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Old 01-19-2008, 02:03 PM   #1
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SantaMonica73 HB User
Help me find a new primary care internist in New York City

Hi everyone. I am a 34-year old male who was diagnosed with severe
osteopenia (z score -1.8) which is right on the borderline of
osteoporosis. This was finally diagnosed as a consequence of 5 stress
fractures in 5 years, an orthopedist at last told me I ought to get a
DEXA scan.

I have done EVERYTHING right my whole life. No smoking. No
corticosteroids. Lots of weight bearing exercise (I was a nationally
ranked athlete when I was age 23-25). Full diet and normal calcium and
vit D levels. All around health.

The first two endocrinologists I met took full blood panels,
determined that there were no major endocrine indications like
cushings or thyroid cancer and told me there was nothing they could do
for me. They also told me they had seen few if any young male patients
with any kind of similar pathology. They said Fosamax is for middle
aged women, and a younger man risks ruining his bone quality. I would
need to wait until I am older and have full blown osteoporosis to take it!

Finally, an andrologist took a look at my numbers, retested just to be sure, and told me that my free Testosterone levels and IGF-1 are at the absolute bottom of therange and taking into account my "*******bolic" lifestyle should be considered hypogonadism and AGHD. He prescribed hormone therapy in the
form of very low dose Testosterone and rHGH injections. Not enough to
make me a bodybuilder, but enough to get my bloodwork results into the
low/middle of the normal ranges for my age at least. Hopefully this
will bring up my DEXA numbers.

Now unfortunately when I go see my general practitioner he looks at me
like I am Barry Bonds trying to hit homers. Anabolics are so vilified
now by the media and it doesn't help that as a lifelong athlete myself
I guess I am stuck in guilt by association. I can tell this is not
going to be a productive relationship any longer.

So, here is the question:

DOES ANYONE KNOW OF A NEW YORK BASED, EXCELLENT, COMPETENT,
WELL-AFFILIATED (NYP, Mt. SINAI, NYU, etc) GENERAL INTERNAL MEDICINE
PRACTITIONER, PRIMARY CARE, WHO MIGHT BE MORE UNDERSTANDING ABOUT THIS CONDITION AND MY CHOICE FOR A COURSE OF THERAPY?

Thanks in advance for any input!

 
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Old 01-20-2008, 07:23 PM   #2
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Re: Help me find a new primary care internist in New York City

Hi SantaMonica: Welcome to the Osteo Board... Sorry for all your problems at such a young age. But it sounds like you found some Drs that are helping you with the hormones and HGH. I wouldn't worry about any stigma with rHGH, your Dr feels you need it and since there's a limited number of meds available for you go for it. I didn't realize there was an age limit on the bisphosphonates. I know most women can't take them till after menopause, but I thought men could. It's a good sign that you don't have any endocrine probs and that they have been checked, since so many people with osteoporosis have secondary causes like thyroid, parathyroid, hormones etc.

Sorry I don't know of any Drs in your area, but is there a particular reason why you want a GP to handle this? I would look for a Endo, Rheumy, or Mineral Metabolism doc at the nearest Univ Medical Center. I know that HSS has really good orthopedics/neuros, but if your looking for treatment and not any kind of surgery, I would look for the above. If you definitely want an Internal Medicine Dr, I would still look at the nearest Univ Med Center, they have the top docs, who usually also teach so they have to know their stuff and NY has a lot of good Universities/Medical Centers. I see a Mineral Metabolism Dr (which are hard to find) that's the co-chair of a osteo research center at a Univ Med Center, and they are involved in a lot of research and are willing to see patients on their limited schedule if you have a referral. That doesn't mean all Univ Med Centers require a referral, it's just the one I go to and several others in my area of CA have the same requirement. Another thing is that these Drs would know more about rHGH, since they are probably studying/researching it in some form.

The Drs I mentioned have more education in the field of bone than GP's or Internists do.

Good luck and keep up the good work...

P.S. There are a ton of us who have done all the "right" things to prevent osteoporosis/osteopenia and we still got it (I did in my early 30's) so don't beat yourself up about that, it just happens!! But there are other things that can be checked, and just to give you an example of a few, Celiac, arthritis, Parathyroid probs, bone archetiture probs that follow spinal surgery, and other spinal degenerative probs, but there are many others as well. Do you have degenerative disc disease, stenosis, or spondilolisthesis? I had 7 spinal surgeries/fractures, 6 that failed so I know about architecture probs caused by surgeries.

Last edited by DesertBloom; 01-20-2008 at 08:51 PM.

 
Old 01-22-2008, 09:07 AM   #3
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Re: Help me find a new primary care internist in New York City

DesertBloom is right, as always . I happen to a patient at HSS this week awaiting my second stage of reconstruction of what remains of my spine. Simply miraculous! I have had contact with a number of HSS specialists many of whom are also affiliated with Cornell,NYP, etc. What an amazing network of people at the tops of their fields. No slouches here! I am not certain what this board's policy is regarding naming specific names, but if you look on the HSS site for the chief of mineral metabolism you will have one of the most impressive physicians I have ever met (and I do not impress easily). Under his supervision, long-standing severe osteoporosis has been reversed back to osteopenia making possible this surgery which will likely give me my life back (which very few surgeons/facilities would even dare attempt).
I wish you all the very best of luck.
Thanks again to all you valuable resource people who have taught me so very, very much especially about taking responsibilty for my own health care
God bless you all!

 
Old 01-22-2008, 12:41 PM   #4
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Re: Help me find a new primary care internist in New York City

Hi Turtlelady: Good luck with your surgery and I'm glad you found such good Drs at HSS!!! Maybe SantaMonica can find someone there too. Could you start a new thread maybe and tell us about the surgery??? If you don't feel like it that's okay, but best of luck to you and take it easy!!!

 
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