, I ended up back on cymbalta, which seems to be the best SSRI for me, but the health anxiety has essentially continued since.

I would say, however, that I am definitely in a better place mentally and feel that I have developed some strategies for dealing with the intrusive health worries when they start to surface. I have also come to learn what my potential "triggers" are (most definitely the googling of health and medical issues) and am working to avoid the same.

If nothing else, I do believe that my latest "issues" with my nasal papilloma and muscle twitching (by the way, I oftentimes feel guilt in over-reacting to my "issues" such as those, seeing as there are so many people out there dealing with much, much, much bigger health conditions and issues!) have not only made me stronger, but have shown me that when health glitches (as you so aptly put it) arise, the best way to respond is simply to "take care of business". When the first ENT told me I had what could be a very dangerous nasal papilloma, of course I panicked, turned to google, and saw the usual incendiary images of poor souls with their eyeballs displaced as a result of tumor growth (good lord, did these people not seek medical attention when they had uncontrollable nosebleeds and completely blocked nasal passages??). Here I am now, papilloma-free, and none the worse for wear, because I "took care of business". All of the lost sleep and worries I had in envisioning the worst possible case scenario were all for naught.

As for my twitching -- well. let's just say it has completely ceased. Perhaps I did rush a bit on that particular issue in consulting a neurologist, but truth be told, as I said before, I feel that perhaps it was meant to be, as I have now completely dismissed the MS and ALS worries for good -- and of course -- I have made a friend in you as a result of the same!

Funny you mentioned my therapy...I had had an appointment scheduled with my therapist for two days prior to my surgery, which I cancelled. I have not as yet made a new appointment to see her. I truly care for her very, very much and she helped me through some of my worst periods, back in 2017. I am just not completely sure that I have been given much in the way of concrete "tools" for dealing with the health anxiety when it starts to surface; perhaps what I am looking for is some more structured cognitive behavioral therapy...? I feel that I am somewhat at a crossroads in terms of staying the course with her as my therapist, or seeking out a new one. As you know all too well, not only is it difficult to "break up" with a therapist (just like a hairdresser lol), but I have so much time and energy invested into my sessions with her, giving her all of my background and history, along with my myriad of health worries as they arose throughout the last two years. It goes without saying, but I would love to hear any thoughts you have on my "quandary". Your input and advice most certainly mean the world to me!

I hope you have been having a great week thus far!! I think I may pack it in here at the office for the evening and head out grocery shopping to "go get me some" Jolly Ranchers!!! Missy :)




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Follow up: Dr. Dariush Saghafi 0 minute later
Hello Dr. Saghafi!! Guess who it is -- none other than your friend from Western New York, Missy! Since I need to take a break from the ever-growing stacks of files on my desk, there's nothing I'd rather do at the moment than correspond with my favorite online doctor!

Some day you will need to share with me your secrets for having so much energy for not only your demanding profession, but also for your wonderful "side-gigs" of coaching wrestling and sharing your musical talent! Is it those Jolly Rancher candies?? Funny you mentioned those -- not too long ago I was speaking with a neighbor who had driven down to Florida nearly non-stop, and he mentioned that his secret to staying awake behind the wheel was sucking on Jolly Ranchers lmao! I think I'm definitely going to buy some next time I'm at the grocery store!

In all seriousness, I absolutely love the juxtaposition of your wrestling and musical pursuits -- you are without a doubt a true renaissance man! South Pacific was my father's ABSOLUTE favorite musical of all time! I remember him playing the vinyl record on the stereo when I was a young girl, listening to "Some Enchanted Evening" and of course, "I'm Gonna Wash that Man right out of my Hair"!! Brings back such wonderful memories! That is going to be an amazing performance for you to be a part of -- how exciting!

I cannot thank you enough for your thoughts on my therapy and progress with my health anxiety. I would say that I have undoubtedly made progress from where I was two and a half years ago -- back in Spring of 2016 I thought I would be able to function without being on cymbalta, and under my doctor's guidance, I weaned myself slowly off of it. Well. that did not go so well and I found myself quite nervous and agitated; the PA at my doctor's office suggested trying wellbutrin, which was a nightmare. It made me nearly manic, and extremely anxious -- while on it, I happened to see an article on Facebook about skin cancer and lo and behold, I convinced myself that I had basal cell skin cancer (I was wrong -- the little bumps on my face were merely sebaceous hyperplasia). Mind you, I had some degree of health anxiety since my teenage years, but the combination of being on the wrong medication and googling skin cancers (yes, there is LITERALLY a picture of a man online with only one-half of his face when you google "basal cell skin cancer" -- good lord!!) sent me into a complete tailspin at the time. Long story short, I ended up back on cymbalta, which seems to be the best SSRI for me, but the health anxiety has essentially continued since.

I would say, however, that I am definitely in a better place mentally and feel that I have developed some strategies for dealing with the intrusive health worries when they start to surface. I have also come to learn what my potential "triggers" are (most definitely the googling of health and medical issues) and am working to avoid the same.

If nothing else, I do believe that my latest "issues" with my nasal papilloma and muscle twitching (by the way, I oftentimes feel guilt in over-reacting to my "issues" such as those, seeing as there are so many people out there dealing with much, much, much bigger health conditions and issues!) have not only made me stronger, but have shown me that when health glitches (as you so aptly put it) arise, the best way to respond is simply to "take care of business". When the first ENT told me I had what could be a very dangerous nasal papilloma, of course I panicked, turned to google, and saw the usual incendiary images of poor souls with their eyeballs displaced as a result of tumor growth (good lord, did these people not seek medical attention when they had uncontrollable nosebleeds and completely blocked nasal passages??). Here I am now, papilloma-free, and none the worse for wear, because I "took care of business". All of the lost sleep and worries I had in envisioning the worst possible case scenario were all for naught.

As for my twitching -- well. let's just say it has completely ceased. Perhaps I did rush a bit on that particular issue in consulting a neurologist, but truth be told, as I said before, I feel that perhaps it was meant to be, as I have now completely dismissed the MS and ALS worries for good -- and of course -- I have made a friend in you as a result of the same!

Funny you mentioned my therapy...I had had an appointment scheduled with my therapist for two days prior to my surgery, which I cancelled. I have not as yet made a new appointment to see her. I truly care for her very, very much and she helped me through some of my worst periods, back in 2017. I am just not completely sure that I have been given much in the way of concrete "tools" for dealing with the health anxiety when it starts to surface; perhaps what I am looking for is some more structured cognitive behavioral therapy...? I feel that I am somewhat at a crossroads in terms of staying the course with her as my therapist, or seeking out a new one. As you know all too well, not only is it difficult to "break up" with a therapist (just like a hairdresser lol), but I have so much time and energy invested into my sessions with her, giving her all of my background and history, along with my myriad of health worries as they arose throughout the last two years. It goes without saying, but I would love to hear any thoughts you have on my "quandary". Your input and advice most certainly mean the world to me!

I hope you have been having a great week thus far!! I think I may pack it in here at the office for the evening and head out grocery shopping to "go get me some" Jolly Ranchers!!! Missy :)




doctor
Answered by Dr. Dariush Saghafi 21 hours later
Brief Answer:
Been TRYING to get a response going to this question all day!

Detailed Answer:
Hello, Hello, HELLO once again.....so happy to see you sending me yet MORE ATTENTION my way......you are the BEST (I honestly wish I deserved it)....and I wish you would just save all the online typing and money and just come and visit XXXXXXX for a weekend! LOL....what a shameful plug that was...but true- Bring your therapist with you....read on and you shall see----

This is going to be a quickie (FAT CHANCE, RIGHT?) only because I know I'm going to be tied up the balance of the evening and I didn't want the clock to overrun the 24 hrs. they give us to respond to questions placed in our hoppers.....I have to get back to finishing a couple of reports now, then, it's off to wrestling practice followed by rugby conditioning later. THEN, home...but I PROMISE I have a LOT more to tell you. You have to write back to me though otherwise, I can't continue the thread.....

Here's the teaser so you'll write back....I perused your message last night....and YES (Off topic for a minute), JOLLY RANCHERS are to die for....buy yourself a 3 lb bag, hide it somewhere....and then, just SUCK for weeks on end and yes, you WILL feel guilty....but they are SO GOOD it's incredible....I absolutely can relate to chewing those things on long car rides. I've done it myself from XXXXXXX to CHICAGO! LOLOLOL.... Never done it from XXXXXXX to XXXXXXX ...but if I visit your land maybe I'll take a bag so I can get into the zone! HAHA.

But here's the thing.....Last night I started looking up different names and practices in XXXXXXX of people who at least CLAIM to do CBT or at a minimum are neuropsychologists.
There are a plethora of them but I didn't recognize anybody's name. I've got one person that I use frequently for my patients and I think he's marvelous as a diagnostician but I'm not entirely convinced he would be the type of clinician to develop actual tools or a plan that someone can use in order to RECOVER or REHABILITATE from whatever it is he would diagnose on the patient. Make sense?

That is something more in the realm of the NEUROCOGNITIVE REHABILITATION SPECIALIST....and frankly, I don't really know such people....In other words, I believe that just about ANYONE who would like to DUB themselves as a NEUROCOG REHAB specialist can do so since there just arent' any....and Lord knows we need them....... Well, that's basically what CBT is all about, you know that....however, it's more than that....

Anyways, you know me Missy. I said this was going to be a quickie (Ha!) and now it's getting to be a SLOWIE! Sorryyyy LOL.....

But I would very much like to explore this a little more....

Hey, here's a light bulb above someone's head....what if your THERAPIST were to be able to work COLLABORATIVELY with like say, a NEUROCOG ENGINEER type of person....you know what I mean? Perhaps, she has the very necessary and vital skills of relating with you in a very comfortable and open way....cool....But to make her even more effective perhaps, she needs someone..who could give her the architectural layout of where you need to get to mentally and behaviorally with several options of the best ways to get there? CBT could be 1 road that leads to Rome but others could be BIOFEEDBACK, HYPNOTISM, RELAXATION TECHNIQUES (Tai Chi, Yoga, Meditation), etc....

Anyways, I really would like to get you over the hump...because I think you are CLOSE...much closer than you may think....I honestly believe you are at the precipice of a major breakthrough (sort of like Ralphie's father in a Christmas Story who got the phone call that he was the recipient of a MAJOR AWARD! Remember that?). Did you know that house is right here in Cleveland? It's a museum....and it's got that LAMP LEG in the window..what a beautiful picturesque sight! Probably one of the most photographed museum pieces in Cleveland's history! LOL!!

Anyhow, I gotta get back to finishing these reports so can go work out and lose all the calories I sucked down last night from the JOLLY RANCHERS.....but PLZ...WRITE BACK....it just has to be a line or 2 if you want. That opens the door for me to respond again and then, when I get home after rugby practice I'll continue researching folks in the XXXXXXX area that might fit this MO I think we're looking for....I might just ask Dr. XXXXXXX (my referral colleague) to let me know if he knows anybody in the XXXXXXX area as well.

So my dear for now----

1. HAVE A XXXXXXX JOLLY RANCHER and in case you didn't hear...
Oh by Golly Have a XXXXXXX Jolly Rancher......Right Now!

2. Enjoy a little Outta Season Burl Ives: https://www.youtube.com/watch?v=nVMCUtsmWmQ

2. Write back with a quickie so I can continue developing my lines of thinking later tonight (when I seem to do my BEST work! LOL).




Can you believe that this literally took 60 minutes to complete and edit....I hate all the typos I make when I send things to you....I'm so embarrassed....sheesh....



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 0 minute later
Brief Answer:
Been TRYING to get a response going to this question all day!

Detailed Answer:
Hello, Hello, HELLO once again.....so happy to see you sending me yet MORE ATTENTION my way......you are the BEST (I honestly wish I deserved it)....and I wish you would just save all the online typing and money and just come and visit XXXXXXX for a weekend! LOL....what a shameful plug that was...but true- Bring your therapist with you....read on and you shall see----

This is going to be a quickie (FAT CHANCE, RIGHT?) only because I know I'm going to be tied up the balance of the evening and I didn't want the clock to overrun the 24 hrs. they give us to respond to questions placed in our hoppers.....I have to get back to finishing a couple of reports now, then, it's off to wrestling practice followed by rugby conditioning later. THEN, home...but I PROMISE I have a LOT more to tell you. You have to write back to me though otherwise, I can't continue the thread.....

Here's the teaser so you'll write back....I perused your message last night....and YES (Off topic for a minute), JOLLY RANCHERS are to die for....buy yourself a 3 lb bag, hide it somewhere....and then, just SUCK for weeks on end and yes, you WILL feel guilty....but they are SO GOOD it's incredible....I absolutely can relate to chewing those things on long car rides. I've done it myself from XXXXXXX to CHICAGO! LOLOLOL.... Never done it from XXXXXXX to XXXXXXX ...but if I visit your land maybe I'll take a bag so I can get into the zone! HAHA.

But here's the thing.....Last night I started looking up different names and practices in XXXXXXX of people who at least CLAIM to do CBT or at a minimum are neuropsychologists.
There are a plethora of them but I didn't recognize anybody's name. I've got one person that I use frequently for my patients and I think he's marvelous as a diagnostician but I'm not entirely convinced he would be the type of clinician to develop actual tools or a plan that someone can use in order to RECOVER or REHABILITATE from whatever it is he would diagnose on the patient. Make sense?

That is something more in the realm of the NEUROCOGNITIVE REHABILITATION SPECIALIST....and frankly, I don't really know such people....In other words, I believe that just about ANYONE who would like to DUB themselves as a NEUROCOG REHAB specialist can do so since there just arent' any....and Lord knows we need them....... Well, that's basically what CBT is all about, you know that....however, it's more than that....

Anyways, you know me Missy. I said this was going to be a quickie (Ha!) and now it's getting to be a SLOWIE! Sorryyyy LOL.....

But I would very much like to explore this a little more....

Hey, here's a light bulb above someone's head....what if your THERAPIST were to be able to work COLLABORATIVELY with like say, a NEUROCOG ENGINEER type of person....you know what I mean? Perhaps, she has the very necessary and vital skills of relating with you in a very comfortable and open way....cool....But to make her even more effective perhaps, she needs someone..who could give her the architectural layout of where you need to get to mentally and behaviorally with several options of the best ways to get there? CBT could be 1 road that leads to Rome but others could be BIOFEEDBACK, HYPNOTISM, RELAXATION TECHNIQUES (Tai Chi, Yoga, Meditation), etc....

Anyways, I really would like to get you over the hump...because I think you are CLOSE...much closer than you may think....I honestly believe you are at the precipice of a major breakthrough (sort of like Ralphie's father in a Christmas Story who got the phone call that he was the recipient of a MAJOR AWARD! Remember that?). Did you know that house is right here in Cleveland? It's a museum....and it's got that LAMP LEG in the window..what a beautiful picturesque sight! Probably one of the most photographed museum pieces in Cleveland's history! LOL!!

Anyhow, I gotta get back to finishing these reports so can go work out and lose all the calories I sucked down last night from the JOLLY RANCHERS.....but PLZ...WRITE BACK....it just has to be a line or 2 if you want. That opens the door for me to respond again and then, when I get home after rugby practice I'll continue researching folks in the XXXXXXX area that might fit this MO I think we're looking for....I might just ask Dr. XXXXXXX (my referral colleague) to let me know if he knows anybody in the XXXXXXX area as well.

So my dear for now----

1. HAVE A XXXXXXX JOLLY RANCHER and in case you didn't hear...
Oh by Golly Have a XXXXXXX Jolly Rancher......Right Now!

2. Enjoy a little Outta Season Burl Ives: https://www.youtube.com/watch?v=nVMCUtsmWmQ

2. Write back with a quickie so I can continue developing my lines of thinking later tonight (when I seem to do my BEST work! LOL).




Can you believe that this literally took 60 minutes to complete and edit....I hate all the typos I make when I send things to you....I'm so embarrassed....sheesh....



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dariush Saghafi 4 hours later
Dr. D...you crack me up in the absolute best sense of the word! I love (and am envious of) your total zest for life, energy and spirit....and....the fact that you share it with others is such a wonderful thing! I can honestly say that you, my friend, have done more for me than anyone in taking such an interest in my health
anxiety “battle” and seeking solutions to help me
work to finally conquer it! Don’t get me wrong, my hubby, coworkers and friends are totally understanding and supportive, but perhaps you being a trained expert in the neuro field of medicine most certainly affords you the “inside scoop” on how this complex organ encased in our skulls functions (of course, your total
compassion for people most certainly adds to the equation!).

I had actually found my therapist from the typical list of participating providers provided by my health insurance company; I guess I should be grateful that they are at least willing to cover a good portion of her fees. I don’t know how you feel about it, but I truly believe that mental health is unequivocally as important as physical health. When I was at my absolute worst two and a half years ago, it was nothing short of a miracle that I was able to function with my job, family and daily responsibilities....but, I did, and perhaps, it has made me stronger.

I’ve psychoanalyzed myself ALOT in the past few years LOL and I believe the primary underlying factor to my anxiety is totally and simply....OVERTHINKING!!!! As I’ve mentioned before, when you add into the equation the inapplicable, misleading and oftentimes incendiary medical information (and images) available online at our fingertips, thereon lies the recipe for disaster in Missy’s mind (Titanic, anyone??)!

Of course, it doesn’t help that I am meeting with clients on a daily basis who are providing me with death certificates for their loved ones and sharing all
of the circumstances surrounding their deaths (just had one where the decedent had a full physical and clean XXXXXXX of health and dropped over from cardiac arrest the following day...geesh!!).

I love your thought of adding in some alternative therapy approaches. My husband and I used to take yoga classes, which we loved, but my work schedule and responsibilities taking care of my ailing mother at the time forced us to stop. Hypnotherapy is quite intriguing....given the fact that this mind of mine is overactive and on hyper-alert in the health realm, perhaps that may be a good match!

I hope your evening was enjoyable with all
of your extra curricular activities (where DO you get all that energy from??)!! I actually stayed home sick from
work today with a bad cold....the kind where you can’t even function and get dressed for work for the day :(. The good news is that I didn’t self diagnose myself with Mongolian Swamp Fever in lieu of a cold LMAO!

Have a wonderful evening Dr. D!! Missy :)

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Follow up: Dr. Dariush Saghafi 0 minute later
Dr. D...you crack me up in the absolute best sense of the word! I love (and am envious of) your total zest for life, energy and spirit....and....the fact that you share it with others is such a wonderful thing! I can honestly say that you, my friend, have done more for me than anyone in taking such an interest in my health
anxiety “battle” and seeking solutions to help me
work to finally conquer it! Don’t get me wrong, my hubby, coworkers and friends are totally understanding and supportive, but perhaps you being a trained expert in the neuro field of medicine most certainly affords you the “inside scoop” on how this complex organ encased in our skulls functions (of course, your total
compassion for people most certainly adds to the equation!).

I had actually found my therapist from the typical list of participating providers provided by my health insurance company; I guess I should be grateful that they are at least willing to cover a good portion of her fees. I don’t know how you feel about it, but I truly believe that mental health is unequivocally as important as physical health. When I was at my absolute worst two and a half years ago, it was nothing short of a miracle that I was able to function with my job, family and daily responsibilities....but, I did, and perhaps, it has made me stronger.

I’ve psychoanalyzed myself ALOT in the past few years LOL and I believe the primary underlying factor to my anxiety is totally and simply....OVERTHINKING!!!! As I’ve mentioned before, when you add into the equation the inapplicable, misleading and oftentimes incendiary medical information (and images) available online at our fingertips, thereon lies the recipe for disaster in Missy’s mind (Titanic, anyone??)!

Of course, it doesn’t help that I am meeting with clients on a daily basis who are providing me with death certificates for their loved ones and sharing all
of the circumstances surrounding their deaths (just had one where the decedent had a full physical and clean XXXXXXX of health and dropped over from cardiac arrest the following day...geesh!!).

I love your thought of adding in some alternative therapy approaches. My husband and I used to take yoga classes, which we loved, but my work schedule and responsibilities taking care of my ailing mother at the time forced us to stop. Hypnotherapy is quite intriguing....given the fact that this mind of mine is overactive and on hyper-alert in the health realm, perhaps that may be a good match!

I hope your evening was enjoyable with all
of your extra curricular activities (where DO you get all that energy from??)!! I actually stayed home sick from
work today with a bad cold....the kind where you can’t even function and get dressed for work for the day :(. The good news is that I didn’t self diagnose myself with Mongolian Swamp Fever in lieu of a cold LMAO!

Have a wonderful evening Dr. D!! Missy :)

doctor
Answered by Dr. Dariush Saghafi 23 hours later
Brief Answer:
The Treatment Paradigm for Health Anxiety

Detailed Answer:
Dearest Missy,

First of all, please tell me that you had or are HAVING a splendid and spectacular VALENTINE'S Day. Have you ever looked into the historical conjectures of how the day originated? I won't go into the variety of hunches and hypotheses that abound as to how a calendar date was chosen typically costing men these days $100.00 for 12 thorny ROSES, but I will tell you my favorite of all is where Valentine’s feast day was set aside by Pope Gelasius I in the 5th century and was to be observed as a lovers’ holiday and a day of romance thought to coincide with the beginning of the mating season for birds.

Here's the line from the prologue of Chaucer's Canterbury Tales that causeth me to be in remembr'nce of that final part of the statement.....do you recall?

".....And smale foweles maken melodye, That slepen al the nyght with open ye"

Oh my goodness, the importance of MENTAL HEALTH....are you kidding....we speak the same language my dear....except, I prefer (as many do these days) to reduce the stigma attached to the term MENTAL health and replace that with BRAIN HEALTH.....and quite coincidentally that YOU should bring that concept up, 2 days ago I watched a presentation, a very heavy hearted presentation by the mother of XXXXXXX KLEBOLD (Columbine shooter) talk to an audience on TED TALKS.....if you've not watched this episode of TED TALKS I highly recommend it for educational purposes of just how evasive BRAIN HEALTH can be and how we all travel such a tightrope between Full On Antisocial and the most beloved neighbor, teacher, or friend of the block.....She tells a very heartfelt story of how long it's taken her to come to some semblance of grips with the horrible tragedy perpetrated by her son and the burdens she's had to shoulder for the past 20 years and surely for the rest of her life.....

BRAIN HEALTH and PHYSICAL HEALTH are truly indistinguishable in my opinion except for one's existence being on a more ETHEREAL PLAIN than the other which can usually be measured by tests and comparators which are standardized and agreed upon by consensus as to what's normal and what's not in contradistinction to BRAIN HEALTH which is certainly more fluid and open to interpretation as to what is normal and what's not depending on many variables. Both are fully interdependent upon one another in order to maximize one's degree of overall health and quality of life.

And so, I ask you dear Missy....being as objective as you can be about YOUR scale of BRAIN HEALTH.....where do you think things are at on a scale of 0-100 with 100 being the upper asymptote and 0 being the lower. in other words, let's suppose that 0 and 100 are theoretical extreme limits which are not attainable by any person. 100 is the maximum (i.e. best) score and 0 is the minimum. Where do you put yourself in the BRAIN HEALTH category? Where does your husband place you on that scale, and where does one of your most trusted friends or colleagues (outside of your immediate family)?

Now, answer that same question for me but think about how you were 2.5 years ago when you were going through rough times....can you give me a relative idea of what the numbers were at that time?

I certainly agree that OVERTHINKING is an important underlying contributing factor to your health issues worries and fears. However, I believe more than just that element is at the heart of the issue. In other words, I believe the core of this complex problem is like a RAISIN cookie and OVERTHINKING is one of those raisins but it's not the whole cookie...nor is it any other raisin...make sense?

So my take on things is that you've improved quite nicely over the past couple of years and maybe you've even taken a few extra rather important LEAPS AND BOUNDS more recently when you convinced yourself that there's nothing more to worry about regarding your fear of MS or ALS. Oh, and there was that snotty papilloma....or perhaps we could call it....SCHNOTTY.

So, I guess what I'm wondering at this point is where you see yourself in the SPECTRUM of this thing we call HEALTH ANXIETY. The other thing we need to discover, independent of how HIGH up on the 100 point scale you may be compared to a couple years ago...what are your risk factors or what is your opinion as to how easily you could take steps backward? Based on how you answer these questions I believe we can make more informed choices when it comes to therapeutic approaches and just how many PRONGS we might need to get you up to the summit of Mount Olympus (I'm watching that TV program with the Rock, TITANS?)....LOLOLOL!

P.S. EXERCISE is a great therapeutic approach to this problem....hugely advantageous to both PHYSICAL AND BRAIN HEALTH to put in other terms!

P.P.S. I hope you are much better with your cold. Are you going in to work tomorrow, or maybe just a nice 3 day weekend to give yourself a little bit more recovery time so you can be at your absolute best come next week.....Is there such a thing as Mongolian Swamp Fever? I'll look it up cuz I'll be there is....if anybody would know it would be YOU!! ROFLMAO!

I'm going to watch an episode of the PUNISHER that our daughter wants us to watch....so, Buenas Noches Chica!




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 0 minute later
Brief Answer:
The Treatment Paradigm for Health Anxiety

Detailed Answer:
Dearest Missy,

First of all, please tell me that you had or are HAVING a splendid and spectacular VALENTINE'S Day. Have you ever looked into the historical conjectures of how the day originated? I won't go into the variety of hunches and hypotheses that abound as to how a calendar date was chosen typically costing men these days $100.00 for 12 thorny ROSES, but I will tell you my favorite of all is where Valentine’s feast day was set aside by Pope Gelasius I in the 5th century and was to be observed as a lovers’ holiday and a day of romance thought to coincide with the beginning of the mating season for birds.

Here's the line from the prologue of Chaucer's Canterbury Tales that causeth me to be in remembr'nce of that final part of the statement.....do you recall?

".....And smale foweles maken melodye, That slepen al the nyght with open ye"

Oh my goodness, the importance of MENTAL HEALTH....are you kidding....we speak the same language my dear....except, I prefer (as many do these days) to reduce the stigma attached to the term MENTAL health and replace that with BRAIN HEALTH.....and quite coincidentally that YOU should bring that concept up, 2 days ago I watched a presentation, a very heavy hearted presentation by the mother of XXXXXXX KLEBOLD (Columbine shooter) talk to an audience on TED TALKS.....if you've not watched this episode of TED TALKS I highly recommend it for educational purposes of just how evasive BRAIN HEALTH can be and how we all travel such a tightrope between Full On Antisocial and the most beloved neighbor, teacher, or friend of the block.....She tells a very heartfelt story of how long it's taken her to come to some semblance of grips with the horrible tragedy perpetrated by her son and the burdens she's had to shoulder for the past 20 years and surely for the rest of her life.....

BRAIN HEALTH and PHYSICAL HEALTH are truly indistinguishable in my opinion except for one's existence being on a more ETHEREAL PLAIN than the other which can usually be measured by tests and comparators which are standardized and agreed upon by consensus as to what's normal and what's not in contradistinction to BRAIN HEALTH which is certainly more fluid and open to interpretation as to what is normal and what's not depending on many variables. Both are fully interdependent upon one another in order to maximize one's degree of overall health and quality of life.

And so, I ask you dear Missy....being as objective as you can be about YOUR scale of BRAIN HEALTH.....where do you think things are at on a scale of 0-100 with 100 being the upper asymptote and 0 being the lower. in other words, let's suppose that 0 and 100 are theoretical extreme limits which are not attainable by any person. 100 is the maximum (i.e. best) score and 0 is the minimum. Where do you put yourself in the BRAIN HEALTH category? Where does your husband place you on that scale, and where does one of your most trusted friends or colleagues (outside of your immediate family)?

Now, answer that same question for me but think about how you were 2.5 years ago when you were going through rough times....can you give me a relative idea of what the numbers were at that time?

I certainly agree that OVERTHINKING is an important underlying contributing factor to your health issues worries and fears. However, I believe more than just that element is at the heart of the issue. In other words, I believe the core of this complex problem is like a RAISIN cookie and OVERTHINKING is one of those raisins but it's not the whole cookie...nor is it any other raisin...make sense?

So my take on things is that you've improved quite nicely over the past couple of years and maybe you've even taken a few extra rather important LEAPS AND BOUNDS more recently when you convinced yourself that there's nothing more to worry about regarding your fear of MS or ALS. Oh, and there was that snotty papilloma....or perhaps we could call it....SCHNOTTY.

So, I guess what I'm wondering at this point is where you see yourself in the SPECTRUM of this thing we call HEALTH ANXIETY. The other thing we need to discover, independent of how HIGH up on the 100 point scale you may be compared to a couple years ago...what are your risk factors or what is your opinion as to how easily you could take steps backward? Based on how you answer these questions I believe we can make more informed choices when it comes to therapeutic approaches and just how many PRONGS we might need to get you up to the summit of Mount Olympus (I'm watching that TV program with the Rock, TITANS?)....LOLOLOL!

P.S. EXERCISE is a great therapeutic approach to this problem....hugely advantageous to both PHYSICAL AND BRAIN HEALTH to put in other terms!

P.P.S. I hope you are much better with your cold. Are you going in to work tomorrow, or maybe just a nice 3 day weekend to give yourself a little bit more recovery time so you can be at your absolute best come next week.....Is there such a thing as Mongolian Swamp Fever? I'll look it up cuz I'll be there is....if anybody would know it would be YOU!! ROFLMAO!

I'm going to watch an episode of the PUNISHER that our daughter wants us to watch....so, Buenas Noches Chica!




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 39 hours later
Dr. D...Happy belated Valentine’s Day! I hope you had a wonderful day with your loved ones! I would never have doubted that you would be the one to know that Valentine’s Day had a potential origin pertaining to the mating season of birds!!!

Oh my goodness I cannot even begin to fathom the weight that XXXXXXX Klebold’s mom will carry with her for the rest of her lifetime..and possibly beyond! How do you even begin to comprehend that the child you have given birth to and love with your entirety could commit such a heinous act? And it most certainly speaks volumes as to the importance of “brain health” ....I like your phraseology better!

To answer your question, I would say that two and a half years ago I was probably 20 out of 100
on the scale you suggested. As for now, I would realistically say I am at 60, and I would venture to guess my husband and friends would agree with that estimation.

I was hoping to enjoy a period of reprieve from the health worries for some time, now being done with the neuro worries and the “schnotty” lol papilloma. For some reason, however, this mind of mine is wanting to latch on to more worries. Perhaps part of it is precipitated by the fact that a former coworker of mine, with whom I worked for decades, just passed away from cancer yesterday.

My mind is currently wanting me to “revisit” a worry I had from a few months ago. When I was at my dentist the hygienist mentioned the fact that I have buccal exostosis (you probably know this obviously....but it’s that extra bony growth above and below my teeth. Well....after that visit I was checking them out in my ten times lighted magnifying makeup mirror (I need to trash that thing!) and noticed a small grouping of three little yellowish/whitish spots high above the bony overgrowth. I don’t think the dentist ever looks up that far as part of the oral cancer screening, so I made an appt with him a few months ago and he believed it may be calcium deposits. I also picked my ENT surgeons brain and had him take a look and he thought perhaps it is visible glands from the prominent exostosis. So for whatever reason, my mind starts thinking about those spots again yesterday and googling (ugh and ugh) oral growths and now I’m fearing it’s oral squamous cancer, and I have asked my dentist for a referral to an oral surgeon to take a look. Why do I do this to myself and why does my brain feel the need to latch on to another worry once prior ones are dismissed?

I know it is most definitely not your specialty, but I’m attaching an image as best as I could get of the spot in question, which I have circled. I found a picture online lmao of some other person’s mouth who has the exact same looking spot (that image had to do with some type of cyst which is in front of the spot that looks like mine). Anyways, crazy as I am, I’m attaching the picture of that strangers mouth with the spot circled, which is a clearer image than of my own mouth. I also checked out my CT sinus scan report and it mentioned the “alveolar process” was normal, so I would think anything insidious would have shown on that. Dr. D....see how this mind of mine works? From what you see, does anything look worrisome to you?

I also obtained a copy of the full 117 pages of my hospital records from the surgery. I glanced through them and lo and behold there was rhe EKG printout and report which mentioned “possible left atrial enlargement”. My doctor and the tech said it was
normal, and my echocardiogram from 2017 said rhe atrium was normal in size. I’ve attached copies of those...do you have any thoughts?

After I typed all of this I feel the need to apologize to you, as I really should have submitted this as a new query, as I’ve lapsed into oral cancer and heart disease fears lol! For whatever reason, I just seem to be having a few days of an uptick in my anxiety :(

Thanks as always, and I owe you a new query to make up for my ramblings in this one!! Missy :)

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Follow up: Dr. Dariush Saghafi 0 minute later
Dr. D...Happy belated Valentine’s Day! I hope you had a wonderful day with your loved ones! I would never have doubted that you would be the one to know that Valentine’s Day had a potential origin pertaining to the mating season of birds!!!

Oh my goodness I cannot even begin to fathom the weight that XXXXXXX Klebold’s mom will carry with her for the rest of her lifetime..and possibly beyond! How do you even begin to comprehend that the child you have given birth to and love with your entirety could commit such a heinous act? And it most certainly speaks volumes as to the importance of “brain health” ....I like your phraseology better!

To answer your question, I would say that two and a half years ago I was probably 20 out of 100
on the scale you suggested. As for now, I would realistically say I am at 60, and I would venture to guess my husband and friends would agree with that estimation.

I was hoping to enjoy a period of reprieve from the health worries for some time, now being done with the neuro worries and the “schnotty” lol papilloma. For some reason, however, this mind of mine is wanting to latch on to more worries. Perhaps part of it is precipitated by the fact that a former coworker of mine, with whom I worked for decades, just passed away from cancer yesterday.

My mind is currently wanting me to “revisit” a worry I had from a few months ago. When I was at my dentist the hygienist mentioned the fact that I have buccal exostosis (you probably know this obviously....but it’s that extra bony growth above and below my teeth. Well....after that visit I was checking them out in my ten times lighted magnifying makeup mirror (I need to trash that thing!) and noticed a small grouping of three little yellowish/whitish spots high above the bony overgrowth. I don’t think the dentist ever looks up that far as part of the oral cancer screening, so I made an appt with him a few months ago and he believed it may be calcium deposits. I also picked my ENT surgeons brain and had him take a look and he thought perhaps it is visible glands from the prominent exostosis. So for whatever reason, my mind starts thinking about those spots again yesterday and googling (ugh and ugh) oral growths and now I’m fearing it’s oral squamous cancer, and I have asked my dentist for a referral to an oral surgeon to take a look. Why do I do this to myself and why does my brain feel the need to latch on to another worry once prior ones are dismissed?

I know it is most definitely not your specialty, but I’m attaching an image as best as I could get of the spot in question, which I have circled. I found a picture online lmao of some other person’s mouth who has the exact same looking spot (that image had to do with some type of cyst which is in front of the spot that looks like mine). Anyways, crazy as I am, I’m attaching the picture of that strangers mouth with the spot circled, which is a clearer image than of my own mouth. I also checked out my CT sinus scan report and it mentioned the “alveolar process” was normal, so I would think anything insidious would have shown on that. Dr. D....see how this mind of mine works? From what you see, does anything look worrisome to you?

I also obtained a copy of the full 117 pages of my hospital records from the surgery. I glanced through them and lo and behold there was rhe EKG printout and report which mentioned “possible left atrial enlargement”. My doctor and the tech said it was
normal, and my echocardiogram from 2017 said rhe atrium was normal in size. I’ve attached copies of those...do you have any thoughts?

After I typed all of this I feel the need to apologize to you, as I really should have submitted this as a new query, as I’ve lapsed into oral cancer and heart disease fears lol! For whatever reason, I just seem to be having a few days of an uptick in my anxiety :(

Thanks as always, and I owe you a new query to make up for my ramblings in this one!! Missy :)

doctor
Answered by Dr. Dariush Saghafi 21 hours later
Brief Answer:
Your all too complex brain being a rascal

Detailed Answer:
Happy Pre-President's Day dearest Missy!

Let's start from the end of your last message and work our way up...shall we? :0

First(ly)-depending on which side of the controversy of proper word usage you're on...Ha!

No need to apologize for another question in the thread my dear. You are most welcome to attach as many questions/responses to your thread as the good folks at Healthcaremagic allow...."It's the Law." The simple fact that you find utility in my answers is so complimentary, how can I possibly be anything less than appreciative of the opportunity to stay in touch by whatever means most convenient for you? As XXXXXXX XXXXXXX said in song in 1977, "Don't Go Changing, etc. etc."

Continuing UPWARD (from the LITERAL END of your last message- Ha!) in your quest for truth....you mention "possible LA enlargement" but I've reviewed the documents you've provided and did not find this to be the case. Both right and left atria were felt to be normal according to the read as far as I can tell. There is a mention of "borderline LV hypertrophy" which could be as well interpreted (in my NON-expert opinion as a neurologist) as "borderline upper limit of normal LV.....however, there is a DEFINITIVE statement in the same echo report that states that LV function is normal. I would therefore, place more emphasis on your normal LV function and recognize the fact that the call of "borderline" when it comes to size, function, shape, etc. is always an opinion of 1 reader. For me, the germane and most important opinion on how you fared on the test comes from how everything tested is finally interpreted in context by the expert (your cardiologist) and as I recall you said that he felt you had a normal study. That's terrific news....you've got a "Perfectly Perfect" ticker as XXXXXXX Poppins would say, ergo, therfore, and thusly......I concur my dear.... ;)

I also did look at the interesting pictures you sent of both your chompers as well as the internet's (how in the HECK did you get that shot of yourself?)....I like YOUR SET way BETTER....trust me when I tell you that I envy your pearly whites....and I'm serious when I tell as well that you've motivated me to get back to my dentist who has been SOOOO PATIENT with me....I've made so many excuses why I can't get back to see him....but in the end....I REALLY REALLY need to get back and at least TAKE ADVANTAGE of my dag nab insurance policy that I pay good money for to get a professional cleaning....Uggghhh.....your dental question has made me reflect on my laziness with my oral health....Perhaps, I just figured that since I wrestle, play rugby, and racquetball that I'm just lucky to have at least the teeth in front that are visible present and accounted for! LOLOLOL!

Soooooo, I would like to ask your leave Milady that we put a temporary break at this point on your oral question BUT that you please respond to this in some manner (smiley face, good lawyer joke, or another photograph of yourself?) which then, reopens the door for me to tell you what I think and what I've LEARNED from your pics and what you've chosen from the internet. And as importantly share with you at least 1 contributing theory/hypothesis to your question "Why do I do this to myself and why does my brain feel the need to latch on to another worry once prior ones are dismissed?"

I believe I have an idea about my Missy's Complex brain that loves to be a Rascal.....

More to come. I want to get to the gym for a workout and to practice jump roping skills. Open Competition for Crossfit is slated to begin in less than 1 week so I want to catch a couple hrs. before continuing our conversation. Cheers my dear!

P.S. Contemplate this question for a minute....can you tell me a bit about ways you like staying in good physical shape...which includes being nutritionally minded and sound...do you have any type of workout schedule that you implement regularly (or even irregularly) with your husband or coworkers? Double Cheers!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 0 minute later
Brief Answer:
Your all too complex brain being a rascal

Detailed Answer:
Happy Pre-President's Day dearest Missy!

Let's start from the end of your last message and work our way up...shall we? :0

First(ly)-depending on which side of the controversy of proper word usage you're on...Ha!

No need to apologize for another question in the thread my dear. You are most welcome to attach as many questions/responses to your thread as the good folks at Healthcaremagic allow...."It's the Law." The simple fact that you find utility in my answers is so complimentary, how can I possibly be anything less than appreciative of the opportunity to stay in touch by whatever means most convenient for you? As XXXXXXX XXXXXXX said in song in 1977, "Don't Go Changing, etc. etc."

Continuing UPWARD (from the LITERAL END of your last message- Ha!) in your quest for truth....you mention "possible LA enlargement" but I've reviewed the documents you've provided and did not find this to be the case. Both right and left atria were felt to be normal according to the read as far as I can tell. There is a mention of "borderline LV hypertrophy" which could be as well interpreted (in my NON-expert opinion as a neurologist) as "borderline upper limit of normal LV.....however, there is a DEFINITIVE statement in the same echo report that states that LV function is normal. I would therefore, place more emphasis on your normal LV function and recognize the fact that the call of "borderline" when it comes to size, function, shape, etc. is always an opinion of 1 reader. For me, the germane and most important opinion on how you fared on the test comes from how everything tested is finally interpreted in context by the expert (your cardiologist) and as I recall you said that he felt you had a normal study. That's terrific news....you've got a "Perfectly Perfect" ticker as XXXXXXX Poppins would say, ergo, therfore, and thusly......I concur my dear.... ;)

I also did look at the interesting pictures you sent of both your chompers as well as the internet's (how in the HECK did you get that shot of yourself?)....I like YOUR SET way BETTER....trust me when I tell you that I envy your pearly whites....and I'm serious when I tell as well that you've motivated me to get back to my dentist who has been SOOOO PATIENT with me....I've made so many excuses why I can't get back to see him....but in the end....I REALLY REALLY need to get back and at least TAKE ADVANTAGE of my dag nab insurance policy that I pay good money for to get a professional cleaning....Uggghhh.....your dental question has made me reflect on my laziness with my oral health....Perhaps, I just figured that since I wrestle, play rugby, and racquetball that I'm just lucky to have at least the teeth in front that are visible present and accounted for! LOLOLOL!

Soooooo, I would like to ask your leave Milady that we put a temporary break at this point on your oral question BUT that you please respond to this in some manner (smiley face, good lawyer joke, or another photograph of yourself?) which then, reopens the door for me to tell you what I think and what I've LEARNED from your pics and what you've chosen from the internet. And as importantly share with you at least 1 contributing theory/hypothesis to your question "Why do I do this to myself and why does my brain feel the need to latch on to another worry once prior ones are dismissed?"

I believe I have an idea about my Missy's Complex brain that loves to be a Rascal.....

More to come. I want to get to the gym for a workout and to practice jump roping skills. Open Competition for Crossfit is slated to begin in less than 1 week so I want to catch a couple hrs. before continuing our conversation. Cheers my dear!

P.S. Contemplate this question for a minute....can you tell me a bit about ways you like staying in good physical shape...which includes being nutritionally minded and sound...do you have any type of workout schedule that you implement regularly (or even irregularly) with your husband or coworkers? Double Cheers!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 12 hours later
Hi Dr. D! Ugh I literally just typed a five paragraph response and when I clicked “submit” it all
disappeared!! How frustrating! I think the tech team
at HealthcareMagic needs to work on that issue, as it’s
not the first time it’s happened to me!

Well, my lost response was definitely more eloquent but here’s the basic version:

Happy Presidents Day to you as well! It’s times such as this that I wish I worked in the government sector for that extra day off!

I hope you had a great training session today! Once again, I am envious of your energy (did you get into those Jolly Ranchers again?).

To answer your question, in terms of exercise my hubby and I LOVE to walk...just about every night we take a three mile walk around our neighborhood. Unfortunately, after my surgery my little sniffer is still quite sore and sensitive to temperature fluctuations,
so I’ve had to take a break from our walks for awhile. I’m thinking about taking up rock climbing, particularly since there’s a sixteen story high structure in my front yard that is just begging to be scaled lol!

Thank you as always for your input on my cardiac “worries” (I think my XXXXXXX anxiety has canvassed just about every area of my body lol). Not sure whether you saw it, but on the second page of the EKG printout there was the doctors report which mentioned “possible left atrial enlargement”, although the echo from 2017 showed none. The PA at my PCPs office as well as the nurse who did the EKG pre-op both said it was normal.

Moving up to the oral cavity, yes....if my crazy worries serve any purpose, let that one be a reminder to you to take some time to schedule YOUR dentist visit! I don’t know Dr. D, maybe I’m overreacting to that little spot but I still feel the need to get it checked by a specialist. I think knowing I developed my rare and crazy schnotty nose growth has led me to believe anything is possible.

Hahahaha isn’t my picture hysterical and isn’t it even funnier that I trolled the internet to find a picture of some stranger’s mouth with the same looking spot? For those of us with health anxiety, I think we learn all of the techniques for capturing the perfect image of our worry du jour suitable for uploading to online doctors lmao! For my picture it was a lovely combination of my lighted 10x magnified makeup mirror and some
major stretching of my mouth. If only I could contort the other areas of my body in such a fashion I could be a limbo champion!

I hope you had a wonderful and enjoyable weekend with your family. We have some blustery snow out there tonight....how many more days until spring??

Have a wonderful evening and a terrific Monday!
Missy :)



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Follow up: Dr. Dariush Saghafi 0 minute later
Hi Dr. D! Ugh I literally just typed a five paragraph response and when I clicked “submit” it all
disappeared!! How frustrating! I think the tech team
at HealthcareMagic needs to work on that issue, as it’s
not the first time it’s happened to me!

Well, my lost response was definitely more eloquent but here’s the basic version:

Happy Presidents Day to you as well! It’s times such as this that I wish I worked in the government sector for that extra day off!

I hope you had a great training session today! Once again, I am envious of your energy (did you get into those Jolly Ranchers again?).

To answer your question, in terms of exercise my hubby and I LOVE to walk...just about every night we take a three mile walk around our neighborhood. Unfortunately, after my surgery my little sniffer is still quite sore and sensitive to temperature fluctuations,
so I’ve had to take a break from our walks for awhile. I’m thinking about taking up rock climbing, particularly since there’s a sixteen story high structure in my front yard that is just begging to be scaled lol!

Thank you as always for your input on my cardiac “worries” (I think my XXXXXXX anxiety has canvassed just about every area of my body lol). Not sure whether you saw it, but on the second page of the EKG printout there was the doctors report which mentioned “possible left atrial enlargement”, although the echo from 2017 showed none. The PA at my PCPs office as well as the nurse who did the EKG pre-op both said it was normal.

Moving up to the oral cavity, yes....if my crazy worries serve any purpose, let that one be a reminder to you to take some time to schedule YOUR dentist visit! I don’t know Dr. D, maybe I’m overreacting to that little spot but I still feel the need to get it checked by a specialist. I think knowing I developed my rare and crazy schnotty nose growth has led me to believe anything is possible.

Hahahaha isn’t my picture hysterical and isn’t it even funnier that I trolled the internet to find a picture of some stranger’s mouth with the same looking spot? For those of us with health anxiety, I think we learn all of the techniques for capturing the perfect image of our worry du jour suitable for uploading to online doctors lmao! For my picture it was a lovely combination of my lighted 10x magnified makeup mirror and some
major stretching of my mouth. If only I could contort the other areas of my body in such a fashion I could be a limbo champion!

I hope you had a wonderful and enjoyable weekend with your family. We have some blustery snow out there tonight....how many more days until spring??

Have a wonderful evening and a terrific Monday!
Missy :)



doctor
Answered by Dr. Dariush Saghafi 45 hours later
Brief Answer:
Good evening my dearest Missy.....All good on the LEFT ATRIAL FRONT!

Detailed Answer:
How are you doing this week so far? Sorry, I've been out of contact. Been unusually busy at the hospital the last couple of days. Sometimes cold weather has the reverse effect on keeping people home....IT DOESN'T! LOL.....

Got rugby practice in about an hour so I'll soon be burning all the calories I'm ingesting right now as I write this to you....HA!

You're right...I missed the 2nd page where there was a comment of POSSIBLE LEFT ATRIAL enlargement.....So, I went back to brush up on some of the finer points of EKG reading and was able to convince myself after a while (2 hrs.) that indeed there are heartbeats that electrically speaking show valid evidence to be able to make the call of POSSIBLE left atrial enlargement, however, the beauty of making that call in a vacuum is that you are really only looking at 2 single leads from a 12 lead recording. While it gives one good practice at refreshing one's read of an EKG it is entirely out of context overall since the other 10 leads are not being taken into consideration.

When the rest of the recording is looked at and compared to those leads (Usually Lead II and V1) the more RELEVANT conclusion I am happy to report is,

"All Quiet on the LEFT ATRIAL FRONT!" ;)

If you come to XXXXXXX I would be happy to give you a crash course in reading EKG's....they really are not hard to look at for the basics and you might highly enjoy it! But you'd have to come here because doing it remotely like this would be really really challenging.....Come up here for a weekend to tour Cedar Point (you HAVE heard of CEDAR POINT, right?), catch a concert of the XXXXXXX Orchestra out at Blossom Music Center, and see the Indians beat up some New York team with pin stripes....LOL....and you could go back as the only attorney in your group that knows the difference between a P-wave and a Wave of P! HAHA!

As far as your radiographic photography....please don't get mad at me if I must balk on that question because it is really way outside my wheelhouse of comfort to say anything about it...."I say whatever the Dentist over there says!" I would just emphasize that your EXOSTOSIS is so much better looking and cleaner than mine that I envy you my dear! Now, the guy you found on the Internet? I've already admitted I shouldn't be opening my yap on this since I'm not good at all with oral cavity radiographs.....but to my very weakly trained eye in that arena....I don't think his spot is anywhere as good looking as yours....and that's the fact, XXXXXXX ... To me, his photo kind of "looks" sick anyways? But yours doesn't tickle me that way....so again, "Whatever the Dentist says is good with me!" LOL!!

So final comment before I have to gallop on my pony to rugby practice my dear.....It sounds like both you, your hubby, family and friends are in agreement that you've come a long way baby on the Health Anxiety scale; very much better now than several years ago...BUT...still a bit off the mark you'd like to be, right? In addition, this has been with the therapist working with you only, correct? NO CBT, no neuropsych or anything extra....except of course, your own desire to get over these last few humps, Yes? I suppose if we were to forward extrapolate to where we might put you on the scale in the next 2.5 years....I might be tempted to say that you could be approaching if not exceeding 80-85/100.....of course, remember, our XXXXXXX target is 99. So, what are your thoughts for getting to 80-85 over the course of 2.5-3 years from now just be keeping things status quo with your therapist, etc.?

What is your time goal for getting to that 99? And have you given any thought as to how it may be expedited by getting in other forms of training and education such as CBT, RELAXATION therapy, STRESS RELIEF, MINDFULNESS Techniques?

BTW, I am thinking daily of setting up an appointment with my dentist....I should let you know when it happens! LOL.....

Good grief....there was one other thing I wanted to mention to you before I signed off....but it's escaped me....I can't for the life of me think of what it is....ugggghhh....hate when that happens.....

Anyways, my dear....tell me what your thoughts are on some of these things and I'll try to think of what it was I was going to tell you....I'm sure it wasn't important and I'm just blabbering right now....

Let me close then, by underscoring again how marvelously well you're doing....I'd love to teach you how to reach a basic EKG strip, and please send me a picture of either you climbing the tower, OR being led away by police to the pokey! ROFLMAO! I'd be happy to come and represent you as the medical expert who told her that in order to fully confront her Health Care Anxieties....she needed to climb those girders and beams....sort of a THERAPEUTIC CONFRONTATIONAL approach we could tell the judge...and then, I would have to promise to spirit you out of the State so that you'd not be a danger to yourself or any Bald Eagles nesting atop the Verizon Monolith and not bring you back until you were all better! HA!

Cheers my dear!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 0 minute later
Brief Answer:
Good evening my dearest Missy.....All good on the LEFT ATRIAL FRONT!

Detailed Answer:
How are you doing this week so far? Sorry, I've been out of contact. Been unusually busy at the hospital the last couple of days. Sometimes cold weather has the reverse effect on keeping people home....IT DOESN'T! LOL.....

Got rugby practice in about an hour so I'll soon be burning all the calories I'm ingesting right now as I write this to you....HA!

You're right...I missed the 2nd page where there was a comment of POSSIBLE LEFT ATRIAL enlargement.....So, I went back to brush up on some of the finer points of EKG reading and was able to convince myself after a while (2 hrs.) that indeed there are heartbeats that electrically speaking show valid evidence to be able to make the call of POSSIBLE left atrial enlargement, however, the beauty of making that call in a vacuum is that you are really only looking at 2 single leads from a 12 lead recording. While it gives one good practice at refreshing one's read of an EKG it is entirely out of context overall since the other 10 leads are not being taken into consideration.

When the rest of the recording is looked at and compared to those leads (Usually Lead II and V1) the more RELEVANT conclusion I am happy to report is,

"All Quiet on the LEFT ATRIAL FRONT!" ;)

If you come to XXXXXXX I would be happy to give you a crash course in reading EKG's....they really are not hard to look at for the basics and you might highly enjoy it! But you'd have to come here because doing it remotely like this would be really really challenging.....Come up here for a weekend to tour Cedar Point (you HAVE heard of CEDAR POINT, right?), catch a concert of the XXXXXXX Orchestra out at Blossom Music Center, and see the Indians beat up some New York team with pin stripes....LOL....and you could go back as the only attorney in your group that knows the difference between a P-wave and a Wave of P! HAHA!

As far as your radiographic photography....please don't get mad at me if I must balk on that question because it is really way outside my wheelhouse of comfort to say anything about it...."I say whatever the Dentist over there says!" I would just emphasize that your EXOSTOSIS is so much better looking and cleaner than mine that I envy you my dear! Now, the guy you found on the Internet? I've already admitted I shouldn't be opening my yap on this since I'm not good at all with oral cavity radiographs.....but to my very weakly trained eye in that arena....I don't think his spot is anywhere as good looking as yours....and that's the fact, XXXXXXX ... To me, his photo kind of "looks" sick anyways? But yours doesn't tickle me that way....so again, "Whatever the Dentist says is good with me!" LOL!!

So final comment before I have to gallop on my pony to rugby practice my dear.....It sounds like both you, your hubby, family and friends are in agreement that you've come a long way baby on the Health Anxiety scale; very much better now than several years ago...BUT...still a bit off the mark you'd like to be, right? In addition, this has been with the therapist working with you only, correct? NO CBT, no neuropsych or anything extra....except of course, your own desire to get over these last few humps, Yes? I suppose if we were to forward extrapolate to where we might put you on the scale in the next 2.5 years....I might be tempted to say that you could be approaching if not exceeding 80-85/100.....of course, remember, our XXXXXXX target is 99. So, what are your thoughts for getting to 80-85 over the course of 2.5-3 years from now just be keeping things status quo with your therapist, etc.?

What is your time goal for getting to that 99? And have you given any thought as to how it may be expedited by getting in other forms of training and education such as CBT, RELAXATION therapy, STRESS RELIEF, MINDFULNESS Techniques?

BTW, I am thinking daily of setting up an appointment with my dentist....I should let you know when it happens! LOL.....

Good grief....there was one other thing I wanted to mention to you before I signed off....but it's escaped me....I can't for the life of me think of what it is....ugggghhh....hate when that happens.....

Anyways, my dear....tell me what your thoughts are on some of these things and I'll try to think of what it was I was going to tell you....I'm sure it wasn't important and I'm just blabbering right now....

Let me close then, by underscoring again how marvelously well you're doing....I'd love to teach you how to reach a basic EKG strip, and please send me a picture of either you climbing the tower, OR being led away by police to the pokey! ROFLMAO! I'd be happy to come and represent you as the medical expert who told her that in order to fully confront her Health Care Anxieties....she needed to climb those girders and beams....sort of a THERAPEUTIC CONFRONTATIONAL approach we could tell the judge...and then, I would have to promise to spirit you out of the State so that you'd not be a danger to yourself or any Bald Eagles nesting atop the Verizon Monolith and not bring you back until you were all better! HA!

Cheers my dear!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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