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  1. Oh..where to start... Let me start by saying I still really like this Immunologist. I think he is open minded and is a "healer" not just a doctor because someone gave him a license. Also, let me apologize, this is gonna be a long one. We talked for a long while. I spent half of that time with my head on his desk, leaving sweaty hand-prints, and fidgeting because I was having an acute attack of what ever this is that I have (I've decided POTS+ is a good name.). It was triggered by walking from the waiting room to his office (50 ft). I knew while waiting for him it was going to happen, I could feel it coming sitting in the waiting room. He did offer assistance but I told him we needed to keep going cause I was gonna run out of steam if we didn't. He asked what my goal is in seeing him and my answer was this, "I want to figure out if there is an underlying cause to my POTS and if there is, treat it the best we can in hopes of getting my life back." He said well, "Good! Well, POTS isn't a diagnosis...it's a syndrome and you can't have this many symptoms going on at one time without having at least one disease process going on, maybe more. We need to treat what we know and see what symptoms we eliminate so we can then see if we need to do more diagnostics." (He wasn't being a jerk about POTS, just saying that he thinks there is something more sinister causing the POTS.) He then said, "You definitely have environmental allergies, we have no question about that. You also have mast cell involvement, I am sure but we can't really prove it anyway. It's really not a separate issue as they are related and go hand in hand. We are going to put you on an H1 and an H2 antihistamine and immunotherapy and see where we can get you with that. Then, we will see what else we need to look into." There was a lot more conversation reviewing my history, my current meds, my familial links to allergy and auto immune. I couldn't think very straight so I didn't ask nearly as much as usual...just tried to answer his questions thoroughly. I asked what the official Dx is and he said POTS and atopic allergic rhinitus. (That's POTS and "severe hayfever"!) I also inquired about the issue someone brought up to me about the allergy shots with a beta blocker and he said that is correct and we will have to be extremely careful. So here's my issues: 1) If I do have mast cell issues, I would like that figured out and spelled out so future doctors, insurance co., and SSA take it seriously. I'm afrai they won't take "hayfever" very seriously. On the other hand, is that important or is it more important that he is basically treating for both possibilities and is really trying to get me better? Thoughts? 2) Here's my bloodwork and I don't really understand how it relates to the allergy vs. MCAD issues: IGa = 99 Normal = 81-463 IGg = 707 Normal = 694 - 1618 (No abnormalities in my IGg subclasses) IGm = 33 Normal = 48-271 ***Low*** Ige = 53 Normal = 0 - 114 No food allergies showed up even though we know I have clinical sensitivities. Basophils and Lymphocytes all at normal levels No natural immunity to pneomococcal infection Good immunity to tetanus toxoid Insight? 3) I am really scared to try these shots again because of the last time (and I usually have no fear abuot medical procedures.) I am torn between fear of it really going badly and the feeling of needing to try because I am not getting better on my current tx plan. What's a girl to do?
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