ULTRASOUND

[Otto44$]

You responded to a question of mine in the expert radiologist forum. I replied to your sarcastic comment. I'm sharing here also, to make sure you see my response.

Please don't assume that I've demanded a Ultrasound for my issue, it was my PCP you ordered the ultrasound for a problem I'm having with my liver. Therefore, common sense would be at the time of viewing the aorta, kidney, pancreas, ect. so, I was only asking if the ultrasound on the kidney area would also show the lump under my 6th rib. It would make more since to me to examine the lump at the same time. With all due respect, I'm entertained by some Dr.'s (not including my PCP) that misdiagnose or perform negligence surgery as I've experienced.  Unfortunately, not only will I and others have to suffer from medical errors. I wonder if he (the dr. that was negligent with me) thought about how it not only affected my pocket book, life, but also the cost of medical care rising from his error's like many other's. I'm sorry but I take human life as a priority. It's not like a computer that you can replace. Sorry, but I don't put a price on human life. Therefore, I'm not one who complains about paying for medical Insurance. Please note: I have a autoimmune disease & it's important for my dr. to investigate any issue to the fullest.  


Note: More of my post following this one, due to exceeding my WHOLE reply exceeds the limit in what is allowed in posting at once.

[Otto44$]

Wow! I should really learn to proofread my writings, before submitting. Corrections; *It's more about me trusting than frustration, now that I'm back on track with sinuses. Let me also add, that I've also now learned that it's important that one watches out for themsevles, than to always take a Dr.'s advice. I'm not insinuating in anyway all Dr.'s are not caring enough, to make sure their patients receive the best treatment.

[Otto44$]

Is more trusting than frustration now that I'm back on track with my sinuses. One thing I've learned is a Dr. can write anything in a report without the patient knowing. This is why I always request a copy of all labs & reports now. Anyhow, I truly do have a issue with trusting more so a new Dr. if referred out. However, I always trusted my PCP, been going to him for yrs. & never had a reason not to trust him. But when I asked what the lump under what he called the 6th rib, that was discomforting & me being concerned because of having  issue's with my liver. He stated it's a muscle that popped out. Then I receive a copy of the report & he states, that the patient thought she pulled a muscle. If I thought I pulled a muscle, I wouldn't of went in for a office visit to have it checked out. In the meantime he was sending me for a ultrasound on the liver, kidney, arota & pancreas, so my point was shouldn't he had of also had that lump scanned at the same time. I had a PCP one time that said I've a goiter yrs. ago. It's funny, when I had to go for a ultrasound on the thyroid, due to high TPO's & having Hashi's. The radiologist report says no goiter. I'm glad you understand where I'm coming from now.

I will definitely take your advice & try the pepcid.

Thank You for all of the good advice & all that you do. GOD BLESS YOU!!

[Christopher R Watters, MD]

Wow.........
I now understand your frustration.

As to your question, if there is no reason to be on a proton pum inhibitor there should be no repercussions of stopping it. We see this after anti-reflux surgery where patients have been on the medications frequently for multiple years. We are successful in getting about 80% of these folks off their medication once the reflux has been stopped. It has been thought that the other 20% are probably acid hypersecreters. If you are having symptoms on cessation there probably is a component of reflux. You might try switching to an H2 blocker like pepcid or Zantac for a couple of weeks before stopping to make the change more gradual. Whereas Protonix reduces acid production by around 90% the H2 blockers are about half as effective. If you still see return of symptoms I think that theremust be a benefit that you are realizing from the medicine. I am unaware of any data suggesting that the use of these agents has any effect on the long term ability of the stomach to make acid.

Thank you for sharing your bad experiences. It helps to understand. I am a biliary surgeon by training which means that one thing I do is to fix injured common bile ducts from other surgeons "oops" during laparoscopic cholecystectomies. I understand the position that your second ENT was in.

[Otto44$]

Ok, I really need to get off of this now. I see I posted the same comment 2 times in copying & pasting, due to this forum only allowing so many character's in one posting. Sorry for any confusion.

[Otto44$]

Sorry, wanted to add this also:

I wasn't able to post all my comment in one box. I had exceeded the limit. Therefore, I'm continuing with the rest here. I'm realizing it's probably backwards due to having to copy & pasting it the way I did. Wow, now it's saying I've exceeded the 2000 character limit, so I'll have to split this message up also. Sorry for any inconvenience.

Here's some of this horrible Dr.'s information pertaining to his malpractice suits, not only for sinus surgeries he's performed, but botox also. I'm sharing with you, because you will be amazed.

Effective Date:    03/17/2009
    Action:    License suspension for three years, stayed with probation for three years and $20,000 fine.The physician completed the terms of his order on March 16, 2012.
    Misconduct Description:    The physician did not contest the charge of negligence on more than one occasion.

updated: 7/8/2010

License stayed suspension for three years, with probation for three years and fine. The physician may practice medicine only when his practice is being monitored once a month by a physician board certified in an appropriate specialty. Effective date 3/17/2009.

Sorry, Dr. Profile site, will not allow me to copy & paste to share all of this Ent's malpractice suits and it's to much for me to type. I can assure you that you can trust me with proof that, he had alot of them where some of them he just settled & some that he contested & was found guilty by the court of law. Not to only mention all the negligent sinus surgeries, he also has been negligent in performing BOTOX where he chose to inject botulinum neurotoxin which was not approved by FDA to use in humans. The label on the bottle of botulinum neurotoxin, states, "FOR RESEARCH PURPOSE ONLY-NOT FOR HUMAN USE" in a large amount of his patients along with other bad chose's he's made in his medical career.

[Otto44$]

Sorry, wanted to add this also:

I wasn't able to post all my comment in one box. I had exceeded the limit. Therefore, I'm continuing with the rest here. I'm realizing it's probably backwards due to having to copy & pasting it the way I did. Wow, now it's saying I've exceeded the 2000 character limit, so I'll have to split this message up also. Sorry for any inconvenience.

Here's some of this horrible Dr.'s information pertaining to his malpractice suits, not only for sinus surgeries he's performed, but botox also. I'm sharing with you, because you will be amazed.

Effective Date:    03/17/2009
    Action:    License suspension for three years, stayed with probation for three years and $20,000 fine.The physician completed the terms of his order on March 16, 2012.
    Misconduct Description:    The physician did not contest the charge of negligence on more than one occasion.

updated: 7/8/2010

License stayed suspension for three years, with probation for three years and fine. The physician may practice medicine only when his practice is being monitored once a month by a physician board certified in an appropriate specialty. Effective date 3/17/2009.

Sorry, Dr. Profile site, will not allow me to copy & paste to share all of this Ent's malpractice suits and it's to much for me to type. I can assure you that you can trust me with proof that, he had alot of them where some of them he just settled & some that he contested & was found guilty by the court of law. Not to only mention all the negligent sinus surgeries, he also has been negligent in performing BOTOX where he chose to inject botulinum neurotoxin which was not approved by FDA to use in humans. The label on the bottle of botulinum neurotoxin, states, "FOR RESEARCH PURPOSE ONLY-NOT FOR HUMAN USE" in a large amount of his patients along with other bad chose's he's made in his medical career.

[Otto44$]

So, my question is, in situations if one doesn't have a hital hernia or no reason to be put on a acid reducer. Is it possible for them to every beable to discontinue the medicine, without causing other issue's to the digestive system as well as the esophagus? I did try to stop taking now on protonix for 3 days on a low fat diet and experienced, indigestion, GERD and nausea, in which I was forced into starting them up again due to the discomfort & not knowing how long I will have to deal with the unpleasant experience. Also, being scared that it would cause other medical issue's pertaining to my digestive system or esophagus. Please advise.

I know this is a long post, as well as hard it was to share with someone I don't know. However, it took me a couple of days to make that decision & to try to get an answer to my question to you above.

Well, gotta go for now. If you could please just share your advice as to my question above pertaining to discontinuing the protonix & if so, providing some advice as to how long it will take for my system to get use to not using a acid reducer anymore. I'd greatly appreciate it.

[Otto44$]

Good Morning! Ok, I'm gonna share my bad experience with you. I had sinus polyps that needed to be removed. So, being a new resident in the city I moved to, due to job relocation. I was younger then, and always held all Dr.'s to high standard, knowing they're not GOD, but thought they would be very good in their field of speciality. Never would I question a Dr. Well, anyhow I was referred to this ENT (whom I found out after the fact, that his speciality is actually plastic surgery even though he's listed as a ENT). So, needless to say he was only suppose to be removing polyps. He decided to drill holes in my maxillary cavities during surgery and never informed me. Anyhow, they caused further complications, constant sinus infections, leaving me no option to take antibiotics & steroids for 7 yrs. every month, in which some I became ammuned  too for taking so long. In any manner, everytime I'd finish them, I'd be good for about a wk. & thinking it was another sinus infection that would appear. Eventually, I was finding my self to have a nasty order that smelled like, blood & iron in my nose along with picking green scabs. Mind you, I wasn't able to blow my nose (in which I constantly complained to ENT about, never would get an answer) because nothing would come out, learning after the new ENT had informed me,that it was because of the bacterial not being able to escape from the maxillary cavities due to not being able to escape from the wholes. When, I ended up with bacterial meningitis & was visited by another ENT in the hospital that had to perform another surgery, stated unfortunately, that reconstructive surgery wasn't an option, due to the holes already being there. However, the he would make like a canal for the bacteria to beable to drain. He informed me being that sinus problems are environmental due to allergies, that I would still get sinus infections (in which I've only had 3 since second surgery) but would only have to be on antibiotics for 10 days, no steroids. he informed me after all said & done, that the Dr. that performed the 1st surgery for some unknown reason put wholes in my maxillary cavities, and that my sinus cavities were now backwards. The example he gave me was that they now are like a coke bottle. For instance, you would put a big whole in the can to drink out of it, a small hole to let gas bubbles out of it. Well, mine were actually the opposite. The bacteria for 7 yrs. was just sitting in them wholes, with no way to escape. Therefore, it was really one infection (that's why I stated above thinking infection after infection) that was not going away, just getting worse from bacteria build up. Anyhow, what happened, was when being treated by the ENT that performed my 1st surgery. At all my post up's, I would ask him why am I getting all these infection's, I was worse than before the surgery with polyps. Note: his own nurse practitioner at one time when I again went in complaining, after she was reviewing my previous CAT SCAN, what did Dr. say he's gonna do with the bacteria in the maxillary cavities. Well, me not understanding at that point, that it was not normal responded, I don't know. Because, I didn't know he put wholes in my maxillary cavities and that it was wrong to do so, being I'm not a Dr. Anyhow, returning back to the Dr.'s again for a sinus infection after another treatment of antibiotics, steroids & sinus rinses with no relief. The Dr. said, I'm probably getting so many infections due to allergies (mind you, I do have allergies, but again never had so many issue's as severe as these) so, I'm gonna have my allergist do testing. I then completed the allergy testing. Well, his allergist has a way instead of having to return once or twice a wk. for injections, of just mixing what you'd receive in a injection into a dropper bottle & instead of adding saline to it, as you would an injection. She adds a sugar base for a better flavor. I was told to put 2 dropper fulls under my tongue daily. Therefore, as always I followed her instructions. Well, can't remember how long later, but my throat started closing & my voice was so hoarse. I then called to go in again and the receptionist couldn't hardly hear me. So, ENT numbed the back of my throat, put a tube down & said I now have a hital hernia, prescribed me  prevacid & sent me on my way. Well, being that the ENT's is closed on the wkend. & my PCP's being open, I decided to go in on a Sat. because symptoms of throat closing was still there & seemed to be getting worse. Anyhow, the Dr. on call wanted to know if I was taking new med's. I informed him of the allergy drops. After thorough examine, he diagnosed me with having an allergic reaction to the drops. He proceeded with having the nurse give me a steroid shot & ordered antibiotic's due to being susceptible to throat infection being that it was closing & insisted not take the allergy drops anymore. I did just that, problem was solved. Ok, so not realizing maybe I really didn't even have a hital hernia and should not be taking the prevacid (even though when the ENT diagnosed me with a hital hernia, I stated I don't get heartburn) until yrs. later. When realizing & proving that this ENT was negligent in treating me. IMO, he was more or less, using everything for an excuse to cover up his error, and one thing being diagnosing me with a hital hernia for a allergic reaction to the allergy drops.  IMO, he probably hoping by some miracle, everything would clear up.

I never realized till after the fact, that he always seemed to blow me off at office visit with complaints. Never could give me answers.

I also know it'll be hard for you to believe, being that I was told Dr.'s usually stick together (hoping that's not true) but the ENT that performed my second surgery (whom I call my angel) did inform me that his group has fixed alot of the first ENT's mess up's. He wasn't to happy and when trying to convince me of having the second surgery. He was very understanding & let me know that, after the horrible experience I went through that his group only at that time specializes in fixing other Dr.'s more or less, mess ups & people born with abnormal sinus anatomy.

Results: Like I mentioned above, I've only had 3 sinus infection in 3yrs. have only had to take antibiotic for 10 days, not steroids. I don't even have to visit my new ENT anymore, just go to the PCP when a infection occurs. In which it's been probably about 2 yrs. since I've experienced another sinus infection.

[Christopher R Watters, MD]

You have referred to this misdiagnosis several times. Can you give me some details as to what the situation was and why you were startednon it initially? The short answer is that there is no data to suggest that the stomach is somehow altered by long term proton pump inhibitors. There doesn't seem to be any rebound of acid production on cessation. Any link to esophageal cancer is not related to the medicine but to the problem being treated. Current thought is that it is not acid reflux but the reflux of bile from the duodenum through the stomach and finally to the esophagus that most likely relates to cancer. Whereas historically most esophageal cancer has been squamous there has been a significant increase in adenocarcinomas of the lower esopagus in recent years. In animal studies there was a concern over an increase in carcinoid tumors of the stomach but this has not panned out in humans. Patients with Zollinger Ellison syndrome (tumor making gastrin) no longer require gastrectomies because they can be managed with high dose proton pump inhibitors at eight times the usual dose. Nnoe of these issues have been seen in these patients.

[Otto44$]

I have a question for you. If I've been taking protonix for yrs. due to the misdiagnosis, is it true that I'll now have to take it the rest of my life? I tried to stop it for 3 days, with a no fat diet, eating just fruits and seasonal veggies. Needless to say, I had indigestion, nausea, a lot of pressure in stomach area. It was then told that I'd have to take it the rest of my life, because my stomach is now use to having very little acid and if I didn't continue to take them, I could get esophagus cancer. Is this correct?

[Christopher R Watters, MD]

I definitely agree with your last comment. That is why billions are spent on TV commercials aimed directly at patients. They work. Patients requesting a specific treatment tend to get it regardless of whether or not it's the best choice. I love the disclaimers telling patients to give their physicians their history as it might be important. I also agree with you that what is probably the most important thing is having a PCP that you trust. It sounds like things have worked out well for you after some bad experiences.

[Otto44$]

Well, everything that I've stated still stands also. However, unfortunately I do have alot of medical issue's that do have to be addressed. One is a cyst in the right kidney, high liver enzymes with symptoms, Hashi's, ect. Therefore, one would be concerned when lumps, bumps, rashes, pain, ect. are discovered. Therefore, I don't think it's appropiate to attack someone when they don't even know one's medical history. Again, I don't put a price on human life, and if I've to pay out of my own pocket for a repeat ultrasound, I would'nt have a problem with that. I've spent alot of unnecessary money, thanks to the negligence caused by that specialist I had. I was just wondering if the lump at time of doing scan of kidney area, would show the lump, that I discovered thru having pain. It was my PCP's choice for me having a abdominal ultrasound, due to having liver problems, cyst in kidney, pancreas, arota, not mine. So, it would've been common sense to scan the lump also, wouldn't you think? (you don't have to answer that question, because common sense tells me yes). I believe the expert radiologist had answered my question. I guess what upset me is the fact, that you didn't even answer my question on that forum, instead you just attacked me in assuming that I abuse medical Insurance with your comment.

It is all too common that I see patients referred from extenders because referral to a specialist is easier than merely discussing a patient with their supervising physician.

This may be true, and if you're insinuating that my PCP is in that category, then you're assuming once again. He treats my Diabetes & Thyroid disease and could've just easily referred me to a Endocrinologist. So, for the record I have a wonderful PCP, which is why I really worry when he does send me for Ultrasounds, recommends specialist after monitoring my diagnose for a long period of time. That tells me, he thinks it's much more serious and it usually is. So, I guess I'd rather have a PCP, that believes better safe than sorry. Let me add, that my PCP treats me for diabetes & Hashi's, i don't go to a Endocrinologist.

It is a shame that everyone doesn't have access to the same resources.

You're right it's a shame that everyone doesn't have access to to the same resources. It's also unfortunate that there's alot of medical negligence performed that could be prevented. Along with some Dr.'s that like to support the pharmaceutical industry by prescribing medicine's that aren't needed.

[Christopher R Watters, MD]

I am sorry to hear of your bad experiences with the medical profession but my comment stands. It is all too common that I see patients referred from extenders because referral to a specialist is easier than merely discussing a patient with their supervising physician. It is frequent that patients have had multiple costly imaging studies that were not required for a straightforward diagnosis that the physical exam would have sufficed. In my area of specialization, it is also common that I am put in the situation of dealing with a patient with an emergency problem because they were given bad advice when it could have been taken care of more simply and much safer when it was initially recognized. I love what I do. It is extremely fulfilling. I am lucky to practice in an area with an extremely high standard of care and incredible support from virtually any specialty needed. It is a shame that everyone doesn't have access to the same resources.

[Otto44$]

I've another question for you. If Dr.'s are so concerned about medical cost rising from unnecessary test. Why is it then, when you're told, for example in my situation I have a fatty liver. Well, instead of telling me the proper treatment in healing the liver. I'm told everything is normal & the reason for my high liver enzymes are caused by lipitor. They'll go down. Well, unfortunately, they are rising. Which will only have me having more test eventually. Therefore, I would think that the Dr. would inform me to make changes or detox the liver to heal it. No, I had to do research myself to find that out. To be honest, I've a hard time in trusting some Dr.'s after my bad experience. I've also realized, that each individual really has to watch out for themselves in doing their own research. I will say that, I've noticed alot of physicians do unfortunately like to support the pharmaceutical IMO. I like many other's have experienced that many many times. What would the reason for that be? I can only assume. To be honest, I only go to the dr.'s now, because of course I need the scripts to have blood test, ect. if I could order my own, there'd probably be no reason to see a physician, unless of course I needed surgery. Sorry, but your comment as you can tell did touch a nerve for being a physician, IMO to be more concerned about medical cost than a human life. I try to use common sense in my life decisions. Some food for thought, maybe medical professional's should lower their fee's and medical care wouldn't be so costly also.

I did forget to answer your question if my lump has been examined by my PCP. I must say it certainly was, however I've to question his response in telling me that something popped out of the sixth rib. Then, once I get home & call for a copy of that office visit. I notice, he states that I thought it was a pulled muscle. Now, if that's what I thought, i sure would've of went & paid a co-pay. So, that told me, he's not even sure of what it is. Sadly to say, but had the same experience with a previous misdiagnosis with a Dr. stating that I had a hital hernia and putting me on protonix (same Dr. that was negligent in a surgery that's irreversible) in which, I've learned I don't have a hital hernia, nevertheless have to take a acid reducer now for the rest of my life. IMO all because he wanted to cover up his negligence, when I had more issue's after the surgery he performed & he didn't have an answer, he figured he'd blame it on something I didn't have. Findings were found in his medical records, where he never put a diagnosis as having a hital hernia instead, stating he put me on protonix because I was complaining of having constant heartburn before pushing me out the door, because he new what he did was negligent. I must also mention, that the same Dr. has alot, I mean alot of malpractice suits against him & he's also has been found guilty in malpractice suits. He's now only able to practice under supervision & on probation. I've not only learned to go to Dr. profile on the internet & do research, look for malpractice and make sure the dr. is board certified, I've learned to get a copy of all my REPORTS & watch out for myself.  Sad thing is, I didn't realize to do the same before being referred to what I call a quack. It's hard to have trust in Dr.'s after bad experiences.