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Dr. Lowe How to Prepare Patient-to-Patient Fibromyalgia Research Foundation
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I recently began providing patients with measurements of their metabolic rates as a stand alone procedure. That is a patient can come to the clinic and get two important physiological measurements: the resting metabolic rate with calorimetry, and body composition with bioelectrical impedance. From these measurements, I then use equations that tell the patient and me two things: first, whether his or her metabolic rate is normal, high, or low, and second, if high or low, exactly how much so. Other patients, however, want to know more than whether they have low metabolic rates; they also want to know the most likely cause. To determine the most likely cause, I do what is called a "differential diagnosis." That is, I systematically differentiate between all the possible causes of a particular patient's low metabolic rate. To make the differentiation, I order a variety of metabolism-related laboratory tests. (Some patients bring the results of these tests that their primary practitioners have ordered.) These include measurements of a variety of hormones that can lower the metabolic rate to varying degrees. I also have the patient get his or her average basal body temperature and average basal pulse rate. I also do a metabolically-related physical exam and assess a set of evaluation forms that I developed over many years of clinical research and practice. With the benefit of all this information, I'm then able to reach a decision about the most plausible cause of the patient's low metabolic rate. To recap, if you choose to undergo a full metabolic evaluation, I will carry you through the following procedures: (1) Measurement of your resting metabolic rate with indirect calorimetry. (2) Measurement of your body composition with bioelectrical impedance. (3) Review of my forms for evaluating your health and metabolic status. (4) Resting electrocardiograph to learn its voltage. (4) Lab tests related to your metabolic status. These include thyroid function tests, a biochemical metabolic profile, lipid profile, CBC and differential, total and free testosterone, and insulin-like growth factor-1 (also called IGF-1 and somatomedin-C). (5) Measurement of your basal body temperature and basal pulse rates, interpreted in relation to your other test results. (6) A physical examination, including:
After we complete your metabolic evaluation, we'll provide you with copies of your test results and I'll explain to you my conclusion about your metabolic status. You have the option of a written report of your test results. The written report includes interpretation of your test results (including calorimetry, bioelectrical impedance, and lab tests), a diagnosis if warranted, and treatment recommendations. Keep in mind, however, that written reports are a bane to virtually every doctor, me among them. We must, then, charge a fair fee for this odious chore. A question most patients ask is how many days they'll need to be in Boulder for their evaluations. The answer is one day. An evaluation takes from two-to-four hours. If you need a prescription for thyroid hormone or another medication, you can see the prescribing doctor who works with me the same day of your evaluation. Please let us know in advance if you need an appointment with the prescribing doctor. You can let Tammy know by phoning her at 603-391-6061 or by writing to her at Tammy@drlowe.com. | Dr. Lowe's Bio | © Dr. John C. Lowe, PLLC 2008 |
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