Surgical options
Question:
– Hide quoted text — Show quoted text -> > > I will look into a local seminar for more info. Do you have any > > > recommendations for the right surgeon in the Seattle area? > > Yes, very definitely as a matter of fact. A colleague and good friend of > > mine, Dr. Peter S. Billing, just moved to the Seattle area within the last > > few weeks – Edmonds, Washington, I believe. He was a medical student of mine > > years ago, trained in Surgery at the Mayo Clinic, and my partner and I did > > virtually all of his training in laparoendoscopic surgery. I have worked > > with him many, many times and he is an excellent surgeon. He is very skilled > > at laparoscopic roux-en-Y gastric bypass and Lap Band and is in the process > > of setting up his new practice there with Dr. Rob Landerholm. I can’t > > recommend him highly enough. He is also extremely knowledgeable about GERD, > > and is highly experienced at lapaorscopic fundoplication. > > HMc > Thank you again, you have been very helpful. I will contact him. > Will my lungs get better after surgery or just stabilize where they are now? > I have COPD and lately have been really producing gobs and gobs of gunk. > I’ve been doing BID or TID nebs. > I just was at 5500 ft elevation and felt like someone was sitting on my > chest the whole time. I grew up at that altitude and indeed spent several > years at 8500 ft. elevation, but know now that the "lack" of oxygen in the > air really does effect people and I’m not immune to it. > I’m currently gathering chart notes and test results to go see your > colleague here in Edmonds. I’ve been doing this for so long now that some > of the tests are old. I hope he doesn’t need to do them again. Each test > just kept pointing me toward surgery anyway and it’s pretty obvious I > haven’t gotten better.
Hard to know if anti-reflux surgery will help your COPD without knowing the cause of it. But there is most definitely a link between GERD and COPD and it would not be unreasonable to expect some improvement in those symtoms. Also, be aware that many of the drugs used in the management of COPD can exacerbate GERD, including beta-agonist nebs. HMc
Response:
- Hide quoted text — Show quoted text -> > I will look into a local seminar for more info. Do you have any > > recommendations for the right surgeon in the Seattle area? > Yes, very definitely as a matter of fact. A colleague and good friend of > mine, Dr. Peter S. Billing, just moved to the Seattle area within the last > few weeks – Edmonds, Washington, I believe. He was a medical student of mine > years ago, trained in Surgery at the Mayo Clinic, and my partner and I did > virtually all of his training in laparoendoscopic surgery. I have worked > with him many, many times and he is an excellent surgeon. He is very skilled > at laparoscopic roux-en-Y gastric bypass and Lap Band and is in the process > of setting up his new practice there with Dr. Rob Landerholm. I can’t > recommend him highly enough. He is also extremely knowledgeable about GERD, > and is highly experienced at lapaorscopic fundoplication. > HMc > Thank you again, you have been very helpful. I will contact him.
Will my lungs get better after surgery or just stabilize where they are now? I have COPD and lately have been really producing gobs and gobs of gunk. I’ve been doing BID or TID nebs. I just was at 5500 ft elevation and felt like someone was sitting on my chest the whole time. I grew up at that altitude and indeed spent several years at 8500 ft. elevation, but know now that the "lack" of oxygen in the air really does effect people and I’m not immune to it. I’m currently gathering chart notes and test results to go see your colleague here in Edmonds. I’ve been doing this for so long now that some of the tests are old. I hope he doesn’t need to do them again. Each test just kept pointing me toward surgery anyway and it’s pretty obvious I haven’t gotten better. Brenda Cole
Response:
- Hide quoted text — Show quoted text -> I will look into a local seminar for more info. Do you have any > recommendations for the right surgeon in the Seattle area? > Yes, very definitely as a matter of fact. A colleague and good friend of > mine, Dr. Peter S. Billing, just moved to the Seattle area within the last > few weeks – Edmonds, Washington, I believe. He was a medical student of mine > years ago, trained in Surgery at the Mayo Clinic, and my partner and I did > virtually all of his training in laparoendoscopic surgery. I have worked > with him many, many times and he is an excellent surgeon. He is very skilled > at laparoscopic roux-en-Y gastric bypass and Lap Band and is in the process > of setting up his new practice there with Dr. Rob Landerholm. I can’t > recommend him highly enough. He is also extremely knowledgeable about GERD, > and is highly experienced at lapaorscopic fundoplication. > HMc
Thank you again, you have been very helpful. I will contact him.
Response:
> I will look into a local seminar for more info. Do you have any > recommendations for the right surgeon in the Seattle area?
Yes, very definitely as a matter of fact. A colleague and good friend of mine, Dr. Peter S. Billing, just moved to the Seattle area within the last few weeks – Edmonds, Washington, I believe. He was a medical student of mine years ago, trained in Surgery at the Mayo Clinic, and my partner and I did virtually all of his training in laparoendoscopic surgery. I have worked with him many, many times and he is an excellent surgeon. He is very skilled at laparoscopic roux-en-Y gastric bypass and Lap Band and is in the process of setting up his new practice there with Dr. Rob Landerholm. I can’t recommend him highly enough. He is also extremely knowledgeable about GERD, and is highly experienced at lapaorscopic fundoplication. HMc
Response:
- Hide quoted text — Show quoted text -> > Thanks for the info. From what I gather the fundoplication is > > probably my best bet, but if it doesn’t work then at that point the > > gastric bypass is out of the question. If I truely want to keep the > > acid out of my lungs I should probably have the bypass, but all that > > goes with that is pretty scarey. Which is the worse of the two evils? > > I guess it’s time to return to the surgeon. > Laparoscopic roux-en-y gastric bypass is certainly feasible in the face of > a > previous fundoplication (Lap Band probably isn’t). It may be more > difficult > to find a surgeon skilled or experienced in laparoscopic re-operative > gastroesophageal surgery, but it is absolutely not out of the question. > I should add, however, that your assertion is on the right track. I would > advise a patient with severe GERD and a BMI of 34 to consider bariatric > surgery. It is worth investigating further, especially if you have > co-morbidities other than severe GERD and are committed to the concepts > attendant on bariatric surgery . You should consider complete investigation > of the laparoscopic roux-en-y gastric bypass, and/or Lap Band, including > attending your local bariatric surgeons’ informational seminar and a > bariatric surgery support group. Surgical weight loss represents a major > lifestyle committment and you need to make sure that you understand it > perfectly, especially if the primary reason you are doing it is for > alleviation of GERD. > HMc
I will look into a local seminar for more info. Do you have any recommendations for the right surgeon in the Seattle area? I realize that the bypass surgery is a huge commitment and because I’d be doing it primarily for alleviation of GERD instead of weight loss it makes the decision much harder. With the constant bombarding of acid into my respiratory system I’m losing ground to even be able to stay active. The resulting EIB from the irritation. My lifestyle has already changed. I can’t even have a good laugh without going into coughing fits that end up with refluxing, gagging and vomiting. I don’t suffer from any other co-morbidities (yet). Although my blood pressure is higher now than it ever has been, but still within the "norm", albeit the high norm. So I may not even qualify for the gastric bypass surgery. Everytime I decide it is time to gather information about the surgeries, I get depressed and put my head back into the sand until the next go round. I don’t know how many more times I can do this. My PCP just looks at me and shakes her head and reminds me I need to have surgery, fortunately she still refills my meds.
Response:
– Hide quoted text — Show quoted text -> Thanks for the info. From what I gather the fundoplication is > probably my best bet, but if it doesn’t work then at that point the > gastric bypass is out of the question. If I truely want to keep the > acid out of my lungs I should probably have the bypass, but all that > goes with that is pretty scarey. Which is the worse of the two evils? > I guess it’s time to return to the surgeon. > Laparoscopic roux-en-y gastric bypass is certainly feasible in the face of a > previous fundoplication (Lap Band probably isn’t). It may be more difficult > to find a surgeon skilled or experienced in laparoscopic re-operative > gastroesophageal surgery, but it is absolutely not out of the question.
I should add, however, that your assertion is on the right track. I would advise a patient with severe GERD and a BMI of 34 to consider bariatric surgery. It is worth investigating further, especially if you have co-morbidities other than severe GERD and are committed to the concepts attendant on bariatric surgery . You should consider complete investigation of the laparoscopic roux-en-y gastric bypass, and/or Lap Band, including attending your local bariatric surgeons’ informational seminar and a bariatric surgery support group. Surgical weight loss represents a major lifestyle committment and you need to make sure that you understand it perfectly, especially if the primary reason you are doing it is for alleviation of GERD. HMc
Response:
> Thanks for the info. From what I gather the fundoplication is > probably my best bet, but if it doesn’t work then at that point the > gastric bypass is out of the question. If I truely want to keep the > acid out of my lungs I should probably have the bypass, but all that > goes with that is pretty scarey. Which is the worse of the two evils? > I guess it’s time to return to the surgeon.
Laparoscopic roux-en-y gastric bypass is certainly feasible in the face of a previous fundoplication (Lap Band probably isn’t). It may be more difficult to find a surgeon skilled or experienced in laparoscopic re-operative gastroesophageal surgery, but it is absolutely not out of the question. HMc
Response:
– Hide quoted text — Show quoted text -> How does the surgeon and the insurance look at a situation like mine > where I wouldn’t be a good candidate for the Stretta (?) or possibly > even the fundo (previous abdominal surgeries > {chole,hyst,appendectomy}), I’m obese, but not morbidly (should I gain > more weight?), but I’m failing all meds and I’m physically exhausted > from coughing and refluxing. I’m taking more drugs to combat the > cough, headaches from coughing (sometimes I feel like a vessel is > going to blow in my brain), but the meds (Vicodan and Vicodan syrup) > make me "hung over" and drugged. The PPI’s make me crampy and > nauseated and I’m overall irritated and grumpy. I also have sleep > apnea, ? assocatied with GERD ?, I’d say I’m a bit of a mess wouldn’t > you? > Maybe the gastric bypass is my only option to get rid of the stomach > acid altogether. All I know is that I’m feeling like I’m at the end of > my rope.
I would be concerned about the efficacy of Stretta in someone who has such a patulous LES. Likewise, Enteryx (biopolymer inserted into the LES) has limits in such a situation. Also, note that both Stretta and Enteryx are considered "investigational" by many, many insurance companies, and not covered. As an anti-reflux operation, gastric fundoplication is likely to be your best bet, even at a BMI of 34. Your insurance company is unlikely to have a problem with fundoplication. I will say the roux-en-y gastric bypass is *very* effective at controlling GERD. However, be aware that this is a big operation with a relatively high mortality rate and significant lifestyle implications post-op. Insurance companies that cover bariatric surgery will do so at a BMI of 35 or greater if co-morbidities are documented. GERD is definitely one of those co-morbidities. Others would include hypertension, high cholesterol, hyperlipidemia, diabetes, degenerative joint disease, just to name a few. HMc
Response:
- Hide quoted text — Show quoted text -> How does the surgeon and the insurance look at a situation like mine > where I wouldn’t be a good candidate for the Stretta (?) or possibly > even the fundo (previous abdominal surgeries > {chole,hyst,appendectomy}), I’m obese, but not morbidly (should I gain > more weight?), but I’m failing all meds and I’m physically exhausted > from coughing and refluxing. I’m taking more drugs to combat the > cough, headaches from coughing (sometimes I feel like a vessel is > going to blow in my brain), but the meds (Vicodan and Vicodan syrup) > make me "hung over" and drugged. The PPI’s make me crampy and > nauseated and I’m overall irritated and grumpy. I also have sleep > apnea, ? assocatied with GERD ?, I’d say I’m a bit of a mess wouldn’t > you? > Maybe the gastric bypass is my only option to get rid of the stomach > acid altogether. All I know is that I’m feeling like I’m at the end of > my rope. > I would be concerned about the efficacy of Stretta in someone who has such a > patulous LES. Likewise, Enteryx (biopolymer inserted into the LES) has > limits in such a situation. Also, note that both Stretta and Enteryx are > considered "investigational" by many, many insurance companies, and not > covered. As an anti-reflux operation, gastric fundoplication is likely to be > your best bet, even at a BMI of 34. Your insurance company is unlikely to > have a problem with fundoplication. > I will say the roux-en-y gastric bypass is *very* effective at controlling > GERD. However, be aware that this is a big operation with a relatively high > mortality rate and significant lifestyle implications post-op. Insurance > companies that cover bariatric surgery will do so at a BMI of 35 or greater > if co-morbidities are documented. GERD is definitely one of those > co-morbidities. Others would include hypertension, high cholesterol, > hyperlipidemia, diabetes, degenerative joint disease, just to name a few. > HMc
Thanks for the info. From what I gather the fundoplication is probably my best bet, but if it doesn’t work then at that point the gastric bypass is out of the question. If I truely want to keep the acid out of my lungs I should probably have the bypass, but all that goes with that is pretty scarey. Which is the worse of the two evils? I guess it’s time to return to the surgeon.
Response:
- Hide quoted text — Show quoted text -> > What is your body mass index (BMI)? > > Look at http://nhlbisupport.com/bmi/bmicalc.htm to calculate your BMI. > > HMc > 34 > Your obesity is certainly playing a role in your GERD, however you are not > morbidly obese as defined by the NIH concensus conference 1991, which is the > definition virtually all insurance companies use in determining > precertification for bariatric surgery. Such bariatric surgery would most > likely have to be paid out of your pocket – tens of thousands of dollars. > Be aware that the success of the lap band in treating GERD comes from the > weight loss associated with that procedure, not from placement of the band > itself. The band goes around the upper part of the stomach, and does nothing > to affect the LES directly. Until that weight loss occurs, GERD and > regurgitation will continue to be a problem. Gastric secretions from the > distal stomach can still reflux since the stomach is not excluded from the > esophagus. With the roux-en-y bypass, the distal stomach is excluded and the > vast majority of gastric secretions are routed well downstream – have no > opportunity to reflux. Furthermore, if chronic esophagitis is present and is > associated with shortening of the esophagus you would not be able to have > the Lap Band done. > Bottom line, Lap Band is not a great treatment for GERD when GERD is the > only disease being treated. > HMc
A few questions, the Stretta procedure is where tiny lesions are made so that scar tissue develops constricting the lower esophagus, correct? What is the procedure where a gelatinous product is placed in the lower esophagus? As I stated before, I was told that my LES showed no reading at all, so would I not be a candiate for the Stretta? How does the surgeon and the insurance look at a situation like mine where I wouldn’t be a good candidate for the Stretta (?) or possibly even the fundo (previous abdominal surgeries {chole,hyst,appendectomy}), I’m obese, but not morbidly (should I gain more weight?), but I’m failing all meds and I’m physically exhausted from coughing and refluxing. I’m taking more drugs to combat the cough, headaches from coughing (sometimes I feel like a vessel is going to blow in my brain), but the meds (Vicodan and Vicodan syrup) make me "hung over" and drugged. The PPI’s make me crampy and nauseated and I’m overall irritated and grumpy. I also have sleep apnea, ? assocatied with GERD ?, I’d say I’m a bit of a mess wouldn’t you? Maybe the gastric bypass is my only option to get rid of the stomach acid altogether. All I know is that I’m feeling like I’m at the end of my rope.
Response:
> What is your body mass index (BMI)? > Look at http://nhlbisupport.com/bmi/bmicalc.htm to calculate your BMI. > HMc > 34
Your obesity is certainly playing a role in your GERD, however you are not morbidly obese as defined by the NIH concensus conference 1991, which is the definition virtually all insurance companies use in determining precertification for bariatric surgery. Such bariatric surgery would most likely have to be paid out of your pocket – tens of thousands of dollars. Be aware that the success of the lap band in treating GERD comes from the weight loss associated with that procedure, not from placement of the band itself. The band goes around the upper part of the stomach, and does nothing to affect the LES directly. Until that weight loss occurs, GERD and regurgitation will continue to be a problem. Gastric secretions from the distal stomach can still reflux since the stomach is not excluded from the esophagus. With the roux-en-y bypass, the distal stomach is excluded and the vast majority of gastric secretions are routed well downstream – have no opportunity to reflux. Furthermore, if chronic esophagitis is present and is associated with shortening of the esophagus you would not be able to have the Lap Band done. Bottom line, Lap Band is not a great treatment for GERD when GERD is the only disease being treated. HMc
Response:
– Hide quoted text — Show quoted text -> > My question is there is a procedure used for weight loss (lap band) > > that cinches off a portion of the stomach. Why can’t this non > > permanent, reversible procedure be used to help refluxers? My LES is > > practically non working. Can’t this be used for this and if it > > doesn’t work, it can be removed. Seems like even if it is in the > > usual placement (making a smaller stomach pouch) it would reduce acid > > from refluxing. > Lap Band is not approved by the FDA for use as an anti-reflux tool. Your > insurance company would never pay for the operation for that purpose. They > wouldn’t pay for a Lap Band under *any* circumstance unless you are morbidly > obese (BMI greater than 35 with severe GERD or other co-morbidities), and > some insurance companies won’t pay for Lap Band ever, period. > Morbidly obese patients very commonly suffer from GERD and bariatric surgery > is extremely effective in curing it. In fact, most surgeons (most smart > surgeons, anyway) won’t even do a gastric fundoplication on patients whose > BMI is greater than 35 because of the very high failure rate in that patient > population, and the fact that a fundoplication makes subsequent bariatric > surgery extremely difficult. > HMc > It is interesting that I had not heard before that and "smart" > surgeons wouldn’t do a gastric fundo on obese patients. I’m obese, > could lose 40 to 50 pounds, but I think I’d opt for the lap-band, > because it is reversible and the weight loss will be a side effect. I > know the insurance won’t cover it. But having had several major > surgeries already and having first hand experience with "after > effects", I’m willing to pay the $$ and take the chance to have a > reversible, fixable surgery. Do you think I’m heading down the wrong > avenue?
What is your body mass index (BMI)? Look at http://nhlbisupport.com/bmi/bmicalc.htm to calculate your BMI. HMc
Response:
- Hide quoted text — Show quoted text -> > > My question is there is a procedure used for weight loss (lap band) > > > that cinches off a portion of the stomach. Why can’t this non > > > permanent, reversible procedure be used to help refluxers? My LES is > > > practically non working. Can’t this be used for this and if it > > > doesn’t work, it can be removed. Seems like even if it is in the > > > usual placement (making a smaller stomach pouch) it would reduce acid > > > from refluxing. > > Lap Band is not approved by the FDA for use as an anti-reflux tool. Your > > insurance company would never pay for the operation for that purpose. > They > > wouldn’t pay for a Lap Band under *any* circumstance unless you are > morbidly > > obese (BMI greater than 35 with severe GERD or other co-morbidities), > and > > some insurance companies won’t pay for Lap Band ever, period. > > Morbidly obese patients very commonly suffer from GERD and bariatric > surgery > > is extremely effective in curing it. In fact, most surgeons (most smart > > surgeons, anyway) won’t even do a gastric fundoplication on patients > whose > > BMI is greater than 35 because of the very high failure rate in that > patient > > population, and the fact that a fundoplication makes subsequent > bariatric > > surgery extremely difficult. > > HMc > It is interesting that I had not heard before that and "smart" > surgeons wouldn’t do a gastric fundo on obese patients. I’m obese, > could lose 40 to 50 pounds, but I think I’d opt for the lap-band, > because it is reversible and the weight loss will be a side effect. I > know the insurance won’t cover it. But having had several major > surgeries already and having first hand experience with "after > effects", I’m willing to pay the $$ and take the chance to have a > reversible, fixable surgery. Do you think I’m heading down the wrong > avenue? > What is your body mass index (BMI)? > Look at http://nhlbisupport.com/bmi/bmicalc.htm to calculate your BMI. > HMc
34
Response:
- Hide quoted text — Show quoted text -> My question is there is a procedure used for weight loss (lap band) > that cinches off a portion of the stomach. Why can’t this non > permanent, reversible procedure be used to help refluxers? My LES is > practically non working. Can’t this be used for this and if it > doesn’t work, it can be removed. Seems like even if it is in the > usual placement (making a smaller stomach pouch) it would reduce acid > from refluxing. > Lap Band is not approved by the FDA for use as an anti-reflux tool. Your > insurance company would never pay for the operation for that purpose. They > wouldn’t pay for a Lap Band under *any* circumstance unless you are morbidly > obese (BMI greater than 35 with severe GERD or other co-morbidities), and > some insurance companies won’t pay for Lap Band ever, period. > Morbidly obese patients very commonly suffer from GERD and bariatric surgery > is extremely effective in curing it. In fact, most surgeons (most smart > surgeons, anyway) won’t even do a gastric fundoplication on patients whose > BMI is greater than 35 because of the very high failure rate in that patient > population, and the fact that a fundoplication makes subsequent bariatric > surgery extremely difficult. > HMc
It is interesting that I had not heard before that and "smart" surgeons wouldn’t do a gastric fundo on obese patients. I’m obese, could lose 40 to 50 pounds, but I think I’d opt for the lap-band, because it is reversible and the weight loss will be a side effect. I know the insurance won’t cover it. But having had several major surgeries already and having first hand experience with "after effects", I’m willing to pay the $$ and take the chance to have a reversible, fixable surgery. Do you think I’m heading down the wrong avenue?
Response:
> My question is there is a procedure used for weight loss (lap band) > that cinches off a portion of the stomach. Why can’t this non > permanent, reversible procedure be used to help refluxers? My LES is > practically non working. Can’t this be used for this and if it > doesn’t work, it can be removed. Seems like even if it is in the > usual placement (making a smaller stomach pouch) it would reduce acid > from refluxing.
Lap Band is not approved by the FDA for use as an anti-reflux tool. Your insurance company would never pay for the operation for that purpose. They wouldn’t pay for a Lap Band under *any* circumstance unless you are morbidly obese (BMI greater than 35 with severe GERD or other co-morbidities), and some insurance companies won’t pay for Lap Band ever, period. Morbidly obese patients very commonly suffer from GERD and bariatric surgery is extremely effective in curing it. In fact, most surgeons (most smart surgeons, anyway) won’t even do a gastric fundoplication on patients whose BMI is greater than 35 because of the very high failure rate in that patient population, and the fact that a fundoplication makes subsequent bariatric surgery extremely difficult. HMc
Response:
– Hide quoted text — Show quoted text -> I am a diagnosed GERD sufferer for 8+ years, I’m 43 yo female. I have > had the million dollar work up. I have been on all the meds and > currently take Nexium 40mg BID. I still suffer from reflux and mostly > suffer with respiratory complications. I realize that I only have one > set of lungs, that are currently not working at maximum, and that I > need to do something more about the reflux, surgically. However, I’m > not convinced that it will solve my problem. Even the surgeon could > not say that it would stop the coughing. > Getting any type of respiratory infection launches me into several > long months of recooperation, including Prednisone, inhalers and > medication changes. The Prednisone doesn’t work any longer. All of > these leaving me exhausted, side effected, ill and afraid of the next > infection that comes along. > My question is there is a procedure used for weight loss (lap band) > that cinches off a portion of the stomach. Why can’t this non > permanent, reversible procedure be used to help refluxers? My LES is > practically non working. Can’t this be used for this and if it > doesn’t work, it can be removed. Seems like even if it is in the > usual placement (making a smaller stomach pouch) it would reduce acid > from refluxing. The other permanent surgical options do not appeal to > me, because if they don’t work (too tight, or too loose)you have just > created another set of problems. > Having just "recovered" from a pneumonia in February that led to the > above and now with a "cold" settling in my chest knowing full well > I’ll be coughing for months has left me depressed at dejected. I’m > really grasping here. Any ideas out there?
Yes, you need a fundoplication or Stretta procedure. Your risks are much greater without an anti-reflux operation than they are with it. Such a reversible device was available 25 years ago. The principle is unsound, and it didn’t work. Look up "Angelchik prosthesis" in Google or http://tinyurl.com/43sdo HMc
Response:
I am a diagnosed GERD sufferer for 8+ years, I’m 43 yo female. I have had the million dollar work up. I have been on all the meds and currently take Nexium 40mg BID. I still suffer from reflux and mostly suffer with respiratory complications. I realize that I only have one set of lungs, that are currently not working at maximum, and that I need to do something more about the reflux, surgically. However, I’m not convinced that it will solve my problem. Even the surgeon could not say that it would stop the coughing. Getting any type of respiratory infection launches me into several long months of recooperation, including Prednisone, inhalers and medication changes. The Prednisone doesn’t work any longer. All of these leaving me exhausted, side effected, ill and afraid of the next infection that comes along. My question is there is a procedure used for weight loss (lap band) that cinches off a portion of the stomach. Why can’t this non permanent, reversible procedure be used to help refluxers? My LES is practically non working. Can’t this be used for this and if it doesn’t work, it can be removed. Seems like even if it is in the usual placement (making a smaller stomach pouch) it would reduce acid from refluxing. The other permanent surgical options do not appeal to me, because if they don’t work (too tight, or too loose)you have just created another set of problems. Having just "recovered" from a pneumonia in February that led to the above and now with a "cold" settling in my chest knowing full well I’ll be coughing for months has left me depressed at dejected. I’m really grasping here. Any ideas out there?
Response:
Categories: Diabetes FAQ | 
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> I don’t know if you have read this or not but found it as I wanted to > help because I know having protein in the urine is one of the signs of > kidney damage. > http://www.kidneywdc.org/brochure_diabetes.cfm > I hope it helps but someone much wiser will be along to help. > Once again it is so nice to see you in the group again. > Diana > Hello old friends and new…it’s good to see you all again. > I’ve been working on getting my health back. I had convinced myself > that > by reading a.s.d and m.h.d I was treating my diabetes. As long as I > *knew* > how to cope with diabetes I didn’t actually have to *do* anything > about > it. I’ve also known when to test to get the *right* readings on my > monitor. (14 day average = 112 – yup I’m doing good). I had a few > more > tricks to make myself look good ‘on paper’, but we’ll skip over > those for > now. > Then, I started feeling bad. So I read more here and on the www. I > was > still having trouble with the Read = Do equation. And my feet > started to > burn and ache – not ache – hurt, unrelentingly! The foot doc put me > in > compression stockings and on neurontin. On my own I added Evening > Primrose > Oil (someone here recommended it – maybe Tony in Mexico). I’ve > since > stopped the Neurontin – the name gives me worry – too much like > neutron – > and I read something bad about but I don’t remember what it was > (more > denial – hey what does it matter that I don’t remember? I read it – > that’s > what counts, right?) > The stockings and the EPO are working for me now. But they aren’t > going to > heal what damage has already been done. If it weren’t for hurting > my foot > I’d kick myself in the ass – repeatedly. > My mouth stayed so dry that i couldn’t talk at times because my > tongue > would be stick to my teeth. My dry mouth is a haven for bacteria > and I > have to see a periodontist every month to try to save my bottom > teeth. The > uppers are too far gone. I’ve lost 6 on the top already and my perio > wants > my dentist to pull the rest of the to ones out because they are > contaminating the lowers. > So now I’m looking at dentures… [what the fuck was I thinking?] > There is a little good news…after hanging in around 6.4, 6.3 for a > couple of years my HbAlc came in at 5.9 this last time. > *I had to do one of those 24 urine collections. When my doc got the > results he summons me to office and prescribed for protein in my > urine – > I don’t know what that means – what it indicates – but I don’t think > it’s > trival. Anyone…? > Truly > T2 
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