Endometriosis, Uterine Fibroids, and Estrogen Dominance
Now, when we have a stage called estrogen dominance estrogen proliferates tissue when it's dominant. Estrogen within itself is very good. I helps us with our brain tissue, our memory. It helps us to think clearly, prevents foggy brain and all this other stuff. Estrogen in itself is very goodit's not bad. But when you have an estrogen dominance situation where the estrogen is very dominant over the progesterone, you're going to have all these symptoms and you're going to have a proliferation of tissue. For instance, if a woman comes in with cysts on her ovaries or cysts in her breasts.
Or she has fibroids on the inner uterine lining, or she has endometriosis these are all tissues that are being proliferated. They are increasing because she's got too much estrogen in her. Thus, we have a lot of increase in the amounts of hysterectomies because women are getting large fibroids and they're bleeding heavy, heavy, heavy, so they have anemia. I went through this myself, personally, in my forties. I had a lot of estrogen dominance but back then we didn't know exactly what to do. And so, I ended up having a hysterectomy because every time.
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ICD10 Coding Annual Physical with Chronic Conditions
Laureen Q Annual Physical ICD10 question, if a patient is in for an annual physical and has chronic conditions like diabetes mellitus or hypertension, would you use Z00.01 Alicia Chandra knows this one. Chandra A Z00.01 is annual preventive or adult preventive examination with abnormal findings. As we talked about earlier, abnormal findings means we found something during that exam that we didn't already know that the patient had. Chronic conditions would be things we already knew the patient had. The thing that I go back to with that and then determining whether we knew it ahead.
Of time, look at some of your documentation guidelines. If you really want to think about it, I'm going to cite inpatient for a minute, but if you look at your Present on Admission Guidelines, they tell you any chronic condition that patient had before they were admitted are considered present on admission. It's kind of the same thought, they come in and do a preventive exam, we knew they had hypertension, we knew they had diabetes, we knew they had whatever. Even if we write them a script to refill those meds, it's not that we found something abnormal.
During this exam. It's simply that we gave them a script for their chronic conditions. Laureen Very good. Alicia If it is a new condition, they'll document that they'll be doing counseling on they're sending them to the diabetes nurse and getting counseling on nutrition that this is a new finding but Chandra And then in that case, then they also have to make sure that anytime they use the code that says they did a preventive with an abnormal finding they need an additional code to identify what that abnormal finding is. That's typically where they're going.
Obgyn Green Bay Elizabeths Testimonial Kaldas Center
I said I'm not doing this again we lost two babies, I said, we're done. My motherinlaw kept bugging me about this doctor Kaldas, doctor Kaldas. And I was just, like, I'm done. I don't want to do anymore. There's nothing that can be done at that point. I just, I want to adopt. I just had this, like, really weird feeling that I needed to call Dr. Kaldas. I called him on a Tuesday, met with him on a Wednesday, had the procedure done on a Wednesday to find out what I have. I had the uterine procedure. And, um, within 10 minutes of that.
Procedure, he said, yeah, you have a septate uterus and that basically means all they have to do it remove my septum which is just a divider in the uterus and then I'm good as new. And I thought, well, just by chance I'm gonna call on Thursday to see if there was any way that I could get in for surgery on Friday. When he was willing to perform that surgery for me on Friday because no one does that, I mean, no one that short of notice, it didn't even sound like the office was open, really. And, um, yeah, he was just, he said.
That I don't want you to have to deal with this for, like, another 6 months so he was just very, very sympathetic towards the situation. It made me feel like I was the only patient he had, really, was what it made me feel like. We'd gone through so much and now everything that we wanted is available and possible. We can, like, try again, if we want. And a month ago, that was noth I was never, ever going to try again. So, he's just, he's phenomenal. It just seemed like he really, really truly cared and was like very compassionate and.
Kaldas Center Testimonial Meghan and Lincoln
When we wanted to get pregnant originally, we found out pretty early on that we were going to have some fertility issues. No one really wanted to treat or really figure out what was wrong with me why I couldn't do this on my own. I felt totally lost. I felt completely on this journey where people were just handing me drugs and saying do this on this day and voila you know and it just didn't work. Having heard really good things about Dr. Kaldas, I went and saw him and he said well, you have you know polycystic ovaries. We know that. Are you on, you know, are you on metformin, are you taking this medication to treat that No one had ever.No one had ever mentioned that to me or given that to me as an option. In the first ten minutes we sat down together, I felt like yeah this guy gets me and he he he's gonna have he's gonna help me. We're gonna make this happen, and we're gonna work together and he's gonna do everything he can to help me get this baby. We did the ultrasound that they initially do to start things, the ultrasound technician turns to me and says well there's a baby in there. And I literally my jaw dropped open. I said, like, what are you talking about you know. There can't be a baby in there. You know and then she goes there is. You're pregnant. There's a baby in there, and I said well you're going to have to give me a whole bunch of photos because my husband is not going to believe me. I feel like had I gone to Dr. Kaldas the first time around, I could have been saved years of heartache, you know, I probably would have been able to get pregnant when we wanted to, you know, without having to go through all the heartache, all of the hormones and the medications and all that goes with that and all the frustration. He wants what's best for you. He wants you to be happy and to have the family that you're dreaming about. Oohh you funny man. Aw yeah you're funny..
Doctors Get Serious About Diagnosing Chronic Fatigue
I'm Miranda Savioli with today's health news. Chronic fatigue syndrome it's a condition that affects millions of Americans each year, yet there are no clear guidelines to diagnose it. Now, a panel from the Institute of Medicine suggests doctors use this checklist Fatigue that lasts for more than six months, discomfort after physical activity, and unrefreshing sleep, as well as either cognitive impairment or orthostatic intolerance, meaning symptoms improve when lying down and patients find it hard to stay upright for long. They also suggest renaming the condition systemic exertion intolerance disease.
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