Re: Want new doc: Pls answer ?? on Gonino? Mahoney? ?

August 5, 2006

-- (re ) I have a long history of illness that went

undiagnosed and untreated, and then was treated with Levoxyl, and it

worked only partially and then failed, and I have Hashi's, and I had

crippling anxiety and panic disorder, and iron problems, so I " feel "

complex.

I get some compensation from my insurance (Golden Rule) but he's out

of plan, so still quite a lot of bucks. I've been using credit cards

and don't care because I was not going to waste any more time or

money with anyone who didn't have the knowledge and experience he

was described as having. I was very sick and scared and exhausted

and I couldn't face doing any more hunting. My DH was also scared

and said let's get to Lubbock NOW. He didn't trust anyone I'd seen

to be able to help me.

I like the doc because he is not running a " slick " operation and

stays focused on the thyroid patient's needs. It's a small family

practice and the staff supports the patient. I believe several

months ago someone went to see him and came back with the

information that he's treated over 1500 thyroid patients. He

educates you as much as you can stand (I tend to love all the

details I can absorb), treats you like an equal, my DH likes him a

lot (and believe me, he's seen lots of docs in our geriatric care

management and home health practice), and he exudes that confidence

and " gravitas " that comes from treating so many patients. And he has

a background in biochemisty, which is one of the things that nailed

my decision. I heard from Jan that he used to teach and did research

in steriods (so all things hormonal) at UT Southwestern Medical

Center here in Dallas, before he became a doc, so I would say he

defnitely " gets it " more than your average doc with 5 or 6 hours of

biochemistry in med school (not sure about that hours thing, but my

DH told me that). I don't know his specific degree(s) or details

about his biochemistry years, but maybe Jan knows more.

The final thing that nailed my decision was the fact that he is

hypo, one of his kids is hypo, and his wife went very critically

hypo and Hashi years ago. I believe his experience with getting his

wife well, when the standard synthetic and limited protocols didn't

work, and my seeing how well she is now, made me an instant

believer.

I've been a patient of his since Jan. '05 and can tell you that I

have cried at times for folks whose doctors don't understand

everything that needs to be done for the patient with this disease

and it's complications. I have a long way to go, but I'm a lot

better than last year. You can't go to this doc and get a quick fix.

That's just peachy with me, now that I understand how complicated it

all is, and how much healing I have left to do. As he and his wife

both keep repeating, " the rules are the rules. " I screw them up at

times, but at least I know it's my own fault and I try to get back

on track.

As Jan has said before, " sell your granny " and get to this doc if

you can. Yes, I'm prejudiced toward this physician and am up front

about it.

And this is all JMHO.

Sara

>

> Well, I am certain that I need a new doc. I surfed past messages

and

> have some questions.

>

> Seems like several members here have seen him, but has anyone seen

> Gonino long enough to establish a track record with him? Anyone

with

> hypo issues more complicated than just getting optimized? Just

> because he is nice and gives hugs, etc, isn't convincing me that

he

> is worth a try. Don't like the click thoughs on his slick

website,

> but I am aware that it is becoming more common.

>

> Anyone seen Mahoney yet? His website is even slicker than

Gonino's.

> I was trying to look past all that when I came across his skin

care

> treatment center. Seems like he might be spreading himself too

thin,

> or too interested in the almighty dollar. Very interested in the

> fact that he will prescribe all thyroid meds. I thought I was on

the

> right track about 5 years ago with Armour and T4, and now I'm only

on

> Armour and 40 pounds heavier.

>

> seems to have a lot going for him as far as the seeing

the

> whole picture. If he doesn't take my insurance, no way I can

spend

> that much on him right now plus flying to Lubbock. Is he really

the

> only one that seems to " get it " ? Jan, I know you love him. Do

you

> have complex problems? How many others see him, and do you have

> complex problems?

>

> Thanks for helping,

>

August 5, 2006

Sara--

Wow...thank you for such great info. After the initial visit, will

he do some phone consult or do you have to go back each time? How

often does he require you to go back? What does " the rules are the

rules " mean? I am really gunshy of hormones, even bio-identical.

Are hormones part of your treatment? Do you know if he will combine

Armour with other thyroid meds?

I have HealthSmart, and will check with them to see what they would

pay for someone out of town.

Thanks again,

> >

> > Well, I am certain that I need a new doc. I surfed past messages

> and

> > have some questions.

> >

> > Seems like several members here have seen him, but has anyone

seen

> > Gonino long enough to establish a track record with him? Anyone

> with

> > hypo issues more complicated than just getting optimized? Just

> > because he is nice and gives hugs, etc, isn't convincing me that

> he

> > is worth a try. Don't like the click thoughs on his slick

> website,

> > but I am aware that it is becoming more common.

> >

> > Anyone seen Mahoney yet? His website is even slicker than

> Gonino's.

> > I was trying to look past all that when I came across his skin

> care

> > treatment center. Seems like he might be spreading himself too

> thin,

> > or too interested in the almighty dollar. Very interested in the

> > fact that he will prescribe all thyroid meds. I thought I was on

> the

> > right track about 5 years ago with Armour and T4, and now I'm

only

> on

> > Armour and 40 pounds heavier.

> >

> > seems to have a lot going for him as far as the seeing

> the

> > whole picture. If he doesn't take my insurance, no way I can

> spend

> > that much on him right now plus flying to Lubbock. Is he really

> the

> > only one that seems to " get it " ? Jan, I know you love him. Do

> you

> > have complex problems? How many others see him, and do you have

> > complex problems?

> >

> > Thanks for helping,

> >

>

August 6, 2006

Just curious, why are you gunshy of hormones? Thyroid is a hormone. If they are bioidentical and given ONLY if needed AND in proper doses AND by a qualified doctor, I don't understand the concern. It is my understanding, although I'm still very new to all of this, that ALL of your hormones need to be balanced in order to get better. I don't want to take any hormones that I don't NEED either. But I think that once one of your hormones is out of balance (thyroid) that often times others are too (adrenal and sex hormones).

Someone please correct me if I'm wrong.

Kim

From: Texas_Thyroid_Groups [mailto:Texas_Thyroid_Groups ] On Behalf Of moonlady0000Sent: Saturday, August 05, 2006 4:41 PMTo: Texas_Thyroid_Groups Subject: Re: Want new doc: Pls answer ?? on Gonino? Mahoney? ?

Sara--Wow...thank you for such great info. After the initial visit, will he do some phone consult or do you have to go back each time? How often does he require you to go back? What does "the rules are the rules" mean? I am really gunshy of hormones, even bio-identical. Are hormones part of your treatment? Do you know if he will combine Armour with other thyroid meds?I have HealthSmart, and will check with them to see what they would pay for someone out of town. Thanks again,> >> > Well, I am certain that I need a new doc. I surfed past messages > and > > have some questions.> > > > Seems like several members here have seen him, but has anyone seen > > Gonino long enough to establish a track record with him? Anyone > with > > hypo issues more complicated than just getting optimized? Just > > because he is nice and gives hugs, etc, isn't convincing me that > he > > is worth a try. Don't like the click thoughs on his slick > website, > > but I am aware that it is becoming more common. > > > > Anyone seen Mahoney yet? His website is even slicker than > Gonino's. > > I was trying to look past all that when I came across his skin > care > > treatment center. Seems like he might be spreading himself too > thin, > > or too interested in the almighty dollar. Very interested in the > > fact that he will prescribe all thyroid meds. I thought I was on > the > > right track about 5 years ago with Armour and T4, and now I'm only > on > > Armour and 40 pounds heavier. > > > > seems to have a lot going for him as far as the seeing > the > > whole picture. If he doesn't take my insurance, no way I can > spend > > that much on him right now plus flying to Lubbock. Is he really > the > > only one that seems to "get it"? Jan, I know you love him. Do > you > > have complex problems? How many others see him, and do you have > > complex problems?> > > > Thanks for helping,> > > >>

August 6, 2006

>

> Sara--

>

> Wow...thank you for such great info. After the initial visit,

will

> he do some phone consult or do you have to go back each time?

---First visit is over a 2 day period - you'd need to stay over at a

hotel and many of us have info on them and our experiences. You

consult the first day and then come back in the morning for blood

draw. The second follow up visit is in about 2 weeks, to go over the

extensive blood work and the regimen plan for you. The consults for

me have been 1+ hours. Very generous. You really discuss the nitty

gritty. Depending on your situation, you might come back in 3 months

or 6 months or whatever your situation dictates. The blood work can

be done locally at this point, if there is a lab they use. The time

between follow up visits is different for everyone. When you are

more optimized, you might go back in 9 months or eventually get to

the once a year min. required visit. All questions between visits

can be phoned to staff. I did a lot of that at first, when I was

really sick. Dr. 's assistant, who is an EMT, who works very

closely with him, will try to answer your questions. He is really

great at helping you work through ideas or concerns. If it's

necessary, he will consult with the doc and get back with you. But

the doc himself does not do phone consults, or we'd all never be

able to get in to see him!

> How often does he require you to go back?

--- This will be customized to your situation. Varies. See above.

> What does " the rules are the rules " mean?

--- Stuff like taking all your meds on schedule, eating well (he

provides a good diet plan for many of us that is easy to follow and

really helps with the blood sugar problems we have), reducing

stress, understanding that it takes time to heal everything that is

screwed up, etc. You need to be compliant to the regimen. Life is

full of roadblocks, but you do the very best you can. It's a

complicated orchestration of getting a lot of systems back " on line "

and working well. I sometimes think of it like trying to get Dallas

back on line after an electrical black out. You can't do everything

real fast all at once, or you'll go down again. It's a carefully

planned slow healing of all systems.

> I am really gunshy of hormones, even bio-identical.

> Are hormones part of your treatment?

--- Highly individual as to need. Yes, I was changed from an

estrogen patch to a compounded tri-estrogen capsule. I had lousy

values and it helped me a lot to get them up. I remember when my

therapist would tell me how leery she was of hormones and refused to

take them, but this year she was feeling so bad she went to a doc

and started them and was thrilled at how much better she felt in

only a week. It absolutely stunned her. I guess she just got to the

point that her quality of life was more important. You can discuss

your blood work and concerns with him. I think he is an open-minded

doc and will discuss it all very intelligently with you.

> Do you know if he will combine

> Armour with other thyroid meds?

>

--- Jan knows about this better than me. I think I heard that he has

done it with patients. I know Jan takes some synthetic T4 herself

along with her Armour.

> I have HealthSmart, and will check with them to see what they

would

> pay for someone out of town.

--- Good luck !! Be sure to call Dr. 's office with

any questions about appointments, treatment, etc., so you can see if

anything I've mentioned has changed. You might be able to talk to

Sharon, his wife, and get some questions answered. But I'm not sure

whether she takes calls or not now. You'd have to ask. If you decide

to go, just be sure to get your paperwork and medical history forms

filled out ahead of time.

>

> Thanks again,

>

--- You're more than welcome! Many of us who see Dr. R can answer

questions.

August 6, 2006

(sound of applause) Bravo!

That's my understanding, too.

>

> Just curious, why are you gunshy of hormones? Thyroid is a

hormone. If

> they are bioidentical and given ONLY if needed AND in proper doses

AND by a

> qualified doctor, I don't understand the concern. It is my

understanding,

> although I'm still very new to all of this, that ALL of your

hormones need

> to be balanced in order to get better. I don't want to take any

hormones

> that I don't NEED either. But I think that once one of your

hormones is

> out of balance (thyroid) that often times others are too (adrenal

and sex

> hormones).

>

> Someone please correct me if I'm wrong.

>

> Kim

>

August 6, 2006

,

I see Dr. , as well. I’m

in San

and frankly can’t afford him (he’s not on my insurance). I’ve

been a single mom for 16 years, just got one kid out of college and still have

another one halfway through, and am barely keeping my head above water

financially. But I was so sick and had no luck with local doctors.

My parents were devastated watching me deteriorate, and when I told them about

Dr. R, they insisted I make an appointment and committed to helping me. I’m

one of the lucky ones in that respect…my dad was retired and has gone

back to work full-time, just to help with my medical expenses and to get my

last kiddo thru college (I was working 3 jobs before I got sick, and just

couldn’t do it anymore…I’m down to just my fulltime job now,

which left me in a lurch financially). They just keep saying they want to

get me well enough to take care of them when they can’t take care of

themselves anymore, so it will all even out in the end.

I’ll just ditto everything Sara had

to share about Dr. R, instead of repeating it all…I sing his praises

right along with her.

As far as how often you have to see him, I

think that’s an individual thing, based on your circumstances. For

me, after the initial visit and followup (my understanding is everyone goes for

the initial, has labs done the next morning, then goes back in 2-3 weeks to

review the labs and get started on meds, etc.), he left it open for me to

return in 3-6 months, dependant on how I was responding. At the 3 month

mark, I was feeling a bit better, but at the 6 month mark, I’m starting

to backslide again (I think this is typical until you’re optimized, and I’ve

accepted it could take a couple of years, at least, to obtain that). I’m

right at 6 months now, and have an appointment on Wednesday.

After 10 years of feeling like crap, and 5

years of actively looking for help, I was second-guessing every doctor I

saw. I immediately knew, after 1 hour with Dr. , that I was in

very good hands, and for the first time in years, I didn’t feel driven to

research or question every single thing he told me the minute I walked out the

door. I knew I could trust him. It’s such a load off my

shoulders to be able to relax and let him take the driver’s seat when it

comes to my healthcare.

From: Texas_Thyroid_Groups [mailto:Texas_Thyroid_Groups ] On Behalf Of moonlady0000