Neperologist Appt. Update

[Guest guest]

Had a " Francis Experience " when tech wanted to take temp while taking BP! She

started to head for my ear and I shook my head no. Continued and ran into

hearing aid. Asked me to remove it and I shook head No again and held up 1

finger (index not middle). She got the message and waited!

Saw Dr. K., the new Nepr. and you will never guess what his first question was:

" So, have you got some BP charts for me? " Now there is a doctor that reviews

the chart and obviously hasn't read the VA SOP manual! He thought he " could

live with those numbers " and smiled when I asked if he thought I could!

He then proceded to latest lab and said his only concern was my Carbon Dioxide

numbers were going down (June 7=23, June 24=16, Oct 24=18 range=20 - 30). He

drew a picture and blamed it on low sodium causing excess acid (blood

bicarbonate level HC03). Said he wasn't making changes today but wanted me to

be aware since he would be making recomendations for a new med if the trend

continues. Guess I've got some researching to do!

We talked about switching from Spiro to Epler and he saiid that would have to

come from an Endo! Love the runaround! He cautioned me that it might not

resolve the Gynecomastia and did I know what the next step was. I asked if it

was I shave my beard and buy a dress! I then told him as far as I know it was

AVS and removal or live with it. He made an endo referral!

In the 6months he's been gone he gained alot of people skills. I thought we had

a good appt. and he seemed to know about the ACCORD study and had an

understanding where JNC8 is headed.

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.