Posts by Keith Chavez3

Where can I get something coil bound? Does every print shop handle that?

Let me try tackling this one more time:

I am not entirely sure if this is the right place for this kind of question. If I am off base, please point me toward the correct section:

I visited my doctor regarding some stomach issues. He noted a preliminary diagnosis of SIC, Gastropathy, etc., though I suspect it’s just an initial assessment. He ordered several blood tests. The paperwork lists: EMA (IgA), CBC, Fe, and serum ferritin. (I assume these are all standard blood panels.)

I went to my primary care physician to get the referral, then scheduled the appointment electronically at Cedars-Sinai to have the blood work done. I received the following response from them:

To whom it may concern,
Attached is the order for the first available appointment for the EMA test. s
We will be utilizing a screening method
(positive/negative) rather than what was specifically requested on the referral order. With the other referral provided, you can also have your ferritin test completed during the same appointment.
The remaining tests
must be performed at your local clinic.

My question is this: given the diagnosis the doctor is investigating, does it matter that they aren't performing that specific "screening method" they mentioned? Should I proceed with the appointment as scheduled, or should I find a facility that performs the exact testing specified in the original referral?

I am unsure if this is the appropriate forum for this topic. If I am mistaken, perhaps someone can direct me to the correct section:

I recently visited my physician regarding some gastrointestinal issues. The doctor noted a preliminary diagnosis of SIC, Gastropathy, etc., though it feels like just an initial assessment. He requested several blood tests. The paperwork specifies: EMA (IgA), CBC, Fe, and serum ferritin. (I assume these are all blood panels.)

I went to my primary care physician to get the necessary referral, then booked an appointment electronically at Mount Sinai to have these tests performed. I received the following response from them:

To whom it may concern,
Attached is the order for the first available appointment for the EMA test, s
noting that we utilize a screening method
(positive/negative), rather than how it was specified on your referral. At the same appointment, you can also have the ferritin test performed under the second referral; however, the remaining tests
must be completed at your local community health center.

My question is this: given the diagnosis the doctor is considering, does it matter that they aren't performing that "screening method"? Whatever that implies. Should I proceed with the appointment there regardless, or should I seek out a facility that performs the specific method requested on the referral?

Sandra Brooks91 said:Sure, you have the right to seek a second opinion from any doctor you choose, provided you actually know which specialist is qualified to handle your specific issue.

So, does she strictly have to provide a referral if I ask for a second opinion?

I’m asking because the last time I saw her, I didn't explicitly demand one, but the moment I brought up the idea of a referral, she pushed back. She basically told me "we aren't doing that" and insisted that she is the one who decides whether or not I need a referral.

I have a lengthy history here, so I will omit certain details to keep this concise. If more data is required, let me know:

I am 25 years old.

Around the summer of 2011, I developed diarrhea that persisted until the summer of 2012. I lost approximately 15 pounds during that time. I deal with various symptoms including excessive gas, stomach noises, and abdominal bloating/popping sensations (like a bubble inflating and bursting). Occasionally, if I eat a large meal late at night, I experience a strange, "rotten" sensation in my stomach, though sometimes eating late doesn't trigger it. My stomach sensitivity to acidic fruit varies. These symptoms fluctuate in intensity. My stool is currently normal, but all these other issues persist. I haven't experienced pain, except for one instance since this began.

This has been the situation from the summer of 2011 to the present. I will skip parts of the timeline because it is too long.

In the summer of 2011, I had tests performed which were negative for Salmonella and Shigella. Later that year, when the diarrhea hadn't cleared by December, I repeated those tests along with screenings for parasites and H. pylori via stool samples. Everything was negative.

In 2013, I finally saw a gastroenterologist. In October, he performed an abdominal ultrasound, which was normal. I then had blood work and an endoscopy.

The endoscopy revealed a minor ulceration at the cardia. Tissue was taken for pathology. The report stated the stomach itself was fine, and samples were also taken from the duodenum to screen for Celiac disease.

However, the pathology report makes no mention of Celiac disease. Here is the full report:

"Tissue samples were received which histologically correspond to gastric mucosa samples. Surface epithelium as well as glandular epithelium show signs of Type I intestinal metaplasia. The lamina propria shows hyperemia, abundant mononuclear infiltrate, and granulocyte infiltrates, which are also found intraepithelially within the glands. On parts of the sample surface, normal stratified squamous epithelium is observed.
With Giemsa staining, rare bacteria resembling H. pylori are found in this material."

My blood work was only recently completed this January, and the results are:

(S) tTg (IgA) 2 (unit: RU/ml) (reference interval < 20)
(S) IgG 12.23 (unit: g/L) (reference interval 7.00 - 16.00)
(S) IgA 0.04 (unit: g/L) (reference interval 0.70 - 4.00)
(S) IgM 0.53 (unit: g/L) (reference interval 0.40 - 2.30)

Two weeks ago, I tested for H. pylori in my stool again; the result was negative.

Last week, I underwent another endoscopy. The doctor stated he found no ulceration, so it likely healed. The report states: "gastric mucosa is slightly hyperemic; biopsy taken for histology and H. pylori," and they again sampled for Celiac disease. The provisional diagnosis is "gastropathy."

Can anyone tell me what this points toward and what medications I should be taking?

I recall hearing somewhere that we have the right to request a second opinion from our primary care physician. Specifically, if we’ve already seen a specialist, can we ask for a referral to someone else just to get a fresh perspective? Is that actually how it works? Is a doctor legally obligated to provide a referral if we want to seek a second opinion?

Please refrain from mockery; I am dealing with some health issues and need advice. What is the appropriate terminology to use when describing flatulence or gas to a doctor? Is simply saying "farts" acceptable, or should I use more clinical language?