Consulting

• Second Opinion Services

• Functional Blood Chemistry Analysis

 

“The good physician treats the disease; the great physician treats the patient who has the disease.” 

Sir William Osler, MD

 

Most of us will face at least one important medical decision in our lives. Have you assembled the right medical team to serve as your trusted advisors? Are you enjoying a level of communication that addresses your concerns?

 

In the case of Achalasia, there are many decisions to me made. What doctor should I see to make the proper diagnosis? What treatment is best for me? What are all the ramifications of the decisions I make? What is the long term prognosis?

 

Second Opinion Services

 

As the Medicare.gov website says, "A second opinion is when a doctor other than your regular doctor gives you his or her view about your health problem and how to treat it. It can help you make a more informed decision about your care."

 

I am both an Achalasia patient and a health care professional. From reading my story, you can now understand that I have been through the ringer - dilations, failed Heller myotomy (with clips left inside my esophagus), and esophagectomy with pyloroplasty. And additional complications above and beyond Achalasia like gastroparesis and atrial fibrillation.

 

I have written Living With Achalasia as a way to help educate patients. But you may have questions specific to your case. It is with this thought in mind that I offer consulting, an additional opinion to help you make a more informed decision about your care. This may mean simply reviewing your records and answering questions. It may bring up more questions to ask your doctor, help you get clarification of your diagnosis and/or treatment, assist you in determining your alternatives, suggest strategies for symptom management, pre-surgical preparation, and post-surgical recovery. And then there is the issue of how you manage your health the rest of your life. Since there is no "cure" that we know of for Achalasia, strategies to manage the rest of your life are most important.

 

Functional Blood Chemistry Analysis

 

Most people are familiar with general blood lab tests and have them done when they visit their doctor for an annual physical examination. These tests are reported as normal or abnormal, i.e. in the reference range or out of the reference range. Most conventional doctors are trained to simply look down the list for tests out of the reference range. What if your results come back as "normal," but you do not feel "normal"? The problem is that once your results are out of the reference range, you are officially diagnosed with a disease.

 

What most people do not know is that the "reference ranges" used by each lab are not standardized. They represent the average individual who comes to the lab. Since people who use these services may not be healthy, these values are representative of poor health. The ranges are used to diagnose disease.

 

For example, when determining whether or not a patient has diabetes, two tests are typically reviewed: blood glucose and Hemoglobin A1c. On the Virginia Mason Medical Center website, it says that that the target fasting blood sugar level for diagnosing diabetes is equal to or greater than 126 mg/dl. And for A1c it should be equal to or less than 6.5%. And they go on to say that "pre-diabetes" is diagnosed when your blood glucose is 100 - 125 ng/dl and your A1c is between 5.7 and 6.4%.

 

Think about that. Is there even such a thing as "pre-diabetes?" No! It is simply "diagnosing" that there is a problem in your body and you are almost at the "official" levels needed to "officially" diagnose diabetes. So, what if your blood sugar is 98 and your A1c is 5.5%. Does this mean that everything is just fine. No again.

 

Functional Blood Chemistry Analysis looks at things completely differently. It looks at health, more specifically the ranges for each test that are in the optimal health range. If test results are not in the optimal range, we immediately know there is a process that has started in your body that can ultimately lead to a "disease." These optimal ranges are more narrow with the goal being to find “hidden” biochemical abnormalities that might otherwise be “lost” within the far wider reference range. The entire point of this analysis is to catch things as early as possible, well before an "official diagnosis" of disease has been made. 

 

The other feature of a Functional Blood Chemistry Analysis is the relationship of one test to another. Conventional medicine frequently uses this algorithm: one test result out of the reference range equals a disease equals a prescription for a drug. However, this is not the way human physiology works. Many parameters must be examined to make a proper determination of a treatment program. 

 

In Achalasia, blood work is simply not part of the diagnostic process and this is a shame. So much can be gleaned from complete blood work. Here is a sample Functional Blood Chemistry Analysis report.

 

It's Your Health...

 

The bottom line is that it's your health in question. You should feel comfortable doing what's best for you and have reassurance that you are on the right path. Dr. Leonard Litchenfeld, deputy chief officer of the American Cancer Society says, "It's your health. It's your life. Don't be shy. Do what you think is right for you. If you want second opinion, go get it."

 

Please contact me at drstevenhorwitz@gmail.com or 214-531-7939 to schedule a consult. Consults are offered in person or via phone, Skype, or Facetime.

 

Read A Matter of Opinion from the Harvard Health Letter and A Greater Understanding from the Patient Advocate Foundation.