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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6802
Experience:  14 years as clinician in the field of Family Practice
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Dr bray. I have a question
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello again!
Anthony Bray MD : What is your question??
Customer: I was at mayo yesterday. My dr did the FMLA paperwork to cover me until july 1st. Mayo
Anthony Bray MD : Ok....
Customer: wanted me to come down june 27. My boss said no. Can she di this ifmy fmla paperworked covered from june 20-july 1
Anthony Bray MD : How did your evaluation at Mayo go??
Anthony Bray MD : Well you SHOULD be protected by your FLMA but the wirker's rights may vary from state to state... Can you go over your boss's head to discuss this ??
Customer: Im not really sure. I met with the gi dr yesterday. He scoped me. Idk the tesults and he ordered abdominal wall injections to see if maybe thats why i had dpugastric pain. But i was suppose to see him again on june 27 but my boss said no. And now its a 3 week wait to see him again
Customer: I think may talk to my gi dr who referred me to mayo and habe him talk to her
Anthony Bray MD : I would discuss this further with the doctors at your clinic...
Anthony Bray MD : Is your immediate boss your ultimate boss or an intermediate supervisor ?? I think that would be key to your situation...
Customer: I explained toy boss thats a 3 week wait to see the dr at mayo again and she said that thats what i have to do
Customer: Shes the nursing supervisor
Anthony Bray MD : I would think that the doctors if the clinic would override her decision...
Customer: If i have to wait 3 mire weeksy anxietys going to get the best of me
Anthony Bray MD : I think you need to be able to take care if your medical needs as a priority and that the doctors of your clinic should support you in this. I think that the nurse supervisor is being unreasonable...
Customer: I understand that we ate short nurses amd hardly anyone is crosstrained in ent but i shouldnt have to postpone it
Anthony Bray MD : I hope that this is helpful. Let me know if you have further questions and I will be happy to get back with you!
Customer: Do you think im being unreasonale?
Anthony Bray MD : I agree with you! They should have some mechanism to back you up!!
Anthony Bray MD : No I don't at all!!
Customer: When i told her i needed 3 days off for it and scoffed that check ups dont take 3 days
Anthony Bray MD : How are you feeling now ?? Doing better I hope!!
Customer: I feel about the same. I had the abdominal wall injection today and no relief. And im tired because its aXXXXXone way
Anthony Bray MD : Do you have paperwork to support your needs at Mayo?? I think that would help your case...
Anthony Bray MD : It sounds that the nursing supervisor is skeptical if your recommended treatment needs...
Customer: I have it and it was turned in. I said i need off until the 1st at the earliest for appts at mayo, scopes, scans, and pain
Anthony Bray MD : if you were willing to request copies of your Mayo medical notes then this would support you but you may object to this invasion of privacy ....
Customer: Inshodnt have to go through all of this
Anthony Bray MD : I would discuss your situation with the doctor or doctors that you assist at your clinic. They could override the nursing supervisor...
Anthony Bray MD : I' m sorry that they are giving you such a hard time ! I hope this gets better for you!!
Customer: I dont want my supervisor to think im a baby and tattling on her
Anthony Bray MD : Well I understand your sentiment there but you need to stand up for yourself and protect your own health and best interest too !!
Anthony Bray MD : How is your ulcer/ abdominal pain doing specifically ?? I would think that you should be seeing some improvement by now via the Protonix, Carafate and diet modification...
Anthony Bray MD : I understand too that the office politics can be difficult...
Customer: It still hurts. Im not on protonix anymore. Im on carafate nexium and chokystyramine. I still occassionally throw up blood
Anthony Bray MD : I see... The Nexium if anything would be slightly stronger that the Protonix . You seem to be maxed out on ulcer treatment!!
Anthony Bray MD : I wonder if you may over- produce acid in your stomach....
Anthony Bray MD : nexium twice a day may fix if this were the problem but usually is not necessary ...
Anthony Bray MD : So Zollinger- Ellison syndrome would be a possible reason for your abnormal degree of trouble... This would require lifelong treatment ...
Anthony Bray MD : I guess that I am a bit skeptical of the abdominal wall injections but I am not really familiar with this technique...
Anthony Bray MD : The doctors that you see at mayo see the worst and most unique conditions though while I see run of the mill conditions--- different perspectives....
Anthony Bray MD : I hope this helps! Let me know if you have further questions or information and I will be happy to get back with you!!
Anthony Bray MD : Best regards XXXXX XXXXX!!
Anthony Bray MD : Anthony Bray MD
Customer: I
Customer: I am taking nexium twice a day. They said when i have my ph studyndown my oh level was normal at 4
Anthony Bray MD : Ok -- I see--- well again you seem maxed out on treatment for ulcers. As I have said before it is also very important that you get adequate nutrition for good healing!! I hope that this is the case!! I think that we have established that you do not smoke or drink alcohol, right??
Customer: I eat when i feel hungry. Since wednesday am i lost 4#. I do not smoke nor do i drink
Anthony Bray MD : Well do try to eat a good mutinous diet but stay away from hot spicy and acidic foods!! Good nutional should mean that your weight stays stable and not dropping...
Anthony Bray MD : If losing weight over time then this is a catabolic state and would tend to make healing difficult. This aspect is often overlooked....
Customer: Im doing my best. But i think lately ive been so stressed over this mayo thing that i just have no appetite
Anthony Bray MD : I understand your point and stress itself is not good for stomach ulcers and in fact too much stress itself may be a cause....
Anthony Bray MD : Good luck to you! I hope that you continue to heal and get stronger with time!
Customer: Im just frustrated. Im sick of feeling lije crap and im mad that i have tomwait until the 18th to see yhe sr at mayo again. They also set me up with a dietician
Anthony Bray MD : I understand -- I am sorry that you are so frustrated... I do hope that things get better for you!!
Anthony Bray MD : I think the dietician is a reasonable idea. Hopefully that will be helpful for you too.
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6802
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and other Health Specialists are ready to help you
Customer: replied 1 year ago.
And you think its ok to talk to my referring dr about my boss
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes I think that would be fine. Her actions do impact your care. It is a legitimate concern.

I hope this helps,

Take care! Anthony Bray MD
Customer: replied 1 year ago.
And its not me tattling
Expert:  Anthony Bray, MD replied 1 year ago.
No I would not consider that " tattling " . You have medical needs to be addressed!! Your doctors should be your advocates in this regard .

I hope this is helpful! Best regards. Anthony Bray MD
Customer: replied 1 year ago.
Can they legally tell me know if i have fmla
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

The legal obligations that relate to an FMLA would vary some according to the state that you are in... ( I'm not a lawyer of course) but I believe that "right to work" states and smaller employers may have more leeway in the regard to FMLA. There are combinations I believe if federal a state law protections in this regard.

I can' t give you too much specific information with regard to your protections in this regard. You might ask a lawyer on this site for further information in this regard.

I hope this helps some-- I wish I could offer more information in this regard. Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.
I talked to a lawyer on here and he said its illegal to deny me that day off
Expert:  Anthony Bray, MD replied 1 year ago.
Ok-- good, I' m glad that you got a more answer to this question . I hoe that this has been helpful to you!!

Take care, Anthony Bray MD
Customer: replied 1 year ago.
So i should take this up with my bosses boss
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well I am glad that you got an answer to your question. I hope this helps to support your case at work! It helps to be armed with knowledge of your rights!

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Can i ask you a medical question? My one breast really hurts. It hurts to
The touch
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

You might have mastitis as one possibility.. This would be a bacterial infection of the breast tissue. This would need to be treated with an antibiotic if this were the case .

You could have costochondritis as another possible cause. This would cause pain and tenderness deep to the breast tissue. In this condition the breast would look normal. It may be sore to press on the breast and tender under the breast. In this condition inflammation if the cartilage below the breast becomes inflamed .

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

Anthony Bray MD
Customer: replied 1 year ago.
Its more my nipple and to the left of it
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

I would have it checked then. It is best to be safe in a situation such as this. It may relate to a blocked duct.

I hope that this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Ok
Expert:  Anthony Bray, MD replied 1 year ago.
Take care--- let me know if you should have further questions.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
The dr at mayo told me to take a fiber supplement. How much fiber
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well the cholestyramine would count in that regard... I guess you could try adding Metamucil and follow directions. It would be about one tablespoon mixed in 8 ounces of water.

I hope this helps! Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I was on miralax and it wasnt working. So they said tru fiber supplement. I have gummy fiber pills that are 5 grams of fiber
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Miralx is a bit different I believe. The products that you mention sound fine. Psyllium fiber is the most common fiber supplement and this is present in many products...

I hope this helps! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
For a supplement 5 grams is enough
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes I think 5 to 10 grams would be fine for you.

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Heres the results from my scope
A. Stomach, Incisura Antrum, Body, endoscopic biopsy: Reactive
gastropathy. Antral and fundic mucosa shows reactive foveolar
hyperplasia, negligible inflammation, and no Helicobacter pylori.
These changes suggest chemical-type injury such as can be seen with
nonsteroidal anti-inflammatory drugs and bile reflux.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well with the bile reflux aspect the cholestyramine should help with that. If you take aspirin, ibuprofen or Aleve or a prescription anti-inflammatory then you should stop! Tylenol should be ok as it is fundamentally different than the others . I hope this helps! Let me know if you have further questions. I will be happy to get back with you! Take care!

Anthony Bray MD
Customer: replied 1 year ago.
I dont take nsaids
Expert:  Anthony Bray, MD replied 1 year ago.
Well that's good. It must be related to the bile reflux up into the stomach then . The cholestyramine appears to be a good call by your gastroenterologist.

Take care!

Anthony Bray MD
Customer: replied 1 year ago.
Whats the cure for it
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

You are on the right treatment. Not a cure per se for the problem as far as I know.

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I just talked to the dr from Mayo and hes stoping all my reflux meds. He says i still
Have an ulcer. And hes going to do some labs when i see
Him on the 10th
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I don't understand the point of him stopping your reflux MEDS! That does not seem to make any sense to me!

Good luck !

Anthony Bray MD
Customer: replied 1 year ago.
Addendum: 6/24/13 16:30
EGD showed gastric ulcer with clean base and persistent gastritis and duodenitis. Biospy showed chronic inflammation. Results discussed with patient. Increase cholestyramine and told to stop PPIs and H2B to check of h. pylori and gastrin levels. Test to be done in 07/10/13. Questions answered.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Ok so they want you to stop two MEDS to check gastrin levels and check for H. Pylori?? Still --- yikes!! It just sounds risky to me.... Discuss further with your gastroenterologist would be my advice...

I hope this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
This is thr mayo gi dr. Im kind of apprehensive. How can he say i have chromic inflammation if the path report says negligible inflammation
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

It sounds that the EGD showed chronic inflammation and ulcer. So with those findings the stopping of your MEDS just sounds risky to me. I would discuss the plan further with your gastroenterologist. I hope that you get good care and that your GI issues get resolved! Best of luck to you!! Take care!!

Anthony Bray MD
Customer: replied 1 year ago.
Do i talk to my gi dr or the mayo gi dr
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

I would run the plan by your regular GI doc. You know the plan from the Mayo doctor. I would simply advise an independent opinion on the matter. I hope this helps! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Im frustrated by all this
Expert:  Anthony Bray, MD replied 1 year ago.
I realize that it must very frustrating! I hope that you get well soon! I am just not confident in the plan to have you stop your MEDS though. That is the aspect that bothers me. I would ask your regular GI doctor if he agrees with that aspect of the plan. I hope this helps. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Will the cholestyramine heal the ulcer I have
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

You may heal without the other MEDS but I feel that the other two would improve your chances. The main factor in the healing of ulcers will be your own body's capacity to heal. This is always the case!! Hence my emphasis on you maintains good nutrition, I hope this helps! Let me know if you have anything further! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
My vitamin d level is still low!
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

I'm sorry to hear that you are still having trouble in this regard. It may be that you eat a very low fat diet. I know that you take vitamin D supplements. Vitamin A, D, E and K do require fat in order to be properly absorbed. We refer to these as the fat soluble vitamins. So if your diet was too low in fat content then that could be a reason for poor absorption despite you taking the supplement. The typical American diet has about 40 % of calories from fat( fat has twice the calories per gram vs carbs or protein) 20 to 30 percent calories from fat would be considered a healthier ratio .

I hope this information helps! Let me know if you have furher questions and I will be happy to get back with you! Best regards !!

Anthony Bray MD
Customer: replied 1 year ago.
It was 13 4 months ago now its only 18. I still have a long way to go to get it back to normal. The lowest it can be while still being normal is 30
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well 20 to 30 % would be considered low fat but still generally healthy. I think it would be hard to be exact on this but would generally aim for this target area. I think that an average of 25% of calories from fat plus the vitamin D supplementation should help you to gain what you need in this regard. A general vitamin that included the others would be a good idea for you as well.

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

Anthony Bray MD
Customer: replied 1 year ago.
Last things. I was put back
On prescription vitamin d. And also put on lorazepam .5 mg twice a day for my overwhelming anxiety
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well good luck on both! Your vitamin D should be correctable. There is no shame in taking something for anxiety if you need it! Let me know if I may be of further help!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
The pain in my stomach is getting worse
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

What are you taking currently? Didn't your GI have you stop some MEDS? If so then that may be part of the problem....let me know and I will get back with you!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Just the cholestryramine. MYo took me off the other ones since they want to do h pylori and gastrin blood test
Expert:  Anthony Bray, MD replied 1 year ago.
Hello,

Well I guess you could take something shirt term to help with your current pain such as Mylanta or Tums. These would help but would not have a long lasting effect on the gastric pH. When do you have the tests done?

Let me know... Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I have test done on the 10th of july
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That is a while to wait. You might call his office to clarify on the holding of the MEDS for so long... ( gastrin levels is not a test that I ever order so I don't know how much time off of the PPI's you need to be but this seems long to me...) I would think that you could take your Nexium up until a few days from the gastrin test but you need to check with the gastroenterologist on the timing...

I hope this helps. For today try the Nylanta or Tuns and one of these will hopefully help some... Let the GI office know of your stomach pains tomorrow too!!

I hope this is helpful. Let me know if you have further questions and I will get back with you!?

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I feel really nausous and weak. My legs feel like jelly when i walk
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

I would recommend that you take something for nausea if you have something on hand---Zofran -- Phenergan -- Dramamine --- Benedryl...

If you can tolerate it then try to put something light in your stomach and this may hp you to feel better... Gatorade sips or small amount of soup....

I wish that you could restart your Nexium and Carafate --- call your GI specialist tomorrow to let them know you have the issues with the GI pain and nausea but have the gastrin level planned for 7/10....

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

Anthony Bray MD
Customer: replied 1 year ago.
Im seeing a dietician at mayo clinic tomorrow
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again!

OK, well I think that should be a helpful step. I hope that it goes well. I hope that you feel better soon! Let me know if you have further questions!

Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
Saw the dietician she says i need 1200 cals a day. Right now im average 850 cals a day. I talked to my reg gi dr about my worsebing pain after stoping relix meds and he says i need something for the reflux. He told me i could start the ranitidine again but that it might affect the results of the gastrin level
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I think it is wise to restart something for your stomach acid. I would think if you stopped the ranitidine 2 days prior to your test that this would less likely affect gastrin levels. As I told you I never order this particular test but I don't think the effect of the medication would alter the test extremely if stopped about 48 hours prior. Discuss further with your GI doctor if you have the opportunity.

As for the diet yes you would need a minimum of 1200/day but a bit more if you could tolerate it would probably help you in healing!!

I think part of your trouble is that you take in too little calories and are in a catabolic state. You will not heal well if in this state as the body looks to obtain energy from whoever it needs such as breaking down muscle and organ tissues--- not conducive to healing ulcers!!! So do please work on your nutrition!!


I hope this helps! Let me know if you have further questions! Best regards ,
Anthony Bray MD
Customer: replied 1 year ago.
I am doing my best dr bray
Expert:  Anthony Bray, MD replied 1 year ago.
Well that is the best any of us can do !

Good luck to you!

Happy 4th!

Anthony Bray MD
Customer: replied 1 year ago.
Pulse is 154. Bp is 102/59. I feel ishy and have a headache
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Pulse rate is very concerning --very high--- potentially could be due to an arrhythmia such as SVT. Would rest and recheck. Vagal maneuvers may be helpful. Do you feel dizzy or have chest pain?? Trip to ER may be needed if this is not just very transient... If rate comes down with strict rest next 10 -15 minutes then I would be reassured. Don't you have some history of tachycardia?? Please refresh my memory on this if so...

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

Anthony Bray MD
Customer: replied 1 year ago.
I have a hx of tachycardia of unknown origin. I take atenolol
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Ok thank you. Obvious question have you taken dose of Atenolol for today? What is your dose? Would wait with rest for ten to fifteen minutes and recheck pulse rate and blood pressure and let me know . I would have to wonder if taking a dose of your Atenolol may be needed.... Do you have reason to be dehydrated at this time?? Severe dehydration could do this( low blood volume) and also severe anemia could do this( we know that you have the ulcers... And have been off of your main ulcer MEDS for a while so this would be a concern) with all of the variables and potential issues here I feel that you may need to be seen at ER if the low BP and high pulse rate continue. You sound to be near or in state of vascular shock....

Please recheck and let me know... I will get back with you! Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Im in 50 mg. but usually by pulse is 50-60 and bp 100/60s
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again---

Well as I said --please follow up check on your pulse and BP--- let me know--- if you think you did not take the Atenolol then take your dose--- I think your history might fit with sick sinus syndrome as one possible cause???? This may be associated with tachy/ Brady syndrome... I rather hope not for your sake as this condition can be very difficult to manage..... Let me know on your follow up pulse and BP...

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
144. Bp is 97/64
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Only slight better pulse and somewhat worse on the BP. Have you had these type vitals much before?? You would seem to be in need of medical help!! These are not stable readings -- BP is WNL BUT resting pulse as you know should be 60 to 120. I know that you would not wish to visit ER. You may have history of such bad tachycardia and hypotension before but honestly you make me nervous. You should be treated for the tachycardia under medical supervision in my opinion. Some evaluation of your hydration status, rhythm of your heart ( ? SVT) hemoglobin should be done at this time.

I hope that this is helpful. Let me know if you have further questions or discussion and I will be happy to get back with you! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
I went to urgent care last night. I had low potassium and my hgb was a little low. I also had a bad uti
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well I'm glad that you got checked. I hope that you are feeling better today. Was this a bad UTI as in pyelonephritis? That could fit with your high pulse... Yesterday I MEANT to say normal resting pulse is 60 to 100 but I don't get too excited unless resting pulse is over 120.... ( just wanted to clarify that point... I muddled my thoughts together in writing to you on that point...) I hope that the pulse has settled down for you.

Let me know if you have further questions or discussion. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Idk if it was bad. Got iv rocephin
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I would treat a kidney infection( pyelonephritis) with IV Rocephin but not a bladder infection. So I suspect you were diagnosed with the more severe kidney infection bases on this course if treatment. With a kidney infection is is important for to have a follow up check after antibiotic treatment ( not necessary after just a bladder infection) they put you on an oral antibiotic as well??

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Was given oral antibiotics as well
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

Right-- that is good. Make sure that you follow up on finishing the antibiotic. ( my preference is to have follow up about two to four days on no antibiotic to help ensure that it has been adequately treated)

I hope this helps. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Thanks. My pulse is somewhat better today Its 128 right now
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Pulse rate of 128 is concerning but not freaking out level as you more closely had yesterday. A serious infection may make you tachycardic. ( actually this is an indicator of infection which in adults is as much or maybe better clue than fever. Adults do not run fever as easily. Kidney infection typically would include malaise, nausea, fever and flank pain

The trend of somewhat lower pulse rate is probably good in your situation.

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

Anthony Bray MD
Customer: replied 1 year ago.
Im either having hot flashes or a fever
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Fever would be expected with a kidney infection. You need to watch the pattern and watch to make sure that the infection is not getting worse rather than better.

Let me know if you have further questions or discussion.

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
My epigastric region really hurts. I also think Im getting dehydrated. My lips and mouth are dry. And im lightheaded upon standing
Customer: replied 1 year ago.
?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I would advise short term Nexium ( hold at least 48 hours prior to gastrin test) Carafate very short term 1 to 2 days... GI cocktail if you have it. I would advise Gatorade generously to help with dehydration.

I hope this helps. Let me know if I may be of further help. Sorry but offline most of today...

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Is it possible that the lorazepam is makong my symptoms worse? Im get hot flashes and lightheaded. My o2 is 100%, bp 100/56 pulse 80
Expert:  Anthony Bray, MD replied 1 year ago.

Hello!

 

No , I don't think that is really possible. If anything it should help anxiety.... Your pulse ox of 100% is consistent with you hyperventialting actually >> anxiety and especially pain attacks is where we see this.. It is a diagnostic clue in being actually too high!!

 

 

Your BP is rathter low but pulse rate looks better. Push fluids and salt and this would tend to help....

 

I hope this is helpful. Take Care!

 

Anthony Bray MD

 

Customer: replied 1 year ago.
What to do you mean its high. Its always 100%
Expert:  Anthony Bray, MD replied 1 year ago.

Hello !

 

It may be your physiology but most people tend to run 94 to 97% has been my experience anyway!! It may be your pulse ox machine too! Could make a difference. If always 100% I would not worry about it...

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
Last thing mayo gi dr said i could start my reflux meds tomorriw
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

Yeah!! Hopefully that will help you!!

 

Take Care!

 

Anthony Bray MD

Customer: replied 1 year ago.
My gastrin level is elevated
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

The high gastrin level would fit with the trouble that you have been having. Gastrin would stimulate the stomach acid ( among some other effects) this could well be associated with Zollinger Elison syndrome = excessively high production of stomach acid. This syndrome may benefit from double the dose if a strong proton pump inhibitor medication ( Nexium) so it would seem logical that the next step for you may be to double the Nexium to twice a day in Oder to bring the stomach acid under control in your case. This improved control of the stomach acid would more likely lead to healing of your ulcers. ( good nutrition is still importSnt toward this goal)

I hope this helps. Lets know if you have further questions or discussion. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Im taking 40 mg of nexium a day. But hes switching me to aciphex
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Aciphex or Nexium would be about the same honestly. With Zollinger Ellison syndrome you will probably be placed on a twice a day regimen as opposed to once a day .

I hope this helps. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
He rxd 20 mg once a day
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I suspect that it will be increased down the road to 20 mg bid. I can't always predict what other doctors would do however! That is what I would do ....

Discuss further with him at follow up!

I hope this helps. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Severe epigastric pain. Scheduled for octreotide scan tomorrow
Expert:  Anthony Bray, MD replied 1 year ago.

Hello!

 

Do you have GI cocktail available? (Mylanta plus Lidocaine) This may help...

 

Are your meds restricted again for this test?

 

Let me know. I hope that you feel better soon.

 

Anthony Bray MD

Customer: replied 1 year ago.
I do not hVe gi cocktail
Anywhere. My meds are not restricted but they havent started working again. I am miserable
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Sorry I was offline last night and will be offline today until about 6 PM..

 

I hope that you are starting to feel better today. I think that continuing your cocktail of Nexium, Questran, and Carafate would be best.

 

Take care, Let me know if you should have further questions...

 

Anthony Bray MD

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