Comments for BITTERSWEET MEDICINE http://bittersweetmedicine.com Opinions from a Family Doctor Fri, 30 Sep 2011 18:25:00 +0000 hourly 1 http://wordpress.com/ Comment on Overrated Medications Series: No. 3 Bisphosphonates To Prevent Hip Fractures by Robert Lemmon http://bittersweetmedicine.com/2010/04/06/overrated-medications-series-no-3-bisphosphonates-to-prevent-hip-fractures/#comment-234 Fri, 30 Sep 2011 18:25:00 +0000 http://bittersweetmedicine.com/?p=156#comment-234 Good to hear from you. I can understand avoiding reclast. But, although bisphosphonates are overrated, that does not mean I never prescribe them. Find out you FRAX score: http://www.shef.ac.uk/FRAX/. If you have a good doctor you trust, take his advice. Also remember that although the NNT was high for bisphosphonates regarding hip fractures, the NNT to prevent vertebral fractures was much lower. You are also a young women and might have more to gain in the long run from using bisphosphonates. There is a new drug available called Prolia which I have not researched throughly yet. You might ask your doctor about that. Good luck to you. By the way, you have some nice art on your web page, you are talented.

]]> Comment on Overrated Medications Series: No. 3 Bisphosphonates To Prevent Hip Fractures by shawnmariehardy http://bittersweetmedicine.com/2010/04/06/overrated-medications-series-no-3-bisphosphonates-to-prevent-hip-fractures/#comment-232 Fri, 30 Sep 2011 04:09:22 +0000 http://bittersweetmedicine.com/?p=156#comment-232 Hello again. I thought I’d pipe in again. I’m nearly due for my second bone density scan (January 2012) and I’m a little worried. Since I wrote last I have found that my pain has progressed to the point where I have had to start physical therapy. While there has not been a diagnosis based on a blood test, my physical therapist has pointed out that my inflammation is coming from chronic bursitis in several joints. I also have Achilles tendonitis, with a tear that doesn’t seem to heal. With hyper-mobility in several joints, early-onset osteoporosis, chronic bursitis and tendinitis, and a daughter and mother with similar symptoms, Ehlers Danlos is our focus for treatment. It is not unusual for patients with ED to have osteoporosis and I’m a little worried about my daughter because she’s only thirteen and has had two fractures already–with only a small amount of impact. Her vitamin D was severely low, as was mine. Both of us are in the normal range now. I have decided that if my numbers are worse than last time, I want to try Strontium. I still refuse the bisphosphonates, especially Reclast.

]]> Comment on Coumadin and Tooth Extractions by Dental http://bittersweetmedicine.com/2010/03/11/coumadin-and-dental-extractions/#comment-230 Thu, 29 Sep 2011 15:43:53 +0000 http://bittersweetmedicine.com/?p=110#comment-230 i have to agree that it is in fact safe. I thank you for the links and will follow up after i read abit more in both areas.
Thanks,
Tyler
2011

]]> Comment on Overrated Medications Series: No.1 Weight Loss Medications by Gerri http://bittersweetmedicine.com/2010/03/21/overrated-medications-series-no-1-weight-loss-medications/#comment-209 Fri, 12 Aug 2011 17:10:01 +0000 http://bittersweetmedicine.com/?p=122#comment-209 It worked for me and my sister and mother. I would hate to think we risked our lives to lose the weight though…

500 calories is basically nothing, but when on HCG (and we used a homeopathic version) some days I wasn’t hungry at all and didn’t even want to eat the 500 calories. I wanted to do one more round this fall, but the risk of sudden death may have just changed my mind.

]]> Comment on Overrated Medications Series: No.1 Weight Loss Medications by Robert Lemmon http://bittersweetmedicine.com/2010/03/21/overrated-medications-series-no-1-weight-loss-medications/#comment-208 Fri, 12 Aug 2011 16:51:23 +0000 http://bittersweetmedicine.com/?p=122#comment-208 I don’t think it does anything based on the trials that have been conducted. But I have never tried it and I know at least three doctors that have. They tell me it works. Diets as spartan as 500 Kcals have been associated with sudden death.

]]> Comment on Overrated Medications Series: No.1 Weight Loss Medications by Gerri http://bittersweetmedicine.com/2010/03/21/overrated-medications-series-no-1-weight-loss-medications/#comment-207 Fri, 12 Aug 2011 04:51:36 +0000 http://bittersweetmedicine.com/?p=122#comment-207 I think diets are the problem and those of us who have struggled to lose weight through dieting have wrecked our metabolism. I do have to disagree with you about HCG though. :) I urge you to read the manuscript called “Pounds and Inches” by Dr. Simeons. It explains that HCG doesn’t cause you to lose weight, but it does allow you to be comfortable on 500 calories a day while you are in phase 2 of the protocol for 6 weeks at a time. Phase 3 is a maintenance phase. When done correctly, the weight does stay off. It’s not a miracle fat cure and it is not easy, but it is effective.

]]> Comment on Dr Lemmon by Robert Lemmon http://bittersweetmedicine.com/about/#comment-205 Wed, 10 Aug 2011 00:19:25 +0000 #comment-205 Many factors go into fracture risk. Try the Frax tool.

If you not Caucasian go to the heading “calculation tool” and then “North America” and “US” and finally select race. You will need to know your T-scores, you can get them from your doctor.

So, I cannot give good advice to a patient I have never examined. Keep in mind the drug will not help much to prevent hip fractures, will probably help more in preventing vertebral fractures and there is some risk of potentially serious side effects. So it is a tough decision as the benefits are small and the risks are small too. You should explain your concerns to your doctor and then you listen to what he has say about YOU and YOUR particular situation and then make your best decision. The best health care is customized to the particular patient. That’s why I prescribe bisphosphonates from time to time; but discontinue them as well in many patients. The final decision, of course, rests with the patient.

]]> Comment on Dr Lemmon by Sheila http://bittersweetmedicine.com/about/#comment-203 Tue, 09 Aug 2011 01:44:34 +0000 #comment-203 I read your blog on bisphosphonates. I have osteoporosis and was on actonel for 3 yrs and my t score didnot get any better. I discontinued the med and now my endocrinologist recommended reclast. I am hesitant to take it after reading the the blogs of patients who were treated with Reclast.I don’t have any fractures and have always exercised and have been taking calcium and vit d. i value your input please. Iam 59 yrs old

]]> Comment on Dr Lemmon by Robert Lemmon http://bittersweetmedicine.com/about/#comment-85 Tue, 15 Feb 2011 23:10:01 +0000 #comment-85 Thanks for the information from Cochrane. I trust Cochrane and I am sure their review of the evidence was better than mine. I interpret the line “we recommend that caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk” as meaning they are not sure. I take on a case by case basis and let a well informed patient make the final decision.

]]> Comment on Overrated Medications Series: No. 3 Bisphosphonates To Prevent Hip Fractures by Robert Lemmon http://bittersweetmedicine.com/2010/04/06/overrated-medications-series-no-3-bisphosphonates-to-prevent-hip-fractures/#comment-84 Tue, 15 Feb 2011 23:06:29 +0000 http://bittersweetmedicine.com/?p=156#comment-84 Like many cases in medicine this one is a difficult call. There is a bit more benefit from bisphosphonates in preventing vertebral fractures and much less benefit preventing hip fractures. If you have had a prior fracture, even a vertebral compression fracture, I would be more inclined to prescribe the drug. You are in the category of patient with a T-score low enough to benefit. Discuss it with your doctor and if you trust him I would go with his recommendation. He knows you better than I.

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