(Note - This appointment happened on Tuesday but as this has been a very busy week (at least by my description) I am just getting around to typing it up tonight.)
This appointment was a follow-up appointment to go over the results and findings of the endoscope I had done back in January and the echo cardiogram I had done earlier in the month. I wasn't too happy that I had to wait so long for an appointment to go over the scope results (which I had already got from my GP) but the office manager / nurse there says she likes to have all tests done before follow-up appointments; and really since there wasn't much to go over from the scope it saved me an appointment.
We get taken back to the office and she comes in and asks how things are going (okay) then basically a 'what's this appointment for' type of question. I started with the scope results and was pleased to find out that she saw no sign of celiac disease (yay!) but I definitely had a motility issue going on. She asked how the dilation was and I told her that it does seem to help a bit in the fact that I can eat faster and take bigger bites now (which is a good thing compared to my old normal!) but that it also lead to a LOT more heartburn. She said that unfortunately that is common because they are basically taking some of the elasticity out of the esophagus so things could go down easier which leads to things coming back up easier as well. I told her that I am on a prescription medication (losec - it's not over the counter here) for the problem but it seemed to not be working as well lately and that I have had to use some over the counter antacids as well. She said that was fine and she actually preferred me to do it that way and only when the heartburn is daily and more severe would be when she would increase my prescription medication. She then suggested instead of using the medication (zantac) that because of my absorption issues, bone issues and EDS she suggests that I instead use tums as it would be broken up before swallowing and also has a calcium dose in it as well (mom told me on the way home that my grandmother actually used tums as her calcium supplement). She said the vitamin D deficiency that I have could be partly from malabsoprion but also because our weather but she suggested getting it rechecked to see if they are going up and for me to keep an eye on any vitamin deficiencies as they could occur. Mom asked her about medications and if the gastroparesis has any affect on them and she said that it could as it might take longer for the medication to get into my system and some medications could cause nausea if they are a more rapid release med that ends up sitting there until my stomach is ready to work. I then told her that I had to stop all of my vitamins in pill form as I would take them at supper, eat my supper and then be very very nauseated for a good couple of hours each night. I told her that I now get my vitamin D in drops, my calcium in soft chews and B vitamins in a gummy form. She seemed very impressed that I figured this out on my own and said that that is the best way for me. To use medications / supplements that are easier to absorb instead of just pill form. Okay that's it about the stomach issues.
So we then turn to look at the echocardiogram that I had done and she said that it was perfectly normal and that nothing showed up, the only thing of note was my pulse which we already know about and are dealing with. She talked about mitral valve prolapse as my old cardiologist said I had it but it didn't show up. She said that it is hard to catch in an echo because it is a dynamic problem and an echo is a static test. Meaning that the opening and closing (or backwards closing) of a valve could be missed during a test but that it was okay anyways because the only problem would be if it was regurgitating. I asked about getting dental work and she said that regulations had changed and even if you have MVP you don't necessarily need them any more. She then had me get up on the exam table to take my blood pressure and was slightly concerned because my top number was in the 90's (looking back I had been sitting for a long time then quickly got up and on the table - POTS) and that I should use our home monitor to take readings for an extended time just to see what it shows. Then the shocker - she doesn't think I need to be monitored heart wise anymore! Unless something comes up or my symptoms change she thinks I will be fine. I wasn't completely comfortable with that so she said that she can do an echo every other year or so if that would make me feel better (which it does!).
At one point, when she was going over any changes she asked about weight changes and I said that no there were none even though I was actively trying to lose weight. She then looked at me and told me to stop. She said we already know most of your weight issue is solely a medication issue and a malabsorption issue and as long as things were stable I should just let them be. She said that is the key word for you - stable. If everything in my body is stable then I shouldn't do anything to upset that balance. Mom and I talked about it and realized she is right. We know that my excess weight is not of my doing (did a full month of eating only 1200 calories a day which should have seen my lose 6 - 8lbs and I didn't lose any) and that my body is holding on to it for some reason so I shouldn't try to upset the boat.
Then the final surprise..... I was 'dismissed'!! She feels that we have got things to were they are stable and good and don't really have any active problems going on that haven't been addressed. Of course she will still do the echo's and if ANY things comes up health wise with me she is 100% still going to be there if I need her. Surprisingly I am completely fine with that. She was able to get a lot of questions answered for me over the last few years - the autonomic dysfunction, a few medication changes, all the new gastro type of disorders and a lot better heart monitoring than my last cardio! The only bad part about the appointment was when she told me that there is no new rheumy coming to down and that she truly feels that I need to be seeing doctor's in teaching hospitals and big cities.
Another new post should be up soon about my positive appointment with my GP (and information from the report that I just got back from the ortho!)
No comments:
Post a Comment