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cnm1

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Posts posted by cnm1

  1. Unfortunately - EVERYONE with these illness gets told this at some point :angry: When my daughter got sick, they said it must be mental because she was not getting better - what does that mean. She went through 5 - yes 5 separate psych evaluations. Each one said they thought this was a physical disorder :blink: SOOOO the pediatrician would insist on a 2nd, 3rd, 4th then 5th opinion. :o

    THEN one of psychologists LECTURED ME that I needed to be more assertive with the MDs :ph34r: since it was obvious this was a medical conditon!!!!!!!!!!!!!!!! I thought I would loose my mind!!!!!!!! WE could not win!!!!

    I see this all the time with pts. I am a nurse midwife. Pts with chronic pain are told it is "stress" all the time. Sorry you had to go through this but it is thw way MDs are taught. If in doubt - blame the pt.

    Louise

  2. I know that for my daughter - dietary restrictions have made a huge difference. In 2006 , an immunologist/allergist dx her with wheat (not gluten), soy, dairy, egg, and peanut sensitivities. This was based on IgG blood tests. He said it was not an exact science but to try dietary restrictions to see if it helped. It did - big time. Of course in the last few months, she was dx with MCAD by Dr Castelles and started on gastrocrom. It is the best she has felt in 10 yrs.

    I want to recommend a wonderful cookbook for those with food allergies/sensitivites: The Allergen-Free Baker's handbook by Cybele Pascale. The recipes are amazing - good even if you have no food allergies. I could not believe the banana cream pie!!! :P

    Louise

  3. For those pursuing mast cell disorder, my daughter, Rachel, has been on gastrocom for 2 weeks (along with her other meds). She says it is the best she has felt in 10 yrs. She able to do aerobic exercise and not crash. Very exciting!!! :D It has been almost 10yrs since she got sick - 5 of those years were homebound. She has made steady progress over the 5 years with meds, diet, lifestyle modication and is attending grad school full time. There is hope!!!!

  4. Hi

    Unfortunately Julie is right - seeing a mast cell specialist is the best idea. My daughter, Rachel, has had several visits with Mariana C Castells, MD in the last few months. Rachel has added MCAD to her dx list and more meds: gastrocrom and something else that I can;t remember right now :blink: . RAchel is in grad school in Boston so it made it a bit easier for her to get into see Dr Castells. Good thing I kept her on my insurance - the tests and meds are pricey and would not have been covered by her crappy grad school insurance.

    Rachel was impressed with Dr Castells - kind of the "Blair Grubb" of mast cell stuff. Good luck!!

    Louise

  5. I have thought that this is the basis for my D's POTS for a while. 6 months before she got sick, she started having random severe flushing episodes and gastointestinal problems. She is now living in the Boston area. She has an appt with Dr Castells in Feb. (FYI Dr Akins, formerly at U of Mich, is now in practice with her). Rachel already takes H1 and H2 antihistamines and is on a restricted diet. She was dx with food allergies/intolerances 3 years ago by a pediatric allergist/immunologist. It has really made a huge difference in her life. I am hoping Dr Castells can fine tune her meds and maybe add gastrocrom. I am so grateful that this site introduced me to this aspect of POTS.

    Louise

  6. Aquadiva

    This is a common problem. Many docs (even so called dysautonmia specialists) don't know the drugs. It is the reason we go to Grubb. It seems that alot of people do not do well with the beta blockers. For my daughter, the order was florinef and wellbutrin xl,midodrine, mestinon. I do not understand why these docs have not read the research out there.

    I was able to get someone local to start the florinef (she knew Grubb and thought highly of him). Of course, she 1st wanted to know if we would like to wait and she how she did on her own. At that point she had been homebound about 2 1/2 yrs and used a wheelchair alot. Uh - no :ph34r:

    Louise

  7. :( (((((Caterpilly)))))-

    For my daughter, we found low doses of alot drugs works best for her. Midodine is only 2.5 mg 3-4 x.day. Mestinon is 30mg 2-3x day. Florinef is .1qd. wellbutrin xl 150. Lots of H1 and h2 drugs. Diet management. She started each med at a 1/4 -1/2 usual starting dose. She would up it until side effects bothered her. If she noticed ANY benefit at the lower dose, she stayed on the drug while we added a new one. Diet is very important for her.

    This seems to be different than doses alot of people use but it took from homebound for 5 yrs to school fulltime (though suffering miserably this week :( .

    Louise

  8. I have no idea what they mean about a test!! The health care organization I work for does 100s of IUDs each year. I suspect they try sounding 1st but I see no point in that at a separate visit. That is done at time of insertion. If you can not sound then; then no insertion is done. (sounding is using a narrow device to see if you can enter the uterus far enough to place an IUD). Doing that at a spearate visit before hand only increase cost and pain. I don't think this doc does many IUDs. Trust me experience helps with insertion!!!

    I don't see a big demand for implanon. For those who want it, I suggest a trial of Depo 1st, similiar side effects and no incisions involved. EMAIL me and where you live; I may be able to offer you another place for a second opinion. I really recommend a second opinion. No offense but I am not impressed with the options your MD is offering and his education on these issues.

    Print out someting on POP and call you doc. He should be able to start you on that immediately. Geez I can't believe how complicated some docs make this stuff. I have to say lots of docs in private practice send their pts to us for IUDS because of our experience with them (using we do them cheaper too since we get a volume discount.

    Louise

  9. Wow, something I can offer some advice on :P I do ALOT of IUDs. In fact, I inserted 2 today - 1 paragard, 1 Mirena. Both never had children. It is like everything some like them, some don't. It certainly hurts going in but it only takes a couple of minutes. Most women are ready to go back to work afterwards but I expect with POTS; probably not. The research indicates little systemic absorbtion with the Mirena but I do have pts who complain of "hormonal" issues. I expect that there are exceptions for everything and some might absorb more hormones than others. My clinic does 50-60 iuds/year!!! Many in women with no children. There is a increase chance of expulsion if you've never had children but not greatly. Things like perforation - rare with an experience clinician. Imbeded - rare too. Geez- I can't think of any IUD in 15 years that wouldn't come out if I could see the strings

    I do suggest inserting an IUC on your period if you have never had children but they can be inserted at anytime if there is no chance of pregnancy. Some clinicians will use misoprostol before an IUC to ease insertion - I am not impressed so far.(taken either 12 or 1 hr before insertion: it can soften the cervix.

    Stacie

    You could also take a progesterone only pill (POP) like micornor/nora b. FOr some reason alot of clinicians forget about them. WHile not as effective as estrogen/progestin pills, they are still highly effective (95%). My former clinic did essure - for most it is a pretty simple proceed with severe cramping for a 1hr or so afterwards. To be honest, from what you have told me, I would suggest a progestin only pill while you consider your options.

    Louise

  10. "Meet Dr. Robert J. Rowen ? the groundbreaking M.D. who?s trained over 400 doctors? cured over 5,000 patients?and helped pass the nation?s first medical freedom law "

    Hi

    Is it this Dr Rowen? I have to admit after visiting his web site, I think he is a quack. The more DRs promise the less I believe. Shoot, I am a nurse midwife. I have cured over 5000 people (of chlamydia, trich, BV, and yeast). I have also trained more than 400 graduate nurses and residents. So has almost all working health care professionals. Just my humble opinion. Now, that does not mean he is never right but I run from miracle workers.

    Louise

  11. I also sent an email to Public Citizen Health Research Group. Their MD thought the FDA removing the drug was a good idea. I emailed them to tell them why they are wrong. It is one more place that people might want to contact. The issue with the drug is not safety or effectiveness: it is politics of our healthcare system!!!

    Louise

    Thank you for contacting Public Citizen.

    I understand that you do not want the FDA to withdraw the approval for midrodrine. I will forward your email to our researchers.

    Again, thank you for contacting Public Citizen.

    Sincerely,

    Ben Weaver

    Consumer Correspondent

    Public Citizen Health Research Group

    Health Research Group

    Public Citizen

    202-588-1000

    hrg1@citizen.org

    http://www.citizen.org/hrg

    http://www.worstpills.org

  12. I have mailed letters, emailed and called Shire, generics, 2 people at FDA, my congressman/women, one FDA petition. I can't even believe this is happening - it is a critical drug for my daughter. Very frustrating!!

    Louise

    I am working on my letters and also working on 'directing' friends and family as to how to speak up. The squeaky wheel gets the grease, right? :P

    I got the automated reply from the FDA to my email, and noticed they had made a couple of changes to the letter. They are below. They have added in yet ANOTHER contact address.

    I am confused about what the best way is to make our voices heard. Is it to have people call, email the FDA, email the doctors, mail letters to the two doctors listed in earlier posts, OR send a letter to the address below. I realize that maybe some of us here on the board will do all of them, but I was wondering if anyone knew the best routes to direct friends and family. I think they would be willing to do ONE of the things.

    Anyways, here is the stuff that was added to letter and the new address they sent.

    Would love to hear your thoughts, Thanks!

    Although we cannot disclose the full regulatory history of this drug, we have exercised some regulatory discretion in retaining ProAmatine and the generics on the U.S. market for this long. Orthostatic hypotension remains an important problem for people who have it and we note that, even now, no FDA-approved alternative treatment exists to treat the condition.

    We appreciate your comments regarding the midodrine withdrawal. The Docket number for the FDA proposal is: FDA-2007-N-0475. FDA is monitoring the comments and will be discussing the potential impact of such an action as withdrawal. Written correspondence to FDA may be posted to the public docket (FDA-2007-N-0475).

    Send to:

    FDA-2007-N-0475

    Division of Dockets Management (HFA-305)

    Food and Drug Administration

    5630 Fishers Lane, Room 1061

    Rockville, MD 20852

    * Entitle your letter: A Response to the FDA proposed withdrawal of Midodrine

    (FDA-2007-N-0475)

    * Clearly and efficiently state your concern and ask your questions.

    * Be sure to provide your contact information.

    * Save a copy for your records.

  13. I also contacted my congresswoman today

    Louise

    I wrote to both FDA and my congressman. I am not sure the latter would be that effective. And apparently the manufacturer was looking at discontinuing production anyway? I just skimmed everyone's messages so not sure I got all completely correct.

    This is what I wrote:

    I am very concerned by the decision of the FDA to withdraw the marketing approval for Shire Development Inc.'s midodrine hydrochloride product, Proamatine. This will require the company to conduct additional testing in the millions of dollars, and apparently the company would rather stop producing the drug at all than go through with this testing. The problem is that this drug and all generic versions are now at risk of no longer being available at all in the US, or only possibly on a very limited basis. Midodrine is a highly prescribed drug for the conditions of Orthostatic Intolerance (POTS, NCS in particular). I have POTS and through a support group have come to know many others with this condition, many of whom depend upon this drug for quality of life/function; without access to this drug, hundreds of thousands of patients are facing the prospect of losing their jobs, their ability to care for family, participate in hobbies, and function without disability. As far as I understand, there is no substitute drug that would work as well. Midrodine is not a widely prescribed drug, so it is not in the economic interest of the manufacturer to conduct extensive additional testing. I am not sure what role congress can play in this issue, but I wanted to bring this to your attention. http://www.ashp.org/import/news/HealthSystemPharmacyNews/newsarticle.aspx?id=3387

  14. My feelings exactly, Chaos.

    You just got to love dealing with government agencies. I emailed the FDA and got the typical response about how they approved the drug in an accelerated manner, they are removing it because the studies weren't done and then they include the sentence about how "in the case of Midodrine there are no alternative treatments...." Then in the very next sentence they say I should talk to my healthcare provider about treatment options. HELLO????? Is he somehow going to be able to snap his fingers and make another drug appear???

    It's not bad enough that we've all gone through **** to get to a doctor that knew enough to prescribe something that actually helped us? Now we have to fight the government to try to keep a drug that at least has allowed some of us to return to a somewhat functional level??? AAARRRRGGGGHHHH!!!!

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