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Indigoblue

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Reply with quote  #1 
Dear Constantine,
 
This is the fourth time I have attempted to contact you with regards to acceptance as one of Dr. Charles Shapiro's patients.  Apparently, he is accepting few new patients, if any.  He is beginning a Clinical Study of Patients who have survived five years.
 
I asked my Oncologist to send a recommendation, and he also approved of your expertise as a Research Specialist on Breast Cancers, etc.  He is not a Breast Specialist, but specialized in Prostate and Hematology and Blood Diseases.  He studied with Dr. Shapiro, and he told me Dr. Shapiro would give me the exact treatment response as him...reluctat to mention names of my doctors. 
 
We know my case is complicated, and you don't know the half of it...sorry to say.  I would like to tell you more, as well as ask you if you have  the influence to hopefully enhance my becoming a patient of the physician you speak so highly.  I live nearest to Columbus, and it would likely be my only choice.
 
I am currently having a great deal of pain; I don't know if it's bone, spine, lung, fibrous material, blood, old injuries, brain, neuropathy...there is a cyst in a broken fibula; I broke a rib during surgery; every part of this anatomy is in pain; my left knee is swollen four time the size of the right one, also swollen.  No one seems to care; They ordered a Dexa...what good will that do which would not have been found on the PET. MRI, CAT or blood tests.  I had surgery Dec. 15, 2005, clean Sentinal Nodes (4) IDC  Grade 3, Partial Mastectomy, 1.7 cm. Aggressive, Stellate, 2.2 mm from Chest Wall, Triple Negative and treatment consisted of A/C x 4, 12 wkly Paciltaxel, 32 Rads, including 8 boosts, and they radiated the lymph nodes, even though they were clean (maybe).  Cut nerves, Gigantic Hematoma, Large Seroma in the Axillary where SLN was performed....
 
Currently this pain feels unlike anything I have ever known.
What is your opinion, and would it be wiser to discuss this case on a private email?  Couln't get it to you, kept coming back...that was the other 9 tries....
 
HELP, dear Constantine....please.
 
Sincerly Yours,
 
Indi
edge

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Reply with quote  #2 

Dear Indi:

I am so very sorry you have not been unable to succeed in contacting me by email - I was unaware of your attempts, and so unfortunately unaware of all that you've been going through, otherwise I would have responded before.

My main medical identity is my edge@evidencewatch.com email address, but I maintain several other secure-channel identities that you could use any of these if you have any problem with the evidencewatch address:

edgerider@hushmail.com
edge@computer.org
ckane@ieee.org



Pain Relief on the Way
As to the pain you're experiencing, and the edema / inflammation in the knee, here's a strategy for some effective relief in the short-term:
  1. To get immediate relief from the swelling and extensive inflammation, along with pain relief, I would advise in this case that you first begin with Voltaren Gel. Although Traumeel Gel can be just as effective for the pain relief, when there is such extensive swelling as you described, I prefer to first use a topical NSAID under occlusive application to quickly reduce the inflammatory burden, then use Traumeel for continuous pain relief once the swelling is significantly abated. It should be applied 4 times daily to the - and all - affected areas, and under occlusive application means that you should first rub it in well, then wrap the entire area, in this case the knee, with a air- and water-tight trauma dressing, and plain old Saran Wrap will do nicely; the wrapping should just be snug, but not tight or stretched, and that dramatically enhances the efficacy of the Voltaren and also makes it work almost immediately. The last application should be a nighttime with the wrapping removed in the morning.

    Voltaren Gel is a prescription product and I suspect you can get a prescription written for it, but should that for any reason present a problem, it can be ordered without a prescription (perfectly legal under the FDA personal use exemption clause) from an authorized pharmacy in a cooperating country; should you need this option, one is Strand Pharmacy in New Zealand, at:
    http://www.strandarcadepharmacy.co.nz/c/135217/1/Voltaren-Emulgel.html
    In New Zealand Voltaren Gel is marketed by Novartis as
    Voltaren Emulgel, and it can be shipped, without a prescription, anywhere worldwide.
  2. The second step is to use Traumeel Gel for pain relief, which can and should be used at the same time as the Voltaren, and it too should be applied under occlusive dressing, following the instructions for Voltaren. It can be ordered from Vitacost.com online, at this link:
    http://www.vitacost.com/Heel-Traumeel-1-76-oz
  3. The third step is to add SAM-e (oral tablets) which will also help dramatically for pain relief, has some anti-depressant activity in addition, and finally also protects your liver function to boot. You have to build up to 1200mg per day, in three divided doses of 400mg at each of three meals. You should build up gradually, starting with 400mg daily for 4 days, then stepping up another 400mg to 800mg daily for another four days, then adding the final 400mg to reach the target 1200mg/daily and stay on that dose thereafter. However, many people can get substantial relief from lower doses, so you can stay at any level - 400, 800, or 1200 mg / daily - that works for you and is providing sufficient relief. Another option for people you want to avoid any potential daytime sedation, the full dosing can just be taken once at nighttime, which can benefit quality of sleep (and mood), as well as pain. You can order SAM-e from Vitacost.com, at this link:
    http://www.vitacost.com/NSI-SAM-e-400-mg-30-Tablets
The combination of Voltaren + Traumeel + SAM-e should provide you highly effective optimal relief.



More Relief on the Way

As to helping you get to Charles Shapiro, consider it done: I will email him in your behalf and add my voice to your oncologist's recommendation; I prefer not to disturb him on a weekend, but I'll contact him straightaway on Monday (tomorrow morning). Hopefully with two voices in your behalf, he may relax his constraints on taking new patients, and I'll do what I can to assist in that direction.

I know you won't lose hope Indi - there are many options for getting you better and more optimal care. And if for any reason Charles Shapiro does not work out in time, there is a fallback option I can suggest of Bill (William) Farrar at the OSU (Ohio State University) Comprehensive Cancer Center - James Cancer Hospital in Columbus; although he is in the surgery department, he is also a fully qualified and gifted medical oncologist and a highly respected breast cancer specialist, and also a very amiable and accessible professional, extremely well-regarded by patients and fellow professionals alike. He would not represent a materially significant compromise to Dr. Shapiro, and is probably a whole lot easier to connect with. So we have alternatives, and one is bound to come through.


We'll continue to be in touch. As I learned through my defeat at the Academy Awards, hope springs eternal.


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com

SoCalLisa

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Reply with quote  #3 
Hi..I saw that Voltaren is now approved by the FDA..when will it show up in pharmacies??I get mine when anyone I know visits Europe..it is over the counter there..

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Reply with quote  #4 
(((((Indi)))))   I am SO sorry you are having so much trouble.  How frustrating.  I am so happy that Edge is going to help you find a good onc.  I will be praying that you find comfort and healing with him.

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edge

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Reply with quote  #5 

Indi:

Whatever is happening with your body, you're obviously a beautiful soul, it comes through in your every expression. So, glad to help, and thanks for the background information.

I just wrote to Charles Shapiro in your behalf re the triple negative breast cancer, and on the HD front, I also contacted the president of the Northeast Ohio Chapter of the HD Society of America (HDSA) - I know some HD specialists at the Cleveland Clinic and at Case Western, but am exploring if there are any experts closer to you (in Columbus I believe). Let's give both these queries a bit to respond, but as I said, if Charles doesn't work out, we still have Bill Farrar at the OSU Comprehensive Cancer Center, and can try him next if necessary.

As to the Voltaren Gel, no, there is typically no skin irritation or burning, but if you find any local irritation (unlikely) you can use the gel along with a non-prescription 1% hydrocortisone cream (any pharmacy), rubbed in well, first one-half hour before and after each application of the Voltaren gel, and that should avoid any local irritation, and this will not compromise the efficacy of the Voltaren Gel at all.

As to worth-while clinical trials, I'll inform you about those in my next posting; you're a generous spirit for the offer of helping through this mode of contribution, and I'd like to see if there are trials that would be of considerable benefit to you also of course.

SoCalLisa raises a good point as to when we're going see Voltaren Gel directly on the US market. The delay is due to the fact that Endo Pharmaceuticals has recently bought the U.S. rights to Voltaren Gel from the original maker, Novartis, so we're in the midst of a changeover. I spoke to reps at Endo and Novartis, and they expect the product to be launched in widespread mode in the US in late May. In the meantime, therefore, overseas ordering would be the best bet - I use New Zealand as a source, as I indicated. However, I'm told Endo may make some items available before the full physician launch in May, so check with them at: (800) 462-ENDO (3636) to see if pre-launch access is available now, or shortly.


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com

Indigoblue

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Reply with quote  #6 

Dear Constantine,
 
Some questions...should I have or be making an appointment with Dr. William Farrer in tandem with Dr. Charles Shapiro?
 
I suffered a concussion in the recent car wreck, and with the "chemo" brain or whatever the memory fog produced during chemo, I've not been thinking logically; as well as experiencing new pains every other day since the accident on April 8, 2008.
 
I remembered I was going to try your pain recommendations, and that was when the accident occurred. lol.  Back pain has been severe, and the "mystery" rib, broken during surgery is now constantly jabbing internally; they said there were no broken bones.  I don't even know how that one was broken over two years ago...my current Oncologist told me about it after the "Bone Scan".  He said it was a "new" break, at the time.
 
Reading about Candidas Albicanus, because my mouth began developing a Trench-mouth thing; Thrush Symptoms; not burning, but a white tongue with growths that look like overcooked rice.  I gargled with Persoxide and water, but it keeps coming back months later. It began a week after surgery, corner of mouth was affects, and I started drooling!   

I found it repulsive;  and it has come and gone since Surgery in Dec., 2005.  I also have had a constant pain in my stomach/intestinal area, feeling like I swallowed a ball of rubber-bands; and it also comes and goes. 

As always, the physicians are in a rush, blame someone else, and treat the condition often without even testing it for what it is, how extensive it is, or if it is even what I am wondering it is!  I hate being a pain, in pain, and not getting effective and caring medical treatment.  Why is this so prevalent?

I have never had cravings for sugar, carbs, or sweet things; but since the surgery, chemo, radiation, I crave sugary junk, abandoning all self-control.  This is a new compulsive habit.  Sickened from sugar in my childhood, I was later repulsed by most sweets.  I liked mint chocolate ice cream, cherry and lemon ices and occasionally Dark Chocolate; odd for a child back in the 60's.            
The information I found on emedicine and a few other sites; stated that the yeast, and various stages of invading fungal forms of Candiasis. create cravings for sweets and carbohydrates. 
 
My eyes almost fell out of my head when I read that one.  I tried to post the  emedicine article 76 and it wouldn't "go".
So sorry.  Vision has been affected as well; this seems like it should be disussed with doctors and patients! 

 
My knees have suffered badly through this ordeal; and during radiation they just collapsed when I flew through the doors at a small mall during a tornado; went in to wait out the storm.
 
Looking back, I was experiencing fatigue; from radiation treatments daily.  I went to an Orthopedic Surgeon who said there was a cyst in one knee, and a spur-like formation in the other.  They were very bruised and swollen from the fall, abnormally, so.  
 
Candidas has so many subtypes; and those afflicted with illness from these flourishing yeasts, are usually suffering from another illness, such as,  a malignancy, a surgery trauma, or treatments given by using equipment containing micro-fungal spores, left in what should be a sterile environment and (knowing the panic, exhausted employees) it's easy to forget; unforgivable, but easy to forget to properly clean, NOT re-use and sterilize everything between patient's visits.).  
 
I developed a rash during chemotherapy and radiation; refused to begin radiation until I knew what it was; all over the breast and stomach (itched and burned).  Finally,  it was suggested (family doc) it was likely a Yeast Infection, Skin Fungus of the Candiasis family, not un-common in breast cancer paitients. The Oncologist percscribed Diflucan and used a  baby-rash powder.  It was gone in less than a week. 
Told it is uncommon...NOT TRUE!  Found out from many doctors and nurses it is, like Hematomas and Seromas, very common.
 
Back to the Candidasis, I had white rice-like things growing in the mucous membranes and tongue.  I had a feeling in my Esophagus (still have it, as it has returned).  It feels like an obstruction, or something; and my voice changed, deepened, and consistently sounds like I have a cold. 
 
I don't know who to ask about these most annoying symptoms too.  I do know, many Breast Cancer Sufferers seem to experience these symptoms, as well.  This fungus can travel through one's blood stream and affect vital organs; particularly the throat, lower respiratory system, stomach, lower intestine, liver, and in one of them, called "OSSEOUS',
the knees, vertebrae, osteo-arthritic inflammations, occur in episodes, and are often confused or accompanied by
 bacterial infections.
 
Did I mention I have had severe spinal and hip pain since chemotherapy, and often wonder why the non-surgical side hurts as much as the surgical side? 
 
Lastly, I was asked to leave the current doctors (all) should I be accepted at the new hospital.  I have been having severe pain in all the places the seat-belt held.  I don't really know what pain is what, from when, then, long ago, or the latest episode.  HELP!
 
I need advice, can't think clearly, and don't know if I am doing anything correctly.  Since the initial breast cancer shock wore off, I was beginning to realize how many confusing and challenging decisions I had to make when first dx.  Medical I  professionals who were supposedly giving me the best advice when this nightmare began, managed to make everything even more confusing. 

You, I know, can understand how confusing and cluttered the choices become (if you get a choice).  I was so ignorant and gullible, I still can't believe it.  I cared for many family members with cancer and illness; my mother's inflammatory cancer was so tricky to understand; care for and find research (in the 80's).  I was a regular at Case Western Reserve Medical Library...and University hospitals.  My sister was ill with H.D., at the time, but we didn't know what was wrong.  So, it was simple research, and I knew what they were suffering from before the doctors figured it out...but as usual, no one listened to me.  They never do. 
 
And how quickly they forget, as I forcibly bite my tongue so as not to say: "I told you so...".  Oh well.
 
Now I question, doubt, wonder, and feel deeply hurt by many physicians, radiologists, pathologists, etc.  That medical world is too crazy for me; and the more I read, the less I know.
 
Currently, the long list of symptoms are of concern regarding Candiasis, and the lack of interest in the conditions which appeared after Breast Cancer surgery.
 
I experienced different yeast infections long ago, and they were not always easy to treat and go away.  Apparently, we all have a certain amount of it in our bodies; enough to maintain a normal balance to keep a healthful system running smoothly.  Exposure to the micro organisms can trigger an over production, and it's so similar to the mechanics of cancer. Call me crazy, but as I read about the many varieties of this fungus, it did cross my mind as to the similarities between the function of these two culprits.
 
Traumatic Injuries, chemical setbacks (chemo and rads), exposure to chemicals and open needle wounds or ports can bring on an episode.  Usually, easily brought under control, but not always.  In my case, I am confused; the recent mouth curd little things, esophagus, stomach (never went away), cravings for sweets,  spinal pain, and pelvis/hip spasms; and doctors who seem like they aren't telling me something...what are they not telling me? 
 
I would never do legal suits, it's obvious if you know me; what is going on and why are they never able to give patients a "straight" answer.  It wasn't a problem for me, or shall I say reality, until the Trauma Unit Experience, and fully awake, saw Insanity and Confusion in it's most Chaotic and Frightening Format!  Unbelievable.  
 
Well, if you could email anything regarding this Candida's Infection and it's variations, I would greatly appreciate it.  I believe it should be something made aware to any and all patients before walking through the hospital doors and possibly facing a surgery or other treatment.  Have you included this in any of your research?
 
Thank you, dear Edge!
 
I hope you are taking care of yourself, sweet Constantine...
we know how you movie stars forget about your own health!
 
love,
 
Indi




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Reply with quote  #7 
Indi,

I hope you get the help that you need!  I go to the James in Columbus, Ohio.  I see Dr. Carson there.   Let me know if you come our way.  I am an hour from Columbus!  We could meet.

Cheryl

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Reply with quote  #8 

Indi:

In addition to this brief posting, I have also just communicated with you using my private edge email identity, but I wanted here to at least address the thrush / candida problem. And I'll have more feedback for you within the next 24 to 48 hours or so.

What you described is known as mucocutaneous candidiasis (MC-candidiasis), one of many candida fungal infections, this variety affecting mucous membrane tracts, especially the mouth but also the oropharyngeal and esophageal tract, causing oral symptoms as well as difficulties in swallowing and salivation, and also often affecting various locations of the skin. In the non-genital subtype of mucocutaneous candidiasis, there is no vaginal involvement, but in immunocompromised patients, like cancer and HIV patients, the genital subtype is quite common, affecting the vagina typically with the specific C. albicans microbe.

Although isolated oral MC-candidiasis, aka thrush, can be simply treated by a topical azole-type antifungal like clotrimazole troches (Mycelex Troches), these are ineffective when, as seems to be the case with you, there is oropharyngeal and especially esophageal involvement, as the active agent cannot remain in contact for sufficient time with esophagus lining to be of any benefit. What's needed with such wider involvement is an oral azole antifungal, as per the evidence-based guidelines of The Infectious Diseases Society Of America: a 14 – 21 day course of either fluconazole (Diflucan) solution or itraconazole (Sporanox) solution. However, it is common to become fluconazole (Diflucan)-refractory after previous use, a telltale sign being the return of the same fungal infection within six months after previous treatment, so I would strongly advise a course of itraconazole (Sporanox) solution because it is known that most patients who develop fluconazole (Diflucan)-refractory infections (which is a lot of patients) will respond to itraconazole (Sporanox). And once the esophagus is involved, OTC (over-the-counter) antifungal preparations are ineffective.

The common vulvovaginal involvement of genital mucocutaneous candidiasis is very effectively treatable simply with topical preparations: clotrimazole (as non-prescription Gyne-Lotrimin Cream), butoconazole (as non-prescription Gynazole-1 Cream), miconazole (as non-prescription Monistat), tioconazole (as non-prescription Vagistat), or if stronger therapy is needed (unlikely) then terconazole (as prescription Terazol), or Nystatin (prescription, dosed at 100,000 Units for 14 days) can be prescribed by your doctor, although the OTC preparations are generally highly effective. Resolution of vulvovaginal signs and symptoms will be typically seen in 48–72 hours, while full mycological cure requires about in 4–7 days.

Finally, the Finnish team of Katja Hatakka in Helsinki has recently decisively demonstrated that intervention with probiotics (beneficial microbes), especially Lactobacillus, reduces the risk of oral candida and high yeast counts by 75%, with benefits suggested system-wide after 16 weeks of daily dosing. Any good health food store will carry several brands of Lactobacillus probiotic, or it can be ordered online from either iHerb.com or Vitacost.com; look for a preparation with no less than 6 billion units per dose. This will help in preventing future infections, and asssit with the gastrointestinal symptoms. 

And "pink therapy", namely extra-strength Pepto Bismol, can also be highly effective  for GI distress - the amazing bismuth subsalicylate active ingredient has always been something of a secret weapon: it's extraordinarily effective especially against even severe GI motility, distress, nausea, dyspepsia, and pain, and has been found highly effective also against colitis and the vague colitis-like symptoms induced by almost all antibiotic, and chemotherapeutic, therapies. And Pepto Bismol is at least as effective and minus the spectrum of side effects of traditional antibiotics against H. pylori as well as killing a broad range of harmful microbes without harming the beneficial ones. I have used it effectively for addressing in patients a syndrome called RAP, recurrent abdominal pain, of unknown etiology (meaning we are stumped). The subsalicylate is an aspirin-like compound that delivers strong anti-inflammatory and analgesic activity directly to the local GI and abdominal tract without systemic side effects, and it's been demonstrated to provide a protective coat of the relevant linings against a variety of oxidative stress including from harsh foods, toxins and even alcohol - indeed it can be taken about 30 minutes before a meal anticipated to be delicious but GI-upsetting (I love Indian food) to protect against distress before it happens. And it's pain relieving activity against poorly understood RAP and RAP-type syndromes is legendary.

More to come, and I am truly sorry for the suffering and many burdens you have now and have been long bearing. As for this glitterati (me), I am busy but in good health and soon to return to my band of friends here in Gina's stellar sanctuary.


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com
Indigoblue

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Reply with quote  #9 

Thank you, dearest Constantine.
 
I called my physician and she phoned in IC Clotrimizole, 10 mg. Troche Rox, to dissolve one tablet on tongue 5 times a day.  She did not test me; she phoned in this presciption, the idea being, if the symptoms are gone by Thursday afternoon's appointment, then it will be the correct drug.

Would Sporanex be a more appropriate drug?  Thie Clotrimizole (Mycelex), seems to have been designed to avoid fungal infections of the mouth and throat in chemotherapy patients; or those with compromised immune systems.  Would it impede the results of a test for whatever these symptoms are?  If there is a more effective medication, would the Mycelex encourage contra-cations if there is a lasting, effective cure? 

If you recall, I took 5 days of Difulcan for a severe, painful skin rash, and similar mouth fungal infection.  Never had mouth sores from chemo; but this was mucous and little rice-like growths and long clear, silicone-like of strings; or thick rubber-band material; choking me. (Gross, I am sorry); it's repulsive!  The Diflucan made it disappear, but it has come and gone, and now it's back.
 
I have had a hoarse, throaty voice, and "almost" sore throat, with colds that almost become colds, and disappear.  Are these symptoms of this Candiasisi Yeast/Fungs Infections?  I either find too much information, or ridiculous nothing information for hypochondriacs or maniacs...help!

 
With the mouth, esophagus, stomach and IBIS like activities since surgery and chemo, I fear taking this because the side effects may prove to be worse than the current (what ever it is) uncomfortable "junk" I've had for such a long time.  The knees, spine, shoulders, and skin make me wonder if this stuff has invaded my entire system, or is it cancer in yet another form, or am I just being paranoid.
 
Don't know if I should take this stuff or not.  Don't trust any doctors these days; wish I could admit myself into a "special cancer unit" and have around the clock treatment which would be overlooked by someone, a physician with your like-minded attributes, intellectual ability, and compassion.  
 
I don't think any such place exists.  I just know,  my experience with breast cancer as well as "general" health care to be dismal and often too dismissive when diagnosing patients. 
 
I can't imagine the statistics regarding those who might have been saved had they been seeing a qualified and caring physician, not overloaded with patients and a lack  of personable and loving care for their patients; only to be neglectful due to the high medical costs, procedures, and lack of insurance so prevalent in today's world. 
 
When easy, is right there, and you can't touch it...drives one to sheer madness.
 
Thank, Handsome Hedgehog; we all seem to be needing your expertise as well as the confidence we have in your brilliance of reserve and careful indications.  Thank you, sweet lovely Constantine.
 
Your Adoring Fan,
 
love,
 
Indi

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Reply with quote  #10 
In the olden days before all these modern drugs,...when my kids had thrush, I used a long q-tip and  painted the inside of their mouths with gentia violet...it turned everything purple, but it did work...

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Indigoblue

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Reply with quote  #11 
So-Cal,
Thank you for the suggestion; although I am familiar with the "Fringed Gentian", of the Gentiana genus, to which belong some 400 species.  These flowers, generally blue or deep blue, some are yellow; have been used medicinally for centuries as a wound healing plant.  The "Fringed Gentian", considered one of the most beautiful of all wild flowers, is illusive, difficult to cultivate and has become almost extinct in North America, as well as Golden Seal, Wild Ginseng, and so many wild flowers with medicinal value.  Unfortunately, people over-picked many, and didn't or couldn't replace so many of the now extinct wildflowers; sensitive and difficult to harvest because the butterflies and pollinating insects are also disappearing.  Habitat Destruction and polution have devastated so much of our beautiful "natural" world.  I can't help but wonder how many cures for diseases were right under our noses before science and research was able to study the glory of our plants and insects. 
 
I do not know of the Gentia Violet, however; will have to look that one up.  Thank you; I love the study of medicinal plants and how valuable they are to early medicinal cures, even now.
My mother used Iodine and cocacola syrup to cure everything. lol.  Caster oil sent us all flying out the door, no matter how sick we were.  Funny, because it's used in many chemotherapy drugs.
 
Send  any information, sweet So-cal Lisa; it is so interesting, and as a "naturalist" I used to teach children about wildflowers, edible plants, trees, the eco-system, and how and where to find these illusive beauties (pink ladies slipper) in the wilderness, which unfortunately is disappearing far to quickly.  Upsets me tremendously when the beloved places I once roamed are now gone, and have been replaced with tar parking lots, no trees, and a lot of malls and stores selling things like "herbal remedies", for cancers produced from petrolium products and poluted water, etc.  Ironic, isn't it?
 
Love,
Indi
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Reply with quote  #12 

Indi:

My sense is that your symptoms are congruent with the oropharyngeal and esophageal form of mucocutaneous candidiasis (MC-candidiasis), as you have described esophageal symptomology, and once the esophagus is involved, strictly local/topical therapy such as clotrimazole troches cannot be effective: they will be effective for the oral and the oropharyngeal involvement but not the esophageal, and esophageal involvement is serious, so I would still favor a course of itraconazole (Sporanox) solution because it is known that most patients who become fluconazole (Diflucan)-refractory as I observe you may have, will respond to itraconazole (Sporanox), and being systemic it is effective against all areas of internal involvement, as well as the cutaneous (skin) involvement. And yes, the symptomology you describe of throat hoarseness, etc., is common in the oropharyngeal and esophageal form of mucocutaneous candidiasis, and I furthermore do think you presenting with system-wide candida infection, again motivating Sporanox, in keeping with The Infectious Diseases Society Of America guidelines. If you supplement with a course of Lactobacillus (6 to 10 billion daily), and keep a bottle of extra strength Pepto Bismol within easy reach, you should be fine.

So my strong counsel would be to give the trial of clotrimazole troches until tomorrow afternoon at latest, and unless all symptoms are manifestly improved (not just the mouth) which is just not plausible, you need to move on to more  optimal systemic antifungal therapy. I want to see you better, and with upper respiratory and esophageal involvement, I would not want to take any chances with what strikes me as the highly underpowered therapy of a non-systemic troche.

Thanks again for all your kind and gracious praise and appreciation.


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com

Indigoblue

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Reply with quote  #13 
Dearest Edge,
 
I pronounce you "King of Heart and Soul" of Research and Medical minds.  How does one give back all you offer to our little lost world of suffering fools like myself?  I will find a way; in the meantime, convincing physicians that you are not a mere figment of our imagination, is something akin to Shakespeare's, " A Midsummer Night's Dream".  I always feel like the donkey...when attempting to explain how and what is going on; and I don't want to be the "'Ass". Would it not be a fantasy to play the part of the fairy princess or the magical queen of midnight, alive, well, and wearing the shimmering evening gown, sparkling in the glowing lights of good health, happiness of painless tomorrows?  Not to worry, and to know all is well,  however few the days left uncounted, and with a wand of mystery, we are given time,  to adore and admire the gift of love and a simple life.  Why is it I can hear Andy Rooney's little 'puck' laughing in my head right now?
 
Thank you for you incredible confidence and guidance, once again, dear sweet Constantine, you may have the adorable soul of the mighty little darling hedgehog; to me, you are the Kindred King of Kindness, Respect, and Generosity of Mind Heart and Spirit.
 
Adoringly, and appreciating you with all my respect, and dare I say endearing fondness beyond any imaginary dreams...you're on-line sites are as fantastic as you and Gina have created for us here.  It is deserving of an Acadamy Award, you know!
 
Love and deepest thanks,
 
Indi
 
I picked up the Clomitrzole Troaches, but chose not to take them...add them to the medicine cabinet of scary side effects and ineffective medicines...I don't throw them out, don't want to pollute the environment.  I will BEG for the itraconzole (Sporanox) and the Lactobacillus supplement.  I have experienced slight relief with Pink Pepito Bismol throuout treatment, and always wondered why it and Kaopectate in liquid form helped serious internal pain, when expensive presiptions did nothing but cause me to become even sicker than a rabied dog or a poisoned racoon.  I wanted to try using the extra strength Pink secret PB,  but the pharmacy did not have it in stock...hmmm.  Wonder why> a secret cure for suffering intestines?
 
Have a lovely day, and I will let you know how tomorrow's appointment with my dear family PCP goes.  She is an angel to me, and I love her dearly, like a mother, sister or my daughter (if I had one).  Perhaps I will ask her to contact you through your website, if you would not be offended or overly stressed.  I can at least mention you, if that is acceptable to you.  She could use your expert advice and invaluable experience. 
 
thanks again, dear king of hearts.
edge

Chief of Research
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Reply with quote  #14 

Indi:

Yes, that would be fine: your doctor, who sounds wonderful, can contact me anytime she wants at my edge email address (edge@evidencewatch.com).

As to the extra strength Pepto Bismol, no problem - just double the dose of the regular strength formulation you found, that's all the extra strength version does. And your right, it is always surprising how few doctors revisit some of the extraordinarily effective "old time" remedies like Pepto Bismol which is powerfully anti-inflammatory, anti-analgesic (pain-relieving), anti-microbial across a broad spectrum of microbes including H. pylori, benefits GI upset, dyspepsia and several ulcerative conditions, as well as colitis, diarrhea, and irritable bowel syndrome (IBS), and abdominal pain of unknown etiology, among many other disorders.

Good luck this afternoon, and thanks again for the kind words, so important as you know to us showbiz types (when I pass, women are often heard to remark "Heh, get a load of him!" and "Do you believe that guy?" and "What planet did he drop off of?", clearly dazzled by my passing incandescent presence).


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com

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