lthomas521

The incidence of "invasive cervical cancer" is about 14,000 women per year, and there are about 4,000 deaths per year from it, in the United States. But there are also about 300,000 women with "high-grade" and 1 million with "low-grade" precancerous cervical lesions every year, which translates to a lot of biopsies and other unpleasant procedures and considerable expense. http://www.aafp.org/afp/20070101/editorials.html Gardasil will prevent relatively more deaths in poor countries, because cervical cancer is easily diagnosed and responds well to early treatment, which is seldom available in poor countries. So it will prevent relatively fewer deaths but prevent more hysterectomies here. There's a serious downside to delaying vaccination. The vaccine is most effective if given before a girl is sexually active. The safety concerns about Gardasil are theoretical. The dangers of HPV infection are well documented. I haven't had Gardasil, because I'm above the recommended age range. I have had the HPV DNA test.

Whenever you try to get information about the benefits and risks of vaccination, remember that there are a lot of people who are opposed to any vaccinations whatsoever, for religions reasons. Such persons are also likely to be against antibiotics, as well, but they won't mention that in their vaccine discussions, because they know it would undermine their credibility. So they pretend to be concerned about the health risks associated with the vaccinations, and they exaggerate these risks out of all proportion. Lately, the Christian Science Monitor has published a commentary recommending that the Gardasil vaccine be kept "optional." http://www.csmonitor.com/2007/0213/p08s01-comv.html The commentary doesn't mention that the Christian Science Church also feels that antibiotics for life-threatening infections and insulin for type I diabetes are also optional. http://www.childrenshealthcare.org/

When I told one of the doctors I saw at my disastrous trip to Mayo Clinic that I was concerned about glucocorticoid effects from Florinef, he sneered at me and told me it was an "old wive's tale." I told him that I have worked in the pharmaceutical industry for several years and was unaware of the FDA ever requiring old wive's tales to be included in the prescribing information for a drug. Incidentally, I grew such a pot belly while on Florinef that a friend of mine who is an Ob/Gyn came up to me at a party, patted my belly, and asked me when I was due. I laughed and told her that it was just weight gain from doing 'roids. I stopped using Florinef after my health improved somewhat. I'm using licorice now, and my tummy is flat again.

In a large case-control study published in the New England Journal of Medicine, there was no evidence that use of birth control pills increased the risk of breast cancer, not even among women who started using them early or who had a family history of breast cancer. The risk did not increase even among the women who used the Pill for a long time or in high doses. http://content.nejm.org/cgi/content/abstract/346/26/2025 Estrogen can increase the risk of blood clots, but the risk of blood clots is also low in otherwise healthy women. Theoretically, a lower dosage would be safer. The following is a Web site that gives some information about the different progestin components of an oral contraceptive and who should not take oral contraceptives. The same basic advice would apply to other hormonal contraceptives, such as the patch and the vaginal ring. http://www.fhi.org/en/RH/Pubs/Network/v16_2/nt16212.htm Recently, there were some evidence that the birth control patch could put you at relatively increased risk for blood clots, because the estrogen dose is so high. http://money.cnn.com/2005/11/11/news/fortune500/patch/ If you want the lowest and most consistent estrogen exposure, use the vaginal ring. There's no evidence that "natural" hormones are any more effective or safer than the synthetic versions. If you want the "natural" hormones for some reason, it might be better to get them in a manufactured product than in a custom compounded product, because the quality control is better in the manufactured product. http://www.mayoclinic.com/health/bioidenti...ormones/AN01133 If you wear pressure stockings, that should decrease your risk of blood clots in the leg somewhat.

When exposed to sunlight, your skin makes a precursor to the active form of vitamin D. This precursor then has to undergo a chemical change in the liver and another in the kidney before it is the active form. Because all of these forms of vitamin D are hydrophobic (they don't mix with water), they need to be bound to a carrier protein to be transported in the bloodstream. So there are lots of links in this chain, any of which can be weak. http://www.vivo.colostate.edu/hbooks/pathp...o/vitamind.html I'm not sure which form the doctors are measuring and which form people are taking by mouth. If you have low vitamin D levels despite adequate exposure to the sun, that is an interesting problem.

Sounds like a neurological problem. Can you see a neurologist? Failing that a podiatrist?

So much for the theory that exercise cures constipation. What kind of exercises are you doing? Are you depriving your bowels of blood to the extent that they slow down? From what I understand, slow-transit constipation can result from excessive sympathetic tone. Remember, the opposite of "fight or flight" is "rest and digest." So if you get a "fight or flight" response every time you stand up or even when you are just sitting up, your sympathetic tone is probably too high for you to "rest and digest." What do you mean by "constipated" anyway? Just infrequent, or uncomfortable, too? Would a stool softener help? Ask your pharmacist.

Yes, that sort of thing could be a symptom of an autonomic problem. Remember, some people with the switched-off norepinephrine transporter gene get panic attacks, and some get POTS, and some poor souls get both. Does it help to know that the feeling is just a symptom? I don't know, because I don't get anxiety.

I've used visualization and relaxation exercises for years on the rare occasions when I had trouble falling asleep. A few months ago, I was lying in bed and couldn't fall asleep. My heart was hammering, regardless of how nicely I visualized. Finally, I just gave up and got a big drink of saltwater. My heart slowed right down and I fell asleep a few minutes after that. My point is that visualization is nice sometimes, but you can't visualize your way out of hypovolemic tachycardia. Nor would it necessarily be a good thing if you could. So don't feel bad if it doesn't always work. Techniques like these are useful for enabling healthy people to feel better adjusted. They can't make sick people well.

It really helped with my fatigue, and it made me feel really chipper. But it also made me more talkative and more likely to speak before I thought, so I quit taking it. It might make you feel more energetic in the short run, but it supposedly generates nitric oxide, which theoretically could make some problems related to chronic fatigue and fibromyalgia worse. http://www.dfwcfids.org/medical/cheney/heart04.part2b.htm

Both panic attacks and POTS are linked to the same problem with norepinephrine reuptake. You can have either or both syndromes if you have inadequate norepinephrine reuptake. I have POTS, but I've never had a panic attack. http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsum Maybe they should routinely do TTTs for people who have panic attacks? My doctor said that the chest pain in people with POTS can be due to the heart "beating on empty chambers." Fluid loading should help that. No one can make any scientifically sound statements about the incidence or likely course of POTS, because there aren't enough data. A forum like this, of course, will attract the more seriously affected people. People with mild illness or remission don't look for forums like this.

A friend of mine who gets bad migraines told me that her doctor recommended that she take magnesium glycinate (chelated magnesium) to help prevent the migraines. It seems to help me, too. A friend of mine who is diabetic was having bad charley horses until I gave him some magnesium glycinate. He stopped having the charley horses until he ran out of the magnesium. So now he bought some of his own and is continuing to take it. Of course, talk to your doctor and especially your pharmacist before you take any magnesium supplement. Magnesium interacts with some prescription drugs.

Why bother dealing with it? She doesn't sound like much of a friend, to me. Why squander your limited energy on someone incapable of compassion? From what you wrote, it sounds as if you are simply giving her an opportunity to gloat about how morally superior she is in comparison with you. Do you really want to feed that kind of ego? This sounds like a poisonous relationship that is bad for both of you. Are you the one who calls her? Try not calling her and see what happens. Incidentally, I think that you are wise. It's better to postpone college until you are well than to do poorly because you are not physically capable of the workload.

When I was very sick, the doctors who didn't think there was anything wrong with me to start with told me that if I would simply exercise, all my problems would go away. When I tried to take this stupid advice, I ended up prostrate. If you are too sick to do ordinary activities of daily living, you may be too sick to exercise. If you feel worse after exercising, you are probably too sick to exercise. If you feel really bad for days after trying to exercise, then you are definitely too sick to exercise, in my opinion. Some doctors think that POTS is just the result of deconditioning, secondary to laziness and cowardice. That is a superstition. If POTS were due to deconditioning, it would be very common. It would be epidemic among office workers and would never occur in highly trained athletes. But POTS is rare and can occur in people who are in good condition. Some people are exercise evangelists. They believe that this modern-day version of "mortification of the flesh" is unquestionably always good. That is about as reasonable as thinking that penicillin is always good. Some people can die from penicillin allergy, and penicillin is ineffective against viral infections. So a blanket recommendation that all sick people should get penicillin would be stupid. The same goes for exercise.

From what I understand, the Epley maneuver is very effective if the problem is that the "rocks" are floating around loose somewhere they aren't supposed to be. If that's not your problem, the Epley maneuvers won't work, but they probably won't be harmful. http://www.earinfosite.org/common.htm

Yesterday, I met a doctor (an emergency room physician) who knows what POTS is. She was walking next to me in the march on Washington yesterday to protest the war. When she told me that she was an ER physician, I gave her one of the DINET cards. She said she knows of other people who have POTS and other forms of dysautonomia. Then she said, "Do you have it?" I said yes. She said, "Then what are you doing out here today? Are you out of your mind? You're going to make yourself sick!" I held up the cane-with-a-seat that I was carrying and promised to sit down whenever we weren't actively walking. I can walk just fine. I told her that I was expecting to be bedridden the following day. (Actually, I feel pretty good today, which I attribute to the cane-chair (which I have named Hi-o Silver) and to the very very salty pretzel that we got from a street vendor.)

Anyone with depression should ask their doctor about omega-3 fatty acids, which you can get from fish oil but also from various vegetable sources, such as flaxseed. Most Americans these days are deficient in them, and societies with omega-3 deficient diets have high rates of depression. There have even been some promising clinical trials of omega-3 fatty acids to treat depression, especially bipolar disorder.

Hi Lina: Sorry to hear that you are sick. Does the doctor know about the burning sensations in your feet? That sounds worrisome to me, because it suggests some sort of nerve problem. Or it could be due to lousy circulation due to POTS. Who knows? You might want to ask your doctor if you can take a lipid-soluble thiamine supplement such as benfotiamine. The lipid-soluble thiamines are naturally produced with thiamine-containing foods are cooked with garlic or onions, and they have been well tolerated in patients with diabetes. They actually succeeded in reversing diabetic neuropathy. Benfotiamine and related compounds are available without a prescription. They smell like garlic, because they are produced when thiamine reacts with a compound in garlic. The advantage to the lipid soluble forms is that they are more easily transported in the body. You don't have to depend on having a functioning thiamine transport system. You might also ask about magnesium glycinate (a chelated magnesium). It really helps to prevent my migraines.

According to my blood volume measurement, I was in class II when I was really sick. Ironically, I wasn't anxious or agitated, probably because it had gone on so long that I was used to it. Of course, the complete absence of anxiety or agitation proves that my problem was psychological. Not. And they laughed at me when I asked for hetastarch!

'"They" do say emotional stress can be a POTS factor.' Really? How can I join the stress-free control group that they must be using in the experiments to substantiate such theories? I'm willing to sign up right now!

Congratulations! I have a relative who has low blood pressure problems and has been having a difficult time quitting cigarettes. I think the vasoconstriction makes him feel better in the short run. Now that I think about it, would midodrine help people with low blood pressure quit smoking?

You will probably have to deal with this problem for the time being. But forever? No one knows enough about POTS or related diseases to make that kind of prediction with any kind of reliability. Unless he has superpowers and can predict the future. In which case he is also superrich from playing the lottery, or at least the stockmarket.

Have you tried B12 shots and carbon dioxide rebreathing?

Some prescriptions medications can cause heavier than usual bleeding during menses. (Look for "menorrhagia" listed among the adverse events in the prescribing information.) Antidepressants are a common culprit. Do you have other kinds of bleeding problems?

I have a healthy lifestyle. I'm also disabled by POTS.