sisblostg

I tried a sleep study a few years ago and I did not sleep at all. They wanted me there from 8pm till 7am. I usually fall alseep on a very good night around 1am, but on a bad night not till 4 or 5am. There was no way I could sleep. There is only place to get a study locally and the dr said he would not try again. I did take Florceinef twice in my life but not more then a week before I said this isn't worth it. The last time I tried it was over 6 months ago. Most of my managment is non prescriptions. I manage with careful fluid, salt and diet (lot of GI stuff). I only take klonopin .5 and clondine .1 as needed and I have taken those as needed for 15+ years. I take a half a lortab a few times a month if my eds pain is bad but it has to be rolling on the floor bad. The only antibodic I can tolerate these days is amoxicillin and I did take that in early january for the sinuses but it did not work. All the antibodics above amoxcillin I have not been able to tolerate (some like keflex, agumentin I took for years just fine but the last 2 years I have horrible side effetcs). I have taken a few advil, vitiam D, and use a neti pot. I had one filing redone, by a wonderful dentist who does not use novicane(understands POTS) and I felt fine after.

I think it is much harder as your kids get older. It was harder physically when my kids were young, but they learned to be helpers fast and we lived in a smaller house. Now it kills me when my kids have sporting events, concerts, and school activites that I can't attend. It has been my one goal to be able to find a way to make it to thse events and each year has been getting better. If the events are under 2 hours, I carefully dose a klonopin (I have issues with aderline surges especially if Im starled and I would not want to embaress my kids) and have my husband or friend drive and I sit where I can get up if I need to. In 2011 I did not make it to one basketball game, 2012 I made it to 8 out of 10, but didn't enjoy myself because I felt awful physically but great mentally for making it to see my kids. In 2013 I have not missed a game and only had one game I felt bad for. It does take all day planning of everything I do, eating, sleeping, fluids, meds for a 1 hour game, but it is worth it. What I am most guilty about it is travel. Even though I am stuck at home I traveled alot as a teen and young adult. Now my kids are as trapped as I am. We live in a decent size but landlocked city. No museums, no culture, no place to travel to within a few hours. Last summer I let my husband take the kids on a vacation. My daughter was so sad to leave me behind. I was happy that tthey got to go to disney and the beach but sad as well that I was not able to see their happy faces. It is so hard because my husband job is great and we can afford to travel and I want my kids to see the rest of the country and europe but I can't travel. We thought of an RV but the travel time takes up alot of the time my husband could take off work.

Getting enough sleep seems to be a big factor in how well my POTS is managed. At the end of 2012 I was having more trouble then normal sleeping because of pain. There was some swelling on my left upper flank (my dr who is never really concerned about much, was concerned over this but after all tests came back ok & the sweeling went away he let it go). I then had to admit that I had a sudden increase in my breast size. 4 years ago I had a sudden jump of a cup size and it came with 4 months of swelling and pain that went away but my larger breat size remained. This time my breast size went up 4 cups sizes in less then 2 months! Mamogram, ultrasound, blood work normal, just pain and some very large breasts. If this change is permenant I have no idea how I can live with my new chest (36G) and Im normal height weight BMI like 23-24. I already have EDs and this is making the back/shoulder pain worse. Could it be the diet (high salt, extra fluids) or adernline rushes from my H-pots that could cause this? Or is it a normal part of hitting the big 40? I finally thought I found the right pajamas, tempature, pillow, position, tv show to be watching to fall alseep and the last weeks have been horrible. I had some of the 80's sitcoms on dvds I would watch as I feel asleep. After the episode was over the tv would stay on a fixed screen and there was no sound. One night my husband got up and shut the tv off. The flash of the tv going off and the room becoming dark sent the aderline rushing? My eyes went weird, the light on my phone and computer charging were unbearably bright. I was shaking, high pulse and it took me 3 hours to get back to sleep. I realized for some reason my eyes can't handle a dark room that has any flashing light. Since then I have had a hard time getting to sleep and staying alseep. It is like Im not sleeping deeply. My daughter got a drink at 4am and I normally would never hear this but it jolted me out of bed again taking hours to get me back to sleep. When I do get back to sleep I wake up feeling horrible. Not a fast heart rate, but I usually have 2-3 totally numb limbs, headache, problems adjusting to tempature, nausea, and alot of morning dizzyness. My ears are ringing so loud when I wake up, there is no way I feel like I can fall back alseep even if I wanted to. Before this started my morning were ok as long as I drank alot of fluids before getting out of bed, & starting my day at my slow pace. Now it takes several hours just to wake my body up. Even after I get up I feel like my circulation is horrible all day. My balance is worse, ears constantly ringing, neck painand headache almost daily and I feel liking I'm quickly sliding back in progress and want to get a handle my sleep issues. My only current infection is my chronic sinus issues. Im also not sure if the lack of sleep is causing a vicous cycle of problems? I also know the fact that most of my family has died before or in their 40's due to anerysms is in the back of my mind but I have known that all my life & have been able to handle it. I have very limted access to medical care locally, just a primary care dr that takes care of my urgent issues and a few specialists that blame each other but do not want to tackle EDS/POTS or anything non strightforward. I am suppose to see a new primary care dr that just came to town in march but I can't go sleepless till then.

During good days standing is 120-125 anf resting is in the 70's. If I don't get enough sleep have any sort of infection, or have not had enough fluids standing is 155+ and resting is 90's.

I hate pills but I do drink the naked juice power C machine(it has 1000% of vitiam C per serving). They started carrying it at costco in the bigger size so it is finally afforable.

Thanks for the info. I finally finished my 720th bottle of orange powerade(my husband got them for .15 each with a coupon) and I then he found purple powerade for .23 a few weeks ago and bought 150. I think I need a change in my drink rotation when I have been referred to as the orange powerade mom.

The fever was the highest for the first week 103-105 and I had a pounding headache along with it. Now it comes and goes (I have been taking motrin & tylenol daily) and is lower 100-101. It usually is higher at night. Taking tyelnol or motrin and a nap make the fever break easily now. Right now the stomach issues and nausea are most bothersome. Of course the worry about the low WBC doesnt help. I also dislike that doctors only work in office here M-Th. So if you have blood drawn after 3pm on Wen you have to wait till monday morning for results. I'm anxious to know where my WBC is now. My dr gave me some phenergan for the nausea. I have never taken it before and after having some bad reactions to new meds when my POTS is very active Im scared to try anything new right now. Especially after my trip to the ER(I hate the ER) blew out 4 veins. I still get shotting pains down my arm 3 weeks later. I think Im having some real bad luck because I have had 100's of blood draws(I was on comudian for 5 years) and IVs and never a blown vein. It is 108 out and Im embaressed to wear a short sleeve shirt because I look like an abuse victim. I know I have a worrying problem and I end up caring too much about people. The positive side of POTS has been spending more time with my kids and helping them learn. I can't believe how much my kids learn just by spending an hour a day with me working on a subject when we used to spend that time going out to movies, dinner, or at the mall. My teenage son who had a learning disablity is now schedule to graduate high school and college at the same time. My daughter skipped a grade and was offered to skip more. Now every parent wants to know what I did and suddenly I have a ton of kids here after school. Up to 20 a day. In some ways it keeps me busy and makes me happy I have something positive to do but with that many kids the law of averages says you are going to hear some sad stories and it is hard not to internalize them. POTS has helped me learned to give up my need for control and helped me deal with change better but Im still a worrier. I do have to say these 2 friends of my daughters that moved, moved to very bad situations so I was worrying more then usual. I can see worrying making you tired or weak but can it really cause a low WBC and high sed rate?

HIV is a No ( I have been tested a bunch of times due to the past CMV & recently for life insurance & I don't partcipate in anything that could cause a new infection), I got tested for lyme a few years ago but not recently. The dr pushed off cancer by a combination of some blood work/cultures and that I have had just about every part of my body scanned/MRI recently (head, legs, feet, spine, abdominal). The lymph node that is the biggest is one that has a history of getting big during past infections so the dr didn't seem concerned because there was records back over 10 years of that same node causing issues. Should I ask about a biopsy I dislike my lack of local medical choices but the good side is since all dr's are in the same network they can see every test and I have a print out of everytime I have ever gotten blood taken. It goes back 15 years. I have over 75 results to compare. The only 2 times in the past 15 years my Blood cell count was not in normal range was during the CMV infection and when I had a 2nd trimester miscarriage. These both happen more then 5 years ago. My blood has been normal for the past 5 years excpet very low vitiam D. How can EDS effect WBC and sed rates? I got dx with eds at the mayo and have had little follow up. The only person who had any knowledge locally was a PT and he just works on pain and mobility not the medical aspects. I didn't dare say this to my dr because they love to use stress to explain myserty diseases but the week before I got the fever was very stressful. I knew it was going to be very hard. My daughters 2 best friends who lived with us most of the school year(kind of felt like they were daughters) were moving long distance and one of them was moving into a sad/scary situation. I had spent the week not sleeping much ith 3 crying girls. I did the most driving and being out of the house I had done in 3 years that week. The morning I woke up with the fever was suppose to be the first day of my long weeknd of rest. My husband had 3 days off and I had a bunch of dvds and I was planning on total rest. I think this is why the dr says viral illness and brought up the EBV and CMV as possible causes. I didnt tell the dr about the stress part just that I was more active the week before and got less sleep. I did google the causes. What do I think it could be? some sort of autoimmune disorder (I have wondered about Sjordens I have severe dry mouth, eyes even nose and my elbows and ankles are so dry it is painful), or the collagen vascular issues. My whole fathers side of the family died of vascular issues young. That is why I got the blood work recently for EDS 4 but who knows if it is some other vascular condition. We have no rhemtologist in town and Im on the waitlist for one about 4 hours away. I really want some sort of answer. I have been too scared to fly(on top of POTS my dad died on an airplane due to a massive vascular event) and my daughter wants to go back east. We cancelled our trip last summer and we promised her this summer. Before the fever I felt okay if my husband took her for 5-6 days but now he doesn't want to leave me and Im in no condition to fly. Im also very bummed because the hospital just got a cardilogist that has POTS knowledge and I had an appointment for a bunch of tests a few dayas after I got the fever. Now I had to push the tests back because I want the results to be accurate. The only med issues have been advil/motrin is really making my stomach worse. I rarely took advil in the past because I have one kidney but since the fever I have taken in daily. Two days before the fever I switched to a different brand of klonopin. I have taken klonopin for 15 years and I could find no pharmacy with 100 miles that had the brand I had taken so I had to take a new brand...not sure if that could make a difference..I guess Im trying to look at ever possibility.

I would love to have a sore throat or sinus symptoims, something obvious. I did get a strep test and they also did some blood work for chronic strep which were okay. I had a 8 month battle with CMV 9 years ago but it my blood work did not show evalated CMV or EBV (I had bad mono in college). My vitaim D is still super low like a 6 after taking 50,000 a week. I do have very swollen glands. One large one in behind my ear that hurts to turn my neck. I did already have my gallbladder out. It had a large clot not stones. How I feel right now is a combo of how I felt the day I got the clot in my gallbladder and when I had mono.

I was tested by Dr Goddman in Scottsdale as well. I had a regular 10 minute TTT with the QSART test and the norepherine 10 minute lying down standing up test. I "failed" the TTT but it was the norepherine test that had the wow results for me. They had me lay down in a quiet room for 30 minutes, then took by BP, pulse and blood and then I stood up for 10 minutes and they did the same. I didn't even think my adernaline issues were that bad that day and they went from under 200 to near 2000 just by standing. I had a speech evaluation the same day which said I had a bad starle reflex which made my aderaline go nuts, but they did not have a quick way to draw blood. I would have loved to know what the levels were. My dx had OI, Hyperandregic state, and POTS in it.

I recently "failed" a bunch of balance tests. Part of my balance has to due with EDS and very flat feet. I was also told that being non-active for so long my muscles are weak (mild atrophy) which does not help balance. Pt really wants me to stregthen my leg muscles to help with balance. What has helped me is taping my feet, getting really good sneakers, not pretty ones , and if I go out walking I have my husbands arm for support or push the shopping cart at the grocery store for support. One dr offered me custom leg braces and another offered a walker. My doctors/Pt have fought over do you give your weak muscles extra support so you have better balance and less pain and walk more or will braces/taping cause muscle atrophy in the long run? Right now I tape or use a generic leg brace if Im going out for more then an hour(my big fear is faliing in front of my kids) and use nothing around the house.

This was the first thing I said that made one of my doctors take notice. At first I said I was dizzy doing a bunch of activites but I said I even feel dizzy going to the bathroom caught his attention. I make sure I sit down and stand up slowly. I also hold on to ( at first the toilet paper holder) now a bar to stabilize myself. Im not sure if it is the h-pots, but if I get unstable the adrenline hits and Im shaky and dizzy.

I did not pool when I first noticed symptoms. Now if I stand for more then 10 minutes I do. I don't even look down in the shower because I know it just makes me more nervous to see the color change. I have also had times recently when I am standing talking to one of my kids friends moms and my legs will ache and I get bruises from just standing in my upper thighs.

I have h-pots and eds 3 (possible eds 4, still waiting to hear about blood work). I have, been very symptomatic for the last 2.5 years. 1 month ago I was having a decent day, was able to cook dinner,played with the kids and even made a trip to the post office. It had been a busy week at my kids school so I was a bit run down but was looking forward to resting over the weekend. That night I woke up with 105 degree temp, usually anything over 99.5 makes me feel horrible so 105 was bad. I had a massive headache, mild stomach ache and no desire to eat. 24 later I went the ER. low WBC (3.4) sed rate elevated, billrubin slightly high (1.4 I think) the fever broke to 100 with double doses of motrin and tyelnol. They gave me iv antibodics (all they could guess was a kidney infection which was not the case because nothing grew on the culture). The next week I still had a fever, it would spike to 102-103 if I didnt take constant motrin. I had a abdominal CT(I have a history of severe constipation and slow gastric empty) which was normal. My wbc went up to 4.1. and sed rate drop a bit. I went to get my blood work redone and I freaked out because I had a head to toe rash. Weird only my hands and feet itched like nuts. The rash last 4 days. The dr said he thought it was related to an unknown virus? It is 2 weeks later and I still am having fevers, though milder, I have no desire to eat anything and if I do I feel full quickly or very naueous. I have lost 9 lbs this month. The stomach pain comes and goes and my stomach feels like an an acid pit. If I eat more then a few bites I get so sleepy. The last three nights I have fallen asleep at dinner. Im almost afriad to try and eat. Im eating the squishiest protien I can. I have an appointment next week with a local GI dr and had blood work repeated today again. Im not sure if the fever/rash are seperated or related to to the stomach issues? I just really would like to be able to be able to eat one meal. I dislike losing weight(Im not skinny but I have normal BMI but losing 9lbs without wanting to scares me). I have had slow gastric empty and constipation issues for 2 years but I have been so careful with my diet and have been okay for the most part. I have never had pain, so much acid or a fever before. I also do not like being down for so long, even a few days in bed with af fever seems to set me back months of progress on my pulse issues. Any tests I should ask for or meds. My local dr's are clueless with the h-pots and eds.

Hi! It sure is different for everyone. I can trace my symptoms back to when I was a teen but back then the symptoms were annoying but not disabling. My first pregnancy got me the dx of OI. I did get better, I think they like to say functionally recovered? for a few years which means I was driving around town but not cross country, or I was going to the grocery store but not walking around a mall for 3 hours, but it was enough that I did not feel like I was missing out on too much. Each time I had a relapse(from pregnancy, virus, stress etc) recovery has been harder. It went from a few months the first time to a year or more to get back to fuctionally recovered. I am not sure it is age, if as I got older it is harder to bounce back? but my last relapse(in my late 30's) left me at my lowest point even getting up and going to the bathroom or getting a drink was hard. When got to that point I went to the Mayo and got an offical h-pots dx w/suspect eds and a "plan" and went from bedridden to being able to cook, do some chores, get out to school functions and drive short distance sometimes. Right now I hope for a more full recovery again but I am happy with what I can do and each new thing I am able to do. I think what has helped me mentally deal is that my family has an ALS (lou gerhigs disease) history and after seeing family members die of ALS, I appreciate the functioning I have and that I get to see my kids grow up. I have found that sleep is very important and well as not losing muscle when you are not active. My legs have atrophy over my years of on and off activity which I think has made recovery harder each time.

Today I got my filling done. I actually had another tooth crack 3 days ago and it was hurting so I opted for that tooth since my orginal tooth was not hurting. Maybe this low vitiam D is suddenly making my teeth bad? I took a .5 klonopin at 8am and another at noon. I was still nervous so who knows if it helped but I did not have a surge. The tooth I had done was on the bottom, the first tooth in front of the molars. I took one small dose of carbanade(sp?) injected very slow and didnt even feel it. The dentist wanted to do a second shot but I felt numb and said lets just try. I think I was nervous because my whole left side felt a little weird after the shot. I didn't feel any pain with the one shot. I think the dentist was surprised since he had to push around the gumline. My pulse was in the 90's before the shot, in the low 100's during the procedure. I was a bit viasably shaky after for about 30 minutes. The shot has been wearing off quicker which is fine. Besides my nerves this has been one of my more positive trips to the dentist. The dentist was nice. He had never dealt with POTS and I'm not sure if he understood it fully. He is the only dentist certifed in some sort of extra heart training and deals with our large senior population with heart issues and had full monitoring equipment and is next to the hospital so it is better then who I was seeing before. My orginal plan was to try and do both teeth at once but since they were on opposite sides I opted not to. I think getting through one, will help with that "secondary anietxy" next time.

I vote mine swings high and low. I do take my blood pressure daily on an accurate machine at the same time of day while sitting down and it averages 128/80. I have had readings as low as 60/40 and as high as the 200's. I have found the lows are when I have to sit and wait for hours at the dr's office my pressure is high. It is also high during surges. I have found it get very low when I am standing and talking(or as I would say just trying to be a normal mom in the school parking lot).

I always seem to end up at the same weight. When I had had some severe symptoms or GI issues I have lost up maybe 10 pounds but once things settle down I always end up at the same weight which makes my BMI about 24. What I dislike is the dr never says much about my weight because it is in normal range but I know I have a higher % of body fat then my overweight friends becasue I have lost muscle for sure over the years. I might be the same weight as I was 10 years ago but I have noticable atrophy in my legs.

I have had some surges in the middle of the night. My heart will suddenly start going 140+ lying down. I have wondered if the sudden fast pulse causes the surge or vice versa (because it is scary to have your resting heart suddenly go so fast). I told my dr there was no way watching Family Matters at 4am on Nick at night was causing a panic! I'm sorry Urkel does not scare me or make me worry. I have also found that taking a small dose of klonopin regularly helps alot but not 100%. I still have 1 night episodes a month. Luckily I have an understanding husband who will sit up with me till I feel better or can get back to sleep or it is morning! If I get a surge at night I usually take an extra klonopin. It takes about 30-45 minutes to help.

I had a speech study done at the Mayo and I failed! I had complained because sometimes I would get so tired just talking on the phone, and a few times was unable to talk. It was kind of like a final straw, like I was stuck in the house and I could not even talk on the phone! The speech study I had to read a little paragraph 3 times. After the second time it was tiring and the third time I could not finish. I also tested positive for a startle reflex(I did not even know the SLP was doing that part of the test). They did a swallow test and it was fine. The PT gave me some muscle strengthening excerises to work on. I also found that when my stomach is full the speech is harder or if I am standing and talking it is harder, not sure how this blood pooling works but I know if I want to talk for a long period of time I have to have not eaten recently and well rested and sitting/laying down. I usually preplan my day around when I will have to talk for long periods of time. I have also noticed it is alot harder to talk on certain phones. I usually use speaker phone. If I have to hold the phone I get tired very quickly. I have H-pots so when my converstaions are stressful I notice that I tire more easily. I hope you get some relief, I totally understand how you feel.

I'm finally better, well not constipated anymore. I got to see a dr on call since my dr was away. He was a better personality fit. I finally got my x-ray. I had taken lots of natural remdies but I was conservative with the laxtives. He sugested just once to clean things out to take a saline and a stimulant at the same time. I had tried both but seperately. I was scared of this but it worked. I took half a bottle of mag citrate and 2 dulcolax and tons of fluids and that worked (really well). The dr offered me Goletly(that colon prep stuff) just in case because it has electrolyetes but I promised him I drink a ton of fluids and I would add extra powerade. I had a follow up x-ray my colon was empty. Then I had to eat light but not a liquid diet for a few days, kind of giving my body a rest and finally 4 days later I had my first solid regular movement in almost 7 weeks. I have been eating again and just using the prune juice in the am and I have been trying to adjust the right amount to keep things moving but not too fast! Sadly my pulse is back up some, not as high but I certainly am not enjoying the little freedom I got a few weeks ago driving. I was averging 10,000 steps a day and now I'm at about 6500, which is still good for me. I just wish the steps were further then running around my house! I'm a numbers nerd and I partciapated in an 7+ year study at Yale years ago, it had nothing to do with POTS but it did document consitipation, my vitals and actvity levels. I have found a definite link between my chronic constipation and health levels. I also found that surgeries that required my to use strong laxtives beforehand I had a much longer recovery time. Who knows if there is anything to it, but at least it has given me a project to do while resting. I had some bloodwork done before before I took my laxitive combo and my vitaim D is lower then ever. It was 12-14 last year and now is 10. The week before the bloodwork I was living on tuna and other fish as my protien and I was taking a supplement. I live in a very sunny 100 degree weather area with not much shade so I get plenty of sunlight. The dr is uping me to 50,000 presciption pill now.

I dont know if it is psychological or not but I have taken klonopin .5 for over 10 years. It was always the generic yellow pill. The last refill I got was a peach pill. I called and they said it was a new brand and it was correct .5. I felt like it did not work as fast during a bad surge. I went to different pharmacy and got a my next refill in my familiar yellow pill. I always ask the pharmacist if the pills they are given me are pure tabs and can be spilt since I usually take small doses because of sensitivty. There have been several genrics and name brands that one was a pure tab and the other one was not. I think the drugs I would be most leary of are extended release. The genrics have to have the same ingredients but doesn't mean they are made the same.

I feel like I have tried every SSRI and SSNI in the last 15 years. Of course it seems all our bodies are so different when it comes to meds, I haven't had great luck with any. Lexapro has been the one recommended to me for h-pots by the mayo and 2 other experts. I was told to start with tiny pieces and work my way up. I had the worst luck with the SSNI like Cymbalta(side effects)and then because I did not like the dependance and having to wean off them slowly. I still feel like klonopin works best for me. I take a small dose daily to keep it in my system and then if I have a adernline surge I can take another pill. I have taken it for over a decade and I still take the same small dose and it works (I have not found any tolerance like some people). I haven't found anything that will take away the h-pots surges totally because I have a bad startle reflex, like the other day some set off a firework near me without me knowing and the noise gave me a huge surge.

I put more then 10 years. I think it is closer to 25 years since about 25 years ago a plane had to make an emergency landing when I was a teen because of POTS like symptoms. The whole trip before the plane ride I was sick, I fainted at disney world. This was also the time I started my cycle. I really feel like for me hormones play some role in the start and with some of my symptoms. I also have been treated with POTS meds for 25 years but for the wrong dx but at least it gave me quality of life and being ignorant of the actual dx I pushed myself to do more and travel alot as a young adult even though I felt horrible. I also feel lucky I went to private school and because I was a good student they let me miss alot of school and still maintain good standing. I missed over 200 days in high school but managed to get into my first 5 ivy league choices. Now Im always scared what if I faint in front of my kids I don't want to scare them and I think I am too cautious. It was 9 years ago I heard the dr say I was OI and treated me for it. I did not heard H-POTS until a year ago which made me feel better because I was driving myself nuts why I had "odd" panic attacks that made no sense.

Right now I am scared for my stomach. It is just not moving. I am not nauseous and have not vommitted(the dr said I most go to the Er if that happened). I eat 2 servings of protien a day (usually fish, finely choped chicken), and mostly juiced liquids and some frozen yougurt. I know Im getting nutrition and ebough calories. I have some muscle relaxers, old script. Maybe Ill try one tonight, since they usually put me to sleep and I have not had good sleep in a long time. I just am so torn. I have done more in the last 2 weeks then in the last 18 months, because of my POTS being better. I have driven my kids places, went shoping, drove to and visited friends. Been averaging 5 miles of walking per day. The only problem is this stupid stomach. I know I can't go on like this forever. the other issue is peoeple say wow you look great, because I'm out, lost 10 pounds, and I got some cool new clothes(spent way too much time shopping online the last year) that I'm finally wearing. I told myself if I ever got out of the house again I would dress better. They think I'm better when in fact the stomach issues feel worse then the POTS. I have Reglan. A dr gave it to me 5 months ago when things first started to slow done but I was too scared because of the stories to take it. Still am scared but I feel like it is one of the only things I haven't tried. Even my husband is frustrated and he is very easy going because of the medical options. I just want an X-ray to see how much stuff is in my stomach. My dr wrote that I must go to the ER for an X-ray and because all the dr's and hospitals are on the same system in a 3 state area, any dr that pulls up my name sees the note and won't order an X-ray.