Medical Specialist Appointment and You

By Amy Price PhD
You have been sent to a specialist…what next? First of all sort out what you expect to happen as a result of this visit. What are your goals? Make sure they are realistic. If this was easy your primary care doctor could probably fix it.

Before your visit explain what records you have and ask which of these they would like you to copy and pre-send. Usually you can get copies of MRIs or other diagnostic tests on CD. They are easier to carry with you or send than bulky films. If you choose to send your diagnostic results and films call and confirm they arrived. Get a cost for a cash price unless you have medical insurance which will cover your visit so that you will know your costs and if you can absorb them.

If you are making a distance appointment insist on a phone consultation so you will know if your expectations are viable. If the staff you speak with don’t have information about a certain area make arrangements to call back when it is available. This way all the preliminary material is out of the way and your appt can focus on what is most important. Explain you are travelling from out of town and are in pain and request the best time of day to be seen promptly. Emergencies or office back ups can still happen but this step minimizes the possibility.

Write down what you consider to be the most important things you want covered in your visit. The reason you may want to do this is because chronic pain and injury can cause us to be sidetracked by emotion. You may get a compassionate response but it may eat away at the time available.

This is the place to get your MRI and other diagnostic tests explained. The doctor that ordered the test is the one who needs to explain it. Get an advance copy of the report and ask about what you don’t understand. We get emails every day from people who want us to translate the MRI or other diagnostics. We cannot do this because the MRI is only part of the equipment needed for a diagnosis. It is your job to make sure you understand your diagnosis before you leave the doctor’s office.

It is helpful to plan a nice dinner out or a treat for yourself for afterwards and if you can, take someone with you who will remember what the Doctor says. The reason for this is it will be difficult for you to reconcile yourself to a 40 minute appt when the injury has taken over your life 24/7. Even though your appointment time may be quite generous, logic and rational thought cannot always be counted on, when you just want it fixed.

Now relax and trust the specialist you have chosen!

Thyroid problems may make you fat and moody

People who have sustained head or serious neck injuries can also damage the thyroid as well. Sometimes people who are diagnosed with whiplash later develop thyroid issues. Many of the symptoms of hypothyroid are the same as those as those for people who have dealt with a brain injury so they tend to be ignored. This is tragic because low thyroid levels can eventually lead to cognitive damage and even dementia. The thyroid can be damaged even if you are thin. It is not always true that people gain massive amounts of weight with this kind of condition just as it is not true that people with a past brain injury need to be constantly exhausted or depressed. The video above will tell you about symptoms and what you can do about this disorder

Your thyroid gland weighs less than an ounce and is located in the front of your neck just below the Adam’s apple. The thyroid acts as a feedback mechanism for your metabolism so when it is too slow or too fast this can upset a lot of body functions The thyroid gland takes iodine and converts it into thyroid hormones. Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3 and T4. T3 and T4 are then released into the blood stream and are transported throughout the body where they control metabolism (conversion of oxygen and calories to energy). Every cell in the body depends upon thyroid hormones for regulation of their metabolism.

Get this checked by your doctor. It takes a simple blood test and oral medication. This disorder can show up years after an injury so be aware.

Symptoms of a slow thryroid include

•Fatigue, Depression

•Weight gain or increased difficulty losing weight, or loss of appetite

•Coarse, dry hair, thinning hair or outer portion of eybrows thinning out

•Dry, rough pale skin,

•Cold and heat intolerance  (you can’t tolerate cold temperatures like those around you)

•Muscle cramps and frequent muscle aches, weakness

•Constipation

•Depression, Irritability

•Memory loss, lack of focus, reduced coordination

•Abnormal menstrual cycles, decreased interest in sex

With spinal injuries and head injuries it is often the secondary damage to the neurons that causes big problems especially when that swelling and inflammation is in the spinal cord or the brain. The worst damage shows up several hours to many days later. Now, scientists in Rochester, New York, have discovered a simple way to stop a lot of this secondary damage in its tracks…at least in mice by using that old familiar blue food dye that gives M&Ms, blue bubble gum and blue raspberry popsicles their color. Patients with spinal injuries could escape with vastly reduced loss of function if this works in people but they’ll turn bright blue in the process.

Much secondary damage is caused by adenosine triphosphate, or ATP. This chemical can go into overkill with trauma and cause neurons to fire until they burn out and die leaving inflammation and sludge to trip up the neurons behind them causing an unhealthy destructive cycle. With spinal trauma, the area around the injury is flooded with ATP, which causes otherwise healthy neurons to fire out of control until they die of exhaustion. It also increases the swelling around the wound. Swelling around an injury site is a positive healing factor in many parts of the body, but because the spinal cord is encased in a narrow column blood supply gets cut off and cells die. But a study published in July 28′s Proceedings of the National Academy of Sciences (PNAS) seems to show that it’s possible to block the actions of ATP and greatly reduce the severity and permanence of spinal injuries – using the same type of food dye that gives blue M&Ms their color, a food dye called Brilliant Blue G, or BBG.

BBG can be administered intravenously with no need to inject directly into the injury site. It has the ability to cross the blood-brain barrier, which then gives it access to the spinal cord. BBG binds to the same neuroreceptor (P2X7) as the ATP binds to but it has a stronger affinity for the receptor than ATP has and gets there first so it effectively blocks the action of the ATP at the injury site.
Only one problem….patients turn blue ! It is temporary and is sure better than having a serious injury. You wear the injury but the blue die wears off…..All I can say is color me blue for spinal injury.

See the full method of the experiments here (PDF). BBG has been a food dye approved by the FDA since the 1920s but would this be considered off label use like the cholesterol lowering of Cheerios cereal. While all the rats were severely injured, the BBG-injected rats showed a greatly improved ability to support their bodyweight on their hind legs, control their bladders, and even walk in some cases. The blue skin coloring eventually faded as well, and no side effects were noted.

Human testing would be required before BBG can be moved forward into clinical use. It would be a terrific tool for ambulance drivers and paramedics. They could begin treatment right at the site of the incident, It is cheap and easy, even hospitals can use the blue stuff as soon as they get the patient hooked up and ready to go.

The kids must have known best when they told me blue ice cream was good for me …As for me…I will stock up on blue Gatorade and drink it down just in case it could make a difference!

There have been multiple articles featuring brain and serious neck injury stating how people have overcome cognitive obstacles despite adversity. I celebrate these articles as I know from personal experience the tolls that this road takes and the cost to family members and supporters. One mother was explaining how one minute her brain injured son could do complex algebra and the next he could not tell a red diamond from a black spade in a deck of cards. I too remember those days.

The cognitive inconsistencies are joined by emotional areas. Sometimes the brain will forget what we want it to remember and play over and over like a broken tape those areas we only want to put behind us. The other day I found some practical help in the way of videos and research on how to navigate the initial trauma. These outline what to expect in the emergency room, how to protect yourself in the event of a crash and ways you can help yourself get the best medical care. I thought I would share them here. If you go to the web site you can download the material as MP3 or as PDF files. This is a brilliant solution as watching a video makes it tough to pick up the references which are the key to deeper study…Enjoy!

In the next few posts there will be strategies for overcoming brain fog and getting the sharp mental edge back