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Archive for July 26th, 2010

Health Updates

First, several people have emailed me privately to make sure that I’m okay after my last post.  Yes, I’m fine, and I did go to my doctor the next day and got a prescription for Pristiq.  Is it helping?  Who knows.  But I think it is.  Unfortunately, it also seems to make me clench my teeth, so it’s causing me some pain as well, but I’ll live.

I went for a second opinion regarding the gastroparesis on Friday.  I didn’t have any desire for a second opinion – I have full faith in my gastroenterologist and I think he’s amazing.  He’s quite possibly the best doctor I’ve ever had and I’ve had a lot of really amazing doctors.  But he wanted the second opinion for his own peace of mind, so I went down to Georgetown.

The doctor at Georgetown was okay, but not anything mind-blowing.  She basically said that my doctor is doing everything right.  The things that were stumping him were that I’m always nauseated, not just when I eat, and that I have significant and persistent abdominal pain.  She recommended a brain MRI (he’d already done a CT, but she said an MRI might pick up a subtlety that the CT didn’t) to rule out other causes of the nausea.  And she said that although there’s no physiological reason WHY gastroparesis should cause pain, it seems to do so in a lot of patients.  Indeed, according to one study (published this year), 90% of study participants with gastroparesis reported abdominal pain.  So, whether it makes medical sense or not, it is consistent with other patients’ experiences.

She did affirm that a gastric pacemaker is an option I can explore.  Georgetown doesn’t do them anymore.  The hospital made a decision to stop doing them some time ago, but she didn’t elaborate as to why.  They recommended a doctor at Temple University who does them – and he sure does look like the man to go to.  His CV is impressive and he has significant experience with gastric pacemakers.  Still… I’m hoping my gastroenterologist knows of something more local.  I’ll go to Temple if I have to, but sheesh.  I’m still not sure it’s the right option.  The doc at Georgetown warned that she’s seen her share of patients who have gotten the gastric pacemaker and have seen no improvement.  She further noted that it seems (anecdotally) the patients who most benefit from the surgery are those with diabetic gastroparesis.  I have idiopathic gastroparesis, which doesn’t mean it won’t work – it just means there’s no way to tell.

She completely agreed with my regular doctor’s approach to treating me so far, though obviously we’d all like it better if it were, you know, working.  She said he’s got me on all the right medications at all the right doses, and there isn’t anything she’d change.  I emailed my doc and told him that basically he’s a supergenius who’s doing everything right.  We’ll meet this week to discuss next steps.

And, just for fun, I’ve got thrush again. Damn antibiotics.

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