I dont know if my question is beyond the expertise of some of the Dr on this board.

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Patient: I dont know if my question is beyond the expertise of some of the Dr on this board. If not I apologize. I was told yesterday that I am a carrier of the Alpha 1 tris gene. My phenotype is pi mz. I had the test due to elevated liver functions without any cause. numerous MRI ultrasounds and dozens of whacky blood tests. My Dr who is a pulmonary specialist and gp sent me to a liver specialist in mt sinai hospital nyc. Where I was tested. My gp Dr states that being a carrier is of no real risk to me, just that I should not smoke. He said that my body does produce enough AAT My range is 88 mg ref 82 to 169. I read that being a carrier can increase my chances of getting lung disease. I had the flu last week and still have a cough for about two weeks .My Dr says it can take sometime and the cough has nothing to due with my results. The liver specialist said in the report that he has seen in some cases increased fibosis in setting like mine. would the Mri and ultrsound showed this. My alt 93

Doctor:
Thank you.

Your gp is correct, as long as you don’t smoke your chances of developing COPD is not increased. Dr Seersholm wrote a 2004 article that addressed this specific topic. His research showed that people with pimz did not have an increase incidence of lung disease as long as they did not smoke. The reason is because a pimz still has, at a minimum 60% AAT. This is enough to stave of lung disease in someone with A1AT def. The cough, is a response that can last for weeks to even a month or longer. The reason is not the lungs (in this case) but the bronchi. The cough is often the very last thing to leave or get better. This is seen in almost all cases of any respiratory issue. Since your numbers are good I would not worry that all of a sudden you developed a lung disease. As for the liver, the MRI or ultrasound would have shown fibrosis of the liver. Your clotting factors would be out of whack. Your protein would be low. It doesn’t appear that this is the case. I would have to agree with your gp on the lung issue and would say that your hepatologist (liver doc) may have seen some cases of worsening, but I guarantee you this was the Continue reading I dont know if my question is beyond the expertise of some of the Dr on this board.→

I have old (2005) 25MG effexor and wish to use it,….is it safe?

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Patient: I have old (2005) 25MG effexor and wish to use it,….is it safe? does it change in composition or in strength?

Optional Information
Gender: Female
Age: 85
Already Tried: Using effexor to reduce hot flashes. Am currently using 80Gm CMPD Progesterone 5% and over the counter Estroven. used these for 30 days with no results, what period of time before I see a change? Very hard and repeat flashes throught the day and night. Any other recommendations? I have not used the effexor only once along with the progesterone. use the P cream twice /day. Hot flashes destroying my life. I can’t believe I am subject to hot flashes at the age of 83 though 85+1/2 HELP !!

Doctor: Hello,

Medications such as Effexor have an expiration date – and drugs from 2005 would now be expired. They lose their effectiveness – so they would not work. The strength decreases and it would do you no good.

If you used this effectively before, you can call your doctor and see if they would represcribe it – they will usually require an office visit, but if it helps – that’s worth it!

Patient: Yes,….the effexor did NOT work before, either, but I was willing to try it aain if it was still good. I have been told over many many yrs that old meds should be avoided.

I need help in finding a med that will help with these Hot Flashes that are destroying my everyday life !!! If you canot tell me an alternative or answer how long to take the progesterone before I get any relief,…you have not helped me a bit.The Dr seems at his wits end in his attempt to prescribe anything that will help.

Doctor: Regarding your hot flashes: treatment usually consists of Hormone Replacement Therapy. If you’ve tried both oral and transdermal patches and those have not worked – you may want to try the following:

Some research suggests that soy may have some benefit for reducing hotflashes and Continue reading I have old (2005) 25MG effexor and wish to use it,….is it safe?→

I wore braces at 40 years of age for a slight overbite.

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Patient: I wore braces at 40 years of age for a slight overbite. Two weeks after the bands were yanked off my molars, I needed a root canal and crown. Two years later the crown broke and a new gold crown was put in place. Two years later I am having horrible pain and my dentist sent me to an endodontist. He said that he will have to go in through the gum and remove the remaining nerves. I thought when you get a root canal that there are no nerves left. I didn’t want 2/3 of a root canal. Is this common? The pain has been horrible. I’ve missed days from work and now the bill is $1400 for a tooth that I have already paid for a root canal and two crowns. What responsibility does my dentist that has performed all this work hold?

Optional Information
Gender: Female
Age: 48

Doctor: hi,

thanks for posting your question on health.is.edu ,

A root canal treatment is used to treat teeth that the decay has reached the pulp,

there is no guaranteed 100 percent success rate in any root canal treatment

http://en.wikipedia.org/wiki/Endodontic_therapy

the root canal treatment usually takes care of the problem, however it Continue reading I wore braces at 40 years of age for a slight overbite.→

My sister (age 76), has Type 2 diabetes. Could this cause her constant severe fatigue?

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Patient: Until the past couple of years she was very active, but the fatigue prevents her from exercise, she says. She also has much stiffness in her body and joints. N.B: This is really my sister, living in California; not me. I live in NYC and see her only once or twice a year, and I get worried.

Doctor: Well controlled diabetes should not cause constant severe fatigue. This should be evaluated further by doing blood test. She should have her hemoglobin checked, her thyroid function checked. These are the first two tests that I would like to do in her case.

Regards