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Date: Mon, May 5, 2008 at 5:51 AM
Subject: She thought that her dizzy spells meant a stroke.
To:
collegeschoolloan@gmail.com[1]
She thought that her dizzy spells meant a stroke. Laura had a difficult childhood. Her single mother was unable to provide for her and Laura had to go away to live with family in Chicago. At 17, she once hyperventilated so much that she fell to the ground and thought she was having a stroke. Laura soon became pregnant and married the wrong man. At present, heavy duty and risky drugs suppress Alice's chronic despair and pain rooted in sorrow. Laura will take to her grave the awful life no psychiatrist has uncovered. I have studied Laura for 30 years, and I have decided to shelf away all I know about her painful and desperate life. Too often, there is no sweet antidote for sorrow rooted in bad parenting and a lousy childhood. Laura felt dizzy because she hyperventilated, blew off carbon dioxide (CO2). Over-breathing causes the blood's carbon dioxide to drop, the pH to increase (alkalemia) and for the free calcium to drop (total calcium is normal). In addition, hyperventilation causes facial tingling, spastic contractions of the wrist, weakness of the knees and fatigue. When I lay off Martha because I decided to close my clinic, she began to experience great anxiety with hyperventilation. Her over-breathing caused her to experience blurry vision. She referred herself to an ophthalmologist who worked her up for presumed Uveitis. Martha was privately insured, fee-for-service, and the ophthalmologist subjected her to an expensive in-hospital evaluation. Martha's symptoms resolved once she got another good job. The issue of self-referring by patients to "specialists" is bizzare; it is absurd and a real health risk. In my case, my patients behave differently; they consult me before they are subjected to any procedure, be it back surgery, tonsil removal, septal deviation surgery or Lasik®. As a long-term medical provider, I must live with the negative consequences I may cause a patient were I to perform an unnecessary procedure. It is easier for a detached doctor, a transient provider, to perform an expensive and unnecessary procedure on a patient he simply sees as a client. An older adult, Alice, recently was subjected to an expensive upper endoscopy for early satiety, bloating and "burning throat." The medicines she was given weren't helping. When I examined Alice, I discovered a major conflict associated with anxiety. She was about to lose her job. Alice's anxiety was causing her a dry throat (globus hystericus; it is a common condition that I call autonomic pharyngitis) that felt like "hair" or "cotton" in the throat. Many patients with depressive-anxiety-migraines or headaches are often treated under the "sinusitis" or "septal deviation money making models. Migraine headaches can be utterly disabling. I have successfully treated over 99 percent of my patients with migraines with rest, conflict reduction, an antidote of hope and Fioricet®, often with one or two teaspoons of a four ounce mixture of promethazine syrup 6.25 mg/teaspoon, 2 oz, with Diphenhydramine 12.5 mg/teaspoon 2 oz. I never prescribe promethazine by itself, i.e., without Diphenhydramine (the active product in Children's Benadryl Allergy Liquid or Target's Children Allergy Medication. Promethazine is a prescription phenothiazine with special neurological properties and can help with the nausea and vomiting. Your doctor should be able to tell you why I mix Diphenhydramine with Promethazine, if not ask an expert in pharmacology. It is difficult for me to see the working poor go to work in pain or risk losing their jobs. Unlike government workers, the working poor can be fired any day, do not have sick days, insurance or vacation. It is inhumane to see the working poor work and sweat for meager wages. Fioricet® is available as generic, is inexpensive, is not controlled, and each tablet contains butalbital 50 mg, acetaminophen 325 mg and caffeine 40 mg. I do not prescribe any of those new and expensive drugs that are marketed for headaches; they are less effective and some have serious side effects. I do not recommend drugs like Aspirin, Aleve®, Advil®, Motrin® because a headache may also portend a serious condition, a hemorrhagic stroke. Advil-PM contains Ibuprofen 200 mg, an over-the-counter non-steroidal-anti-inflammatory drug (NSAID) that has potentially serious side effects. Advil PM also contains Diphenhydramine 38 mg and is sedating. For chronic tension headaches, my patients take Acetaminophen (the active ingredient in Tylenol®) and one Sominex® (Diphenhydramine) 25 mg; both are over the counter. When a patient asks for a physical exam, he's really asking for a "brain tune up" and often involves a lot of psychiatry. An hour with a patient can save tens of thousands in unnecessary care. Luis Lomeli M.D./Beta
Author: [2]LuisLomeliMD
Keywords: [3]Advil [4]PM [5]sominex [6]headache [7]dizziness [8]blurry [9]vision [10]fatigue [11]tingling [12]anxiety [13]gas [14]dry [15]sore [16]throat [17]Luis [18]Lomeli [19]M.D.
Added: May 3, 2008
rss@youtube.com (LuisLomeliMD) Sat, 03 May 2008 23:28:46 -0700
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