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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22099
Experience:  Over 20 yrs of Family Practice
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Dr chip. I am sitting here absolutely terrified

Customer Question

Dr chip. I am sitting here absolutely terrified
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Why so?
Customer: replied 1 year ago.
Because i dint know whats going on. My uncle said treatment for high gastrin level is to Take out most of stomach or part of pancreas making too much gastronomic
Expert:  Dr. Chip replied 1 year ago.
I noticed you changed accounts. You owe me a rating on the previous question and I see that on this account you talked to to other experts about high gastrin levels which is fine but you rated their answers and they basically told you what I had told you. And your uncle is talking about what has to be done with some gastrinomas and we don't know yet that you have one.
Customer: replied 1 year ago.
Im scared
Expert:  Dr. Chip replied 1 year ago.
OK but what do you want me to tell you?
Customer: replied 1 year ago.
Tell me what you would tell any of your friends or patients
Expert:  Dr. Chip replied 1 year ago.
What I've told you--this doesn't mean you have a gastrinoma so there's no need to freak out just now. And sometimes the surgery isn't that extensive and it's certainly curable.
Customer: replied 1 year ago.
Do you think i can go home tonight? They probably wont do any tests this week right?
Expert:  Dr. Chip replied 1 year ago.
Are you supposed to do more there tomorrow?
Customer: replied 1 year ago.
No but the mayo dr said that if the gastrin was elevated hed do more testing to see where its from. I dont wanna go home to ight if he calls tomorrow and tells me he wants me to come in and do tests
Expert:  Dr. Chip replied 1 year ago.
Then the sensible thing to do is stay tonight and get in touch with him tomorrow.
Customer: replied 1 year ago.
Tell me everything else it could be
Expert:  Dr. Chip replied 1 year ago.
I have already. One question--how long had you been off the Zantac and the PPI before the test was run?
Customer: replied 1 year ago.
2 weeks and a day. Tell me again
Expert:  Dr. Chip replied 1 year ago.
Tell you again what?
Customer: replied 1 year ago.
Everuthing it could be
Expert:  Dr. Chip replied 1 year ago.
It might actually mean nothing at all. It could be a lowering of gastric acid that you didn't have before. And very unlikely it could be a gastrinoma but seriously you need to have the Mayo doc tell you exactly what he thinks.
Customer: replied 1 year ago.
Do you honestly think its nothing? Or do you think its a significant finding in trying to find out why i keep getting ulcers
Expert:  Dr. Chip replied 1 year ago.
It still is significant if it's a case of atrophic gastritis but seriously here--we can't really do or say anything more about it right now. Talk to the Mayo doc tomorrow and let me know what he says. And, again, you owe me a rating on the previous page.
Customer: replied 1 year ago.
I fid give you a rating on the other page
Expert:  Dr. Chip replied 1 year ago.
Sorry--I wasn't notified of that
Customer: replied 1 year ago.
Ive been up since 3 am throwing up
Expert:  Dr. Chip replied 1 year ago.
Talk to the Mayo doc as soon as you can
Customer: replied 1 year ago.
I wanna go home
Expert:  Dr. Chip replied 1 year ago.
Not yet--finish the job first and talk to him and get back to me in about three hours
Customer: replied 1 year ago.
I dont wanna wait. I wanna go home now
Expert:  Dr. Chip replied 1 year ago.
Whatever--I have to be off for three hours
Customer: replied 1 year ago.
He still
Has not called me
Expert:  Dr. Chip replied 1 year ago.
Have you tried to call him?
Customer: replied 1 year ago.
I called his office again this morning. They told me they will send the message and mark it as ASAP like they did yesterday
Expert:  Dr. Chip replied 1 year ago.
Well, it's a bit early still--give him a little time
Customer: replied 1 year ago.
I dont wanna stay here all day
Expert:  Dr. Chip replied 1 year ago.
And I don't want to here that again--your choice but unless you want to freak out all day about what the elevated gastrin level might mean, you should make every attempt to talk to him.
Customer: replied 1 year ago.
You used the wrong hear. He can call me and tell me what it means. I dont necessarily have to stay in Rochester right? What's your recommendation
Expert:  Dr. Chip replied 1 year ago.
Stay there until you hear from him
Customer: replied 1 year ago.
Please don't be mad at me
Expert:  Dr. Chip replied 1 year ago.
I'm not but be sensible and wait a while longer.
Customer: replied 1 year ago.
Btw h pylori was negative
Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year ago.
Why are you so hard on me
Expert:  Dr. Chip replied 1 year ago.
How so?
Customer: replied 1 year ago.
You just are.
Expert:  Dr. Chip replied 1 year ago.
Don't have any idea what you're talking about. Any sensible person would tell you to hang on a little longer to speak with the GI and you drip info to me like the H pylori and what do you expect me to say?
Customer: replied 1 year ago.
Ill give it yntil 11 then i have to check out of thehotel. Deal?
Customer: replied 1 year ago.
Whatever
Expert:  Dr. Chip replied 1 year ago.
Had to opt out because it wouldn't allow me to respond. 11:00 is fine
Customer: replied 1 year ago.
He wants to do a ct of the pancreas
Expert:  Dr. Chip replied 1 year ago.
So you talked to him? What all did he say?
Customer: replied 1 year ago.
That they are doing a ct to check for tumors. He said hes not overly concerned because the gastrin levels
Not over 1000.
Expert:  Dr. Chip replied 1 year ago.
OK--did that at least make you feel better?
Customer: replied 1 year ago.
No. It woukd make me feel
Better if i didnt have to have a ct to check for tumors
Expert:  Dr. Chip replied 1 year ago.
Why did it make you feel worse? I don't understand
Customer: replied 1 year ago.
I dont know. And he wants me to stay here an extra day so he can go over the ct results with me in person. I think ct results can be given over the phone so i can go home
Expert:  Dr. Chip replied 1 year ago.
True but you really need to sit down with him and ask all the questions you can so you can get the most out of the trip and have a better idea of what exactly he thinks the problem is.
Customer: replied 1 year ago.
But i really want to go home. And i can ask him all my wuestions over the phone
Expert:  Dr. Chip replied 1 year ago.
Up to you but I don't think that would be the best way to do it
Customer: replied 1 year ago.
Just talked to my boss. I have to be at work tomorrow so he is going to have to call me with the results. Do
You think the ct will show anything. I had a ct a month ago that was normal
Expert:  Dr. Chip replied 1 year ago.
I really don't think it will but it will be directed at your upper abdomen so it needs to be done.
Customer: replied 1 year ago.
So you are thinking its not gastinoma
Expert:  Dr. Chip replied 1 year ago.
I told you before that it's unlikely but that needs to be ruled out
Customer: replied 1 year ago.
I have so much anxiety about all of this. I hate it. If the ct is normal does that rule out anything bad
Expert:  Dr. Chip replied 1 year ago.
It will rule out tumors so yes it will rule out the bad things.
Customer: replied 1 year ago.
If its normal then do they have to do any more tests to see why gastrin was elevated
Expert:  Dr. Chip replied 1 year ago.
Maybe another gastric pH but ask the GI all those questions
Customer: replied 1 year ago.
If something does show up then what
Expert:  Dr. Chip replied 1 year ago.
That's why you need to ask the GI exactly what his opinion is--we can't just go round and round with what if's
Customer: replied 1 year ago.
I feel like im about to
Throw up
Expert:  Dr. Chip replied 1 year ago.
I can't help with that and you know it
Customer: replied 1 year ago.
What uf i throw up in the ct machine?
Expert:  Dr. Chip replied 1 year ago.
Won't do it any damage and we're starting to chat again
Customer: replied 1 year ago.
Excuse me fir being worried
Expert:  Dr. Chip replied 1 year ago.
No problem
Customer: replied 1 year ago.
Guess who threw up everywhere
Expert:  Dr. Chip replied 1 year ago.
In the scanner?
Customer: replied 1 year ago.
Yep.
Expert:  Dr. Chip replied 1 year ago.
Did they at least get the scan done?
Customer: replied 1 year ago.
They let me go. But idk how goos the image will be since i was vomitting while it was taking them
Expert:  Dr. Chip replied 1 year ago.
We'll just have to see
Customer: replied 1 year ago.
The iv dye always makes me puke
Expert:  Dr. Chip replied 1 year ago.
We're chatting again
Customer: replied 1 year ago.
Followup visit.
IMPRESSION/REPORT/PLAN
Mrs. Miller is a pleasant 24-year-old female who came today for followup visit for uncontrolled epigastric pain secondary to recurrent gastric ulcers. She mentions that her pain was severely exacerbated once she stopped the Nexium and ranitidine for today's tests. We collected blood today for a gastrin level after stopping the PPIs for over a week. We will wait on the results of this test.
#1 Recurrent gastric ulcers
#2 GERD
Seems like Nexium and ranitidine were helping control her symptoms. We will switch her Nexium to AcipHex and wait for her insurance approval. In the meantime, we recommend continuing the Nexium and the ranitidine while we wait for the results of the tests. Depending on the results of the gastrin levels, we will proceed either with further acid studies or symptomatic management of her persistent epigastric pain. This was discussed with the patient.
#3 Bulimia nervosa
We appreciate the recommendations of our eating disorders specialist, and the patient decided to continue working with her therapist at home. She will cancel her further appointments with our specialist.
We will contact the patient with the results of the gastrin.
Addendum:
Gastrin level elevated 378 pg/ml. The result is suggestive of gastrin producing tumor in this patient who has been without acid suppressing medications for 1 week. We will proceed with a CT scan of the pancreas, triple phase protocol.
DIAGNOSES
#1 Recurrent gastric ulcers
#2 GERD
#3 Bulimia nervosa
Original: AJA:csm by aja
Electronically Signed: 11-Jul-2013 11:09 by A.J. Acosta Cardenas, MD, PhD
Expert:  Dr. Chip replied 1 year ago.
Doesn't say much new.
Customer: replied 1 year ago.
But he says it suggestive of a tumor
Expert:  Dr. Chip replied 1 year ago.
Just suggestive--that doesn't say it is a tumor
Customer: replied 1 year ago.
But reading it makes it seem like he thinks i have a tumor. He didnt say suggestive of atrophic gastritis
Expert:  Dr. Chip replied 1 year ago.
You're not a doctor so don't try to interpret it. I don't read it as saying a tumor is likely.
Customer: replied 1 year ago.
But he didnt mention anything else
Expert:  Dr. Chip replied 1 year ago.
We aren't really getting anywhere with this page.
Customer: replied 1 year ago.
Im fricken scared ok
Expert:  Dr. Chip replied 1 year ago.
I know but our just talking about what if's isn't helping that
Customer: replied 1 year ago.
Would you be scared if you were me
Expert:  Dr. Chip replied 1 year ago.
A little concerned but no, not scared
Customer: replied 1 year ago.
Does gastrin cause ulcers
Expert:  Dr. Chip replied 1 year ago.
Yes it can
Customer: replied 1 year ago.
If i have a tumor whay do they do for it
Expert:  Dr. Chip replied 1 year ago.
Here you go again. It depends on the exact location as to what the surgery would entail and I can't tell you any more than that.
Customer: replied 1 year ago.
You are getting frustrated with me. So do you want to give me an answer now so we can close the page
Expert:  Dr. Chip replied 1 year ago.
I'm just not going to go over something that hasn't even been established as yet and again it doesn't help you to ask these kinds of questions. I'm trying to help you out here by not talking about your "possible" tumor--that's a great way to fuel your anxiety. But unless you have something more specific and different to discuss right now, we should close the page.
Customer: replied 1 year ago.
Todays a crappy day. My dogs missing
Expert:  Dr. Chip replied 1 year ago.
How so?
Customer: replied 1 year ago.
How so what?
Expert:  Dr. Chip replied 1 year ago.
How so is your dog missing?
Customer: replied 1 year ago.
My sister put my dog at 9 this am and then went to work; leaving me dog outside. When she got home at 130 she wasnt outside anymore. And they cant find her
Expert:  Dr. Chip replied 1 year ago.
Is that the usual way it goes? The dog is just let loose outside?
Customer: replied 1 year ago.
We have a fenced in backyard. But my dog is little and she will dig under the fence when shes left outside too long. Im sure shes run over somewhere
Expert:  Dr. Chip replied 1 year ago.
Has she ever gotten loose before? What has your sister done to try to find her?
Customer: replied 1 year ago.
She gets out and comes to the front door to be let in. My sister has walked around town looking for her.
Expert:  Dr. Chip replied 1 year ago.
Well, it doesn't mean she's been run over. Could be that someone picked her up
Customer: replied 1 year ago.
No she doesnt like strangers
Expert:  Dr. Chip replied 1 year ago.
Well, still doesn't mean she won't show up. If she'd been run over I'd assume whoever might have done so would not have stopped and taken the body somewhere
Customer: replied 1 year ago.
I hope not. I love that dog
Expert:  Dr. Chip replied 1 year ago.
I have three cats and I've lost a lot of pets over the years so I know how you feel.
Customer: replied 1 year ago.
What if she got eaten by a coyote? Or even worse what is shes scared and injured somewhere
Expert:  Dr. Chip replied 1 year ago.
Can't say anything about that except to let me know if she's been found
Customer: replied 1 year ago.
Shes still missing :(. If she doesnt come home tonight she is for sure going to get eaten by coyotes
Expert:  Dr. Chip replied 1 year ago.
We can't keep going on like this so let's close the page
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22099
Experience: Over 20 yrs of Family Practice
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