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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6532
Experience:  14 years as clinician in the field of Family Practice
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I dont generally eat protein

Customer Question

I dont generally eat protein
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello again,

Anthony Bray MD :

You do need an adequate componant of protein in your diet....

Anthony Bray MD :

Meats of course are a primary source...

Anthony Bray MD :

Milk, cheese, eggs, penut butter would be good sources as well...

Anthony Bray MD :

The requirement for protein is 0.8gram protein PER kg of body weight....

Anthony Bray MD :

per day...

Customer: I could probably add in some peanut buttee
Anthony Bray MD :

OK

Anthony Bray MD :

Your doctro can check prealbumin in blood work to see if you are taking in adequate protien....

Customer: I had one done and it was 16 i think. It was low they said
Anthony Bray MD :

OK that makes sense...

Anthony Bray MD :

Do you like seafood?

Customer: No i absolutly hate it. I dont know what my issue is with meat but i have a hard time with it
Anthony Bray MD :

I see>> well hopefully you can find adequate sources that you do like.....

Anthony Bray MD :

You might go to a store such as GNC and inquire then as to some supplement options>> they may have something there that would work for you...

Anthony Bray MD :

You can check with any pharamcy as well >> protein bars ets are of course available...

Anthony Bray MD :

Do you like eggs or no??

Customer: Not really. Before my eating issue begain i had no problem with eating protein
Anthony Bray MD :

I see....

Anthony Bray MD :

an appetite stimulant might be considered if really you had too much trouble with this... this would not be my suggestion as the best option though... more towards last resort...

Anthony Bray MD :

I would advise that you try to make conciuos effort to increase your protein however....

Customer: I will try
Anthony Bray MD :

OK >> Good luck >>

Anthony Bray MD :

I hope this helps

Anthony Bray MD :

Let me know if you have further questions.

Anthony Bray MD :

Best regards,

Anthony Bray MD :

Anthony Bray MD

Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6532
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.
If i had ulcers would that make me feel pukey after eating
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Yes >>it can >>> sometimes food may bring relief as it initially buffers acid BUT the presence of food stimulates the release of more... irritation of the stomach lining may certainly cause nausea... this can be frank ulcers or diffuse irritation of stomach lining = gastritis....

 

I hope this helps! Thank you very much for the positive feedback!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Anything i can do abour it
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well YOU ARE doing what you can >> Protonix// Carafate // Zantac.... you are doing what you can to ease these symptoms. I suppose a nausea med might be needed as a potential of the nausea is bad enough...

 

I hope this helps!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
I have phenergan suppositories and zofran. Is one better than the other
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

I would pick Zofran >> both are effective but less side effects with the Zofran vs Phenergan such as drowsiness..

 

I hope this helps. Let me know if you have further questions!

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
Ijust feel sick today
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

I'm sorry to hear that. I hope that you feel better soon. Hopefully the Zofran will help. If nausea now it should help with that.

 

Let me know if there is anything else that I may help with!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Im having a lot of problems with regurgitation
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

On NO!! That's not good.. I guess that you are using the Zofran? You may alternate the Phenergan and Zofran to start...

 

I would advise easing back to liquid diet for 12 hours and then bland.. see how you tolerate these...

 

I hope this helps!

 

Let me know how you are doing. I hope that you are feeling better soon!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Ill stick with a liquid diet today
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

OK I hope this helps... I hope that you feel better soon!

 

Let me know how you are doing...

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
What antibiotics typically cause cdiff
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well many can potentially lead to this problem. Getting to the point however the Augmentin would be relatively high risk because it is active against gram negative bacteria AND anaerobe type bacteria ( these two types are predominantly in the GI tract) the killing of the normal bacteria I'm the GI tract does increase the potential for C. Diff... This is one of the most antibiotic resistant bacteria. Taking a probiotic ( Activia , Danactive, yogurt as examples ) these would help to decrease your potential risk of C. Diff.

C. Diff would more likely present with symptoms of colitis---lower abdominal pain and diarrhea.....

I hope this helps. Let me know if you have anything further.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
What percentage of people get cdiff
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Low percentage but can't give you exact.... Less than 1 percent...

I hope this helps. I hope that you are doing better!

Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
Bp is 91/58
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That BP is very low --- are you getting dehydrated again??
I would advise that you keep monitoring this! 90/60 is about the lowest that most people can tolerate,

Let me know if you have further questions.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Im not getting dehydrated
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Do you feel OK? Are you light headed??

>>>>>
Customer: replied 1 year ago.
I just feel yucky
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

Well I can relate to that but can't say much on that vagueness of description from a medical perpesctive . Let me know if you have further specifics on which you wish me to comment on. I do hope that you feel better soon!

Let me know if you have further questions!

Best regards XXXXX XXXXX!

Anthony Bray MD
Customer: replied 1 year ago.
My chest hurts. My o2 is 95%.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

OK---chest pain is of course a symptom of concern. Can you tell me details if this? Does it hurt to take a deep breath?? Does it hurt to cough or are you coughing now?? Do you feel short if breath? Does the pain feel like a pressure sensation? Is it sharp/ dull or tearing?? Is it a burning sensation? Do you have risk factors for heart disease?? The pulse ox of 95 is OK although may be lower than your best... It itself is not of concern at that level...

Is there anything that makes the pain worse?

Anything that makes it better ??

Any associated symptoms like the nausea or cold sweats??

Let me know.... I'll get back with you ASAP!!

Use common sense in such a situation and if you have reason to believe that this chest pain may be heart related then don't hesitate do call 911 or go to hospital.

Let me know....

Take care----

Anthony Bray MD
Customer: replied 1 year ago.
Im only 24 i dont think its heart related. It hurts to cough and it hurts to inhale. My chest feels full of pressure when i lie flat
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Based on your age and the quality of the chest pain I agree with you that this does not sound heart related!

It sounds consistent with pleuritic type pain instead. This is caused by inflammation between the lung and the chest wall. This may range in cause from mild cases of viral pleuritis to pneumonia as underlying cause. A lower respiratory infection ( bacterial or viral) ranging from bronchitis to pneumonia can cause pleural lining inflammation. There then becomes a stickiness between the lung and chest wall and these surfaces normally slide across each other like butter on Teflon.. When these surfaces stick then it hurts to cough or take a deep breath.

Pleuritis would tend to benefit from anti- inflammatory treatment BUT with your history of GI Problems you should probably stick to Tylenol which may help some.

If you should progressively feel worse/ develop fever/ worse Pleuritic pain/ nausea/ shortness of breath--- then follow up with your doctor and evaluation with a chest X-ray would be recommended!!

I hope that this helps. Let me know if you have further questions!! I will be happy to get back with you!

Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.
Can i take nsaids all
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

I would be very careful before using much of an NSAID. A few doses might not be too bad. A cox 2 product such as Celebrex or Mobic would be the better potential options for you here!! These are true anti- inflammatory MEDS with less potential GI side effects.

I hope this helps!

Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.
I was taking mobic when i got ulcers last time. I guess no nsaids for me
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well strictly speaking the Mobic is not quite a Cox 2 ---it is high ratio Cox-2 vs Cox -1 . The Celebrex is strictly Cox 2 inhibitor--- but you are right that none are completely risk free--- Celebrex is low risk with regard to the GI tract. Also an option is Arthrotec which is a combination Of anti- inflammatory plus a GI protectant ingredient. Tylenol is not a true anti- inflammatory but can give you some pain relief.....

I hope that this helps! Best regards

Anthony Bray MD
Customer: replied 1 year ago.
If it was pneumonia would one lung hurt more than the other
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes that would be likely. Pneumonia involving one lung is more common than bilateral pneumonia but both are possible....

I hope this helps. Let me know if you have further questions . Take care!

Anthony Bray MD
Customer: replied 1 year ago.
I feel overheated and am sweaty
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

How is the temperature / weather where you are? Could this be a factor?

Have you been exerting yourself? This could be a factor....

Can you check your temperature? If so then keep track over time---- this feeling may be associated with fever( chills when body temp goes up but hot and sweaty when body temp comes down or "fever breaks")

I hope this helps. Let me know if you have further ....

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I live in mn its 40 degrees. I have a temp of 101.2
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

OK , the fever concerns me as a potential symptom of pneumonia ( I hope this is not the case but I worry...) with you being on third treatment now of Augmentin this current fever further concerns me with regard to your increased risk to have a treatment failure as well. If the antibiotic were being successful for the sinus/respiratory infection then you should not have a pattern of increasing fever. So I would advise follow up evaluation with your doctor and to have a chest X-ray ( or consider a chest CT)

I hope this helps! Let me know if you have further questions! I hope that you feel better soon!

Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.
With tylenol the fever goes down
Expert:  Anthony Bray, MD replied 1 year ago.
Hello !!

Anti-Pyeuretics such as Tylenol should help to bring your temperature back down toward normal. This effect would be helpful for about four hours. You may take 500 to 1000 mg Tylenol every four hours max BUT IT is best to limit the Tylenol to 3000 to 4000mg per day and 3000 mg/ day if taken more chronically. This should help to control your fever. If you tolerated low dose Advil 200mg every sic hours the this ms be alternated with Tylenol.

I hope that this helps . Let me know if this helps and if you have further questions.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
My epigastric region really hurts
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

This could be due to diffuse irritation of the esophagus, (= esophagitis) or esophageal ulcers or it could relate the diverticulum that you have,,,,,

I hope this helps ! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
What can i do for it
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

You are already doing what you can with your medications ( Protonix/ Carafate/ Zantac) you also need to stick more to bland type foods when you are more symptomatic --- avoid acidic/ spicy/ " hot" foods....avoid if course alcohol and coffee--- and we have discussed the possible anti- inflammatory MEDS that you might be able to still take....

I hope that this helps. I hope that you feel better soon! Take care!

Anthony Bray MD
Customer: replied 1 year ago.
I am
Covered in welts. Dr rxd me 60mg prednisone today the taper down by 10 mgs until gone
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I'm sorry to hear that. It sounds that you had an allergic reaction to the amoxicillin in the Augmentin as a likely cause . This is very common allergy to occur. Other allergies are possible I would say but the allergy to amoxicillin is very common. ( Part of the reason for this common scenario is that allergic responses occur more commonly when you are sick with an infection---- the immune system is of course more active at these times)

I hope this information helps. Please let me know of you have further questions.

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Im on prednisone. Took 60 mg day then taper by 10mg daily. Also prescribed zyrtec 10 mg 1-2 tabs twice a day. Is this standard treatmebr
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes the prednisone taper plus the Zyrtec would be standard treatment to control a significant allergic reaction.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
So its ok to take 40 mg of zyrtec a day? By the prescriptions i got you would assume it is. Significant reaction
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Zyrtec is generally 10mg/ day----did you mean the prednisone??

While Zyrtec is a pretty harmless medication I have NEVER heard of anyone prescribing 40md/ day of this!! ....

Double check your prescriptions and let me know....

Anthony Bray MD
Customer: replied 1 year ago.
The zyrtec all day is 10 mg. the sig is take 1-2,tabs by mouth twice a day. The prednisone is also 10 mg with sig take 6 tabs today then decrease by one tab a day until gone
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

OK --- that is OK to take this dose. It is just a bit unusual prescription for it -- that's all--- Zyrtec is an anti-histamine and the main side effect from the higher dose may be some drowsiness....

The combination should help to quickly control and improve the allergic rash...

I hope that this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Do you think it sounds like a significant reaction
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

What you described sounds like urticaria = hives--- this is significant enough but not the most severe type of allergic reaction ( not anaphylaxis which is the worst... Not swelling of the throat nor wheezing ... So it is bad enough but could be much much worse)

I hope this helps. Let me know if you have further questions---

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Will the itchyness go away by tomorrow. Also my chest hurts and my throat feelsxweird. I dont know how to explain it
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

The itching should improve but I can't guarantee you that it would be completely gone by tomorrow of course. The rash and itching allergy symptoms would be expected to clear pretty quickly with the treatment that you are on.

I hope this helps. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
My chest hurts
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

The chest pain would NOT be an allergy symptom. This would rather be due to pleuritis as we discussed before....

I hope this helps. Let me know if you have further questions.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Dr bray. This am
Afterfor i got out of bed me hr was 140. Adter i got out of bed it was 168
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Wow--- that is awfully fast--- as I recall you take a beta blocker .... Is this correct??

Do you know your diagnosis? Might you have been diagnosed with sick sinus syndrome or tachycardia- Brady syndrome or other ????

Let me know and I will be happy to get back with you!!

Take Care!!

Anthony Bray MD
Customer: replied 1 year ago.
Saw urgent care and theu said inwas fine
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Don't you take a beta blocker?

How do you feel now?

Do you know what your blood pressure is?

Is the heart rate staying that high past ten- 15 minutes rest??

It would not be that abnormal with exertion but would be abnormal resting

heart rate.... ( normal resting is 60 - 100)...

How do you feel?? How is your respiratory infection doing??

Do you still hurt in your chest??

Let me know and I will get back with you....

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Take atenolol. I feel flushed. After resting it goes tp 130s-140s. My respiratory status is fine
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Ok-- I thought that you did take a beta blocker-- Atenolol is of course a beta blocker. Again as I recall you have a history if episodes of the rapid heart rate but I do not you sharing to me exactly what your diagnosis was/is for this...

I recall this being a previously evaluated problem though...

If you have ongoing breakthrough tachycardia( rapid heart rate) greater than 140 at rest then I must advise that you be seen at ER for that and follow up with your cardiologist( it may be that you might meet your cardiologist at the ER or whomever is own call for his/ her group)

It would be a good idea to contact your cardiologist's office and report your current high heart rate. As you are familiar to this doctor then he/she would be in the best position to further direct you...

The current infection that you are fighting could contribute to higher heart rate but would not be expected for your rate to be as high as what you report ...( especially not at rest)

Let me know if you have further questions or other to report...

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
My cardiologist said im a medical
Condundrum.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I can understand the comment. I still think that updating your cardiologist with your current changes would be called for. I think this would be a sensible and hopefully helpful step for you. They may direct you to take an added dose of the Atenolol or might request that you come in or other....

I hope this helps. Let me know if I may be of further help!

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
My pcp said hes not concerned. Hes the one who rxd the atenolol. I think it might be from the prendisone
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Hmmm-----it sounds rather odd to me---- if your heart rate is as high ( resting) as you say then I would think this would be of concern to your PCP and cardiologist. Perhaps you have a rather benign sinus tachycardia with stable blood pressure. Even so--- if your heart rate is that high in a resting state then it would seem to me that you should at least have follow up on this. Perhaps a holter monitor for 24 hours and perhaps a higher dose of Atenolol might be considerations for you .... What is your current dose of Atenolol??

Let me know if you have further questions

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Current dose is 25mg once a day. My current pulse is 132, and ive been in bed for the last hour and a half
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

It would seem to me that you need a higher dose of Atenolol most likely BUT I think it important to know both your max and minimum heart rate to make this call. I would advise follow up with your cardiologist and while there ask for clarification of your diagnosis.... (Let me know)

Your blood pressure is also needed to make judgment call on the Atenolol dose. ( I am not trying to treat you or change your medication but I do recommend that you follow up with your doctor on this issue-- cardiology opinion best for this situation I think)

On your respiratory infection are you having fever? Shortness of breath? These could be factors to put stress on your body and increase heart rate ....

I hope this helps. Let me know if you have further.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Not having any feber but was sob this am
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well worsening of your respiratory infection could cause the rise in pulse rate. Worsening of your anemia could also cause rise in your pulse rate. Other factors are possible. I would advise that you get further help and evaluation depending on how you feel and this persisting high pulse rate. ( there is reason that this is referred to as a VITAL SIGN.... If you catch my drift....) the picture that you describe seems to be very concerning to me....

Let me know if I may help further . Take care!!

Anthony Bray MD
Customer: replied 1 year ago.
My ekg was normal but at a fast pace. Ddimer was normal thyroid was normal basic panel was normalish
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Normal EKG except fast pace would be referred to as sinus tachycardia. I presume that today us not atypical day for you with regard to how HIGH your heart rate is--- correct?? This would indicate stress to your body in some form. This could be the respiratory infection... Also potential concern for worsening if your anemia....

The D-dimer would be to test for abnormal clots such as a pulmonary embolism... So this was normal at the time that you had the test. At your age this was seem to be a low risk cause for you unless you had an inherited clotting abnormality or other unexpected risk factor for clots.. So I would doubt this as being likely cause but the combination of some of your symptoms(chest pain , shortness of breath and tachycardia) could certainly fit with the clinical picture if a PE( pulmonary embolism) your history suggests that you have been down this path before however....

If you feel worse then seek further help. By this I mean watch for signs of fever, worse shortness if breath, light headed, any worsening of heart rate.... Then consider going to ER. Your pulse rate and other symptoms would make me inclined to advise you to go ahead to ER ( or PCP or cardiologist) but I doubt that you are likely to go....

I guess what makes judging your situation more difficult us that it sounds that your baseline is not exactly normal either.....

I hope this is helpful. Let me know if you have further questions.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Im sorry that im difficult. But i did call my pcp and he basically said that im fine.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Perhaps that your PCP knows something that I don't ....you aren't a hypochondriac are you?? If you are being honest in reporting your symptoms and vital signs then it sounds to me that you need further evaluation. If you are exaggerating then that may be another avenue of discussion. If your report is true then it sounds that you would need to be seen.... What is your current pulse rate??? How about BP if you have home cuff... Temperature if you have thermometer .... These would be helpful to keep abreast of your situation....

Let me know and I will get back with you !! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I cant believe you think im a hypochondriac. My pulse i 124. My bp is 98/60. Temp is 98.8. My dr doesnt really know what to think. At one point he suggested Pots syndrome
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

I was not accusing but simply asking!! I find it odd that your PCP is not more concerned with your history. So that was the point of my question.

Yes POTS syndrome could account potentially for tachycardia but this would be more tied to a rise in pulse and drop in BP with standing....this possible diagnosis would be supported by checking for the tell-tale changes in pulse and BP with orthostatic position changes(lying- sitting- standing)

What does YOUR pulse typically run? How far elevated is today for you?? This would be helpful to know....

If POTS then this too would have a specific treatment strategy....

Are you currently experiencing fever? Worsening if cough? Shortness of breath? Is the discomfort in the chest about the same??

Let me know and I will get back with you! Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Since starting atenolol my pulse has been between 50-65 bpm. I have no fever temp is 98.8. The disconfort in my chest is about the same
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

OK--- well to me, I find it very concerning that your heart rate is more than double its baseline with still low blood pressure!!!! This could mark possible problems of pneumonia, severe anemia , pulmonary embolism( we have already discussed this one of course) . The drastic change in your vital signs seems to me to be of major potential concern however. I would advise that you strongly consider evaluation at the ER if this is the best route for you at this time. I think that you should have further evaluation to include physical exam, CBC( complete blood count) chest X-ray and EKG ( to confirm normal type rhythm and not conversion to something like atrial fibrillation) .

I can't in good conscious tell you to ignore your symptoms!!

I hope this is helpful for you!! Keep me updated! Take care,

Anthony Bray MD
Customer: replied 1 year ago.
i already had an ekg
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes I realize that but as with many other tests it may change!!! Today's result MIGHT not be the same as previous ....if you went to ER then they could tell rhythm by placing you in telemetry which would be standard practice with your abnormal vital signs....

It may just show sinus tachycardia. It would be one of several potential problems to rule out however...

I hope this helps. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I will see how i feel tomorrow
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again

OK---well good luck to you. I hope that you feel better tomorrow.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Just so you know. My pcp is kinda lax in my care. When i was in the throe of my eating disorder he depended on me to determine when i needed labs and fluids. When i was admitted to the hpspital it was my choice. He said that it was my
Choice wether i wanted to be admitted or just get fluids. When i was discharged from the hosp the dr said i needed to be closely followed lab wise but my dr refused.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well that does not sound too encouraging to me on the quality of care that you are getting!! Perhaps you need a new primary care doctor!! From your description your current doctor sounds dangerous to me!!

Let me know if I may be if further help!

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
I have periodically been seeing a different md because hes more experienced
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That sounds like a good idea to me!! I hope this other physician is more caring and responsible as well!!

Best regards to you! Let me know if I may be of further help!

Anthony Bray MD
Customer: replied 1 year ago.
Maybe im just too conplicated
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Oh I would agree that you are complicated but that would not be an excuse for giving you poor care or having a lax attitude about serious health issues....

I hope that this helps! Take care,

Anthony Bray MD
Customer: replied 1 year ago.
What about me is complicated
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That seems rather obvious , is it not?? You have a set of complex issues especially at your age. The problems with severe GERD, possible need for Nissan fundiplication , esophageal diverticulum, anemia, eating disorder history, PTSD, tachycardia NOS, possible POTS syndrome. You have had the recent illnesses with marked dehydration low blood pressure, tingling. You reported the marked drop in your hemoglobin which needs follow up.... More recently the sinus infection leading into the lower respiratory infection with pleuritic pain. You now are allergic to Augmentin and still finishing treatment for this, correct? And today you have abnormally high pulse rate despite being on Atenolol and low BP with this. Yes, you would seem quite complicated!!

Let me know if I may be if further help. Let me know if you have further questions or discussion.

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Im not doing the augmentin anymore tor the sinus infection. I never was sick except for this past 1.5 years
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I hope that you may be restored back to good health without ongoing problems...

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I am seeing a new gi dr tomorrow What kinda tests would you order for my issues
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I think that the single most important test for the GI issues would be to repeat the upper endoscopy. I think it important for your gastroenterologist to SEE your diverticulum, check the condition of the esophagus in general and especially the LOWER esophagus ----check for recurrence of ulcers especially in light of your drop in hemoglobin. The esophagus, stomach, and duodenum may be checked with upper endoscopy. Possible sources of bleeding might be identified. The possible presence of a hiatal hernia may be identified. The possibility of H. Pylori infection ( leading cause of ulcers) may be rechecked( I realize it has not been that long since this was checked but I think it potentially helpful in light of the problems that you have had...)

So I would favor the EGD as the main test to be of benefit to you at this point although I realize this is a repeat for you...

I hope this helps. Let me know if you have further questions. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
You dont believe i am a hypochondriac to do you? My gi dr wants me to go to Mayo clinic. Whats your thoughts on that
Expert:  Anthony Bray, MD replied 1 year ago.
Hello,

No I don' t think that you are a hypochondriac. I asked that because it seemed that your PCP was being SO nonchalant attitude about what seemed to me to be very serious complaints/vitals/circumstances. I was trying to make sense of this seeming inconsistency.... That's all....

I hope this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I dont think i can increase the atenolol because my bp is already low. Typical bp is higher80s-low 100s over higher 50s-60s
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

I agree that it may have potential to lower your BP too much. (This becomes complicated because too high of heart rate may also LOWER cardiac output...and therefore BP.... so there are times where lowering rate may actually stabilize BP) You need a cardiologist to help if the rapid heart rate and low BP are frequent or prolonged problems though....

 

I hope this helps. Let me know if you have further questions. You may wish to start another thread as this one has 50 Q and A's back and forth now...

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Pulse is down to 119 this am
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well that is better but still abnormally high......

 

How do you feel this AM??

 

Let me know and I will get back with you >>>>

Customer: replied 1 year ago.
I feel alright this am. Have a sore throat but thats all
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

OK well I am glad to hear that you feel better. I suppose that I also worried that your need to stop the Augmentin may have left your respiratory infection under-treated. I would watch for the emergence of any concerning symptoms in this regard such as new sinus pain/pressure, cough, chest discomfort, fever, wheezing, etc...

 

OK to gargle with the sore throat > Listerine or salt water or 1:1 hydrogen peroxide: water (don't swallow any of these) gargles may be repeated several times a day. Some Tylenol may help with sore throat and some throat spray such as Chloroseptic may help...

 

Let me know if you have anything further that I may help you with.. Best regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Last thing the new gi dr took me off all the reflux meds. Said my issues come from costochondroitis
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

I think that you may very well have both. I'm not so sure that taking you off of reflux meds is a good idea... don't you have a strong sense of having reflux as well??

 

As I recall from our discussions the costochondritis symptoms came after the onset of the sinus infection but that you had a long history of reflux plus the abnormal previous studies with history of ulcers as well. Add to that the recent drop in hemoglobin and I think that you probably need to stay on reflux meds. I suspect that the new GI doctor may not be aware of your entire situation thus far....

 

 

I hope that this information helps. Let me know if I may be of further help to you!

 

Take care,

 

Anthony Bray MD

Customer: replied 1 year ago.
The new gi dr has access to my whole chart
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

Well he may have had access but it does not sound that he has the complete picture to me...

 

Best regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Honestly do you think its all IBS? I know i have reflux. But i also know i have costochondrotis. Them two things feel differently. I dont really think he cares. He wants to see me back in a month but id rather see the other gi dr because he at least believes i have reflux. Who woyld tell someone with a history of ulcers to take nsaids? Thats bazar. Should i switch my diet to see if that helps? Right now im avoiding spicy, fatty, citrusy foods and caffeine and chocolate. Im frustrated that no one can tell me whats wrong with me
Expert:  Anthony Bray, MD replied 1 year ago.

Hello!

 

I think that this last doctor has just not put in adequate time to really get to know you so far...it is common problem... too many patients vs too little time...

 

I agree that you probably have both GERD and costochondritis!! I would NOT take a regular NSAID if I were you!! Celebrex would be OK (relatively) or Arthrotec...

 

I would advise that you stay on diet restrictions and and take your reflux medications....

 

BTW ... PLease start a new thread as it takes about 3 minutes for this long thread to load and also down load after I answer a question...

 

Best Regards,

 

Anthony Bray MD

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