Please critique my plan

[Clay Coker]

Please critique my plan

 

56-year-old female, with multiple medical problems, starting with polycystic ovaries syndrome, breast cancer, in situ, status post lump ectomy. DVT and PE on tamoxifen, subsequent chronic anticoagulation and IVC filter.

Laparoscopic gastric sleeve procedure.Hysterectomy, and cholecystectomy.

History of knee replacement at age 40, complicated by  MRSA , requiring revision.

Also Cspine surgical intervention, complicated by MRSA

She has sleep apnea, chronic insomnia, requiring multiple medications, including Ambien, and oxycodone.

 

My plan is to start with Epithalon , For 10 days, along with semiglutide oral, as I have access to some samples. Then start TA1, I think this combination will help with sleep, inflammation, And insulin resistance. Hopefully improve her pain.

and insulin resistance. Hopefully improve her pain.

I would like to addDSIP, to get her sleep better regulated, so that we can get her compliant with cpap  addTB4 in there somewhere also

All advice is welcome.

 

[Anonymous]

I have never avoided estrogen with women with breast cancer -read my new book ‘the good news about estrogen’ the science behind the safety of estrogen.

[Clay Coker]

Thanks Uzzi.  I appreciate your help.

[Mary Ann Butler]

Most likely she also needs her thyroid optimized. In PCOS we optimize thyroid, control insulin, and usually put on progesterone. That is not progestin or Medroxyprogesterone acetate, but micronized progesterone. Once her insulin is under control then you can start her on a low dose of testosterone. Controlling the insulin resistance will  lower visceral fat which is what leads to inflammation and probably her cancer in the first place.

(2014). Is Breast Cancer Risk the Same for All Progestogens? Arch Gynecol Obstet, 290 (2), 207-209.

(2013). Risk of Breast Cancer by type of Menopausal Hormone Therapy: A Case- control Study Among Post-Menopausal Women in France. Plos One, 8 (11), e78016. (2005). Progesterone Inhibits Human Breast Cancer Cell Growth Through Transcriptional Upregulation of the Cyclin-dependent kinase inhibitor P27kip1 Gene. Climacteric, 579 (2), 5535-5541.

(2016). Inflammation, Dysregulated Metabolism and Aromatase in Obesity and Breast Cancer. Current Opinion in Pharmacology Volume 31, Pages 90-96. doi: 10.1016/j.coph.2016.11.003.

 

[Clay Coker]

Thanks Mary Ann

[Robin Rose]

Aloha clay: long complex life of medical issues. Makes me want a really thorough low hanging fruit assessment : lifelong personal discipline? So that what’s diet, exercise, stress like? With all this pathology I wonder what toxins enter her mouth and skin daily?  Is she supported in her family and life to step up and do the needed actionable self care? And then the absolute need: educate and guide and offer benevolent reassurance that changing is Medicine! As an evolving peptide doc : these need to be placed upon the terrain that’s tended at least a bit. All these diagnoses scream Lifestyle Medicine upgrade.

First question for her: who hurt you. Mind body call out in this case. Epithalon can prime all those pumps. Great case!!

[Rajka Milanovic Galbraith]

Thanks Mary Ann for the research links: I am actively collecting them to always have the studies behind what we do!

 

 

[Cynthia Keller]

I just wanted to throw in the reminder as well to ask her what her biggest complaint is.  Meaning, “what of what she is experiencing is the biggest hinderance to her daily quality of life?”

I have found over and over, that if I make sure that this is one of the first issues corrected, they are more “all in” for all of the changes that will be needed of them (lifestyle wise, medication use, etc).  This also gives them back some hope.

And at times I have been shocked to hear that what affects their life the most, is not that what I was most worried about medically, nor what I guessed what they would have said.

And I agree with Robin as well that her case says “support her emotionally” to me.

And lastly, with two episodes of MRSA complications, consider swabbing nares to make sure that she isn’t colonized.  And if she is, correct this before her next intervention which breaks the skin.

-Cynthia

 

[tim blend]

since i am quite new to the use of mulitple peptides, i will be side lined and listen to my experienced collegues. i am however quite versed in BHRT and neurotransmitter therapy and i dont here much about this in the various discussions. My belief , (and im open to change) is that management of the HPA axis and the appropriate BHRT including thyroid can do alot for this women. Lifestyle change which can be the most difficult for some people due to family dynamics and working conditions. Sleep and general fatigue certainly can be helped with NT support like P.serine, 5HTP, ashwagonda along with oral progesterone. Sleep first!

[tim blend]

BTW how do I get my merit badges after taking the courses?

 

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