FROM OUR EXPERTS
About a month ago I had my first endocrinologist appointment since well before Mateo was born. During the pregnancies, my perinatologist (high-risk OB) took care of all of my diabetes management with a focus on tightly controlled blood sugars. In the weeks leading up to the endo appointment, I'd had a couple epiphanies I was looking forward to acting on.
First of all, I noticed that the blood glucose range I'd unconsciously been striving for was probably too restrictive for a non-pregnant diabetic. All the years of trying to keep my blood glucose level between 70-140 mg/dl had really skewed my perception of what constituted a "high" blood sugar. For instance, I would get a result of 150 mg/dl and correct it, which often led to lows. It dawned on me one day, "I don't have to correct for a 150 mg/dl!"
This led me to another revelation: if I'm able to keep my blood sugar steady within a slightly wider range of blood suga...
For some of us who have migraines, the nausea that often occurs during migraine attacks can be the worst of our symptoms. It can be more severe and debilitating than the pain of a migraine attack. Moreover, it can truly wreak havoc with any oral medications we might take during a migraine. Many migraineurs have commented that keeping their meds down during a migraine is one of their biggest treatment challenges because of severe nausea and vomiting.
BUT, Here's a Vital Question:
Is the severe nausea and the accompanying vomiting truly making the meds, "not stay down?" The very, very important answer to that questions is, " Probably not entirely. " You may have read about gastric stasis and how it can keep oral medications from absorbing correctly and being optimally effective. That's not uncommon, but even if gastric stasis is a problem, SOME of the medication can enter our system within seconds of swallowing it.
Here's a Huge Problem:
Some of the same migraineurs who have commented t...
Q: How do most patients get referred to a rheumatologist in the first place? Kremer: Usually, it’s the pain that’s perceived to be arthritis pain. Sometimes it’s muscle pain. Other times it can just be a nagging pain from anywhere that the primary care provider cannot diagnose. It’s more helpful to be referred to a rheumatologist when there are other symptoms along with the pain, such as early joint swelling. Q: What does the rheumatologist do when they see a referred patient? Kremer: We’ll take a history. Do you have morning stiffness? Fatigue? How long has this been going on? Do you have any family history of these same symptoms? After history, you do a physical exam looking for impaired joint movement, which joints are swollen, warm to the touch, difficult to move. Q: When do you take lab tests? And which tests do you start with first? Kremer: It depends on where the initial history and exams lead you. You many test for Rheumatoid factor (...
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