Laus Deo !!!


Selected letters (answers to asked medical questions can be found at this link) from the inbox since 10/9/96:


The latest feedback can be found on Facebook.


Subject: Re: depression + binge eating
Date: Sun, 15 May 2005 11:22:43 -0500
From: xxxxxx@prodigy.net
To: cardiologist2@heartmdphd.com

I and a friend of mine with diabetes can relate. Have found that talking to a counselor and taking antidepresants really has helped me. You have to understand that depression can be caused by having a chronic illness. Most people with chronic diseases do suffer from depression.
Good Luck
xxxxxx

Subject: RE:Question
Date: Sat, 30 Apr 2005 23:28:15 -0500
From: xxxxxx@LILLY.COM
To: ac1@heartmdphd.com

Dr. Chung,
I am sorry to bother you but I just found a website that posted questions to you. I have a complicated medical history dating back to my late teens, early 20's. I'm 52, a health care professional, who has been in relatively good health except for a long history of illnesses, disorders, and complications that appear to be related to connective tissue disorder. I was diagnosed with MVP in my 20's after being symptomatic for a period of time. Chest pain, fatigue, syncope, PVCs, runs of bigeminy, and trigeminy. I've always been sensitive to sleep deprivation and when forced to work double shifts (grave yard shift), my radial pulse would become very irregular and low (26 bpm). Needless to say, I've battled this for years and have tried to ignore it while getting adequate rest and avoiding exertion.

I developed hypertension while pregnant at age 32. All 3 sons were delivered 3 weeks early. I became hypertensive 4 weeks prior to my due date with my first son. Hypertension occurred at the end of the 2nd trimester during the 2nd pregnancy (also developed severe asthma). Both hypertension and asthma disappeared after delivery but reappeared early in my 3rd pregnancy. I was put on bedrest at the end of 1st trimester for 3rd son. Following delivery, I suffered from both labile hypertension and asthma for years. The labile hypertension is not a white coat phenomenon. ( I also have ADD which may suggest noradrenergic dysfunction.) In any case, I've always felt like I've been in flight or fight.
My MVP was stable with the exception of my normal PVCs. (When I was pregnant I had 26 PVCs a min). Over the years, I've developed many hypersensitivities, including Candida, dairy allergies (asthma), medications (asthma,

Although I have had labile blood pressure for years, I have never tolerated blood pressure medications, except diuretic which doesn't control B/P. My cardiologist put me on several new blood pressure meds last fall because I now have left atrium enlargement and left aortic branch enlargement secondary to severe mitral regurgitation and hypertension.

The big problem is that I don't tolerate the blood pressure meds. I developed asthma with Caduet. I am tolerating Uniretic well. I had to stop Toprol XR because I developed all symptoms of prodromal syncope. I had episodes of syncope (dizzy, whooshing in my head, break out in a sweat, feel cold, difficulty seeing, weak) several times a day. I am on an SNRI and don't know if there may be drug interactions. The episodes of syncope became noticeable in Jan. and continued to worsen through March. I saw my cardiologist in March who said to stop the SNRI but I still had significant symptoms related to syncope. I stopped the Toprol and was better within a few days. I restarted the SNRI (for fibromyalgia, anxiety). The problem is that my base pulse has been running around 40 and irregular since the fall. When I get these episodes, I can't function. Fortunately, my mitral regurgitation in less severe and my lef

I do not doubt that I may need a repair or replacement of my valve in the future. My cardiologist wants me to wait until my blood pressure is under control. I have serious doubts that he will be able to control it because I do think I have underlying autonomic dysregulation that is not easily treatable. New data out suggests that early surgical intervention is associated with better outcomes. Autonomic dysregulation is not associated with good outcomes. Is there a specialist you could recommend that may have experience in this area? I am fairly close to the Cleveland Clinic but I am willing to travel to see someone who can put the whole picture together and get me on the right path.

I very much appreciate any advice or wisdom you can share with me.

Sincerely,
xxxxxx

Subject: Jen Gallagher-Advent Associates
Date: Fri, 22 Apr 2005 13:01:04 -0400 (Eastern Daylight Time)
From: "Jen Gallagher" (jgallagher@adventassociates.com)
To: nospam7@heartmdphd.com

Hello Dr. Chung!

I just wanted you to know that I signed your guestbook on your website and remember working with you several years ago when you first came out of fellowship and were looking for a position in cardiology!

We share your love and belief of Jesus Christ here at Advent Associates, we are all Christians! We also now specialize in cardiology recruiting.

Just wanted to let you know that and I enjoyed your website as well as your personal faith and witness for Jesus.

Sincerely,

Jen Gallagher
888-280-7684

Subject: question
Date: Fri, 22 Apr 2005 01:22:14 EDT
From: xxxxxx@aol.com
To: cardiologist2@heartmdphd.com

Hello,

I am looking to find information regarding the connection, if any, between heart disease and dementia. I have moved in with my 70 year old mother who about 2 years ago had 2 medicated stents put in. I have been noticing some lapses in memory and repeating stories at least 3-4 times in one day to me, ( More than usual ) and has even forgot where a local store was.

I have been on her case a little in regards to going to get assessed for alzheimer's. I know that sounds terrible of me, but I was under the impression there was treatment for it as well as either a gene or something of substance to diagnose it. Maybe an MRI or something.

After researching it, I was thinking it might be something else. Another form of "dementia". My question is, after oxygen is not as well circulated before the stents, could that have caused some dying brain cells and or dementia? Do elderly people not regenerate brain cells like younger people? Do brain cells regenerate? I am way too ahead of myself here. Is it the heart disease that is causing my mother to be a bit loopy? Or am I just over analyzing her, and not taking into account that she is getting older?
Please advise,
Patti xxxxxx

Subject: atrial fib
Date: Mon, 11 Apr 2005 17:57:04 +0100
From: xxxxxx@blueyonder.co.uk
To: cardiologist2@heartmdphd.com

Dear Andrew
Brief history Diag June 03 with atrial fib but have since found out cannot have vein ablation due to damage to center wall left vent and some at front of heart i am 52yr Male they have tried two cardioversions neither lasted long was on amoridine but now on bisoprol furmanate 5mg linsoprol 30mg warfarin 2mg a day can you suggest a way forward from here.
ps i live in uk
Many blessings xxxxxx

Subject: FW: Doctors Without Borders Thanks You!
Date: Fri, 4 Mar 2005 14:13:01 -0500
From: xxxxxx@pechter.com
To: cardiologist2@heartmdphd.com

Dr. Chung,

Thank you for answering my questions regarding my mother’s heart problem. I appreciate your way to serve the society, so I made the donation to Doctors without Borders. Thank you again.

Subject: Hope
Date: Sun, 27 Feb 2005 23:37:52 EST
From: xxxxxx@aol.com
To: ac1@heartmdphd.com

Hi Doctor, I'm a 30 year old women just diagnosed with having 3 leaking valves and an enlarged left ventricle. I was experiencing dizzy spells and I have suffered from migraines. I went for a physical. An echocardiogram and a carotid Doppler was ordered. The carotid Doppler was normal the echocardiogram revealed that my Mitro, bicuspid and aortic valve were leaking. My current Cardiologist has ordered 3 exams. I wore a holter monitor for 24-hrs and I am also going to have a loop test and a stress test. I haven't completed these exams due to the fact that my insurance does not cover any cardiac testing. My blood test was ordered my blood work was normal. I do not suffer from hypertension, nor do I have high cholesterol, tryglecirides or diabetes. My family medical history my dad suffers from hypertension and maternal side my mother had cervical cancer, grandmother had colon cancer, great aunt had breast cancer. May you explain worse case scenario and what procedure would normally be done if any should be.

Thank you for your time

Subject: Unspecific ST-Elevation
Date: Fri, 11 Feb 2005 18:16:28 +0100 (CET)
From: xxxxxx@yahoo.de
To: cardiologist2@heartmdphd.com

Hello,

my last EKG + stress-EKG showed an "unspecific ST-elevation", CK-MB was normal. My MD wasn't concerned, he said he sees this 5 times a week. Shouldn't he be concerned, as my old EKGs do not show that elevation?

I do have chest pain, my MD says it's intercostal-neuralgia because it's sensitive to pressure. Shall I order more tests, if yes which? Btw.: It's not Coronary Heart disease, as I'm just 20 years old and non-smoker, non-drinker, good cholesterol, not overweight etc...

thanks, Michael

Subject: Viagra and WPWS
Date: Mon, 31 Jan 2005 12:21:43 -0700
From: xxxxxx@mms.gov
To: ac1@heartmdphd.com

Is there a problem with having WPWS and taking Viagra?

David xxxxxx

Subject: question
Date: Tue, 18 Jan 2005 03:50:24 EST
From: xxxxxx@aol.com
To: ac1@heartmdphd.com

hello dr. chung,

i have a question for you. i am a healthy 31 year old female. i just got married this month and when i was getting married, my heart was beating very very rapidly. ( i've never experienced this even with nervousness) afterwards, i had chest pain on the left side which was dull and smarting. it lasted for hours and i still feel pain now. do you think this was anxiety? i've had two panic attacks and i do have anxiety. i have also experienced skipped heart beat. my doctor tells me it's because of stress. i had an ekg done in may 2004, all was fine. what do you think is wrong with me?

thank you,
xxxxxx

Subject: RE: Post In Arthritis News Group
Date: Fri, 7 Jan 2005 17:48:28 -0500
From: xxxxxx@bellsouth.net
To: ac1@heartmdphd.com

Hello!
I tried to email you, sir, about your post in this group concerning Limbrel (sorry if I misspelled it!). The whole thread was interesting and your comment spiked my interest in what this product might be. Hopefully, this email will reach you--the first one was deleted by your spam guard... and I was afraid that your reply would be stopped by mine! Thank you for any information you feel free to share. BTW, I live down the river from you in Columbus, GA.
Peace,
xxxxxx

Subject: Re: nadolol, problems -> does it disappear when blood vessels turn to vasodilation
Date: Sat, 18 Dec 2004 10:20:59 +0100
From: xxxxxx@gmx.net
To: cardiologist2@heartmdphd.com

Hi,

I have heard that over long term use of betablockers, the vasoconstriction of peripheral blood vessels would turn into a vasodilation. Perhaps symptoms of erectile disfunction could disappear. But I am not sure, is that true? Does a betablocker result in vasodilation over long term use?

Thanks

Subject: Write, that others may read.
Date: Fri, 17 Dec 2004 14:16:46 -0800
From: xxxxxx@excite.com
To: cardiologist2@heartmdphd.com

My friend in words,

In early 2005, a new global, spiritual awakening will begin. You will read about it, see signs of it everywhere. The issues of today will be set aside and a new world vision will come into focus. It is the time you knew was coming. The moment you have waited for:

It is a time to share your thoughts with others...to share your writings. New opportunities will arise. Be mindful and watch for them. The signs may be subtle. But observe them. It will be a time of risks and adventure. But happiness lies not in what you might imagine the future to be, but in the connections you make as you step forth to share your own thoughts with others through your writings.

We are strangers, but I share this vision with you, for that is how realities begin, and you are among those who have something to share with the world.

Many good wishes to you for a joyful New Year.
Mind the signs.

xxxxxx
(one who sees and is humbled)

PS -- a reply is not necessary. I am selling nothing. I felt compelled to share these thoughts and will not write you again.

Subject: Interest in cardiology
Date: Wed, 15 Dec 2004 19:29:15 -0500
From: xxxxxx@bc.edu
To: ac1@heartmdphd.com

Hi Doctor,

I ran into your site online because of your many post on google groups. I think it's a great way to stay informed. I'm currently a junior pre-med/biochem major at Boston College. I was accepted early to Tufts Med and will be attending there in 2006. I have worked as an emt for several years and at home I work for a private company and ride with paramedics. The most common calls I have seen are chest pain and through working many stand-bys I have been able to run two cardiac arrests myself. From what I have seen and read so far, I really love cardiology and really think it's the most direct way to save someone's life. Over last summer I read several books on ekgs for fun since the medics let me try to interpret the rhythms first when I am with them on calls. Also, next semester I am teaching a emt con-ed on sudden cardiac arrest and will be a cpr instructor soon. I know I have a long time before I have to decide what I really want to go into, but I was just wondering what's the best way to find out more about the field and was wondering if maybe you could tell me why you chose this wonderful field. Are there any particular books you would recommend?

Thanks,
xxxxxx

Subject: Dr. Can You help?
Date: Tue, 16 Nov 2004 16:53:10 -0500
From: Pascal Dupuy ext225 (PASCAL@ategra.com)
Organization: Ategra
To: Andrew Chung (ac1@heartmdphd.com)

Dr.Chung - I know I just sent you my nationwide update, but one of my clients just sent me an amazing opportunity and you never know when the next opportunity that is presented to you is the right one. Do you know anyone who would be interested?

My client is seeking TWO Interventional Cardiologist/electrophysiologist ?

Two opportunities: Specialty Clinic-- join a larger multii-specialty group who provides three rotating cardiologists to practice primarily at the Medical Center for 1:4 call. Competitive income guarantee (upper 200+K range). They did 200 interventions, 600EPs, 250 pacemakers, and 50 ICDs last year collectively.

Southeast Cardiology-- Join a group of three interventional cardiologists for a ¼ call schedule on weekends and 1:5 on weekdays. Aggressive group has several remote clinics (Enterprise, Opp, Marianna, Blakely) in which they provide 1 day clinic each week to a specific clinic. GA and FL license a plus. Competitive income guarantee. They did 500 interventions last year collectively. Andreas Muench (UTX-Houston) will join them in August, 2005. Base: 350K

The two groups share call with an interventionalist. All groups perform stenting.

Please pass this to any colleague who you think would be interested in this opportunity or call me as soon as possible at 800 466 9919 x225. To speed things up, please also send me a copy of your resume, (if you haven't already done so). I will keep your resume confidential and will not release it to anyone without your permission. My services are at no charge to you.

Thank You !!
Pascal - 800 466 9919 ext 225

---------------------------------------------------------
Ategra Systems Inc
Specialists in Permanent & Contract Staffing
7085 University Blvd
Winter Park, FL 32792

To Learn More About Ategra:
http://www.ategra.com

Subject: doctor referral
Date: Thu, 4 Nov 2004 04:18:25 -0500
From: xxxxxx@webtv.net
To: ac1@heartmdphd.com

Hi,
I found you through the discussion forums & wish you were my doctor! You are so knowledgable & nice. But since I live too far away, can you please give me a referral of a good cardiologist, internist, or diagnostitian that practices similar to you in my area of Philadelphia, PA?
---Thank you!

Subject: North Carolina Cardiology Opportunity
Date: Mon, 25 Oct 2004 09:26:58 -0400
From: Bill Brochetti To: ac1@heartmdphd.com

Dr. Andrew Benhua Chung, M.D.,Ph.D.,

ESA Medical Group has been retained by a Cardiology Practice in North Carolina to provide a BE/BC Invasive/Non Interventional or a Non-Invasive Cardiologist.

Guaranteed first year salary of $350,000.00 to $400,000.00, plus bonuses, with a full benefit package, short track to partnership, and much more awaits this compassionate and caring Cardiologist.

Location offers an outstanding family oriented community, year round activities for the whole family, plus a host of other amenities.

If you are interested, or know of any Cardiologist that is interested in this opportunity, fax or email your CV to:
FAX: 216-289-1635
EMAIL: bill@execsearchamerica.com

For immediate information call Bill Brochetti, at the ESA Corporate Office, 216-261-7400 ext 226.

ESA MEDICAL GROUP REPRESENTS PHYSICIAN PRACTICE OPPORTUNITIES THROUGHOUT THE WORLD.

Regards,

Bill Brochetti
Vice President
ESA Medical Group
Cleveland, Ohio

Subject: Help in decifering results
Date: Fri, 3 Sep 2004 09:18:06 -0500
From: xxxxxx@logantele.com
To: ac1@heartmdphd.com

Thanks for replying to my problems in the posting in the cariology part of sci.med. Thgought maybe you could help with this:

Got holter monitor test back. He said I had "2 events svt" and "many short run svt". I dont know what that means. He refered me to a cariologist but I cant get in until next week. Under Supraventricular Ectopy it said:
SVE Total: 217
Sve Rub Total: 31
Longest SVE Run: 14 beats at 5:21
Maximum HR sv run: 193 beats at 22:18
sve's per 1000/per hour: 3/10
Total Aberrant Beats: 9
Atrial Flib/Flutter: n/a

Under Conclusions it said:

Average heart rate was 61. The minimum heart rate was 41 at 16:04. The maximum heart rate was 130 at 05:22. Paus greater than 2.5 seconds were 0. Ventricular ectopy was 16, with 0 v-runs and 0 pairs. Supraventricular ectopy was 217, with 31 sv-runs. st episode minutes totaled 0.

Can anyone explain if this is good or bad?

Also, after I got this report yesterday I started having trouble again for about 4 hours. Went to an urgentcare clinic. They did an ekg, bloodwork, checked oxygen. My oxygen was 100. egk was fine with no tarcardia or something like that. I was not anemic but the thyroid and electrolite tests had to be sent out.

She said if these came back fine she would think it was anxiety or panic attacks. I have never had these before. I am not under any stress. These are worse in the afternoon and sometimes just happen if I am sitting on the floor.

Cna you guide me?

Subject: My suicide attemt
Date: Mon, 23 Aug 2004 15:16:55 +0000
From: xxxxxx@hotmail.com
To: nospam7@heartmdphd.com

Dear Doctor,
Two years ago I attemed suicide. I was on alot of cocaine and tried to kill myself. I took 3 tylonal pm. I was almost asleep when a girl came over i was in love with. For some reason her rejection made me want to take my own life. I did a line thinking it whould kill me. Well i didn't. Now I am having lots of problems with my circulation and i think it is because of what i did that day. Am I going to die and at this late in my condition is it posible i could still live?

Subject: Case Review
Date: Mon, 19 Jul 2004 14:38:16 -0400
From: xxxxxx@xxxxxx.com
To: cardiologist@heartmdphd.

Dear Dr. Chung,
My name is Paulette xxxxxx, I work with an insurance defense firm that defends physicians in medical malpractice cases. We have a case at the present time involving a cardiologist and the use of amiodarone. If you review cases and available to review this case, please contact me at the number below.

Thank you for your time and consideration of this matter.

Sincerely,
Paulette xxxxxx

Subject: Hello, Repectively
Date: Fri, 2 Jul 2004 09:00:04 -0700 (PDT)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Hello, my mane is Aprial xxxxxx and I am interested in a career in cardiology. I was looking through your website for more information but I was hoping I could get more in depth with it. If you can please take some time to answer some questions I have, I would really appreciate it. I am doing research for myself and for my High School Careers class.

What are the responsibilities of a Cardiologist?
What are the requirements for college?
What colleges offer it?
How many years of college for a Ph.D or Master's?
What are the requirements for a good job?
What is the salary?
What are the benefits?
What kinds of other professionals do Cardiologists work with?
What sorts of technology do Cardiologists use?
What are the not so good things?

Thank you for taking the time to read and hopefully respond. I know it seems like a lot but it would really help me out. Thank you for your time and patience.

Aprial xxxxxx
Subject: Please help me!
Date: Wed, 9 Jun 2004 21:43:36 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

My mother is a 74 yr old WF. She has had heart disease for over 35 yrs. First, caths. and angioplasty, followed by bypass surgery 19 yrs. ago. She has had numerous caths, and currently had 3 stents. She had an MI about 5 yrs. ago. She is a diabetic, which is currently controlled by Glucotrol-XL 5 mg. She was diagnosed with CA of the lung 2 1/2 yrs ago. (She also had breast CA 18 yrs. ago). Her CA is under control. She has rheumatoid arthritis. In Feb. she had a positive stress test. She had a Cath and her stents were open . Her heart damage is on the back of her heart. She was put of Zebeta, 10 mg and had multiple symptoms such as low pulse, headaches, dizzy, no energy, etc. She started to have angina with any activity. Was sent back to cardiac rehab. on Friday. She only lasted 10 minutes, had severe angina and was taken to the ER. Admitted 8 hrs. later. Put on blood thinners and doubled her Imdur from 120 to 240 mg. Discharged Sunday. Her angina now is terrible. I feel like the Drs. here are blowing her off because she has "cancer".I am not sure what are the correct questions to ask the Drs. I feel like she has symptoms of CHF, but she has never been told that. I'm not looking for a miracle, just some respect. If they feel they can do no more for her, then say that or tell us what her choices are. I'm in Maryland (Salisbury), which is about 3 hrs. away from Hopkins. Could you please advise me on what to ask the Drs. or where I should take her? I sincerely appreciate your time, and thank you for listening to me. xxxxxx

Subject: My mother is in the hospital
Date: Wed, 02 Jun 2004 10:33:56 -0400
From: xxxxxx@dhr.state.ga.us
To: cardiologist@heartmdphd.com

and she needs another opinion about her CHF Treatment (very Bad) Do you have any suggestions in the Northlake/ Dekalb Hospital Corridor? Thanks

Subject: Re: what's your diagnosis?
Date: Fri, 7 May 2004 15:35:11 -0700
From: xxxxxx@mailaka.net
To: "Dr. Andrew B. Chung, MD/PhD" (nospam5@heartmdphd.com)

Dr. Chung:

This is probably off-thread at least. But, regarding your 2lb diet, it seems that further directions are needed. Supposing that for week x I dedide to eat two pounds of walnuts per day. The next week: two pounds of celery per day. I guess you are assuming that any user of the diet is sophistacated enough to know better. Shouldn't there be an addendum describing the permissable foods for a daily diet?

Subject: MVP, AF, CARDIOVERSION
Date: Sat, 24 Apr 2004 14:38:01 EDT
From: xxxxxx@cs.com
To: cardiologist@heartmdphd.com

I have been diagnosed with AF and Mitral Valve Prolapse, 3 valves of the 4 leaking and "mild congestive heart failure." I was prescribed first Tropol XL twice daily, with 40 mg of Norvasc twice daily, and coumadin twice daily. I had been taking 20 mg of Norvasc for the last 5 year in conjunction with Atacand for hypertension. When I started the Tropol XL, it caused extreme adverse reactions--overall swelling, shortness of breath, and more severe AF. When I called the cardiologist, he changed it to Atenolol 40 mg, and the problems disappeared. However, the heavy dosage of Norvasc caused my lower legs and feet to swell, as well as other parts of my body, causing aches and pains and fatigue. The cardiologist said the benefits outweighed the side effects, and I would just have to put up with that. My family doctor felt he was over medicating, but would not interfere. However, both doctors were skeptical of my reaction to the Tropol xl, which was witnessed by my husband and family, not to mention the frightening discomfort I endured. The fact that the reaction subsided after stopping Tropol xl, to me, seems to speak for itself, so why the skepticism. I have always been sensitive to drugs (allergic to penicillin, codeine, sulfa, etc.). The doctors I had before I retired to Florida, told me I was difficult to treat because of the limitations, but never did they insult my intelligence by doubting my reported reactions. It would be to my advantage not to have adverse reactions.

My last visit, April 21, the cardiologist recommended strongly that I have the electrical cardioversion, saying I still had AF (though I thought it was gone) and the mild congestive heart failure would be worsened unless the AF was stopped. He changed the Norvasc to Lotensin, and I can't believe the relief from the swelling--I am taking prescribed Lasix daily with a potassium supplement. I see my endocrinologist (Dr. xxxxxxx, Ocala, FL--I am hypothyroid) Monday, April 26, who has not been apprised of this condition, and I am taking him requested copies of the extensive tests performed by the cardiologist. I wish to get his opinion.

I would like your opinion on the above.

xxxxxxx

Subject: FW: ECG Consultation
Date:Mon, 19 Apr 2004 14:50:37 +0100
From: xxxxxx@tiscali.co.uk
To: andrew@heartmdphd.com
CC: cardiologist@heartmdphd.com

Dear Dr Chung,
I sent you an e-mail about 2 weeks ago inquiring if you could help me with an ECG problem. As I have got no reply I was wondering if you had not received it. I just noted you have a different address on the discussion groups.

I would very much appreciate your advice on the problem. If you cannot help kindly advise on where I could go. Please find below the old message.

xxxxxx

Subject: Personal from Dr. Klatz
Date:Mon, 12 Apr 2004 22:04:01 -0400 (EDT)
From: Dr.Klatz To: cardiologist@heartmdphd.com

Dear Colleague,

I read of your work on the Internet and I believe you will have interest in advanced biotechnology for the intervention of disorders of human aging. Our medical society will be hosting the International medical events of the year with the 12th Annual World Congress on Anti-Aging Medicine in Chicago, August 20-23, at the Hyatt Regency, and again in Las Vegas at the Mandalay Bay Resort, December 3-5. This is my personal invitation to you.

The A4M is a nonprofit organization of physicians and scientists from over 70 countries worldwide and have grown from just 12 members in 1993 to over 12,500 members today. Our reach is wide as we now provide educational seminars, training, and advanced biotech information to over 100,000 healthcare professionals.

For your convenience I've included links to the following important resources

12th Annual World Congress on Anti-Aging Medicine flier, speakers, topics, and registration. http://www.worldhealth.net/event/
Our latest Biotech E-Newsletter of breakthrough technologies for aging interventions. http://www.worldhealth.net/ebn/a4m_040406.html
Our Society's official web site, www.worldhealth.net: The #1 source for anti-aging medical information. You can find application information for our society as well as board certification information and requirements for the American Board of Anti-Aging Medicine.

Thanks for taking the time to review this correspondence. We look forward to working with you, and hope you will join us at our August conference in Chicago. If you have no interest check here and I will remove you from my personal private mailing list.

Best Professional Regards,
Dr. Ronald Klatz MD, DO, FAOASM
President of the American Academy of Anti-Aging Medicine

Subject: no where to turn
Date: Mon, 12 Apr 2004 19:47:33 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Dr. Chung, I was searching for information on the net and had seen some of the responses that you made to others and decided to take a shot. October of 2002 my father a healthy 65 year old had triple bypass surgery. Immediately after surgery he began to have complications. after numerous visits to doctors we hospitalized my father in January. We found out that he had Phrenic nerve palsy. I have tried everything including two trips to New York to see a neurologist and thoracic surgeon with not much help. My father is on a ventilator and will probably remain on a trach for the rest of his life. We have come to accept this, but have yet to find a doctor that can explain to us how this happened and what steps we can take to make my father more comfortable. He has been int the hospital 15 times in the last year and seems not to be comfortable. If there is anything you can tell me to help us understand his condition or tools we can use to make him live a healthier life I would appreciate it.

Thank you
Amanda xxxxxx

Subject: Breast Mass
Date: Mon, 12 Apr 2004 06:36:17 -0400
From: xxxxxx@mac.com
To: cardiologist@heartmdphd.com

Dr. Chung,

I am writing you to avoid panic.

After a MIDCAB in May 2003, I have developed a very painful mass in my left breast. I am male so I can’t imagine this to be anything but a normal result of the surgery. Should I see my cardio or my surgeon or someone else? I am rather embarrassed and don’t want to embarrass anyone needlessly.

Regards,

Glenn xxxxxx

Subject: Zocor
Date: Sun, 21 Mar 2004 21:59:28 -0800 (Pacific Standard Time)
From: xxxxxx@earthlink.net
To: cardiologist@heartmdphd.com

I see there are many questions regarding the use and also the problems with Zocor. There is much information that is faulty and some good. What is you opinion of taking a patient off Statins without several weeks of downward titration.
Thanks,
xxxxxx

Subject: None
Date: Mon, 8 Mar 2004 20:44:31 -0500
From: xxxxxx@prodigy.net
To: cardiologist@heartmdphd.com

Doc,
I am concerned about a sharp shooting pain in my heart region, it feels like a shard of glass. I am 18 years old very active and eat relitively healthy. I have asked my friends if they have this condition and they all have told me that they also have these pains. I was wondering if this is any thing to be concerned about and what might cause this?

Subject: Question
Date: Tue, 2 Mar 2004 16:50:31 -0600
From: xxxxxx@mindspring.com
To: "Dr. Andrew B. Chung, MD/PhD" (cardiologist@heartmdphd.com)

Hi Andrew

Sorry to bother you, but I wondered if you might have a recommendation. I have had chronic (daily) headaches since 1990. I have had many doctors, and eventually ended up at Shepherd Center for Spine Care (formally Shepherd Pain Center), where they determined that the headaches are caused by a head injury in 1980. After an auto accident the headaches didn't start immediately, but after 10 years, arthritis built up and is pressing on the nerves.

I now had headaches everyday since 1990, with some days being unbearable. My doctor has done some procedures like destroying the pain fibers of the nerves, but I am still in pain everyday, particularly behind the eyes. Some days, especially lately, I have had to go to the ER for a shot or strong pain killers to diminish the pain level (It never completely goes away, but I have learned to set a goal of just getting it down to tolerable). My doctor has told me that I will be in pain for the rest of my life.

My doctor is on the leading edge of new procedures and recently tried implanting a T.E.N.'s unit on the occipital nerves (which was just approved for the neck). It helped in the back of my neck, but not behind the eyes. He even placed a needle through my jaw to do a nerve block on the nerves behind the nose, but it didn't stop the pain behind my eyes. All of these procedures are guided by x-ray (I'm sure you've heard of them).

Most recently, I have been told at the ER that one of my eyes (the one that hurt that night) was dilated different from the other eye. Also, my face was swollen on one side during another ER visit with a severe headache. These symptoms are new in the last 6 months. The ER doctor did a Cat Scan, but it was normal.

I have previously been to neurologists, but am wondering if I should go to another Neurologist for these new symptoms. I guess my question to you (after boring you with this) is do you know of a good neurologist that I could try. Years ago, I went to Jerome Walker, who a lot of people consider the Atlanta Guru of headaches, but did not care for his treatment, demeanor, or office staff.

I appreciate your time and advice.

By the way, I became a christian late in high school as well and enjoy a genuine relationship with Christ as well. I have played in a contemporary christian band for about 13 years (on the side). Thanks for your witness in your emails. And just to let you know, I have prayed for relief and healing for years, including having the elders of my church anoint me with oil and pray. So far, God has other plans. I have told him that I would rather have pain everyday and be connected with him than healing and missing his plan. I have to believe that there is a bigger purpose for my pain, but on the worst days, it's hard to see (you know what I mean?).

Listen, I appreciate your insight and recommendation and your time to read this.

Thanks Again Andrew,

xxxxx

Subject: Research Questions
Date: Sun, 29 Feb 2004 22:02:32 -0500
From: xxxxxx@athensacademy.org
To: cardiologist@heartmdphd.com

Hi, I am a 9th grader at Athens Academy doing research on the profession of Cardiology. I was wondering if maybe in your spare time, you might be able to answer just a few (and I promise it will only be a few)questions. I do not need great detail just a brief answer. I am not in desperate need but if you could answer these questions it would be greatly appreciated. Thank you so much.


xxxxxx (Athens Academy - 9th Grade)
Email: xxxxxx@athensacademy.org or just reply to this message

Questions: (Here are a few questions and you don't need to answer all of them. Whatever you can write is helpful. Thank you so much.

1. What drew you to becoming a Cardiologist?

2. How long did you go to school to become a Cardiologist?

3. What did you major in college and what courses did you take to become a Cardiologist?

4. What is the hardest part of being a Cardiologist?

5. What kind of vacation time and off time do Cardiologists normally get?

6. What do you dislike about being a Cardiologist and do you have any regrets?


Subject: A message from xxxxxx from the Cardiology Listserv
Date: Wed, 18 Feb 2004 18:41:28 -0800 (PST)
From:xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Andrew:

It occurred to me that you might be interested in this piece I received via email. I have done little to verify it's authenticity but the writing seems to speak for itself.

I have yet to decide if I will see the film. My beliefs are firm. Do I need to watch hours of endless suffering to be convicted? I don't think so. However, I must admit that over the past several months, I have gained enormous respect for Mel Gibson.

Since this is very off topic, I chose to send it to your private email. Please forgive me if I overstepped boundaries to your privacy.

xxxxxx

THE PASSION OF THE CHRIST"

Below are Paul Harvey's stirring comments concerning Mel Gibson's new movie, "The Passion of the Christ," due to be released on February 25, 2004.

For more information abut the film, see http://www.passion-movie.com.

Note that Harvey says the movie is "a kind of art that is a rarity in life."

I really did not know what to expect. I was thrilled to have been invited to a private viewing of Mel Gibson's film "The Passion," but I had also read all the cautious articles and spin. I grew up in a Jewish town and owe much of my own faith journey to this influence. I have a life long, deeply held aversion to anything that might even indirectly encourage any form of anti-Semitic thought, language or actions.

I arrived at the private viewing for "The Passion", held in Washington DC and greeted some familiar faces. The environment was typically Washingtonian, with people greeting you with a smile but seeming to look beyond you, having an agenda beyond the words. The film was very briefly introduced, without fanfare, and then the room darkened. From the gripping opening scene in the Garden of Gethsemane, to the very human and tender portrayal of the earthly ministry of Jesus, through the betrayal, the arrest, the scourging, the way of the cross, the encounter with the thieves, the surrender on the Cross, until the final scene in the empty tomb, this was not simply a movie; it was an encounter, unlike anything I have ever experienced.

In addition to being a masterpiece of film-making and an artistic triumph, "The Passion" evoked more deep reflection, sorrow and emotional reaction within me than anything since my wedding, my ordination or the birth of my children. Frankly, I will never be the same. When the film concluded, this "invitation only" gathering of "movers and shakers" in Washington, DC were shaking indeed, but this time from sobbing. I am not sure there was a dry eye in the place. The crowd that had been glad-handing before the film was now eerily silent. No one could speak because words were woefully inadequate. We had experienced a kind of art that is a rarity in life, the kind that makes heaven touch earth.

One scene in the film has now been forever etched in my mind. A brutalized, wounded Jesus was soon to fall again under the weight of the cross. His mother had made her way along the Via Della Rosa. As she ran to him, she flashed back to a memory of Jesus as a child, falling in the dirt road outside of their home. Just as she reached to protect him from the fall, she was now reaching to touch his wounded adult face. Jesus looked at her with intensely probing and passionately loving eyes (and at all of us through the screen) and said "Behold I make all things new." These are words taken from the last Book of the New Testament, the Book of Revelations. Suddenly, the purpose of the pain was so clear and the wounds, that earlier in the film had been so difficult to see in His face, His back, indeed all over His body, became intensely beautiful! . They had been borne voluntarily for love.

At the end of the film, after we had all had a chance to recover, a question and answer period ensued. The unanimous praise for the film, from a rather diverse crowd, was as astounding as the compliments were effusive. The questions included the one question that seems to follow this film, even though it has not yet even been released. "Why is this film considered by some to be "anti-Semitic?" Frankly, having now experienced (you do not "view" this film) "the Passion" it is a question that is impossible to answer. A law professor whom I admire sat in front of me. He raised his hand and responded "After watching this film, I do not understand how anyone can insinuate that it even remotely presents that the Jews killed Jesus. It doesn't." He continued "It made me realize that my sins killed Jesus" I agree. There is not a scintilla of anti-Semitism to be found anywhere in this powerful film. If there were, I would be among the first to decry it. It faithfully tells the Gospel story in a dramatically beautiful, sensitive and profoundly engaging way.

Those who are alleging otherwise have either not seen the film or have another agenda behind their protestations. This is not a "Christian" film, in the sense that it will appeal only to those who identify themselves as followers of Jesus Christ. It is a deeply human, beautiful story that will deeply touch all men and women. It is a profound work of art. Yes, its producer is a Catholic Christian and thankfully has remained faithful to the Gospel text; if that is no longer acceptable behavior than we are all in trouble. History demands that we remain faithful to the story and Christians have a right to tell it. After all, we believe that it is the greatest story ever told and that its message is for all men and women. The greatest right is the right to hear the truth.

We would all be well advised to remember that the Gospel narratives to which "The Passion" is so faithful were written by Jewish men who followed a Jewish Rabbi whose life and teaching have forever changed the history of the world. The problem is not the message but those who have distorted it and used it for hate rather than love. The solution is not to censor the message, but rather to promote the kind of gift of love that is Mel Gibson's filmmaking masterpiece, "The Passion."

It should be seen by as many people as possible. I intend to do everything I can to make sure that is the case. I am passionate about "The Passion." You will be as well. Don't miss it! This is a commentary by DAVID LIMBAUGH about Mel Gibson's very controversial movie regarding Christ's crucifixion. It, too, is well worth reading.

Subject: Not angina?
Date: Mon, 16 Feb 2004 16:02:21 EST
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Hello heart doc.
I have had noticiable ectopic heart beats since last easter time, they started soon after i had an accident at work in which i had some fragments of glass get in my throat which caused an infection (the infection comes and goes and is signified by a yellow spot that appears in the back of my throat) went to the local hospital to get the ectopic beats checked out and had an ECG test. the cardiologist there said the ectopic beats were nothing to worry about, however he did say that one of the traces showed an abnormality that may be angina. I went for another ECG test this time whilst walking on a treadmill. This test showed that i do not have angina but no mention was made of what the abnormality might really be and no further appointments or tests were suggested. My question is could the throat infection i have be causing some abnormality in my heart beats? Could it perhaps have spread to my heart? Could bacteria from it be causing the ectopic beats? Lots of questions i know, but sitting in the doctors office i always seem to forget to ask them home here i have the time to think about it.
Thanks for your time and i hope you are able to reply.
xxxxxx


Subject: Interventional Cardiology - Florida
Date: Fri, 23 Jan 2004 14:18:44 -0500
From: Peter Luciano (pluciano@fgp.com)
Organization: Find Great People, Inc.
To: cardiologist@heartmdphd.com

I represent a Heart Specialist practice in Ft. Lauderdale, Florida that is wholly owned by the local multi-hospital system. They have an excellent opportunity for an experienced interventional cardiologist. The practice currently has five cardiologists and seeks to expand.

Because of the structure of the practice, this is an employed opportunity with salary, benefits, fully paid malpractice insurance, and retirement.

The range of salary is mid $300's to mid $400's depending on experience with an additional bonus potential of up to $100K. This is an excellent package given there are no expenses to the physician.

Ft. Lauderdale is a lovely community offering a wide range of lifestyles, beautiful gated communities, waterfront living and excellent schooling opportunities for family.

I would encourage you to share this opportunity with colleagues. Interested individuals should email me your CV and to contact me at your convenience. Best Regards,

Peter R. Luciano SPHR
Consultant
FGP International
www.findgreatpeople.com or www.fgp.com

"I Find Great People in healthcare"

150 Executive Center Drive, B82
Greenville, SC 29615

e-mail: pluciano@fgp.com
(800) 638-1661

Subject: Questions about Dr. Wallace
Date: Mon, 5 Jan 2004 11:21:20 -0800 (PST)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Dear Dr. Chung,

I found your name and background information after conducting a search for past students from Dr. Douglas Wallace's lab. I am a first-year grad student in a Ph.D. program at the University of California, Irvine and will be starting a rotation soon in his lab (he recently moved here from Atlanta).

Because he is so new, there are only post-docs in his lab and I was hoping to gain the perspective of some of his former grad students before I make a decision about my thesis lab. Could you tell me what it was like to have him as an advisor? Did you like working in his lab? How long did it take you to finish your Ph.D. work? What did you feel were his strengths and weaknesses?

I understand that you are very busy and appreciate very much your time in this matter. If you also know of anyone else that was in his lab and could give me some feedback, that would also be very helpful.

Thank you again (and congratulations for all your successes in life)!

Sincerely,

xxxxxx

From: xxxxxx@surfmore.net
To: cardiologist@heartmdphd.com
Subject: pulse rates
Date: Thu, 1 Jan 2004 21:15:13 -0600

Hello, I am a 51 yr old lady petite always had a low blood pressure. Lately , my pulse rate has gone up to 137. Which is far from normal for me. My whole body will turn red from head to toe. And , stay that way. for a while it takes 2-3 days for it to slowly come down. It has only happened twice. But, right now it is 100 and it has been doing rather good for 2weeks. My doctor took urine for 24 hours and put in acid for that time in refregerator. Then I turned it in . The first one something was wrong . But, my urine was very dark , you could say black. The second was ok. and normal clear. now he wants me to wear a monitor for 24 hours and turn it back in.
What is my problem?
xxxxxx

From: xxxxxx@xxxxxx.co.uk
To: cardiologist@heartmdphd.com
Subject: FW: Thank you for your donation - Information about Cardiac Revascularisation options
Date: Tue, 30 Dec 2003 13:01:59 -0000

-----Original Message-----
From: donations@efundraising.org [mailto:donations@efundraising.org
Sent: Tuesday, December 30, 2003 12:47 PM
To: xxxxxx@xxxxxx.co.uk
Subject: Thank you for your donation

Dear Donor

On behalf of Medecins Sans Frontieres [UK], we would like to thank you for your kind donation of USD 35.00.

[Details snipped]
----------------------------------

Dr Chung

I wonder if I might seek some information from you about possible treatment options for cardiac revascularisation.

I am a 52 year old architect living in the UK. I had angioplasty and stent in July 2002 and am being referred back to the Cardiology Dept by my GP (Primary Care Physician) due to deteriorating angina. The problem I have is getting information about treatment options which are not constrained by the limitations of our National Health Service in order that I might discuss these with my cardiologist when I see him on 7 January.

I travelled to Belgium for my angioplasty, as the waiting list in the UK was nearly 2 years. My UK cardiologist was supportive of my decision to go abroad for treatment and willingly provided a letter of introduction providing full medical details of my condition. In return the belgian cardiologist provided details of the treatment to my UK cardiologist for follow-up care.

I had a 90% blockage of the LAD at the trifurcation of the first septal branch and intermediate diagonal branch. After the treatment I was free of symptoms but ETT at 8 weeks was positive. Subsequent ETT at 12 weeks showed 2mm ST depression and an angiogram showed mild neointimal hyperplasia of the stent and narrowing of the first diagonal and moderate to severe ostial stenosis of the diagonal branch at the base of the stent. It also showed normal LV with normal RCA, left circumflex and left marginal. I was advised that they wanted to treat this with drugs only as it would be very difficult to repair by angioplasty and CABG was not an option for single vessel disease. I was also warned that I might lose one or both of the arteries.

It is now 15 months since this angiogram. My medication has progressively been increased and my tolerance of exercise has decreased. The deterioration has been slow but relentless. My current medication is Diltiazem 240mg, Isosorbide Mononitrate 20mg twice a day, Propranolol 160mg, Valsartan 80mg, Atorvastatin 20mg, Aspirin 75mg. General health good but 20kg overweight which I am working on. Blood tests, Cholesterol, BP etc are all normal except kidney function (creatinine).

To date I have not had a heart attack and I am concerned about the prospect of "losing" one of these coronary arteries and presumably the consequent loss of heart muscle. Is it normal just to allow coronary arteries to infarct or should I be considering seeking treatment outside the UK as I did before? I suspect that as I have not already had a heart attack I am low priority so far as our National Health Service is concerned, but I am sure my cardiologist would support another trip abroad if other treatment options were available.

xxxxxx
xxxxxx
xxxxxx, UK

Date: Tue, 23 Dec 2003 21:50:20 +1300 (New Zealand Standard Time)
From:xxxxxx@paradise.net.nz
Subject: Dilated Cardiomyopathy
To: cardiologist@heartmdphd.com

Dear Dr Chung, My name is xxxxxx and I live in New Zealand. I recently had a mild heart attack and from there it was discovered that I had Dilated Cardiomyopathy but the medical staff did not tell me that or explain the problems that I would face with it.
As I work in a hospital I was quite stunned that many staff members could not explain it to me so I started surfing the net and found many interesting articles written in America and I understand a little more about heart muscle disease.
It seems to me Americans are better informed on heart disease than us Kiwis.
A question can this disease be reversed, what harm does high blood pressure play when after six months pills have not brought it down and also infections are they harmful.
As a group of us are interested in making people more aware of this disease is there good material you can recommend.

Kind regards
xxxxxx

Date: Fri, 5 Dec 2003 12:02:24 -0800 (PST)
From: xxxxxx@yahoo.com
Subject: Big Change in Cholesterol
To: cardiologist@heartmdphd.com

Hi Dr. Chung.
I found your name on a Google Group list and thought I might ask you a question. I recently had a cholesterol test that showed my total count as 317, which of course is ridiculously high. I had a test 11 months ago that had my total count at 235, which is borderline high but certainly much better than 317. My diet hasn't changed much in those 11 months, I haven't gained any weight, though I am a bit less active (I walk more but get rigorous exercise less). Is an 82 point jump in cholesterol in 11 months possible or at least reasonable? I'm being retested, but I'm still shocked at the result. I'm a 30 years male and otherwise in excellent health. Hope to hear from you. Thanks.

Regards,
David xxxxxx
xxxxxx, NY

From: xxxxxx@singnet.com.sg
To: cardiologist@heartmdphd.com
Subject: help
Date: Fri, 5 Dec 2003 21:00:37 +0800

Dear doctor,
I am from Singapore. I came to your webpage accidentally and find it really informative. I am wondering whether can I get some advice from you. Recently my grandmother has been diagnose with Ischemic heart disease. Doctors here said that her blood vessels (coronary artery) are very occluded. Her ECG is still normal but her cardiac ultrasound is showing atherosclerosis everywhere. She got carotid bruit also. In addition her kidney function is estimated to be only 10% though she has not had sign of kidney failure like vomiting yet.

May I know what treatment can be offered tor her to treat or prolong her life. I really love my grandmother. Hope you can enlighten me. In Singapore, the cardiologist seems unable to help. His plan to do a coronary angiogram was cancelled because of the kidney failure.
Oh yes, she has isolated systolic hypertension of 170-180/70mmHg

I would really appreciate if you can give me some advice.

xxxxxx
Dentist (oral maxillofacial surgeon)
Singapore
xxxxxx@singnet.com.sg

Date: Sun, 23 Nov 2003 04:59:19 -0000
xxxxx@msn.com
To: cardiologist@heartmdphd.com
Subject: Omega 3

Dear Dr. C,

What is your opinion about omega 3 supplements? I take them daily. I believe that a significant part of mental and cardio health problems are due to this fat not being a part of most people's diets. I have read about Scandanavians that adopt an American style diet start to have higher incidents of depression and heart/cardiovascular disease than Scands that maintain a traditional diet.

Your friend and classmate,

Paul xxxxxx

From: xxxxxx@hotmail.com
To: cardiologist@heartmdphd.com
Subject: help for our essay on dextrocardia
Date: Wed, 12 Nov 2003 17:04:22 +0000


Dear Sir/ Madam,

We are three students from the Netherlands who are writing an essay on dextrocardia (situs inversus). As this disorder is quite rare, we have not been able to find more information than provided on the Internet. We would like to ask you, if you would be so kind as to give us some extra information on this subject. Our most important question is if you could tell us in which population group this disorder is most common. But any help is welcome, such as recommending particular literature etcetera. It would mean a lot to us, since this essay is quite important for our final exam. We would very much appreciate it if you would be able to answer us as soon as possible.

Yours sincerely,

Saphira xxxxxx, Arthur xxxxxx and Irini xxxxxx.

Subject: Pressing heart problem for 25 y/o
Date: Fri, 7 Nov 2003 13:45:38 -0500
From: xxxxxx@adelphia.net
To: cardiologist@heartmdphd.com

Dr Chung,

Thank you for reading my email, I have several questions for you. I have been having the following symptoms over the past three months: difficulty breathing, cold hands and feet, shooting shocking like pain in the left arm, and at times chest, feeling as if arms and other extremities have fallen asleep, nausea, increased coughing with brownish and white milky phlegm, dizziness, jaw pain, as well as dull to severe pain the left chest area, dried blood in left nostril, snoring and extreme tiredness. I have had an EKG, Enzyme blood test, echo, cardiolite stress test; all appeared normal per the cardiologist. I have also seen a lung specialist, who did nothing, telling me that I have postnasal drip. I have been to the emergency room several times regarding this, however they are at a loss. My mother as well as aunt have mitro value prolapse, however the cardiologist has said no, might their be any other tests that could be run. I know my own body, pain in a specific area is med school 101, and it is not in my head, I’m rather tired of physicians telling me, that 25 is too young to have a heart problem. I also have requested but not had a cholesterol test, per all the physicians I have asked. I have drank several years while in college seven to be exact, also my blood pressure is rather high 130-140/80, however my GP thinks this is normal, I disagree. Any additional ideas, because this is scarring the hell out of me, and is seems as if the Dr’s are brushing me off. I will gladly send a $35.00 donation for an objective response, towards this pressing problem.


Sincerely,


xxxxxx

From: xxxxxx@xxxxxx.com
To: cardiologist@heartmdphd.com
Subject: Quick question on your two pound diet
Date: Tue, 28 Oct 2003 00:39:35 -0800

Hi,

I'm really looking forward to going on your diet. I read your page and what you are saying makes a lot of sense.

When you say, "Sugar free drinks", what do you mean? I thought you meant diet soda. Instruction 3 seems to treat skim milk as a sugar free drink. I have always thought carbs and sugars were pretty much the same. Are there other "free" drinks? What about "Sugar free" fruit juices? (Sugar free cranberry juice -- YUCK. Its full of carbs, no doubt.)

I'm planning to succeed on your diet and look forward to writing a testimonial. And by the way, I really liked your FAQ. It really cut to the chase.

Thanks & Regards,

xxxxxx

From: xxxxxx@earthlink.net
To: cardiologist@heartmdphd.com
Subject: May I pose a question?
Date: Sat, 11 Oct 2003 23:29:18 -0400

Dear Dr. Chung,
I appreciate your website and your participation with the cardiology news group,however I have become leary of some of the posters and would not care to post there.
May I ask a question of you at this address.
If so thank you, if no I apologize.

Best Regards
xxxxxx

From: xxxxxx@webtv.net
Date: Tue, 16 Sep 2003 23:13:15 -0400 (EDT)
To: cardiologist@heartmdphd.com
Subject: temporary password and username

Would you send me temporary password and username?
Thanks

xxxxxx

From: xxxxxx@aol.com
Date: Sat, 6 Sep 2003 22:52:25 EDT
Subject: 2lb diet
To: cardiologist@heartmdphd.com

I enjoyed your website and the theory behind the "2lb diet". It makes sense...............years ago people lost weight on diets based on eating rice and pasta. Then along came the no fat/low fat diets. Again people lost weight. Adkins no carb diet....people lost weight.
Several years ago one of the doctors at the hospital where I worked was constantly on some fad diet or another. Finally he went on MediFast and lost the weight. After he lost the weight he merely cut back what he ate. Being divorced and in his late 50's he ate out most of the time. He would tell the server to cut everything on his plate in half BEFORE bringing it to the table and put it in a take out container (or often times throw it away). This worked for him..............if he didn't see it, he didn't crave it and he didn't eat it.
Kind of like the 2lb diet.........eat less therefore weigh less.

Date: Sat, 06 Sep 2003 16:38:46 -0600
To: cardiologist@heartmdphd.com
From: xxxxxx@xxxxxx.com
Subject: s.m.c, etc

Dr. Chung,

I have been enjoying your contributions to sci.med.cardiology for quite a while now. What brought me to this newsgroup in the first place is that I have had paroxysmal atrial fibrillation for about six years now.

I have greatly appreciated the care and concern with which you have answered people's questions about their medical conditions. I also really appreciate that you are witnessing your faith in such a public way. I'm sure that this causes a lot of the darts and arrows that have been launched in your direction.

I would like to suggest that you consider a different approach to the fools and idiots that have plagued the newsgroup. I would suggest that you apply the wisdom of Matt 10:14 and Luke 9:5 to this problem. I.e., ignore them. Use your killfile if you have one, or your self control if you don't. You have patiently explained the issues to these people over and over. They don't want to know the truth. Jesus has taught us to leave these people behind and concentrate on those who do want to hear the message.

If you can't resist arguing with these people could you please leave s.m.c out of the groups you post your replies to? This will allow me and others to killfile the idiots and never see their posts as long as we confine ourselves to s.m.c. Every time you respond to them in s.m.c, I am forced to see their blather. Unless you change your approach, the only way I can let my filters work for me is to kill file you too. I do not want to do this. But I am sometimes tempted to do so.

Please consider this.

God bless,
xxxxxx

From: simone@zacorpinc.com
To: cardiologist@heartmdphd.com
Subject: Exchange Links
Date: Tue, 2 Sep 2003 20:02:16 -0400

Hello,

My name is Simone. I discovered your website http://www.heartmdphd.com on Google and found it to be very informative. I was wondering if you wanted to exchange links with 4 of our sites? If so please add the following information and send us your link information and your site will be added within 24 hours. If you require that we link first we will do so. Just let us know.

Thank you for your consideration.

Simone
Webmaster
ZACORP INC.

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Date: Fri, 29 Aug 2003 17:04:04 -0400
To: cardiologist@heartmdphd.com
From: Erik Grissom (erik@polarishealth.com)
Subject: link suggestion

Hello. I am writing to suggest our company, Polaris Health Directions, as a possible link from your page at http://www.heartmdphd.com/

Our organization has recently won a major grant from NIH to study depression and anxiety in patients receiving cardiovascular treatment.

You can visit our web site at http://www.polarishealth.com

Thank you.

Erik

From: xxxxxx@telus.net
To: cardiologist@heartmdphd.com
Date: Thu, 28 Aug 2003 10:06:03 -0600
Subject: when to take statins


Hi again Dr. Chung

Endocrinologist told me to take them at night ie) supper or after because liver makes most cholesterol at night.

Why don't you post the AMA page with your creds? Why do you put up with the b.s. on the board. Makes me sad to go there.

xxxxx

From: xxxxxx@mountain.net
To: "Dr. Andrew B. Chung, MD/PhD" (cardiologist@heartmdphd.com)
Subject: Re: Anti Atkins
Date: Sat, 23 Aug 2003 13:39:43 -0400

thanks Dr. Chung. . Saved me for starting this diet. Will stick with the walking and lower fat.

Subject: Fw: Your Online Donation to Doctors Without Borders
Date: Fri, 15 Aug 2003 16:27:08 -0700
From: xxxxxx@juno.com
To: cardiologist@heartmdphd.com

Dear Dr. Chung::

I had stress test and thallium test few months ago, my cardiologist recommended an angiogram. Out of fear for another bypass surgery ( I had a bypass surgery 4 years ago), I opted for medication. I am taking nitroglycerin 5mg twice a day. I learn there is a non-invasive therapy called EECP (Enhanced External Counterpulsation). Is it effective?

Thank you.

----- Forwarded Message -----
From: "Donor Services at Doctors Without Borders" (donations@newyork.msf.org)
To: xxxxxx@juno.com
Date: Fri, 15 Aug 2003 19:03:51 -0400
Subject: Your Online Donation to Doctors Without Borders
Message-ID: (OAKTREE17FRaqbC8wSA00000003@relay.com)


Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

Subject: thanks for the chat
Date: Wed, 18 Jun 2003 17:19:38 -0700 (PDT)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Andrew, so good to find you. I have lots to discuss with you about the genetics study regarding WPW and the electron CT scan. Gonna go for a walk, may log back on later. Take care, xxxxxx

Subject: Christ's Healing
Date: Sat, 14 Jun 2003 23:31:11 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Dr. Chung,
It is wonderful to see a physician give credit to OUR LORD'S marvelous works while HE was on earth. I believe that more and more of the medical community are recognizing the POWER of OUR LORD & SAVIOR!!

Dr. Chung, you are truly one in a million! Wish I had you as my cardiologist !!!

My GOD watch over you and your practice.

xxxxxx

Subject: Website Suggestion for http://www.heartmdphd.com/research.asp
Date: Thu, 12 Jun 2003 23:02:04 +0530
From: xxxxxx@rediffmail.com
To: cardiologist@heartmdphd.com

Hi,

I came across your site and found it very informative and nice. Thank you for putting up this wonderful site. It really helped me in my research.

I would like to suggest a website for inclusion on your page at http://www.heartmdphd.com/research.asp [Research Links:] and other such related appropriate pages.

You could find the below information useful to link to the site:

Url: http://www.1upinfo.com/

Title: 1Up Info - Encyclopedia

Description:

Browse articles in all areas of topics within Earth & Environment, History, Literature & Arts, Health & Medicine, People, Philosophy & Religion, Places, Plants & Animals, Science & Technology, Social Science, Law, Sports, Everyday Life, and more.

Thanks and I would really love to recommend your wonderful site to a lots of my friends. In facts, I already suggested it to many of them :)

Regards,
xxxxxx

Subject: Best MDs
Date: Thu, 12 Jun 2003 09:26:58 -0400
From: xxxxxx@mac.com
To: cardiologist@heartmdphd.com

I would like to nominate my cardiac surgeon, Dr. L. Wei of UPMC, Pittsburgh, to your “best” list. He was very professional, had tremendous patience for my questions, and performed an exceptional job of performing an MIDCAB. His ability to transfer knowledge and calm with confidence was exceptional.

xxxxxx

P.S. Dr. Chung — thanks for your efforts with the website and your participation in the sci.med.cardiology newsgroup. It’s been a great source of practical information.


Subject: The Best MDs
Date: Mon, 9 Jun 2003 23:12:10 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

I can give you my Dr's name for your list, just don't ask me how to pronounce it, Chukwudi Uchegbu,M.D. Adult Medicine / Primary Care . he has an office in Tucker and one in Alpharetta

Subject: Research Nurse Needed
Date: Wed, 4 Jun 2003 10:24:45 -0400
From: "Caroline Diamond" (CarolineDiamond@MSNHealth.com)
To: cardiologist@heartmdphd.com

Dr. Chung,

I was wondering if you may know anyone looking for a Clinical position in Atlanta Georgia. Your experience in cardiology is very extensive so I thought you may know someone looking for a position as a Research Nurse in the cardio field. I also have an opening for someone in Regulatory affairs. This is a great opportunity for someone looking to get into the pharma research field. Any help you could give me would be greatly appreciated.

Caroline Diamond
Account Manager
Clinical Resources,
a Medical Staffing Network, Inc. Company
6110 Executive Blvd. Suite 905
Rockville, MD 20852
(301) 468-2500 Ext. 129
(301) 770-2253 fax
carolinediamond@msnhealth.com
http://www.msnhealth.com/

Subject: Dr. Recommendation
Date: Tue, 20 May 2003 22:10:07 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Robert Albee, MD. He is a GYN, but specializes in Endometriosis. He is in Atlanta, GA. His website is http://www.centerforendo.com.

He is one of the top in the world for this disease.

xxxxxx

Subject: heart question
Date: Tue, 20 May 2003 16:02:36 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Hi, I found your information on the internet and hope you don't mind me contacting you...

I work for a film director who wants to know something specific for a film. Basically, fake medics are trying to sneak a prisoner out of prison in an ambulance, saying he is having a heart attack. Something has to go on so the guard knows they are lying - something the guy is doing wrong in faking the attack, something about the pulse, I don't know... do you have any ideas?

Thank you!!!

xxxxxx

From: xxxxxx@cs.jhu.edu
To: drchung@heartmdphd.com
Subject: Mitral Valve Prolapse
Date: Thu, 24 Apr 2003 19:35:37 -0400

Dear Dr. Chung,

Viewed your webiste, and I now have a few questions about mitral valve prolapse:

What is a rough estimate of the chance that somebody with mitral valve prolapse will develop mitral regurgitation?

What are the symptomps of mitral valve prolapse with mitral regurgitation?

Do people with mitral valve prolapse without mitral regurgitation need to see a cardiologist every few years if they do not experience any symptoms?

Sincerely,
xxxxxx


----- Original Message -----
From: Donor Services at Doctors Without Borders
To: xxxxxx@cs.jhu.edu
Sent: Thursday, April 24, 2003 7:27 PM
Subject: Your Online Donation to Doctors Without Borders


Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

From: xxxxxx@xxxxxx.com
To: drchung@heartmdphd.com
Date: Fri, 4 Apr 2003 14:24:36 -0600
Subject: Recommendation of Dr. Van C. Reeder

Dr. Chung,

We have never met but I understand you publish a "Best Doctors List" and I would like for you to consider Dr. Van C. Reeder for this list. Dr. Reeder has been my cardiologist for almost 3 years and without his excellent medical care, I don't believe I'd be alive today. Dr. Reeder always takes time to answer my questions and is willing to go "the extra mile" to ensure I receive the best medical care possible. Dr. Reeder practices medicine at Birmingham Heart Clinic in Birmingham, Alabama.

Choosing a physician is an important decision and I believe good physicians should be recognized for their contribution to society. I truly believe references such as your "Best Doctors List" assist in this selection process and I believe Dr. Reeder is deserving of this special recognition.

Please don't hesitate to contact me should you have any questions.

Regards,

xxxxxx


Subject: Fwd: Your Online Donation to Doctors Without Borders
Date: Wed, 26 Mar 2003 14:08:43 +0000
From: xxxxxx@hotmail.com
To: drchung@heartmdphd.com

Dr. Chung - I am a 33 year old male. I used to be quite athletic, mainly running until about 6 moths ago. I have generally felt in poor health - mainly tired and started getting skipped beats. The doctor said pvc's. He referred me to a caridologist three weeks ago (I still need to wait one more week for my appt). My symptoms have gotten worse with sometimes several pvc's per minute. I also have begun to feel my heart racing when I sleep. From the best I can tell this is Atrial Fibrillation. It happened for a few seconds several times per night and would always stop when I moved. Now it happens almost continuously during the night and does not go away until I move quite a bit. Is this something that could wait another week?What medicine would be the safest to take? Could an artery blocakge cause this? Could something with my stomach cause this? What might other causes be?

I appreciate you providing this service and helping a worthy cause through donations

>From: "Donor Services at Doctors Without Borders"
>Reply-To: donations@newyork.msf.org
>To: xxxxxx@hotmail.com
>Subject: Your Online Donation to Doctors Without Borders
>Date: Wed, 26 Mar 2003 08:54:03 -0500
>

Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

In a world where the need for Doctors Without Borders' work is greater than ever, your support is the fuel that drives us to reach the most vulnerable, to raise issues that are not popular, and to demand - and help bring about - an end to suffering. Without you, our work simply would not be possible.

If you have any questions about the processing of your donation, please feel free to send an email to donations@newyork.msf.org or call Katie Lane, our Donor Services Assistant, at (212) 655-3757.

You will also be receiving a thank you letter in the mail, which will serve as your legal receipt.

Please find below your donation information as it appears in our records.

-----------------------------------------------------

E-mail address: xxxxxx@hotmail.com

xxxxxx,
xxxxxx
www.heartmdphd.com
xxxxxx
Donation Amount: $35.00

-----------------------------------------------------


Subject: Fw: Your Online Donation to Doctors Without Borders
Date: Tue, 18 Feb 2003 19:08:04 -0500
From: xxxxxxx@lanshop.com
To: drchung@heartmdphd.com

See the donation information below.

My father was admitted to xxxxxx xxxxxxxon December 24th with congestive heart failure.

He was released eight days after that and since that time has had a case of persistent hiccups. Dr. xxxxxx, his cardiologist referred him to a neurologist.

The hiccups still persist to this date, even though four different medications have been tried – metaclopramide first, then novochlopromazine, clonazepam and lastly novodivalproex.

As the hiccups are quite debilitating for my father, I am looking to evaluate alternative treatment plans. Both he and my mother are becoming quite distressed.

Despite the medication, the hiccups which have abated for some periods, still persist.

Other medications and treatments show up in the medical literature as effective combating hiccups. These include the muscle relaxant Baclofen, Benztropine and Lidocaine. I have not performed an exhaustive search but certainly chlorpromazine and baclofen show up consistently. Treatment of the phrenic nerve with medicine or surgical procedure is also indicated, but as a last resort.

Most articles discuss the need to determine the underlying cause for the hiccups and then plan the treatment accordingly. I’m not sure what the cause is but could guess it was a direct result of his heart failure/attack – possibly irritation of the phrenic and/or vagus nerve.

I am not a doctor and my information is strictly from what I’ve gathered on the Internet. I have no idea what side affect or interactions certain drugs have.

What I do believe, however, is that a definitive plan of attack has to be implemented to address my father’s hiccups.

Doctor Chung, what would you recommend? Should we see another neurologist for a second opinion, or perhaps a GI guy or even an anesthesiologist?

----- Original Message ----- From: Donor Services at Doctors Without Borders
To: xxxxxx@lanshop.com
Sent: Tuesday, February 18, 2003 7:03 PM
Subject: Your Online Donation to Doctors Without Borders

Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

In a world where the need for Doctors Without Borders' work is greater than ever, your support is the fuel that drives us to reach the most vulnerable, to raise issues that are not popular, and to demand - and help bring about - an end to suffering. Without you, our work simply would not be possible.

If you have any questions about the processing of your donation, please feel free to send an email to donations@newyork.msf.org or call Katie Lane, our Donor Services Assistant, at (212) 655-3757.

You will also be receiving a thank you letter in the mail, which will serve as your legal receipt.

Please find below your donation information as it appears in our records.

-------------------------- ---------------------------

E-mail address: xxxxxx@lanshop.com

Mr. xxxxxxx,
xxxxxx xxxxxx
www.heartmdphd.com
xxxxxx, xxxxxx
Donation Amount: $35.00

-----------------------------------------------------
Subject: Excellent CARDIOLOGY practice opportunities
Date: Fri, 14 Feb 2003 09:13:54 -0500
From: Kathy Avers (kavers@stjohnjobs.com)
Organization: St John Associates
To: "Andrew Chung, MD" (drchung@heartmdphd.com)

Dear Dr. Chung,

I can use your help.

Please review the following practice parameters and forward this message to any colleagues for whom you feel this may be appropriate. I believe these will be great practices for the right physicians. Thanks for passing it along.

DALLAS EP: Join a single specialty cardiology group in Dallas with more than 20 members including 4 electrophysiologists. The senior EP member will be retiring this fall and they want another EP to start before he retires for a seamless transition. This well-established group has offices affiliated with several large Dallas hospitals and offers the chance to be involved in clinical research trials in their private research facility. The electrophysiologists practice EP exclusively including 1:4 EP call. With a population of over 1 million, Dallas is a hub for banking, high tech industry, and corporate headquarters.

CHARLOTTE INTERVENTIONAL: A Charlotte NC group has been asked by a local hospital to be the practice to start an interventional program. The new interventionalist will be joining a group of 9 cardiologists with 3 interventional members to share call. The community hospital has just completed a renovation project and added a new digital cath lab, emergency department and MRI and CT scanner. The office has echo and nuclear cameras. If you like golf, this is the place to be! Drive west and you're in the Blue Ridge Mountains or head east to the Atlantic beaches.

PHOENIX NON-INTERVENTIONAL: A Phoenix group with 11 cardiologists needs another non-interventional cardiologist to cath and help with their quickly expanding nuclear program. Unlike many Phoenix area groups, this one covers only a couple of offices and hospitals so you don't run around all day between locations. Anticipate great compensation and a short trip to partnership! With more than 300 days of sunshine and a robust economy this group enjoys the best of the Southwest.

Dr. Chung, please forward this message to any physicians for whom you believe this practice may be of interest or call me to confidentially discuss their qualifications.
Have a great day!

Kathy

Kathy Avers
St. John Associates, Inc.
(800)737-2001
kavers@stjohnjobs.com
http://www.stjohnjobs.com

Subject: electrophysiologist
Date: Sat, 11 Jan 2003 08:53:52 -0800 (PST
From: xxxxxx@yahoo.com
To: drchung@heartmdphd.com

Dr. Chung.

Can you or an assistant review a legal case.

The scenario: patient went in for an ablation in an attempt to cure arrhythmia. She was told there was a 99% chance it would cure her.

Unfortunately, there was an accidental puncture of the heart before the device was in position. The patient was coded but survived after emergency surgery to address the puncture.
The ablation was accordingly never performed and the patient has been told she is no longer a candidate for the procedure. She still has the arrhythmia.

This procedure was performed in Tennessee.

If you can help provide legal assistance regarding this unfortunate complication please respond to the email.

Thanks xxxxxx

Subject: Cardiac Questions
Date: Wed, 8 Jan 2003 22:16:21 -0000
From: xxxxxx@tesco.net
To: drchung@heartmdphd.com

Dear Dr Chung,

Thank you very much for your excellent website and the help that you dispense through sci.med.cardiology on the internet. I am writing for advice for my Wife. Before I start I should point out that I am in the UK and have been unable to make a donation to any of the organisations that you list from here. Are there any international medical or christian organisations that you know of active in the UK which I would be able to donate to from here. Can I suggest a charity called The Leprosy Mission which works to bring medical relief and christian teaching to leprosy sufferers world-wide?

My wife is 38 years old, in otherwise good health and not taking any medication of any kind. I would like to ask for information/advice on two matters (1) Ventricular Ectopic Beats and (2) Adverse reactions to cardiac medication

In April 2001 she was diagnosed with Ventricular Tachycardia which was occouring several times a day. This was treated by giving her a drug called Flecainide (Tambocor). She had an extrme adverse reaction to this drug (more details below) and so it was replaced by Beta-blockers - first Metoprolol and later Nebivolol. She was unable to tolerate these drugs either and so her cardiologist agreed to a Radiofrequency ablation which he did in July 2001.

(1)
Since the ablation she has had maybe a dozen occurances of something which felt to her like VT (although we have not been able to prove this as none have occoured when she had a holter monitor on). However, she does have lots and lots of ventricular ectopic beats. These will occour randomly - sometimes very few in a day, at other times they will go all day. Sometimes every third of fourth beat will be a VEB for hours on end. She has recorded runs of bigeminy on the holter monitor too.

Often the ectopics worson about half-an-hour after she has eaten a meal for about an hour or so.

Her cardiologist has said that they are benign and that the only available treatment is medication - which her body can't tolerate.

My questions are:
:-Is there any other way to treat VEBS?
:-Are there any natural ways to combat them?
:-Can they be cured by ablation in the same way that VT is?
:-Are there any lifestyle changes which my wife can make which might reduce the number of VEBS that she gets? (She does not smoke, drink lots of alcohol or tea or coffee)


(2)
The extreme reaction my wife had to the Flecainide consists of the following symptoms:
:-continual pre-syncopal lightheadedness, a feeling of everything 'fading away' and looking distant (Sometimes to the point where she feels sedated)
:-Unnatural tiredness (She often sleeps until noon and still has no energy)
:- 'fizzy', tingling feelings in her arms and legs
:-Continual Tinnitus (mostly buzzing in the left ear)
:-Sounds resonating in her head
:-Diverse pains in various parts of her head and up and down her neck
:-Diminished vision (especially in poor light)

We expected these to go away when she stopped taking the drugs but they have not. They came on within 5 days of starting to take Flecainide and have been constant ever since. She feels the same way 24 hours a day, 7 days a week and has done for 20 months. Her cardiologist will not accept that the drugs he gave her could have had these effects on her.
:- Are you aware of anyone else having a similar reaction to cardiac medications?
:- Do you know if it is possible for overdoses of cardiac medication to cause long-term damage which might cause these symptoms?
:- Any advise or suggestions as to the cause or treatment of these symptoms would be very welcome.


Thank you very much for taking the time to read this and reply.

God Bless you in your work and ministry,

xxxxxx

Subject: Rythmol Versus Propafenone
Date: Sat, 21 Dec 2002 18:30:28 -0800
From: xxxxxx@verizon.net
To: drchung@heartmdphd.com

Greetings and Happy Holidays!

My mother-in law has been taking Rythmol (150 mg.) for the last 2 years as a result of a stroke. Due to the fact that the cost is so expensive, we are wondering what your opinion of the generic version propafenone is.

Thanks for your time,

xxxxxx

Subject: Dr. Chung -- I REALLY like your approach!
Date: Wed, 11 Dec 2002 16:15:53 -0800
From: xxxxxx@teleport.com
To: drchung@heartmdphd.com

Dr. Chung:

I'm a psychologist in Portland, Oregon and I like things simple. Your approach is very simple, and it seems to accomplish those things you want it to -- that is, reduce the volume of the food. (Also refreshing is your attitude towards the foolishness of three meals a day when obesity is so rampant here in the U.S.)

As a psychologist, I keep track of numbers on my watch of the days on diet and the pounds I have lost. This keeps me focused on my goal of being "good enough for long enough."

Also I have an different way to use a balance beam scale. (That is, when I am reducing my calories greatly to lose weight, I do not let the indicator go higher. Therefore, when I get on the scale, I know there is no way I will be demotivated by fluctuations in weight due to water retention.)

I'd be interested in your reactions to these two approaches. I stuck a manual on the web at http://www.teleport.com/~xxxxxx and you can see how the numbers and balance beam work.

Again, I REALLY like your approach! Neat! Easy to follow!

Excellent!

Yours,

xxxxxx, PhD
Portland, OR

Subject: A cholesterol spike
Date: Wed, 11 Dec 2002 13:46:33 -0500
From: xxxxxx@scrtc.com
To: andrew@heartmdphd.com

Hi Dr. Chung,

I post under the nickname of "xxxxxx" and in the past have expressed my appreciation for your participation in the cardiology newsgroup.

One very quick question if you don't mind. My cholesterol has (under recently)always been below 200. This spring and summer I had readings of 185, 186, and 175. One month ago it was 213. Today it was 217. My diet, exercise regimen, and weight hasn't changed. The only change was a few months ago I went on thyroid medication for an underactive thyroid. I've had this underactive thyroid for a few years now so thought maybe I should go on the medication. This was in spite of having no symptoms of being hypo.

My question is, have you ever heard of anyone having their cholesterol elevate because they were taking thyroid medication?
Thanks,

xxxxxxx
Subject:
Date: Wed, 27 Nov 2002 19:57:58 -0500 (Eastern Standard Time)
From: xxxxxx@bulloch.k12.ga.us
To: drchung@heartmdphd.com

Dr. Chung,

I am taking a chance that you will actually respond to this e-mail. My mother is a 59 year old white female who was diagnosed with (an ?) idiopathic cardiomyopathy last December. Recently, her heart was "operating" at 10-15 percent (efficiency ?).

She has an initial visit scheduled with a specialist at Emory in January (Local physicians have failed to regulate her heart through medication thus far). Although you know nothing about her situation, are their options other than a transplant (i.e. experimental treatments)? And if a transplant is required, can you give us some guidance on success rates, etc?

As you, I am a Ph.D. and, more importantly, a Believer. I assume you are very busy, but she is the only mother I will ever have. Any help or guidance you are willing to offer would be very, very appreciated.

xxxxxx

Subject: worried about my heart.
Date: Sat, 23 Nov 2002 17:39:16 -0700
From: xxxxxx@hotmail.com
To: drchung@heartmdphd.com

Dear Dr. Chung,
I am worried about my heart. Lately is has been hurting and beating very hard and rapid. I'm not sure if I have heart disease or high blood pressure, but in the past my doctor told me I had a high white count and for me to come back in. I never did.
I'm not sure how I can tell or what I can do. Any advice or information you can guve woulf be greatly appreciated

xxxxxx

Subject: ECG vs ECHO
Date: Wed, 13 Nov 2002 20:27:31 -0800
From: xxxxxx@tiscali.co.uk
To: andrew@heartmdphd.com

Hello Andrew,

Thanks for posting your reaction. There were a few replies to my query and some people suggested I hadnt given enough information. Here it is.

The initial BP assessment was incidental to a general visit to the doctor.

My age. 39, non smoker, total cholesterol. 5.2. HDL 1.6. LDL 2.9 renal function normal. not overweight.

No chest pain or exertional problems but suffer from some sort of symptoms like missed beats and palpitations which no no one has seen fit to investigate so far, Most days and sometimes if I wake at night.

Often BP seems normal at home. Not persistently over 90 even without treatment. Varies. If am very busy/concentrating hard then a measurement is higher, if I am relaxed reading a book, perfectly normal In Doctors surgery, 150/102 to 150/110 quite usual. I measured it in the car once having come from the surgerym and it dropped from 150/102 in surgery to 130/83

24 hr average ambulatory was 125/87 and even white coat like factors could apply there. I mean the artificiality of it, the awareness of the measurement procedure especially in company, people are aware of the auto inflation. I would knock a few points off the measurement for that although this is a unscientific approach !

I think that the 125/87 (which was without medication) was not an alarming result. But maybe the doctor ought to have paid attention to the daytime average as more relevant than the 24 hr because the night time period distorts the picture. The night time would be (I think) more relevant if it showed a failure to lower.

No questions were asked about my lifestyle or diet. I wasnt encouraged to consider any non drug strategy

I suffer from anxiety and I think my BP is consequentially labile.

The doctor asked for an echo but the hospital just did a repeat ECG If I would have preferred the echo the doc asked for. he said it would be more reliable and it seems most people or sources do. I really want that echo just to be sure I havent got anything nasty

Best regards xxxxxx

Subject: Need Help in Tallahassee
Date: Sun, 10 Nov 2002 13:46:39 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dear Dr. Chung,

We are in desperate need of some medical advice. My 35 year girlfriend xxxxxx was in the ER last Sat with pulmonary edema. The edema has manifested over the last 9 mths culminating with the hospital visit last week. The hospital internist recocognized her symptons as nightime syncope and scheduled her for an ECG. The results of that test were severe mitral valve regurgitation. She has been scheduled for a cardiac catheteritization on Wedsnday this week, without even a consultation with a cardiologist. I find this to be ludricous for such an invasive test, without even a consult. I do not understand why she has not been sceduled for a stress echo or transesophigal echo. Please...your input is invaluable to us. We would like to get the best advice from the best cardiologists available.

We can be reached at 850-xxx-xxxx, xxx-xxxx, or xxx-xxxx
xxxxxx

From: xxxxxx@slingo.com
To: andrew@heartmdphd.com
Subject: Your SCI.MED posts
Date: Mon, 28 Oct 2002 15:02:08 -0500

Hey -

I asked you a couple of questions previously about Toprol XL - i'm 24 and take it for NMH/Vaso-vagal episodes (2 this year). Failed the tilt table after 2 mins and got 50MG daily.\

Anyway - would you recommend this med for this purpose? I notice that i get a significant "brain fog" and am having difficulty losing weight. Would another BB reduce these side effects?

All in all i'm happy with the toprol, but the brain fog and slow thinking is really becoming difficult to deal with.

Thanks,

xxxxxx


From: xxxxxx@lvcm.com
To: andrew@heartmdphd.com
Subject: Greetings...
Date: Sun, 27 Oct 2002 19:48:51 -0800

Dear Dr. Chung:
Hello. I am a freshman at the Academy of Allied Heath in the Medical Program at Rancho Highschool. I am doing a research paper on being a cardiologist. I was wondering if you can aide me in these subjects:
1.Any information that has to do with LICENSING: Where do you go to get this? Any exams that have to be taken? How many? How many times do you have to take it? etc.
2.Where do you get education in a cardiology subspecialty?
3.What is the salary range and potential outlook?
4.Any other interesting information about this career you would like to share? (Do you prescibe laughter as a prescription???)

Thank you sir. I would appreciate it if you would respond by October 31, 2002. Thank you again.

Sincerely,
xxxxxx

Date: Sun, 27 Oct 2002 19:20:13 -0700
To: andrew@heartmdphd.com
From: xxxxxx@direcway.com
Subject: you may want to know that my

homepage was moved from crosswinds.net to different server and currently has an address : http://dradam.polscy-lekarze.net

You may want to update your listing.Soon I will have English language version.

Dr. Adam Poradzisz
Edmonton, Alberta, Canada

From: xxxxxx@worldnet.att.net
To: andrew@heartmdphd.com
Subject: Full-Body CT Health Scan Results
Date: Wed, 23 Oct 2002 16:57:33 -0700

Hello, Dr. Chung --

Appreciate your response received a few months ago.

My husband and I have just undergone complimentary full-body CT scans in connection with my audio program on Oregon Public Broadcasting. I interviewed a staff radiologist from one of the CT clinics about this procedure, which has just come to the Pacific Northwest (Oregon and Washington State) in the past year or so. They offered to provide the scans "gratis" and we accepted.

Now that I have the results, I don't really understand them! I am confused about the calcium scores. What scale is used? I've read it goes from zero to 7600? What do these scores mean, really -- and what about the suggestion that they don't provide any concrete information to assess risk?

My husband (male, age 68, ht. 5' 8", wt. 162) had a score of 110, which the doctor said put him on the 50th percentile of men his age in terms of chances of having CAD and/or a heart attack. The usual suggestions were to lose weight, continue exercise, diet, asprin and statin therapy. He is currently taking lovastatin (Mevacor) and a daily baby 81 mg. aspirin, and has an overall cholesterol score of 215. No family history of CAD.

As for me (female, age 63, ht. 5' 2", wt. 166(!), my score was 23, which the doctor said put me on the 75th percentile of women my age to have CAD or a heart attack. (LOWER number means HIGHER RISK for women???) Same suggestions as above. I have just increased the Lipitor to 15 mg. daily, take 1/2 of a 325 aspirin and have an overall cholesterol score of 205. Parents and grandparents had heart problems; some died quite young. I am completely asymptomatic as far as I know.

Aside from losing weight and increasing exercise, I think that's about all I can logically do. I did read somewhere that there is an increased heart risk for people who are Type A, hostile, assertive, distrustful and who have a tendency to depression. I'm afraid I must claim all of the above, although I've tried to mellow out to some extent.

Thanks for your opinions and the good work you do to answer people's questions. I wish you were closer! I enjoy reading the cardiology newsgroup but have had so much spam -- probably due to the archiving of posts going back years at Google.com.

Warm regards,

xxxxxx

Date: Sun, 13 Oct 2002 10:11:10 -0500
From: xxxxx@peoplepc.com
To: andrew@heartmdphd.com
Subject: Thank you

Thank you for your response to my "Why take Lipitor?" question on sci.med.cardiology. It opened my eyes to a new way of seeing the issue. Best regards.
xxxxxx

From: xxxxxx@aol.com
Date: Sun, 13 Oct 2002 01:16:47 EDT
Subject: ECHO and Stress ECHO
To: andrew@heartmdphd.com

Dear Dr. Chung,

I am an internist in a small town south of columbus. I am interested in learning and be certified in reading ECHO and stress ECHO. I tried several links to reach department of Cardiology but was unable to. Then I reached your link, I figured you can help me find out who I should the right person to discuss the matter. Thanks in advance for the reply.

xxxxxx, M.D.

To: andrew@heartmdphd.com
From: xxxxxx@canada.com
Subject: Re: mri report
Date: Fri, 11 Oct 2002 09:00:14 -0700 (PDT)

Hi Dr Chung,
How is it going ? I talked to you some time ago about my problems. I was wondering if you wouldn't mind give me your opinion on my mri report. I would reaaly appreciate your feedback. I have a history of chronic muscular and shoulder pain.

History : left shoulder pain
Technique : a routine noncontrast mri of the shoulder was performed

Report :
There are mild degenerative changes in the acromioclavicular joint.

The acromion has a flat undersurface but there is a moderately large enthesophyte related to its anterolateral undersurface.

There are quite marked changes of tendinosis in the supraspinatus tendon and a bursal surface partial-thickness tear approximately 1 cm medial to the insertion on the greater tuberosity. In addition there is a small amount of fluid in the subacromial/subdeltoid bursa. There are also changes of tendinosis in the infraspinatus tendon.

The subscapularis tendon appears normal. The bicep tendon also appears normal and is located within the intertubercular sulcus.

No gross labral abnormality is identified.

Conclusion :
There are changes of tendinosis within the supraspinatus and infraspinatus tendons and in addition there is a small bursal surface partial-thickness tear of the supraspinatus approximately 1 cm proximal to its insertion.

From: xxxxxx@earthlink.net
To: andrew@heartmdphd.com
Subject: Best Doctor list
Date: Mon, 7 Oct 2002 22:38:52 -0400

My Surgeon, Dr. Raymond S. Waters, Hudson Florida is Exceptional. Bayonet Point Cardiac www.bpcardiac.com

Thank You for adding my cardiologist Dr. Eldin, he deserves it.

From: xxxxxx@wi.rr.com
To: andrew@heartmdphd.com
Subject: Question
Date: Wed, 2 Oct 2002 17:34:22 -0500

Dr. Chung--
My mother is 83, and takes medicine for glaucoma [she's had breast cancer twice, but the last time was about 7 years ago] and also for occasional high BP [atenolol, 25 mg.]. Ten days ago she had an episode where she almost fainted -- felt lightheaded, and a bit sweaty. They called 911 and took her to the hospital and her BP was high, about 200. However, after about 2 hrs. -- with no treatment -- she was fine, and has not had any further problems. In the hospital they had her overnight and took countless EKG's and blood tests and everything was fine. She also had an echo cardiogram, which was fine, but the cardiologist said there was a very slight valve leak and not to worry about it. He also put her on Cozar [spelling??] for her BP, which was fine by then. He told her to see her doctor when she got home, and she did; he sent her to a cardiologist who could not find anything wrong, but is going to do a Holter monitor test and also a nuclear stress test. What do you think her problem might be? She still feels fine, and is home. Are there any other tests she should be having? Thank you, in advance, for your insights.

xxxxxx

From: xxxxxx@aol.com
Date: Sun, 29 Sep 2002 20:19:54 EDT
Subject: Re: Best Doctors List
To: andrew@HEARTMDPHD.COM

Andrew,

In Atlanta, GA I would highly recommend:

W. Scott Brooks, Jr. MD-Gastroenterologist st Piedmont Hospital..His website is http://www.atlgastro.com

Charles A. Henderson, MD-Oncologist/Hematologist at Piedmont Hospital...his website is http://www.phoc.com.

John Galloway, MD-Surgeon at Emory University

S Houston Payne MD-Hand Surgeon at Piedmont Hospital...Dr. Payne is with Grady Clinkscales, one of the top hand surgeons in the country.....

I have been using these docs for over 10 years, and they all have excellent reputations...I wouldn't use anyone else in those areas of medicine.

xxxxxx
Atlanta, GA

Date: Sun, 29 Sep 2002 12:56:46 -0700 (PDT
From: xxxxxx@yahoo.com
Subject: Re: [Henderson82] Best Doctors List
To: andrew@heartmdphd.com

I have two recommendations for best MD :

1) Dr. Ron Ito, family practioner, Liburn, GA. Great doctor, great guy, great with his patients and extremely smart. He is my PCP and I know at least 10 other people who use him.

2) Dr. Jeffrey Olsen, neurosurgeon, Emory Hospital. Fabulous brain surgeon, good bedside manner, good with his patients, friendly staff.

From: xxxxxx@comteck.com
To: (andrew@heartmdphd.com)
Subject: Re: Request
Date: Fri, 27 Sep 2002 03:41:04 GMT

I will recommend Dr. Clifford Hallam. He's with The Care Group primarily based at St. Vincent Hospital in Indianapolis, IN. He's been my cardio. for over 11 years (my 1st MV repair operation). He has 2 qualities I really appreciate - 1) he lets me take part in my treatment by listening to my comments and suggestions; 2) he's not afraid to admit there's something he can't explain.

Subject: Best Doctors List
Date: Thu, 26 Sep 2002 14:43:47 -0400
From: xxxxxx@earthlink.net
To: andrew@heartmdphd.com

Hello
I am responding to your request on the newsgroup, The Best Doctor List. I would like to add my cardiologist, Adel M. Eldin, MD www.brooksvillecardiology.com, Brooksville Fl.

I'm sure you hear everyone's story, so suffice it to say Dr. Eldin is a good listener. and that saved my life. I am a 41 year old women recovering from a triple bypass getting stronger and looking forward to everyday.

I hope you will consider Dr. Eldin for your List.

xxxxxx

Subject: Best Doctors List
Date: Wed, 25 Sep 2002 18:49:18 +0000
From: xxxxxx@hotmail.com
To: andrew@heartmdphd.com

Dr. Chung,

Good afternoon. I see that you are soliciting recommendations for your "Best Doctors List". I recommend K. Lance Gould, MD., a cardiologist at the University of Texas Health Sciences Center in Houston. He specializes in noninvasive treatment of heart disease and the use of PET scanning for diagnosis and follow up.

I enjoy reading your posts at sci.med.cardiology. Thanks.

xxxxxx

Subject: Best doctor nomination.
From: xxxxxx@drdc-rddc.gc.ca
To: andrew@heartmdphd.com
Date: 25 Sep 2002 11:08:37 -0400

In Newmarket, Ontario, Canada (about 1 hr north of Toronto):

Dr. Peter Watt, OB/Gyn

He's delivered both of our babies and looked after my wife through various gynecological complications. He is straightforward, knows his own limits, explains things in detail, takes whatever time is required to ensure his patients understand their situation and never sugar-coats anything.

I really enjoy your contributions on sci.med! Thank you for your great patience (:-) with that group. I've been on the Net for about 16 years now (just before the Great Renaming) and seen a lot of MDs who contributed significantly to the groups become (justifiably) disgusted with some of the folks and find other uses for their time. The input of some of them, like David Nye the neurologist, was instrumental in my wife and I coming to a better understanding of her fibromyalgia.

Thanks!
xxxxxx

From: xxxxxx@att.net
To: andrew@heartmdphd.com
Subject: Best Doctors' List
Date: Tue, 24 Sep 2002 19:39:29 -0400

A. "Best cardiologist," at least from one man's experience:

Henry M. Greenberg, (MD)
Roosevelt/ St.Luke's Hospital,
Columbia Medical School
and (practice) UMPA,
425 W. 59th Street, New York, NY 10019.

Procedures only. Others do the riskier stuff. He is an author and cardiology consultant, a competent statistician, and former Chairman of the New York Academy of Science, but relatively young (around 50) and possibly not available - yet good for referrals.

Became his patient in 1995: By then, I had nearly memorized various "heart" books, most recently the "Yale Heart Book," yet received nearly the same prognosis/ diagnosis from all cardiologists until the above who (under some persuasion) agreed to 2 tests before would dismiss me as just another "normal" case of an irregular heartbeat (PVCs).

Against his better judgment (1995) he gave me some type of echo cardiogram plus the exercise thing. Lo and behold, I had atrial fibrillation and a scar on a ventricle suggestive of a "silent MI" numberless years ago. He took me on.

B. Nota Bene:

(1) In 74 years, especially the latter half-century, I've been to 10-15 cardiologists, and was even rejected for officers candidate school by the USNR after an examination by a "team" of MDs in Chicago, during the Korean War, because of questionable (PVCs?) heart rhythm factors;

(2) My "best" GP was in Cleveland and I located him by methods of "market research" (my career) which I commend to you:

(a) As a youthful "market researcher," I interviewed about 5 nurses from each of two hospitals (in Cleveland) for the "best" personal physician in their experience; the nurses mostly enjoyed it; and I hit paydirt....

(b) At one such hospital (1974), 5 nurses offered to sit with me during a break of some sort, in a hospital room, and finally agreed that Dr. "X" (I've forgotten his name - an Internist) seemed to be the most competent physician consistent with his ability to get along with other staff and with patients. One participating nurse volunteered to get his detailed credentials from their central file (this was 1974 and such data was not public domain) to see how he measured up to my other concerns: i) name of medical school; and ii) his standing in his class. Amazing help.

He was 5th in his class of perhaps 50 (?) at an Ivy League medical school. (He worked out very well for me.)

Other random thoughts:

(I) It is a mistake to go by a doctor's "ego wall" as any MD can accumulate drug company mock-ups for specialties while on venal vacation(s), etc.

(II) Also there is something like a White-Coat Code of Silence, whereby no *successful* doctor (often dependent on his income from referrals and relationships with peers) is likely to say anything negative about another doctor in the same market. There is no solution for this as it is human nature.

Interesting that this knee-jerk group psyche does not apply to dentists or lawyers. I think of a cartoon I just saw of a battered lawyer who was run over by an ambulance that suddenly backed up.

(III) Nearly every patient thinks his/her doctor is about "the best" even though said doctor may have been last in his class at the University of Tierra del Fuego. Said doctor may even have record malpractice rates at an institution with otherwise nominal rates, and perhaps lost a significant percentage of his patients under anesthesia when surgery was not a clear and present top-2 step;

(IV) Caveat: The only student in my undergraduate class (Haverford College, Haverford, PA) had to repeat 1 year in order to graduate, not being expelled probably because his father was important on the board of managers, but he became a "successful" MD all his life, having gotten his medical degree in a Caribbean or other offshore mill. (At least he passed the Michigan boards).

(V) There are other sources such as the one you are creating but they vary by state; and none, to my knowledge, gives med school class standing, papers or similar significant achievements. (I have seen such references but cannot recall them.) Can you identify them and link to them to your web site? Can you hope to do that sort of thing?

Also, superficial medical diagnoses can be done by good software. Have you utilized any such on a PC?

It would be like "walking-on-eggs" but things such as the above are potentially invaluable, desperately needed, and might suit your disposition and drag your profession kicking and screaming into the 21st Century. Get funding from the NIH. Dubya would be proud at the improved mortality, though maybe not the SSA.

Dr. Chung, I have read most of your Internet materials and sites. They seem to sell you "short" slightly, but many of your NG notes are good and I often read them. In fact, a few years ago, we exchanged one or two e-mails, in or out of the NG - not sure. In any case, you're becoming a valued net resource.

Much luck to you,

xxxxxx


From: xxxxxx@aol.com
Date: Wed, 18 Sep 2002 23:20:08 EDT
Subject: Dr. Chung
To: andrew@heartmdphd.com

Dr. Chung,
Would there posssibly be a relationship of a chronic dry, hacking cough and edema to CHF? I am back to 4+ pitting edema again of legs to knees. My next cardiologist appt. is not until 10/16/2002. I had hoped this issue was settled...but now I am not sure.

Thanks,
xxxxxx@aol.com

From: xxxxxx@hotmail.com
To: andrew@heartmdphd.com
Subject: Questions from an italian student about Medicine
Date: Tue, 17 Sep 2002 21:41:36 +0000

Dear Dr. Chung,

I'm an italian student (I apologize for my english...).

I've been lurking on sci.med.cardiology newsgroup, and I think you are *very* helpful person. So I'm writing you to ask your opinion about the following situation.
I have to do a very important choice in my life, i.e.: I'm considering study medicine and becoming a physician. I'm hard-working, and I'm particularly interested in internal medicine. However, situations with "lots of blood" really move me (e.g.: some scenes from "E.R." TV series upset me). I'm not interested in surgery, but in internal medicine (I'd love to become a cardiologist). Do you think that I can't have a career in medicine, because of my "upset" for some lots-of-bloody situations?

Moreover, do you know of italian MDs who did/do their residency in USA? Is it possible for a non-US MD to do residency in USA? After graduation from Medical School, it is possible to immediately afterwards enter the residency, or the routine is to wait some years before entering the residency after graduation?

Thank you *very* much for your time, and for your possible reply (which I'd love to get...)

Yours faithfully,
xxxxxx

From: birthday@crpf.org
To: andrew@heartmdphd.com
Date: Tue, 17 Sep 2002 11:08:10 GMT
Subject: A personal note of thanks from Christopher Reeve

Dear Andrew,

Thank you so much for taking the time to send an electronic card for my 50th birthday! Your support means the world because it demonstrates your concern for me and millions of other people affected by spinal cord injury and other disabling conditions.

As you read, an anonymous donor has pledged to donate $1 to the Christopher Reeve Paralysis Foundation (CRPF) for every card sent, and this will significantly impact our cutting-edge spinal cord research and quality of life programs. I hope that you will stay informed about our progress and help spread the word about CRPF.

With warmth and gratitude,


Christopher Reeve
(dictated, not signed)

_________________________________________________________
-QUESTIONS?
If you have any questions about this message or any other Christopher Reeve Paralysis Foundation issue, please click here:
http://www.christopherreeve.org/feedback/feedback.cfm?MX=146&H=0


Subject: diuretics
Date: Sun, 15 Sep 2002 17:35:09 -0400
From: xxxxxxx@enter.net
To: andrew@heartmdphd.com

My Uncle is in his seventies and has suffered a number of ailments.....among them are hemachromatosis, diabetes, renal failures, heart disease. He has had two heart attacks, has had a pacemaker and a defibrillator inserted. He is on numerous meds, and has been having serious complications with retailing fluids. His fluid retention went from about 24% to 60% in less than one month. Of course, the swelling is causing pain and other difficulties, including coughing, etc.

Are there any physicians we might be able to contact who specialize in diuretics? Can you get me any information that might help him?

Thank you for your time!

xxxxxx


From: xxxxxx@aol.com
Date: Tue, 10 Sep 2002 10:58:27 EDT
Subject: Donation to MSF
To: andrew@heartmdphd.com

I have been impressed by information and available help on your website.

I would like to make a donation to a humanitarian organization but find it very difficult to make it to Medecins Sans Frontieres - worthwhile in their stated mission. In many cases, however, their attention and left wing evaluation of certain world situations are biased in the extreme.

Do you have any other organisations that could take the place of MSF?

xxxxxx

Subject: thallium poisoning
Date: Fri, 6 Sep 2002 10:58:23 +0100
From: xxxxxx@a.dii.mod.uk
To: andrew@heartmdphd.com

My sister went out briefly with an odd chap. He had divorced his wife, who had suffered some paralysis. He had a previous girlfriend, who also suffered an ill-defined illness. Shortly after he began dating my sister, she lost the use of her lower legs, then the upper legs, then her arms, then her sight, her ability to speak, to see, her skin erupted in extremely severe psoriasis, mostly her face; he left, her condition began to steady, she is now paralysed and bed-bound, feet have dropped, swallow reflex gone, eyesight pretty well gone, unable to speak, obviously all there mentally. Process has gone on for years but she was very ill within

eight months of first symptoms. Only through dedicated care she has survived so long. Twenty five when it happened, bedbound for the last twelve years or so.

I think the guy poisoned her, and I think he used thallium.

Have you any advice? She underwent tests under the Liverpool University medical department, but they could find nothing. They were looking for M.S. Now, they have written her off, and classified it sudden onset MS but have no clinical confirmation, just symptoms. They did not check for poisoning as far as I know.

My sister is still alive, but only just. Any advice on diagnosis and trewatment, I'd be very grateful.

xxxxxx

From: xxxxxx@riverrun.com
To: andrew@heartmdphd.com
Subject: post angioplasty complications...need help
Date: Fri, 23 Aug 2002 16:16:53 -0000

Hello Sir

I have seen several articles posted by you on various web sites. I have a question regarding a complication developed by my father after angioplasty (stenting).

Following is a brief description:
My father under went bypass surgery in 1990. Four grafts were applied to LAD and LCX using veins at that time.

Recently (on 29th July) he developed severe engina pain following which he was moved to the hospital. While angiography was being performed, it was discovered that all the grafts had choked again and the remaining RCA had developed about 95% block. Doctor advised to go for stenting on RCA. The stent that was used is a drug coated J&J device. After about 5 days he was discharged from the hospital.
Recently (on 18th Aug) he developed some kind of allergy, which looks like rashes (red in color) or swelling at places or kind of boils at other places. This allergy would crop up at one place (in hands or legs) sometimes then dis-appear at other places. The intensity of the subsequent crops would repmain same or increased. He is also having hiccups for last 5 days.
My father is also a diabetic.

Could this drug coated stent had caused this? or this could have been due to some medicine that were advised to him post angioplasty?

I am extremely confused and don't know where to go for help. Any advice would be of great help.

With lotsa regards

xxxxxx

Subject: Heart Q.- Would you make a comment?
Date: Thu, 22 Aug 2002 14:50:14 -0700
From: xxxxxx@netnitco.net
To: andrew@heartmdphd.com

Dr Chung,

Would you be willing to make a comment? I frequently read you postings on sci.med.cardiology and find the information very interesting and helpful.

As background, I have no ‘medical training’ although I am familiar with basic physiology. I obtain psychophysiological recordings from individuals, and the recordings obtained are of the respiratory waveform, non-invasive blood volume and heart rate changes (cardiosphygmogram), and electrodermal activity. The recordings are obtained ‘under mental stress’ although the person would be sitting slightly reclined and as relaxed as possible. As a matter or routine, I utilize an automated Marshall digital blood pressure device to record the persons blood pressure on the onset of the recordings (I concede the device is not ‘clinical grade’).

I am curious, aside from an indication of High Blood pressure, if the below scenario would be indicators of some other potential heart ‘problem’ of significant urgency? and if so, what would be consistent with the recordings?

The subject is a 57 year old male who weighs 280lb, and is a 2 pk/per day smoker. He c/o severe and frequent headaches upon awakening in the a.m. and periodic numbness to his fingers and toes. He reports his last physical exam was 2 yrs prior, and does not report his physician expressing any concerns to him at that time. He reports on past Dr office visits, his BP was recorded as being ‘high’. He states he is not on any prescribed or over-the-counter medications, (except for taking Excedrin for headache when awakening in the a.m. hours). The subject presents himself as not being in any medical discomfort, other than c/o sinus drainage to the back of the throat. He does not c/o nor reports experiencing heart palpitations, ‘fluttering’ or noticing ‘skipped beats.’

BP and HR recorded at the onset of obtaining the tracings, and on separate ‘charts (each lasting ~5 minutes).’ The separate 'charts' were recorded over a period of 1 ½ hours on the same day although a brief break occurred between the recordings as well as a "comfort break."

135/105 - 86 bpm; 159/105- 84bpm; 115/94- 66bpm; 147/103- 77bpm; 118/73-68bpm; 164/139- 75bpm. (I find it interesting the two lower BP recordings were obtained)

On the separate‘charts’, there were frequent extrasystoles occurring during the recordings, and in a couple of areas the HR diminished to approx. 35 bpm for periods that lasted from 15 to 30 seconds, and then returned to the 75-86 level.

Respiratory rate ranged 20-24, and was pronouncedly ‘waxing/waning," very similar in appearance to Cheyne-Stokes, but there was no complete periods of apnea (although significant descending tidal volume to near apnea).

As a safety precaution, and based on the BP recordings, change in HR, and extrasystoles, I suggested he may want to consult with his physician and undergo a physical. I did so for concern ‘there may be’ some other heart problem which needed addressed.

Thank you for your time in reading the lengthy email and commenting;

xxxxxx

Date: Thu, 22 Aug 2002 16:40:39 -0500
From: xxxxxx@houston.rr.com
To: andrew@heartmdphd.com
Subject: hard question

well, here's one for you..and only you can tell me. remember the email I wrote asking if a stent could be replaced/cleaned out etc.. on this friend of mine.. well ...
here's the scenario. He was over here a couple of weeks ago all day and told me how much 'chest' pain he had been having the prior 2 days and was just about living on his nitro. Also, the pain was making him very weak. Told him to seek help PDQ .. he did. After testing ( unfortunately, Dr Maislos, was out of town) they did a double bypass. Now, he was 71 years old and in only fair health..and had slowed down a lot. took all his meds, lipitor etc etc etc and diuretic. after surgery.he was in ICU 12 days. Off and on respirator and O2 ..and his kidneys NEVER did start functioning again. He was only semi conscious 2 days and then totally 'out of it' He died 'naturally' ..
now..the 2 hard questions.
When tests show the person is in that bad a condition is a bypass totally necessary ?
and .. IF he had written a directive to physicans.... and a medical POA .. could he have been removed from life support ?
I have both these instructments and I sure as hell know I do NOT want to lie in ICU 12 days on 'display' with no chance to live and not have the 'right' thing done.
You see, I feel very strongly about not prolonging death .. (you sure are not prolonging 'life')
just take your time ..and then when you're ready .. I'd like to hear your thoughts about this.
sorry this is so long ..but ..just HAD to ask you ..

xxxxxx

From: xxxxxx@webtv.net
Date: Mon, 19 Aug 2002 21:30:47 -0400 (EDT)
To: andrew@heartmdphd.com (Dr. Andrew B. Chung, MD/PhD)
Subject: MRI

I had car accident and my attorney wants me to have an heart MRI to rule out acute heart attack as result of accident and any previous MI.On doctor's order request form how should(acute and old MI) these two things be written?Thank you Dr.Chung.
xxxxxx

From: xxxxxx@parker4218.fsnet.co.uk
To: andrew@heartmdphd.com
Subject: Angina?
Date: Mon, 19 Aug 2002 11:43:46 -0400

Hi I am In the u.k, I am very concerned about my brother, he is 46yrs old, on holiday in ireland a week ago after approx nine days of drinking of which I will stress he would be consuming,pints of cider, about 4 a in the day, he would then continue into late evening drinking double whisky,s with ice approx 10 or 15 this happened every day for the nine days, on the tenth day being in the local bar after drinking his first pint he went to the toilets where he threw up the pint he had drank, this he would do regularly the next morning after a skinful, returning from the toilet he developed pains in his chest, he thought it would go away it did,nt he began to panic and walked to the hospital near by(Royal Victoria,Belfast) when there he was given a E.C.G. a drip was put in blood was taken and tablets were given, He was kept there for four days as he was returning home the following day by plane at first we were unsure wether he would be able to travel, his last E.C.G came back normal we were just waiting for a blood result and then he could go . He was given a letter to take to his G.P at home. All was well and he was allowed out under the understanding he went straight to the G.P. he was told he would have to go into hospital over here to continue tests, he has to have a heart scan and go on the treadmill to be assessed. He was able to get to see his G.P 4 days after he returned, he has took another blood test, G.P said he will have to go into hospital for tests but will only be in for a day, Nothing has really been explained to him, in Belfast they suspected Angina? and said something about a slight defect to one of the heart valves, we are all left guessing and very worried, He is a binge drinker and as i,ve said consumes a lot when he starts and has done this for numerous years, the medication perscribed is aspirin, Lansoprazole,thiamine and vitamins, we don,t know WHY these have been perscribed, could you please give us your analysis to all the above. We would be extremely grateful and may help with the worry I would like to add our dad died of a heart attack when he was 67 he did smoke unlike my brother, thankyou for your help.
xxxxxx

Subject:ECG
Date: Sun, 18 Aug 2002 20:12:16 -0700
From: xxxxxx@tiscali.co.uk
To:andrew@heartmdphd.com

Dear Doctor Chung,

I was interested reading your replies in the Google Groups. In fact I am particularly interested in the subject of hypertension as my own doctor prescribed amlodopine on the basis of my ambulatory readings of 125/87 average and pulse average of 59 (24 hrs) My clinic readings were MUCH higher. (diastolic especially) and as a rule my own readings taken with my digital monitor are less than 135/90. Often 130/80 or lower. I felt that immediate treatment with drugs was contraindicated but I now realise that there is no universal truths in hypertension, except that generally lower is better and the risk of medication is worth it However, I had an ECG recently, and although my doctor glanced at it and said it was fine, I would be pleased if you could have a look at it. I tried to learn to read it via http://www.ecglibrary.com/norm.html but I fely my patterns dont match the normal patterns depicted in the guide to interpretation on that website.
I realise its rather rude of me to ask but I dont really want to bother my GP

Hope you can help.
Many thanks/

xxxxxx

To: andrew@heartmdphd.com
From: xxxxxx@canada.com
Subject: muscular problem
Date: Wed, 14 Aug 2002 07:09:28 -0700 (PDT

Hi Dr Chung,

I have been following your threads on sci.med and am pretty impressed with your responses. On that note, I would like to get your opinion on a medical issue.

I know this isn't your area of expertise, but I would like to know if you have any idea about this problem of mine.

I have suffered from jaw pain and shoulder pain/musculoskettal problems for quite a while. (app 10 yrs) Needless to say, I have tried almost every therapy out there and still struggling to find something that would give me relief on a consistent basis and give me a stable life.

I'm pretty young at 37 yrs old and pretty intolerant of physical exercise. One of the things I was told was that I had a rotator cuff and was prescribed much physical exercise which I did religiously, but everytime I did, the pain just got worse. Sometimes I will get some relief, but it is usually short and not consistent. After months of treatment, I am finally convinced it's not a rotator cuff. My muscles might have become stronger, but the original pain profile is still there. Pain ranges from strong headaches to dull and stabbing, varying from day to day and are located around the shoulder areas, neck and jaw areas. There seems to be a connection between the jaw pain and the shoulder pain like in a cycle. If I am able to relieve the pain in some of the shoulder area, I am positively able to relieve some of the pain in the jaw area. It's a chicken and egg situation. Is it a TMJ problem which is giving me shoulder pain or is it my shoulder pain which is giving me a tmj kind of symptoms ?

In my history, I had 4 wisdom teeth taken out under general anesthesia . I also hurt my shoulder badly when working out on machines. Any kind of racket sports make the pain worse and unbearable. I need to take pain relievers the next day. Puch ups do the same thing.

So, I'm at a point where I'm trying to think hard what possibly could have been missed by the doctors. Maybe the difficult part is that 2 problems are present here and feeding on each other. Maybe I have a mitochondrial myopathy kind of problem which affects my muscles, but that would affect all of my muscles , not just neck and shoulder muscles. What do you think ?

Thanks for your feedback and let me know if you need to know some other parts of my profile that I might have missed.

xxxxxx

Date: Tue, 13 Aug 2002 15:05:15 -0400
From: xxxxxx@lcs.mit.edu
To: andrew@heartmdphd.com
Subject: Elevated heart rate after dietary changes / exhausting run

I decided to drop from 195lbs to about 185 or 180 (I'm 6'3", 26 y/o) for an upcoming marathon. I run a decent amount (30-40 miles per week), so this is fairly easy; I cut my diet back from whatever it was before (3500+ calories) to around 2800. Over the last week, I've noticed that my heart rate is about 10 bpm higher while maintaining the same pace running. On the low end, I would normally run a rest day at 9 minute miles, with my heart rate at about 130, but now it's up at about 137 or 138 for the same pace.

My resting HR is unchanged, at about 43-47.

The complicating factor is that I goofed two weeks ago and ran an 18 miler too fast on a really hot day, and completely exhausted myself. After some cold gatorade and food, I was OK, however.

My diet is fairly healthy; lots of fruits and veggies, and I'm fairly certain I get enough protein. I take supplemental calcium and vitamin C.

My best guess is that my glycogen stores are depleted still, but I'm not certain. I seem to be responding more poorly to running in the heat than I did a few weeks ago, so I'm not sure if that's what's doing it.

Any suggestions or pointers you have would be welcome. I have medline access, and I'm happy to go digging around, but I'm not certain on which avenue to poke first.

Thanks,

-Dave

Date: Tue, 13 Aug 2002 03:22:15 -0700 (PDT)
From: xxxxxx@yahoo.com
Subject: We needyour advise - Please HELP
To: andrew@heartmdphd.com

Dear Dr. Andrew B. Chung, MD/PhD,

My 6 year old daughter weighing 20 kgs has been recently diagnosed to have "ATRIAL SEPTAL DEFECT" measuring 10mm. She is however physically active.

The 2-D Echocardiogram report is as below: The interatrial septum shows a moderate sized ostium secumdum ASD measuring 10mm. The shunt is left to right. The superior rim is 16mm and the inferior rim is 18mm. The defect is away from the Mitral & Tricuspid valves. The right atrium and right ventricle are volume overloaded. There is no evidence of pulmonary hypertension or pulmonary stenosis.

We have found that a treatment called "TRANS CATHETER CLOSURE" has been recently developed.

Please help us to know which is the best remedy possible and whether the above treatment "TRANS CATHETER CLOSURE" is successful and advisable for her. Also please forward any details regarding which Doctor is best renowned to do this closure and the approximate cost in Bombay, India.

Sorry for bothering you, I hope you will understand our anxiety and concern. Please do reply, we are banking on you. My e-mail ID is xxxxxx@yahoo.com

Thank you, God bless you,

Nogesh

Date: Fri, 9 Aug 2002 09:42:02 -0700 (PDT)
From: xxxxxx@yahoo.com
Subject: the lunatics posting anti-Chung venom
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)

I've read your posts on sci.med and sci.med.cardiology for years.

I find the recent vitriol directed toward you an absolutely amazing example of a very disturbing psychopathology. Some of your detractors should probably be locked up for everyone's protection.

The hatred is beyond comprehension. The lies and charges are bizarre.

You have my deepest sympathy for the grief these lunes are causing you. I was esepecially disappointed by C. Gregory. He has in the past usually been far more reasonable.

I'm using a pseudonym, but a functional e-mail address.

Please don't stop providing advice on sci.med.cardiology. You have helped a lot of people.

From: xxxxxx@aol.com
Date: Thu, 8 Aug 2002 22:41:36 EDT
Subject: Just a note to you.
To: andrew@heartmdphd.com

If I were in your locale.... YOU would be my cardiologist.


Subject: Question about website and diet
Date: Mon, 5 Aug 2002 15:45:42 -0500
From: xxxxxx@cox.net
To: andrew@heartmdphd.com

Hello,

I am Frieda xxxxxx, better known as xxxxxx on the newsgroups. I wonder if your 2 lb. diet might be better received with the common disclaimer for consulting a physician before changing diet, exercise, etc.

It is only a suggestion to have it better received for those I perceive to be very resistant to trying anything new. Unfortunately I have found that the overweight most in need of change are also the most resistant to changing their habits AND pointing fingers. Even those of us that want to change, have haphazard results and return soon after to our 'comfort.' Like many of my overweight peers, I have amassed some knowledge in the area of obesity and fitness, and was approached by Weight Watchers to be a counselor at one point, but I had insufficient personal time to assign to this activity.

I have been up and down on the scale at least as many times as I was pregnant, and have a medium to bad family history of hypertension (both parents) heart disease (father had quint. bypass), Type II DM (father) and stroke (maternal grandmother). I plan to try your diet as soon as I can get a scale, which I hope is soon.

I have never smoked, drink 2-3 times a week for only one drink, and didn't drink for over 25 years at all. I feel at wit's end with the lack of energy (I used to work out often including walking, wind sprints, and weight training) and insufficient weight loss despite my efforts while on atenolol, and when I find a new doctor, will seek to find a better alternative. I read many things on beta blockers that seem to point to good preventative medicine, but my quality of life AND MY WEIGHT has suffered tremendously. I have been cutting back on the atenolol every day and taking my bp with a regular cuff. Is this sufficient for backing away from it? I don't plan to discontinue completely unless the doctor says I can, or unless I am now down to a negligible amount per day. At present..it's 25 mg every other day, with half that in between, and I seem to maintain at most about 130/85 along with the HCTZ, which I want to be off of. I have more energy now than before, but my weight just doesn't budge. I also take .088 mg Synthroid, and it is time for my biannual TSH and renal test.

Despite what others say about your seeming (?) arrogance, I find it refreshing to find someone that takes their time to inform others here in usenet. It appears that the more knowledge, confidence and/or curiousness that one has, or shows, the more enemies they find. Their loss. :-)

Sincerely,
Frieda xxxxxx

From: xxxxxxx@aol.com
Date: Sun, 4 Aug 2002 23:40:30 EDT
Subject: Hello
To: andrew@heartmdphd.com

Hi ! My name is Ciara and I am 14 years old. I was wondering can a xray determine that I have a breathing problem? I have a dorsal hump in my nose and I noticed that I have trouble breathing through my nose.

Thanks, Ciara

From: xxxxxx@cox.net
To: andrew@heartmdphd.com
Subject: My 77-yr-old father frequently faints?
Date: Mon, 29 Jul 2002 01:39:20 -0700

Over the last several years, my 77-year-old father hasn't been able to find a solution to his 'fainting spells'. He would like to be able to have a few intelligent medication suggestions or questions for his doctor, to explore different avenues.

He is 5' 9", weighs 180 lbs.; struggles with angina (...has had 2 or three angioplasties in the last 5 years); experiences stomach digestion problems and periodic chest pressure; otherwise seemingly reasonably healthy, other than the fact that he experiences serious fainting problems quite often. He does monitors his blood pressure and has observed that whenever his blood pressure falls between 100, to high 80's (...88/55 not being uncommon), he cannot even take a walk without having to stop and lay down until he stabilizes, and then gives up on the walk.

Might there be some sort of medication which he could have handy and take, as needed to quickly and temporarily increase his blood pressure, whenever he feels these fainting spells coming on....?

Current Meds:
(1) Metoprolol - 50mg, morning; 25 mg, evening
(2) Lipiqor - 10 mg, once/day
(3) Tamsulosin - 0.4 mg, once/day
(4) Losec - 20 mg, once per day
(5) Aspirin - one per day

Your suggestions are much appreciated.........

Harvey xxxxxx


From: xxxxxxx@mail.k-inc.com
To: andrew@heartmdphd.com
Subject: blue eyed baby
X-OriginalArrivalTime: 28 Jul 2002 17:19:05.0634

DOC;

MY QUESTION IS; CAN 2 BROWN EYED PEOPLE HAVE A BLUE EYED BABY?

THANK YOU

BOB

--
HAVE A VERY GOOD DAY

From: xxxxxx@prodigy.net
To: andrew@heartmdphd.com
Subject: statins and elevated CPK
Date: Thu, 18 Jul 2002 09:18:25 -0700

Andrew,

I hope you don't mind me asking you this outside of the cardiology newsgroup, where I read your response concerning Lipitor and muscle aches. I had a similar reaction under Lipitor, slighly elevated CPK that returned to normal after cessation of Lipitor. My question is, Are all statins equal in their potential to cause this reaction? I'd like to be taking a statin, but my doctor has suggested that I'd have a similar CPK reaction to all members of that class?

What do you think? Thanks in advance,

xxxxxx


Date: Wed, 17 Jul 2002 17:14:19 -0500
From: xxxxxxx@houston.rr.com
To: andrew chung (andrew@heartmdphd.com)
Subject: got a question ..

as usual (g... and will go directly to you instead of going to the NG ..

briefly ..I have a friend .. male 70 ... reasonably good health..had a heart attack about 4 years ago. Had a stent put in ..and now it's clogged up (don't know how much etc.. but it's enough to be realllly to be slowing him down and making his left arm 'weak') .. my question is ..(and I dont' know why he hasn't gotten a good answer from Dr xxxxxx (our cardio?) but .. can a stent be 'cleaned out' ?.. or can it be replaced ? Is it too risky to try ? Would that be a reason for hesitation ? I don't know much about this first hand ..so, forgive the lack of details ..
Hope you're doing well .. and my Chol is doing great ! .. and now LoCholes has gone generic ! Bout time .. it was about $56 a CAN !
deep bow (G)
xxxxxxx

From: xxxxxx@aol.com
Date: Sun, 14 Jul 2002 13:51:31 EDT
Subject: Hi Dr Chung
To: Andrew@heartmdphd.com

Have been following some of your posts and am impressed with your knowledge and obvious ability to "speak" with the layperson and answer their questions and concerns "without" sounding so pedantic as SOOO many docs in my experience seem to do!!

Good luck tho trying to deal with "doe" ie ironjustice the" iron causes everything freak!! " The guy truly is a loon,,,invading every newsgroup with his junk.....continue please to counter whatever misinformation he is propagating,,,,as he seems to "back off" when you provide real info,,,as to young Kelly the gal with pvcs....I just read her latest info re her porta cath being too far into the heart causing the arrythmias,,,etc...

I am a nurse practitioner with a master's degree in nursing,,and 35 years experience since RN school...so undoubtedly I am old enuf to be your mother!!...however my experience has been in primary care med and so I am NOT afraid to admit that my cardiology is somewhat limited,,,at best..

But a question,,personal...tho it be...my 62 year old hubby had a massive anterior MI in Feb 2001...the guy was a "risk factor waiting to happen" which I will not bore you with...but neither of us was a bit surprised when the event happened!!

Luckily...he received prompt and excellent care...thrombolysis with TNK (just an aside...Genentech "used" him in their annual report this year!! as their poster boy for their product...it is available online at genentech.com,,,I think!!)...anyway...he had at least 90-95% occlusion of LAD,,,and after a harrowing experience prior to the clot dissolving (my sister the cardio nurse called his ST segments "tombstones" !!) he underwent angioplasty with 3 stents...since then he "obviously" has changed his lifestyle..takes statins and an ACE,,,,excercises,,,lost weight,,and retired from his ultra high stress career...all great...right??

Only ONE problem..and it is a biggie,,,in my book...he is totally impotent and NOW has a totally "crooked penis" so even with Viagra...which WORKS in the erection dept....we cannot have intercourse without excrutiating pain,,etc...so we don't even attempt it....needless to say...I miss the intimacy...tho our marriage is strong,,and just having him around after the MI is without a doubt better than NOT...

MY question:...is it possible that the angio itself...which caused a HUGE hematoma and lump that lasted months ...have caused the BEND in his penis?? I have read enuf about Peyronie's disease,,to realize that might be it...but am wondering WHY this never happened BEFORE the cath??? as far as the impotence,,,I also realize it is probably the statins...he was originally on Lipitor....and the impotence occured almost immediately....when he stopped it for a month due to muscle weakness,,,he was able to achieve erection,,however it was then that we "discovered" the "crooked penis" problem!!....Several months ago his internist gistgave him Viagra samples...tho he did NOT profess to understand the crooked penis problem...as I say..the erection problem IS treated by the Viagra...

I also realize that athersclerosis is a body wide affliction,,,so the penile vessels are probably also affected..but again,,,why did this not manifest itself PRIOR to the cath?? My question is can the cath procedure itself cause plaque to be "liberated" so to speak,,,into the penile vessels??? OR,,and this is my biggest question,,,could the angiogram and the swelling,,etc that followed,,,cause a NERVE impingement or something that has caused the crooked problem??? and lastly....WHO or what specialist should we see??? If it is plaque.,,,,is their anything that can be done??? If it is a nerve problem,,,is it too late to reverse any damage??

I realize this is a big question to "ask" you.....as you can imagine,,my husband is pretty mortified by this turn of events....he FINALLY asked his doc about it over a YEAR after the events started!!! We currently do not have a cardiologist following him....due to insurance screwups,,,and his internist is quite skilled at following him medically...

Thanks in advance for any guidance you might be able to provide...I just sorta needed an "expert" like you to bounce some of these questions off of...we both have a fair amount of medical knowledge...ironically he spent his entire career in the medical device industry..selling,,you guessed it....open heart surgery stuff!! But it sure is different when the event strikes so close to home....as they say...medical people can make the worst patients!!

hoping to hear your ideas..and thanks again for trying to shut up the irondude...I have tried the past few years to reason with him....but he is a pretty lost cause...

xxxxxxx/////southern calif


To: andrew@heartmdphd.com
Subject: dehydrated foods
Date: Sat, 13 Jul 2002 21:45:23 -0700
From: xxxxxx@sonic.net

Hi Andrew,

I found your diet and website interesting, but have a comment about the following, in your FAQ:

----
Wasn't the food the climbers would have taken when climbing Mount Everest dehydrated or freeze dried.

Ok... 10 lbs of dried food + 4 lbs of snow = 14 lbs of rehydrated food.

14 lbs divided by 7 days = 2 lbs per day.
----

I go camping and backpacking regularly and eat lots of deyhdrated foods. Typically they require between 2 and 4 times their weight in water. (e.g. 4 ounces of dry food might require between 8 and 16 oz of water depending on whether it is an entree or soup).

So, even taking the low end of that figure, 2 times, we get:

10 lbs of food + 20 lbs of water = 30 lbs or 4.3 lbs per day.

This is similar to Shintani's review of the diet litereature which shows that people who free feed (eat as much as the want) are satisfied with around 4 lbs of food per day.

I am intrigued by your diet, I was able to keep off 40 lbs for a year by journalling and counting calories (and eating whatever I wanted, just in reduced quantities). It was very hard and unpleasant work and I finally was unable to keep it up. I hate journalling. I hate stopping eating when the food looks so good. By sheer will power I can do it for short periods of time (a few weeks to a year), but it never seems to become habit for me. Needless to say I have put the weight back on. I don't see how I could convince myself to only eat 2 lbs of food per day for the rest of my life. I could do for a little while, but not for the rest of my life. Sucks.

--
Michelle xxxxxx
xxxxxx@sonic.net

Date: Fri, 12 Jul 2002 20:31:31 -0700
From: xxxxxx@shaw.ca
Subject: Question from fellow MD
To: andrew@heartmdphd.com

Dear Dr. Chung,


I am a 41 year old primary care physician in Victoria, BC Canada. I have been diagnosed with a BAV 6 years ago. It was found accidentally on a routine echo. So far everything looks OK. I had three sequential echos one year apart that showed no change, with the last echo 3 years ago. It showed mild (2+) regurg and my aortic root at 38mm (normal 20-37) with my ascending aorta slightly dilated at 41mm. I am completely asymptomatic and healthy. There was not much of a gradient there perhaps 15. My next echo is scheduled for next week.
Being a physician myself all the studies I read are usually with people that have significant pathology and are worrying me. I have also read in some journals that "most" people with BAV will live a normal life and wont require surgery until their 70s or 80s. Seeing as it is perhaps the most common congenital heart abnormality, I am wondering if you have any information on what proportion of BAVs go on to complications and what factors are predictive of the probability of replacement or repair of the valve.

Thanks,

xxxxxx


Subject: Summer Science Research Student
Date: Wed, 10 Jul 2002 13:39:34 -0400
From: Jonathan xxxxxx (xxxxxx@optonline.net)
To: andrew@heartmdphd.com

Dear Dr. Chung,
My name is Jonathan xxxxxx and I am a sophomore at Clarkstown South High School in West Nyack, NY.
Currently, I am enrolled in a summer science research program that will continue through the next three years. The topic that I have chosen to research is Wolff Parkinson White Syndrome, as I had this disease and recently had an ablation to cure it. While looking for background information online, I can across your webpage. I was wondering if you could possibly direct me to a more specific topic under the general idea of WPW. I understand that it is now known that this disease is hereditary and involves a mutation on chromosome 7 of the gene PRKAG2. I was thinking of possibly doing a project on the heredity of WPW, but I am not sure if that will work. Do you have any ideas as to how I can turn the topic of WPW into a research project? Any of your advice would be greatly appreciated. Please respond to this e-mail at your own convenience.
-My e-mail address is xxxxxx@optoneline.net
-My address is xxxxxx Rd.; West Nyack, NY 10994
-My phone number is (845) 358 xxxx
Once again, thank you so much for your time.

Sincerely,
xxxxxx

Subject: FW: Your Online Donation to Doctors Without Borders
Date: Tue, 9 Jul 2002 11:24:10 +0200
From: xxxxxx@eu.odedodea.edu
To: 'Dr Andrew Chung' (andrew@heartmdphd.com)

RE: Consultation for Second Opinion of Dilated Cardiomyopothy

Dr. Chung:

I am contacting you to schedule an appointment for a second opinion on the current state of my heart condition, treatment and likely outcome/recovery.

Most recently, the results of a myocardial biopsy revealed I have parvo B19 positive active myocarditis. I intend to travel this summer to the US for this purpose.

I am an American presently living in Germany (I work for the US Government), and although I feel confident in the actions and competency of the Cardiologists here, I feel the need for a second opinion. Perhaps to abate my concerns over explanations that "get lost in the translation" and/or a more aggressive approach to the treatment of my issues (particularly raising my ejection fraction).

Over the past year (since June 01) been diagnosed with 1st degree, then 2nd degree heart block, explained as degenerative disease of the conductive system (LEV or Lev Lenegre's Disease). Due to continued degeneration (frequent EKG, Echo, and Holter monitoring) by Nov 01, I had complete heart block and had a pacemaker implanted (11/01).

All seemed well. By February 2002, I was then diagnosed with aitrial Fibrillation/Flutter - as I was then complaining of shortness of breath. In May 2002 I was hospitalized for an episode of Ventricular Tachyardia (3 days).

Currently am suffering from a dilated atrium and ventricle and on June 5 had the biopsy preformed . Also during that procedure, a catheter ablation to correct the aitral fib. was done (sinus rhythm restored). At the time of the biopsy, my ejection fraction was 32%.

As I mentioned above, the biopsy results revealed I have a Parvo B19 positive active myocarditis. This result has just come in (analysis took 4 weeks) as such, I have not yet gone for the recommended treatment (3-4 days treatment of pentaglobin). I have not yet received a "complete" biopsy result, just a quick email from the biopsy cardiologist indicating the finding and treatment.

Some of the issues I'd like addressed are: What is parvoB19 and where did it come from?
Is the recommended treatment (pentaglobin) the only course to follow? What other alternatives are out there? Is it likely that my heart could return to (or partially) "normal size? Will my ejection fraction increase? What else can I do to improve my heart function? (I'm open to any type of alternative/non traditional therapy).

I have much more detail about my condition/symptoms/medications/history etc.. over the past year. Being a 45 year old healthy person (prior to that rarely went to the Dr.) I refuse to accept that in one year my heart (and health) have deteriorated so quickly and severely(walking up a flight of stairs gets me out of breath).

Any advice, opinions or recommendations you may have would be greatly appreciated. I can FAX or Email any and all reports/results from any of my cardiology visits here in Germany. Per your web page I am forwarding below the return message from Doctors Without Borders.

Cordially,


JULIAN xxxxxx

Subject: Cardiology
Date: Thu, 27 Jun 2002 12:37:39 -0500
From: "shannon montbriand" (shannon@hctran.com)
To: andrew@heartmdphd.com

Dr Chung,

Hello! My name is Shannon Montbriand and I am a physician recruiter for Healthcare Transitions. I was searching for CV’s on the internet and came across yours. Currently, I am recruiting a cardiologist for an excellent opportunity. If you or anyone you know are interested, please contact me toll free at 866-311-0000. Or, if you have any information regarding cardiology that may help me, please let me know. I look forward to hearing from you.

Sincerely,

Shannon Montbriand

Recruiter

Subject: Your Online Donation to Doctors Without Borders
Date: Wed, 26 Jun 2002 21:06:13 -0700
From: xxxxxxx@tds.net
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)

Wow! I really appreciate your quick response. You are providing an excellent service, which makes me want to donate more money to Doctors Without Borders. A couple of points. The doctor who never spoke with me regarding my echo results IS a cardiologist. The botched ablation was done with a basket catheter mapping device. They were nowhere near my AV node. For some reason no one understands, both my AV and Sinus node were damaged. I thought you might be interested as this involved some relatively new technology. I am in California, so I guess I'm not close to you, but I wish I were! One last question...
The ejection fraction of 60%--what significance does this have? Again, I very much appreciate your dedication.

Linda xxxxxx

Subject: Usenet postings
Date: Wed, 5 Jun 2002 10:19:45 -0400
From: xxxxxx@scn.org
To: "andrew@heartmdphd.com"

Sir:

I have been following the flame wars over your two pound diet on the sci.med.cardiology new group. I was married to a woman for 19 years who was obese. 300 pounds plus for many years. 150 when I married her at age 21. I have seen about every fad diet there is. In fact, I have lost weight on most of them at one point or another. Everytime my ex went on one of them we all went on the damned thing. I had to sneak my kids out for junk food simply so they got a reasonable calorie intake as what was on the dinner table was often a joke. Well, guess what? She lost a little weight on some of them for a few weeks then gained it all back plus some friends. And it was always the familys fault because we were not giving her the proper support. Thank goodness she finally became so convinced that it was all my fault because I was such an asshole that she wanted a divorce and threw me out. Today I am very happily remarried (14 years) to a wonderful woman who is not overweight. And the last time I saw my ex several years ago she weighed more then ever.

I personally think your two pound diet makes a hell of a lot of sense. Simply eat less!!!!!!! What could be simpler? There is only one small problem. Most fat people are not going to change. Why? Who knows. Maybe it is simply because they have psychological problems, maybe they simply like being fat. I do not have a clue. I have a very good male friend who is very overweight. 300+. Yesterday his doctor told him they may have to amputate one foot and he must retire immediately. Mike is 60 and has no money. He has adult diabetes, some eye problems, high blood pressure and water retention out of this world as well as poor circulation in his legs. His physicians have been telling him to loose weight for years. He gets zero exercise. To walk 50 yards is a major effort and causes very heavy breathing. I would guess that by 50 yards his heart rate is sky high. Probably 175. Oh yes, he smokes 4 packs of lung busters a day. Mike is a very intellegent man. But he is a compulsive personallity and simply refuses to loose weight. He gave me some shit yesterday about how he hardly eats enough to keep a bird alive. I have eaten with him and know his eating habits. If I ate what he eats I would be a balloon. And I run 10 miles a week and walk 20 over and above a naturally very active life style. Seems fair for a 61 year old to me.

You do not have a hope of even breaking even in the flame wars on the net. You keep thinking that these people are rational and reasonable. I submit that you are dead wrong. They are not at all rational. They worship crystals and magnets and other occult healing aids. They spend a lot of money on bee royal jelly and other magic elixers. They will do anything rather then face reality and admit that they have a weight problem because of their own lack of simple will power. They have read it all in prevention magazine and know that the chemists we have these days all work for the government and are poisoning all of us with toxic emmisions from airplanes.

The flame wars can be fun I know. But do not dream that you will change any of these folks. It aint going to happen sir But thanks anyhow for trying.

By the way, I am not a health nut or anyone particularly unusual. I am an ex smoker of 30 some years on the drug. I am an ex caffiene addict of equal length. I quit both drugs at the same time. Giving up smoking was not hard at all. Giving up caffiene was the hardest thing I have ever done in my life other then learn to read German in grad school. But with both I simply decided to quit and I quit. Been dry of both for 15 years. Still like to sit downwind from someone smoking a good cigar. But have not touched one in 15 years. Caffiene is the next target someone should go after. I have seen it really mess up a few addicts life when they could not control it. And if you are overweight it makes staying on a diet almost impossible.

Nice to see a real doctor post on the net as opposed to most of the internet dummys that live there. Best of luck to you.

xxxxxx

Subject: why the huge drop in my mother's HDL?
Date: Fri, 31 May 2002 22:54:45 -0400
From: xxxxxx@scrtc.com
To: andrew@heartmdphd.com

Thanks again Dr. Chung. Yes, my mom is hypo and she's was suppose to have had a thyroid panel done with her other blood work. Somehow they forgot at her doctor's office, but she has rescheduled.

I'm borderline hypo myself (but with no symptoms) and perhaps that is why my total cholesterol is 185 after decades of being in the 160 to 170 range. Then again, maybe it's just the fact I'm older. Regardless, I have added 18 ounces of 100% grape juice to my diet so anxious to see if that has any effect on my cholesterol level.

Just curious if you agree with one of my observations and that being that long-lived people (90 and over) share one commonality and that's high levels of HDL. The Wall Street Journal had an article about some scientists studying siblings who live over 90 and that was one of their findings. Some of us will never have high HDL levels so I'm going after longevity by getting my total cholesterol/HDL under 3.

My lady friend has a 89 year old mother and 84 year old father who are in remarkable shape. This lady friend herself is in remarkable shape at 53. Never sick a day in her life, always in a good mood etc. And she has the worst diet imaginable. I suspected her genes (and cholesterol) were the cause and I had her get a cholesterol test. Total cholesterol 161 and HDL 77!

Many of us appreciate your participation in the newsgroup.

Gary xxxxxx

Subject: Any more doctors like you in the world? ;-)
Date: Mon, 27 May 2002 04:44:14 -0700 (PDT)
From: xxxxxx@yahoo.com
To: andrew@heartmdphd.com

Dr. Chung,

I admire your willingness to discuss medical details with anyone, medically trained or not, as shown on the newsgroup sci.med.cardiology. Are there more cardiologists like you? Specifically, can you suggest a cardiologist in the Detroit metropolitan area with a similar willingness to discuss the details and provide full information to a patient?

Thanks in advance.

David xxxxxx
a patient whose doctors appear not to like to talk the facts with patients


Subject: EKG advice
Date: Wed, 22 May 2002 02:41:14 +0300
From: xxxxxx@otenet.gr
To: andrew@heartmdphd.com

Dr. Chung,

Kudos on your http://www.heartmdphd.com/medfaqs.asp page. Well done!

I am a 42 yo male, slightly overweight with minimal physical exercise (but started regular fitness walking recently), suffer from occasional PVCs (with normal echo and stress test), borderline hypertension (diastolic 80 to 90+) and had been on Inderal for about 2 years when I was about 20 yo. I have also been diagnosed with very mild mitral prolapse (with no regurgitation). PVCs were caught in a 24h Holter (which showed 4 couplets too) which was normal. Yet, I have resting bradycardia, around 50+ ppm (at times when I am really quiet and settled -- at work, beats are always 70+) or even 45 when asleep (the doctors did not seem to be concerned about this).

My question regards an EKG that I had about a few years ago, which read "borderline" and mentioned "intraventricular conduction delay". I had done that EKG right after the only arrhythmic episode that I had in my life (laster about 1.5 hours but did not catch it on the EKG, so me and the doctor speculated it might have been a lone episode of a-fib); in fact my PVCs pretty much started back then and continue, much abated thank God, to the present day.

I would appreciate your brief opinion on the EKG and any valuable advice you would be kind enough to share.

Very best regards
John xxxxxx PhD


Subject: Weight lifting and ASD repair
Date: Tue, 21 May 2002 14:35:05 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

My son had ASD repair when he was 4 years old. It was successful, he does however, had mitral valve insuffienciency. He is 15 years old, and has been it very good health, he has been in sports very activally since he was 5 years old. My question is he recently had a yearly check up and we mentioned weight lifting. THe doctor said he should not lift over 100 lbs because it may pull sutures? No one has mentioned this before. He said he should do more repetitions at lighter weights. What is your opinion on this matter?

Subject: Cardiologist in Florida
Date: Thu, 9 May 2002 15:58:29 -0400
From: "Mamie Rudd" (mrudd@ameritech.net)
To: (andrew@heartmdphd.com)

Dr. Chung,
Found your interesting website while looking for information on Cardiology Fellows programs. I am a Recruiter/Headhunter who has recently entered the field of Medical Recruitment. Although I have been a recruiter for over 10 years in the high-tech field, the recession put a halt to that part of my business.

My first assignment as a Medical Recruiter is to find a Non-Invasive Cardiologist for a heart clinic in Jacksonville, FL. My client is looking for someone who has recently completed their fellowship in cardiology and who would like an opportunity to grow with their group. They are paying $200k the first year, with a substantial increase the 2nd year and an opportunity to become a partner in the 2nd year.

I have been informed that the salary may be too low to entice the right applicant. Is this true??

If you know of anyone who may be interested in this position, would you pass along my contact information??

Thank you for your time.

Mamie Rudd
Richard Kader & Assoc.
7850 Freeway Circle
Cleveland, OH 44130
Phone: 800-968-3738
Fax: 440-891-1443

Subject: calsification
Date: Wed, 8 May 2002 15:53:43 -0700
From: xxxxxx@bellsouth.net
To: (andrew@heartmdphd.com)

My husband has calsification covering the entire back of his stomach and also on the wall of his chest. This was found through a CAT scan done to diagnose severe chest pain. The doctor said he had never seen calsification to that degree on the stomach wall and asked if he had ever had tuberculosis. My husband also has CLL but the doctor did not see any connection between the CLL and the calsification. The doctor suggested my husband have a tuberculosis test to see if he ever had TB. The chest pain didn't last long and they can't quite explain it. Maybe indigestion?

Any thoughts?

Donna xxxxxx

Subject: INACTIVE TUBERCULOSIS
Date: Mon, 6 May 2002 07:34:11 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dr. Chung,

I have a friend who is an inmate in prison. Yesterday I went to visit him and he told me he was given a TB skin test and it was positive. The doctor told him that it was inactive and he has to take medication for 9 months. I visit on a regular basis so should I get tested to make sure I was not exposed to TB to be on the safe side. I am extremely worried about this. Thank you for any info. xxxxxx

Subject: Heart question
Date: Fri, 3 May 2002 18:20:09 -0500
From: xxxxxx@msn.com
To: (andrew@heartmdphd.com)

My 54 year old husband is a pastor who loves the Lord. I am seeking for him some solid medical answers for treatment of what has been diagnosed as PVC's/mitral valve prolapse. His heart beat suddenly goes "off" for weeks at a time. That is, his heart pauses between steady heart beats. This occurs all day long when it is "off". A Cardiologist gave him Rythmol to take, as needed. This stops the PVC's for about 8 hours but then the PVC's start all over again. This time the episode has lasted for one month without his heart beat returning to normal. He is now complaining of being very tired and says he has some difficulty in getting a deep, complete breath. Please, can you help? Thank you. xxxxxx

Subject: PAT or PAC
Date: Fri, 3 May 2002 18:29:21 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

I've been diagnosed with PVC and PAT (or PAC). I believe PVC is preventricular contractions, but I don't know what the acronym PAT (or is it PAC) stands for.

Would appreciate your response.

Delma xxxxxx

Subject: CardioVision Testing
Date: Wed, 1 May 2002 18:41:35 -0700
From: xxxxxx@worldnet.att.net
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)

Dr. Chung,

Do you know anything about the CardioVision test to measure the brachial artery for the possibility of atherosclerosis/cardiovascular disease/arrythmia, etc.?

My husband took the test today. He is in the low-risk category, but I have to decide whether I want to take this test or not. My insurance doesn't cover it, and I guess I wouldn't know what to do with the results anyway.

Best regards,

Ellen xxxxxx

Subject: high ldl
Date: Sun, 28 Apr 2002 08:42:41 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Good morning

I recently learned my chloresterol level was 293 w a 211 ldl Any sugestions other than meds i.e. nutritional support etc.

Thanks Robert xxxxxx

P.S. Sandra is one of my favorites too.

PS.S. loved the web site

Subject: An email question about the Atkins thread
Date: Fri, 26 Apr 2002 16:04:53 -0400
From: xxxxxx@xxxxxx.com
To: (andrew@heartmdphd.com)

Andrew,

Thanks for taking the time to reply. Your position sounds just like the one I'd expect a reasonable man to take :-) I appreciate your perspective on this obviously controversial issue.

All the best,
Paul

Subject: Student Interested in Cardiology
Date: Tue, 23 Apr 2002 20:57:33 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Hello,
I'm a high school student at Captain Shreve High School in Shreveport, La. We are writing a research paper on our future career choice and I chose a cardiologist as my career choice. I was just curious, I'm sure you're busy with all your work but I want to know if you would be able to your time and fill out this questionaire. And if I may add I would like to quote you on some of the answers in my paper. Thank you for your occupying your time.

Josephine xxxxxx

1) What exactly does a cardiologist do in his line of work?
2) What is the best thing about being a cardiologist?
3) How is the education to become one?
4) What are the disadvantages of being a cardiologists?
5) What are the benefits of being one?
6) What is the estimated salary for the common cardiologist?
7) Are there any benefits?

Subject: Request for comment on my question submitted to newsgroup
Date: Mon, 22 Apr 2002 09:27:04 -0700
From: xxxxxx@email.msn.com
To: andrew@heartmdphd.com

Dear Doctor Chung,

I recently posted a query in the newsgroup sci.med.cardiology but have not received any replies. I notice that you are a frequent contributor to this group so I have taken the liberty to ask you my question directly…, which is:

When I record the blood pressure in my right arm the readings are consistently in the range of 130 or so over 82 or so...but when I take the pressure in the left arm the readings are significantly higher... often around 155 over 90. What is the explanation? I have been told that I have borderline high blood pressure and take 2mg Hytrin before bed each evening.

Thanking you in advance for a brief comment, I am,

Sincerely,

John xxxxxx

Subject: dissected distal aorta
Date: Sun, 21 Apr 2002 14:38:17 -0400
From: xxxxxxx@kw.igs.net
To: andrew@heartmdphd.com

Greetings Dr. Chung,

I'm a recently minted 50-year-old male whose bicycling adventures covered 5,800 kilometres last year and raised $5,500 for charities.
Earlier this month, I was diagnosed with a dissected distal aorta (roughly from below the kidneys into the iliac artery). Maximum size 3.8 cm, too small to operate, I'm told. I was given beta blockers to lower my blood pressure (normally about 142/92) and heart rate. Keep my heart rate to 100 beats per minute, no heavy lifting, and see you again in six months for a CT scan.
Are I missing something or is there no good news in all this? The heart rate level precludes cycling (I bought a heart monitor and found I could stay below 100 by coasting downhill or pedalling on flats), I've ditched my charity work to reduce stress, no one seems pressed to operate (too small, too early) and it feels like I'm being asked to slow down to rocking chair mode for the foreseeable future.
Shouldn't we consider the knife now while I'm fit, rather than later?

xxxxxx


Subject: short pr and incomplete right bundle branch block
Date: Thu, 18 Apr 2002 21:01:31 EDT
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Is further follow up or periodic testing necessary? Age 17 first ekg , sinus rythym vent 59 , pr int 116, qrs duration 104, qt/qtc 388/388, p-r-t axes 4-58-61. rsr in v1 and v2. No delta wave. Stress test normal. Echo essentially normal , trivial mitral valve insufficiency. Age 19 basic ekg, durations p 88 qrs 110, intervals pr 124 qt 358 qtc 385 , axes p 85 qrs 85 t 78. sinus rhythym incomplete rbbb st-t changes in septal lead conistent with normal juveniele t waves. Had symptoms for several months at age 17 but no symptoms now . Doc wants me to see ep cardiologist. Thanks.


Subject: What Do You Recommend I Ask My Cardiologist To Test
Date: Sat, 30 Mar 2002 21:02:54 -0500
From: xxxxxx@email.com
To: andrew@heartmdphd.com

First, thanks much for your time.

I am 50, male, light, intermittent light tightness below and about the lower costal. I am 5'8', 195 lbs with a medium build. My family history is a father with CAD at 55, heavy alcoholic and a paralyzing apoplexy at 62. My mother died of pancreatic cancer at 38. No smoking and 500 ml of alcohol daily. My diet is lo sat fat and is protein/carb dominated. White, two children. Internist physical Nov 2001, EKG OK, BP 120/85

I have a stress thallium for April 12 th after my cardiologist reviewed me M28th. No changes to above but tightness is present since Jan 1. Lightly uncomfortable but no real pain. Comes and goes with rare early morning. Take 80mg aspirin w/ Zantac near daily.

What other test would you suggest I ask my cardio to perform? Blood labs again? Pancreatitis check? Chest X-Ray?

xxxxxx

Subject: aortic aneurysm and coronary artery bypass
Date: Thu, 28 Mar 2002 21:17:37 EST
From: xxxxxx@aol.com
To: Andrew@heartmdphd.com

Dear Sir,

I'am a wife of a 55 yr old who had aortic aneurysm and coronary artery bypass surgery at the same time in 99'. I'am trying to do some research on wheather or not it would have made sense to have fixed the aneurysm first. What happen was the surgeons tried fixing the blockage first, then the aneurysm. He ended up with a hypoxic brain injury from this. What I'am trying to find out is, I want to know if it is reasonable for them to do the bypass first or not? If you can help out in anyway with some type of info, I would be greatly thankful. I hope to get a reply back soon.

Sincerely
xxxxxx

Subject: Link on page doesn't work
Date: Tue, 26 Mar 2002 22:23:01 -0700
From: xxxxxx@cox.net
To: andrew@heartmdphd.com

On the page http://www.heartmdphd.com/welcome.asp , where you say: “Simply click on this link and fill out the form...” the link does not work.

Thought you’d like to know.

Fascinating web site, full of useful and succinct information, thank you.

I found your site after doing more background checking on the EBT Heart Test scan I had done some time ago (got a score of ZERO). Also thought you’d like to know that in my opinion, the message to keep our hearts healthy is really getting out here to the general public. For example, I am 40 years old, slightly overweight but in reasonable physical condition and I went and got that test just for peace of mind. Paid for it out of pocket, too, it was that important to me. Personally, I’m even a touch paranoid sometimes about my heart condition and I always have been, even since my 20s. And the only reason for that is the knowledge that it’s the biggest killer out there yet we have such a great degree of control over it.

I could do better with my heart health (poor diet), and I am improving it, but I think the years of heart healthy messages from the medical community have really hit home with a lot of people. I wonder if the statistics validate my observation. Or maybe it just home with ME.

Earl xxxxxx

Phoenix AZ

Subject: heart surgery after bowel surgery
Date: Mon, 25 Mar 2002 13:30:35 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Hello Dr Chung

I was meant to have mitral valve repair/replacement and RF ablation for AF last Sept but was found to have a tumour in my colon (Dukes A). This was removed in August and my surgeon is optimistic for me. In his words "he expects to cure me". Soon I will travel to London to see the surgeon who was to operate on my heart. In your experience would a heart surgeon want to wait , say, two years after colon surgery before operating on the heart? Or would it all depend on my general condition? During my last surgery in Dec - to reverse the stoma - I was A-systole. The cardiologist I was referred to then and in whom I have little faith gave me an appointment for three months later which was this week. This man said in Oct 2000 that my case was middle range but after an extremely brief examination this week said "sounds moderately severe to me". Our system is so different to yours but, in your opinion, would waiting another year be a viable ! proposition?

The only medications I take are Digoxin and a diuretic - nothing for AF.

Hope you can comment

Thank you

Diana

Subject: Questions about aortal valve leakage
Date: Wed, 20 Mar 2002 13:06:58 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dear Dr. Chung:
I am a 53 year old woman, who until recently has had no problems with a "functional" heart murmur (diagnosed at birth). I have also been on synthroid .2 for about 24 years to treat hypothyroidism.

In the beginning of January 2002, I was put on Activella (HRT). About the end of February, I noticed that I was no longer able to do my hour's work out on the treadmill at 3.5 miles per hour pace. By three weeks ago, I was not able to breath well enough to do more than 20 minutes at 2.3 per hour with no incline. My heart seemed to be pounding, and the glands in my neck felt swollen. The accelerated heart rate and shortness of breath now occurs when I wake from a nap or just when I am sitting. Small tasks to which I would have given no thought a month ago, exhaust me.

Last Friday, I had an echo Doppler, and "leakage" in the aortal valve was noted. My cardiologist prescribed 1/2 Toprol XL 50 mg and 1/2 Micardis 80 mg per day. I thought that I notice a difference for the first two days, but today, it is again difficult to breath.(I can breath in and out without a problem, I just don't seem to get enough air). It is the same sort of sensation as when you swallow something just a little too big and it goes down, but slowly. Also, I feel as if someone is pressing on the left side of my chest near the sternum and on the left side of my upper-middle back near the spine. A chest xray done in January showed that my heart is enlarged, but still within normal range.

I will be having a nuclear stress test on the 25th of March. Should the medicine(s) not alleviate the problem, 1. would you recommend a good place to have valve replacement done; and 2. a surgeon or surgeons who excel in valve replacement? I live in the Miami area, but will travel. Any and all suggestions and/or recommendations will be appreciated.

Sincerely,
Judy xxxxxx

Subject: Lactic Acid Emulation
Date: Tue, 19 Mar 2002 12:37:19 -0500
From: xxxxxx@stmargaret.org
To: andrew@heartmdphd.com

The week before I started having the "condition", I increased the resistance on the rower to try to work the upper body. I did feel a bit of discomfort, but attributed it to overdoing it. Part of the reason is that I dislocated both shoulders in a parachute jump with the 82d Airborne Division in 1980 and I have occasion bouts when the weather changes, etc. My cardiologist, when I was in the Army, explained that the nerve endings connect at the same vertebra for the shoulders and heart and there can be some sympathetic pain.

When I had the problems riding, I was at the beginning of my ride and possibly not warmed up. My heart rate was probably low, but I don't know what (didn't wear my Polar monitor). Later I pushed up hills and had no problems. The following Monday I road on the wind trainer and after a warm up of 20 min started pushing and at 158-160 had the problems.

I have been very good about diet, eating a very low fat and cholesterol diet, have increased my exercise routine (last summer I routinely pushed my heart to 160-175 on some tough hills), and have tried to control stress (with limited success). That is why it surprised me when I had the twinges.

Is there a test for angina pectoris? Any recommendations on who to see or how to proceed? I have an appointment with an athletics oriented cardiologist next Tuesday for a second/third opinion.

By the way, my stress test last Friday would have been read as "normal" if I didn't experience the pressure/pain. My cardiologist indicated that there was a slight thinning at the top of the heart as the blood flows in, indicating some obstruction is possible. When I had my angio in 93 I had several blockages, three over 90%, one 98%. Since then, I have not had any symptoms and had an angiogram in 94 to confirm the first balloon was holding (that is when I found about the shoulder sympathy pains).

Thanks you for your assistance.

Rob xxxxxx

Subject:Heart Ablation
Date: Mon, 18 Mar 2002 22:51:33 EST
From: xxxxxx@cs.com
To: andrew@heartmdphd.com

I had SVT which really went crazy in September of 2000. I went and had an ablation in January of 2001. Since that time I am still experiencing like short speed ups and skipped beats. Sometimes worse than others. I am on 25 milligrams of Toprol XL a day. My doctor was kind of dumbfounded when he found out that I still had problems after the surgery becuase he had never had anyone who had problems after the surgery. My heart no longer goes up to 280 beats per minute, but it wants to speed up for about two seconds. I did not have this problem before the surgery. I am a small person. I weigh 118 pounds, 5 4. I watch what I eat and only drink water most of the time. I don't eat much sweets, no caffeine, no soft drinks. I watch my diet very carefully, but still I experience these episodes. I have tried every natural way that you can imagine and still I have th! ese things. Could you offer some advice that might help me or refer me to a doctor who looks at the total body. Someone I feel like there is some off in my body that is causing this symptomatic thing to occur?

Subject: brown eyes
Date: Fri, 1 Mar 2002 23:22:37 EST
From:xxxxxx@aol.com
To: andrew@heartmdphd.com

Hi Dr. Andrew Chung, i am wondering if there was any possibility that two blue eyed parents can make a brown eyed child. And please explane why or why not. This is also not for me it's for somebody that i know. Cause I don't see how it is in any way possible at all !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Please write back as soon as possible.

Thank You,

Kimberly

Subject: Secondary Pul. Hypertension
Date: Thu, 28 Feb 2002 21:30:37 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

You are one in a million! We need more doctors like you!

I, too, enjoy helping people....that is why we are in this field!!!

xxxxxx


Subject: Aneurysm Surgery
Date: Thu, 28 Feb 2002 14:44:25 -0600
From: xxxxxx@hotmail.com
To: andrew@heartmdphd.com

Dear Doctor,

I have read with great interest most of the pages of letters you have posted. My problem is not just regular surgery for the repair of an aneurysm but has been classified as inoperable by my regular cardiologist. He suggested that I should get a second opinion. I had one aneurysm surgery about 18 years ago. Now I have one back just below where the other one was. It has grown to approx 7cm in the last few months. I just had a pacemaker and defibbulator put in at Florida Hospital in Orlando. The Doctor was telling me about how great strides had been made recently on this type of surgery and he certainly felt I should seek a surgeon who was familiar with the macro repair of the aorta. Are you knowledgeable about this and could you please help me.

I would like the name of the best Doctor whom you feel could do this operation. I certainly thank you in advance for your help.

God Bless You,

xxxxxx
xxxxxx@hotmail.com

Have a great day!


Subject: Question on Interpretation of ECG
Date: Wed, 27 Feb 2002 19:51:16 +0100
From: xxxxxx@aaahawk.com
To: Dr. Andrew B. Chung, MD/PhD (andrew@heartmdphd.com)

Ok..jan 2001 first event of atrial fib. Cardizem converted in ER. No medication taken afterwards. Feb 2002.. atrial flutter (133 BPM) cardizem converted in ER. The attending ER cardio (Dr. Brown) said it was flutter (steady beating at 133). When I checked out another Dr. said it was SVT. I fax my copy of ECG to my uncle, a highly respected cardio in Wash... He says its classic flutter and prescribes atenolol (50mg). The ER cardio says that rythmol should be given for flutter and not atenolol. So, is it flutter of SVT?

My BP has been borderline but at times has hit 160/100. Othertimes it has been 130-140/80. Could the BP have triggered the flutter. I had a complete stress test/eco at the hospital last year and everything was fine. Given the BP situation and the flutter (although one Dr. says it's SVT) would the beta blocker be the drug of choice. I can fax you my EKG to confirm it is in fact flutter.

I live in GA and have heard good things about you. I Would like to contribute to Dr's w/o borders but I do not know anything about the organization. I would also like a password for your website. Would you be willing to look at my faxed ECG.

Regards, xxxxxx


Subject: Can you offer any suggestion
Date: Tue, 19 Feb 2002 13:18:32 -0500
From: xxxxxx@golden.net
To: andrew@heartmdphd.com

Dr. Chung:

Along with other meds (Metoprolol, Norvasc, Rampril, and ASA) I use a 0.4mg. Nitro Dur patch daily. In 1996 I had a TURP to deal with a chronic prostate problem. With the combination of the TURP and the meds I experience significant Erectile Dysfunction. Can you give me some idea about:
a) The influence of cardiac meds (Especially Beta BLockers) & E.D. (men) & decreased libido (men & women).
b) With the daily use of the patch Viagra is not an option are you aware of a medication (sic method) appropriate for a coronary patient in this situation.

I work as a volunteer at our local hospital Cardiac rehab program. Seems that this situation is somewhat common among folks taking cardiac meds. The consistent theme is : 1) Beta Blockers (Espec.- Metoprolol)
2) Diuretics

Can you help me out with a reading or research done in this particular area. Most of the men won't volunteer that the problem exists until they find that they are not alone. They are reluctant to bring it up with either their Cardio or GP

Thanks for listening

xxxxxx


Subject:Msg
Date: Sat, 16 Feb 2002 17:23:14 -0600
From: xxxxxx@juno.com
To: andrew@heartmdphd.com

Dear Dr Chung,
I found your site in a search and had some questions. A series of tests recently showed that I had PVC's and the cardiologist I was referred to said that he recommended that I have a mylogram with a treadmill. I am 67 and my max heart rate was calculated to be 150. They wanted to run the stress test to a max of 135 which was 85% of my max rate. They took the mylogram pictures. Then I did the treadmill and was able to go 11 min to a pulse rate of 150. (I ran 30,000 miles and 6 marathons from age 40 to 60). When I met with the cardiologist he said that the mylogram revealed 2 things: I had an ejection fraction of 32% and one of the interior muscles of the heart showed reduced Oxygen. He said that I needed to have an angiogram. I did the next day and he found that my left anterior descending 80% blocked. In fact he said he saw(for the first time) what appeared to be a clot forming at the time he did the angiogram. He put a stint in the artery and said that it was back to 100%. Considering that I have 180 cholesterol, LDL 80, and HDL 70(the highest he had ever seen) he told me he could not explain it and that he could only tell me to go on doing whatever I had been doing. The MD is xxxxxx who practices in xxxxxx, AR. He is board certified and has done 16000 angiogram.

How on earth could I have developed a problem like this? How could the PVC's and mylogram indications have all been false and I still have a problem? I am back to my regular routine with the thought that I need to really be cautious of foods with cholesterol and saturated fats. Howeve, due to the fact that all these years I was told by MD's that I had the lowest potential exposure to heart disease they had seen, I am ignorant about diet. I have eaten anything I wanted up to this posture with this misguided view. How can I become educated on how to eat? My weight is 165 and I am 5' 9"(now, I used to be 5'11")

I noted that you went to Ga Tech and that, also you are a Christian. I graduated from Tech in 57 and am also a believer. If you have any thoughts or answers for me, I would apprecite it. Thanks for any help.
xxxxxx


Subject: Seeking Information
Date: Mon, 11 Feb 2002 20:17:25 -0600
From: xxxxxx@lordbissell.com
To:andrew@heartmdphd.com

Hello Dr. Chung,

I am looking at cardiologist sites because I have had occasional pain or "pinching" feelings in my chest from time to time over the past few months. My blood pressure has been rising the last couple years since I stopped any serious physical activity (I used to ride a bike and train intermittently in Aikido, but now find myself working 12 hr. days and parts of Sat/Sunday). My heart rate has risen, and my weight has gone up about 15 pounds as well.
I am worried about the condition of my heart and arteries (I am 51 yrs old), and I don't want to wait until I have a heart attack to find out just what it is. I rarely get sick and have never been hospitalized.
I am looking for a cardiologist who likes to work with patients seeking a more holistic approach to their health care.
I have an aversion to programs that are drug centered. I would like to improve my physical condition naturally, but I am the type of person who needs a current benchmark (and risk assessment) to work from. For example, I was very interested in articles I have seen by Dean Ornish, because he outlines an approach that focuses on the cause, not the symptom.
I was attracted to several things on your website. Your interest in Doctors without Borders, and other statements that said to me that you were interested in partnering in your patient's care. Also, as a Chem. E. grad from Purdue (before I switched to law), I recall struggling greatly with my one E.E. course, so your record there (and in molecular biology) tells me a lot.
How does this sound? Do you think there is a patient/doctor fit here? I look forward to hearing from you, and for your temporary password so I can explore more of your site.
Thanks,
xxxxxx


Subject: (no subject)
Date: Sun, 03 Feb 2002 20:47:50 -0500
From: xxxxxx@bellsouth.net
To: andrew@heartmdphd.com


Dr. Chung,
I have been looking for a cardiologist and wondered if you were accepting new patients? I had the opportunity to review your web site and I liked and was impressed by what I saw.

I have been having some palpitations, shortness of breath - feels like asthma and a feeling of blood rushing to my head from time to time - once every couple of days. I have not blacked out or passed out but I do think it's time to get it checked out. I am going to call my personal physican tomorrow and get a referral which is why I wanted to know if you were taking new patients.

Thanks in advance for your response. xxxxxx


Subject:Re: Why is HDL good?
Date: Wed, 30 Jan 2002 18:26:00 -0800
From: xxxxxx@groove-salad.com
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)


Dr Chung-

I just "subscribed" to this group because I find science and medicine fascinating. I've worked in a hospital as a lowly transporter pretty much throughout my college career and now I'm being trained as an OR Tech. I plan on going to a med school somewhere here in TX and specialize ( that is if my mind doesn't wander to another area ) in cardiothoracic surgery. I noticed you're a cardiologist, so I just wanted to say hi. Have a great day.


xxxxxx

Subject: Re: Angioplasty Info Sought?
Date: Wed, 30 Jan 2002 09:54:28 -0000
From: xxxxxx@eircom.net
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)


Dear Dr Chung

Thank you for the information

Regards

xxxxxx

ps I will contribute to Doctors Without Borders


Subject: Sunny Florida
Date: Tue, 29 Jan 2002 15:54:30 -0500
From: xxxxxx@earthlink.net
To: ANDREW CHUNG MD/PHD (andrew@heartmdphd.com)

Hi Andrew- Thanks for the e-mail for the lawyer. I gave it to him Plus the medical files. Hope to hear something soon. I will have to petition court NEXT week for more time. Again..thanks for All your help and support. As always...xxxxxx :)


Subject: Angioplasty Info Sought?
Date: Tue, 29 Jan 2002 20:14:01 -0000
From: xxxxxx@eircom.net
To: andrew@heartmdphd.com

I was diagnosed last year with two stenosis. One was in the Left Artery Decending and was 85% which was treated with Stent Baloon Angioplasty. The second which was 55% was left untreated I have asked why they did not Angioplasty it and have been told the risks outweighed the benifits.

Is this normal?

How large must a stenosis be for Angioplasty to be considered?

Am I a heart atack waiting to happen?

Would appreciate any help

Regards

xxxxxx

Subject: God :)
Date: Mon, 28 Jan 2002 19:58:03 -0500
From: xxxxxx@earthlink.net
To: andrew chung (andrew@heartmdphd.com)

If God had a refrigerator, your picture would be on it.

If He had a wallet, your photo would be in it.


He sends you flowers every spring.

He sends you a sunrise every morning.

Whenever you want to talk.....He listens.

He can live anywhere in the universe............but He chose our heart.

Face it, friend........He is crazy about you!

Send this to every "beautiful person" you wish to bless, and return it to the person who sent it to you.

God didn't promise days without pain.....
laughter without sorrow...
sun without rain.

But
He did promise strength for the day...
comfort for the tears...
and light for the way.


Subject: Fran xxxxxx
Date: Mon, 21 Jan 2002 09:05:05 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dear Dr. Chung,

I just wanted to say hello and see how you and your family were doing. I still want to come see you as soon as possible. I have misplaced your business address. Could you please email me with phone numbers, address etc. once more. I have two questions about my future care. They told me here that the ablation procedure would fix the fast heart beat but not the PVCs. Is that true? They also said that to do the procedure, I would have to go off the medicine. I am taking flecanide and I am afraid to do that. Would that be standard procedure? Would it be safe to do? I have the utmost trust in your opinions. Please answer as soon as you can. Give my love to the family.

Fran xxxxxx

Subject: ?? Donation to Doctors Without Borders
Date: Mon, 21 Jan 2002 14:09:02 +0900
From: "harry xxxxxx" (xxxxxx@kornet.net)
To:(andrew@heartmdphd.com)

Doctor Chung:
As you can see, I have included or forwarded the receipt from Doctor Without Borders.

My question is as follows:
Have noticed that there have been several procedures conducted on people (many, many on animals other than humans) that involve use of cells to repair the damaged areas of hearts following heart attacks. Can you point me in the direction to find out more about these procedures, outcomes, etc.

Thanx,
Harry xxxxxx

Subject: Heart Inquiry.
Date: Fri, 18 Jan 2002 01:31:26 +0500
From: xxxxxx@skt.comsats.net.pk
Organization: Performance Surgical
To: (andrew@heartmdphd.com)

Dear Sir,

Sorry to inform that my son, Tariq xxxxxx only 8 year old has been involved with, (Heart Atrial Septal Defect). Inspite of long treatment of different Specialist But With not Results.

Now the doctors have advised to get satisfied treatment from USA Specialist Doctor.I am placing the case history of the patient comprising 6 peges. Please you Have Advised the history of patient and possibal response,I can send you the fax patient History,I have vist the your website I am very Satisfied your website.Please your Favorablr response soon.

As this is the question of the life and future of my son,therefore, please treat this As most urgent.

Respectfully Yours,

Faisal xxxxxx f/o Patient.
Fax.xxxxxxx.Sialkot.Pakistan.
E-mail.xxxxxx@skt.comsats.net

Subject: Atlanta Opportunities
Date:Wed, 9 Jan 2002 20:29:55 -0500
From: xxxxxx@dcmrc.mc.duke.edu
To: andrew@heartmdphd.com

Dr Chung: I am currently finishing a post doc year in cardiovascular MRI at Duke university in North Carolina. I am interested in practice opportunities in Atlanta. I am wondering if you may be able to help direct me to possible avenues. I am attaching a copy of my cv.
--
xxxxxx


Subject: Help with Heart medicines
Date: Tue, 8 Jan 2002 09:10:50 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Hello Dr Chung, I am sending you this e-mail for my neighbor who is having a lot of problems with her heart medicines, she receives a small social security check each month and that is all of her income and she can't afford to pay the $ 35.00 If you can help her with some advice. If your reply is yes I will send you all of her Information . Thank You and God Bless .

xxxxxx

Subject: question regarding Wolff Parkinson
Date: Fri, 4 Jan 2002 08:55:02 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

My doctor says I have Accelerated A-V conduction. Is this the same as Wolff Parkinson White Syndrome? Is it the possible beginning of this syndrome. I don't get chest pain but I do get light headedness every now and then, however I do have low blood pressure. Should I be concerned? Thank you


Subject: Best Doctors
Date: Fri, 4 Jan 2002 02:54:49 -0000
From: xxxxxx@pghmail.com
To: (andrew@heartmdphd.com)

Dr. Chung,

I know of a few more Cardiologist that should be added to your list. and what about the Cardiovascular team at the Mayo Clinic, in Rochester. Anyway Where would the cheapest place for me to purchase Sotolol/Betapace. I have to take it twice a day or I die. I have no prescription plan and the Commonwealth of Pennsylvania claims I make to much dough. Rubbish I say but do you know where I can score some of these pills at a reasonable price or where I may get some donated to myself.

Thanks for your time,

Sincerely Mike xxxxxx

Add to your list Dr David Schwartzman at UPMC, Pittsburgh

and Dr. Danielson the thoracic surgeon at the Mayo Clinic.


Subject: Re: UGH !!!
Date: Mon, 31 Dec 2001 08:48:14 -0500
From: xxxxxx@earthlink.net
To: "Dr. Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)

Hi Andrew---
Just wanted to wish you and your wife a HAPPY NEW YEAR !!! I have spent 4 days ( few hours) looking under that cardiology web site.
Too many things that look alike. CAD- atheroscleriosis- peripheral or arterial diease.UGH!!!! They are all looking the same. Can't find anything about telementary monitoring, standard of care for monitors, etc. Got another site for me too look at. Isn't their a book of standards or something?????
Anyway....HAPPY NEW YEAR and hope we have better luck in 2002.
Thanks again for all your help in 2001....and looking foward to finding some answers in 2002.
As always...xxxxxx

Subject: ventricular inversion
Date: Sun, 30 Dec 2001 09:18:05 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dear Andrew,
I am one of those frustrated mothers desperately seeking information. Hope you can help.
I have an 11 year old son that has ventricular inversion. He recently developed heart block, and had a pacemaker put in on June 7th. After the surgery he had episodes of afib, and was started on 25 mg of atenolol (he still continued with afib on this dosage). On November 5th while he was fencing, he had severe chest pain. After interrogating the pacemaker we discovered that his heart rate had been 185 for 10 minutes. We also discovered that when his pacemaker hit the maximum heart rate of 150, the pacemaker basically cut his heart rate in half (down to 70). His Right atrium was racing at 185 but his ventricle was dropped down to 70.
We also learned that in this 2 week period he had over 100 episodes where his heart rate was 175 or higher (the max was 203 for a few seconds) After adjusting his pacemaker to a minimum rate of 80 and max of 170, and increasing the atenolol to 50 mg I have not noticed any more episodes.
Now we have moved on to something else. Trevor had chest pains under his left arm where the breast meets the rib cage and on the left side of his chest half way between his collar bone and nipple. These pains lasted for about 3 1/2 hours. Our cardiologist had us go to the emergency room. The EKG was normal. During this time while he had the chest pain, he was so tired he fell asleep and was hard to wake up. As soon as the chest pain stopped, his color was better and he sat up and was cracking jokes. While joking around he suddenly said "wow! I feel really tired again. Mommy, it's like someone is turning my energy on and off with a light switch." After a few minutes this passed and he was fine again. The doctor's said it was costa condritis. Even though he had no pain associated with breathing, no pain near his sternum, and the pain went away suddenly. He had chest p! ain for about 1/2 hour the next day (Wed) and for about 1hour on Thurs. He then had chest pain on Monday (Christmas Eve) for about 1 hour. He was getting these pains during periods of inactivity; sitting in class at school, watching TV, and waiting to open presents. It doesn't make sense! I feel like something is sporadically interfering with blood flow to the heart. He has some regurg that we know of. He has never had an echo w/contrast or a cath. I hate to put him through any more test, but I feel that something is changing or progressing.
I have so many questions:

Are there any pediatric cardiologists that specialize in ventricular inversion? If so, how do I find them? Our cardiologist are at Columbia Children's Hospital in NYC.

What could cause chest pain that comes and goes?

Should I push these doctors to do more exploratory testing?

Why can't he have blood drawn or IVs started in his left hand or arm? Could this be related to vascular issues?

I really am frustrated. As a mother it's hard to push when you have no idea what your pushing about. I know something, I just don't know what.

Any ideas you have would be appreciated.

xxxxxx


Subject: heart palpitations due to alcohol or opiate abuse ?
Date: Mon, 24 Dec 2001 13:46:48 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Doctor my question is re: possible connection of palpitations of the heart that occur maybe 20 times per day and mostly detected while laying down. This person has a longtime history of opiate and alcohol abuse and has a peptic ulcer at this time no family history of heart problems known and is about 47 years old... Could there be a connection and what sort of test should this person get to know for sure?


Subject: Best Doctors List
Date: 12/03/2001 05:06 AM
From: xxxxxx@verizon.net
To: andrew@heartmdphd.com

Dear Dr. Chung,

I nominate Dr. Ashley B. Lee, MD, as a "Best Doctor".

When I reached the ER I was assigned to a cardiology group consisting of two fellows who left me in a vacuum about the state of my heart for nearly four months. I guess they were distracted with the breakup of their partnership and packing to move off to greener pastures. When I was forced back to the ER, they passed me off to Dr. Lee and I couldn't be more pleased.

The man is a healer, thinker, and concise yet effective communicator. I now know the extent of my condition and no longer fill the vacuum with apprehension, as I did when I had MDs who didn't communicate. His full address:

Dr. Ashley B. Lee, MD
Assistant Professor of Medicine
University of Pittsburgh Physicians
120 Lytton Avenue
Pittsburgh, PA 15213

Thanks for providing the service.

Regards,

Glenn xxxxxx
Aliquippa, PA


Subject: best cardiothoracic surgeon
Date: 11/24/2001 09:42 PM
From: xxxxxx@sympatico.ca
To: andrew@heartmdphd.com

I would like to affirm your listing of Dr. Tirone David, MD as the BEST Cardiovascular and Thoracic Surgeon in Canada. He recently performed life saving surgery on my father.

During my dealing with staff, patients, and the families of other patients at Toronto General Hospital, the overwhelming consensus is that Dr. David is the best surgeon in the WORLD.


Subject: afib once again
Date: 11/24/2001 09:57 AM
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Hi Andrew and Happy Thanksgiving!
I have been writing to you on and off for the past three years ever since I was diagnosed with afib. Everything had been going OK with off and on episodes not lasting too long. But, things have changed. We had an approaching hurricane around Nov 1st here in Key West, Fl. I react to these things by getting afib. Could not get to a Cardiologist for about 5 days due to everything being shut down, plus it all happened during a weekend. I kept thinking the afib would resolve itself, but it didn't.

Went a few weeks ago to DR and I am now on Coumadin. Also Atenolol and Cardizim.

We are waiting for my blood to thin and then he is planning to put me in the hospital for a 24hr stay, starting me on Betapace. I am not having tachycardia symptoms, but the pulse is irregular quite often. It is also normal at times. What do you think of the plan? Would you do anything differently?

You're the best..

Eileen


Subject: worry from no info
Date: 11/23/2001 03:14 PM
From: xxxxxx@ntlworld.com
To: andrew@heartmdphd.com

I hope you can help as it is near impossible hear in the UK to get to speak to a senior cardiologist.

I am a 45 year old male Firefighter in good health and a high level of fitness, good diet (low fat intake) and no family history. I did smoke but I stopped as I was taken into hospital five weeks ago with severe chest pain. My ECG was described as suspicious, and the blood test revealed a .38 Troponin T level. I was given an angiogram this showed slight roughness at the first branch of the right coronary artery. The DR sent me home saying their was not enough evidence to prove an MI and that I could go back to work and carry on as normal. If I have not had an MI where has the Troponin come from and do you think that the exercise tolerance test and the Echocardiogram they have now decided to send me for will help to decide MI or not MI.

I hope I have made the question clear, and I do hope you can help.
Marty xxxxxx

Contribution to the American Red Cross --> Order ID#: 2804170496


Subject: Normal QRS and Depressed T Wave
Date: 11/19/2001 03:20 AM
From: xxxxxx@yahoo.com
To: andrew@heartmdphd.com

Dear Dr. Chung,

Could you please tell me what the normal QRS interval is, and what a depressed T wave is indicative of.

Thank you, I am most grateful.

Lisa


Subject: Visit
Date: 11/19/2001 02:41 AM
From: xxxxxx@prism.gatech.edu
To: andrew@heartmdphd.com

Andrew,

I just wanted to tell you thanks for the wonderful time that I had this afternoon. It was good to be able to talk to you about medicine and college in general. I had a great time and I do appreciate your generosity in giving up your time to meet and be interested in me. Moreover, I did mean it when I said that I didn’t want to take this PS alumnus interview as a mere assignment. I wanted to meet with somebody I really wanted to do something worthwhile and not just ask questions. Furthermore, I really hope that we will be able to stay in contact and do things. I would love to come up there to the movies and meet your wife and all. Oh, my parents said that next time that they come up they would love to meet you and that if you are ever wanting to come down to the Waycross area (why I am not sure) or if you want to go over to St. Simons’ Island or Jekyll Island (we are only one hour away) that you are more than welcome. Once again, it really meant a lot to see that you were actually interested and I really appreciate it. Thanks again for your time and hopefully I will see you soon.


Sincerely,


Matthew xxxxxx


Subject: Atrial Fibrillation
Date: 11/18/2001 12:57 PM
From: xxxxxx@mindspring.com
To: andrew@heartmdphd.com

Have you heard about any connection between Atrial Fibrillation and drinking Slim Fast products? I have two friends - both diagnosed with A-Fib. One is 32 years old and was on a Slim Fast and Protein diet before the first episode of A-Fib. His doctor has told him not to use this product (Slim Fast). Have you heard of anything to support or document this theory? Could a product, such as Slim Fast, possibly affect electrolyte or mineral (potassium?) balance?

Thank you.
Sincerely,
Fran xxxxxx
xxxxxx@mindspring.com


Subject: Thanks
Date: 11/15/2001 08:32 AM
From: groller@rutherfordhosp.org
To: andrew@heartmdphd.com

Dr. Chung, Thanks for your response to my previous email seeking to recruit an invasive cardiologist to Rutherfordton, NC

I visited your web-site and found it very interesting. It sounds as if you have a well-balanced, "centered" life. I commend your calling to medicine and wholeheartedly agree. I regret not being able to entice you from the Atlanta area. We could definitely use someone with your depth of character and obvious compassion.

Best regards,
Gale Roller


Subject: Need Advice
Date: 10/29/2001 10:43 PM
From: xxxxxx@avaya.com
To: andrew@heartmdphd.com

Andrew,

Hi, I've been reading your replies on sci.* and reading your web site. I appreciate your skills and techniques, compared to those doctors who don't really get it ...

I would really appreciate you answering the following questions.

I realize that your reply is for "information" only and based on very limited info I can give you ....

1) Was it good advice for my father to have a double-bypass before taking his cruise???
2) Was it wrong, debatable, or correct for them to replace his Valve?

History
--------
Age 73 Male
Heart attack late 30's
nitro

3-4 years ago and maybe before too: Balloon therapy

Last Year: Coughing violently for about a 6 months, his cardio did not detect anything, finally went to hospital. Took out lots of fluid from lung (Over a quart I believe), every heart test possible, concluded it was a lung issue... ... could not get all the fluid/sludge out, they tried to flush it out with strepokinase, still some fluid ,doctors wanted to operate on lung, we said no due to danger of heart attack, and that the lung was still draining from the tube, e.g getting better. They were angry. Over several weeks they pulled the drain tube out, and he recovered fine.

6 months or so ago: (can't recall before or after this lung thing)...had 2 stents put in.

also 1 artery blocked but had enough new vessels grow around them to be good enough.

some/minimal heart damage.

After about 6 months of the stents, did not feel any better, out of breath easy, etc... Referred to Surgeon at B&W in Boston.

Surgeon said he needed double bypass or he risk having a heart attack on the cruise he wanted to go to next month. He said you will recover in 2 weeks, and can go on the cruise no problem and you will feel better too.

We wanted to do a cather test ... but surgeon said it didn't matter what the result showed, still needed surgery.

Did test anyway, showed the stents started to clog up, 1 about 30% clog, 1 about 50%, .. can't remember the exact numbers. as before 1 was 100% but had sufficient new vessel growth.

Also cath test said some Valve calsification ... valve will need to be inspected at time of surgery.

They did the double bypass ... 1 month before the trip (next week), and also replaced the value with a cow valve. They said 3/5 of the leaflets or something were clogged, and a little stenosis. Pathology said "moderate" or "moderate plus" calcification".

After surgery had Atrial Fib, in such a pattern that his heart would slow down that they said he needed a pacemaker because of the damage caused by the valve replacement.

They also drained 1.5 quarts of fluid out of his lung about 1.5 weeks after surgery, and finally went home after 2 weeks. His body is very swollen with fluid, now taking 80mg lasix (spell?).

He is extremely short of breath, can't do much without having to take a rest. Very short walk around house.

His local cardiologist (also his PCP), the one that did not diagnoise his lung fluid problem that almost killed him, said the new valve was not necessary since it was working just fine.

Now, 3.5 weeks after surgery, he is feeling much worse than before, and probably doesn't have the energy to go on the cruise, and gets a mild fever < 100, on and off, and is still very swollen (hands, legs)...

So ...

1) Do you think it was wise to get the bypass at all, and if so, get it before the 2 week cruise, when he was feeling pretty normal relatively but not too great ... minimal energy but enough.

2) Do you think the surgeon was correct to just go ahead and replace the valve when his local cardio says that just because it is calcified doesn't mean there will be a future problem ... and that the surgeon was playing God in predicting that 4-5 years in the future he will have valve problem ... should of waiting .. and that because of his overall bad health that the valve was too much for him to handle ... ??

thanks

xxxxxx


Subject: 2# diet
Date: 10/24/2001 10:19 PM
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Andrew,
I just may have to try this. I have lost a lot of weight already, but am probably still eating more than I need-based on your info !

Nice photo of you! [:)] Wonderful profile/human interest - we have a surgeon in our hospital that has many birds also. He and his wife were featured "front page" in our local newspaper this past Sunday....with several of the birds.

I cannot thank thank you enough for all your help with the Cor T information. Today, I was given phone#s of docs at UAB to call for a consult. Will set up the consult tomorrow.

Again.........many THANKS!
xxxxxx


Subject: Cardiac Enzymes High
Date: 10/20/2001 06:25 PM
From: xxxxxx@ix.netcom.com
To: andrew@heartmdphd.com

Guess I wasn't really clear. The cardiologist read the report (although I won't see it until Monday), and he is the one who discharged me. According to the people in our Cardiac Care Unit, and Nuclear Med, he is the best cardioloogist on staff. BTW, I work in Medical Records at the hospital, so will read the whole chart on Monday.

How accurate is the troponin test? Thank you very much for your help.

xxxxxx


Subject: PTSD
Date: 10/19/2001 10:07 PM
From: xxxxxx@worldnet.att.net
To: andrew@heartmdphd.com

10-19-2001

Dear Doc:

Do you know of any appropriate research, with a significant N, correlating Anxiety/ PTSD/Panic attacks on BP; hypertension.

When you see patients there vitals are taken. Why does psychology or psychiatry not take the vitals.

When one alleges anxiety, panic attack, phobia etc. the pulse, BP will elevate as well as the respiration.

Allowing a patient to observe there pulse and BP would be an excellent therapy tool.

I would appreciate your input and suggestions for other research on this topic.

I was a medic in Vietnam in the infantry/ambulance company.

Thank you.

Joel xxxxxx, Sr., Ph.D., LMHC, NCC

Subject: Heart Question
Date: 10/17/2001 04:33 PM
From: xxxxxx@fraxis.com
To: andrew@heartmdphd.com

Hello Dr. Chung,

I was reading your messages today on the usenet, and I just visited your informative web page. I wanted to ask your medical advice based on my situation.

I am a 30 year old male. When I was 29 years old (1 year ago), I was diagnosed with 3 blockages in my heart. One was in my LAD, RAD, and the other was in a small branch of my heart. Based on my age, my cardiologist opted for Angioplasty. I had one stent inserted into my LAD, and 3 stents in the RAD. The branch block was left alone with the hopes that the heart would make new "pathways" around the block. My cholestorol was 170 at the time of this procedure. I was made aware of my situation because of left bicep pain I was experiencing while bowling on my bowling league. I had High Blood Pressure for about 5 years that I never treated, and my GP never felt I required medical attention. (My BP was always 150/90). If I would of know then what I know now, I would have started BP medicine right away.

I am currently on the following medication: 10 mg Norvasc. 150mg Metoprolol, 20 mg Lipitor, 325mg Aspirin, 10mg Lotensin, and 1 mg of Folic Acid.

With all of these medications I have been taking, my blood pressure has been excellent for the past year, and my pulse rate has been in the high 50's, low 60's.

However, I have notice during the past month, with mild exertion, my blood pressure gets elevated. Usually my blood pressure is 110/60, but lately when it gets elevated, it goes to 135/70. This usually happens if I am walking a short distance, or walking uphill, or during Sex.

What I am concerned about is, that 6 months ago, it took a lot of exertion to get my blood pressure to rise. Now it takes next to nothing. I have read other usenet messages about Metoprolol losing its effectiveness over time. I was wondering if that could be happening to me. I know I am at the max dosage of Norvasc. I think I can go up to 300mg of Metoprolol, and I am not sure about the max dosage of Lotensin (I am just re-affirming these numbers with you, I do not plan to increase my dosages without my doctors consent).

I have an appointment to see my doctor next week, but I wanted to gather as much information as possible about what could be causing my current change in BP.

Any opinions or advice or insight would be greatly appreciated.

Thanks for your help, and your web site.

Shawn xxxxxxx


Subject: Physician Recommendation
Date: 10/16/2001 06:26 PM
From: xxxxxx@home.com
To: andrew@heartmdphd.com

Dear Andrew;

While doing research for a new web-site design, I came across your site (Very Nice by the way.) I have a recommendation for your "Best Physicians" list.

Sharon R. Weil-Chalker, M.D. FACC, FACP
Perinatal Cardiology Consultants
Philadelphia, PA
215.829.6841

She's the Doctor you want if it's your kid that's sick (If you know what I mean) She's out there doing battle with the evil forces of modern medicine, as they try their best to grind her down.

She saved our child, after the "Big Guys" in town misdiagnosed him 3 times. She actually guessed what was really wrong with him just by hearing the story, and confirmed it by Echo. Children's Hospital of Philadelphia did the surgery, even though they were SURE she was wrong;.... But she wasn't wrong.
She is very modest and personable, but one of her nurses told me confidentially that you would think "they" would learn.
She says she sees this all the time, and Dr. Weil hasn't been wrong yet.
But Dr. Weil will pooh-pooh that sort of talk if you bring it up.

This is all the information I got from her staff.
She was trained by the Gods of Pediatric Cardiology at UC San Francisco, and her only Partner Was Dr. James Huhta until they ground him down and he went to Tampa Children's.

Northwestern University Medical School
Residency in Pediatrics-St. Christopher's Hospital for Children, Philadelphia, Pennsylvania
Fellowship in Pediatric Cardiology- Cardiovascular Research Institute-University of California at San Francisco, San Francisco, California
Research Fellowship in Pediatric Cardiology-St. Christopher's Hospital for Children, Philadelphia, Pennsylvania

LICENSURE AND CERTIFICATION
Current State of California Medical License
Current State of Pennsylvania Medical License
Current State of Delaware Medical License
Current State of New Jersey Medical License
Board Certified, American Board of Pediatrics
Board Certified, American Board of Cardiology

Thanks for your time.

William


Subject: Why?
From: xxxxxxx@cfl.rr.com
Date: 10/10/2001 12:15 PM
To: andrew@heartmdphd.com

Dr. Chung, Karl and I are devastated to learn you are leaving Ocala. Karl was a patient of three other cardiologists before finding you, THE VERY BEST IN OCALA, and we now face the task of finding another. Should you have any recommendation, it will be appreciated.

I pray you find a community that will appreciate your honesty. I am certain it will not be difficult to find patients who appreciate your gift of doctor-patient communication.

I worked with an outstanding medical group in Orlando (MD Anderson Cancer Center ) for 23 years and perhaps some could match your intellect, and perhaps some could match your bedside manner, but none had both.

We will miss you more than words can convey.

And one more comment--there is no doubt in my mind that the politics of medicine had a great deal to do with the events surrounding your departure. I admire you for standing for what you believe in, and not what the community might dictate.

Most sincerely,

Eula and Karl xxxxxx


Subject: Why?
From: xxxxxxx@aol.com
Date: 10/10/2001 11:56 AM
To: andrew@heartmdphd.com

Please explain why you are leaving..........I'm 55 and just became your patient after having problems with Dr. Alonso's staff regarding their incompetence in giving me test results. I was told I was fine and should consult a GP for further follow up, when in fact I have a 100% blockage in my left leg. I don't want to go to just another Cardiologist...and am hoping you can make a suggestion.

Kathy xxxxxxx


Subject: previous patient
From: xxxxxxx@aol.com
Date: 10/06/2001 05:17 PM
To: andrew@heartmdphd.com

Doctor Chung please rest assured that I think they have lost the best doctor that the group had. Please let us know where you are practicing as I want to come to you for my treatment and follow up care. I will bring my brother with me. If you have a direct email address please let me have it. If not, I will contact you at this one. Hope you answer soon. Best regards, Fran.


Subject: your practice
From: xxxxxxx@mindspring.com
Date: 10/02/2001 08:34 PM
To: andrew@heartmdphd.com

Andrew-

I am sorry it didn't work out for you in Ocala. We chatted a couple of times on here. I am in Atlanta (Duluth). If you end up back in the Atlanta area ...let me know. I sure would like to have you as a cardiologist if that were possible.

Best of luck.

Fred
(triple bypass in 2000 - doing good but I am sure I could learn more)


Subject: So sorry!
From: xxxxxxx@juno.com
Date: 10/01/2001 04:31 PM
To: andrew@heartmdphd.com

We are very disappointed that you are leaving Ocala. Hope you find a good place that appreciates you! Received a letter from Alonso stating that Tom is no longer a patient of his. There is a temper there I believe. Hope that had nothing to do with you're leaving! Best of luck!! Barbara


Subject: follow-up
From: xxxxxxx@atlantic.net
Date: 10/01/2001 09:59 AM
To: andrew@heartmdphd.com

Dear Dr. Chung:
My name is Shirley xxxxxx and you referred me to Dr. Bittl at MRMC for an angioplasty, which I had done
Everything went fine, but when I called for an appointment with you, I was told you were no longer working there due to an emergency with your wife. I need a doctor for a follow-up visit. Can you help me? If you moved to another practice, I would like to continue with you. I hope everything is okay with you and your wife.

My Best Regards,

Shirley


Subject: Address of best hematologist in toronto
Date: Mon, 26 Feb 2001 23:25:40 -0500
From: xxxxxx@home.com
To: (andrew@heartmdphd.com)

Hi,

I need the contect address of Dr,nancy olivieri please

Thanks

Subject: MVP
Date: Mon, 26 Feb 2001 16:56:45 -0800
From: "David&Karie" (xxxxxx@sandiego.com)
To: (andrew@heartmdphd.com)

Appreciate all I can learn on-line about MVP. I wanted to make a post at Goggles which I had joined months ago under another web site name. How does one post ? I have a support club for 225 MVP patients and I was reviewing other sites to learn and share. I was a premature baby born with heart murmurs and do medicated before dental works now.

Thanks,
Karie

Subject: hello from australia
Date: Wed, 7 Feb 2001 16:25:55 +1100
From: xxxxxx@eurocom.com.au
To: andrew@heartmdphd.com

hi I was wondering if it was ok to put a link to your site from my site its at www.eurocom.com.au/userpages/ndw
I think your site is fantastic I wish I found it before my daughter had her operation

Ellen xxxxxx


Subject: Two pounds
Date: Sat, 27 Jan 2001 23:13:40 -0500
From: Ronald xxxxxx (xxxxxx@northnet.org)
To: "Andrew B. Chung, MD/PhD" (andrew@heartmdphd.com)

Dear Andrew,
Your name appeared frequently on a science and medicine chat line so to speak. I was beginning to think it was something of a personal domain. I then read your web site a bit and had a sense that we may have some values in common. My personal weight has in recent years come under my own scrutiny and I have been reading and trying to understand exactly how to reasonably overcome my basic habit to eat in excess. I was stunned by the stinging truth of your observation. I have practically made the notion of "two pounds per day" a mantra that I can't quite believe, but can't quite eliminate from my thoughts. If your observation helps me, I am going to invite you to speak at grand rounds in my community one day.
I am a Nephrologist with strong academic ties and research interests who works with a population of chronically undernourished adults. Your concept I find intriguing.

Sincerely,


Ron xxxxxx, M.D.


Subject: Best Doctors List Nomination
Date: Sun, 28 Jan 2001 16:36:20 +0000
From: xxxxxx@flash.net
To: andrew@heartmdphd.com
Hi - I've enjoyed your web site a lot! Very glad I ran across it. I'd like to add to your list of best doctors with a recommendation for Dr. Alan A. Miyake. He is an oral surgeon who recently removed a nasty infected wisdom tooth for me. He bedside was A+ and his skills were outstanding. Little pain, no bleeding, great follow up. He works in Houston and Missouri City, here in Texas and we're lucky to have him!

Thanks for the great web site - I'll look forward to coming back for updates.

-Carol xxxxxx

Subject: Nominee for "Best Doc" page
Date: Tue, 23 Jan 2001 21:52:46 -0800
From: "Deja User" (xxxxxx@my-deja.com)
To: andrew@heartmdphd.com

Hello,

I found your page through your links on sci.med.cardiology (I've only lurked there so far). I must say the links and volume of information is impressive. I've got it bookmarked for future reference.

I think the best docs page is a great idea. It has been some time since I have been to my own doctor (I know I should be better about physicals but I am pretty healthy right now) but my sister has a doctor that she has been quite impressed with. Apparently, he was quite diligent in helping her to figure out some problems that had eluded diagnosis by a few other docs. She also takes her daughter (my niece) to see him and he also impressed her by diagnosing her cough variant asthma that had been blown off by her previous pediatrician.

His name is Christopher Ish, M.D. in Baltimore Maryland. I think his specialty is family practice. If you need any more information I could probably get it for you.

Thanks for the great site,
Owen

Subject: hi
Date: Thu, 02 Nov 2000 12:07:36 -0800
From: xxxxxx@seaside.k12.or.us
Organization: Seaside High School
To: achung@emory.edu

hello my name is sal

Subject: Questions and answers
Date:Sun, 22 Oct 2000 07:00:08 -0700
From: "Barbara Walters" (xxxxxx@email.msn.com)
To: (achung@emory.edu)

I see many good questions on your site, BUT where are the answers? Showing the answers directly below the question, could be helpful to those reading.

Thank you for considering that option.

new to your site
BWalters

Subject: Your Web Site
Date: Wed, 27 Sep 2000 12:31:08 -0700
From: xxxxxx@interwrx.com
To: achung@emory.edu

Hi Andrew,

I like your web site - straight forward stuff! We need more of that these days. Perhaps yu would like to view our site? We have over 1,348,000 visitors and our site is mostly an information site. Mostly about alternative health care but it also has other subjects that may be of interest.

Link?

Regards,

Larry

Subject: Weight Loss Info
Date: Tue, 26 Sep 2000 10:28:50 -0500 (CDT)
From: xxxxxx@sinnfree.sinnfree.org
To: "Andrew Chung, MD/PhD"

Two files on your web site ,losewtnd.doc and losewtdm.doc, are in Word format and have to be downloaded. Not all of us have a computer that can read a file formatted in Word. (These files are a "mess" when read on my computer.)

Yet the promise of a method for *Permanent* weight loss is something I want to study!

Could you make this information available in text format or html format?

Lyle

Subject: questions
Date: Sun, 24 Sep 2000 18:23:32 -0700
From: xxxxxx@harborside.com
To: achung@emory.edu

I scanned through all the questions but wondered where all the answers were. What do you click on to see the answers?
Thank you,
Jeanette

Subject: (no subject)
Date: Wed, 30 Aug 2000 00:06:46 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

I am a 28 year old female who happens to be the first successful cure of W.P.W. on the West Coast, by open heart surgery. I had my surgery December 14, 1988, at Sharp Memorial Hospital, San Diego Ca. I since have hadd no problems and has even had three children since the surgery. I have only known a few other people diagnosed with W.P.W. but I am happy to say I have regained control of my life. I was a 17 year old senior in highschool, and a yearround fastpitch softball player at the time, and had put my parents life on hold. I was diagnosed at the age of 6, and cured at the age of 17. I would like to get any feedback if possible, and was excited to see information on W.P.W. syndrome on the internet.

Subject: in re: treating a difficult patient
Date: Sun, 13 Aug 2000 21:24:06 -0700
From: xxxxxx@earthlink.net
To: achung@emory.edu

Hi--- I wonder if you could help me out. My sister is a massage therapist, and has a patient who is for various reasons very difficult and who she would rather not treat. Is it in any sense illegal for her to say she won't treat him?

Thanks-- Tori

Subject: Hi
Date: Sat, 17 Jun 2000 21:02:42 -0500
From: xxxxxx@prodigy.net
To: (achung@emory.edu)

Just found your pages by using findwhat.com/, and was pleasantly surprised. I was looking for the Hippocratic Oath, and I like the owl icon in the top corner. Looked over a few pages, and like your site, and will come back and spend more time another day. I came in as an informal researcher, and used the patient label to navigate. Maybe you could use a visitor or guest label, so I don't have to feel ill to look around. I will bookmark your site and maybe recommend it to a few friends. Good luck. Follow the rule laid down by Hippocrates of Cos and you will earn a good name and a good many friends...and the gratitude of those you heal. Sincerely yours, MJ.

Subject: your website
Date: Thu, 18 May 2000 15:38:42 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

I am a layperson and I want to thank you for your terrific website. I shall be a frequest visitor and will certainly let my friends know about you.

Subject: Hereditary Angio edema
Date: Tue, 16 May 2000 20:12:56 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

What is HAE and how do you treat it? My brother possibly has this dx and is living in Ireland. Different parts of his body swell up for no apparent reason. One hand and then the other hand, his face. One night is tongue swelled up and he had to give himself a shot. Thanks in advance for your help.

Subject: Cardiology question
Date: Wed, 3 May 2000 19:36:01 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

Hello I am doing a report on cardiology in school and I was just wondering if you could tell me how much a cardiologist gets? I would appreciate you reply ASAP!
Sincerely
Jessica

Subject: (no subject)
Date: Fri, 21 Apr 2000 19:33:02 EDT
From: xxxxxxx@aol.com
To: achung@emory.edu

Dr. Chung,
I'm a male to female transgender person whom has allready had surgery. I would like to have a child with a female.I was wondering if the dna from my blood could be placed in a neutralized sperm cell from an outside doner to impregnate my female freind to get her pregnant.I'm hoping this is'nt "cloning."We want to have a child together .Besides the only other way for me to have a child is to have one myself and that I'm sure would entale me haveing the child.I think that would have to include a great deal more of genetic manipulation. I'm being straight foward with you in hopes you don't write me off as a nut.

Danielle xxxxxxx

Subject: ekg question
Date: Sat, 15 Apr 2000 20:20:38 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

Dr. Chung :

Could you please tell me what a " T - Wave Inversion " on a 12 lead ekg means & is this serious or even fatal?

Frank xxxxxx

Subject: Hepatitus C
Date: Tue, 11 Apr 2000 07:03:35 GMT
From: "xxxxxx" (xxxxxxx@hotmail.com)
To: achung@emory.edu

Hi, Andrew I wrote you concerning two close friends that had liver complications. I found out that my one friend had hepatitus way back in the early eighties it was labeled not H-B or H-A. Now years later he ate some bad chinese food recently and got Hep-A. When they were doing his tests they discovered a dormant H-C. He told me that his Dr's told him he was okay and the next time he gets a physical to get his liver ensymns checked. Do you know anything about H-C or where I could get any info. as I am pretty clueless on this particular Hepatitus.

Thanks Marla

Subject: What is angioedema?
Date: Sat, 8 Apr 2000 10:41:34 -0700
From: xxxxxx (xxxxxx@email.msn.com)
Organization: Microsoft Corporation
To: (achung@emory.edu)

Thanks, Dr. Chung.


Subject: good website
Date: Wed, 5 Apr 2000 14:15:44 -0500
From: xxxxxx (xxxxxx@juno.com)
To: achung@emory.edu

Hi, I'm 11 years old and love to use the web. I just wanted to say that I think it's awesome that you have the Hippocratic Oath on the web to show. It helped me with research and report work for school and i needed to find the Hippocratic Oath. I am homeschooled and we are studying Greece in this unit. Well, I just wanted to say I appreciate your website. Keep my updated on anything special on it! Thanks and good bye.
Sincerely,
Talia xxxxxx


Subject: Deja post
Date: Sun, 26 Mar 2000 09:00:00 -0500
From: Mike xxxxxx (xxxxxx@home.com)
To: achung@emory.edu

Thank you for your answer on Blood pressure and aging.

Subject: Comment/Question
Date: Sat, 25 Mar 2000 09:19:29 -0500
From: "Steven xxxxxx" (xxxxxx@worldnet.att.net)
To: (achung@emory.edu)

Dr Chung:

Your Web site is outstanding! I stumbled upon it by accident and now I've bookmarked it for future reference.

Question: I am being treated for hypertension with Monopril, Norvasc and a diuretic. The diuretic was started less than a month ago when my systolic increased somewhat (125/95). Ever since I started the diurectic (Triamturtine), I've felt generally weak. Getting up too quickly from a prone position often causes considerable lightheadedness. When I walk up a flight of stairs, my heart beats so hard, I feel it in my throat and it causes an urge to cough. (This is most likely to happen just after I've eaten a big meal.)

My doctor doesn't seem concerned about all this. Should I be?

Thanks . . . Steve


Subject: David Letterman
Date: Sun, 06 Feb 2000 09:37:53 -0800
From: "xxxxxx" (xxxxxx@powernet.net)
To: achung@emory.edu

Thanks for understanding!!!!! :) :) :)

I'm just not into the BLAME GAME in disease.

I just want to live my life as best as I can, and if there's something out there that can help me, then I'm grateful!

Lipitor not only lowered my LDL (Doc wants it under 100 -- Lipitor lowered it to 72), but ALSO my triglycerides (to normal for the first time in my life!) AND raised my HDL (to 59!!), which, as you know is bloody difficult to raise!

I really appreciate your participation on the ng!

Smiles,
Natalie xxxxxx


Subject: Tuberculosis Symptoms?
Date: Wed, 12 Jan 2000 21:36:18 -0100
From: xxxxxx (xxxxxx@xxxxxx.freeserve.co.uk)
To: (achung@emory.edu)

Dear Sir,
I am healthy 46 year old gay male. I have tested negative to HIV infection for many years and am in a monogamous relationship. I have a history of high blood pressure, but due to a healthy eating plan and regular training sessions at the gym I have lost 52lbs in weightover the period of one year. I am still prone to weight gain if I stray from my fat free eating plan, so deduce that my weight loss is genuinely from my own efforts. My blood pressure is near normal without any treatment, and I take no medication for any other illness.
I am moderately fit therefore! However, I have for over the last 10 months had nightsweats that leave my bed linen damp and I feel the sweat pouring from me when I wake up throughout the night. Should I be worried about T.B? I look forward to your reply.
Thank you in anticipation.
Respectfully yours.
xxxxxx xxxxxx.


Subject: Pulmonary Stenosis
Date: Tue, 11 Jan 2000 19:34:00 -0000
From: "xxxxxx" (xxxxxx@buybytes.net)
To: (achung@emory.edu)

Can you help ,I'm key worker for a man who has Pulmonary Stenosis. He can't tel me how it feels because he can't talk / comunicate in any way. I wondered if he will feel dizzy spells .or other unpleasantaries are people who suffer from Pulmonary Stenosis prone to vomiting wounds taking longer to heal I'm new to the computor world and I don't know how to get my letter up for the world to see and answer Jillian.


Subject: TB Treatment/Vitamin B6
Date: Sat, 8 Jan 2000 07:38:52 -0800
From: "xxxxxx" (xxxxxx@desertlinc.com)
To: (achung@emory.edu)

Doctor, My 18 yr. old son recently obtained a positive skin test. He was given Isoniazid and told to take Vit. B6. He phoned me as he was not instructed as to how much B6 to take. Is there a usual dosage?? Thank you. xxxxxx


Subject: from wheely
Date: Tue, 14 Dec 1999 06:18:53 EST
From: xxxxxx@aol.com
To: achung@emory.edu

hey, while searching thru the web for pharmacuetical info,,, i found this link out there, you should ask them if you could add them to your web page, well here it is-----------> http://www.biospace.com


Subject: TB Question
Date: Tue, 07 Dec 1999 16:33:20 -0500
From: xxxxxx@gwu.edu
To: achung@emory.edu

Dear Dr. Chung,
I am a biology major at the George Washington University in D.C. I found your site while researching TB for a microbiology paper and I have a quick question for you. A year ago I had a boyfriend that I found out had inactive TB. I am no longer seeing him, but was I ever at risk for the active form and am I still? or could I have contracted the inactive form as well? Can you explain it to me?
Thank you,
xxxxxx


Subject: Add to Best Doctor list
Date: Sat, 27 Nov 1999 10:16:39 -0400
From: xxxxxx@hom.net
To: achung@emory.edu

Dr. George R. Brahn
1701 Watson Blvd.
Warner Robins, Georgia 31093
912/923-0144

Surgical Associates specializing in General and Vascular Surgery


Subject: Best Doctors list
Date: Tue, 19 Oct 1999 01:40:01 -0400 (EDT)
From: xxxxxx@webtv.net
To: achung@emory.edu

From Orlando Fl
Dr. Cary Lee Stowe, M.D. of Cadiovascular Surgeons, P.A. see info at CTSNet site http://www.ctsnet.org/home/cstowe among his background info: Emory University Cardiothoracic Fellowship,1985-1986

====>this recommendation is from a grateful patient who is alive today due to God's grace and the skill He put into this man's hands.... :-)


Subject: Appointment
Date: Wed, 1 Sep 1999 23:22:09 -0400
From: xxxxxx@juno.com
To: achung@emory.edu

I don't have an appointment with you until Oct. 21. They rescheduled me for Sept. 30, but called back after a few days and said you wouldn't be there, then rescheduled it on Oct. 21.

Don't know why I'm telling you this. I guess so you'll know I followed your advice--just FYI. (Maybe I'll have a medical condition by then, but I hope not.)

xxxxxx


Subject: hi
Date: Wed, 1 Sep 1999 15:46:38 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

I have uncontrol blood pressure and the doctor doesnt know what to do about he had me on a lot of pills but my pressure goes up to 220/110 sometimes i had three TIA. i am so upset about this sitution a am in i am young if you tell me what to do
xxxxxx


Subject: Your web site
Date: Tue, 24 Aug 1999 01:16:41 -0400
From: xxxxxx@thebest.net
To: (achung@emory.edu)

I found your web site absolutely fascinating. I graduated from Emory a thousand years ago (1959) so I was pleased to find all this information. One question- do you ever sleep? I can tell you spend many hours on your sight. I am new to the internet and have found myself losing sleep. When I find a site I like, like yours, I keep on going until I can't hold my eyes open.

Thanks again for making this available. Are there any other web sites at Emory you think I might enjoy?

Sincerely,
xxxxxx


Subject: Successful acyclovir treatment of herpes simplex type 2 hepatitis in a patient with systemic lupus erythematosus: a case report and meta analysis
Date: Mon, 23 Aug 1999 10:02:13 -0700
From: "DR.xxxxxxx" (xxxxxx@fsd.comsats.net.pk)
Organization: PAKISTAN WAPDA
To: (achung@emory.edu)

Successful acyclovir treatment of herpes simplex type 2 hepatitis in a patient with systemic lupus erythematosus: a case report and meta analysis.

Chung AB, Fas N

Department of Medicine, Emory University, Atlanta, GA 30322, USA. achung@emory.edu

RESPECTED COLLEAGUE

Please provide me the photocopy/reprint of the above-mentioned paper. I will be obliged if you allow me to be benefited from your other papers/work. It will be further appreciated if you can help me regarding studies on the role of mosquitoes etc in the spreading/ transmission of viral hepatitis.

Yours Faithfully,

DR.xxxxxx

My mailing address is as under;
DR.xxxxxx

WAPDA HOSPITAL ABDULLAHPUR
FAISALABAD
PAKISTAN


Subject: question
Date: Thu, 19 Aug 1999 19:58:45 -0400
From: xxxxxx@sunlink.net
To: (achung@emory.edu)

Hello, I'm a male, 36 year old bicycle racer. I have asthma, my medicines are: theophylline 300 mg twice a day, singulair once a day, claritin once a day. A year ago, I had an exercize stress test done. I was able to go up to 360 watts and 16.9 mets, but my blood pressure went up to 262/92. My asthma seems to be under control with my peak flows running 650-700. I have a family history of high blood pressure and heart disease, my mother is on medicine and also my 40 year old brother is on medicine for high blood pressure. My question is this: Can high blood pressure affect exercize performance in a very strenous sport ( bicycle racing )? I do races that are 20 - 50 miles sometimes with very big hills to climb and it seems that when I get to a big hill I seem to lose my energy, I feel like something is holding me back, my breathing seems to be fine, but my legs feel heavy and lethargic. Currently I have 3900 miles since February, I train 4 days a week, I use a heart monitor so I don't overtrain. I took a week off because I felt tired,since then I still feel terrible on the hills, compared to about 2 months I was feeling great and I was flying over the hills. I can't seem to find any information on how blood pressure affects exercize performance. Would you be able to send me information or tell me where I could find it? I work at a large hospital and none of the doctors seem to know anything about this. On occasions some doctors that I saw, said that I should keep an eye on my pressure. Some of my readings were:

150/90 142/80 136/76 148/86

I will wait for your response.

Thank You for your time!

xxxxxx
85 xxxxxx Road
Danville, Pa 17821

xxxxxx@sunlink.net


Subject: PS wanting some advice . . .
Date: Tue, 06 Jul 1999 10:11:07 -0400
From: xxxxxx@mindspring.com
To: achung@emory.edu

Dear Dr. Chung,

I am a current PS at Georgia Tech, and I am very interested in Emory's MD/PhD program. I found your page through Emory's search engine when I looked up "MSTP."

Do you have any advice for someone applying to the program? I will be graduating in May 2000 after three short years at Tech, and my research experience in the sciences is limited to two quarters of SPECIAL PROBLEMS classes in the Biochemistry Department. I have been doing research in Emory's Urology department for the past four years, and I have helped in writing a couple of papers there.

I guess I want you to tell me if I have a chance at getting in, so I'll give you a little bit more of the picture . . . I have a 3.94 GPA, and I will be taking the MCAT in August.

Thank you very much for your time!

Sincerely,
xxxxxx


Subject: New question for you!
Date: Mon, 21 Jun 1999 09:54:48 -0500
From: xxxxxx (xxxxxx@Indigo7.com)
To: (achung@emory.edu)

I don't know if this is where I should be submitting a question or not, but here it is anyway...

What are the possible causes for unilateral exopthalmos?

Thank you!

xxxxxx@indigo7.com


Subject: Several Items
Date: Mon, 31 May 1999 09:05:41 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

Hi,
As noted above- there are several items-
- My son, Mike is hiking the AT for the ACS- his website www.cancerhiker.com is great - but then I am his mother. You might want to put up a link- One of the guys had prostate/bladder cancer at 19 and is hiking with an artificial bladder.

- I am looking for a laptop, and the Fujitsu lifebook B interested me because of the touch screen- with osteoarthritis in my hands/fingers, it sounds idea. Any feedback on it?

- last but not least, you have a great webpage - enjoyed it.

Best,
xxxxxx


Subject: Cardiology Project
Date: Mon, 24 May 1999 20:11:50 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

Hello my name is xxxxxx and I was surfing the web trying to find information for my project for school and I was wondering if you could help me. I see your website gives good accurate information on cardiology and I wish to inquire about spacific questions. I am a student at the Academy of Allied Health and Science, it's one of the Monmouth County Vocational schools. Ok well this is my assignment:
1) find 12 occupations for before, during, and after the heart transplant (total of 36) that help the patient through holistic care.
2) Develop a "Prevention Plan" for a patient who just went through a heart transplant to keep a healthy heart. This plan must contain an excercise plan, and diet guide.

If you can help with the slightest bit with either of these I will be thrilled. I am getting pretty desperate searching the net and I now think communicating with a doctor directly will be the best solution. My e-mail address is xxxxxx@aol.com I will greatly appreciate your concern. Thanx again!

Sincerely,

xxxxxx


Subject: Employment opportunities in NZ
Date: Tue, 11 May 1999 15:47:05 +1200
From: Lorraine Marsh" (lorraine.marsh@xtra.co.nz)
To: "Andrew Chung" (achung@emory.edu)

Dear Dr Chung

My name is Lorraine Marsh and I am an associate consultant for a medical specialist recruitment agency in New Zealand. I obtained your details of a web site on the internet. The purpose of this email is to find out if you would be interested in long term or locum placements in NZ. The service will cost you nothing and you are under absolutely no obligation to accept any of the positions that might be offered to you.

Generally if a position is offered to you, the employer will pay your return airfares (and sometimes your immediate family), temporary accomodation and transport and if the position is long term, they might even assist with the relocation of your household furniture and personal belongings.

You could use this opportunity to have an overseas experience in one of the most natural and beautiful countries in the world and also gain some professional experience in another environment. NZ has much to offer, short or long term.

If you are interested in pursuing this further or would like more information, please contact me as follows:

email: lorraine.marsh@xtra.co.nz
Ph: 64 6 345 2635
fax: 64 6 345 2636


Subject: Question
Date: Mon, 3 May 1999 19:52:00 -0700 (PDT)
From: xxxxxx (xxxxxx@yahoo.com)
To: achung@emory.edu

My family has a long history of having high blood pressure on my father's side of the family. My mother's side of the family has a history of heart problems. I am now 46 years old, hold a Master of Business Administration degree, have a somewhat stressful job, and developed high blood pressure about 10 years ago. Two medications have been somewhat successful in treating this condition but have had unfavorable side effects. I am seeking the name of a highly trained medical doctor (in treating hypertension)who can evaluate my specific condition and offer some hope. Thanks for any advice you can offer. You may e-mail me at xxxxxxx@yahoo.com
I live in the Atlanta, Georgia area.


Subject: good info doc
Date: Thu, 08 Apr 1999 09:40:06 -0400
From: xxxxxx@sunet.net
To: achung@emory.edu

but wonder how you find the time to attend to it.

first time to your page although we have communicated before...... approaching the two year mark.

On May 5 it will be two years since I had a Pylodinal cyst (still get spelling incorrect) lanced and would you believe it has yet to heal up totally. you previously told me about the nature of the cell structure there and prolonged "healing" time.

no problems/infections or reoccurance of the swelling. occasional slight drainage still. have to wonder what will happen if and when this thing closes up completely.

is two years abnormal?

NO hurry on any replies you may feel useful/warranted.

xxxxxx

PS. i have a digital pic of the incision taken shortly after the procedure. the amount of cotton wadding he inserted afterwards could have been used to fly a kite. that was the most uncomfortable aspect of the ordeal.


Subject: Autopsy
Date: Mon, 1 Mar 1999 14:38:47 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Dear Andrew,

I can't thank you enough for helping me. The doctors don't seem to think a 20 year-old is important enough to bother answering questions for, so I have been staring at this report, completely dazed. I really appreciate anything you can offer.

Here's what the Clinical Summary says:

This 51 year-old white male had been diagnosed with prostate carcinoma in Septemeber of 1998, and was admitted in December of 1998 for a bleeding duodenal ulcer. He was readmitted on January 2, 1999 complaining of melena.
He was also hypostensive with orthostatic symptoms. EGD revealed a large duodenal ulcer with a large caliber bleeding vessel. The patient then went to surgery where he underwent a Brilroth I procedure with over-sewing of the gastroduodenal artery. Post-operatively, the patient remained hypotensive. Troponin I level was found to be 256. The patient subsequently developed ventricular fibrilation and asystole.

The primary finding is that of myocardial infarct. A transmural acute infarct was noted in the lateral wall of the left ventricle. Additionally, there was subendocardial infarction of the left ventricle. These infarcts likely resulted in congestive heart failure, as evidenced by pulmonery edema, pleural effusion, congestion, and dilation of the hepatic sinusoids, and splenomegaly. Addtional findings include early diffuse alveolar damage and focal bronchopneumonia.

Here's some of what was written under cardiovascular and respiratory examination:

There is an area of epicardial hemmorage on the left ventricle. There is also subendocardial circumferential pale discoloration and hemmorage. The left anterior descending and left circumflex coronary arteries both have severe artheriosclerosis with greater than 90% narrowing of the lumen. The right coronary artery is also effected with approximately 70% narrowing. There is recanalization of what appears to be an old organized thrombus in the lumen of the vessel.

Thick hardened fibrous plaques are noted on the anterior surfaces of the parietal pleura bilaterally. Approximately 250 mg of serous fluid is present in the right hemithorax.

If you could explain any of this to me in English terms, that's be great. You know, my dad drank and smoked for years, so it really doesn't surprise me that his heart gave out on him, but I'd just like to know the little details of what was wrong with his system. I guess it's just a closure thing...

Thanks again,

Emily


Subject: Dr.'s Andrew Chung and Steven Harris - EXCELLENT CONTRIBUTORS to Humanity
Date: Wed, 17 Feb 1999 07:29:58 GMT
From: YOURSHOESwinklerj@cadvision.com (Jay Winkler)
Newsgroups: sci.med

Dear All,

I have been part of the sci.med groups for the past several years and would like to acknowledge who are the most important, caring and knowledgable contributors to our sci.med group.

It is not hard to find that Dr.'s Andrew Chung and Steven Harris are very deserving of special accommodation in the quality and unselfishness of their posts that assist many people who otherwise may not get the type of proper medical advice that these two physicians have given over the years.

I have endlessly enjoyed Dr. Harris's attacks on quackery and those charlatans that, like weeds, infiltrate this group from time to time. I have also taken great pleasure in Dr. Andrew Chung's experience and knowledge, especially in the cardiology groups, give solace to those that would not be able to receive it any other way.

I predict that someday these two humanitarians will receive a very prestigious award recognizing the help they have given others. If anyone wishes to debate a point made, I can accept that, but any attack on these clinicians is the lowest form of any perverse, personal emotion.

Sincerely,

Jay Winkler Creator and Monitor of: sci.med.diseases.osteoporosis
.oooO Oooo. Work, like you don't need the money
( ) ( ) Love, like you've never been hurt
\ ( ) / Dance, like no one's watching
\_) (_/
Jay Winkler http://www.cadvision.com/winklerj
ICQ#: 1211379
Remove "YOURSHOES" to reply


Subject: Mother Diagnosed with T.B. of Bladder
Date: Sun, 14 Feb 1999 19:48:31 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Dear Dr. Chung,
My mother was recently diagnosed with probable T.B. of the Bladder after her second Bladder biopsy and several months of being very ill. Her bladder is severely infected and she was released on the T.B. med protocal about 4 days ago. The tests are still coming up negative, however, two neurologists and an infection control Doctor xxxxxx here in Charleston, S.C. feels all symptoms point to the disease.
We're extremely concerned that my mother's bladder symptoms have not subsided and she seems to feel as bad if not worse than when she was hospitalized.
Do you have any words of wisdom for our family? We're really upset that she still feels so badly and the bladder is still terribly infected(with something). Her Urologist is Dr. xxxxxx of Charleston,S.C. The docs have been as aggressive as possible but we still wonder why she cannot get her strength back. She is 68 years old. Should she be calling the doctor more to inform how badly she feels? She has very little bladder control and has been up from 10 to 18 times per night with burning urination and leakage. She takes medication for pain, blood pressure and high cholesterol.
She is being followed by an infection control T.B. nurse.
Any response would be helpful. Feel free to forward this to any physicians necessary.
Thank you for taking the time to read this.
Sincerely,
xxxxxx
xxxxxx@aol.com
(843) xxx-xxxx


Subject: blood pressure baffle
Date: Sat, 13 Feb 1999 05:46:35 -0800
From: xxxxxx (xxxxxx@email.msn.com)
To: (achung@emory.edu)

Dr. Chung,
I am a 39 year old white female with chronic essential hypertension. I saw Dr. Hall a couple of times around 10 years ago (he is a personal friend of a former boss.) I am very discouraged because this has been going on for so long, but ironically not during my two pregnancies, 11 and 15 years ago. I am currently taking Cardizem with very little result - pressure usually runs 160/100 or so. I weigh around 115 lbs, try to watch my diet, etc. Anyway, I certainly am not attempting to receive a net diagnosis - just wondered if you have any suggestions as to any program you have going that might help. I understand that Dr. Hall is now retired. I live outside of the Atlanta area (about 60 miles) but I did drive up to the clinic near Grady when I saw Dr. Hall previously. I appreciate your time immensely... By the way, Cardizem is just one drug in a long line of attempts to bring this thing under control
(i.e., Norvasc, Procardia, Plendil, etc.)

Thanks, xxxxxx
xxxxxx@hotmail.com


Subject: Hello
Date: Fri, 12 Feb 1999 08:41:35 -0500
From: xxxxxx (xxxxxx@earthlink.net)
To: (achung@emory.edu)

I'm not sure how to post a question on the news group for cardiology, but I do have a concern. My wife get "skipped beats". (Extrasystols?) She feels like the heart hesitates and then the beats hard. She has had it for about eight years. Ekg was done and nothing was found wrong. Recently she has developed a lot of anxiety when she gets them and is becoming increasingly worried. A week ago she called 911, they gave her an EKG on the spot and said that her heart was fine. She also says sometimes it feels like her heart looses it's rhythm for about 5 to 10 seconds, where it's not actually beating but fluttering. This is when she really gets nervous. Any information you can give us would be greatly appreciated. Is there something that her physician could be missing with the EKG? Thank you very much,
xxxxxx & xxxxxx


Subject: Thank you
Date: Tue, 09 Feb 1999 20:36:31 -0500
From: xxxxxx (xxxxxx@bellatlantic.net)
To: achung@emory.edu

Thank you for your reply to my posting regarding alternatives to Coumadin.

Moty


Subject: Tums and calcification
Date: Mon, 8 Feb 1999 18:26:31 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Hello Andrew: Your advice to people on the heart newsgroup has helped me immensely. So here if you will is my weird question. I have been taking Tums forever and when I had a complete blood panel, my serum calcium was a little over normal. My doctor said he didn't know why that was, and I volunteered that it might be the Tums. No response. Is this possible, or am I off base? Also could the Tums be causing calcification anywhere in my body? I am trying to cut back on the Tums, which have become something of a habit. I am taking Lanoxin and Atenolol, and I am also hoping these meds are not affected by the Tums. What do you think? Thanks.
xxxxxx


Subject: Sydneham's Chorea
Date: Sun, 7 Feb 1999 16:17:47 -0600
From: xxxxxx (xxxxxx@iglobal.net)
To: "'achung@emory.edu'"

I have had Sydenham's Chorea when I was about 9 years old. I am now 44 years old. I was told when I had it that I had the chorea, but they caught it before I got the rheumatic fever. I have never had any cardiac problems and do not have a murmur. They treated it like rheumatic fever to decrease my chances of the chorea developing in to that. My mother concers this is what they told her to back then. I was on penicillin for two years and in bed (completely) for 4 months. I was very irritable from the chorea.

Now doctors are telling me I had to have rheumatic fever in order to have the chorea. Can you please enlighten me as to whether or not this is true. Doctors agree my heart if fine. Also, one doctor told me that having had rheumatic fever prediposed me to arthritis. He says I now have osteoarthritis. All I know is I hurt alot after exercise and I have always been a very active person. My wrists, elbows, ankels, and bones in the top of my feet hurt.
Sometimes my fingers do and my right shoulder. My hips occassionally will be sore or stiff. I hobble at first when I wake up and if I have been sitting for a short while.

I need some accurate information on the following questions:

1. Did the chorea and/or rheumatic fever predispose me to arthritis?
2. My father has fibromyalgia. Am I at increased risk of developing that disorder?
a. If so, is it because of heredity or the chorea and/or rheumatic fever or both?
3. Is it possible to have chorea without having rheumatic fever?

I appreciate your quick response.

xxxxxx


Subject: Your Excellent Article on TB
Date: Sat, 30 Jan 1999 19:42:59 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Your article is quite excellent, and I would be most grateful if you could help.

I'm writing on behalf of a 34 year old young man who had been exposed to TB in Viet Nam some years ago. He's today a professional living in New York. They're giving him antibiotics for one week, but the doctor was not happy with the progress and told him that if it doesn't work after 4 weeks, he'll die.
The following is his treatment:

Isoniazid (NH) 300 mg
Pyrazinamide 1500 mg
Vitamin B6
Risampin 600 mg
Myambutol 1200 mg

The young man is a good friend and has a family. Does the treatment sound appropriate, what is the meaning of these antibiotics? The doctor was not happy after the week how he was responding to these antibiotics. Any leads or suggestion you may have is much appreciated. Thank you.


Subject: Hypertension
Date: Tue, 26 Jan 1999 13:17:25 -0600
From: xxxxxx (xxxxxx@BOEING.com)
To: achung@emory.edu

I have been following my blood pressure for 20 years, always on the highest level allowed by the faa medical exams every 6 months. Last time I had to lay still for 15 mins. to get it down enough to pass. I have been checking it on a machine at work (Boeing) and it averages about 175/125. I know this is to high to pass my next physical. I have lost from 265 lbs to 245 and I am an xfootball player at 5'1o" What's new as far as first line alfa blocker's that you would advise me on? Is there anything to this bioeletric treatment? are Alfa Blocker better than Beta Blockers?
Please let me know your opinion.
xxxxxx age 45
609 xxxxxx
Wichita Ks. 67235
Ps What about EDTA treatment?
316-xxx-xxxxxx.
E-mail xxxxxx@aol.com


Subject: Fragile X and Apnea
Date: Sun, 24 Jan 1999 15:14:51 -0600
From: "xxxxxx" (xxxxxx@arn.net)
To: (achung@emory.edu)

Dear Dr. Chung,

I'm not sure if this is the correct way to post a question to the board. If not please direct me to the correct place.

My question is this: How frequently is fragile X associated with apneic episodes?

Thank you very much for your time.

Sincerely,
xxxxxx, JD


Subject: help!!!??
Date: Fri, 22 Jan 1999 11:15:40 PST
From: "xxxxxx" (xxxxxx@hotmail.com)
To: achung@emory.edu

dr. chung,
i have a problem, and apparently you may be able to steer me in the right direction...i have recently been diagnosed with holiday heart syndrome by a cardiologist, although his diagnosis is correct,(for what he believes the syndrome to be), i am not satisfied with my diagnosis, and believe (because of my symptoms) this ailment to be much more complex in nature. first of all, im a healthy 26 year old caucasian male, good diet, vitamin supps. etc. etc. symptoms include flushing, increased heart rate, pvc's (never been caught on monitor, i can only assume), and yes, atrial fib when things get bad, now, heres where it gets weird,...symptoms never begin until very late in the day the next day and can last into the next day after that!!!.... now i've heard everything from underconditioning (im in moderately good shape), to vitamin/mineral deficiency.....(most importantly thiamin..magnesium etc.), but i was very intrigued about your comments on aldehyde dehyrogenase....im not an alcoholic, or even what i consider to be a "binger", and this problem seems to be getting worse, i never had symptoms before the age of 22 or so, when i used to be a real "binger"!!!....could my probs be related to a deficiency in the enzyme???....ive also read on methyl alcohol being found in most drinks, and since the same enzyme breaks down AH and formaldehyde, maybe having a lack of deydrogenase for the break down of that which happens at a later period in the game (symptoms always later in the day????)......OR doc, am i totally off base here... anyway, you seem to be the only one with the slightest interest, and the greatest amount of knowledge on the subject, and any guidance you could give me would be much appreciated....

thanks a million,
xxxxxx

p.s. vodka is supposed to be lowest in formaldehyde concentration, and im gonna get "absolutly" blitzed tonight as a test...

Subject: Antibiotic Prophylaxis
Date: Fri, 22 Jan 1999 10:09:31 -0500
From: xxxxxx (xxxxxx@astro.ufl.edu)
To: achung@emory.edu

Hello there Andrew hope the new year finds you in health and joy.

Would you mind my asking again a question on whether to medicate myself or not (this time) during the fitting of my crown?

I did medicate during the preparations for it. This time they will fit it poke at it I reckon and glue it on the stump tooth. The dentist this time maybe it would be necessary and it is up to me. So would you advise your patients in a not very serious mitrov prolapse but nevertheless one during which a ""little blood" backs up (or something).

I feel during the last 10 years especially (and during my lifetime in general) I have been loaded with antibiotics. But again if it is a matter of heart I will go on.

Thanks Andrew

xxxxxx
(from Gainesville)


Subject: Worried about having TB
Date: Tue, 19 Jan 1999 00:34:16 -0500
From: "xxxxxx" (xxxxxx@enter.net)
To: (achung@emory.edu)

I hope I am not jumping to conclusions but just to be on the safe side I feel compelled to follow my curiosities about the symptoms I have been having lately. I originially felt that I just had the flu and went to the doctor to be treated for that. I was blowing my nose and started to bleed and just felt that my bleeding was the result of blowing to hard. I keep on bringing up spudim that alot of times has blood in it. My chest did hurt to the point that I had to squeeze my chest with my arms when I coughed because it caused me great pain on coughing. My doctor gave me emycin. I took it from friday to sunday night but did not feel that it was doing very good so I went to see the doctor again, Dr. xxxxxx, Brienigsville, PA. My chest pain stopped but still I was spitting up blood every so often after clearing my chest of its mucus. I feel a mild sensation in my chest right now but not painful like it was before. I also feel tired and right now feel kind of raw in my throat and have a taste of blood in my throat. My head gives me pain now because of my coughing. I have had these sympthoms for about 8 days so far and don't remember feeling this sick this long from what I thought was a cold/flu. Today I returned to the doctor and he gave me biaxin a stronger antibiotic. He is sending me for a sinus x-ray tomorrow and I was wondering if I should have other tests to place my other fears at ease.I am confounded by these sympthoms and having to address them when I am ill does not make me as pragmatic as I would want to be when I evaluating possibilities. I am perplexed and would appreciate any information that would assist me in this situation. Please forgive me if I just seem to be over-reacting. I would like to get on with my life but 8 days of this illness is not helping me to keep positive about this event. Your suggestions are welcomed. Thank you for your time Doctor. I am xxxxxx / xxxxxx@enter.net. If you can direct me to someone who can help me put my fears at rest I am located at Bethlehem,PA18105 and the hospital that I dealt with in this matter was St. Luke's Hospital located in Fountain Hill, Pennsysvania. Thanks again. :-)


Subject: Posts to sci.med.cardiology
Date: Mon, 31 Aug 1998 10:01:50 -0400
From: Tom xxxxxx (xxxxxx@umich.edu)
To: Andrew Chung (achung@emory.edu)

Dr. Chung,

I just wanted to drop a line of thanks for your concise and articulate postings to the news group.

As a layperson who browses the newsgroup regularly, I really appreciate the information to be found there. I'm being seen here at the U. of Michigan Med. Ctr. for a fairly serious aortic insufficiency (Dr. xxxxxx is my cardiologist) and it's good to be able to read some of the updates on some of these conditions.

Best regards,

Tom xxxxxx

Subject: Thanks
Date: Wed, 12 Aug 1998 12:20:39 -0700
From:xxxxxx@rsvlonline.net (Charles xxxxxx)
To: achung@emory.edu

As a "lurker" on the newsgroup, starved for information on cardiology-having suffered from a heart attack and quad by-pass, I too always seek new information. Although blessed with good physicians your additions and comments are informative, helpful and useful. Thanks for taking the time to contribute to the newsgroup.

Regards

Charlie

Subject: Andrew's HomePage (A Physician's Web Resource) - Netscape
Date: Sun, 9 Aug 1998 09:24:05 -0500
From: "Bill xxxxxx" (xxxxxx@mindspring.com)
Organization: mindspring.com
To: achung@emory.edu

Thanks for having your WWW page. It's kind of like a security blanket. Makes me feel good knowing it's there when needed.

Thanks.

Bill

Subject: thank you
Date: Sun, 21 Jun 1998 03:31:12 -0500
From: Don or Darla xxxxxx (xxxxxx@datasync.com)
To: achung@emory.edu

your a big help to the group you are on,sci.med.cardiology i try to go there some times, and i like your web site, i just wanted to say i wished there were more out there care about us and not the money, thank you for caring, god bless you.
from darla xxxxxx

Subject: Add my web page
Date: Sun, 7 Jun 1998 05:18:38 +0200
From: "José Eduardo González Díaz" (diaz@iname.com)
To: achung@emory.edu

Dear Andrew:
I'm a physician from Albacete, Spain with a web page, and I would like a link in your page to mine. I'll do the same in: http://www.geocities.com/CapeCanaveral/Lab/4685/medicos.htm
Sincerely:
José Eduardo González Díaz
http://www.geocities.com/CapeCanave

Subject: Cardiac Catheterization
Date: Wed, 3 Jun 1998 22:37:48 -0500
From: "Stuart xxxxxx" (xxxxxx@tilc.com)
To: "Andrew Chung" (achung@emory.edu)

Mr Chung

Could you please answer a question for me. If Cardiac catheterization was done on a 2 year old would the patient be awake or would they be put under general anasthetic. Our Cardiologist is wanting to do this procedure on our daughter whn she reaches 2 to assess her risk of SCD , we are meeting with him soon to discuss it. I have done a lot of reading onthis procedure and everything I have read says the patient will be awake during the procedure. Does this apply to patients so young as I cannot imagine that a child so young could go through such a procedure being aware of what is going on, especially my daughter as she is very afraid of anyone in a white coat at the present time because of experiences she has had, she is 14 months old now.

Thank you so much for any guidance yo can give me

Karen xxxxxx

Subject: Re: Anatomy question
Date: Wed, 3 Jun 1998 18:35:43 -0400 (EDT)
From: Emma xxxxxx (xxxxxx@qlink.queensu.ca)
To: achung@emory.edu (Andrew Chung)

What causes finger joints to make a popping sound? Is something "displaced"? I seem to recall a science article saying it was nitrogen moving around.

emma
:)


Subject: RE: Anatomy question
Date: Wed, 3 Jun 1998 17:02:28 -0500
From: Scott xxxxxxx (xxxxxx@STB.com)
To: Andrew Chung (achung@emory.edu)

Hello,

Thanks Andrew for the information. I really appreciate it. I have an appointment with my doctor but I figured I might ask on the net while I wait for my appointment. I'm sure its nothing, but I'm sure you can understand that pronounced anatomical differences can be sort on unnerving especially when they seem to only pertain to you. My biggest fear right now (until I find out otherwise) is that my doctor is going to say "is that all?". On the other hand if it is something serious I have always heard that catching it early is a key to fixing the problem. By the way are you a doctor or a med student?

Scott


Subject: Personal Web Site
Date: Mon, 1 Jun 1998 08:49:06 +1200
From: I Bell (doc@docbell.com)
To: achung@emory.edu

Hello Andrew,

Thought you may like to add my homepage to your list of sites,

www.docbell.com

Thanks,

Iain Bell MB ChB
New Zealand


Subject: if this is an active email
Date: Sun, 31 May 1998 10:15:00 -0400
From: xxxxxx, Jim" (xxxxxx@gaatlanta1.btna.com)
To: achung@emory.edu

if this is an active email and you have have the time lets talk about some things: chronic prostatitis and antibiotics/bacteria

james xxxxxx


Subject: WPW
Date: Thu, 28 May 1998 22:53:27 -0500
From: Stuart xxxxxx (xxxxxx@tilc.com)
To: Andrew Chung

Andrew Chung

My 13 month old daughter has WPW, she was diagnosed at 4 months old after a severe incident of SVT, her BPM was 290 and ER doctors could not convert her. This as far as I know was her first incident of SVT. She was hospitalised for 2 weeks, WPW was diagnosed and she was released on medication, Tambocar.

Over the following few months we had breakthrough SVT due to her outgrowing her medication. We have had no breakthroughs and no medicine increases in almost 5 months now and her cardiologist is considering taking her off medication if she continues to do well.

Our cardiologist explained to us that at about a year old children can cease to have problems until they are of adolesence and if this is the case with my daughter he plans to do ablation at 10 years old. I understand why he wants to take her off medication and have spoke to others who have children who have come off medicine and been fine but I am trying to get as much information as possible as to whether this is the right thing to do. It frightens me that she will be off medicine and have attack of SVT as we nearly lost her at 4 months I cant go through all that again and she cant. Does risk of side affects of medicine outweigh risk of SVT.

Also I read in the newsgroup that I got you're e-mail address from a question from a guy that no-one has responded to yet. He asked if there was any significance to him always having sinus congestion at the onset of SVT. When my daughter had her first SVT she was congested, she was actually at the doctors office when SVT occurred, I was there to have the congestion checked out. I told them at the hospital that she was congested and they said it had no significance to her diagnoses, I figured I was very lucky she had been congested otherwise I wouldn't have been at the doctors office that morning. Every time since then that she has had SVT she has had sinus congestion and until I read this guys question I hadn't really realised it . Is this just shear co-incidence or is it of relevance in you're opinion.

Any help you could be would be appreciated.

Thank you so much for you're time

Karen xxxxxx


Subject: Your site
Date: Wed, 27 May 1998 12:41:56 -0600
From: xxxxxx@ix.netcom.com
To: achung@emory.edu

Enjoyed it very much. Will explore more at my leisure. A physician site you might want to add is Ed Friedlander "The Pathology Guy" at www.worldmall.com/erf
He has a truly comprehensive set of lecture notes for his classes at the University of Health Sciences in Kansas City, and tons of other interesting stuff written in a provocative and unique style. He also answers everybody's questions for free--at length!
Thanks for a great & helpful site. --Helen xxxxxx


Subject: SVT
Date: Wed, 27 May 1998 10:51:33 -0700
From: xxxxxx@webtv.net
To: achung@emory.edu

Hi, I am a 25year old m and have SVT,hr-120-160 and have been on Toprol 150mg for 6 months. My hr is now 60-70bpm.How long can safely take toprol?Thank you
Eddie xxxxxx


Subject: Hi there! I have a cardio question.
Date: Tue, 26 May 1998 23:00:20 -0700
From: "Caron, Harold & Norman" (xxxxxxx@sprint.ca)
To: achung@emory.edu

Hello,

I am new to the web. I found your page through the cardio newsgroup. Being newly diagnosed with hypertrophic cardiomyopathy has sent me in search of information while I wait to see a cardiologist. There were not many entries on cardiomyopathy from your page, however, I must say that I am really impressed that you take the time to write such clear responses to the many and varied queries that you do get. You must be a very nice person. I enjoyed your quip about Dr's who write books.

My story is:

Several dead family members and a 35 yr old cousin with a transplant have made my hopes of a mistaken diagnosis very slim. However, I am asymptomatic at present and am hoping to find that there is some kind of treatment which can increase my life expectancy, especially since I have an 8 month old son who could possibly have inherited the disease as well. Almost 20 years ago a 20 yr old cousin died from myocarditis. At the time my siblings and I were told that it was NOT hereditary, despite the fact that our mother had just died from a MI at age 43 yrs. Diagnostic tools back then consisted only of cholesterol tests and ECG's. Trust me, I had a few of them! Luckily our GP's didn't know too much about "autosomal dominant inheritance with variable penetration" (whatever that means!) back then because it enabled my sibs and I to live worry-free for the last 20 years.

My questions are: Where can I go for information on treatment for hypertrophic cardiomyopathy? Can I find out how quickly the disease usually progresses? (My family history has people dying in their 20's, 40's and 50's, the transplant cousin who was 35 (and is still going 3 yrs later) and his Mother who is diagnosed but asymptomatic in her 60's.)

I would sincerely appreciate any pointers for further information that you can offer.

Best wishes,

Caron xxxxxx


Subject: Re: Heart attack?
Date: Tue, 26 May 1998 23:46:27 -0400
From: "Lawrence xxxxxx" (xxxxxx@allie.com)
To: "Andrew Chung"

Thank you for the info and the access to your website. -Larry


Subject: Re: Help Again
Date: Tue, 26 May 1998 17:55:40 -0400
From: Qualman (xxxxxx@netmcr.com)
To: Andrew Chung

Dr. Chung,

Just wanted to thank you for your help. While I trust my cardiologist and have a good relationship with him it has made a difference knowing there is a site I can go to and receive answers. Keep up the good work!!!

D. xxxxxx


Subject: hernia repair home page
Date: Sun, 24 May 1998 23:16:31 +0200
From: Luigi (aluigi@masterweb.it)
To: achung@emory.edu

Please visit and link my home page at http://www.geocities.com/HotSprings/Spa/4382. I am an italian surgeon, living in Bordighera (near Sanremo, famous for the flowers, and Montecarlo - France - famous for the casino and the Grand Prix). Sorry for my poor english and congratulations for your page.

Luigi Amorosa


Subject: Kawasaki disease?!?
Date: Sun, 24 May 1998 15:03:18 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

My nephew has been diagnosed with kawasaki's disease; yet the doctors aren't too sure what it is and how to treat it. Do you have any answers? Maybe you can help us.

Thank you,
Amanda xxxxxx


Subject: Comment
Date: Thu, 21 May 1998 11:05:11 +0100
From: "Graham xxxxxx" (xxxxxx@updata.co.uk)
To: achung@emory.edu

Nice work!
sam.


Subject: Comment
Date: Thu, 21 May 1998 11:05:11 +0100
From: "Graham xxxxxx" (xxxxxx@updata.co.uk)
To: achung@emory.edu

Nice work!
sam.


Subject: question
Date: Tue, 19 May 1998 19:47:47 EDT
From: xxxxxx@aol.com
To: achung@emory.edu

I saw your name in regards to high cholesterol count and am looking for someinformation..I have a friend who has been told that his cholesterol count is 787..is that possible,...he has been taking meds for almost a year..and his count has risen almost 200 points...please give me any help that you can..I appreciate your time


Subject: Strange Exercize Problem
Date: Mon, 18 May 1998 16:02:26 -0400 (EDT)
From: Mehrdad xxxxxx (xxxxxx@usa.dupont.com)
To: achung@emory.edu

Andrew:
Thank you very much for your knowledgeable responses on sci.med.cardiology. I had a particular problem over the weekend that I would rather ask directly, as it may not be applicable to most. I would appreciate your response:

I was bicycling uphill with heart rate monitor. As I was making my climb, my heart rate was at about 145. Suddenly I felt a feeling of quivering and cold sweat. I stopped and put myself in rest condition. but the quivering and "bad feeling" continued for a few more minutes, and my heart rate kept on climbing to about 160, even though I was at rest. Eventually my heart rate returned to about 100 (my normal rest heart rate is about 60). After that I was not feeling very well, and was able to return home very slowly. Every time I tried to have normal speed the same bad feeling and high heart rate continued. Generally I felt weak for about 3 more hours. My heart rate did not return to normal for about 5 hours. I am wondering what happened to me.

A few notes:

I bike a lot in hilly terrain without problems. I am a 45 year old male with a family history of iskemic heart desease. Did not feel any chest pain, but general discomfort. No lightheadedness. Had a strong cup of coffee before the ride.


Subject: New Emory Web link
Date: Mon, 18 May 1998 07:32:53 -0400
From: "Allan Platt, PA-C" (aplatt@emory.edu)
Organization: Sickle Cell Center
To: achung@emory.edu

Please add a link to The Sickle Cell Information Center at http://www.emory.edu/PEDS/SICKLE
Thanks
--
Allan Platt, PA-C
Clinical Instructor
Emory University School of Medicine, PA Program
Program Manager
The Georgia Comprehensive Sickle Cell Center
Grady Health System
1 404-616-5994 E-mail: aplatt@emory.edu


Subject: Thank you!!!and More...
Date: Thu, 14 May 1998 18:01:04 +0900
From: "Zhao xxxxxx" (xxxxxx@rdmpy.iwa.fujixerox.co.jp)
To: "Andrew Chung" (achung@emory.edu)

Hello Mr.Chung

I am in sincere appreciation of your valuable suggestions via email and reply on sci.med.cardiology. It give me much help on understanding about my situation.

Sorry for so many questions below. My main question is about 'EP'.

I have missed one thing about my recent physical examination in Japan, Doctor also check me using 'ultra-voice wave' or 'ultra-sound wave' and found no palpitation.What does it imply?

Now I am reading your article about WPW syndrome on your Web page. Owing to my lacking in medical words, I should go on with it.I also wonder what is 'EP' mentioned in your Re article on sci.med.cardiology, and is it true that there are only few EP specialist in the world? :-(. Do you know if I can find those people in Japan or Chinese? Do you have a figure about EP treatment fees?

Some years ago I learned my mother do have heart problem. And I want to know if I marriage with someone( not known yet), Is there a big possibility that our child (given I may have) will have this syndrome? What about future's efficacy of medicine?

Thank you for your time.

Best regards,
adam xxxxxx


Subject: Thank You
Date: Wed, 13 May 1998 17:19:12 -0400
From: Stanford xxxxxx (xxxxxx@erols.com)
To: Andrew Chung (achung@emory.edu)

Hi Andrew!

I am subscribed to the cardiology newsgroup and always read your posts. I appreciate your participation and have learned a number of things through the newsgroup. I am also subscribed to the Heart-List run by Jim Revkin at Yale (Jim Revkin ), although this list has not had any activity for some time.

I merely wanted to thank you for your participation. I am a 50 year old male who had an MI 5 years ago that was successfully treated with tPA therapy and angioplasty in the circumflex artery. I have made numerous lifestyle changes, and am trying my best to stay alive and avoid thoracic surgery!

Thanks again!

Stan xxxxxx


Subject: Enjoyed your URL
Date: Tue, 12 May 1998 16:46:38 -0500
From: anita (xxxxxx@phoenix.net)
To: achung@emory.edu

Hi..
always read your comment on sci.med.cardiology and find them very informative. now,today I'm cking out your Web Site .. learned a lot more !!!
thanks .. Knowledge IS power when it comes to one's health ..

'nita in Houston


Subject: Exercise Induced Hypertension
Date: Sat, 09 May 1998 22:12:55 -0600
From: Greg (xxxxxx@mci2000.com)
To: achung@emory.edu

Please excuse the direct e-mail - I haven't figured out Newsgroup posting yet -

I am a 50 year old cyclist riding 20 to 25 hours per week at a heart rate of about 130 bpm. It was noted during a recent cycling stress test that my blood pressure went from a baseline of 124/78 to 180/85 in the first 4 minutes, with a heart rate of 135, and to 210/85 8 minutes later at a heart max of 180. The technician called this 'exercise induced hypertension', and suggested I consult with my family physician. My PPO gatekeeper doctor's opinion was that nothing is really amiss. Aside from this, I am in excellent health. Is 210/85 for 10 hours at a time and OK situation, or should I be alarmed ?

Any insight you can offer would be appreciated.

Thanks,
Greg xxxxxx


Subject: Pulsing Abdomen -- Advice?
Date: Fri, 8 May 1998 17:09:35 +0100
From: Ed xxxxxx (xxxxxx@tiac.net)
To: achung@emory.edu

Dear Andrew,

I'm sending this note directly to you rather than the sci.med.cardiology board. If you can respond, please do so directly to me.

I wonder if you can offer me any advice: I am a 39 yo M in good health. For at least 4 or 5 years I have noticed that my abdomen pulses in time with my heart.

I am a little overweight (240 lbs, 6'8" tall) and my abdomen is soft. When I look down at my navel, I can see the whole thing pulsing in time with my heart. The pulsing isn't localized.

I never really thought about it until I happened to read about abdominal aortic aneurism. I then remembered that my grandmother had such an aneurism repaired when she was in her ?? early 60s.

I don't smoke (I did until about 10 years ago), eat moderately, exercise sparingly. I had a physical last year. BP 130/80, total cholesterol of 210, HDL of 70. I didn't think to ask about the pulsing at the time.

Because I am very tall and nearsighted, I was evaluated for Marfan's syndrome about 9 years ago. In the course of that evaluation, I had an echocardiogram of the heart which revealed normal mitral valve action. I don't recall having the abdominal aorta evaluated specifically then. I don't have any other striking Marfan's symptoms, and height runs in my family.

I think I've got med student's disease -- it never would have occurred to me to worry about the pulsing until I read about AAA, but I'm wondering if I should be concerned.

Thanks for any advice you can offer,

Ed X.


Subject: 'white coat hypertension'
Date: Wed, 6 May 1998 18:42:11 EDT
From: xxxxxx (xxxxxx@aol.com)
To: achung@emory.edu

Hey Dr.`Andrew,
I like your web page.

My name is Beth xxxxxx. I am a doctoral student in clinical psychology at Adelphi Unniversity, Garden City, NY. I am currently doing a research project on the effects of subliminal psychodynamic messages(via a tachtistoscope) on hypertensive patients who suffer from white coat effect.

Would you be willing to answer some questions I have?

I have run about 28 subjects and even though I am 'blind' to the positive message I am starting to see results with one field. My question is why some patients respond with a lower systolic after the intervention, some have a lower diastolic response and some patients respond with both systolic and diastolic pressures. Any random thoughts?

Hope to hear from you,
Beth


Subject: An aspiring medical student
Date: Mon, 04 May 1998 19:52:10 -0400
From: Michael xxxxxx(xxxxxx@prism.gatech.edu)
To: achung@emory.edu

Dr. Chung,

Hello. My name is Michael xxxxxx, and I am currently a Georgia Tech President's Scholar, majoring in chemical engineering. I am an aspiring medical student, with no past history of doctors in my family. I have networked with other students on the Tech campus, but I still have general questions about medicine, medical school, and research opportunities.

If you could let me know if it would be appropriate for me to ask you questions regarding these topics, I would appreciate it. I do not want to impose and that is why I am asking you first.

As both of us have had the "Tech experience," I hope that we will be able to relate on some topics relating to the undergraduate experience.

Thank you for your time, Dr. Chung, and I hope to hear from you soon.

Michael xxxxxx
xxxxxx@prism.gatech.edu


Subject: Hello!!
Date: Wed, 29 Apr 1998 21:14:19 -0400
From: Allison xxxxxx (xxxxxx@gsu.edu)
To: achung@emory.edu

Hi there Dr. Chung,

I was just wondering if you are accepting new patients?? I live near Emory and am looking for a new primary care physician. :) I am extremely impressed by your advice and the content of this web page. I wrote to you once before some time ago about asthma and thought I would check in with you now about your availability.

Let me know, if you have a chance.
Thanks,
Allison


Subject: High Cholesterol
Date: Wed, 29 Apr 1998 09:48:12 -0400
From: JM (xxxxxx@blippybellsouth.net)
Organization: very little
To: Andrew Chung (achung@emory.edu)

Hi Dr. Chung:

First of all, I'd like to thank you for being so contributory to the cardiology NG. It's great when professionals in a part. field get involved in Usenet newsgroups.

But I have a question concerning Dr. Ornish's regression claims. In the short time I've been reading the card. group, and your posts, I can see that you clearly disagree with his theories. I've always realized that Ornish could well have the old agenda of selling books, programs, making a name for himself, etc., but I also felt that there would probably have to be at least some truth to what he was saying, else he would be opening himself up to all sorts of discredit. Without getting into a lot of the gory statistical details, do you believe that he is using bad data, or are the studies he uses to support his claims flawed?

I guess the idea of regression is very appealing to people, such as myself, who have some hereditary risk factors. But I'd really like to find the truth on this matter. Thanks again.

Jay


Subject: mitral valve prolapse an a-fib
Date: Tue, 21 Apr 1998 23:23:16 -0400
From: xxxxxx@webtv.net (James xxxxxx)
To: achung@emory.edu

Dear Mr. Chung,
I was recently diagnosed with mvp after attacks of a-fib that happened maybe four to six times a year since 93. I was also found to be suffering from pericarditis which was causing me alot of pain. I am taking lanoxin .125 1x a day, coumadin 2.5 1x a day and klonipin for the panic attacks i suffer. i have been feeling good since i got out of the hospital (mar 20) but for the last two days my heartbeat has been irregular and hitting 115-125 bpm at rest. when i take my lanoxin it lowers my heart to 70-85 bpm but my heart is still beating in a irregular fashion. is this irregular heartbeat dangerous in itself? i dont have health insurance and the clinic where i go is only open once a week. I also suffer from bi-polar disorder so when my heart feels funny my mind really plays tricks on me. also in your educated opinion when my heart is in the 115-125 range at rest is it safe to be active and at what heart rate does one enter the danger zone? i have problems with chest pain but since being put on anti-immflamatory for the effusion ive felt better. I have also been feeling sick to my stomach lately. is that a sign of mvp. im sorry to bombard you with all these questions but from what ive read in the cardiology bb i see you are a caring and knowledgable doctor. any help you could give me would be extremely helpful.
Also one last question. what do i do if im working and i feel these palpiations or bout of a-fib is it safe tobe running around (i work as a waiter)? thanks again and god bless james xxxxxx


Subject: 12 lead ecg
Date: Tue, 21 Apr 1998 11:50:02 EDT
From: xxxxxx (xxxxxx@aol.com)
To: achung@emory.edu

Do you have any info an the effect electrode position or placement has on ecg recordings? The 12 lead serial ecg. When the initial ecg is performed, the electrodes are removed. 8 hours later the next ecg ,,, the electrodes may not be in the same position as in the first set. Especially in V2,V3, V4, and V5. I have found important misleading changes when the electrodes are not placed in the original position.

Sincerely,

Steven xxxxxx


Subject: 2 questions..
Date: Mon, 20 Apr 1998 17:33:41 -0400
From: Chris (xxxxx@worldnet.att.net)
To: achung@emory.edu

Hi,

I have two simple questions: is "physical diagnosis" considered a rotation or clerkship ? Would that be taught exclusively by the department of internal medicine ?

Thanks for your answers. BTW interesting website.

Chris


Subject: hippocratic oath
Date: Mon, 20 Apr 1998 14:39:57 +1000
From: "Kellie xxxxxx" (xxxxxx@gmp.usyd.edu.au)
To: achung@emory.edu
could you please email me a version of the hippocratic oath in caligrahy . P.S, EMAIL address is xxxxxx@gmp.usyd.edu.au From a med student


Subject: Appreciate your knowledge and advice
Date: Sat, 18 Apr 1998 15:21:21 -0700
From: Sandy xxxxxx (xxxxxx@pacbell.net)
To: achung@emory.edu

Dr. Chung,
I hope you will not mind an email sent personally instead on the newsgroup. Your work you do on the internet is very impressive. I have really enjoyed and learned a tremendous amount of information from you.

In Dec. 1995 I fractured my back at the T-12. I have had progressive weakness since then with chest, hip, and leg pain. I had HMO insurance at that time and I have accepted my doctor's advice (a GP)that I may always have pain and weakness and nothing can be done. The weakness and tiredness grew worse. Since I was working nearly two full time jobs, I decided to leave my full time job and go on full time at my second job. I could no longer go on - I could barely make it through a 12 hour shift.

I changed my insurance now I pay the price to be able to go to any doctor of my choice, but since I have been with the same GP for so long and he has all my records, I have stayed with him. I work full time for Scripps based in the CCU as a Respiratory Therapist. I continue to have progressive weakness, cannot walk up a staircase without feeling like I am going to collapse, and have been having chest pain for several months.

I went to my Gen. Pract. He sain I am high risk for Heart problems and he put me on nitro and ordered a Stress Test for three weeks later. I asked for an Echo and he said there would be no need for one. He has done no other tests, not even an ECG, just ordered the nitro for me. I have some concerns and athough I believe we have a great team at Scripps, it is my wish to keep this personal. I do not want to be treated at the hospital that I work and I never want my co-workers doing my care. It is very personal to me. I don't even wish my work to know of any problem, unless it would become necessary.

My question to you - Do you know a Cardiologist in the San Diego area that you know their work and can highly recommend them? One which is not in the Scripps Hospital system please. I have the insurance to choose and do not have to go through a primary physician.

Thank you in advance,
Sandy xxxxxx


Subject: scenario
Date: Thu, 16 Apr 1998 21:01:09 -0500
From: bigeye (xxxxxx@io.com)
To: achung@emory.edu

Could you describe a scenario for me in which a man of 60 years being treated for high blood pressure but otherwise apparent good health, begins to feel shortness of breath and chest pains. He goes to the emergency room and it turns out he needs emergency heart surgery.

Is this scenario plausible? Could you describe what type of surgery this person would most likely need, etc?

thanks,
bigeye


Subject: hippocrates oath
Date: Tue, 14 Apr 1998 16:57:57 -0400
From: James and Lynn (xxxxxx@gte.net)
To: achung@emory.edu

Hello,
I came across your e-mail address while I was searching the web for information on the Hippocratic oath. I hope you don't mind me asking you a question as I am sure you are very busy. My question: Must every doctor / physician take the Hippocratic oath as a part of their medical school? Not just study about it, but actually take the oath. And if so can a medical board find you guilty of breaking the Hippocratic oath? Or is it just a nice statement of the medical profession? Kind of an anchor to ground the profession to something solid? It would be most helpful if you could find the time to answer my question.
Thank you for your time. James


Subject: webpage address change
Date: Mon, 13 Apr 1998 17:06:53 -0400
From: Joel S (jds1@usa.net)
To: achung@emory.edu

I'm listed on the Physician's Online page at an outdated address. It should be changed to:

http://www.geocities.com/HotSprings/1364/

Thanks,

Joel Selanikio
jds1@usa.net


Subject: perplexing wrist pain
Date: Thu, 09 Apr 1998 09:22:42 -0400
From: GA (xxxxxx@sunet.net)
To: achung@emory.edu

Any insight welcomed. Only 45 yrs old and falling apart already. Do not engage in ANY regular activity that can explain the following, except 50 or 100 push ups daily.

Right wrist pain, not carpal tunnel. Sudden onset. Cause totally unknown - no event or trauma whatsoever. I DO sleep on my arms and hands and this wrist is (was) typically placed under my right pelvis bone during sleep. I also do daily push-ups, sometimes with thumb spread from body of hand but there has been NO specific event that can be identified as underlying this sudden onset.

The pain, sometimes accompained by a popping or snapping of the wrist joint occurs at a point on the SIDE of the wrist directly above the thumb, where wrist flexion/bending occurs, at the point where a watch would encompass the wrist.

SLIGHT DISCOMFORT - if I simply spread my thumb and fingers to the extent one would to rub ones eyes and proceed to rub the eyes.

SEVERE DISCOMORT accompained by popping/snapping of the wrist - Forearm and hand facing down, spread the thumb and at the point where the thumb and index finger create an "L" (extreme flexion, 90 degree angle) AND simultaneous inward movement of the wrist.

The pain is associated with side to side/inward flexing of the wrist, NOT an up and down "goodbye waving motion", with the thumb spread - creating the V or L configuration. Grasping ability not effected. When disturbed the pain throbbing can persist for 20 seconds or so.

Thank you for your time. If this not within the realm of your expertise perhaps you can refer me an individual with familiarity in this area. Just purchased a carpal tunnel wrist splint to prevent and lessen general wrist movement.

Greg xxxxxx


Subject: Thank you
Date: Tue, 7 Apr 1998 10:34:05 -0400
From: "Gary Rimar" (gary@glolink.com)
To: achung@emory.edu

I appreciate being able to learn about Physician profiles on the web. You helped me find the links. Thanks!

Gary Rimar
Internet Consultant
GlobalLink New Media
248-433-0900, extension 225


Subject: Employment Opportunity
Date: Wed, 1 Apr 1998 17:32:48 -0800
From: "CAROL" (carol@gyro.net)
To: achung@emory.edu

Dr. Chung,

Hello, my name is Carol. I am an Internet Researcher employed by a recruiting firm located in Austin, Texas. We are currently hiring individuals with your work experience. I found your resume on the Internet, but it did not indicate if you would be interested in relocating. There are no fees involved, all positions are fee paid. If you are interested, please respond to this email.

This will be the only email you will receive from me, if you find it to be an intrusion please accept our apologies.

Enjoy your day!

Carol Schultz


Subject: Medical transcriptionist research
Date: Mon, 23 Mar 1998 04:18:46 EST
From: Wabewawa (xxxxxx@aol.com)
To: achung@emory.edu

Dr. Chung:

I am an MT fairly new to the Internet. I have accessed most, if not all, of the MT newgroups and boards and am getting a lot of info. there.

However, when it comes to esoteric research regarding product names, for example, I am not having a lot of luck. I have been referred to two multi- engine searches, Dogpile and Mamma, that did help with finding the correct spelling for "ChoICE guide wire," but I am having no luck finding info. an a "Bonnie/Bonni/Bonney balloon catheter" which has been dictated with two different spellings to myself and another MT.

Any information you might have regarding sites for product searches especially would be greatly appreciated.

Thank you,
Mariette xxxxxx


Subject: Web Page
Date: Sat, 21 Mar 1998 20:07:16 -0500
From: "Charles xxxxxx" (xxxxxx@worldnet.att.net)
To: achung@emory.edu

I would like to get a web page put togther like yours I have 20 years in Healthcare can you direct me to the sources?


Subject: ?????
Date: Sat, 21 Mar 1998 01:12:12 EST
From: MondoCane3 (xxxxxx@aol.com)
To: achung@emory.edu

These sentiments are nice.....it's just too bad that the members of the medical community seem to have forgotten them, or even worse, never learned them.


Subject: national resident organization
Date: Sat, 14 Mar 1998 07:12:46 -0500
From: "Paul Ambrose, M.D." (ambrose5000@Hitchcock.ORG)
Organization: Department of Community and Family Medicine
To: achung@emory.edu

Andrew-

We have a group of residents who gather throughout the year to reflect upon the residency experience and share common interests and concerns. These individuals typically come from the major specialty/trade associations with resident sections. Currently, however, we are attempting to make our presence known to a wider audience of residents. We have two national conferences scheduled for September 26-27, 1998. Our website is www.residents.org. Please forward this email to any interested residents. Please feel free to contact me at ambrose5000@dartmouth.edu.
Thanks..paul ambrose


Subject: information request
Date: Sat, 7 Mar 1998 15:51:02 EST
From: xxxxx (xxxxxx@aol.com)
To: achung@emory.edu

Please send me information re the Emory Univ School of Medicine Division of Hypertension: I would like more information re their research as it pertains to Blacks and hypertension control; please mail to Vera xxxxx, xxxxx Hopkins st , Inkster, Michigan 48141


Subject: hypertension
Date: Fri, 6 Mar 1998 19:12:28 -0500
From: xxxxx@webtv.net (ELIZABETH xxxxxx)
To: achung@emory.edu

What is the best medicine for lowering high-blood pressure apart from CARDIZEM CD? Please give me a feedback asap. Thank you in advance.

******************************************
NIKE


Subject: Heart Symptoms vs Costochondritis Symptoms
Date: Thu, 5 Mar 1998 16:13:37 -0500
From: xxxxxx@webtv.net (Edward xxxxxx)
To: achung@emory.edu

Dr. Chung,
A while back you posted an answer to a person who was going to participate in a TST. He said he was'nt sure what was causing his chest pain. You suggested sublingual nitroglycerin to make the distinction.

I brought this to the attention of my exercise physiologist who rejected the idea because of the way I wanted to do it. Occassionally, during some of my cardiac rehab exercises, which normally take 5 minutes each, I will experience a concentrated mild pain located right above and in the right nipple area. If it comes on at all, it comes on during the last 30 to 45 seconds of the particular exercise. If it comes on sooner, it quite often goes away with continued exercise.

In any case, as soon as the exercise is finished, the pain disappears. What I wanted to do, is to have the nitro at the ready while on the exercice machine and pop it into my mouth when the pain appears and continue exercising. She said, can't do. She was'nt too clear of the reason why. So, I dropped it.

My cardiologist said he is not so sure that it is angina. In fact, he knew of the pain before I took part in my last stress test and we were both watching for it during the test. The test lasted 9 min 15 sec and the pain showed up at about the 7th or 8th minute and then went away. I appear to be the only one concerned about it.

My cardiologist had me try Imdur for about 30 days a while back during which time, it had no effect on the pain.

Should I continue to drop the issue, or is there another way to use nitro as I wanted to?

I am 65 years old, had 3 bypasses in Feb '94, started to experience this pain in late Summer '96, a little over 2 1/2 years after surgery. In the past 4 years, I have maintained an exercise program and low saturated fat/cholesterol diet and hav'nt smoked since '64. I am a male and have taken part in chelation therapy beginning late last Summer and am now in a maintenance program for it. Some subtle other symptoms that are usually cardiac related have disappeared. I am also on a nutritional supplement program.
All this to avoid any more invasive procedures. One angiogram and CABG is enough. I would sincerely appreciate a suggestion on your part on how to nail down the source of the nipple pain.
Respectfully,
Edward xxxxxx


Subject: physicians
Date: Thu, 05 Mar 1998 11:18:22 -0800
From: Jim xxxxxx (xxxxxx@bhschools.org)
Organization: Bunker Hill School District
To: achung@emory.edu

My name is Mollie xxxxxx and I am doing a report on a job I want to be when I am older. I picked physician. I am 12 years old. I wanted to know if you could send me some info on what physicians do what kind of education you need the salary the diadvantages and advantages. Oh and also the growth of how many jobs will be open by the year 2000. My e-mail is xxxxxx@hotmail.com. I would be very thankful if you could send some information.

thanks,
Mollie xxxxxx


Subject: What is it?
Date: Tue, 24 Feb 1998 13:47:33 -0800
From: Denise xxxxxx (xxxxxx@bc.sympatico.ca)
To: achung@emory.edu

I am hoping that you can help me. I have been trying to find out what "Zestral" is and what it is used for?

Signed,
curious


Subject: drugs
Date: Mon, 23 Feb 1998 20:00:53 -0500
From: xxxxxxx (xxxxxx@astro.ufl.edu)
To: achung@emory.edu

OK what is the concensus on the following two?

avapro (irbesartan) and
monopril (fosinopril sodium)

are these two calcium beta blockers?

This is what Erika was prescribed.

She was told they are the newest.
Newest does not always means safests(sic)

Thanks again
mariou


Subject: Running out of time: Hereditary Angioedema Type II
Date: Mon, 16 Feb 1998 11:38:51 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Dr. Chung: I am not a regular web crawler, but am trying to become one for the sake of my son...and myself. We were diagnosed with Hereditary Angioedema Type II almost ten years ago, and my doctor was satisfied with keeping me barely functional on valiums and narcotics. I am "between" doctors; mine was felled by a massive stroke two months ago. My son, who suffers greatly from HAE, is a brave, wonderful and intelligent young man whose doctors have just...ignored the semi-definitive tests done ten years ago at Syracuse University Hospital. His symptoms are classical HAE, yet his pediatricians have consistently (and, IMHO, criminally) "band-aid" treated his gastro problems, his breathing problems, etc ad nauseum. They refuse to read the clinical info re: HAE. Probably too time consuming. Nevertheless, my son has survived, even thrived; he is currently a freshman (under heavy grant and loan status, we are not wealthy; in fact, I am on SSI because of HAE) at Cornell University, Ithaca, New York, College of Engineering. His health took a nose dive this past year, with breathing problems, and many of the neurological problems seen in HAE patients. A psych evaluation diagnosed him with ADD and depression (the school's idea) and he was subsequently sent to the campus clinic for monitoring....now a doctor THERE thinks the ADD diagnosis is wrong, and HAE may be heavily contributing to his severe health problems. He was placed on a selective serotonin reuptake inhibitor. She wants to give him an epinephrine pen, some antihistamine, etc, and she is willing to do a search of sorts, but she never heard of HAE until my son...She is THE FIRST doctor in a DECADE to give some credence to HAE, but I fear she may be out of her league, so to speak.

My son and I DESPERATELY need help getting this miserable hereditary disorder addressed. I am so tired....I faded out of "the fight" a few years back, but my son, my beloved, deserving son, is sick and getting sicker. I feel like Arnold in "the Terminator II", rallying that last amount of life force, to prevent tragedy; my son's symptoms seemed to abate some when he hit puberty, but it didn't last. THAT is why I turn to ANY source of hope. (I found your really cool web site when I did a search on Yahoo, and your "selected letters" was listed under "Hereditary Angioedema: 10,000+ references yeek!)

Please help...I try to keep my anxieties in check (they're not good for HAE, either) but sometimes,...I wonder, if today is going to be the day something dreadful happens to my son...he is sufferring greatly from the throat edema this past month.

I don't expect you to provide me with answers today. If you could acknowledge receipt of this long-winded obsessive letter, I would be much appreciative...

Thank you for reading, and I hope I have reached you...

Kyle xxxxxx
x xxxxxx Ave
Binghamton, NY xxxxxx
(607) xxx-xxxxx

email: xxxxxx@aol.com


Subject: excellent site and a question
Date: Sat, 14 Feb 1998 18:32:02 +0100
From: "E.J. xxxxxxx" (E.J.xxxxxxx@AMC.UVA.NL)
Organization: AMC - Amsterdam, NL
To: achung@emory.edu

Dear colleague,

First of all, my compliments on your excellent site, saves me a lot of time !! all those links.
As a last year resident in Internal Medicine at the Academic Medical Center in Amsterdan, the Netherlands I more and more am trying to use the Web as a medical resource but in Holland I am one of the few. I really am enjoying the ACP-Library on disk which I received as a present from ACP when they had a booth at the European Federation of Internal Medicine congres in Maastricht last October.

Furthermore I am chairman of the junior board and member of the board of the Netherlands Association of Internal Medicine (NIV) and I am very interested in implementing the electronic medical record in internal medicine practice. I therefore founded the "information technology" committee of the NIV and will attend the pre-course Electronic Medical Record of the ACP annual session in San Diego in April. Do you know relevant sites on this topic ?

Finally, I am looking for a discussion group just for doctor where they post there questions in the hope a colleague knows the answer. I do not find "sci.med" the proper place. And I am not a member of the ACP so I cannot use theirs. Any suggestions ?

P.S. I have a (out-)patient without a diagnosis: a 45 year old male, musician, married two kids: weightloss of some kg's now stable, nightswet without fever, obstipation and an uveitis, now cured with eye-drops; no medical history, all started after summer '97, no tropical visits, family-members healthy * no abnormalities at physical examination (apart from the uveitis OD.)
* laboratory abnormalities: SER 45, ASAT 54, ALAT 118, AF 182, GGT 292, ferritine 2070, (iron 35.2), IgG 27.3, ANA + in urine sediment
hep ABC, CMV EBV: - (anti-EBNA +) anti-DNA Farr: - / anti-RNP, Sm, SS-AA/B: - ACE / lysozym - brucellosis serology -, tuberculine skin test -, toxoplasmosis serology -, TPHA -
* normal chest X-ray, slight hepatomagaly at ultrasound, no glands, normal bowel X-ray with bariumcontrast
* liver biopsie performed yesterday: result follows

any suggestions ?

Looking forward to your reply, with kind regards

E.J. xxxxxx


Subject: Drug resistant tuberculosis
Date: Mon, 9 Feb 1998 19:54:16 EST
From: xxxxxxx@aol.com
To: achung@emory.edu

Dear Dr. Chung:
As you already know I am an eigth grade student at Riverdale Middle School. In the unit of tuberculosis we are now studying " drug resistant tuberculosis". I was wondering if you could give me some info on this topic and answer some questions. In dealing with drug resistant TB patients, what kind of medicine do you prescribe to them? Would it be Rifadin or Rifamate(Rifampin/Isoniazid) as the regular TB patients take or would it be something different? Also, what is the recommended dosage of Rifadin and Rifamate when prescribed to an active/inactive TB patient? Is the dosage based on the severity of the disease? I would greatly appreciate it if you could answer these questions. If you can't, that is fine also. I understand that you probably have a very busy schedule.
Sincerely,
Candace


Subject: Hemachromatosis
Date: Mon, 09 Feb 1998 14:58:05 -0800
From: xxxxxx (xxxxxx@ohmeda.boc.com)
Organization: Ohmeda MSD
To: achung@emory.edu

Hi Dr. Chung,
I'm not sure how to get my question onto your web-page so I'm e-mailing you. Perhaps you can place it there or perhaps you can answer my queston. My boyfriend was recently diagnosed with Hemachromatosis. I recently read somewhere that vitamin C helps absorb inorganic iron (from veggies & fruits). We both take about 3-5grams (yes grams) of vitamin C a day. Can the vitamin C can more absorption of iron, thus aggrivating the HH? If you post this on the internet would you please let me know so I can check for responses? Thanks.

Sherri


Subject: help me find Verdolin
Date: Tue, 03 Feb 1998 22:02:54 -0800
From: Eric xxxxxx (xxxxxx@flash.net)
To: achung@emory.edu

Dr. Chung,
I am a friend of Mike Verdolin from Bethesda (I'm now an anesthesia resident out in San Diego). I've been trying to get in touch with him through email. Do you happen to know his address or his homepage site? I can't seem to get through with my old ones (I haven't talked to him in about a year). I'm sure he has changed servers. I saw your name next to his on the homepages of Miami alumni. Appreciate the help.
-Eric xxxxxx


Subject: Tuberculosis
Date: Mon, 2 Feb 1998 17:50:53 EST
From: xxxxxx@aol.com
To: achung@emory.edu

Dear Dr. Chung:
My name is Candace and I am an 8th grade student at Riverdale Middle school. In my gifted class we are talking about TB and how it affects the body. I was wondering if you could answer a question for me. How do doctor's protect themselves or take precautions while treating a TB patient? Are you just a researcher of infectious diseases or a doctor (or both?)? I would be very thankful if you answered these questions for me. It would really help me out on my study of this disease.

Sincerely,
Candace


Subject: Throat constriction during exertion
Date: Mon, 2 Feb 1998 12:29:12 -0500
From: xxxxxx@webtv.net (James xxxxxx)
To: achung@emory.edu (Andrew Chung)

Dear Andrew Chung,
Thanks for your quick and informative reply.
I took your advice and started using a stairmaster about 5 times weekly for 30 minutes per session and have had more success than I expected!
I only had to use the inhaler twice and one of those was as a preventive measure prior to exercising.
Just a month ago I would not have been able to last more than five minutes on the S.M. without the inhaler. I am assuming this is because of the almost 4 weeks worth of Cardizem that I have taken since 1/8/98.
The Internist this AM prescribed Zocor 5mg daily to lower my cholesterol, he started me at a lower dose than usual because I have had twice weekly bouts with very loose bowel movements. I asked if this could be attributed to the Cardizem, but he thought it more likely as a lack of fiber in my recent diet change to low fat and low cholesterol foods. He suggested Metamucil, once a day.
I have already lost 7 lbs. in the past two weeks while exercising (after your honest but blunt assessment that I was 50 lbs. over ideal weight). I have been limiting my calorie intake to about 1600 per day with about 30 to 35 grams of fat and under 300 mgs of cholesterol.
I go see the Cardiologist this PM and will keep you posted.
By the way, the internist looking at the Stress test report said that I have never demonstrated Hypertension or high blood pressure readings either resting or during testing! So I still wonder why I am taking Cardizem even though I do feel better from it.
Thanks again, Jim xxxxxx


Subject: For Your Health
Date: Wed, 28 Jan 1998 17:53:27 -0800 (PST)
From: Heartoheart@earthlink.net
To: achung@emory.edu

Dear Andrew

While I was constructing my website I came across a variety of medical links that I would like to now share with you. I am providing these links to you for FREE. You are under no obligation at all to use any of these links. You can either visit and use these links or you can just delete this mail.
If this page is of use to you than feel FREE to bookmark this page for your future reference.

http://www.valentinas.com/health/health.html


Subject: Angina (Location)
Date: Wed, 28 Jan 1998 15:48:34 -0800
From: webmaster@ptca.org
Organization: 20th Anniversary of PTCA Project
To: Andrew Chung (achung@emory.edu)

Dear Dr. Chung:

I have been reading your postings on sci.med.cardiology with interest, especially your current interchange with Dr. Wayne. Your comments have been very reasoned, not "ablating" his side, only clarifying it and putting his comments into perspective.

I was writing to suggest that you check out our web site, if you haven't already, at http://www.ptca.org. I looked at yours and would like to include it under our "resources" links, if that's okay with you.

I've been to Emory many times, first back in the 80's when I interviewed Andreas Gruentzig on several occasions. You know, he originally only thought that 5-10% of patients could be helped by PTCA. He was very conservative publicly about making any kinds of claims that could not be thoroughly substantiated. He was interested in science and proof, although he did experiment with many new technologies.

Anyway, let me know if listing your site is okay.

Best Regards,
Burt Cohen
Webmaster
http://www.ptca.org


Subject: A-Fib
Date: Wed, 28 Jan 1998 13:47:20 EST
From: xxxxxxx (xxxxxx@aol.com)
Organization: AOL (http://www.aol.com)
To: achung@emory.edu

Andrew, I read a reply you gave to someone who has A-Fib. I'm hoping you can give me some info.

In June 97 I fell through a window and severed my brachial artery in my left arm. The ER doctor misdiagnosed the wound as a vein insted (sp) of an artery. He let me lay there for 5 hours before a surgeon recognized the mistake. Since then I have had A-Fib, arrhythmia. Is it possible that the blood loss caused this condition. I definately (sp) did NOT have this prior. Please E-Mail ASAP.

Thank you, John xxxxxx
xxxxxx@aol.com


Subject: mitral and tricuspid valves
Date: Fri, 23 Jan 1998 17:51:01 -0500 (EST)
From: xxxxxx@voicenet.com (xxxxxx)
To: Andrew Chung (achung@emory.edu)

Hi Andrew--

I haven't written to you in a while and I hope your holidays were pleasant!

If a female patient complains of chest pain, numbness and drawing in the left arm, and drawing and pressure below the xiphoid process... could this be something other than angina? She also has redundant mitral leaflets, tricuspid regurgitation and multifocal PVC's?

Thanks,

Bonnie


Subject: estrogen replacement
Date: Fri, 23 Jan 1998 14:42:42 -0800
From: "Wanda xxxxxx" (xxxxxx@email.msn.com)
To: achung@emory.edu
Could you give me the name of the new estrogen replacement medicine that will be out on the market soon. My doctor said that is the one I will be taking. It was just approved by the FDA. Do you know what company will be manufacturing it? If you don't have these two pieces of information, can you give me a source? Thank You. Wanda xxxxxx


Subject: Throat constriction during exertion
Date: Thu, 22 Jan 1998 09:15:25 -0500
From: xxxxxx@webtv.net (James xxxxxx)
To: achung@emory.edu

Dear Dr. Chung,
You were very helpful to my wife last May when she was experiencing a conduction delay. Now perhaps you could advise me.
I recently (since mid September) have experienced a constricting feeling in the base of my throat when I exert myself. It is a condition that arose suddenly, I rode a bike in the beginning of August for over 4 hours continuously in the heat of the day without any ramifications, but six weeks later I took my bike out for a leisurely ride in the neighborhood and felt like I had to walk it back home after about 10 minutes.
I also noticed while raking leaves in the Fall that I had to stop after about 5 minutes. I took a puff on my son's inhaler, which was albutol, and had almost instantaneous relief, raking for 3 hours without any further discomfort.
I went to an Internist who did the usual work up, BP 120/80, pulse 72.
He sent me for Blood work which came back with a Cholesterol of 299! He said that he was not so concerned because my "good" cholesterol was also high (I later learned that it was 46 which was not particularly high to me). He administered a PFT test to test lung capacity, function and flow and said that it was excellent. He referred me to a Cardiologist for a stress test which I did on Jan 8, 1998. The doctor kept asking me about hypertension history of which there is none either in me or my family history. He said that the test result was equivical? I was sent to SUNY-Stony Brook Hospital on Tuesday, 1/20/98 for a Cardiac Catherization and possible Angioplasty, he said because of my age (49), my smoker's history (I quit 8/1/97 after 35 years of 1 1/2 packs a day), my symptom with my throat, and my stress test.
I had the Cardiac Catherization on Tuesday and the doctor said that my arteries and veins were as clean as a whistle, no build up of any kind, my heart was functioning perfectly, and my BP afterwards while in recovery was 116/69 to 124/72.
He is perplexed but wants me to remain on the Cardizem (180mg) and a daily baby aspirin, I also use an inhaler, Combivent, which gives immediate relief of the constricted feeling. He referred me back to the internist for follow up and further testing, with a recommendation that I be put on medication for control of my cholesterol which in the hospital was 268 & 56.
Do you have any suspicions of what I should pursue in the future testing. The Cardizem has lessened the constriction slightly but not significantly. Some of the advice and explanations sound contradictory to me and I am confused as to where we are going now.
I am a 49 year old, male, 5'8" tall, 190 lbs., no known allergies, I would have to describe my life style as sedentery.
I would appreciate any suggestions or advice you might have for me. Thanks.
Respectfully,
Jim xxxxxx


Subject: Atrial Fibrillation
Date: 22 Jan 1998 09:40:35 +0000
From: "xxxxxx, John" (John.xxxxxxx@mcl.co.uk)
To: ACHUNG@EMORY.EDU

Dear Andrew,
not sure where you fit in here but I am looking for some information from the USA on AF. Have you any idea where to look. I have tried to look at your web page but due to restrictions placed by my company ( firewall ) I am unable to access your site.

I suffer with lone paroxysmal AF. I have seen on the net that Cardima www. cardima.com , have initiated a trail with a Catheter that burns the diseased tissue away in the atrium. and correct the problem. My understanding of the news and what Cardima are telling me. That there is no pace maker involved and no ongoing medication. In fact a cure. AF ablation

I have trawled the Net but I have not seen any references to this with the exception of the Cardima press releases.

Have you seen of heard anything over there.

hope you don't mind this mail.

regards

John xxxxxx


Subject: Hypertension
Date: Wed, 21 Jan 1998 05:13:46 -0600
From: Judette xxxxxx (xxxxxx@nckcn.com)
To: achung@emory.edu

Hello,

I would like your explanation of why it is important for an individual with hypertension not to use a hot tub or spa following strenuous exercise? Is in not true that those with hypertension are sometimes advised not to use a spa at all??

Thank you for your response.


Subject: mybloodpressuregoesupafterihave sleptabouttwohours.itisnormalwhen
Date: Sat, 17 Jan 1998 18:19:10 -0700
From: xxxxxx@webtv.net (Ginny xxxxxx)
To: achung@emory.edu

igotobed.iwakeupwithschreechinginmyearsandbloodpressureover200ontopandover100onbottom.thishasbeenhappeningeverynightfortwoweeks.ithappenedabouteveryotherweekforabotthreemonthsihavetotakeseveralofmybloodpressurepillstogetitdown.iamveryweakafterandfeltiglinginmyhandsandarmsahdweaknessinmylegs.ialso h havepainimyneckandhead. ihavebeentoseveraldrs,andtheycantfigureitout either.doyouhaveanyideas/


Subject: none
Date: Sat, 17 Jan 1998 17:07:20 -0500
From: "Walter xxxxxx" (internationalfinancing@worldnet.att.net)
To: achung@emory.edu

Your(sic) the biggest wierdo ive(sic) seen in my life. Say hello to the birds your(sic) the only one thats(sic) speaks there(sic) language.


Subject: First, do no harm?
Date: Wed, 14 Jan 1998 16:57:08 -0800
From: xxxxxx@ix.netcom.com
Organization: Weintraub Genshlea & Sproul
To: achung@emory.edu

Where does this phrase:"First, do no harm?" come from? Is it derived from the Hippocratic "I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone?" Is it simply a modern restatment of this principle or does it have a source independent of the Hippocratic Oath? xxxxxx@Weintraub.com Thanks


Subject: website
Date: Sun, 04 Jan 1998 18:31:54 -0500
From: Mark xxxxxx (xxxxxx@gte.net)
Organization: Fuzzy, Inc.
To: achung@emory.edu

Nice website. Lot's of interesting stuff here. I have it bookmarked and will refer to it frequently. Thanks for all the hard work.
Happy New Year!

--
Mark xxxxxx, RN,CCRN,CEN,EMT-P
Good Shepherd Med. Center
Cardiac Cath Lab
Longview, Tx.


Subject: Positions Available
Date: Fri, 02 Jan 1998 10:14:43 -0600
From: Jim Pokladnik (CSESNON@IX.NETCOM.COM)
To: achung@emory.edu

Andrew;

I saw your resume on the internet and wondering if you were looking for a position?
My name is Mike Loftis and I am a medical recruiter. I work with facilities and Group Practices all over the country.

If you are interested or know of somebody that is interested - please contact me at:

Mike Loftis
888-663-0700
F-402-292-7830
csesnon@ix.netcom.com


Subject: Macular Degeneration
Date: Thu, 01 Jan 1998 20:05:52 -0500
From: xxxxxx@worldnet.att.net
To: achung@emory.edu

Hello,

I have a friend who has become blind as a result of "macular degeneration." Although there does not appear to be any effective treatment, CNN featured a special type of "glasses" which allow folks with M.D. to see. They were developed by Emory University.

If you are familiar with these "glasses" I would appreciate any comments which you might have.

Chris


Subject: Positive PPD
Date: Mon, 29 Dec 1997 01:03:05 +0100
From: Rosita xxxxxx (xxxxxx@ptialaska.net)
To: achung@emory.edu

I have a 5 year old who had a positive PPD in October and again on Dec.26th. I had her chest x-rayed, it was negative. She is now being given 200 mg of isoniazid per day for 9 months. This medicine is in the form of 2 tablets per day. My questions:
How much time is required to go by from the time of exposure 'til the time that a positive reading is possible?
Is it really as simple as someone coughing on someone to create this condition?
I assume that my whole family should be tested, and I plan to do that this week. Would that be your suggestion also?
My daughter has in the past had a history of asthma like symptoms every time she catches a cold. Does this have any impact on a positive PPD?
If my family is negative, what can I do to protect my 5 year old from a repeat exposure?
Is it possible that she was infected 2-3 weeks before testing? or would it have to be longer.
The red lump on her arm was measured at about 18 cm. I believe.

I'd appreciate any help you can give to help me to clarify this in my mind.
Thank you,
Rosita


Subject: your webpage
Date: Sun, 21 Dec 1997 22:20:09 -0500
From: xxxxxx (xxxxxx@mail.del.net)
To: achung@emory.edu

Hi Andrew.

I too am a Doctor, but of Physics not Medicine.
I saw your webpage when I did a search on Chrysler Laser
through Infoseek.

I see that you maintain the car yourself. Have you ever
changed the clutch?

I'm trying to find out how to do it, but I can't find
anything on the web about it.

Any advice would be really cool.

Regards,
Darryl


Subject: Thank you
Date: Fri, 19 Dec 1997 14:41:37 -0500
From: xxxxxx (xxxxxx@astro.ufl.edu)
To: achung@emory.edu

Dr Chung:

Once again you have been extremely helpful.

Merry Christmas

Mariou


Subject: grady phone card
Date: Thu, 11 Dec 1997 20:31:14 -0500
From: xxxxxx@moe.cc.emory.edu (Eric xxxxxx)
To: achung@emory.edu

hello Dr Chung,
where can i get one of your amazing grady phone cards? someone on my team
found one someplace and now everyone wants one!
thanks,
eric xxxxxx
surgery resident


Subject: THANKS
Date: Tue, 09 Dec 1997 15:28:42 -0500
From: Judy xxxxxx (xxxxxx@ingress.com)
To: Andrew Chung (achung@emory.edu)

Thanks very much for your excellent site, from which we are adding to Homework Heaven. We are featuring the Online Heart as a best site of the week.

We promised a JUMBO! yoyo as a token of thanks. If you would like us to send one to you or a friend, please let me have the address by email.

All the best.

Judy xxxxxx, Senior Editor
Homework Heaven


Subject: Sci.med FAQs
Date: Mon, 08 Dec 1997 17:42:41 -0800
From: "Cory xxxxxx." (xxxxxx@hotmail.com)
Organization: Malaspina University-College
To: achung@emory.edu

Hello.

I would just like to make a small comment about the FAQ pages. Besides the fact that they are very informative and quite useful, I would suggest categorizing the different questions. Sure this is easy for me to say b/c I don't have to do the work, but it sure would make it easier for one to find what one is looking for. The 'find' function on Netscape is useful, but it's too specific and one may miss info of a more general nature if there is no specific answer to one's question. Other than that, keep up the good work!


Subject: http://www.emory.edu/WHSC/MED/HTN/~achung/
Date: Sun, 7 Dec 1997 15:57:34 -0500
From: xxxxxx@acy.digex.net
To: achung@emory.edu

Great Web page. Thanks. As a librarian, I am always looking for reliable sources of information and good reference sites. I will pass this along to our reference librarians.
diane xxxxxx


Subject: Tiny error on (http://userwww.service.emory.edu/~achung/medfaqs.asp)
Date: Sat, 6 Dec 1997 17:05:29 -0800
From: Steve xxxxxx (xxxxxx@brecher.reno.nv.us)
To: achung@emory.edu

> Subject: Primary Physician
>
> What is the difference between internists, family and general practitioners?
>
> The differences arise in the postgraduate training (training after
>graduating from medical school with an M.D. degree). Family
> amd general practitioner's train for 2-3 years
^
^

Apostrophe excision is indicated.

Thanks for an informative site.

--
Steve xxxxxx


Subject: Web pages
Date: Tue, 02 Dec 1997 03:58:52 -0500
From: Ruth and Clinton xxxxxx (xxxxxx@gator.net)
To: achung@emory.edu

Thanks for such a wonderful and useful web page and links!!!!


Subject: CT scans
Date: Sun, 30 Nov 1997 15:19:06 -0600
From: Ellen xxxxxx (xxxxxx@xxxxxx@postoffice.worldnet.att.net)
To: achung@emory.edu

Is a CT scan a reliable way to rule out whether or not there is something somewhere in the airways causing air trapping? Or is bronchoscopy the only way. Also, if relying on CT, should inspiratory/expiratory scans be done?

Thanks for your help,
Ellen xxxxxx


Subject: Atlanta Cardiology Group Web Site
Date: Sun, 30 Nov 1997 08:57:19 +1100
From: David xxxxxx (xxxxxx@c3.telstra-mm.net.au)
To: achung@emory.edu

Hi Andrew

Your link to the above site is giving a FileNotFound
Cheers

David


Subject: Thank you
Date: Thu, 27 Nov 1997 09:42:39 -0500 (EST)
From: xxxxxx@aol.com
To: achung@emory.edu

Another pharmacist that "discovered" you in a newsgroup just sent me your homepage. Thank you for putting all the time and effort into your homepage and answers. While some of it goes over my head, most of it facinates me, and what a great way to learn! I work for a 1-800 line that "dispenses" information over the phone as a pharmacist. While I dont play doctor, and granted its not always an appropriate forum for counseling, I have a strong drive to learn and keep up with what is going on currently. I will be visiting frequently-Thanks again-Laurie xxxxxx Rph


Subject: Need help
Date: Thu, 27 Nov 1997 14:33:15 +0200
From: Rami xxxxxx (xxxxxx@infinity.com.eg)
To: achung@emory.edu

Dear Andrew

I have searched and asked in vain. I would be grateful if you could help.

I want to practice medicine in the UK. Do I take the PLAB or the MRCP? It is that simple.

I understand of course if you have no knowledge in that area.

Sincerely
Ramy


Subject: Hi!
Date: Wed, 26 Nov 1997 07:28:45 -0500 (EST)
From: Sally.xxxxxx@vtmednet.org
To: Andrew Chung (achung@emory.edu)

Andrew,

Just wanted to wish you and your family a Happy Thanksgiving!

BTW, since they started to look for the ictal-bradycardia syndrome at GWU they have found another case. Funny thing how you don't find something if you're not looking for it....

Take care,
Sally


Subject: BLOOD PRESSURE QUESTION
Date: Tue, 25 Nov 1997 21:25:35 +0000
From: James xxxxxx (xxxxxx@globalnet.co.uk)
To: Andrew Chung (achung@emory.edu)

Thanks very much for your quick response to my posting. I would be very grateful for a bit further explanation of the physics behind the pressure drop beyond the constriction. By reducing the diameter of the arterioles, the resistance increases, but I don't see why this should reduce the overall arterial blood pressure, i.e. why does vasoconstriction reduce blood pressure?

Thanks again,

James xxxxxx


Subject: LVEF & RVSP
Date: Mon, 24 Nov 1997 20:57:09 -0500 (EST)
From: xxxxxx@voicenet.com)
To: Andrew Chung (achung@emory.edu)

Hi Andrew!

Can you tell me what the normal range is for LVEF?
Also, what is the normal range for PA or RVSP?

Thanks,

Bonnie


Subject: Residency at Emory
Date: Sun, 23 Nov 1997 12:12:49 +0000 (GMT)
From: "madhav.xxxxxx" (xxxxxx@green.oxford.ac.uk)
To: achung@emory.edu

Dear Dr.Chung,
Greetings from Oxford.
I am a final year doctoral student at the University Department of Clinical Pharmacology.I have just been offered an interview at Emory for the Residency programme in Internal Medicine/Neurology. I have been going through your web pages and have found them full of useful "inside info"!!I wonder if you would have any advice on whom I could contact at Emory and find out more about the programme and the clinical rotations.It would be great to get in touch with someone who has actually started out on a residency recently ( and preferrably is as bad an E-mail junkie as I am!!)
I look forward to hearing from you.
sincerely,
Dr.Madhav xxxxxx


Subject: Congrats...
Date: Mon, 10 Nov 1997 20:11:08 -0600
From: John xxxxxx (xxxxxx@ix.netcom.com)
Organization: Sound Applications, Inc.
To: achung@emory.edu

Well, now I'm happy. Good stuff.

The Prof


Subject: Help needed - Drugs
Date: Sun, 09 Nov 1997 10:24:39 GMT
From: xxxxxx@bigfoot.com
To: achung@emory.edu
References: 1

I wonder if you could be so kind to give me your opinion.

Would a daily intake of 150mg of Clomipramine(Anafranil) SR antidepressant drug affect a breathalyser reading at all? eg by the chemcials it contains, or the effect it may have on the body in eliminating the alcohol. Would it slow the rate of elimination down?

Also the same question concerning 80mg of Half Inderal LA (Propranol) beta blocker drug.

If there is any hint at a suggestion that either of these drugs could cause the reading to be higher than normal when compared to a person not taking the drug, then that may well enable it to be used as a defense.

Please reply ASAP, is the matter is quite pressing. Many, many thanks!


Subject: crypto coccosis
Date: Sat, 8 Nov 1997 19:57:59 +1100
From: "David xxxxx" (xxxxx@oem.com.au)
To: (achung@emory.edu)

Hello Andrew,

You may recall the above Email late last year.

I'd like to thank you very much for your time to reply to me then, it provided some backgound detail which we were able to discuss with my wifes doctor.

She has made a complete recovery, but still has to do monthly blood tests to confirm the eradication of the problem.

She's had a number of CT scans and Bronchoscopies, and all is going well.

Thanks again for your help, we really appreciate it.

Regards,

David xxxxxx


Subject: Very nice
Date: Thu, 06 Nov 1997 21:44:04 -0500
From: Allison xxxxxx (xxxxxx@gsu.edu)
To: achung@emory.edu

Dr. Chung,

I read one of your posts on asthma and I was very seriously impressed. Thank you for sharing your knowledge with the readers of alt.support.asthma. I have asthma and try to be literate about the current medications. Reading the news on the web concerning asthma can be a mixed bag. :) Are you a praciticing physician at Emory?

Thanks again
Allison


Subject: Coumadin activity
Date: Wed, 05 Nov 1997 11:23:39 -0500
From: xxxxxx (xxxxxx@usaor.net)
To: Andrew Chung (achung@emory.edu)
References: 1 , 2

andrew,

Thanks for your response to my question in the cardiology newsgroup.

The input will be useful in formulating my questions as well as answers to my physician.

Thanks again,

John xxxxxx


Subject: Auscultation
Date: Wed, 5 Nov 1997 08:19:43 -0500 (EST)
From: xxxxxx@voicenet.com
To: achung@emory.edu

Hi --

I found your notes through a friend and I was wondering if you could answer a question or two.

Can you differentiate an atrial from a ventricular arrhythmia during auscultation?

Thanks-

Bonnie


Subject: Atrial fibrillation
Date: Sat, 1 Nov 1997 23:52:29 -0500
From: "conrad xxxxxx" (xxxxx@worldnet.att.net)
To: "Andrew Chung" (achung@emory.edu)

Dr. Chung,

Many thanks.

I had read your Sci.Med.FAQs with its summary statement. I'll see if I can get reinforcements with the citation you just sent as stimulus. I'm a statistician (as is my cardiologist), and had dug around for statistically significant, time-series reports with bias assessments in the Internet without luck. Maybe too many places to look? I'm glad to have the reference and thank you for it.

In the Abstract, I wonder about their use of the term "significant." Statistical significance with that sample size is hard to come by (at, say, the 95% confidence level), even with lab mice. Nothing's perfect but every such study is worth a check for non-random selection procedures, representativeness and other methodology and validation issues. It's tough to extrapolate from what I have read in other sources ("Yale Heart Book" esp.), but most agree with your (and the BHJ) conclusions. They're plausible, certainly, knowing the effect of alcohol on other tissues.

In that connection, isn't it reasonable to assume it is a matter of degree (what, how much, how often, whether with a meal - perhaps by body weight, diet, liver health, etc.) and individual differences otherwise.

I've almost put in my 3-score-and-10 (9 only) and am a regular drinker who 2 months ago earned my a-fib diagnosis. The cardioversion didn't convert. I want to put the statistical and representative definitions to rest and then at least consider the quality-of-life question before changing my happy cocktail custom of 50-years standing. Ha! Yes, it's conceivable I have my own bias. ;-)

Your Homepage is good and I value it. (And your response on another issue a while ago was also much appreciated.) I don't mean to gush, but it sure beats flaming (g).

Thanks again.

Conrad


Subject: Thallium Stress Test
Date: Thu, 30 Oct 1997 11:17:55 -0500
From: "John xxxxx" (xxxxxx@inforamp.net)
To: achung@emory.edu

Will a thallium stress test definitely rule out heart problems as a cause of chest pain?


Subject: I need your advice about High Blood Pressure
Date: Wed, 29 Oct 1997 15:47:14 -0600
From: Fred xxxxxx (xxxxxx@uvtv.com)
To: "'achung@emory.edu'" (achung@emory.edu)

I have HBP 140/90 and my teeth are bad (have several holes). Do you think that I need to fix my teeth so that they would trigger the HBP which would cause headache ? I have had headache (spining like motion syndrome) and my doctor told that the HBP and bad teeth are the causes. Is this true ?

Currently I am under Covera 180 mg (two tablets taken once a day at bedtime). What is the side effect of this medication if taken like 3 months already ? I worry that this medication will somehow damage my liver, etc. Any advise as to change medication to lower HBP ?

Thank you for your info at your homepage, it is so helpful.

Once again thank you doctor,

Fred xxxxxx


Subject: memphis doctor
Date: Fri, 24 Oct 1997 14:08:50 -0500
From: Chris & Jill xxxxxx (xxxxxx@aeneas.net)
To: achung@emory.edu
I have a question and i was wondering if maybe u could help me. I have an appt. with a doctor in Memphis and i was wondering if there was any way of checking out his credentials before i went. Someone told me there was a web page where you could check up on any Dr. Are you aware of this web page and if you are could you please send me the URL ? Thank you so much for your time, Jill


Subject: Tuberculosis treatment
Date: Mon, 13 Oct 1997 23:17:28 +0300
From: xxxxxx (xxxxxx@pop.netaddress.usa.net)
To: achung@emory.edu

Dear Andrew,

Recently I've seen a posting of yours on the internet about TB treatment. You suggested 4 drugs for the treatment:

(1) INH + B6
(2) PZA
(3) Ethambutol
(4) Rifampin

Since I've been prescribed those drugs lately, I came up with some questions:

1. when is the best time to take those drugs ?

2. what is the correct dosage for each of those drugs ?
(I weigh about 175 pounds).

I will be obliged for your answer,

Thanks in advance,

xxxxxx


Subject: Osteoporosis
Date: Thu, 2 Oct 1997 13:02:32 -0500 (CDT)
From:xxxxxx@dmc10.com
To: achung@emory.edu

Please excuse the intrusion. Your email address was linked to an Osteoporosis site on the web. Consequently I thought I'd take a chance and write, perhaps you can help me.

I am looking for a Scientist to lead a lab unit in the Osteoporsis Research department to support the identification of therapeutic targets for osteoporosis. Someone to participate in the analysis of potential therapeutics through the use of biochemical and cellular biological assays; to develop new approaches to the determination of drug action on bone cells and tissues both in vitro and ex vivo.

A PhD in Biology, Cell Biology, Biochemistry, or related field with 2 years postdoctoral experience is required. We are a leading pharmaceutical company with research facilities in Conneticut and can provide excellent benefits (health insurance, dental, and vision plan, bonus program, paid vacation and more). A high impact, high profile position with excellent opportunity for advancement.

If you know someone that would be interested I can be contacted at: Scott xxxxxx by phone at xxx-xxx-xxxx Ext.218, fax xxx-xxx-xxx or E-Mail to xxxxxx@dmc10.com


Subject: Question
Date: Tue, 30 Sep 1997 01:27:18 -0500
From: "Peggy xxxxxx" (xxxxxx@bellsouth.net)
Organization: xxxxxx
To: Andrew Chung (achung@emory.edu)
References: 1 , 2

Hi Dr.Chung,
Is carisoprodol (soma) addictive? My daughter's best friend was rear-ended about 7 years ago and had a neck injury that could not be resolved thru surgery and has been on the above medication for that long. She kept asking her doctor if it was addictive and he kept saying no. She thinks it is and wondered if new info has become available that confirms that. I looked all over the internet and found nothing other than the drug is being abused because combined with something else.....I can't remember. I appreciate you taking the time with me. I decided not to post on the newsgroups because my address will be 'way too public'. Thanks again, xxxxxx


Subject: Plasma Renin Study
Date: Thu, 25 Sep 1997 11:38:18 +0000
From: "Larry xxxxxx" (xxxxxx@bucky.win.bright.net)
To: achung@emory.edu

Dr. Chung, I came upon your page on the computer, so I thought I would give this a try. We are sort of in a bind and hope that you can give a little guidance. Should my friend be concerned about her "plasma renin study" for her high blood pressure? She's 75, only 1 kidney, type II diabetes. The doctor in Mesa, AZ wants to pump 20000cc of normal saline into her in a couple of hours to see what it will do. What should it do? Should she do the test? What are the risks? That seems like a lot of fluids. Thank you, very, very much.
xxxxxx


Subject: Internal Medicine - Physician
Date: Tue, 23 Sep 1997 14:21:00 -0400
From: "xxxxxx" (xxxxxx@ix.netcom.com)
To: (achung@emory.edu)

I am seeking a recommendation for a doctor of internal medicine at Emory University. I need a physician that is a participant in the Aetna PPO Perferred Provider Plan.

My physical problem deals with Linchen symplex chronicus which has developed into possibly phlebitis. I have had two previous surgeries on my left leg with bone being removed. Also, same leg the knee cap has been broken since surgery. My last surgery was at the Piedmont Hospital performed by Dr. James xxxxxx - Piedmont Orthopedic.

If you have any recommendations, please forward them to me at: xxxxxx@ix.netcom.com

Thanks,
xxxxxx


Subject: patient care programs using molecular biology and genetics
Date: Mon, 15 Sep 1997 16:39:43 -0700
From: jerry xxxxxx (xxxxxx@concentric.net)
Organization: xxxxxx
To: achung@emory.edu

Hi Andrew. My name is jerry xxxxxx and I'm writing from the Queen's Medical Center in Honolulu. We're looking into what might be practical patient care applications in the area of molecular biology and genetics that have the business purpose of creating a leading service for us. Ran across your page while surfing and thought I drop you this note since your page is so friendly. Any hot links about the purpose I've stated that you could suggest that other hospitals might be into?? Thanks and good luck.


Subject: Usefulness of an MD/PhD
Date: Thu, 11 Sep 1997 14:42:50 -0400 (EDT)
From: David xxxxxx (xxxxxx@moccasun.utc.edu)
To: achung@emory.edu

Dr. Chung:

My name is David xxxxxx, and I am a senior at the University of Tennessee at Chattanooga majoring in Chemistry. I am currently applying for entrance into a number of medical scientist training programs (MSTP - combined MD/PhD degree). I noticed on your homepage that you had graduated from this type of program, and was wondering if I could trouble with some questions.

A little background on me:

* I have a strong research background in chemistry, and will have completed 6 semesters and 2 summers worth of research experience at UTC. Two papers are currently in press at JAC and four presentations at national chemistry meetings have been made.

* In addition to chemistry, I have a practical background with computers and information systems. I've worked as a CIO of an Internet Service Provider and also as an independent consultant for a number of Fortune 500 companies.
* I also have a large amount of clinical experience, almost 500 hours over the past 4 years.

I am hoping to tie all of the above together by a career in research, possibly working with MRI or other radiology areas.

With this in mind, a number of well respected chemists (including a nobel prize winner) have advised me to persue a Ph.D. and a M.D. degree seperately. They pointed to a statistic which indicated while the average PhD/MD took 8 years, the average PhD by itself took 6 years. "Obviously they are short changing somebody somewhere," I was told.

Do you feel that you were 'short changed' in your education in a combined MSTP program? Is a combined program better to join than doing them seperately?

I have also put my application in at Emory. Do you have any thoughts on their MSTP program in particular that you could share (admissions/curriculum/staffing)?

Any comments you can give would be greatly appreciated!

Thanks,

David xxxxxx


Subject: I said "hi!" to your Home Page!
Date: Sun, 07 Sep 1997 16:40:39 -0700
From: hhomler@ix.netcom.com
To: achung@emory.edu

Andrew, I enjoyed browsing through your home page. Yes, you're quite right, IgA nephropathy does have a worse prognosis than I had thought!
Thought you'd like to see my AMA page, although it's nothing compared to your site... http://www.ama-assn.org/iwcf/iwcfmgr206/SESSION_ID=7876/SESSION_AR=69/frm_name=aps_result?action_detail.x=hello&row=0&key=0&form_type=r

H2


Subject: a tuberculosis query
Date: Wed, 03 Sep 1997 16:28:37 -0400
From: xxxxxx (xxxxxx@doull.com)
Organization: Hollinger Digital
To: achung@emory.edu

Andrew - Sorry to bother you, but I came across your page via your tuberculosis post to sci.med.

My wife and I just moved to NYC from the UK and in the process of applying for green cards were given Tuberculin skin tests. While I reacted negatively, she reacted positively and the surmise of our doctor in the UK is that this was caused by the BCG inoculation she was given as a child. The US doctor has suggested that she follow a course of treatment, but we are concerned about the toxicity of this, particularly if it is not strictly necessary. IF we are confident hat the reaction was as a result of the BCG is there a downside to leaving well enough alone? My suspicion is that the US doctor is merely recommending treatment out of a heightened American sense of liability. Finally, is there a possibility that the subcutaneous reaction will be permanent, and should we be annoyed that having indicated that she had had a BCG, my wife was tested anyway? BTW she is 28 and incredibly healthy (she excercises 1.5 hours/day and has the cardiovascular system of a professional athlete).

Again, sorry to bother you - and please feel no need to reply if you are too busy (I can imagine how annoying random e-mail solicitaions for medical advice must be - sort of the '90s equivalent of meeting a doctor at a cocktail party and asking about a pain you've been having).

Matthew xxxxxx


Subject: Re: Shingles
Date: Wed, 3 Sep 1997 10:31:39 -0400
From: xxxxxx (xxxxxx@astro.ufl.edu)
Organization: Astronomy Dept. University of Florida
To: achung@emory.edu

Please forgive me for intruding.

Could you kindly tell me what the present consensus is about which drug one should take to lower ones chol.levels?
I have heard or rather read the side effects from those medications and I am absolutely terrified. My physicians do not share my fears I reckon But again it is not them that will have to consider taking the medications but me.

At any rate any suggetions or any directions towards any particular board/site to gather the information would be greatly appreciated


Subject: Home Page
Date: Mon, 01 Sep 1997 23:56:19 -0500
From: Joe xxxxxx (xxxxxx@linknet.net)
Organization: Linknet
To: achung@emory.edu

Great !!!!!!!!!!!!!! Thanks, Joe xxxxxx


Subject: medication for arrhythmia
Date: Sun, 31 Aug 1997 07:44:22 -0700
From: DQ (xxxxxx@win.bright.net)
To: Andrew Chung (achung@emory.edu)

Andrew,

I have been suffering from PAC's for about 2 years now. They don't seem to be getting better. I feel them a great deal, and it has caused me to stray away from physical activity. I was once extremely active, being a distance runner, and an avid outdoorsman. I am taking atenolol, but that really doesn't do much when I'm active. I get an irregular beat 2 to three times a minute doing any kind of moderate activity. Very very uncomfortable! I have asked my doctor to put me on a more formal anti-arrhythmic. But instead he sent me to a take biofeedback to see if I could learn to relax more because he thinks they are due to stress. Originally I think that was the cause. But right now the stress is the PAC's. I've come to the point where I really need some advice about what to do. I'm gaining weight and in kind of a depressive mental state. I'm only 42, but I feel like an old man, yet generally speaking I'm in good physical condition.

Why won't the doctor give me an anti-arrhythmic like quinidine or digoxin? I know there are risks, but isn't my mental state just as important for my health? I just don't get it.

Any suggestions?


Subject: American Cherokee Confederacy
Date: Thu, 28 Aug 1997 10:33:49 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Dr. Chung,
I am a Native American and am representing Chief William "Rattlesnake" Jackson of the American Cherokee Confederacy of Albany, Georgia. The ACC is in the process of becoming a federally regcognized tribe and are interested in DNA testing for some members who want to determine the amount of Native American blood they have. Is this possible and how do we go about having this done? Our next tribal meeting is on September 27, 1997 in Albany, GA and we would like to have this service available then to members who are interested in doing this. Can you provide this service? We appreciate any information that you can provide us with.
Thank you.

Laurie xxxxxx
xxxxxxx@aol.com


Subject: Merck lecture at WCU
Date: Sat, 23 Aug 1997 14:45:21 -0400
From: Tim Starn (tstarn@dec.cs.wcupa.edu)
Organization: Chemistry Dept., West Chester University
To: achung@emory.edu

Dear Dr. Chung,

I am organizing the Merck Scholars lecture series at West Chester University, and I wanted to contact you to see if you would be interested in presenting a seminar on your work with Dr. Wallace in mitochrondrial DNA. If so, would you be able to visit us sometime this academic year? We will, of course, pay for your travel expenses.

West Chester University is located about 25 miles West of Philadelphia and focuses primarily on undergraduate instruction. However, scholarship is very important to us as well.

If you are interested and available, please send me your mailing address so that I may send you a formal invitation. Some URL's you might be interested in checking out are www.wcupa.edu and www.cs.wcupa.edu/~tstarn/merck/merck.html for more information about WCU and the Merck program.

Thank you for your time and consideration.

Best Regards,

Tim Starn, Ph.D.
WCU Chemistry Dept.
610-436-2684
tstarn@wcupa.edu


Subject: Neuro-Borreliosis questions
Date: Sat, 23 Aug 1997 14:37:50 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

I'm in treatment for persistent Lyme, taking 2 g IV Rocephin and 200 mg Doxycycline daily. I'm responding well, and plan to finish treatment with multiple oral anti-biotics.

I had the ECM bite. I am reactive on ELISA , LUAT, PCR DNA ,and Western Blot. My SPECT scan shows hypoperfusion of my left temporal lobe . Cognitive/ NeuroPsych testing and all clinical symptoms are all consistent with Lyme.

I read your post on TB treatment, so I thought I'd ask you for any comments or feedback on Lyme treatment, especially compound therapies or adjunctive therapies.

Thanks, Paul xxxxxx


Subject: PHYSICIAN OPENING
Date: Thu, 21 Aug 1997 19:03:52 -0700
From: Daniel Gomez (med-serv@dzn.com)
Organization: medical staffing
To: achung@emory.edu

Dr. Chung,
My name is Daniel Gomez, I'm the Executive Director of Med-Serv. The reason I'm contacting you is to find out if you are interested in any positions we have availible and if you are willing to relocate for the right opportunity. We currently have Physician positions availible. If you would lide more information please feel free to respond and Iwould be happy to answer any questions you may have.

Sincerely,

Daniel A. Gomez
Med-Serv


Subject: what's new in hypertension therapy
Date: Thu, 21 Aug 1997 19:53:02 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Dear Dr. Chung,
I am a 39 year old woman with hypertension. I've been on medication for about four years. I don't smoke and I'm not overweight at all. Hypertension runs in my family and I always figured I would eventually get it, but not at such a young age.
At first I was on Vasotec. It worked well for about three years and then my blood pressure went up. In December I started on Cardizem, first 180 mg, then 240, and finally 300. My problem seems to be my diastolic number which is hard for me to keep under 90. I'm now trying the Cardizem 240 along with a diuretic. My numbers aren't much better. I was wondering if you had any new suggestions for me. I take my condition very seriously. I worry about my heart, kidneys, eyes, etc. I would appreciate any of your feedback. I was also wondering if you knew anything about biofeedback and its relationship (if any) to lowering blood pressure

Sincerely,
Cindy xxxxxx


Subject: Questions!
Date: Mon, 18 Aug 1997 20:55:13 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Hello - Your interest in Hypertension caught my eye and I wondered if you could answer some questions or refer me to someone how can.

I have a 17 year old daughter who was diagnosed with Takaysus Arteritis about a year ago. Since that time, she has had two stent placements and 4 Angio's and has another one schedule for tomorrow. Her doctor has been in touch with Dr.'s at Emory and he told us that the next stent placement she needs, he is sending us to Emory, because of the research and advancement on stents and radiation.

Are you familiar with Takaysus Arteritis at all? I feel confident in the Drs. here and what they have done for her, but want to make sure we know all we can.

I appreciate your time. Thank you!


Subject: about doctors, medical info etc...
Date: Sun, 3 Aug 1997 13:50:37 -0230 (NDT)
From: Adam xxxxxx (xxxxxx@InfoNET.st-johns.nf.ca)
To: Andrew Chung (achung@emory.edu)

I wonder if you may know if there is any mailing list or web page for asking about medical issues? Any way to find medical info besides just checking out a med news group from time to time? I figure maybe one may just have some dumb-ass questions one wouldn't want to bother people in a med news group about, or maybe embarassing, or just trivial sounding, so forth... What do you think? Thanks for any advice.


Subject: varied
Date: Tue, 15 Jul 1997 09:18:56 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

This past weekend I became cacertified personal fitness trainer. I became concerned about my health because of the constant emphasis on hypertension and cardiovascular preoblems. i also have a side issue.

I am taking 2 50 mg metroprolol-equivelent to lopressor. twice a day. I am having readings of 150,160 over 98,104. i am not overtly anxious or stressed.
Oct. a catherization was performed and i have a few arteries with 40 % blockage.

REQUEST:
WHAT IMPACT CAN AEROBICS HAVE ON THE BLOOD PRESSURE AND CARDIO - CAN THIS TAKE ME INTO A CRITICAL RANGE ??
IS THERE A MONITOR THAT CAN BE WORN FOR BP - I WEAR A POLAR HEART MONITOR.

DOES YOUR INSTITUTION HAVE ANY INFORMATION ON THE QUANTITY OF NEUCLEOTIDES IN INFANT FORMULAS

GEORGE


Subject: TTP
Date: Mon, 14 Jul 1997 09:27:32 +0000
From: xxxxxx (xxxxxx@pnp.co.za)
To: achung@emory.edu

Hi Andrew,

browsing through the net in desperate need for information, I saw your name in a newsgroup discussion. My girlfriend almost past away in january, when she was diagnosed with TTP. She is also a Cystic Fibrosis sufferer and a day after the plasma transfer, had a seizure, followed by 6 weeks of half coma during which she had a severe pneumonia and a renal failure. She is well now (considering she was 5 weeks on a respirator!), her hair is growing back (she had some Chemio), but she is now starting to realise the consequences. She is getting very panicky and the doctors here is South Africa don't give ou much info. We have got millions of unanswered questions, and it makes our life very tense.
Do you know somehow a way of reading about TTP? I thought at one stage I found a Homepage about TTP, but I can't find it anymore

Can you help us somehow?

Thanks a lot

Jean-Francois


Subject: Hypertension Problem
Date: Thu, 10 Jul 1997 00:15:56 -0400
From: Mike xxxxxx (xxxxxx@aol.com)
Organization: Talon Holding Corporation
To: achung@emory.edu

Hi Dr. Chung...

My name is Mike xxxxxx, and I live in Hollywood, Florida. The reason that I write to you is because I am concerned about my mother, who has been diagnosed many years ago with hypertension. At that time, she was put on certain medication to control the severity of the hypertension. Amongst the host of medicines prescribed, she was taking a drug called Caposide, which controls the water retension and the blood pressure.

During the last 6 months, she has suffered with these unusual and severe facial swellings and potentially dangerous swelling of the tongue and oral membranes. At first, her doctor attributed this to eating strawberries, even though the hospital staff told her that they suspected the Caposide. When the swellings failed to cease and became even more dangerous, and blocked her breathing passages, she decided to stop taking the drug Caposide.

Consequently, she no longer suffers from swelling membranes and breathing passages, but now her blood pressure is clearly out of control, measuring over 240/100 throughout each day. Even though her doctor has doubled all of her prescibed blood pressure medicines, without taking a single test or examination, this has caused an unusual fluctuation in the pressure, which drops down very low for the first 30 minutes after taking the medicine and then promptly returns to the high levels shortly thereafter. To make matters worse, my mother now suffers from headaches and nausea.

Quite frankly, I am very concerned about her and I really believe the doctors offices around this area are far too busy to pay any attention to my mother.

What would you suggest for a situation like this? She monitors her blood pressure daily, but lately she can't do this anymore, because the machine she uses stops at 240, and her pressure now exceeds this level.

Please give me your advice.

Thank you...

Mike xxxxxx


Subject: uncontroled hypertension
Date: Thu, 26 Jun 1997 21:02:05 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Dr. Chung,

I've been under treatment for hypertension for the past 10 years with little or no relief.
i' ve been treated with just about every medicine currently on the market. Ace inhibitors, Ca channel blockers, diuretics, you name it, i've been there, and still no relief.
I'm currently taking Diovan, 80 mg PO BID, Ziac, 10 mg PO QAM, and Cardura, 4mg PO QHS, with a BP of 180/110.
I've had renal ultrasound,KUB, and other renal studies which showed nothing. My Cardiologist is currently exploringan MRA of my renal arteries.

If you can offer any suggestions as to areas I have not yet explored, I would certainly appreciate it.
Thanx. Ron xxxxxx...............xxxxxx@AOL


Subject: how would I find out the Drs.
Date: Tue, 17 Jun 1997 16:45:05 -0400
From: "xxxxxx"
Reply-To: @hom.net
To: achung@emory.edu

in Neurology that treat Parkinsons Disease?


Subject: May I intrude?
Date: Tue, 17 Jun 1997 16:58:55 GMT
From: xxxxxx@mail.island.net (xxxxxx)
To: achung@emory.edu

Good Morning Andrew Chung,

Forgive me for barging into your email, but this morning, in searching Deja News for articles on irregular heartbeat, I noticed your post to a fellow and you mentioned "consider subacute thyroiditis in a post-viral setting".

Since I myself have been having these irregular heartbeats for a while now, with a peculiar thumpety-thump sensation, I am starting to question what is happening. Previous to this, there were times when I laid down to sleep and my heart raced like crazy and I felt and heard my pulse so strongly. Now... I'd like to question just what is causing this, in my forties, when I am perfectly healthy and without any other complaint of any sort.

I had been attributing this to a heart thing, yet I noticed you mentioned thyroid could be at the root of this. How can I find more information out about this sort of thing, please?

An interesting sidelight to all this, is that for the past two months I have been on a low carbohydrate foodstyle and lost 20 lbs. (Have 10 more lbs to lose). The interesting part is that prior to beginning this foodstyle, I was forever "internally" cold and could never warm up. But this foodstyle has seemingly changed all that. At any rate, this is the only change I have made in my lifestyle. And the extreme heart racing/blood pounding was before.... while I now have instead, this irregular beating.

There is no stress of any kind in my life.
I'm a pretty laid-back lady :-))
Somewhere.... there has to be an answer.

Would you be willing to tell me more about "subacute thyroiditis" ?

With many thanks,
xxxxxx


Subject: Holter test report
Date: Tue, 17 Jun 1997 11:56:44 +0800 (HKT)
From: xxxxxx (xxxxxx@hkabc.net)
To: achung@emory.edu

My Holter test says I have more then 8,000 aberrants and premature aberrants. My doctor cannot explain to me what is the difference between these two. He just said my arrhthmia is benign and don't worry. Will you recommend some books for me to read so that I can understand the subject better? You have helped a lot of people in cardiology newsgroup. Your email reply will be greatly appreciated. xxxxxx from Hong Kong. xxxxxx@hkabc.net


Subject: Job Opportunity
Date: Wed, 11 Jun 1997 19:55:23 +0000
From: "Sr. Consultant" (DHRST.Louis@worldnet.att.net)
To: achung@emory.edu

Hello -
My name is Brett Midgley and I'm an executive recruiter with DHR International. We have been retained by one of our clients, VHA, to fill a position for them consisting of an Accounting Manager for one of their many divisions. I was hoping to talk to you about this position to see if you know of anyone who is currently looking for a job, and who might be a qaulified candidate. The position is located in Atlanta, and VHA prefers to hire someone already located in Atlanta. Please feel free to call me and we can discuss this opportunity in greater length. I appreciate your time and help.

Brett Midgley
Senior Consultant
DHR International, Inc.
Phone: 314/725-1191
Fax: 314/725-9286
E-Mail: DHRSt.Louis@worldnet.att.net


Subject: seeking physician referral
Date: Wed, 4 Jun 1997 10:06:19 -0400
From: Judy xxxxxx (xxxxxx@earthlink.net)
To: "'achung@emory.edu'"

Dear Andrew,

Hello! I hope you don't mind my writing to you. I cam across your web page while surfing. I have a friend who has a pheochromocytoma. His doctor doesn't know where to send him for treatment. (The patient lives in Kentucky, but is willing to go anywhere in the US for treatment.) Do you know of anyone who can treat this? If you do, please let me know.

Thanks,
Judy


Subject: Quick Question
Date: Sun, 25 May 1997 21:20:34 -0700
From: xxxxxx (xxxxxx@nwrain.com)
To: achung@emory.edu

Andrew - in doing some research I came about your web page. I am a registered nurse (public health focus) working in Phnom Penh about 1/3 of my time (commute between Phnom Penh and Seattle due to the needs of an aged parent here in the USA).

In Phnom Penh the son of a lady who used to work for me in my apartment has a heart problem. Diagnosed (not be cardiologist) as ASD but sounds to me - using my tapes from physical assessment - as a VSD. We do not do any open or closed heart in Cambodia as you may guess. We do have echo - ecg - and xray facilities but there is no pediatric cardiologist to check the results.

Quick question comes - what specific tests or exams should I look for to confirm this locally in Cambodia? Any specific lab work? The boy in question is Vietnamese which is a minus factor in getting treatment there however he was born in Cambodia and is a "Citizen" under law. I can get some further workup at the Bangkok Christian Hospital but need enough to go on to know what I am dealing with to get a visa. The boy is 11 years in age but looks to be about 6-7 in size - family is poor but does feed him - failure to thrive. Other than a very pronounced beat at the apical area which you can see and feel, he has no clubbing, signes of poor arterial infusion in nail beds, etc. he plays normally but does need rest more often than his peers.

If there are specific things I should look for in the next workup we will do in Cambodia next month I will appreciate any ideas -

Paul xxxxxx, R.N.


Subject: Great Web site--and thanks!
Date: Sun, 25 May 1997 14:17:55 -0400
From: Dale Machado (kawasaki@compuserve.com)
To: Andrew Chung (achung@emory.edu)

Dear Andrew,
After receiving your (greatly appreciated!) response to my Usenet post, I thought I'd check out your site. It's a very useful roundup of online med resources. I coordinate a support network for families affected by Kawasaki Syndrome. Our site is at:
http://ourworld.compuserve.com/homepages/kawasaki
Support-group sites may be a little too specific for inclusion on your pages, but I'd appreciate any thoughts you have on spreading the word to medical professionals so they can refer their patients. Are there, for example, any pediatric cardiology sites you'd recommend? I know there is a listserve for professionals.
You sound like good-hearted doctor (no pun intended--oh, heck, maybe it WAS intended) and a fun guy. My husband used to work (while in college) as a "bird man" at the local tourist-attraction park. He learned then how birds have distinct personalities. Our babysitter is an animal lover who, among her activities, nurses sick and injured birds. She's always saying how birds are underappreciated as pets.
Aloha to you and your wife!
Vicki Machado
Kawasaki Families' Network
Kaneohe, Hawaii
kawasaki@compuserve.com
machado@hawaii.edu

Subject: Can you please help?
Date: Sat, 24 May 1997 12:03:36 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Hello.

My name is Maria Thomas and I just moved from NJ. I was wondering if you would be able to direct me to the individual I need to speak to about research work in the medical field here in Atlanta.

My brother has just completed his second year of medical school and is taking his Boards (part 2) in August. In the mean time, he would like to find some work doing research. He currently resides in NJ but is willing to move to GA if he can find the work. Is there someone you can direct me to who has more information?
I appreciate your assistance.

Maria xxxxxx (xxxxxx@aol.com)


Subject: lump under arm and chest pain
Date: Thu, 22 May 97 13:01:19 EDT
From: xxxxxx@aloft.micro.lucent.com (xxxxxx)
To: achung@emory.edu

Sorry to bother you via private email but perhaps you can point me in the right direction. I picked up your address from Sci.med.

For several months I've had pain in the left side of my chest that is easily bearable but its intensity seems to depend on the position of my body (angle of arms, head, neck, etc). The pain can be anywhere from my left armpit to fairly close to the center of the chest. Taking a quick deep breath also causes pain in the same region. Occasional moderate exercise or climbing stairs does not make it any worse. I believe the level of the pain has remained about constant over all this time.

In addition I occasionally have faint tingling sensation in parts of my left hand or arm.

Treatment so far has included EMG of the left arm (negative), chest xray (ok), CT scan of the neck (ok), and EKG (ok). My doctor is next considering an MRI based on the recommendation of an orthopedic specialist she sent me to.

One of the frustrations I have is that it's taking so long to diagnose this. Each new appointment with a specialist or for a test takes 2-3 weeks to set up and complete.

Should I get a 2nd opinion?

Regards, xxxxxx xxxxxx@lucent.com


Subject: New Link
Date: Tue, 20 May 1997 09:00:05 -0700
From: "Arash Tirandaz, MD" (tirandaz@dallas.net)
To: achung@emory.edu

Hi,

I am internist in Plano, Texas, and I was wondering if you could add my
page to your links:

http://www.dallas.net/~tirandaz/Arash/

Thanks.

--Arash


Subject: alternative approach to mild hypertension
Date: Sun, 18 May 1997 22:31:04 -0500
From: "Donna G. xxxxxx & K. Paul xxxxxx" (xxxxxx@calpha.com)
To: achung@emory.edu

dr. chung:
i am interested in a diet or herb approach to dealing with mild or borderline hypertension.
male, age 42, 6'2", 248 lbs, bp 135/95-100. beginning to walk on a regular
basis again, used to be a jogger; pretty athletic in younger years. now
plays golf, jet ski; retired from softball and racquetball. pretty good
health, just a little out of shape and heavy. ideal weight was about 210
6-7 years ago.
would be interested in articles or research findings, suggestions.
thanks,
k.paul xxxxxx
waco, texas
xxxxxx @clapha.com


Subject: Hypertension
Date: Wed, 14 May 1997 15:54:12 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Hi. I am 17 years old and I am doing a research project at school on
hypertension. I was wondering if there was any way that I could get some of
your information for my project; it seems like you have a lot of stuff on it.
Anything you could send would be great! Thanks!

~Busy Chic


Subject: heart disease
Date: Tue, 13 May 1997 12:39:52 -0700 (PDT)
From: Joseph xxxxxx <xxxxxxx@linfield.edu>
To: achung@emory.edu

Hi Andrew:

I'm looking for a list that covers heart disease where I can subscribe and
receive e-mail digests. Do you know of such a list?.

Iwas on a prostate list and it was very helpful

Thank you.

Joe xxxxxx
chemistry.



Subject: pylodinal cyst
Date: Mon, 12 May 1997 00:45:17 -0400
From: " GA" <xxxxxx@sunet.net>
To: <achung@emory.edu>

spelling no doubt incorrect - tailbone cyst. any advice on the best
manner/technique to implement to hasten healing of drainage
incision? cyst was (small) egg size, time from "development "to
incision - 4 days. incision/drainage was 5-1-97. everything back
to normal in 3 or 4 days except it appears 1/2" incision is having
difficulty healing due to rigors subject to by virtue of location. a
vertical incision in crease of buttocks. how is it possible for such
an incision to heal without sutures - ? thank-you, george xxxxxx



Subject: Re: Flushing when drinking wine.
Date: Sat, 10 May 1997 19:52:50 -0400 (EDT)
From: Hiroatsu xxxxxx<xxxxxxandrew.cmu.edu>
To: Andrew Chung <achung@emory.edu>
References: 1 , 2 , 3 , 4

Thanks for the info, BTW nice web page.



Subject: Just Hello
Date: Fri, 09 May 1997 23:58:33 -0500
From: "Peggy xxxxxx" <xxxxxx@bellsouth.net>
To: achung@emory.edu

I wish you well. Aren't those birds extremely messy?

PC from PC



Subject: Hello, Andrew
Date: Sat, 03 May 1997 19:22:54 -0700
From: DQ <xxxxxx@win.bright.net>
To: achung@emory.edu

Hello Andrew,

I've always appreciated your comments on the cardiology newsnet. Short
and to the point. As someone who suffers from PAC's I'd like a little
input. How good is verapamil in suppressing them? Any ideas?

By the way I think you have a great web page.



Subject: Re: Question about thyroid test results
Date: Sat, 26 Apr 1997 14:09:16 -0400
From: kay xxxxxx <xxxxxx@bellsouth.net>
To: Andrew Chung <achung@emory.edu>
References: 1 , 2

Andrew,

I have a friend who is under the care of Emory physicians and
endocrinololgists. She continues to decline. She was a runner 3 days a
week, ran 4 Peachtree Road Races, rode cycling events all over the
country and was vital part of the scientific/toxicological/biological
community here in Atlanta. She is now unable to go to work for 4
months. She has been to Drs. xxxxxx, xxxxxx, and xxxxxx. My friend
has lost 20 pounds, has heart palpatations and a myriad of other
symptoms. Under Dr. xxxxxx's direction she has gone to see a
physiciatrist who told her the symptoms were NOT physcosomatic and that
she needed to seek additional medical care until a physician was willing
to listen and help her. Where in the Atlanta Medical Community to you
suggest she find a practitioner who will sincerely try to find the
source of this incidious illness.

Sincerely, Kay xxxxxx
xxxxxx@bellsouth.net
home: xxx-xxx-xxxx



Subject: Medical Rates
Date: Fri, 25 Apr 1997 22:55:44 -0600
From: "Daniel Z." <xxxxxx@mail.internet.com.mx>
To: <achung@emory.edu>

I4m a medical director of a life insurance company in Mixico, and I want to
start an HMO in Mixico City but I need some information about the history
of the HMO'S. Here in Mixico the medical rates are more or less based in
the rates of the U.S. so I4m wondering if you have some information about
the rates of all procedures (medical and surgical).
Thank4s for your help

Dr. Daniel xxxxxx xxxxxx FACC



Subject: Re: venous thrombosis
Date: Thu, 24 Apr 1997 13:04:43 -0400 (EDT)
From: xxxxxx@aol.com
To: achung@emory.edu

Hola Andrew!

Thankyou. Thankyou just does not seem a strong enough word that describes
what relief your reply has given me. Your email brought very comforting and
welcomed news, especially coming from a person with your educational
backgound and training.(you've done a great job on your home page!) I feel
much more at ease about the whole situation.

Thankyou,

Mike xxxxxx
xxxxxx@aol.com



Subject: Diet for hypertension.
Date: Thu, 24 Apr 1997 10:58:40 -0400
From: USER <xxxxxx@bellatlantic.net>
To: achung@emory.edu

Andrew,

Can you sugest any reading sources pertaining to the control of
hypertension with diet. I know that a low sodium diet is helpfull,
but it also seems that a low fat intake would also be beneficial. Any
good web sites would also help! Thanks for your time, Michael.



Subject: Hereditary Angioedema (HAE)
Date: Mon, 21 Apr 1997 14:47:47 -0500 (CDT)
From: Beth xxxxxx <xxxxxx@tenet.edu>
To: achung@emory.edu

I am a 24 year old female with Hereditary Angioedema (HAE). My granfather
has HAE as well as my mother and my aunt. My family members all take
Winstrol for the HAE, I do not, although it is against doctor's orders. I
am able to maintain the HAE, but I'm really not sure how!! I am very
careful of the foods I eat, additives, aftificial sweeteners, etc, and I
am careful to consistently take synthroid for hypotyriodism and a
multivitamin daily.

I am in search of alternative maintenance and research on HAE. My
grandfather has developed liver damage over the 17 years of taking
winstrol. I don't want that to happen to my mom and aunt, or to me for
that matter.

I hope that you can help me.

Thanks.

Elizabeth xxxxxx
Special Education Department
Region 10 Education Service Center
xxxxxx@tenet.edu or xxxxxx@aol.com



Subject: Re: Rapid rises in HR during a run
Date: Mon, 21 Apr 1997 08:38:53 +0100
From: P.xxxxxx@xxxxxx.ac.uk (Dr P J xxxxxx)
Organization: British Geological Survey
To: Andrew Chung <achung@emory.edu>
References: 1 , 2

Thank you for the information.

All I need now is a dictionary to translate :-)

pj



Subject: posts on sci.med
Date: Tue, 15 Apr 1997 18:09:50 -0400
From: anne@xxxxxx.tec.army.mil (Anne xxxxxx)
To: achung@emory.edu

Hi!

I love your posts on sci.med. You must be a
terrific doctor.

regards,

anne



Subject: Re: doctors of the nation - unite?
Date: Mon, 14 Apr 1997 00:58:55 -0700
From: "Ed xxxxxx, RPA-C" <xxxxxx@servtech.com>
To: Andrew Chung <achung@emory.edu>
References: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9

Dr. Chung, I admire your attempts to reasonably argue with Mr. xxxxxx and
others of his ilk.....
--
Edward J. xxxxxx, RPA-C
Family Practice
xxxxxx@servtech.com
----------------------------
"Diplomacy: the art of saying "nice doggie" until you find a rock....""



Subject: Re: Heart Failure-Diastolic or Systolic Dysfunction?
Date: Thu, 10 Apr 1997 08:26:11 +0100
From: "C.xxxxxx" <xxxxxx@sghms.ac.uk>
To: achung@emory.edu
Thank you for your useful and informative reply to my questions.

Regards,

C. xxxxxx

Subject: Chicken pox in adults
Date: Tue, 8 Apr 1997 00:54:34 -0400 (EDT)
From: Vincent xxxxxxx <xxxxxxx@access.digex.net>
To: achung@emory.edu

Dear Dr. Chung,

Forgive me for writing, but I found it somewhat entertaining that we both
sent essentially the same response, although different language was used,
to the 25-year-old woman who asked about the above subject (I e-mailed
her).

Here is a copy of what I e-mailed that person:

To: xxxxxxx@flash.net
Subject: Re: chicken pox @ 25, female
Newsgroups: sci.med
In-Reply-To: <860438464.20773@dejanews.com>
Organization: None


Chicken pox can be dangerous in an adult. A co-worker's daughter-in-law
caught it last year and was lucky to survive -- the virus (probably) got
into her brain (viral encephalitis). Also, the same pox that show on a
person's skin are also present inside their body, such as inside their
lungs, making breathing difficult.

I'm not a physician, just a lay person letting you know of the potential
dangers. Ask your doctor or pharmacist about putting you on antiviral
therapy (such as acyclovir).

Good Luck,

Vincent
--
Vincent xxxxxx (xxxxxxx@access.digex.net)

Subject: Re: Hypertension - difficult to control
Date: Thu, 03 Apr 1997 08:21:03 -0500
From: SWS <xxxxxx@onramp.net>
Organization: Something Cool
To: Andrew Chung <achung@emory.edu>

Thanks for your reply. I believe you have written me recently on this
subject. If you don't mind I need to ask a couple more questions.

I beleive he has ruled out hyperaldosteronism based on a 24 hr urine
done in 1989 by my cardiologist. But I understand it can be difficult to
detect even with a 24 hr urine. True or not?

I also had a cat scan a number of years ago looking for pituitary or
adrenal tumors. I understand the cat scan may have been a poor choice
for the kidneys, especially for pheochromocytoma. True or not?

My primary care physician is entertaining my request for a check for
renal artery stenosis. He will order a Captopril renal arteriogram at
months end when I am clear of Zestral. My doctor, however, does not
believe it is renal artery stenosis. His opinion is that my blood
pressure would respond to nothing, not even nifedipene. Some things I
have read inidcate that screening on this basis is not reliable.

I am thinking of seeing an endocrinologist prior to the renal
arteriogram. I think a second opinion might set my mind at ease on the
secondary causes issue.

My cardiologist and primary care physician seem to have ruled out
secondary causes. This is probably for good reasons, I don't have the
knowledge and experience to judge. However, without a clear explination
from them or the time available to answer all my questions I remain
uncomfortable. My fear is that I have become a nusiance patient which
leaves feeling like I have been "painted into a corner" by the problem.

I am worried. I have a friend whose wife just died of a CVA. She was the
same age as me and started being treated for high blood pressure at the
same time as me. She lost a lot of weight and her blood pressure fell to
a level that they reduced her medication. She went essentially untreated
for the last five years.

All mortality statistics I read indicate the 10 year outlook for me
isn't great. A quick fix to the problem would be nice, but I don't think
I am going to get it.

Thanks for all of your help.

Best Wishes

Steven W. xxxxxx

Subject: Impressions
Date: Wed, 2 Apr 1997 09:40:09 -0600
From: Smurf <xxxxxx@intplsrv.net>
To: "'Andrew Chung'" <achung@emory.edu>

Andrew,

A few weeks ago you gave me you impressions on my Wife's cardiomyopathy diagnosis. We have since gone to see another Cardiologist for a second opinion. The information that you passed to me during a flury of e-mails. It gave me a better understanding of the condition and also enabled me to ask meaningful questions to the Cardiologist.

He ordered a nuclear stress test to determine if any heart damage might have occured from silent heat attacks as some of the EKG results indicate. He also insisted that her diabetes be closely followed as you mentioned and is increasing her dose of Vasotec.

Andrew I just wanted to say thanks for taking time and communicting with me all of this valuable information and to extend an open invitation to visit the most beautiful city in the south east, Charleston SC. If you happen to be in the area feel very free to call xxx-xxx-xxxx.

Sincerely,

Greg P. xxxxxx
xxxxxx@intplsrv.net
xxxxxx@aol.com



Subject: is it genetic
Date: Sun, 30 Mar 1997 19:33:06 -0500
From: "Elizabeth M. xxxxxx" <xxxxxxx@ctwok.com>
To: achung@emory.edu

How in the world does a guy like you have time for this? Do you ever
sleep.

I was checking out your accomplishments on that nice website and
wondered how people like you do it.

I'm a student, wife, mother, employee, and I have a life with friends
and activities. This seems minute compared to what you do and yet you
have time to answer quetions on the net, watch movies, .....

I have no time for much other than study.

Is there a trick or is it genetic? I sometimes wonder if I really
should persue a degree in medicine because things seems to come very
hard to my understanding, yet I cannot deny my love for the subject.

Subject: request
Date: Mon, 24 Mar 1997 18:00:50 -0800
From: C/O.American.School.of.Tangier-Tangier-Morocco@marocnet.net.ma
To: achung@emory.edu

Dear Sir,

I have ound your email thanks to the internet.

We are group of people trying to help a 26 years old moroccan who has a rheumatic heart disease and who needs to be operated on. For that he needs two Standard Carbomedics prosthesis : Aortic #25 and mitral #29.Because they are very expensive in Morocco we are trying to see if we could bring them from elsewhere.

We kindly ask you to tell us, if you can, the prices for such prosthesis in America.

Thanking you very much or your time and hoping this request will not cause too much trouble,I remain

Sincerely yours,

Karim xxxxxx
C/O American School of Tangier
xxxxxx@marocnet.net.ma


Subject: Celiac/Cardiac Article
Date: Sun, 23 Mar 1997 21:21:37 -0500
From: Marilyn xxxxxx@gte.net
To: achung@emory.edu

Andrew,
I am having a problem sending messages to the newsgroups. That is why
I am E-mailing you. Just found out the problem with sending is with
my service provider - they are having problems.

A cardiologist thought he recently read an article in a journal about
Celiac and cardiac problems. Did you happen to see this article or
do you know where I might be able to check on finding this type of
article? I am a self diagnosed celiac.

Any info would be appreciated.

Marilyn


Subject: hyperytension in teenagers
Date: Sat, 22 Mar 1997 19:25:28 -0800
From: Jody xxxxxx@nternet.net
Organization: Fort Macon State Park
To: achung@emory.edu

I have been trying to locate some information on hypertension in
teenagers (13 year old) My main concern is with a 13 year old female
that has diabetes. If you know of any sources of information that may be
hellpful I would appreciate it.

Thank you,

Jody xxxxx


Subject: Can You Help?
Date: Mon, 17 Mar 1997 16:12:04 -0500 (EST)
From: xxxxxx@aol.com
To: achung@emory.edu

Hi Dr. Chung,

My name is Tim xxxxxx. I am a Ga Tech graduate of Physics and Computer
Sciences. I worked under Dr. Roger xxxxxx in molecular BioPhysics while
in Graduate school at Tech.

I am currently seeking a position as a research scientist/engineer and would
appreciate any suggestions you may have for persons to contact at Emory.

My resume is posted at http://members.aol.com/xxxxx

The resume as posted is slanted toward getting work as a programmer/analyst,
but as you can see, I have an extensive background in research and product
developement.

I enjoyed your Web page, and hope to hear from you soon.

Best Regards,

Tim xxxxxx


Subject: Lump on Tongue
Date: Thu, 13 Mar 1997 08:32:48 -0500
From: "Andre' xxxxxx" <axxxxxx@ix.netcom.com>
To: achung@emory.edu

Dr. Chung,

Thank you so much for your message. My mom actually got to see her Oral
Surgeon today. He said that the pea-sized lump within the tongue was most
likely caused by an inflammatory response to the surface activity. He
suspects an inflamed papillae (sp?) or mucous gland. He gave us a list of
other possible causes including cysts, but strongly doubts by its
presentation that it is anything serious.

He wants her to rinse with warm salt water and gently brush the area. He
will see her again in 1 week to re-examine and decide upon further action
if necessary. We are just praying that it will spontaneously resolve by then.

Thank you so very much for your message. It was truly appreciated.

P.S. I really enjoyed your home page. It is very well constructed and
organized. I also enjoyed reading about you and your background. It is
very comforting to know there is a knowledgeable, dedicated physician out
there who seems to truly love his craft as well as the people he deals with.

Thank you once again, and may God Bless you and your family.

Andre' xxxxxx


Subject: Cardiac Rx Classification
Date: Mon, 10 Mar 1997 10:58:38 -0800
From: John xxxxxx (xxxxxx@ally.ios.com)
Organization: San Diego CHARGERS
To: Andrew Chung

Andrew,

Thank you for this clarification. As I try to
learn more about coronary artery disease (my
74 yr. old mom has CAD), I find alot of seemingly
conflicting info...

As an aside, have you heard of EECP ? A hospital
local to us is offering it, and they're "marketing"
it heavily to angina sufferers. Any thoughts
would be greatly appreciated.

...john


Subject: Web Page
Date: Thu, 06 Mar 97 16:55:10 PST
From: Greg xxxxxx (xxxxxx@intplsrv.net)
To: achung@emory.edu

Dr. Chung

I have looked for your web page at the U of Emory and have had no
luck. The address at bottom of your last e mail did not work for me.

Thanks again for taking time to answer my questions. It's very
important to me as it envolves my wife. She happens to be in
charleston SC and I am with the USAF going to school in Oklohoma for
another 2 months.

Just trying to vacume information from any source.

Would you be interested in seeing her past evaluations on a consulting
basis? Money is no factor.

Thanks again

Greg
xxxxxx@intplsrv.net


Subject: Medical Web Pages
Date: Wed, 5 Mar 1997 23:26:50 -0800 (PST)
From: "Leonard J. Tyminski, M.D." (radiologist@earthlink.net)
To: achung@emory.edu

Check out my web page at:
http://home.earthlink.net/~radiologist/
While not entirely medical it is mostly so. Try out the "Case of the Week"
in the study. BTW, I did my internship at Emory/Grady. See my full CV at:
http://home.earthlink.net/~radiologist/cv/
Note:
16 bit color or better is recommended. The grayscale of the medical images
is hammered by browser dithering with 8 bit (256) color displays.


Subject: Dilated Cardiomyopathy
Date: Wed, 05 Mar 97 14:08:13 PST
From: Greg xxxxxx (xxxxxx@intplsrv.net)
To: achung@emory.edu

Mr. Chung,

Could you pls send me information on the possibility of the heart muscle
repairing damage after dilated cardiomyopathy has been diagnosed?

Greg


Subject: what was that site again?
Date: Wed, 05 Mar 1997 05:50:04 -0800
From: Howard xxxxxxx MD (xxxxxx@compuserve.com)
Organization: Fellow, American College of Physicians. Associate Clinical Professor of Internal Medicine at UC Davis Medical School
To: "Dr. Andrew Chung" (achung@emory.edu)

Andy, Could you please send me the URL for that site you have on
molecular biology/genetics? I lost it from a reply you made on the
sci.med.newsgroup because my computer froze temporarily. I was trying
to read more about acute fatty liver of pregnancy and LCHAD deficiency.
Thanks, H2


Subject: sci.med posting re antibiotic
Date: Wed, 5 Mar 1997 12:21:10 -0000
From: "Peter xxxxxx" (xxxxxx@derbes.com)
To: "'Andrew Chung'" (achung@emory.edu)

Thank you for your response to my March 2nd posting. I attach my original posting
for your convenience.

As you might have surmised, I am an attorney representing the family of the
48 year-old woman in question (Katherine xxxxxx, of New Orleans, LA). I am search
of an expert who can address the issue of whether the delay in giving her antibiotics
decreased her chance of survival.

With regard to your comments, the physician who admitted her from the E.R. to a
ward (at 1am Saturday) wanted to have a nephrology consult sometime later that day
(Saturday), and saw no need for an immediate consult. His orders, written at 1 am
Saturday, called for Timentin 2 gm. every 12 hours with 3.1 gm to be given after each
hemodialysis. Mrs. xxxxxx got the Timentin IVPB at either 4 am or 6 am that morning
(there appear to be two times written on the chart, with 4 [am] apparently written over
6 [am]), after she was resuscitated following a respiratory arrest at 3:15 am Saturday.
At 11:40 am Saturday, the Timentin is discontinued and Gentamycin (100mg IVPB x1)
and Vancomycin (1g IVPB x1) ordered and given at about 12:30 pm Saturday.

It is not clear when the blood culture work was done. There is a time stamp on the test
results suggesting either that the sample was taken, or the results obtained, on Saturday
at 00:30. Presumably some test result triggered the switch from Timentin to Gentamycin
and Vancomycin. Could cultures be done so quickly (i.e, between 8 pm and midnight)? I am
attaching a copy of the culture results, with apologies for the size of the file.

Finally, I have seen nothing in the record regarding hyperkalemia, or whether that was of
concern to anyone involved.

If you or someone you know would be interested in getting involved in this case as an
expert, please let me know. Feel free to call me or my associate, Frank xxxxxx, collect
at the number below. Your assistance to date is greatly appreciated.

Regards,
Peter xxxxxx
xxxxxx@derbes.com

p.s. Where might I put my hands on literature or documentation showing that the standard
of care requires a more timely administration of antibiotics?


Subject: good news
Date: Wed, 5 Mar 1997 08:17:44 +0100
From: xxxxx@axcasp.CASPUR.IT
To: achung@emory.edu

Dear Andrew and E-Lee:
A very good news. We just had the results of the amniocentesis.
The baby is fine, and she is a girl too!!!!! Laurie decided the name (I am
not too much convinced about) It will be Isabel Jacqueline (very long!!!).
A big hug. Ciao Antonio

Dr. Antonio xxxxxx
Dip. Genetica e Biologia Molecolare
Univ. "La Sapienza"


Subject: my homepage
Date: Tue, 04 Mar 1997 22:47:06 -0700
From: xxxxxx@v-wave.com (ADAM PORADZISZ)
To: achung@emory.edu

Hi !

You are invited to my homepage "www.agt.net/public/dradam/adam". I have a
links to more than 50 of other physician's homepages. Enjoy !

Dr. Adam Poradzisz
dradam@telusplanet.net


Subject: Re: Deja News Retrieved Document
Date: Tue, 4 Mar 1997 12:01:29 -0500
From: "Claudine xxxxxx" (xxxxxx@smb.com)
To: achung@emory.edu

Hi, I'm actually curious in reference to baby aspirin, I don't have a heart
condition but I do have a problem w/ clotting when I get my period.
I've been concerned that maybe I have poor circulation, & thought that mabye a
daily dose of baby aspirin .81 mg could be helpful.
I've been trying to conceive after a miscarriage two years ago, & had asked my
RE about it. She claims that there is no evidence that this is helpful.
Can you give me any information that may support my theory???

Regards,
Claudine xxxxxx


Subject: Fwd: Cardiology Newsgroup posting
Date: Mon, 3 Mar 1997 22:31:13 -0500 (EST)
From: xxxxxx@aol.com
To: AChung@emory.edu

Andrew, I had my 6 month echo done today.Your estimate of 40% EF was very
close. My Doctor couldn't get a Echoologist(?) to interpret it but he
estimates my EF in the mid 30's. I feel like I just dodged a bullet. My
Doctor said the 1 year mortality rate for a person with a 15% EF, which I
had, is about 25-30% and that the mortality rate for someone with an EF in
the mid 30's is about 3%. Does that sound about right?

I'm to get another echo done in 6 months. Care to venture another prediction
as to the EF then?

Thanks.

Dennis xxxxxx
xxxxxx@aol.com


Subject: GLAXO WELLCOME HELIX
Date: Sun, 2 Mar 1997 16:45:17 -0500
From: xxxxxx@erols.com
To: achung@emory.edu

Andrew Chung,

www.helix.com

This is a powerful medical research and continuing education site
that I highly recommend you visit. Besides offering free MEDLINE
searches, it offers many continuing education courses on line,
hyper links to numerous association/organization web sites, and hyperlinks
to medical news web sites such as the Medical Tribune.

You will need to register to use HELIX. When you get to the site click on
"professional registration" to register.

One of the best features of HELIX is MEDLINE which is updated weekly and
contains the entire database. Soon, AIDSLINE will be online at HELIX,
as wells as USP DI Vol. 1 and Vol 2., and virtual reality training seminars.

If you have any questions or comments on HELIX, please feel free to reply
to me via e-mail.


Subject: regarding anlage
Date: Fri, 28 Feb 1997 13:17:02 -0500 (EST)
From: Ildefonso xxxxxx (xxxxxx@emory.edu)
To: achung@emory.edu

Andrew:
Wonderful idea to have a inter-house-officer communication through the
internet. I want to be included in and let me know if I can be of any help
Thanks,
Ildefonso


Subject: Re: PLEASE RESPOND QUICKLY!!
Date: Wed, 26 Feb 1997 15:32:00 -0500
From: "xxxxxx, Lori " (xxxxxx@msgate.ColumbiaSC.NCR.COM)
To: Andrew Chung (achung@emory.edu)

Andrew:

Thank you for replying!!! What is prostatitus? Is that bad?

Thanks!!!!!!!!!

Lori


Subject: Cardiology Newsgroup posting
Date: Wed, 26 Feb 1997 13:54:49 -0500 (EST)
From: xxxxxx@aol.com
To: achung@emory.edu

Andrew, thank you for the attached response to my question on the Cardiology
newsgroup asking if and A/V fistula could cause Cardiomyopathy.

I have been off dialysis for 7 years and was advised not to remove my fistual
as there was no reason to remove it. Then I was diagnosed with dialated
cardiomyopathy with no blockages of valve problems found. I had the fistula
removed almost 6 months ago and was told it was circulating about 1.5 gallons
per minute. My EF measured 6 months ago was 15%. I am having another echo
done next week. Any predictions on my current EF?

Thanks.

Dennis


Subject: Blood problems NEED HELP !!
Date: Sun, 23 Feb 97 20:47 +0200
From: xxxxxx@vms.huji.ac.il
To: achung@emory.edu

Hi Andrew

I'm an internist here in Israel and queried the poster. It seems
that this patient has a rare Factor V deficiency. I suggested that
her internist in Tel Aviv refer this case to our hospital's
hematology unit whose director is one of the 5 top experts in the
world in Factor V deficiency.

Take care

Josh


Subject: primary pulmonary hypertension
Date: Thu, 20 Feb 1997 22:13:53 -0500 (EST)
From: xxxxxx@aol.com
To: achung@emory.edu

tell me what this is .


Subject: hypertension and arteriosclerosis
Date: Tue, 18 Feb 1997 13:13:56 -0800
From: marlene xxxxxx (xxxxxx@sympatico.ca)
To: achung@emory.edu

My husband is 73 years old and was diagnosed to be hypertensive at the age
of 24. He was discharged from the Canada Armed Forces in 1948 with a
severe nervous condition. At the present time he receives a 60% pension
for nerves from the Canadian Pension Commission. He wasn't treated
agressively until about 1980. Previous to this he was on diruetics and
rauwolfia drugs. Is there a possibility that hypertension (even though
remote) could lead to or cause arteriosclerosis? He has PVD and problems
with his heart valves and inferior wall problems. He also has problems with
his abdominal aorta.

Thank you,

xxxxxx@sympatico.ca


Subject: internet @ hospitals
Date: Sat, 15 Feb 1997 18:43:24 -0500
From: "Leigh xxxxxx" (xxxxxx@physio.emory.edu)
Organization: Emory University School of Medicine
To: achung@emory.edu

Hi Andrew -

Thanks for writing the MSTP re-entry page! I look forward to using it
when I finally find my way back to the VA (hopefully by the end of this
year).

Also, I've been meaning to get in touch with you for a few weeks... I am
part of a small team (including Bob xxxxxx, Judy xxxxxx, Andy
xxxxxx) working to establish 24-hour Internet access for our
faculty/residents/students at all of our hospitals by July 1. At their
last meeting, the GME Advisory Committee resolved that this should
"happen", and Bob & I are beginning to make contact with all of the
hospital CEOs, Information Services folk, librarians, etc. who will be a
needed part of this effort. I've also been in touch with Tom xxxxxx,
and we'll be working together to coordinate this project with the
planned renovations to the Grady 16th floor.

I'd very much like to get your perspectives & thoughts on our current
plans. (An aside: An impetus for doing this is the need to get our
LearnLink-based intranet available to the M3s & M4s on the wards). I'd
particularly like to hear your thoughts about the initial hardware &
software "specifications" we've developed, & any other ideas you wanna
share.

If you're interested, please lemme know. My evenings are usually pretty
flexible...

Thanks.

--Leigh xxxxxx


Subject: Pancreatitis
Date: Tue, 11 Feb 1997 08:17:06 -0500
From: Robert xxxxxx (xxxxxx@lhccorp.com)
To: "'andrew chung @ emory'" (achung@emory.edu)

Andrew

I saw your posting regarding pancreatitis in usenet. My sister, Stacy,
(30 years old) is currently hospitalized in Florida with pancreatitis
and is on an IV. She has had her gallbladder removed and has had an
ERCP. After seeing your posting, I was wondering what your thoughts
might be for treatment in the case of a stricture in the pancreatic
duct. Apparently, that is what the docs in Florida have diagnosed.

Also, I have read a lot lately that the use of anti-oxidants seems to be
effective in minimizing the symptoms of pancreatitis. Do you have any
thoughts about this?

Finally, my sister has been to Atlanta and is thinking of moving here.
She clearly has a medical condition which requires escalated medical
care. I would like to learn more about the resources available at Emory
to treat folks with pancreatitis. Are there practices based at Emory
which focus on this disease? Are there any docs you could recommend?
How about you, what is your position at Emory and are you accessible to
patients?

Any information you provide will be appreciated.

Sincerely,

Rob xxxxxx


Subject: adding webpage
Date: Mon, 10 Feb 1997 16:59:17 +0000
From: Olivier Wenker (wenker@bcm.tmc.edu)
Organization: Baylor College of Medicine
To: achung@emory.edu

I just surfed onto your page. Please link to my home page at
http://www.ispub.com/wenker.htm

My name is Olivier C. Wenker, M.D.

Thank you

Olivier Wenker


Subject: cardio-myopathy
Date: Fri, 7 Feb 1997 21:38:32 -0500 (EST)
From: xxxxxx@aol.com
To: achung@emory.edu

Andrew- thanks so much for the advice. I just found this site and I think you
and the other proffesionals who respond to patient's questions here provide a
wonderful service. If you have time, some other questions I forgot to ask
are, what would a flat "t" wave in "v6"on an ecg signify? non-specific st
changes? 72mm "r" wave in v6? Could quinidine and dig. together produce
dangerous arrythmias? and, What are "bigeminal patterns"? I know these are
alot of questions and you must be a very busy guy. so no hurry to get back to
me.

david xxxxxx


Subject: Need other opinions
Date: Tue, 4 Feb 1997 17:07:36 EST5EDT
From: "Jacob xxxxxx" (xxxxxx@radonc.som.sunysb.edu)
Organization: Radiation Oncology SUNY Stony Brook
To: Andrew Chung (achung@emory.edu)

Andrew,

Thanks so much for getting back to me. I spoke with another
physician I know here at the hospita, who also mentioned damage to
the pituitary gland as a factor in the child's blood pressure
problem. Last night they had to transfuse her because her
hemaglobin value was going critical. Today, her blood pressure was
going all over the place, and I hear they are trying a new
medication. The family is now in contact with a homeopath in
Ontario, trying to find other viewpoints and advice.

Thanks for your kind words. Take care.


-Jacob


Subject: Thanks for Posts
Date: Sun, 02 Feb 1997 11:37:10 -0700
From: "David xxxxxx" (xxxxxx@ix.netcom.com)
To: Andrew Chung (achung@emory.edu)

Andrew,

Just wanted to stop and say thanks for your posts on the
sci.med.cardiology newsgroup. Although I scan the group every day for
heart rhythm related subjects (atril fib. and PVC's) I always stop and
read your posts no matter what the subject. I appreciate the truly
professional information.

David xxxxxx


Subject: Thanks for the response
Date: Tue, 28 Jan 1997 17:42:08 -0500
From: "Josh xxxxxx" (xxxxxx@ix.netcom.com)
To: (achung@emory.edu)

Andrew -

Thanks for the response regarding my father's problems with coumadin and
his current internal bleeding. The situation, as you correctly assessed,
is a catch-22. The problem right now is that they can't seem to locate the
source of the bleeding. They removed a polyp from his stomach (which they
subsequently lost before they were able to perform a biopsy on it).
However, they are not sure that the location of the former polyp is the
spot from which he is bleeding.

I was hoping that there might be some nutritional changes he could make
that would thin his blood to a consistency that would be safe for his valve
without having him continue on the coumadin.

Josh xxxxxx


Subject: Where to look for historical views on heart failure.
Date: Mon, 27 Jan 1997 12:32:22 -0600
From: Blake xxxxxx (xxxxxx@bellsouth.net)
Organization: Med-Travel Books
To: achung@emory.edu

Andrew,

I'd appreciate any info you can give that would point the way to
medical books that describe the earliest known teartments for any kind
of heart failure. I'm trying to trace and record the earliest
understandings and treatments of CHF to the present day understanding
and treatment. Any help would be greatly apporeciated. Thanks very
much.

Blake xxxxxx
xxxxxx@bellsouth.net

PS/ I don't care what earlt ideas or treatments were employed--just the
facts describing the thoughts about the disease and its various
treatments.


Subject: Swelling around belly-button... should I get it examined?
Date: Fri, 24 Jan 1997 22:36:59 -0800
From: "Jeff xxxxxx" (xxxxxx@agora.rdrop.com)
To: "Andrew Chung" (achung@emory.edu)

Thanks, I thought it might be hernia too, but I've never heard of
hernias around one's belly button. I'll have it checked out.

-- Jeff


Subject: M.D. xxxxxxx
Date: Wed, 22 Jan 1997 19:45:10 -0800
From: xxxxxx@ix.netcom.com
To: achung@emory.edu

I live in Nashville, TN and a Doctor here has recomended I see a Doctor
in the Atlanta area whose name is xxxxxxx. Is there anyway you
know of to get some information about this Physician or their practice?
The telephone number information hasn't proved helpful. Thank you.

Casey xxxxxx


Subject: left ventr. filling pressure
Date:Wed, 22 Jan 1997 06:45:58 -0600
From: xxxxxx (xxxxxx@onramp.net)
Organization: Home
To: achung@emory.edu

I enjoyed your "horse analogy: to heart failure. I am not a medical
professional but would reason that "getting a new horse" would be one
solution to your dilemma.

If you get a chance please read my entry from last Sunday seeking info
on Amyloidosis.

Add to my note:

I just got an echo report which shows mild elargement of LA, RV, septum
and aortic root. I have S4 but no S3. Grossly normal LV wall motion
(whatever that means). EF = 65%. Heart valves normal and otherwise
normal heart.

Thanks

Steven xxxxxx


Subject: New Cold Medicine
Date: Tue, 21 Jan 1997 09:40:23 -0800
From: xxxxxx (xxxxxx@globalserve.net)
To: achung@emory.edu

Hi,

I read your site - very interesting and impressive. I know you like to
"give without expecting anything in return" so how about a little free
advice. I'm from Canada and I've heard about a new cold medicine
available in the US called "Cold-Ease". Apparentlty it reduces the
length of a cold by 50%. Have you ever heard of this? Do you know the
manufacturer? Is it perscription?

I really appreciate any help you can offer.

Sincerely,

Robert xxxxxx
xxxxxx@globalserve.net


Subject: Searching for MEDLINE program
Date: Wed, 15 Jan 1997 14:56:46 +0100 (MET)
From: Ricardo xxxxxx (xxxxxx@pinon.ccu.uniovi.es)
To: Andrew Chung (achung@emory.edu)

Thanks about your information of MedLine,
just tell me if you want anything from
Spain ...

Bye.


Subject: When to stop Asthma Treatment?
Date: Sat, 11 Jan 1997 18:57:48 +0800
From: Andy xxxxxx (xxxxxx@post1.com)
To: Andrew Chung (achung@emory.edu)

Hi Andrew

Can you please advise? I am 63 years old and have been suffering from asthma since my childhood days. For more than 15 years I have been relying on Ventolin Inhaler (salbutamol BP 0.1mg per dose). I used one puff at night before going to bed, and sometimes one puff in the morning. Occasionally, I had to use more than twice a day. Since my asthma was under control, I rarely had to see a doctor.

A few months ago, my asthma got a little worse and I had to use my Ventolin Inhaler 4 to 5 times a day. I decided to see a government doctor. He prescribed Becotide Inhaler (beclomethasone dipropionate BP 50 mcg) and asked me to inhale 2 puffs 2 times daily. Since I switched to Becotide Inhaler, I did not have to use Ventolin Inhaler. I do not get any more asthmatic attacks.

I have already finished one Becotide Inhaler (200 doses). I understand I have to carry on using Becotide Inhaler until I am told to stop. The reason why I am not going to see the doctor is that he is so busy seeing so many patients a day, that I can predict what he is going to tell me.He spends less than 5 mins per patient, on the average.

So what I would like to know is that if I do not get any more asthmatic attacks, can I reduce my dosage from 2 times a day to once a night. And if I still don't get any more attacks, can I further reduce from 2 puffs a night to one puff a night? Finally, if no more asthma on one puff at night, how long do I have to continue with Becotide? When can I completely stop using Becotide?

Any advice you can give will be greatly appreciated.

Thank you .

Andy


Subject: would you like me to show you mine?
Date: Sat, 11 Jan 1997 17:03:29 -0800
From: Howard xxxxxx MD (xxxxxx@compuserve.com)
Organization: Fellow, American College of Physicians. Associate Clinical Professor of Internal Medicine at UC Davis Medical School
To: achung@emory.edu

Very nice www page! I thought the intern survival guide was great!
It's something every teaching institution should have! Some of your
links didn't go through---not sure if the site was tied up or the
site obsolete... Let me know if you want me to show you my
"bookmarks"--
I don't have my own www home page yet...H2


Subject: Re: Anlage
Date: Sun, 8 Dec 1996 11:15:39 -0500 (EST)
From: "Beth xxxxxx" (xxxxxx@emory.edu)
To: Andrew Chung (achung@emory.edu)

ANDREW,
HOW DO YOU SEND MAIL TO THE VA HOSPITAL? I HAVE TRIED USING @ATLANTA.VA.GOV AND IT ALWAYS SAYS "HOST UNKNOWN."
THANX
BETH


Subject: Cancer patient in the Philippines
Date: Sat, 07 Dec 1996 11:08:21 -0800
From: Telmo & Mariella xxxxxx (xxxxxx@pacbell.net)
Organization: Fog City Services
To: achung@emory.edu

Hello Dr.
I'm not sure if you can help me. I have a co-worker that has a cousin living in the Philippines with cancer . She is following a certain therapy from a the Dr. Gerson "cancer therapy". Have you ever heard of this doctor? Anyway, the lady has to be fed with liquid food. something similar to "Ensure" sold here is the USA. It is extremely expensive in the Philippines so, my Co-worker, her cousin is looking for the product here in the USA to send it to her. I tried looking for the Dr. Gerson's home page but I haven't found him. Can you help me?
Please answer to xxxxxx@pacbell.net
Thank you!
Mariella xxxxxx


Subject: pacemaker programmed rates
Date: Mon, 25 Nov 1996 18:35:21 +0100
From: MarGe (xxxxxx@pi.net)
Organization: Planet Internet
To: achung@emory.edu

Hai there... I visited your homepage and reayour replies in the various newsgroups and I just thought that you might be able to help me as well. Maybe you have already seen my message in the newsgroups, but I am sending you my e-mail nevertheless. Do you have any experience with pacemakers and the programmed rate? I am having a =pm myself, and it is programmed at 45 bpm (just a few weeks ago it was even set at 40 bpm). I notice that this seems a bit low, considering my activities etc. I also wonder if the one lead (VVI mode) is enough for me now.
The pm paces quite a lot during the daytime, and it is a nuisance if and when the device starts pacing. It also seems that the heart has "problems" following the pacing. It starts pounding heavily after ten or fifteen pacings (at a stretch). I hope that you understand a little of what I am saying....

Do you have any information at all as far is the programming is concerned? For your information: I am 29 years old and diagnosed with (fast deteriorating) SSS with bradys/tachys and asystolie. The PVC's are also occurring more often, but I don't think this is such a big problem.

If you could find the time to answer me, please do. I would highly appreciate your help and info. Thanks.
Regards, Mariette+++


Subject: New medical site . . .
Date: Thu, 07 Nov 1996 13:20:37 +0000
From: Carole xxxxxx (xxxxxx@arena.com)
To: achung@emory.edu

Hello,

We noticed that you had a link to a similar site and were wondering whether you would oblige us by adding a link to our site also.

The Montreal Institute for Reproductive Medecine offers to infertile couples, among others, services in fertility and genetics counselling, In Vitro fertilization, insemination and a sperm bank.

http://www.infertility.ca

Combining research, the latest technological and ethical developments, diagnostics, clinics and teaching, the Montreal Institute for Reproductive Medecince offers services to infertile couples: fertility, infertility, urology, genetics and psychology consultations; medically induced ovulation, superovulation, In Vitro fertilization, inseminations, sperm microinjection, epididymal or testicular sperm aspiration; embryo freezing, sperm cryopreservation; endocrinology and andrology laboratories, and semen analysis.

Thank you in advance.

Carole xxxxxx
xxxxxx@arena.com


Subject: HyperMed Pediatrics software
Date: Thu, 07 Nov 1996 12:12:48 -0800
From: Josepha xxxxxx (xxxxxx@jer1.co.il)
Organization: HyperMed Ltd.
To: achung@emory.edu


Hello,

I invite you to view the new HyperMed Pediatrics web site at: http://www.hm1.com

Click the free zone icon and view the chapter of the week.

Could you please add us to your general medical resources list? We would appreciate that.

Sincerely,
Josepha xxxxxx


Subject: Neil Schulman, MD
Date: Thu, 31 Oct 1996 10:10:15 -0500
From: Sandy xxxxxx (xxxxxx@acpub.duke.edu)
To: achung@emory.edu

I'm trying to get Dr. Neil Schulman's e-mail address. Is is available in the Emory directory or on-line? Have tried several paths, so could use your assistance. Thank you.

Sandra xxxxxx


Subject: newsletter
Date: Mon, 14 Oct 1996 18:25:14 -0400 (EDT)
From: Edward xxxxxx (xxxxxx@emory.edu)
To: Andrew Chung (achung@emory.edu)

hi andrew

why dont you remind all the third year residents that we need to register for the BOARDS before 12/1/96

edward


Subject: What do you call medicine under capitalism?
Date: Sun, 13 Oct 1996 01:20:50 -0700
From: Garrett xxxxxx (xxxxxx@adnc.com)
To: achung@emory.edu

PROFIT MOTIVE!!!!
If you are a med student, congrats, maybe you'll let me wax your Mercades.

Garrett.
B.A. English/Lit.


Subject: ICAM-1 Hypothesis in Atherosclerosis by Ron xxxxxx
Date: Sat, 12 Oct 1996 17:45:20 -0700 (MST)
From: xxxxxxxx@CBE.AB.CA
To: achung@emory.edu

Dear Dr. Chung:
I wonder if you would be good enough to read over the following paper,
and offer any comments that come to mind? Thanks in advance for your time.
Ron xxxxxxx

ICAM-1 Hypothesis in Atherosclerosis
by Ron xxxxxx

This article is intended as suggestive, only.
(body of article omitted)


Subject: P-Trax
Date: Thu, 10 Oct 1996 20:47:09 -0400 (EDT)
From: xxxxxx@emory.edu
To: Andrew Chung (achung@emory.edu)

Thanks for the alert, Andrew.
-Mike


Subject: Just What Is Aortic Insufficieny??????????????????????????????
Date: Thu, 10 Oct 1996 14:19:17 -0700
From: xxxxxx@ix.netcom.com
To: Andrew Chung (achung@emory.edu)

Dear Andrew,
Thank you for your information I appreciate it. I do have a couple of more questions though; one being why not corrective surgery now? And why would the doctor tell my girlfriend her life expectancy will be shorter, or at least a good chance of it. If you know more on the subject I'd love to hear it if you have the time. And if you respond could you e-mail me directly?
Thank you again,
Brian


Subject: Mitrochondrial Myopathia
Date: Wed, 9 Oct 1996 19:40:32 -0800
From: xxxxx_xxxxx@mindlink.bc.ca
To: Andrew Chung (achung@emory.edu)

Andrew,
Thanks for your speedy reply...it's much appreciated. I'll pass the info on to Ted in Italy.
Best regards-- Art


Subject: Need laymans general info on nephrotic syndrome
Date: Wed, 9 Oct 1996 14:40:54 -0400
From: xxxxx@aol.com
To: achung@emory.edu


My mother-in-law is a 70 year old diagnosed with nephrotic syndrome. I would like any general info on treatment, outlook, causes, etc. Thank you.



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