2013년 11월 25일 월요일

About 'suburban home health care'|... that the hospital cared a lot more about my insurance than they did about my health . When it finally DID come time to go home , they were all ...







About 'suburban home health care'|... that the hospital cared a lot more about my insurance than they did about my health . When it finally DID come time to go home , they were all ...








In               my               ongoing               series               of               articles,               which               I               call               the               "What               is…"               series,               I               describe               all               sorts               of               medical               tests               and               experiences               from               a               layman's               point               of               view.

I               was               inspired               to               start               this               series               by               a               wry               moment               in               which               I               was               pondering               the               amount               of               money               I               have               paid               in               HMO               co-payments               over               the               past               year,               and               figured               I               could               just               write               about               the               experiences               I               have               been               having               during               this               incredibly               expensive               and               frustrating               year               until               I               was               even.

The               website               Associated               Content               offers               (a               little)               money               for               such               articles,               and               thus,               I               decided               that               I               would               allow               Associated               Content               help               to               foot               my               medical               bills,               albeit               slowly,               while               I               exorcised               some               medical               demons.

It               was               a               tiny               little               justice,               but               it               was               mine.

But               writing               the               "What               is…"               articles               have               become               something               more               to               me               in               recent               weeks.

I               have               been               living               with               a               confounding               hodge               podge               of               symptoms,               diagnoses,               and               misdiagnoses               for               many               years,               and               the               more               I               have               attempted               to               solve               the               puzzle,               the               more               confusing               my               medical               state�has               become.

I               would               have               one               test               performed               to               dispel               one               diagnosis               and               get               a               new               one               thrown               into               the               mix               out               of               the               blue.

As               my               host               of               ï¿½ologists               became               more               frustrating               and               frustrated,               and               my               primary               care               physician               admitted               to               feeling               "in               over               her               head"               with               my               case,               I               began               to               research               my               symptoms               as               thoroughly               as               I               could               on               my               own.

No               one               else               would               ever               be               as               inspired               to               devote               the               time               and               attention,               and               certainly               the               interest,               than               I               would.

I               decided               to               become               my               own               test               case.
               I               am               fortunate,               more               fortunate               than               most               experiencing               a               confusing               illness,               that               I               work               in               a               major               medical               center               in               the               city               of               Boston,               which               is               one               of               the               most               prolific               cities               in               the               world               for               medical               research.

Due               to               the               nature               of               my               job,               I               have               access               to               a               database               of               medical               journals               that               is               second               to               none.

I               also               possess               the               knowledge               of               how               to               conduct               a               thorough               search               of               medical               papers               and               gain               access               to               information               about               studies               performed               on               specific               conditions.

Still,               I               kept               striking               out.

My               array               of               diagnoses               just               didn't               seem               to               fit               any               sort               of               pattern               that               I               could               detect.
               But,               most               frustratingly,               as               tests               and               studies               were               ordered               for               me,               I               had               a               terrible               time               finding               information               about               what               I               was               in               for               with               each               of               these               experiences               to               come.

When               my               former               primary               care               physician               informed               me               that               she               wanted               to               order               a               test               called               and               "EMG"               for               me,               she               responded               to               my               inquiries               about               what               the               test               would               entail               by               stating               that               the               test               was               not               "exactly               torture."               In               subsequent               internet               searches               I               was               able               to               discover               that               an               EMG               was               a               test               that               utilizes               electrical               shocks               to               determine               the               muscles'               and               nerves'               responses               to               electrical               stimulation,               followed               by               a               procedure               in               which               a               charged               needle               was               inserted               into               the               muscles               of               the               arms               or               legs               to               determine               impairment               of               the               nerve               response.

What               I               could               not               find               were               any               case               reports               from               every               day               people               who               had               been               through               this               test,               and               who               could               simply               share               what               they'd               experienced.

Frankly,               I               wanted               to               know               how               bad               it               was               going               to               be.

And,               thus,               my               "What               is…"               series               was               born.
               So,               what               is               wrong               with               me?

Simply               put,               I               am               a               survivor               of               an               electrical               injury.

I               have               always               known               this,               but               because               I               walked               away               from               the               incident,               and               it               occurred               so               long               ago,               it               never               occurred               to               me               to               look               into               the               aftermath               of               electrical               injury               as               a               possible               cause               of               all               my               problems.

It               is               a               condition               about               which               there               is               very               little               understanding               or               study               because               there               are               so               few               survivors               that               fit               into               my               category,               and,               much               like               myself,               those               that               do               generally               live               out               their               lives               scratching               their               heads               over               the               strange               confabulation               of               seemingly               unconnected               maladies               they               possess               and               never               discover               the               source.

I               was               very               fortunate               that               a               particular               conversation               I               had               with               one               of               my               physicians               in               the               department               of               Behavioral               Neurology               just               happened               to               contain               enough               phrases               and               juxtapositions               that               it               provided               me               with               an               "Ah               ha!"               moment.

I               was               even               more               fortunate               that               this               particular               physician               was               savvy               enough               recognize               that               although               she               had               never               heard               of               such               a               thing,               it               would               require               looking               into.

Without               that               one               conversation,               I               would               still               be               biding               my               time               in               the               Purgatory               of               the               undiagnosed,               fearful,               confused,               and               exhausted.
               When               I               was               five               or               six               years               old,               I               snuck               into               the               kitchen               of               my               suburban,               Southern               Californian               home               and               decided               to               do               something               I               had               never               done               before.

I               had               just               hit               that               age               where               the               desire               for               independence               was               a               few               steps               ahead               of               the               tools               I               actually               possessed               to               execute               that               independence.

And               so,               when               it               occurred               to               me               that               what               I               would               really               like               more               than               anything               was               a               nice               English               Muffin,               rather               than               ask               Mom               to               make               it               (and               run               the               risk               that               she               might               inform               me               that               it               was               too               close               to               lunch               time               for               a               snack),               I               figured               that               I               could               just               slip               in               and               make               it               myself.

Hey,               I               was               a               big               girl,               and               I'd               seem               Mom               do               it               countless               times.
               Well,               as               English               Muffins,               with               all               their               nooks               and               crannies               are               wont               to               do,               my               muffin               got               stuck               in               the               toaster.

I               problem               solved               (still               feeling               pretty               good               about               the               new               skill               I               was               acquiring),               grabbed               a               knife               and               stuck               it               down               into               one               of               the               slots               in               the               old               toaster               to               pry               the               muffin               free.

The               next               thing               I               knew               I               was               crumpled               in               a               ball               on               the               floor               against               the               wall               at               the               other               end               of               the               kitchen.

I               had               hit               one               of               the               electric               coils               with               the               sterling               silver               knife               and               had               been               blown               straight               through               the               air               across               the               kitchen,               stopping               when               I               hit               the               wall               on               the               other               side               of               the               room.

My               sobs               brought               my               mother               running.

She               picked               me               up,               checked               me               over,               and               upon               discovering               that               there               were               no               burns               or               broken               bones,               brushed               me               off               and               gave               me               a               scolding               for               sticking               the               knife               in               the               toaster.

And               that               was               that.

What               has               now               become               one               of               the               most               significant               experiences               pertaining               to               health               of               my               adult               being,               was               for               many,               many               years               nothing               more               than               a               family               anecdote.
               Now,               I               will               preface               the               report               of               the               onset               of               the               various               symptoms               I               have               experienced               throughout               my               life               by               sharing               that               I               am               an               adopted               child.

As               my               body               became               quirkier               and               quirkier,               my               family               and               I               were               content               with               the               knowledge               that               we               did               not               have               a               reliable               medical               history               for               me,               and               therefore               found               it               easy               to               shrug               off               certain               occurrences               of               symptoms               as               possible               inherited               traits.
               The               first               problem               I               experienced               was               the               onset               of               migraines               at               the               age               of               about               twelve.

Migraines               are               fairly               common,               and               adolescence               is               a               typical               time               for               them               to               begin               to               occur,               and               so               nothing               much               was               made               of               them.

The               only               significance               of               my               migraines               when               compared               to               so               many               peoples               is               the               severity.

The               stabbing               pains               in               my               head               fall               right               up               at               the               top               of               the               severe               range.

Without               the               proper               medication,               and               there               is               only               one               that               works               for               me,               I               vomit               until               I               end               up               in               the               emergency               room               for               pain               control               and               IV               fluids.

However,               as               I               am               hardly               unique               in               this,               no               special               investigation               into               the               source               of               the               migraines               seemed               warranted.

We               did               the               usual               checks-               an               MRI               of               the               brain               to               rule               out               tumor,               checking               for               allergies               or               sensitivities               to               foods               (certain               foods               like               chocolate               and               aged               cheeses               are               the               culprits               in               many               migraine               cases),               biofeedback               therapy               to               help               me               to               gain               some               control               over               the               tension               in               my               muscles.

In               the               end               it               was               determined               that               I               suffered               from               migraines,               etiology               unknown.
               Many               years               later,               when               I               was               in               my               mid               twenties,               I               began               to               have               some               trouble               with               my               arms.

They               grew               progressively               numb               over               a               period               of               days               until               it               reached               a               point               where               I               could               not               hold               a               pen.

I               saw               my               doctor               who               decided               that               it               was               probably               a               pinched               nerve,               and               as               it               resolved               itself               in               time,               nothing               more               was               made               of               it.

Over               the               years               the               numbness               would               return               and               disappear,               and               soon               my               feet               and               legs               were               involved               as               well.

I               continued               to               see               my               doctor               about               this,               but               she               did               not               know               what               was               causing               it.

I               also               relayed               to               her               that               I               had               very               little               sensitivity               in               my               hands               and               feet,               and               that               this               had               been               the               case               for               as               long               as               I               could               remember.

Growing               up,               I               just               thought               that               I               had               very               strong               skin.

I               was               the               girl               who               could               run               around               barefoot               over               black               asphalt               in               the               hot               Southern               Californian               sunshine               and               remove               things               from               the               oven               without               an               oven               mitt.

As               I               grew,               I               began               to               suspect               that               perhaps               these               abilities               were               a               little               more               than               "strong               skin,"               and               when               the               numbness               began,               I               was               more               suspicious,               still.

After               a               few               tests,               including               another               MRI,               it               was               determined               that               I               suffered               from               peripheral               neuropathy,               etiology               unknown
               And               then               the               problems               with               my               memory               began               to               grow               evident.

Having               always               been               considered               a               little               bit               absent               minded,               despite               a               high               IQ,               problems               with               my               memory               were               always               just               chalked               up               to               lack               of               attention               or               possibly               to               a               side               effect               of               the               medication               I               must               take               for               my               migraines.

As               I               aged,               however,               I               noticed               that               the               short               term               deficits               I               possessed               were               beginning               to               effect               my               daily               life,               and               I               ruled               out               the               absent               mindedness               I               had               always               been               accused               of,               as               I               was               trying               everything               I               could               to               compensate.

I               saw               my               doctor               again,               and               another               negative               MRI               later               it               was               determined               that               I               suffered               from               short               term               memory               deficits,               etiology               unknown.
               Then               one               day,               just               over               six               years               ago,               everything               became               very               confusing               and               scary.

I               was               hit               by               a               migraine               that               was               nothing               like               anything               I               had               experienced               before.

I               can               always               depend               on               experiencing               what               is               called               an               aura               before               the               pain               hits.

During               the               aura,               I               experience               blurry               spots               in               my               vision,               sensitivity               to               light               and               sound,               a               general               cognitive               "fuzziness",               and               a               tingling               sensation               in               my               skin.

These               auras               will               last               anywhere               from               ten               to               forty-five               minutes,               and               although               they               are               disconcerting,               it               is               a               good               warning               sign               that               I               need               to               take               my               medication               before               the               pain               comes               on               (taking               a               dose               once               the               migraine               is               in               full               swing               is               never               anywhere               near               as               effective               for               pain               management,               as               the               pain               becomes               what               I               call               "entrenched").

Then               I               simply               get               to               where               I               need               to               be               for               the               duration               of               the               migraine               (preferably               home,               work               is               out               of               the               question).

But               that               morning               I               woke               up,               stood               up               to               go               to               the               bathroom               and               was               suddenly               struck               by               an               abrupt               surge               of               all               the               symptoms               I               typically               feel               during               an               aura               and               then               immediately               was               hit               by               a               crack               of               pain               so               severe               I               had               to               be               taken               directly               to               the               emergency               room.

I               was               experiencing               what               is               called               a               "flash               migraine",               which               had               never               occurred               to               me               before.
               At               the               emergency               room,               it               was               decided               that               I               would               need               another               MRI               to               rule               out               any               physical               problems               in               the               brain.

As               the               doctor               was               taking               my               history,               I               related               the               problems               I               had               been               having               with               the               peripheral               neuropathy               and               the               memory               problems.

He               informed               me               that               I               would               need               to               see               a               neurologist               because               it               sounded               to               him               like               I               should               be               examined               for               Multiple               Sclerosis.
               And               in               that               moment,               I               felt               like               my               world               was               falling               apart.

I               had               just               met               the               man               who               would               later               become               my               husband,               I               had               an               incredibly               busy               and               active               job               managing               group               homes               for               people               with               developmental               and               physical               disabilities,               and               frankly               I               was               spread               a               little               thin               to               be               considering               the               possibility               that               I               had               a               demyelinating,               progressive               disease               that               would               likely               leave               me               disabled.

Compounding               matters,               my               new               life               partner,               whom               I               was               (and               remain)               absolutely               crazy               about               is               blind.

I               was               the               driver.

I               was               the               shopper.

We               had               come               up               with               a               beautiful               division               of               labor               in               the               relationship               and               I               was,               quite               frankly,               freaking               out.
               So,               I               saw               the               neurologist               who               looked               me               over,               played               with               his               tuning               forks               and               pointed               sticks               and               said               the               magic               words               "this               is               not               MS."               I               was               overjoyed.

When               he               told               me               that               I               was               suffering               from               another               disease               called               Charcot-Marie-Tooth,               I               could               not               have               cared               less,               I               was               just               so               relieved.

Charcot-Marie-Tooth,               or               CMT,               is               also               a               progressive               disease,               in               the               same               family               of               neurological               diseases               as               MS,               and               involves               numbness               (neuropathy)               of               the               limbs               and               appendages,               and               wasting               (atrophy)               of               the               muscles               and               soft               tissue,               but               none               of               the               cognitive               impairments,               paralysis,               or               sudden               attacks               that               MS               can               cause               to               occur.
               I               walked               out               of               that               office               a               happy               woman,               and               decided               not               to               think               too               much               about               the               fact               that               while               I               certainly               had               well               documented               neuropathy,               my               muscles               and               soft               tissue               were               hearty               and               hale-               showing               not               even               the               slightest               sign               of               atrophy.

I               also               ignored               the               fact               that               by               this               time               I               had               come               to               know               my               biological               mother,               and               had               known               my               biological               father               for               a               short               time               in               the               past,               and               neither               of               them               had               ever               mentioned               CMT,               which               is               exclusively               a               hereditary               disease.

I               chose,               instead,               to               assume               that               I               had               inherited               the               disease               from               my               father's               side               of               the               family,               and               that               it               had               never               occurred               to               him               to               disclose               that               there               is               a               progressive,               highly               inheritable               (50%               chance)               neurological               disease               running               through               my               gene               pool.

It               sounded               right               to               me.
               And               I               tried               not               to               dwell               on               the               fact               that               each               time               I               saw               another               health               care               provider               who               works               with               CMT               patients               (podiatrists,               adaptive               brace               specialists,               even               my               primary               care),               they               would               remark               on               how               "atypical"               my               case               was.

Hey,               I               had               a               diagnosis               I               could               live               with,               and               nothing               was               going               to               take               it               away               from               me.
               Or               so               I               thought.

Over               the               last               two               years               there               have               been               evolutions               in               my               symptomology               that               have               forced               me               to               take               an               honest               look               at               my               happy               little               CMT               diagnosis.

Added               to               the               problems               I               was               already               struggling               with,               about               21               months               ago               I               began               to               experience               dizziness               and               vertigo,               which               in               its               acute               state               was               severe               and               then               settled               into               a               mid               line,               persistent,               chronic               state.

I               saw               my               primary               care,               and               once               again               she               was               baffled.

Back               into               the               MRI               machine               I               went.

I               was               seen               by               an               otolaryngologist               and               an               audiologist               to               rule               out               vestibular               problems,               and               also               had               extensive               vestibular               testing               performed               (the               testing               is               not               pleasant               if               you're               already               dizzy),               saw               the               world's               leading               specialist               in               dizziness               and               vertigo,               and               once               again,               nothing               was               determined.

Possibly               converted               migraine?

That               was               the               closest               the               specialist               could               come.

Essentially               it               was               determined               that               I               suffer               from               dizziness               and               vertigo,               etiology               unknown.
               And               then               my               biological               father               chose               to               drop               back               into               my               life,               once               and               for               all               extinguishing               my               last               drop               of               hope               that               I               suffered               from               (relatively)               benign               little               Charcot-Marie-Tooth.

He               had               never               heard               of               the               disease,               which               is               virtually               impossible               if               there               was               a               history               of               it               in               his               family.

I               was               a               bit               desperate.

Could               I               be               a               spontaneous               mutation?
               And               then               my               arms               began               to               experience               severe               pain               and               numbness               at               night.

I               had               lived               with               the               neuropathy               for               years               and               thought               I               knew               all               its               tricks,               but               I               had               never               experienced               the               excruciating               pain               I               was               now               experiencing,               which               seemed               to               come               up               out               of               nowhere.

I               was               prescribed               a               muscle               relaxant               called               Flexoril               to               calm               any               muscle               spasms               that               might               be               causing               the               pain.
               Two               days               later,               I               was               driving               in               my               car               and               was               suddenly               overcome               by               dizziness               so               severe               that               I               thought               I               would               pass               out.

I               pulled               over               until               I               was               able               to               see               straight               and               drove               myself               to               the               emergency               room               of               the               hospital               that               is               responsible               for               my               care,               which               was               thankfully               less               than               a               block               away.

After               a               thorough               examination,               and               reaffirmation               that               I               needed               to               be               once               again               evaluated               for               MS,               it               was               discovered               by               an               EKG               that               I               possess               something               in               my               cardiac               electrical               system               called               a               "short               pr               interval."               This               short               pr               causes               my               heart               to               experience               arrhythmias,               which               would               finally               explain               my               dizziness.

I               was               immediately               taken               off               the               Flexoril               and               all               caffeine               and               any               other               medication               that               might               be               stimulating,               and               I               noticed               a               decrease               in               my               dizziness               within               a               few               days.
               Now,               besides               needing               a               good               Neurologist,               I               needed               a               Cardiologist               as               well.

My               body               was               seriously               starting               to               piss               me               off.

How               could               one               basically               healthy               person               have               so               many               unconnected               things               wrong               with               her?
               Once               again,               I               was               back               in               the               MS               dance.

I               was               set               up               by               my               primary               care               physician               with               the               EMG,               which               could               definitively               diagnose               or               rule               out               Charcot-Marie-Tooth               (and               which               was               not               ordered               by               my               first               neurologist               who               had               diagnosed               the               CMT).

The               EMG               did               rule               out               CMT,               but               threw               Carpal               Tunnel               Syndrome               into               the               mix.

Another               malady,               apparently               unrelated               to               my               other               problems.

Just               throw               it               on               the               junk               pile.

The               Carpal               Tunnel               was               considered               very               advanced               in               a               woman               my               age,               and               was               not               due               to               repetitive               stress               injury.

It               was               spontaneous               and               unexplained.

And               it               was               definitely               responsible               for               the               advancement               in               arm               pain               I               had               been               experiencing.
               I               then               saw               a               neurologist               at               the               MS               Center               in               Boston,               and               he               felt,               like               the               neurologist               before               him,               that               I               did               not               have               MS.

He               ordered               another               MRI               of               my               brain               and               spine,               which               confirmed               his               findings.

This               time               I               was               not               able               to               feel               the               elation               I               felt               the               first               time               I               was               told               that               I               did               not               have               MS,               there               was               just               too               much               going               on.

It               appeared               that               my               body               was               falling               apart               piece               by               piece               and               no               one               could               figure               out               what               was               happening.
               Fortunately,               the               next               step               taken               was               to               set               me               up               with               some               cognitive               testing               to               find               out               what               sort               of               deficits               we               were               looking               at               in               the               old               noggin.

The               results               of               those               tests               were               the               first               illuminating               bit               of               information               I               had               ever               received               during               this               decades               long               odyssey.

The               cognitive               impairment               I               was               experiencing               and               had               been               experiencing               for               so               many               years               were               determined               by               the               testing               to               be               caused               by               impairment               to               the               frontal               lobes               and               to               the               white               matter               tracks.
               I               sat               quietly               for               a               moment,               absorbing               what               my               doctor               was               telling               me.

I               just               looked               at               her               and               said               "I               don't               know               what               ï¿½white               matter               tracks'               are.

Are               they               some               sort               of               information               conduction               system?"               She               responded               that               they               were.

And               so               I               added               "there               is               a               problem               with               the               conduction               system               to               my               heart,               and               to               the               conduction               system               of               my               brain?

Are               you               telling               me               that               I               am               basically               short               circuited?"               She               smiled               and               shrugged               and               said               that               my               phrasing               was               probably               not               an               inaccurate               characterization.
               And               then               everything               just               opened               up               inside               my               brain               and               a               strange               calm,               calm               that               I               had               not               felt               in               almost               two               years,               settled               in.

It               was               the               "Ah               ha!"               moment,               and               I               knew               the               answer               before               even               I               posed               her               the               question.

"Could               this               have               anything               to               do               with               the               fact               that               I               was               electrocuted               (sic)               as               a               child?"               And               I               saw               a               knowing               look               pass               over               her               face               as               well.

"That               is               a               very               interesting               question,"               she               said.

"I               am               going               to               need               to               look               into               this."
               Well,               that               was               all               I               needed               to               hear.

I               returned               to               work,               logged               into               my               database               of               medical               journals,               and               let               some               steam               out               of               those               search               engines.

What               have               I               found               as               documented               results               of               electrical               injury?

Well,               let's               tally               it               up.

I               have               found               papers               about               the               relationship               between               electrical               injury               and               severe               migraine,               peripheral               neuropathy,               short               term               memory               loss               and               confusion,               Carpal               Tunnel               Syndrome               (occurs               in               10%               of               cases               of               hand-held               electrical               injury),               and               disruption               to               the               electrical               conduction               system               of               the               heart.

The               documentation               is               challenging               to               find,               as               I               mentioned               earlier,               there               are               very               few               cases               documented.

Also,               correct               phraseology               has               to               be               discovered               before               a               search               can               be               successful.

For               instance,               until               I               began               my               research,               I               was               ignorant               of               the               fact               that               the               word               "electrocution"               referred               only               to               cases               in               which               the               electrical               injury               resulted               in               death.

Therefore,               there               is               very               little               literature               available               to               be               discovered               from               a               search               on               the               phrase               "symptoms               of               electrocution,"               as               the               only               symptom               would               therefore               be               death.

The               phrase               "electric               shock"               brought               up               scores               of               papers               on               Electro               Shock               Therapy,               but               was               not               helpful               to               my               endeavor.
               So               what's               it               like               to               live               with               the               aftermath               of               an               electrical               injury?

It's               frustrating.

It               is               ever               changing.

It's               hard               to               trust               your               body,               as               you're               never               sure               when               new               impairments               are               going               to               present               themselves               as               the               body               ages.

And               there               is               definitely               a               feeling               of               insecurity               whenever               you               have               to               explain               your               problems               and               their               causes               to               a               new               doctor               who               has               never               heard               of               anything               like               it.
               But,               it's               fine.

I               am               now               able               to               take               my               symptoms               apart               one               by               one               and               determine               which               are               treatable.

The               neuropathy               is               not               likely               to               go               away,               but               now               that               we               know               that               there               is               Carpal               Tunnel               going               on               in               there               as               well,               some               of               my               pain               and               numbness               will               be               relieved               as               we               treat               that               part               of               the               equation.

With               the               aid               of               braces               that               I               wear               at               night,               I               have               already               been               able               to               reduce               the               pain               significantly.

The               dizziness               is               also               very               much               improved               now               that               we               know               that               it               is               cardiac               in               nature,               not               vestibular,               or               the               result               of               "converted               migraine"               for               which               we               found               no               successful               treatment.

The               impairment               to               the               frontal               lobes               and               white               matter               tracks               are               not               likely               to               improve,               but               there               is               nothing               that               suggests               that               they               will               degrade,               either.

I've               been               compensating               for               those               problems               all               my               life,               and               I               was               clever               enough               to               marry               a               man               with               a               photographic               memory.
               So               here               it               is,               my               magnum               opus,               the               completion               of               my               "What               is…"               series.

I               have               tried               very               hard               throughout               this               article               to               use               both               clinical               and               casual               terms,               so               that               anyone               searching               while               struggling               to               find               out               what               is               wrong               with               them               will               be               able               to               find               some               results,               or               at               least               some               input               on               how               to               go               about               getting               an               answer               to               the               seemingly               unanswerable.

And               I               will               say               this,               it               is               dangerous               and               counter               productive               to               try               to               diagnose               yourself               for               any               kind               of               illness               or               problem,               but               there               is               nothing               that               says               that               you               can               not               work               in               partnership               with               your               physicians,               sharing               with               them               the               information               you               are               able               to               obtain               and               receiving               their               feedback.

You               are               your               own               best               advocate               and               certainly               your               most               interested               party.






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