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Posted 10/15/2005 4:50 PM (GMT 0)
Have been on Nexium little over a month....would like to try the low carb thing Norm promotes....what about my nexium?  I take one 40 mg tablet each a.m.  Do I stop cold turkey, go every other day, or what?  My doctor is very easygoing about this drug, like he does not see it as more than taking an aspirin or such. Any thoughts on what will happen if I just stop?  Thanks.
Posted 10/15/2005 6:37 PM (GMT 0)
Jennifer, My doctor seems baffled by all of this. He gives the no tomatoes, no citrus, etc... speech. Mentions exercise but says since you are not overweight, exercise probably won't help with this problem. If I go see him 2 or 3 times in a row about this problem, he says he has done all he can and refers me to the digestive disease doctor who smiles at me and gives me drugs and says things like...Gerd does not cause chest pain!! Ugh!!! Why don't they just admit they are clueless?? It does seem like a shame to get off the Nexium since the heartburn is gone...but it costs me $5.00 a pill and I take one a day!! Very expensive....my insurance won't cover one penny of anything gerd related since I had a script written by a doctor before my policy took effect. That is why I have not had the endoscopy...it would cost me $2500.00!! Even my regular doctor said since it would cost ME then he would not do it, cause all they will do is prescribe the same Nexium I am on now. Very frustrating to say the least. Every pharmacist I have talked to has told me to quit the Nexium and go on OTC Prilosec....same drug and a whole lot cheaper. I plan to call my doctor on Monday and ask him about this one. Sorry...did not mean to go on and on. I am just so tired of this stuff. I can't eat like a normal person and I am afraid to accept a job (I am a sub teacher) for fear that this will flare up in the middle of the day and I will need to leave quickly. It is sort of taking over my life and I don't like it.
Posted 10/15/2005 11:54 PM (GMT 0)
Hearty,
Wow! You sound like many of us here. This thing we call GERD is a pain in the backside;literally.

I would suggest sticking w/the Nexium or OTC Prolisec while initially trying low carb diet. If the low carbs appear to be working for you, maybe, you could talk w/dr about gradually decreasing your dosage. It seems to have helped quite a few folks out. I would try it myself if I didn't have a weight issue.

I am currently taking prescribed Prolisec 20 - 40 mg which seems to help but still have to watch food intake. I had cut back on prolisec about a week or two ago to 20 mg @day, only to get sick as a dog on yesterday from binging on coffee and all kinds of other junk the prior day or two. Well, I'm officially back to 40 mg @day and no coffee for awhile. Darn!!!!I love Coffee & junk food, this GERD gets old.

Hearty, I hope you're able to get some real relief in order to feel comfortable w/accepting a job as it seems like you desire.


Hang in there, I'm rooting for you! You know we all understand what your going through here.

Vanessa
Posted 10/16/2005 12:28 AM (GMT 0)

Hi hearty,

I quit my meds cold turkey (as you read in another thread) the day after I started my diet and I suffered no ill effects - thankfully. I dont know if it's safe to do it like that or not. I am usually very carful about this stuff but dropped the ball on this one. I am seeing my doc on Monday and will find out how he feels about ditching our GERD drugs cold turkey. Im a little afraid of what he is going to say about my making this decision about my meds and not asking him about it first. Ill make sure share what he thinks about my situation asap. It's too bad your doc isnt a very good listener. I dont know what I would do if I had a doc who wouldnt listen and wouldnt be open to helping me as I try new ideas in my search for a healthier life. Best of luck to you.

Posted 10/16/2005 2:46 AM (GMT 0)
Hi Guys, Hi Hearty,
I'm not an MD as most on the site know. But based on my experience and research on this disease, here is my opinion on this subject. If you truly are ready to move to a controlled carb diet, I would suggest that you listen to your symptoms. For most GERD sufferers, controlling their carbs leads to a complete sessation of reflux symptoms. Many people just stop the meds immediately. If you stop eating the excess carbs you should, at the least, be able to reduce your meds to 1/2 the dosage and then within a week or so stop entirely. I have consulted with an MD friend of mine for this advice and it has worked for others. What is the worst that can happen? It doesn't work and you go back on the meds.

I am pulling for all on this site. I am a former GERD sufferer. It sucks and most docs don't have a lot of depth in this area. It's too easy to write a script.

Dr. Norm
Posted 10/16/2005 9:34 AM (GMT 0)

Hey Hearty --

I noticed that you said that you had an endoscopy ... what did the results reveal? 

Certainly - if there is any sort of EE involved, PPI therapy is essential to your treatment and you should strongly consider the consequences before discontinuing the medication.   I'd consider discontinuation of therapy with your GE physician as well as his opinions on your possible adoption of a low-carb diet. 

Hope this helps and that this finds you feeling well!

Best,

ckgMD

Posted 10/16/2005 6:02 PM (GMT 0)
ckgMD, I did not have the endoscopy. My insurance won't cover any of it so it will cost me $2500.00. Too much money for me!! Even my general doctor said not to have it done as they will just prescribe the same Nexium anyway! I am just so frustrated. My heartburn is completely gone....from the first day on the Nexium. That is a huge relief, let me tell ya!!
But I still have the chest/upper back pain, occasional regurgitation, belching symptoms. My doctor is convinced it is all acid reflux. I have had an ekg, barium swallow test, and gallbladder ultrasound....all negative. Sometimes my stomach just burns too. Also, sometimes right after I eat, I get sudden severe cramps and some pretty wild diarrhea. The only reason it is hard to manage is because it is something every day. I can handle the cramps because even though they make me feel like I am going to pass out, once I am through....I am back to normal. It is the waking up with the chest heaviness, burping, etc....enduring it all day.....going to bed with it....that really gets to me. I just wish I knew what caused this. I know when it happened. In the summer of 2003, I took 5 rounds of antibiotics (different kinds) in a couple of months in addition to other drugs. I got really sick. Lost 35 pounds, severe headaches, basically bed bound....it was the first time in my life I had heartburn...it made me cry!! Since then I had a football size fibroid removed through abdominal surgery, including my uterus and one ovary. I am free of all symptoms except this acid reflux or whatever it is!! The digestive disease doctor thinks it is stress (he told my other doctor, not me) and my regular doctor thinks it is acid reflux but he says he can't help me other than to prescribe the Nexium, and if I need additional help, I should go back to the digestive disease doctor. My insurance won't cover any of this as I have a rider on my policy. I can't afford to have acid reflux. I actually got off all PPIs this summer and drank vinegar water for two months and felt great!! Then one day it all just came back. So.....I am terribly confused. Any advice or thoughts on what I wrote would be greatly appreciated. This site is quite helpful. Thanks.
Posted 10/16/2005 6:05 PM (GMT 0)
Dr Norm...You say you are a former gerd sufferer? So you have zero symptoms now? How wonderful!! How long were you on meds before you discovered the low carb "cure"?
Posted 10/16/2005 6:06 PM (GMT 0)
One more quick question....for you two "docs".....why do my calf muscles cramp when I am on Nexium?
Posted 10/16/2005 9:12 PM (GMT 0)
"docs" meant tongue in cheek....therefore the " "

don't mean to imply otherwise....I am well aware we are all just offering our opinions


Thanks for your concern.....Yes....I have a few questions to ask my doctor tomorrow....but it helps me to generate intelligent questions by talking to others on this site....I definitely am asking him about low carb diet and going off Nexium....it should be interesting to hear his response


Have a great night!!!!
Posted 10/17/2005 12:17 AM (GMT 0)
Hey Hearty,

Have you been tested for H. Pylori? Do you have a family history of heart disease? How did your last LFT, CBC, FLP look? The muscle cramping is a little weird -- and -- in my opinion, is probably not a side effect of the medication.

Yes, you're correct -- if an endoscopy would be performed and it found EE -- PPI therapy is the course of therapy to follow. So, some insurances don't like to pay for them. Alternatively, there are some insurances that require you to have them to continue to pay for the medication (insurance companies are the worst!).

Not to be too forward -- but how is the stress in your life? If it's unable to be managed, I'd consider discussing this with your physician as well. As I've mentioned previously - I've begun to treat some GERD patients with mild anxiolitics for those who discuss a history or prevalence of high-stress in their lives. In medicine -- you can never really rule many things out, especially the impact that the mind has on the body. It's a very powerful thing, indeed.

As I've written many times -- the effects of the "low carb" diet have not been scientifically proven in the treatment of GERD/EE. Unfortunately, as novel as the results may seem -- you may be placing your body at risk without realizing it. Acid damage to the lining of the esophogus and stomach does not necessarily correlate to heartburn severity. Annecdotally -- almost 50% of the patients who are taking chronic NSAID therapy and develop a gastric ulcer (i.e., bleeding out) are asymptomatic. I think that Norm & I have come to a bit of an impass on this issue - until we are able to find some scientific evidence in a large, placebo controlled trial that proves that controlled-carb diet works in the treatment of GERD.

Hope that this finds you well!

best,
ckgMD
Posted 10/17/2005 1:49 AM (GMT 0)
I realized after I posted that I should have mentioned the h. pylori test....it was negative too.
My grandmother took nitroglycerin and died at 82 but that is all I remember....no other heart problems I know of.
I am a 39 years old if that helps you any.

cbc good...cholesterol just under 200 so doc not worried but I know enough to know my good numbers should be higher

I do not know what LFT AND FLP mean? Sorry...can't answer there.

My bp has been erratic lately when I go to the doc....once 140 over 90....I kinda think it is a nervous thing but my doc said it should be lower but just suggested exercise and weight loss (even tho he says I am not overweight) kinda odd

I do carry any excess weight around my middle

The thing with the stress is that the past couple of years I have been through amazingly stressful stuff...thinking I could have cancer (per the football tumor) husband hospitalized (type 1 diabetes diagnosed) which meant major lifestyle changes, daughter starting college, me quitting work (due to my health and husband), finances not as good as before, my husband also requires a lot from me...I think the health thing with him has caused some sort of mental thing...he just needs a lot of encouragement and direction from me....he forgets things and I have to almost walk him through things...not like he was before....That is very stressful for me but there is noone I can turn to because he is the one I would have turned to....know what I mean? He asks a million questions a day and needs me to help with the most basic of tasks.

I mentioned the stress to my doctor....especially since I have noticed trouble with sleeping which I know can be a mind/body thing but he just kinda smiled at me....I hate to ask for a drug.

My left shoulder area is really sore....it radiates into my neck....it feels muscular to me....deep heat and heating pads and hot baths take care of it and tylenol helps but it seems like maybe the muscular tension is stress related too? My doc said it could be a disc problem. He had me move around and do some exercises and seemed quite satisfied it was not serious. He has given me exams, tests, etc....and tells me he is convinced it is not my heart or anything serious but he is sure it is acid reflux and he concedes stress could be a factor...Nexium is all he offers me.

He understands my finances and has sided with me to not get the endoscopy. He was shocked at the price!! I was too.

If this is all stress, how do I get it to stop? I don't feel like I am anxious or anything....I just find myself worried when I go to church, the mall, etc....that the chest/burping/etc...will get out of hand....I feel safer at home...now I know that doesn't sound normal!!!! I believe the stress of the surgery and my husband's health/money/mental state has been greater than I usually admit. I just don't know how to deal with it.

I appreciate your reply. So if acid damage does not correlate to heartburn, it would make sense to have the endoscopy to be sure of the damage? See my dilemma? Also, do you think it is a safe test? The release form was quite scary....similar to the one I signed concerning the hysterectomy!! Would you take the test?
Posted 10/17/2005 2:11 AM (GMT 0)
Hearty, I had an endoscopy done 20 times in 2 yrs. without any problems.  I had an esophagectomy and had to have my throat dialeted about once a month and they ran the scope to check out my throat and stomach.   Did get pneumonia once because my stomach wasn't empty and aspirated into the lungs but you shouldn't have that problem.  I think it is a fairly safe test.            Dave   P.S.  My stomach doesn't empty completely  because of the esophagectomy.


Post Edited (dfox6) : 10/16/2005 8:14:31 PM (GMT-6)

Posted 10/17/2005 2:14 AM (GMT 0)
Thanks...they make you sign this paper which lists every possible complication...Ugh....

20 times in 2 years...wow....sorry you had to do that. Sure hope your insurance pays.

I have to pay out of pocket and the test is $2500!!!!!
Posted 10/17/2005 2:35 AM (GMT 0)
Hearty,
If you are not going to try low carb to treat what seems to be classic GERD symptoms and insist on staying on the PPI meds, take over the counter Prilosec (omeprazole). It's every bit as good (no offense ckg) as Nexium (esomeprazole) at a fraction of the cost. The molecules are essentially identical (mirror images) and have literally the same acid reduction profiles. Nexium is a rip off. Doctors and AstraZeneca are making millions on a pure marketing scheme. I agree with Vanessa on this. I challenged ckg to present the proof Nexium was superior and the only paper he came up with that even tried to claim that Nexium was superior to Prilosec (at the same dosage) was published by researchers (If you can call them that) at AstraZeneca. In my opinion there was no stastistical difference and didn't pass the red face test.

I think your muscle cramps may be due to running down the pharmacy too often.. just kidding.

ckg,
Why do you keep harping on this H. pylori? Do you think Hearty has a gastric ulcer? I believe you acknowledge that H. pylori is not a causal factor in GERD.

As for your idea about asymptomatic esophageal damage, I agree some individuals can sustain damage without symptoms. This may be because the damage is coming from intestinal enzymes and not acid or that perhaps the esophagus has become desensitized from the continued damage. Both PPIs and low carb can stop active symptoms so one could presume that both midigate the damage from reflux. If I am correct, controlled carb does this by treating the root cause of GERD, gas production by gut microbes in repsponse to excess carbs thus, stopping reflux, while PPIs do it by simply neutralizing the stomach acid, and not preveting reflux which can include duodenal enzymes. If I am correct, PPIs my not actually stop the asymptomatic damage, while controlled carbs will, thus making this holistic approach superior. Its also a more healthy diet by literally all health indicators and mirrors the way we evolved to eat. And while one is getting more healthy, reducing blood pressure, preventing diabetes and loosing excess pounds on controlled carb dieting, people taking PPIs are often having severe side effects, and putting themselves at risk for pneumonia (and that is, as you know, substantiated in a very large controlled study published in a prestigious peer reviewed medical journal).

By the way, controlled carb for treating GERD and other health problems is supported by both a clinical study (admittedly a small one) and several doctors (including Michael and Mary Dan Eades) with many years of patient experience.

Vanessa,
I had GERD with severe reflux for over 20 years. I took all the meds and ate antacids like candy. I see that as a very unhealthy practice as I look back on it. Controlled carb dieting did cure me 100 percent. Its quite amazing. I am much happier and healthier overall from eating this way. It has been two years now.

Norm
Opinions based on my experience and research into the root cause of GERD
Posted 10/17/2005 3:28 AM (GMT 0)
HI again,

I have enjoyed reading the exchanges between ckg and Norm...but Im sorry to say that this last one Norm, disappointed me a little. Can I just say, without insulting you or nitpicking, that Healthy disagreements are wonderful and make this forum stronger. But healthy disagreements can quickly change into an argumentative form with words like "harping". There are a lot of different beliefs and opinions here based on different theories and fact - way too many to start trying debating them. I'm sure you understand what I am trying to say and I dont need to go on and on (like I usually do :-) ). And to everyone else, I know It wasnt any of my business....what can I say?

Posted 10/17/2005 3:38 AM (GMT 0)
Here is where I see a big problem!  Norm you are not a medical Dr. and it shows when you are dismissing symptoms from a patient that may or may not be having other problems going on here.  You cannot diagnose on a forum.  You shouldn't be diagnosing at all.

Hearty, please do not take all this "advice" over your own MD's recommendations!  You are talking about things here that could be symptomatic of several things and I don't think for one moment you should do anything without the advice from your Dr.!  If you do not think very highly of your Dr.  Find another.  You sound as if perhaps there could be other ways that you might be helped, however, only your Dr. that sees you in front of him or her and with certain testing can tell you that for sure.

My suggestion is to make an appt. with a physician and start from there.

My best wishes to you and may you and your family have a happy, healthy life!!

Hugs, Teri :)

Posted 10/17/2005 4:31 AM (GMT 0)

Teri16 said...
Here is where I see a big problem!  Norm you are not a medical Dr. and it shows when you are dismissing symptoms from a patient that may or may not be having other problems going on here.  You cannot diagnose on a forum.  You shouldn't be diagnosing at all.

With the utmost respect for everyone's posts, I have to say that Dr. Norm has made it quite clear that he is not a medical doctor and has routinely stated in his posts that his ideas are based on his personal experience and his own research only.

He has also on many occasions referred other posters to see their doctors, so I don't feel he is trying to diagnose.  He is just offering his humble opinion based on his own experience.

Everyone has to be responsible for his/her own healthcare.  To take another person's word for anything on the Internet would be sheer folly.

I have read some of Dr. Norm's writing and I have found absolutely nothing in his material that sounds 'off base' or weird.  In what he has published, I have found continued and repeated advice for readers to consult their physicians.

This is not to say that I agree with every single thing he has suggested.  I do feel, however, that he might be on to something and I appreciate his thoughts and views on the subject.

As for 'ckgMD', I also very much appreciate his ideas as an MD.  His advice is very valuable also.  BOTH of these knowledgable posters bring something to the table.

In my opinion, it behooves us to keep an open mind about all discussions.  It goes without saying that everyone should consult their own doctors, and don't even take their opinions as the last word!

Remember, medicine is a healing art.  Science does not always play a part in a diagnosis.  Buyer beware.

Posted 10/17/2005 6:40 AM (GMT 0)
Dee and Teri,
Points taken. I do wish for an open discussion on this issue and I firmly believe that people should continue to see their primary physician to be educated by them and to educate them. I have to admit that I have been frustrated with what I personally perceive as a relatively close minded approach to this disease in the medical community and an incessent drive to push drugs that are, in my opinion, bad for people. Worse yet, pushing Nexium over Prilosec is nothing short of ripping people off.

Ten years ago this year, my mother was diagnosed with the worst form of brain cancer, glioblastoma. She discovered this on a trip from Saudi Arabia, where she lived at the time, to San Francisco where we were to visit. Her flight was diverted to Japan, due to her stoke-like symptoms . I spent some time in Japan communicating with my step sister who has a Ph.D. in medicinal chemistry. Between the two of us we found out about every experimental medicine and ongoing (open to enrollment) clinical study in the United States. I was allowed to attend the daily meetings with the surgical team at Chiba University Hospital. Imagine that in the United States! I began to notice that when ever I spoke the resident oncologist was scribbling furiously. I realized that in a couple of weeks I knew many things he didn't. This should not come as a surprise. When you or a loved one has a life threatening condition, you can become highly motivated to find answers. Some physicians have a lot of passion for thier job and research the latest findings vigorously and some don't. I believe in taking action when you don't feel satisfied with what the medical establishment offers. I challenge everything and I expect to be challenged in return.

I also have a great deal of respect for ckg, particularly his position treating patients directly. His bed side manner even shows on these boards. However, I remain committed to understanding GERD and changing some minds in the medical world.

I do think I could have chosen a better phrase than "harp on" though. And for that I am sorry. I will watch myself in the future.

Thanks for your comments as well Searchin.

Norm
Posted 10/17/2005 12:48 PM (GMT 0)
It's very considerate of you to offer an apology Norm. Again, I'm sorry if I butted in. Deep down, we are (I like to believe in my heart) after all, only trying to help everyone in the best way we know how. Having "docs" , "nurses" and other "field experts" may make some members worry that other members may lend ear to only those members' advice and follow their instructions without consulting their own doctor. As a member said...treatment and diagnosis' can change quickly when other factors are presented via tests etc. Actually "seeing" a patient actually helps a doctor make a diagnosis. Now let's get back to our posting, sharing and caring. :-)  
Posted 10/17/2005 12:49 PM (GMT 0)
oh and hearty...don't you just feel so looooooved right now!!!  hehehe. Hope your doc apt goes well...heading for mine now.

Posted 10/17/2005 2:22 PM (GMT 0)
Well went to docs and it wasnt so bad. He wasnt angry with me about ditching the meds(I haden't told him about it before today)...but only because he isnt quite sure that I have the ulcers and only because my heartburn IS gone. I will have to see him again after I have my barrium Xrays on the 27th. If there are ulcers then we will add the meds to my diet, which he did know about. He asked a bunch of questions...how Im sleeping, feeling, what Im eating, when etc and is pleased with the diet I am following, wants me to pay attention to my sugars. However he asked that I start the meds if and as soon as I start having the heartburn again regardless of why I have it (meaning if I fall off the wagon with my diet etc) and call to make an appointment immediatly (they take me in as soon as I call for cases like this) Also asked about my NSAIDS and he assured me I shouldnt worry since I am not taking them on a full time basis and never have and I have regular check ups  and blood work. He would have like to have an endo set up for me to eliminate the possibility of colitis etc... because of the blood in stool but I said I rather not. I just had an upper and lower one a few years ago anyhow. We both agreed the chances of something more than IBS were slim and my symptoms arent severe so....we left it at that unless something else develops. According to my blood work etc and despite my having low BP, low sugars, fibromyalgia (and many side dishes), RA, Osteo, IBS, spasms, GERD, Hiatal Hernia, a sinus condition and several GYN probs...I am very healthy - that made me laugh. He laughed too, but assured me I was..and I do know it. I have always eaten very well and tried to be physically active (fibro prevents that by times) although I am carrying a little extra around the middle too hearty tongue . I sure am glad we don't pay for medical tests and pay very little for meds (for example my script for GERD..although close to $100 only cost me about $5). I think that's about it...Im in a rush again cause I have to go pick up my daughter at pre school. Oh we finished the meeting with him asking me to call and let him know what that spaghetti squash tastes like, he might want to try it. I really do like my doc (as well as his sec and receptionist) and would suggest everyone try and find one they like too. Makes things much easier. Oh and I like reading both posts from Norm and ckg...so dont stop please!!!!
Posted 10/17/2005 3:42 PM (GMT 0)
Hi dee, What a lot of illnesses you have, and you stay so upbeat. It must be hard at times coping with ayoung child with all your health problems. I was interested in a couple of things you mentioned. I had a sinus condition, til I found out it was the acid washing up into my sinuses and causing the problems. When I raised the head of my bed it stopped happening. I had awful pains in my head and never made a connection til I read somewhere about it. Also have you found an improvement with your IBS since changing your diet? I have had a significant improvement in mine.
Oh, and I agree with you about Dr. Norm and ckg. I love to read their posts and I hope we carry on getting advice from them and listening to their disagreements!!!!

Take care, Vanessa
Posted 10/17/2005 4:58 PM (GMT 0)

HI Vanessa,

Trust me, trying to remember all those conditions is worse than actually dealing and living with them LOL. In fact, I probably forgot or omitted a few in the list hehehe. Oh and I have my down days like everyone else...I spare everyone and lock myself up in the room during those times tongue . I try to avoid the down days though because I find I have a hard time getting out of them and I end up in much worse pain. I think you could call what I get "the dominoe effect". One thing falls down, they all go. LOL! (Tricks to avoid down days are a whole different topic, post, thread and even forum lol).

I doubt my sinus coniditon is due to the acid...but you never know. I had some kind of thing with a camera or something shoved up my nose etc and it was discovered that my cavities are all dried up. I cant remember the name of what this condition is or how to properly describe it (I have to little memory left to use it up on my medical stuff...hubby does it for me hehehe) except to say I remember her saying that instead of them being wet, or whatever, they resemble a little like scar tissue...thick and hard etc. She said smoking caused it (docs tend to blame everything on smoking lol), but I think it was something else although Im sure smoking didnt help the situation (I have since quit by the way, going on 11 months now). Anyhow, it can get very painful. I have a cortisteroid spray which I use only when I absolutly cant stand the pain...which is about 1 per month at most now. I have learned that when it comes to sinuses, prevention is the best treatment (which is mighty hard considering Im allergic to almost everything and allergies are a trigger). Anyhow, I am very proud of myself this year. I usually start on a severe sinus attack around the end of september and it continues right until the first or second week of November...i didnt get it this year. The lack of cigarettes???? I don't know. Thank you for suggesting the acid though. I love hearing different thoughts about different conditions. If one thought doesnt help me...chances are it can help someone else I know. And yes, as much as Norm and ckg are at opposite ends of the spectrum on their medical views...isnt interesting to have access to such a wide variety of information, possible treatments etc. My doc loves hearing all my thoughts and suggestions even when I carry them from the internet. He encourages me to seek as much info as I can get. I wish I could share him.

 almosst forgot...yes I am seeing a diff in IBS...less of both C&D (unfortunatly I have both) Havent had difficulty in that area since I started diet. Well, nothing that caught my attention anyhow.


Posted 10/17/2005 5:12 PM (GMT 0)
Thanks for replying Dee, I am so pleased that this diet is helping us with the IBS too. I hope some people from the IBS forum pop over and take note. My doc is like yours, really interested in what I learn from the internet and she is all for this low carb diet and getting off the meds.
Well done with the quitting smoking. I wish I could but with everything going on in my life I am afraid I need the cigs.
Take care, Vanessa
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