Polycystic Ovary Syndrome (PCOS) » Endocrine disorder

Question re: Medical

admin — Thu, 10 Jun 2004 00:00:00 +0000

Question:

Any ideas, opinions or suggestions? Thanks, Cap

No facts, just opinions. Anyone who will ramp check you will only see a valid medical and leave you alone. The government only works from 8 – 4:30, Monday – Friday. This leaves alot of time to fly if you are really worried. If you have not received a letter from the FAA, you have not received any indication you can’t fly. The AME does not have the authority to ground you, he just makes recommendations to OKC. All of this is hearsay, but I think you get the point that I think you should still be able to fly. If I were in your shoes these are some of the things I would use if they ever gave me a hard time. There is an AME who frequents the group. He’s stated what the DE said. Maybe he’ll chime in with some facts. Good Luck. z

Response:

[snip] You might want to talk to www.leftseat.com. My father is using them to attempt to restore his flying privileges after some heart trouble. It’s early in the process yet, but he has been pleased with his discussions with them so far… Cheers, John Clonts Temple, Texas N7NZ

Response:

I don’t know the legal answer to your question but it sounds like we have the same endocrine condition. My situation was a little bit different because I was diagnosed while I had a class III medical. When it was about to expire I went for a new AME exam and was told by the doc that he would have to defer me. I immediately called AOPA and they said have him send it to the regional flight surgeon instead of Oklahoma City. He did and my class II was approved in two weeks, but it specifically stated on it that it was not valid for any class after one year. The letter from the regional flight surgeon told me that if I went for my AME exam at the beginning of the month the medical expired then I should have my medical back from the regional office before my medical expired at the end of that month. My following year sounds similar to your situation. I had a medical that would expire at the end of the month when I went to see the AME. The AME deferred to the regional doctor but that doctor had already told me I was OK to fly after the AME exam up to the actual expiration date printed on the medical. (I know that normally a class II medical becomes a class III after one year but mine specifically stated it did not) I would also point out that the FAA does not have a list of approved meds. The AOPA keeps a list of medicines that the FAA has approved in the past for certain people, but just because the medicine is on AOPA’s list does not mean it will be approved in every individual’s case. After three years of the above situation with the regional flight surgeon working perfectly my AME’s staff made a mistake and sent my deferral to Oklahoma City. What had taken the regional doctor two weeks (all by himself) took a team of doctors in OK four months to accomplish. And once everything was sent to OK they refused to send it back to the regional doctor who was perfectly willing to accept it. This made me want to pull my hair out because OK was saying it was taking so long because they had a big backlog but they weren’t willing to get rid of at least one of the cases causing the backlog. All they would have had to do was make a phone call to the regional doc and he could review the file on the computer and issue the medical. Oh well, our FAA at work. – Hide quoted text — Show quoted text -Howdy. I’m currently having a problem with the FAA Medical Division. The situation is as follows. I have a minor endocrine disorder that is easily managed by a medication that is already FAA-approved. Neither the disorder nor the medication has *any* side effects that could remotely impact flying, and I have been stable on this medication for over 5 years, with no problems whatsoever. I have had two previous physicals, a Class III and a Class II. Both times, the AMEs signed me off without question or problem, and both times the medication and underlying disorder were reported to the FAA, which apparently had no problem with it either. This disorder is not listed among disqualifying disorders, but it is relatively rare. I have solid medical documentation that there are no problems, the medication is safe and effective, and that I am stable on it. I went to a different AME this time for my Class II (it expired in May, so had I not seen him I would have had my Class III privileges for an additional 2 years). The guy I saw (I found out later) has a bad reputation among local pilots, to the extent that his name has been crossed off the list of local AMEs that several flight scools give to students because of all the problems he has caused. Anyway, he ‘deferred’ me to Oklahoma City, and did not issue my medical. He said that there was a 99.99% probability I would be approved, of course, but he wasn’t willing to ‘take the chance’, whatever that means. I talked with the FSDO and they advised me that I am grounded for the duration of this review period (probably 3-6 months). I had heard that position before, that as soon as you request a new physical, your old one becomes invalid. But I cannot find anything explicitly stating that anywhere in the FARs, parts 61 or 67. I find information regarding ’suspended’, ‘denied’ and ‘revoked’ medical certs, but my situation is *none* of those. I find information requiring me to ’self-ground’ upon receipt of knowledge that I have a condition that may make me ineligible for a medical certificate, but I have no such knowledge; my medical situation is *exactly* the same as it was last year, when an AME found me fit to fly, and the FAA did not superceded that; specifically the disorder and medication I am on *is* clearly one with which I can fly, since the FAA has known about it for years with no problem. Nobody has requested that I return my medical cert, I am still in physical posession of an (apparently) valid medical certificate allowing Class III privileges for 2 more years. Nothing I signed stated that my previous medical became invalid, and nothing I have received from anyone states anything about that. So….my question is, where is the black-letter law stating that my previous medical has been superceded by my new one? I cannot find it. My application is being reviewed, it has not been denied, nor approved. I have talked to the AOPA (which seems to agree that I am on the bench), and with a very experienced DE who went through the exact same thing several years ago, and states that the FSDO and the AOPA are wrong on this. His position (one which I *really* like, obviously) is that, since I am in physical posession of a valid medical certificate, and since I have not been requested to surrender it by certified mail, and since I have no official communication from anyone that it has been revoked, suspended, denied, or superceded that I am perfectly legal to fly. His position is that is is essentially like a checkride that has been discontinued; i.e. that it has not be ‘failed’ nor ‘passed’, but that in the meantime, any previously valid certificate is still valid. If he is wrong, then there *must* be some black-letter law somewhere that specifies that. If anyone can point me to it, I would greatly appreciate it, because absent some binding authority (a verbal opinion from a FSDO, while significant and useful, does not seem to constitute legally binding authority in this matter) I do not see any reason to believe that I cannot fly. Obviously I don’t want to make the situation worse by getting violated for flying without a medical. But equally obviously I don’t want to sit on the bench for 3 months for what should be a trivial review and a near-automatic approval. I really can’t shell out several thousand dollars for an aviation attorney, nor would I want to get into a pissing match with the FAA anyway. If I can’t fly, then I can’t fly and I’ll live with it…but if there is any way that I can legally stay in the air (however loohole-ish it might be), then I want to. Any ideas, opinions or suggestions? Thanks, Cap

Response:

and have you talked to the AOPA? is your medication on there "list" of approved or disapproved.. BT

– Hide quoted text — Show quoted text – Howdy. I’m currently having a problem with the FAA Medical Division. The situation is as follows. I have a minor endocrine disorder that is easily managed by a medication that is already FAA-approved. Neither the disorder nor the medication has *any* side effects that could remotely impact flying, and I have been stable on this medication for over 5 years, with no problems whatsoever. I have had two previous physicals, a Class III and a Class II. Both times, the AMEs signed me off without question or problem, and both times the medication and underlying disorder were reported to the FAA, which apparently had no problem with it either. This disorder is not listed among disqualifying disorders, but it is relatively rare. I have solid medical documentation that there are no problems, the medication is safe and effective, and that I am stable on it. I went to a different AME this time for my Class II (it expired in May, so had I not seen him I would have had my Class III privileges for an additional 2 years). The guy I saw (I found out later) has a bad reputation among local pilots, to the extent that his name has been crossed off the list of local AMEs that several flight scools give to students because of all the problems he has caused. Anyway, he ‘deferred’ me to Oklahoma City, and did not issue my medical. He said that there was a 99.99% probability I would be approved, of course, but he wasn’t willing to ‘take the chance’, whatever that means. I talked with the FSDO and they advised me that I am grounded for the duration of this review period (probably 3-6 months). I had heard that position before, that as soon as you request a new physical, your old one becomes invalid. But I cannot find anything explicitly stating that anywhere in the FARs, parts 61 or 67. I find information regarding ’suspended’, ‘denied’ and ‘revoked’ medical certs, but my situation is *none* of those. I find information requiring me to ’self-ground’ upon receipt of knowledge that I have a condition that may make me ineligible for a medical certificate, but I have no such knowledge; my medical situation is *exactly* the same as it was last year, when an AME found me fit to fly, and the FAA did not superceded that; specifically the disorder and medication I am on *is* clearly one with which I can fly, since the FAA has known about it for years with no problem. Nobody has requested that I return my medical cert, I am still in physical posession of an (apparently) valid medical certificate allowing Class III privileges for 2 more years. Nothing I signed stated that my previous medical became invalid, and nothing I have received from anyone states anything about that. So….my question is, where is the black-letter law stating that my previous medical has been superceded by my new one? I cannot find it. My application is being reviewed, it has not been denied, nor approved. I have talked to the AOPA (which seems to agree that I am on the bench), and with a very experienced DE who went through the exact same thing several years ago, and states that the FSDO and the AOPA are wrong on this. His position (one which I *really* like, obviously) is that, since I am in physical posession of a valid medical certificate, and since I have not been requested to surrender it by certified mail, and since I have no official communication from anyone that it has been revoked, suspended, denied, or superceded that I am perfectly legal to fly. His position is that is is essentially like a checkride that has been discontinued; i.e. that it has not be ‘failed’ nor ‘passed’, but that in the meantime, any previously valid certificate is still valid. If he is wrong, then there *must* be some black-letter law somewhere that specifies that. If anyone can point me to it, I would greatly appreciate it, because absent some binding authority (a verbal opinion from a FSDO, while significant and useful, does not seem to constitute legally binding authority in this matter) I do not see any reason to believe that I cannot fly. Obviously I don’t want to make the situation worse by getting violated for flying without a medical. But equally obviously I don’t want to sit on the bench for 3 months for what should be a trivial review and a near-automatic approval. I really can’t shell out several thousand dollars for an aviation attorney, nor would I want to get into a pissing match with the FAA anyway. If I can’t fly, then I can’t fly and I’ll live with it…but if there is any way that I can legally stay in the air (however loohole-ish it might be), then I want to. Any ideas, opinions or suggestions? Thanks, Cap

Response:

Forward all this information to the AOPA medical section….

Response:

Howdy. I’m currently having a problem with the FAA Medical Division. The situation is as follows. I have a minor endocrine disorder that is easily managed by a medication that is already FAA-approved. Neither the disorder nor the medication has *any* side effects that could remotely impact flying, and I have been stable on this medication for over 5 years, with no problems whatsoever. I have had two previous physicals, a Class III and a Class II. Both times, the AMEs signed me off without question or problem, and both times the medication and underlying disorder were reported to the FAA, which apparently had no problem with it either. This disorder is not listed among disqualifying disorders, but it is relatively rare. I have solid medical documentation that there are no problems, the medication is safe and effective, and that I am stable on it. I went to a different AME this time for my Class II (it expired in May, so had I not seen him I would have had my Class III privileges for an additional 2 years). The guy I saw (I found out later) has a bad reputation among local pilots, to the extent that his name has been crossed off the list of local AMEs that several flight scools give to students because of all the problems he has caused. Anyway, he ‘deferred’ me to Oklahoma City, and did not issue my medical. He said that there was a 99.99% probability I would be approved, of course, but he wasn’t willing to ‘take the chance’, whatever that means. I talked with the FSDO and they advised me that I am grounded for the duration of this review period (probably 3-6 months). I had heard that position before, that as soon as you request a new physical, your old one becomes invalid. But I cannot find anything explicitly stating that anywhere in the FARs, parts 61 or 67. I find information regarding ’suspended’, ‘denied’ and ‘revoked’ medical certs, but my situation is *none* of those. I find information requiring me to ’self-ground’ upon receipt of knowledge that I have a condition that may make me ineligible for a medical certificate, but I have no such knowledge; my medical situation is *exactly* the same as it was last year, when an AME found me fit to fly, and the FAA did not superceded that; specifically the disorder and medication I am on *is* clearly one with which I can fly, since the FAA has known about it for years with no problem. Nobody has requested that I return my medical cert, I am still in physical posession of an (apparently) valid medical certificate allowing Class III privileges for 2 more years. Nothing I signed stated that my previous medical became invalid, and nothing I have received from anyone states anything about that. So….my question is, where is the black-letter law stating that my previous medical has been superceded by my new one? I cannot find it. My application is being reviewed, it has not been denied, nor approved. I have talked to the AOPA (which seems to agree that I am on the bench), and with a very experienced DE who went through the exact same thing several years ago, and states that the FSDO and the AOPA are wrong on this. His position (one which I *really* like, obviously) is that, since I am in physical posession of a valid medical certificate, and since I have not been requested to surrender it by certified mail, and since I have no official communication from anyone that it has been revoked, suspended, denied, or superceded that I am perfectly legal to fly. His position is that is is essentially like a checkride that has been discontinued; i.e. that it has not be ‘failed’ nor ‘passed’, but that in the meantime, any previously valid certificate is still valid. If he is wrong, then there *must* be some black-letter law somewhere that specifies that. If anyone can point me to it, I would greatly appreciate it, because absent some binding authority (a verbal opinion from a FSDO, while significant and useful, does not seem to constitute legally binding authority in this matter) I do not see any reason to believe that I cannot fly. Obviously I don’t want to make the situation worse by getting violated for flying without a medical. But equally obviously I don’t want to sit on the bench for 3 months for what should be a trivial review and a near-automatic approval. I really can’t shell out several thousand dollars for an aviation attorney, nor would I want to get into a pissing match with the FAA anyway. If I can’t fly, then I can’t fly and I’ll live with it…but if there is any way that I can legally stay in the air (however loohole-ish it might be), then I want to. Any ideas, opinions or suggestions? Thanks, Cap

Response:

I'm tired, cranky and fat.

admin — Sun, 04 Mar 2001 00:00:00 +0000

Question:

I’m on medication that makes me tired. I suffer from depression so my natural mood includes apathy and lethargy. My dietary habits aren’t bad, I have seen more than one nutritionist who has agreed. I drink water constantly. I have trouble sometimes making myself exercise but can usually manage at least two or three times a week for 20 minutes even when I am feeling at my worst. SO WHY THE HELL AM I GAINING WEIGHT?!?!?! My scale only goes up to 270, I am at 265 now. What the hell do I do? I can’t stack, I am already too nervous. Atkins is out of the questions because of one of the medications I am on. My calorie intake hovers between 2200 – 2500, well within the range for me to lose weight. My protein/fat intake is limited to one meal a day, my carbohydrate intake is rarely over 100. This g*)&*^%mn weight thing isn’t helping my mood! I hate the way I look and rarely leave the house. If I’m going to continue gaining weight anyway, I might as well fill up the tub with chocolate cheesecake and dive in. What the hell do I do? What kind of doctor should I seek out (btw, I have been tested for every endocrine disorder known to man, I am fine just fat)? Is there an alt.support.fat.depressed.ready-to-die? Emma Time is the best teacher; unfortunately it kills all its students. When the pin is pulled, Mr. Grenade is not our friend.

Response:

My experience has been that people who work out regularly don’t need anti-depressants. The endorphins released during a good burn are enough. And they are 100% natural!

The causes of depression are much more complicated than that. You can use yourself of someone you know as a basis for your knowledge but do not generalize this knowledge to other people. That is just foolish thinking.

Response:

Emma: Please don’t ever stop asking for help if you need it. Dr’s, friends, clergy, co-workers, ASD. We are here because we care. –Phil Marshall–

Thank you Phil. It’s nice to hear that I’m not being a bother. Emma Time is the best teacher; unfortunately it kills all its students. When the pin is pulled, Mr. Grenade is not our friend.

Response:

– Hide quoted text — Show quoted text – I’m on medication that makes me tired. I suffer from depression so my natural mood includes apathy and lethargy. My dietary habits aren’t bad, I have seen more than one nutritionist who has agreed. I drink water constantly. I have trouble sometimes making myself exercise but can usually manage at least two or three times a week for 20 minutes even when I am feeling at my worst. SO WHY THE HELL AM I GAINING WEIGHT?!?!?! My scale only goes up to 270, I am at 265 now. What the hell do I do? I can’t stack, I am already too nervous. Atkins is out of the questions because of one of the medications I am on. My calorie intake hovers between 2200 – 2500, well within the range for me to lose weight. My protein/fat intake is limited to one meal a day, my carbohydrate intake is rarely over 100. This g*)&*^%mn weight thing isn’t helping my mood! I hate the way I look and rarely leave the house. If I’m going to continue gaining weight anyway, I might as well fill up the tub with chocolate cheesecake and dive in. What the hell do I do? What kind of doctor should I seek out (btw, I have been tested for every endocrine disorder known to man, I am fine just fat)? Is there an alt.support.fat.depressed.ready-to-die? Emma

Emma, are you seeing a doctor, or a psychiatrist? I’m sorry if this is a pesonal question, but when depression is an issue, I think you need to talk to someone (therapy) along with taking meds. The "I’m depressed because I’m fat…am fat becasue I’m depressed…." is a real issue that needs to be addressed by either finding alternative meds for depression and finding a good therapist. The doctor you go for when you have the stomach flu may not be the best candidate to go to for depression or other problems of the like. I don’t think life has to be a choice between either being fat or being happy. And just to qualify here, I’ve been treated on and off for depression and anxiety most my life. Just wanted to let you know I know how it feels. — Lisa B. 243/146.5/145 – Hide quoted text — Show quoted text – Time is the best teacher; unfortunately it kills all its students. When the pin is pulled, Mr. Grenade is not our friend.

Response:

What the hell do I do? What kind of doctor should I seek out (btw, I have been tested for every endocrine disorder known to man, I am fine just fat)? Is there an alt.support.fat.depressed.ready-to-die?

Sometimes it helps to just vent your frustrations. Most of us feel that life is not fair in one form or another, but then we learn to deal with it and go on. Take baby steps, if you have to, or start journaling. Sometimes it helps to write things down to get them out. I have lived with depression my whole life so I know how you feel. I was diagnosed with chronic depression 16 years ago due to a chemical imbalance. I had no reason at the time to be depressed but lots of good therapy has taught me to deal with it.

Response:

Have a good vent then get down to work as you can’t change the past and need to practice damage control if you want a slimmer future. I weighed 217 was hungry, food aware all the time and jealous and angry of slimmer people who just ate spontaneously. Those days are gone for now and I hope forever. 217/148/155 – Hide quoted text — Show quoted text – What the hell do I do? What kind of doctor should I seek out (btw, I have been tested for every endocrine disorder known to man, I am fine just fat)? Is there an alt.support.fat.depressed.ready-to-die? Sometimes it helps to just vent your frustrations. Most of us feel that life is not fair in one form or another, but then we learn to deal with it and go on. Take baby steps, if you have to, or start journaling. Sometimes it helps to write things down to get them out. I have lived with depression my whole life so I know how you feel. I was diagnosed with chronic depression 16 years ago due to a chemical imbalance. I had no reason at the time to be depressed but lots of good therapy has taught me to deal with it.

– Diva "HoldingHands"-not your average allergy group http://groups.yahoo.com/group/HoldingHands

Response:

My calorie intake hovers between 2200 – 2500, well within the range for me to lose weight

Who told you this? Your doctor? I suggest you get a second opinion! Especially if you’re on anti-depressants and you’re still depressed! My experience has been that people who work out regularly don’t need anti-depressants. The endorphins released during a good burn are enough. And they are 100% natural! Everybody is different. We all have different needs nutritionally. If you’re gaining weight, I think it’s probably because you’re not getting the right nutrition and you’re eating more calories than are being burned off. My suggestion is to simply maximize the burn any way you can. This means fewer calories, don’t eat your biggest meals the later the day gets, work out on an empty stomach (like in the mornings), and keep drinking the water.

Response:

Question about diagnosing PCOS

admin — Sat, 24 Apr 1999 00:00:00 +0000

Question:

I have had irregular periods for most of my life. Within the last 5 years, I have also gained about 125 pounds. Based on these two facts alone, my new OB/GYN has decided that I have PCOS. I have *none* of the other symptoms and the little bit of blood work that my GP did showed that my estrogen is extremely low…not elevated. Am I wrong to think I should seek another opinion? Or is the anovulation and weight gain enough in and of itself to make this diagnosis? My Gynecologist doesn’t see any reason to do "thousands of dollars worth of hormone tests" to prove what she "already knows." Thanks for any help you can give me. Beverly

Response:

HI there, As far as I knew, its the testosterone that is high, and the cysts on the overies etc, and you need a vaginal ultrasound for that….it never hurts to get another opinion. Hope all goes well Fiona – Hide quoted text — Show quoted text -beve…@neHtusa1.net wrote in message <372264CF.5F173…@netusa1.net>… >I have had irregular periods for most of my life. Within the last 5 >years, I have also gained about 125 pounds. Based on these two facts >alone, my new OB/GYN has decided that I have PCOS. I have *none* of the >other symptoms and the little bit of blood work that my GP did showed >that my estrogen is extremely low…not elevated. >Am I wrong to think I should seek another opinion? Or is the >anovulation and weight gain enough in and of itself to make this >diagnosis? My Gynecologist doesn’t see any reason to do "thousands of >dollars worth of hormone tests" to prove what she "already knows." >Thanks for any help you can give me. >Beverly

Response:

In article <7ftp0c$29…@the-fly.zip.com.au>, "fiona" wrote: > HI there, > As far as I knew, its the testosterone that is high, and the cysts on the > overies etc, and you need a vaginal ultrasound for that….

I have read and been told by doctors that they no longer consider PCOS and ovarian cysts to be directly linked. You can have PCOS and not have cysts, and you can have ovarian cysts and not have PCOS. They’re probably going to start using a new name, although I’m sure the old one will be sticking around for quite a while. It seems to be a toss-up right now, between docs who look at the overall set of symptoms and say "this fits the profile for PCOS more than it fits anything else," and docs who believe that the link to insulin resistance is cut-and-dried *the* definition of PCOS now, and confirm a diagnosis based on blood testing for that. When I had the ultrasound, they said that my ovaries *weren’t* cystic, but that even with PCOS with cysts, they come and go, so my not having them then doesn’t mean I don’t ever have them. They also never did the fasting insulin-to-glucose ratio that’s supposed to indicate insulin resistance. My hormone levels, weight, etc. convinced them enough to try Glucophage, which seems to be working, at least as far as the weight goes. Response to treatment *is* a legitimate way to test for a given disease or condition. You give the drug a try, and if it works, that was what you had; if it doesn’t, then you have something else. In retrospect, I probably would have asked for the ratio to be measured, but I had already started Glucophage when I heard of that, and it probably wouldn’t be an accurate reflection of my pre-drug state now. > it never hurts to > get another opinion.

Absolutely. If you have any question, then either tell your doctor you’d like to confirm the diagnosis before you start on drug treatments, or ask for a second opinion (and call around for someone who *will* ask for the tests). You’re talking about drugs with potentially dangerous and/or uncomfortable side effects, which you will be taking long-term, if not for life, so you have every right to make certain that you *should* be taking them before you do. -Janet 253/235/168 (Haven’t had a scale handy lately, middle # may be off…) ———–== Posted via Deja News, The Discussion Network ==———- http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own

Response:

>Am I wrong to think I should seek another opinion? Or is the >anovulation and weight gain enough in and of itself to make this >diagnosis? My Gynecologist doesn’t see any reason to do "thousands of >dollars worth of hormone tests" to prove what she "already knows." >Thanks for any help you can give me. >Beverly

The thing is perhaps you should see a reproductive endocrinologist. Other disorders can cause symptoms similar to PCOS such as hypothyroidism, Cushing’s Syndrome, tumors of the adrenal glands or the pituitary glands. You should be thoroughly tested just for your own peace of mind. Please see an RE, who will probably give you an exam as well as a battery of blood tests, some do ultrasounds to see if they actually see any cysts, but since cysts is only one of the possible symptoms, the absense of cysts doesn’t mean you are PCO free. In particular, you should be tested for insulin resistance.

Cathy (to email, delete spamslam) My Web PCO page

Response:

>The thing is perhaps you should see a reproductive endocrinologist. Other >disorders can cause symptoms similar to PCOS such as hypothyroidism, >Cushing’s >Syndrome, tumors of the adrenal glands or the pituitary glands.

Absolutely – PCOS is diagnosed by excluding other rare but serious conditions as well as looking for the obvious symptoms (if they are any). The tests are not that costly and are done in most but the most obvious cases. Al am…@medscape.com

Response:

In article <372264CF.5F173…@netusa1.net>, beve…@netusa1.net wrote:

> Am I wrong to think I should seek another opinion? Or is the > anovulation and weight gain enough in and of itself to make this > diagnosis? My Gynecologist doesn’t see any reason to do "thousands of > dollars worth of hormone tests" to prove what she "already knows."

Run, don’t walk to another OB/Gyn or RE who does not have her head up her rectum. You could have any number of problems, such as Cushing’s Disease or pituitary tumors. Sorry to speak so plainly, but you know, your doctor is *negligent.* Good luck to you. Beth ———–== Posted via Deja News, The Discussion Network ==———- http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own

Response:

While this is true, insulin resistance seems to correlate best with transvaginal US appearance and when you are treated with gonadotropins for ovulation induction, you behave like PCOS regardless of other stigmata. In UK, they believe TVUS is an important criteria. In the US, menses and androgen abnormalities (ie, chronic anovulation hyperandrogenism) are considered most important. Shutting your eyes to either diagnostic criteria means you will miss out on some of the benefit from the newer therapeutic options. – Hide quoted text — Show quoted text ->I have read and been told by doctors that they no longer consider PCOS and >ovarian cysts to be directly linked. You can have PCOS and not have cysts, >and you can have ovarian cysts and not have PCOS.

Response:

So, in your professional opinion, to confirm a diagnosis of PCOS before starting a patient on Metformin, what tests would need to be done? Is a gtt necessary? What about TVUS? I went to a Mayo Clinic RE (you might have read some of his articles) to see about getting on Met. He said that if I didn’t want to be treated via traditional treatments (BCPs–which I will never take again) then he would Rx Met after confirming the diagnosis of PCOS and insuring that I am, indeed, IR. Is it really possible to have the one problem without the other? He set up a TVUS (though mainly because I asked if he was going to do one), two days of gtt (one lasting 3hrs, one 5hrs), and had a list of labs ordered (insulin, FSH, LH, progesterone, prolactin, free testosterone, thyroid cascade, DHEA-S, and 17-hydroxyprogesterone). There was no C-Peptide, no blood glucose, no PAI-1, no estrogen. While I was very interested to see the results of the gtt’s and tvus, I chose to cancel all of the above appts. because he was very arrogant and not someone I would like to discuss such personal issues with. I asked him every question that came to mind and, at the end of the appt., he said that he would give me some articles to read over so that I could ask better questions next time (one of a few crappy comments made). He gave me three articles to read; guess who wrote them all. He did, of course. Amazing, huh? I decided that I am willing to travel out of state and spend the extra time and money to see a doc that is great. I think he viewed my goal of feeling better, losing weight and getting healthy as pretty trivial (as opposed to wanting to get pregnant, I guess). I think he doesn’t view treating PCOS as necessary in single women not trying to conceive. There are still the health risks, however, along with self- esteem issues of being overweight. Mayo Clinic, despite their reputation, is a terrible place to be treated. You only get listened to if you have a lot of money and/or are famous. Otherwise, the docs (mostly specialists) treat you like you are an annoyance in their day and talk to you like you are five years old and wouldn’t have a clue about anything medical. I’d take a private practice doc anyday over a large clinic or hospital. They tend to be much nicer and more receptive to their patients. Sorry to get off on a tangent. It just makes me so angry how I’ve been treated there (have also seen 2 reg docs and an endo who were also terrible). I drive or fly to Michigan (live in Minnesota) to see a wonderful family doctor out there. Sad, really, that I have to do that. By the way, are you/your clinic accepting new patients? Thanks! Darlene – Hide quoted text — Show quoted text -Mark Perloe wrote: > While this is true, insulin resistance seems to correlate best with > transvaginal US appearance and when you are treated with gonadotropins > for ovulation induction, you behave like PCOS regardless of other > stigmata. > In UK, they believe TVUS is an important criteria. In the US, menses > and androgen abnormalities (ie, chronic anovulation hyperandrogenism) > are considered most important. Shutting your eyes to either diagnostic > criteria means you will miss out on some of the benefit from the newer > therapeutic options. > >I have read and been told by doctors that they no longer consider PCOS and > >ovarian cysts to be directly linked. You can have PCOS and not have cysts, > >and you can have ovarian cysts and not have PCOS.

Response:

Darlene: You might want to see just a plain endocrinologist. The goal of an RE is to get you pregnant. PCOS is an endocrine disorder. I see just a regular endocrinologist and he is wonderful. Should I ever desire to try and have children (which isn’t likely since my chances are so very poor from this and other health concerns), he would work in partnership with any doctor I choose. So, if you aren’t trying to get pregnant, go to just a plain endo. Louise

Response:

WORST flight experience ever

admin — Mon, 02 Nov 1998 00:00:00 +0000

Question:

Well, why were the seats assigned in this way to begin with?

You who seems to be well traveled should ask this?? I am sure you know that even planning ahead doesn’t guarantee advance seat assignments–I have failed to get them even 3 weeks in advance on a popular flight. Also, there are many airlines which will NOT assign any seats in advance.

Response:

Amazing…..bulkhead seats??? Not where we were seated. How was a family of 5 to take the 3 seats in a row??? The other person wasn’t asked to move, just me! Then my husband & I when I refused to be seperated. I stood in line for 20 mins for my seat #, same goes for everyone else. So what’s the gripe? You weren’t there to accept or reject the poor attitde of the steward with many other seats available with empties next to them. — THE AWESOME 1 Managing Editor of GameMaster Online http://www.gamemasteronline.com "Living The Good Life"

Response:

This raises an interesting point. Do you think the cabin crew should advise other passengers when accomodations need to be made because other passengers are travelling in an emergency? I know I would certainly be more willing to change my seat, even to an undesireable middle seat, if the reason for the request was to acommodate someone’s emergency travel to see a sick or dying loved one, obtain medical treatment, etc. I’d also readily relinquish a treasured bulkhead seat if the FA explained that someone with a slipped disk (or bad leg, etc.) needed it to avoid physical pain and discomfort. On the other hand, I’d be a lot more reluctant to accomodate someone who simply was too stupid and selfish to plan ahead and, instead, expected the world to accomodate their whims. It seems to me that a judicious word from the FA, assuming the reseating situation warranted it, could avoid a lot of unpleasantness, as could a complimentary drink or two to the dispossessed. – Hide quoted text — Show quoted text – There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid. Excuse me for asking, but what makes you think she didn’t pay? The only way NOT to pay for a child under 2 years old is to hold that child on your lap. Since she had 3 toddlers and a newborn, I think it is pretty clear that the newborn was on her lap (and thus didn’t pay), but the other 3 children had to have their own PAID seats. I think you were pretty selfish about the whole thing. Every parent I know does tons of planning before embarking on a trip with even _one_ kid, let alone 4! And this poor woman was _alone_ with 4 kids. Did it ever occur to you that she didn’t have pre-assigned seats because she was traveling for an emergency or a death in the family? I am sure you know that if you want a pre-assigned seat, you have to get it early. Otherwise, you have to take what is left. It seems likely that this is what happened to her. I think your behavior was, well, childish.

Response:

[snip] Did it ever occur to you that she didn’t have pre-assigned seats because she was traveling for an emergency or a death in the family? I am sure you know that if you want a pre-assigned seat, you have to get it early.

Yo. The airline was Southwest. There are no pre-asigned seats at all. Otherwise, you have to take what is left. It seems likely that this is what happened to her.

Something is strange about this story. Women with infants get to board first DESPITE not standing in line early for a boarding card. The lady just flat showed up late (with 4 kids in tow who wouldn’t). I think your behavior was, well, childish.

Well. This is a tad strong. But the real problem is created by Southworst. This open seating crap is what leads to this problem. You show up early to get your low number so you can get a seat you want/need. You stand in line after line to give yourself some sort of assurance that you will get theses seats. You get on board, stow your junk, buckle up, watch everyone else come aboard, then some sad sack comes along and you are tossed to the 4 winds for whatever dregs are left now that everyone has already sat down. Kinda blows the point of the whole system. If they would just drop the whole charade and assign SOME seats to those folks who need/pay for this service it would solve the whole problem. But they are so focused on maintaining this "greyhound" facade that they refuse to give it up. It’s just stubborn, which is another childish behavior.

Response:

But here’s my question about the late-boarding mom with toddlers bumping people in the bulkhead: why should she get to bump people with prime seats? If they’ve got to be together, ask someone who’s in ordinary seats to move. Just because she has an armload of kids, she doesn’t get the best seats. If she’d planned ahead, fine. As it is, isn’t there some restriction on multiple kidlets flying with one adult? Pamela Brown Yaeger

There should be, and for a whole lotta more reasons than safety.

Response:

Freddie: If I am selfish, then how if we boarded in Cleveland after waiting for a # to get on the plane to chose unreserved seats that are FIRST COME FIRST GET! Then in Nashvilles a party of 5 want a row with 3 seats & only 2 of us moving??? Pretty close quarters???? Some jerk transforms my post saying we were in a bulkhead area, WHICH WE WERE NOT, but in the crammed, hard as rocks seats & a leak to the poor guy seated across the aisle from us & he got no new seat and his leak started over Akron OH! Let me guess, you work for SWA — THE AWESOME 1 Managing Editor of GameMaster Online http://www.gamemasteronline.com "Living The Good Life"

Response:

If she’d planned ahead, fine. Not everyone can plan ahead. Sometimes there are emergencies. Whether you approve of emergencies or not, they are "fine" too. By the way, planning ahead doesn’t always get you seats. I have often booked 3 weeks in advance and have been told that I cannot get a seat pre-assigned.

How does the saying go, "Bad planning on your part does not constitute a crisis on mine." I recall a flight, I think on HP, where a woman with a kid appropriated my assigned window seat because her odd kiddie-carrier required it. I made damn sure the FA found me a new window seat. Yes, it’s good to help out someone in distress. But far too many people these days EXPECT their poor planning and inconsideration to be accomodated by others. Ed R.

Response:

Sounds like a bus! In that case, where the family boarded in a different city–a later stop, as it were, one would have hoped that someone (even you) would have volunteered to help them out. How long was the remainder of your trip? Let me guess, you work for SWA

Nope! I have never even flown them. I have heard that they operate like a bus.

Response:

But I don’t think that this would come under the ADA regulations (and as the regulars here know, I am no fan of ADA).

NOTHING about passengers in airplanes comes under ADA regulations. NOTHING. There is a specific clause in the act exempting public carriers. The Air Carrier Act of 198? covers flight of handicapped people and it doesn’t require the airlines to roll over and die when someone who obviously can’t fly safely, as in the case of someone who won’t fit into a seat, wants to get on a plane. ADA talks about "reasonable accomodation"; ACA talks about safety. — Mary Shafer NASA Dryden Flight Research Center, Edwards, CA SR-71 Flying Qualities Lead Engineer Of course I don’t speak for NASA URL http://www.dfrc.nasa.gov/People/Shafer/mary.html

Response:

There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid. Excuse me for asking, but what makes you think she didn’t pay? The only way NOT to pay for a child under 2 years old is to hold that child on your lap. Since she had 3 toddlers and a newborn, I think it is pretty clear that the newborn was on her lap (and thus didn’t pay), but the other 3 children had to have their own PAID seats. I think you were pretty selfish about the whole thing.

Well, why were the seats assigned in this way to begin with? Personally, I would have done just about anything to get AWAY from four young pax, but if the seat’s assigned to the woman and her husband, she has every right to be there.

Response:

[snip of woman with kids moving poster from seat she'd occupied] Well, why were the seats assigned in this way to begin with? Personally, I would have done just about anything to get AWAY from four young pax, but if the seat’s assigned to the woman and her husband, she has every right to be there.

They weren’t assigned–it’s Southwest. Brenda and her husband just got to the seats before the woman with the kids. Somebody else also said something about them being bulkhead seats and therefore more favored–as far as I can see, that’s confusing it with the original poster on this thread, because I can’t find anything in Brenda’s post that called them bulkhead. It might work better as an analogy if you consider so, however, since bulkheads seem to be assigned in a rather Southwestish manner sometimes. Deborah Stevenson

Response:

Pardon me, but the whiner said NOTHING about "prime seats." The person went on quite a bit about having gotten a special deal–something like $25 per leg. There was no mention of obtaining any "prime seats" for that price. Just because she has an armload of kids, she doesn’t get the best seats.

There was no mention of "the best seats" — only the need for her to be with her kids. If she’d planned ahead, fine.

Not everyone can plan ahead. Sometimes there are emergencies. Whether you approve of emergencies or not, they are "fine" too. By the way, planning ahead doesn’t always get you seats. I have often booked 3 weeks in advance and have been told that I cannot get a seat pre-assigned. As it is, isn’t there some restriction on multiple kidlets flying with one adult?

ROTFLMAO!!

Response:

snip While it is unfortunate that this family may be split up, a pax that followed all the rules and arrived early so as to be assured of early boarding should not be forced to vacate their seat.

snip -Heck, what are we coming to? So, given the fact that this lady missed the preboarding, we’re supposed to say, "Forget it, you missed your chance. We’re not going to try and help you at all?" While we do not know why this woman boarded late as she did, if the FA did in fact demand that a pax relocate, that is unreasonable.

Again, unreasonable that we try and help somebody out who really needs it? Not to mention the fact that this is probably in everybody’s best interest to have the woman sit with the children. If Southwest had said, "Sorry, we’re going to make you get off the plane and rent a car to drive across country to your destination," that would have been unreasonable. Asking, "Can the two of you move to other seats" is just trying to do the decent thing. I mean, for crying out loud, we’re talking about small children here. For all we know, this family could be an extreme hardship case that SW was providing free transportation on a standby basis. If that’s the case, you take what you can get.

And if they weren’t "extreme hardship? And even if they were, that somehow lessens our responsibility to our fellow man? Yeah, let’s appease ourselves by saying "it’s okay, they’re poor people." You know, I usually get to these discussion groups because I’m interested in finding out a specific piece of information. I’m reminded again of why once I find that information I stop reading the group. IMO, the attitudes expressed by so many of today’s society are appalling. I don’t say "members of society" because membership typically denotes responsibility towards the shared group and it is evident that many feel no responsibility at all. Would it really be so bad for people to stop defending their "rights" for just a bit and see what is needed by others around them? I myself despise poor service, but getting ugly about it doesn’t help anybody involved, it just ruins the day of everybody around you. My first reply may have been "uglier" than I might prefer, but I am appalled at the complete callousness demonstrated in the post I replied to. Sheyrl, can you imagine people giving up their seats on a crowded bus to let a woman or elderly person take the seat, even though the bus ride might be for 5-6 hours? I saw it happen regularly in South America. In the U.S. it appears most think even changing seats is unreasonable. Sad.

Response:

- Hide quoted text — Show quoted text – There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid. Then they told us we both would be moving. I again I stated BS! We stood in line for a seat #, did she??? Did they???? Absolutely agree, why should anybody at all ever be asked to help out another human being in this life time, especially when you paid for your tickets. Completely agree that I would rather have that mother sit several rows away from a couple of her kids so they can scream even louder and tear up the plane even more, throwing stuff at the other passengers. Who the hell does she think she is to try and get across the country to visit the grandparents or maybe even her husband working in an entry level position for some sweatshop consulting firm and disrupt the rest of us who paid money for our seats just like she did (except for the children under two). If she wanted seats together, she should have gotten to the airport earlier and let those kids get even fussier than the already were. Children and mothers just tick me off. Glad you never were one or ever had a mother.

As a very frequent Southwest Airlines pax, I disagree with some aspects of Ms. Moran’s post (ex., the 13 hour part); however, your response is way out of line. First of all, SW announces pre-boarding for pax such as this woman with small children. It is quite likely that this family was flying standby and thereby wasn’t able to take advantage of pre-boarding. While it is unfortunate that this family may be split up, a pax that followed all the rules and arrived early so as to be assured of early boarding should not be forced to vacate their seat. If Ms. Moran was accurate in that this one adult was travelling with 4 children, to my knowledge, SW Airlines is the only carrier flying a 737 that would even offer the possibility of all of them being seated together, as they have several sets of seats facing each other. If it weren’t for that seat configuration, the family would have to be split up if for no other reason than because of the number of oxygen masks available per row. While we do not know why this woman boarded late as she did, if the FA did in fact demand that a pax relocate, that is unreasonable. For all we know, this family could be an extreme hardship case that SW was providing free transportation on a standby basis. If that’s the case, you take what you can get.

Response:

There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid.

Excuse me for asking, but what makes you think she didn’t pay? The only way NOT to pay for a child under 2 years old is to hold that child on your lap. Since she had 3 toddlers and a newborn, I think it is pretty clear that the newborn was on her lap (and thus didn’t pay), but the other 3 children had to have their own PAID seats. I think you were pretty selfish about the whole thing. Every parent I know does tons of planning before embarking on a trip with even _one_ kid, let alone 4! And this poor woman was _alone_ with 4 kids. Did it ever occur to you that she didn’t have pre-assigned seats because she was traveling for an emergency or a death in the family? I am sure you know that if you want a pre-assigned seat, you have to get it early. Otherwise, you have to take what is left. It seems likely that this is what happened to her. I think your behavior was, well, childish.

Response:

While we do not know why this woman boarded late as she did, if the FA did in fact demand that a pax relocate, that is unreasonable. For all

The last time I witnessed an incident similar to this was on a TWA flight from St. Louis to Jacksonville. Apparently a mother had reserved two seats for her and her infant…window and middle…but the aisle seat in that row had been assigned to another female passenger. As the mother was boarding, one of the FAs tactfully told the aisle seat passenger she could stay in her assigned seat or she could move to another aisle seat, if she wished. (The flight wasn’t completely full.) The woman moved to the aisle seat in the row in front of me; then the passenger with that seat assignment arrived. At that point the FA indicated the displaced woman should just go on up into First Class. (And yes, by that time the mother had had baby supplies across all three seats in her row.) –Dennis

Response:

You guess it. FLight Full But he said at the beginning ‘almost completely full’….then later on he said "flight full’. Did he mean that to say that when he looked around that there were NO empty seats available? A lot of times I have asked for a seat closer up front and have been told that the seats were already taken. Imagine my ire when I get on the flight and see empty seats galore in where I originally wanted to sit! Grrrr…. Maryanne.

Response:

You can probably thank the "no shows" for holding those seats so you cant have them. It’s frustrating to have no good seats available when you know you’ll probably, not all the time, but more often than not, have several good seats reserved with noshows. Someone who wants a better seat is out of luck and whoever walks up at the right time -when the seats are put back- gets one. If it looks like I’ll have lots of good seats to put back I have people check back with me 20 mins before dept when seats are cancelled. This isnt always the case though. Another good thing (non rev trick since we’re usually last to board anyway) is to hang out near the door and just let the crew know you are waiting for last call so you can see about a different seat. Of course you have to be sure your bag will fit under your seat or you’ll probably have to check it, but I’ve gotten some of those -unassignable- seats at the last minute just before the door is closed. In the case of the original poster though, it sounds like there were 0 seats available on the plane.

Response:

There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid. Then they told us we both would be moving. I again I stated BS! We stood in line for a seat #, did she??? Did they????

Absolutely agree, why should anybody at all ever be asked to help out another human being in this life time, especially when you paid for your tickets. Completely agree that I would rather have that mother sit several rows away from a couple of her kids so they can scream even louder and tear up the plane even more, throwing stuff at the other passengers. Who the hell does she think she is to try and get across the country to visit the grandparents or maybe even her husband working in an entry level position for some sweatshop consulting firm and disrupt the rest of us who paid money for our seats just like she did (except for the children under two). If she wanted seats together, she should have gotten to the airport earlier and let those kids get even fussier than the already were. Children and mothers just tick me off. Glad you never were one or ever had a mother.

Response:

worst flight experience I am not quite sure how to answer this…I wonder if whoever was in charge of flight service on your flight ever checked to see how uncomfortable your spouse would be sitting next to someone of such girth. But I don’t think that this would come under the ADA regulations (and as the regulars here know, I am no fan of ADA). DL put a notice on our FF statements several months ago that said bulkhead seats wre subject to re-assignment up to one hour before flight time, if someone with a handicap requested one of those seats, but in an email that DL sent me in reponse to questions that I had, DL retracted what they said and told me that pax in bulkhead seating were _not_ required to give up those seats if so asked. You did not say if the FA offered to re-assign you and your spouse elsewhere if space was available. Granted, going from a bulkhead seat to one several rows back (but with more room for the both of you), may not have been the greatest in terms of location in the plane but it might have made you more comfortable. You did not indicate to say if your flight was full or not. If it wasn’t, I think the FA should have given you that option if it was available, and I am suprised that they did not. Maryanne.

Response:

Actually, he did explicitly say the flight was full. I’m intrigued by what the Delta FA told him about "the rules," though; it seems to run counter to the available info. If these are indeed the rules, *everybody* is going to be miserable in this situation, including the overweight passenger. Deborah Stevenson

Response:

worst flight experience

He said <

Response:

$25 Southwest Airline Anniversary special. Yep, I fell for it logging onto their web site vs the overly busy phone #. We wanted to get to Las Vegas for cheap to visit friends. $25 per airport making $100 RT PP. Leave CLE at 9AM ET, arrive Nashville. There a woman with 3 toddlers & a newborn get on the flight & I am TOLD to move to another seat so they may sit together. I refused as I sit with my husband as we paid. Then they told us we both would be moving. I again I stated BS! We stood in line for a seat #, did she??? Did they???? Not guaranteed seats together since it is a first come first serve flight. End of conversation. Then they serve peanuts & pop, and they skip us. So we thought what jerks & get to LAS. What is a 4.5 hours trip on CO took 6 hours with SWA. The trip home was WORSE! Get our #’s after arriving 2 hour in advance & are seated together on a flight we thought was headed to Chicago Midway, but it stopped in Omaha Nebraska! Sat for 1 hour boarding folks from a stranded flight & then onto Chicago. There you must get off the plane, get in line for a new # & board a different plane at a different gate. Then they want you ready to board, no time for food at nowhere-to-be-seen restaurants at that area, So on the plane we get, more peanuts & pop & finally get to CLE 13 hours later from LAS!!!! Never again – even for FREE!!!! Give me reserved seats & decent planes with an educated staff. Now i understand the nickname for SWA "Greyhound of the Sky". — THE AWESOME 1 Managing Editor of GameMaster Online http://www.gamemasteronline.com "Living The Good Life"

Response:

My wife and I recently flew from East Coast to the West Coast on that carrier that just recently settled it’s strike with their employees. We like ‘exit row seating’ or ‘bulkhead seating’, because I am tall and I feel there is more room in this arrangement. We know from previous experience we must get to the airport very early and ask for these seats. Well—-we got to the airport very early (90 minutes) and sure—they have plenty of these seats available. We were assigned to Row 11, Seats D & E. This was a wide body plane with 2 seats, an aisle, 5 seats, an aisle, then 2 more seats. They were bulkhead seats and OK with us. Now, the plane is just about completely filled with passengers—as all the commotion for storage in the overhead compartments had died down—folks were belted in and reading or snoozing and we notice that the seat "C" next to my wife is still empty. The flight attendents were moving up and down the aisles checking seat belts and asking for seats to be moved into the upright 11, Seat C. Now this was a sight to behold. This fellow was so immense in the "wide" catagory that he couldn’t sit in the seat or even on the seat cushion. He had to sit on the arm rests (left and right of his assigned seat) and was given two (2) additional seat belt straps by the flight attendent closely following him. He was about 5′ 8" tall and easily 500-550 lbs. I doubt I have ever seen an individual so large. His right shoulder and arm were in the middle of my wife’s seat. He couldn’t hold his arm out of her space because of his girth. He even wrapped the additional seat belt around his arm to hold it against his body. We were so stunned by all of this that we were in the midst of take-off before my wife and I gathered the courage to whisper to one another about what to do. After we were in flight and the ‘fasten seat belt’ sign was off, I approached one of the fight attendents about the availability of empty seats. You guessed it. Flight full!!!!! I raised the issue about the ‘big fellow’ next to my wife and was told "nothing can be done about it". In the mean time my svelte wife (5′4", 120lbs) moves to my seat upon my encouragement. For the whole flight from the East Coast to the West Coast, either my wife or I were standing or leaning up against some part of the plane. We paid for two (2) seats, but got only one—or 1 1/2. Both of us even felt guilty about protesting this situation, because of this fellows obvious endocrine disorder. Later in the flight I talked to the ‘Head Flight Attendent’ about the situation and was told about the American’s with Disabilities Act and how the airlines had been sued and the fact that they cannot ask passengers about buying two (2) tickets to accomodate their disability. So, why not a free additional seat for these people? Why should the airline offer a free additional seat along with the paid ticket when they have unsuspecting full pay bozos like my wife and I flying all day long? Dazed, disillusioned and dead tired we got home. Is something wrong here? Sucked up and shut up in Seattle Gerry P.S. As we exited the plane at Seatac in Seattle we were given an envelope by the Head Flight Attendent. Hmm—-I wondered. I opened it later to find a Coupon for a Free Drink on my next flight. Egad!

Response:

Help! Strangely sore legs

admin — Thu, 22 Sep 1994 00:00:00 +0000

Question:

From Brad Jaeger of Tri-Maryland. A lot more info is needed about your training and previous aches and pains. Height, weight, experience and miles accumuluated over the year. Any history of rhuematoid arthritis in family? Does pain and/or swelling decreasing with icing or with anti-inflammatory medications? When, where and how does pain increase or decrease with certain types of training? Diet, your full time job, family life, all of these must be taken into consideration. Maybe it’s physical, mental or a combination of both. Your best bet is to ask training partners or friends for their suggestions. Outside, but close influences will most likely give you the best (and cheapest) places to start. If none of these suggestions work, I would just join a convent.

Brad, Thanks for the suggestions. Gee, I posted my original question a long, long, long time ago! Since then, I figured out what was making my legs so sore and took care of it. They only hurt twice since then, and not strangley, but in the quite conventional way: once in Hawaii, and once last weekend in a 35-mile trail run (now I just need to figure out how to descend a flight of stairs Kostya Vasilyev SYMANTEC Corp. Development Tools Do not seek to follow swim-bike-run in the footsteps of the wise; swim-bike-run Seek what they sought. swim-bike-run — Basho

Response:

writes: From Brad Jaeger of Tri-Maryland. A lot more info is needed about your training and previous aches and pains. Height, weight, experience and miles accumuluated over the year. Any history of rhuematoid arthritis in family? Does pain and/or swelling decreasing with icing or with anti-inflammatory medications? When, where and how does pain increase or decrease with certain types of training? Diet, your full time job, family life, all of these must be taken into consideration. Maybe it’s physical, mental or a combination of both. Your best bet is to ask training partners or friends for their suggestions. Outside, but close influences will most likely give you the best (and cheapest) places to start. If none of these suggestions work, I would just join a convent.

Response:

[snip snip] I agree with Mark Jenkins. I experienced symptoms like Kostya’s several years ago, and I required several months (4 I think) to fully recover. I also agree with Matt Mahoney. Kostya, you just did a 10:45 at IMC. Back WAY OFF now, while there is still time before Hawaii. You will be much better off and you will NOT lose your conditioning at all. In fact the rest will do you some good. Rolf Arands, PhD

Great advice all around I think. Just a story to follow up on this. Last year a friend of mine qualified for Hawaii at IMC. He took two weeks completely off, and two more to ramp back up the training. Lucky for him, last year Hawaii was like 8 weeks after IMC. He said he still felt tired and "kind of run down" waiting for the cannon in the water at Hawaii. The last thing you want is to be tired at the start. To put things in perspective, he went 9:50 at IMC and 9:40 in Hawaii… I think the rest did him good. myke morgan p.s. personally, I feel great after my first Ironman. I think the 8 week (and counting) layoff did wonders .

Response:

Are you using a heart rate monitor? Sometimes there can be important clues about whether you are overtraining, overtaxing yourself, &tc. which your HR reveals, especially if you take it when getting up in the morning. — net.disclaimer: I do not speak for Santa Claus, no matter what I’m wearing.

Response:

: In the last 6-8 weeks, I’ve had some interesting leg soreness that I : think is not the usual lactic acid "burn". It is currently in the way : of my training in a major way, so I’d like to ask for adivce. : Are you using a heart rate monitor? Sometimes there can be important clues : about whether you are overtraining, overtaxing yourself, &tc. which your HR : reveals, especially if you take it when getting up in the morning. Not to overly alarm you, but did you see my earlier post on the net regarding arterial injuries? There are three cases of arterial complications causing unusual leg pains that I’ve uncovered here in North America. I’d be interested in hearing a more detailed description of your problem. BTW, I am NOT an MD, so this should not be construed as a consult!! Tom Ruta

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: I’ve been experiencing a slightly different kind of soreness that : hopefully someone can shed some light on. About 1 – 2 months ago : I noticed that my joints were "creeking" a lot more than they used : to. It started in my knees and ankles, but now has spread to all : my joints. This has since be accompanied by short lived ( 2-10 seconds), : often sharp, mussle pains. A visit to the doctor didn’t turn up anything. : He said a blood test showed no sign of imflamation (sp?). : He advised me to continue training as much as I want. I can live with : the pain, but I don’t want to do any permanent damage. : Any idea? : Andy I’ll bet, if you asked him/her, your doctor would say that he/she is PRACTICING medicine. Most other professionals only "practice" until they know what they’re doing. Then (and ONLY then) do they charge a fee for their service. – Except maybe lawyers or Catholics. (sippinSamuelAdams&chucklininLongBeachCaliforniawheretheearthmovesundermyfe et)

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inflammation has two m’s, nitz.

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I’ve been diagnosed with Epstein Barr virus (reactivated) wass the term my M.D. used. I’ve been fighting this for a year +. fatigue, tired legs, slower training pace, weight gain, etc. Have taken periods of time off but to no avail. Recently I’ve been trying to train easily. Three months of every other day 4 mile runs with a heart rate around 140 or under. Suggested by one Dr. Falsetti in Calif. (cardiologist who trians bikers). Tried Prozac for two months based on success of Alberto Salazar…only got dull headaches…help!!!!!! what can I do? Is this really EB virus? Thanks

Response:

| Kostya, | | Let’s see you | started feeling this right before Canada. I would guess you were training | quite a bit. Was this your first Ironman? If I remember right it was. | Also, I remember you are on the young side too. Low 20’s right? | | An Ironman is quite an event and puts tremendous demands on the body. | Being your first one, I would think it would be even more of a shock | to a younger body that has not spent years building up to this kind of | attack. Ok, now you’ve finished the Ironman, what did you do in the | way of recovery? Look back at what you’ve done as far as workouts. | If you did any long runs (10+) or long rides (60+) within 3 weeks | of the race, I would think your body would be screaming right about now. | Also, if you did any high intensity stuff, you may have also hindered | recovery. I know you want to get ready for Hawaii, but you first priority | should be to recover from Canada. All of the training is under your | belt, rest and recover should be the motto. | | As they say..better to be over rested than overtrained….. Just thought that I would add some input since Kostya is in a similar position that I was in in 1990. I completed my 4th IMC and qualified for Hawaii. It was to be held 6 weeks later. I set a PR in Canada and "needed" to rest afterwards. I was 40 years old at the time and had done 45+ Triathlons during the past 4 years, so I had an OK base. I will agree with everyone that has suggested to just relax. Do maintinance type workouts and "SAVE IT". Keep realistics goals for yourself in Hawaii and don’t get sucked into running or riding too much or too fast in the days before the race once you are in Kona. Also make sure you drink more water than you ever have once you are there. Depending on the year, the course can be more brutal than others. At our awards ceremony they describe it as a "Legend" year. 20-45 mph winds on the bike and 110+ degrees in the lava fields. I actually saw a small fellow from Japan get *Blown* over on the last climb to Hawi. It was exciting and it was humbling, I was very happy to finish, even if it did take an hour longer than Canada. It’s a great experience, I have a picture from the bike course on my desk at work, mannnnnnnnnnnn it was hot! Good luck to you and everyone else that will be going, my wife and I are with you in spirit and hope you all have a safe race. Curt Simkins Hewlett-Packard McMinnville, Oregon

Response:

In the last 6-8 weeks, I’ve had some interesting leg soreness that I think is not the usual lactic acid "burn". … PS 3 weeks to go before Hawaii Ironman! Scary!

Chill, dude! It’s called "overtraining". I’m sure you read about it, but didn’t think it could happen to you too. Try to cut your daily 5-6 hour workouts down to 30-60 minutes or so. And not just tomorrow, but for the whole next 3 weeks. Start tapering NOW, dammit! #include "disclaimer.h" |____|

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- Hide quoted text — Show quoted text – In the last 6-8 weeks, I’ve had some interesting leg soreness that I think is not the usual lactic acid "burn". It is currently in the way of my training in a major way, so I’d like to ask for adivce. –snip It started happening before Ironman/Canada, early in August. The pain is in my quads, hamstrings and calves. It feels like it’s on the –snip Simultaneously with this pain, I have a complete loss of power/strength in my legs. I.e., my speed on the bike on the flats drops from my normal 22-25 mph to like 16-17 mph. –snip Last Saturday, I rode 70 miles, very slow (avs = 17.5 mph). After the ride, my legs felt like Jell-O (and towards the end of the ride, too). –snip PS 3 weeks to go before Hawaii Ironman! Scary!

Kostya, Read Mark’s article on overtraining then look at what you wrote above and tell me if there is any correlation. Let’s see you started feeling this right before Canada. I would guess you were training quite a bit. Was this your first Ironman? If I remember right it was. Also, I remember you are on the young side too. Low 20’s right? An Ironman is quite an event and puts tremendous demands on the body. Being your first one, I would think it would be even more of a shock to a younger body that has not spent years building up to this kind of attack. Ok, now you’ve finished the Ironman, what did you do in the way of recovery? Look back at what you’ve done as far as workouts. If you did any long runs (10+) or long rides (60+) within 3 weeks of the race, I would think your body would be screaming right about now. Also, if you did any high intensity stuff, you may have also hindered recovery. I know you want to get ready for Hawaii, but you first priority should be to recover from Canada. All of the training is under your belt, rest and recover should be the motto. As they say..better to be over rested than overtrained….. Just some rambling observations. I hope my picking out some of the variables it might have made some sense. John K.

Response:

This sounds like the kind of problem that some serious massage work might help. Some heavy trainers really swear by it, and have their legs worked on regularly. If the rest of your body is complaining the way your legs are, massage isn’t going to solve the problem, but if it’s just your legs it might. Finding a competent masseur is another problem; maybe if you ask the newsgroup someone in your locale will have a suggestion.

Kostya, I have a few names of good masseurs that I fairly local. Send me some e-mail and I could tell you. John K.

Response:

– Hide quoted text — Show quoted text – In the last 6-8 weeks, I’ve had some interesting leg soreness that I think is not the usual lactic acid "burn". It is currently in the way of my training in a major way, so I’d like to ask for adivce. It started happening before Ironman/Canada, early in August. The pain is in my quads, hamstrings and calves. It feels like it’s on the surface of the muscles, and is more of a stiffness than real pain. It is present all the time, not only when training, but training makes it worse. It does not go away, but if I take a few days off, it gets better. With this pain, I can barely train: i.e. I have to skip a few days and then run or ride and then it gets worse again. Simultaneously with this pain, I have a complete loss of power/strength in my legs. I.e., my speed on the bike on the flats drops from my normal 22-25 mph to like 16-17 mph. Last Saturday, I rode 70 miles, very slow (avs = 17.5 mph). After the ride, my legs felt like Jell-O (and towards the end of the ride, too). On Sunday, even though very sore, I went for a 15-mile train run and my legs really hurt a lot, but I was just cruzin’. The pain is definitely not the lactic-acid kind. If I try to really listen to my legs and feel what’s there, it seems that there is good strength deep inside the muscles (which are rested!), but this strange pain just doesn’t let muscles work my getting in the way. I know this is a strange request, but does anyone have any idea of what this may be? I am thinking it can be something like the compartment symndrome, any ideas? Thanks in advance! PS 3 weeks to go before Hawaii Ironman! Scary! PPS Stretching _really_ hurts!

Something to consider is the "overtraining syndrome". It is no secret among athletes that in order to improve performance you’ve got to work hard. However, hard training breaks you down and makes you weaker. It is rest that makes you stronger. Physiologic improvement in sports only occurs during the rest period following hard training. This adaptation is in response to maximal loading of the cardiovascular and muscular systems and is accomplished by improving efficiency of the heart, increasing capillaries in the muscles, and increasing glycogen stores and mitochondrial enzyme systems within the muscle cells. During recovery periods these systems build to greater levels to compensate for the stress that you have applied. The result is that you are now at a higher level of performance. If sufficient rest is not included in a training program then regeneration cannot occur and performance plateaus. If this imbalance between excess training and inadequate rest persists then performance will decline. Overtraining can best be defined as the state where the athlete has been repeatedly stressed by training to the point where rest is no longer adequate to allow for recovery. The "overtraining syndrome" is the name given to the collection of emotional, behavioral, and physical symptoms due to overtraining that has persisted for weeks to months. Athletes and coaches also know it as "burnout" or "staleness." This is different from the day to day variation in performance and post exercise tiredness that is common in conditioned athletes. Overtraining is marked by cumulative exhaustion that persists even after recovery periods. The most common symptom is fatigue. This may limit workouts and may be present at rest. The athlete may also become moody, easily irritated, have altered sleep patterns, become depressed, or lose the competitive desire and enthusiasm for the sport. Some will report decreased appetite and weight loss. Physical symptoms include persistent muscular soreness, increased frequency of viral illnesses, and increased incidence of injuries. There have been several clinical studies done on athletes with the overtraining syndrome. Exercise physiologic, psychological, and biochemical laboratory testing have been done. Findings in these studies have shown decreased performance in exercise testing, decreased mood state, and, in some, increased cortisol levels — the body’s "stress" hormone. A decrease in testosterone, altered immune status, and an increase in muscular break down products have also been identified. Medically, the overtraining syndrome is classified as a neuro-endocrine disorder. The normal fine balance in the interaction between the autonomic nervous system and the hormonal system is disturbed and athletic "jet lag" results. The body now has a decreased ability to repair itself during rest. Heaping more workouts onto this unbalanced system only worsens the situation. Additional stress in the form of difficulties at work or personal life also contributes. It appears that there are two forms of the syndrome. The sympathetic form is more common in sprint type sports and the parasympathetic form is more common in endurance sports. The results from various measurements taken during exercise physiologic testing differ between the two forms, but decreased overall performance and increased perceived fatigue are similar. In the parasympathetic form there may be a lower heart rate for a given workload. Athletes training with a heart rate monitor may notice that they cannot sustain the workout at their usual "set point." Fatigue takes over and prematurely terminates the workout. Regulation of glucose can become altered and the athlete may experience symptoms of hypoglycemia during exercise. I won’t comment on all of the differences between the two forms, but one example is resting heart rate. In the sympathetic form, the resting heart rate is elevated. In the parasympathetic form, however, the resting heart rate is decreased. If this sounds confusing, then you are not alone. There is very little agreement in the literature about abnormal laboratory findings. Additionally, it is possible to have the overtraining syndrome, but have completely normal physical findings and biochemical tests. At this point, there is no single test that will confirm the presence of overtraining. The overtraining syndrome should be considered in any athlete who manifests symptoms of prolonged fatigue and performance that has leveled off or decreased. It is important to exclude any underlying illness that may be responsible for the fatigue. The treatment for the overtraining syndrome is rest. The longer the overtraining has occurred, the more rest required. Therefore, early detection is very important. If the overtraining has only occurred for a short period of time (e.g., 3 – 4 weeks) then interrupting training for 3 – 5 days is usually sufficient rest. After this, workouts can be resumed on an alternate day basis. The intensity of the training can be maintained but the total volume must be lower. It is important that the factors that lead to overtraining be identified and corrected. Otherwise, the overtraining syndrome is likely to recur. The alternate day recovery period is continued for a few weeks and then an increase in volume is permitted. In more severe cases, the training program may have to be interrupted for weeks, and it may take months to recover. An alternate form of exercise can be substituted to help prevent the exercise withdrawal syndrome. All of the medical studies and advice on overtraining have involved single sport athletes. For triathletes and other multi-sport athletes the recovery process may be different depending on the circumstances. If it can be identified that the overtraining has occurred in only one discipline, then resting that discipline along with significant decreases in the other sports can bring about full recovery. It is vitally important not to suddenly substitute more workouts in one sport in an attempt to compensate for rest in another. The athlete that does this will not heal the overtraining, but will drive him or herself deeper into a hole. Overtraining affects both peripheral and central mechanisms in the body. Resting from overtraining on the bicycle by swimming more will help a pair of fatigued quadriceps, but to the heart, pituitary, and adrenals, stress is stress. As with almost everything else health related, prevention is the key. Well-balanced gradual increases in training are recommended. A training schedule design called periodisation varies the training load in cycles with built in mandatory rest phases. During the high workload phase, the athlete alternates between high intensity interval work and low intensity endurance work . This approach is used by a number of elite athletes in many sports. A training log is the best method to monitor progress. In addition to keeping track of distance and intensity, the athlete can record the resting morning heart rate, weight, general health, how the workout felt, and levels of muscular soreness and fatigue. The latter two can be scored on a 10 point scale. Significant, progressive changes in any of these parameters may signal overtraining. Avoiding monotonous training and maintaining adequate nutrition are other recommendations for prevention. Vigorous exercise during the incubation period of a viral illness may increase the duration and severity of that illness. Athletes who feel as if they are developing a cold should rest or reduce the training schedule for a few days. In conclusion, the prevailing wisdom is that it is better to be undertrained than overtrained. Rest is a vital part of any athlete’s training. There is considerable evidence that reduced training (same intensity, lower volume) for up to 21 days will not decrease performance. A well-planned training program involves as much art as science and should allow for flexibility. Early warning signs of overtraining should be heeded and schedule adjustments made accordingly. Smart training … read more »

Response:

In the last 6-8 weeks, I’ve had some interesting leg soreness that I think is not the usual lactic acid "burn". It is currently in the way of my training in a major way, so I’d like to ask for adivce. It started happening before Ironman/Canada, early in August. The pain is in my quads, hamstrings and calves. It feels like it’s on the surface of the muscles, and is more of a stiffness than real pain. It is present all the time, not only when training, but training makes it worse. It does not go away, but if I take a few days off, it gets better. With this pain, I can barely train: i.e. I have to skip a few days and then run or ride and then it gets worse again. Simultaneously with this pain, I have a complete loss of power/strength in my legs. I.e., my speed on the bike on the flats drops from my normal 22-25 mph to like 16-17 mph. Last Saturday, I rode 70 miles, very slow (avs = 17.5 mph). After the ride, my legs felt like Jell-O (and towards the end of the ride, too). On Sunday, even though very sore, I went for a 15-mile train run and my legs really hurt a lot, but I was just cruzin’. The pain is definitely not the lactic-acid kind. If I try to really listen to my legs and feel what’s there, it seems that there is good strength deep inside the muscles (which are rested!), but this strange pain just doesn’t let muscles work my getting in the way. I know this is a strange request, but does anyone have any idea of what this may be? I am thinking it can be something like the compartment symndrome, any ideas? Thanks in advance! PS 3 weeks to go before Hawaii Ironman! Scary! PPS Stretching _really_ hurts! Kostya Vasilyev swim-bike-run SYMANTEC Corp. Development Tools eat- eat -eat (408) 446-7165 program in C++

Response:

Help With Cushings Disease

admin — Sat, 30 Apr 1994 00:00:00 +0000

Question:

I am looking for information relating to the diagnosis and treatment of cushings disease. My mother has been diagnosed with cushings disease, however her doctor does not seem to be acting to treat it. In fact, she has gained nearly eighty pounds since the problem began, is losing the hair on her head and has elevated blood pressure, purple striae on her body, and extreme weakness and fatigue. She is steadily deteriorating physically but is not being treated with drugs or any other means. Is this type of practice normal for cushings disease? What can she do to help herself or get quality medical care for her condition? Any information from somebody with knowledge of endocrine disorders would be enormously appreciated. Fenton Williams

Response:

Help With Cushings Disease: First thing is not to seek assistance from the folks here at misc.health.alternative. Cushings Disease is a potentially life threatening endocrine disorder that, depending on the cause, can be completely cured. It is not always a simple diagnosis to make. You need to get your mother to an endocrinologist preferably one at a large teaching center. When you go bring copies (do not rely on them being forwarded) of all medical records including scans (not reports) and lab tests (actual lab reports – not just your doctor’s notes). This material belongs to your mother and you should not be given a hard time about transporting it to the doctor yourself. Having ALL this material with you will save you a wasted first visit. Good luck.

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