One reader suggests that I add my credential. Here is a bit about my credential:
I have an MD degree and a PhD degree (in one of the biological sciences). I am board-certified in Internal Medicine and Endocrinology. I practice as a specialist in pheochromocytoma and other neuroendocrine tumors in a large US hospital. I do clinical research in pheochromocytoma.
I never copy and paste any sentences to my blog. In other words, I type every letter in my blog.
The initial blogs are common situations in pheochromocytoma and I say the same words many times to my patients. Therefore I write them down here so that any one interested can read them. I anticipate I will answer more questions than write on general topics in the near future.
The real testament of my credential will be and should be whether my answers to specific questions make sense, help patients and colleagues, and are later confirmed to be correct.
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Welcome! I am not sure I am going to get this commenting stuff right...but let's give it a try.
ReplyDeleteAs a pheo-ite the more I can learn about pheos the better. When you have the inclination I would like to read your opinions on a whole host of pheo related issues, primarily related to metastatic pheos. I personally have had surgeries and high dose I-131 MIBG treatments.
I could have made better decisions along the way....if I had known X. My first (X1) is the problem of diagnosing benign from malignant from metastatic. Although most doctors know about "pheochromocytoma" they usually have only encountered it at medschool. You do a good job of "How is pheochromocytoma diagnosed?" and I think that there should be an article "What to do if pheochromocytoma is diagnosed?" This should be aimed at both doctors as well as patients with the simple answer "Don't proceed with local 'convenient' treatment until the patient has had a complete review at a recognised center of expertise in pheos". Let's see if this comment "get's through" and perhaps we can discuss?
Dennis
Thank you, Dennis. Comments like yours are exactly what I look for to tailor my blogs to the needs of patients and colleagues. I will write on "What to do if pheochromocytoma is diagnosed?" very soon. And I of course would be happy to discuss these further with you.
ReplyDeleteDr. Pheo
I'll continue with "what to do.." from my own perspective (I'm still on X1) that you can perhaps weave into your recommendations.
ReplyDeleteThe various blood and urine tests for pheochromocytoma can vary, not just because of variations in the patients levels but also because of path "lab problems". Putting aside the usual problems of wrong container or out-of-date samples we have the problem of different labs using different test methods with widely differing results. I ran into this problem with CgA between Quest (they send to CA lab) and a lab in Utah. Quest has a "maximimum" guide of 36.4 while the Utah lab, if I recall correctly was 76. I forget the units at the moment. If you are trying to track tumor burden with CgA as I was doing then sending off to any old lab will not do; the doctor/patient has to ensure it is always consistently measured.
Parenthetically, while on this subject I have found good correlation between CgA and 24 urine collection results of mets+cats having tracked my results over a 5 year period through two MIBG treatments (and CgA is far more convenient than a 24hr collection!).
Later I'll comment on scans!
Dennis
I read this blog.and it's very helpful to gain information.
ReplyDeleteCredentialing Verification