(MAC/MAI) MYCOBACTERIUM AVIUM COMPLEX PULMONARY DISEASE/BRONCHIECTASIS

Posted by Katherine, Alumni Mentor @katemn, Nov 21, 2011

I am new to Mayo online .. I was hoping to find others with .. MYCOBACTERIUM AVIUM COMPLEX PULMONARY DISEASE (MAC/MAI) and/or BRONCHIECTASIS. I found only 1 thread on mycobacterium accidently under the catagory “Lungs”. I’m hoping by starting a subject matter directly related to MYCOBACTERIUM AVIUM COMPLEX PULMONARY DISEASE (MAC/MAI) I may find others out there!

I was diagnosed by a sputum culture August 2007 (but the culture result was accidentally misfiled until 2008!) with MYCOBACTERIUM AVIUM COMPLEX PULMONARY DISEASE (MAC/MAI) and BRONCHIECTASIS. I am now on 5 antibiotics. Working with Dr. Timothy Aksamit at Rochester Mayo Clinic .. he is a saint to have put up with me this long! I was terrified of the treatment . started the first antibiotic September 3, 2011 … am now on all 5 antibiotics for 18 mos to 2 years. Am delighted at the very bearable side effects!

I wrote on the 1 thread I found: If you google NON-TUBERCULOUS MYCOBACTERIUM AVIUM COMPLEX PULMONARY DISEASE (MAC/MAI) you will learn a LOT about the disease. But PLEASE do NOT get scared about all the things you read .. that is what I did and nearly refused to do the treatment until after a 2nd Micomacterium was discovered! Educate yourself for “due diligence” .. but take it all with a grain of salt .. you are NOT necessarily going to have all the terrible side effects of the antibiotics! Good luck to you!

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January 2017 Update

One of our great Connect Members .. @Paula_MAC2007  .. had a wonderfully helpful idea that I wanted to share! Her idea .. as you read through the pages to gather information on our shared disease of MAC you can develop a personal “file cabinet” for future reference without the necessity of reading all the pages again!

If you have the “MS Word” program on your computer:

  1. Document Title Example:  Mayo Clinic Connect MAI/MAC Information
  2. Then develop different categories that make sense to you such as:  Heath Aids .. Videos .. Healthy Living .. Positive Thinking .. Baseline Testing and Regular Testing .. Antibiotics ..
    Tips for
  3. As you read the pages .. copy/paste/save things of interest into that MS Word document under your preferred categories for future reference.

Then as you want to refer back to something in the future .. YEAH!  You have now created your own personal “file cabinet” on MAC/MAI!  Go to it!

KateMN

@katemn

Pamela, I reposted this is MAC & Bronchiectasis as I saw it under “Harmonica Therapy”

Posted by @pamelasc1, 1 hour ago
This is just a general question to the group: I will be ending my 18 months of being on the meds for MAC end of April. I do cough some, but infrequently and do not bring up much of anything. How am I going to get a sputum sample? Before, I had no trouble with that as I was coughing all the time. I just began using a nebulizer in the AM to see if that would bring up stuff, but so far it has not. If I can not get it myself, will I have to have a bronchoscopy? I dread that as I had it done once, but that was years ago and they used no sedative or anything! Maybe it is less invasive now? Can anyone suggest all the ways to bring up sputum? Before stopping the meds, I do want to know if the MAC has been beaten back. Thanks, Pamela

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@katemn

Pamela, I reposted this is MAC & Bronchiectasis as I saw it under “Harmonica Therapy”

Posted by @pamelasc1, 1 hour ago
This is just a general question to the group: I will be ending my 18 months of being on the meds for MAC end of April. I do cough some, but infrequently and do not bring up much of anything. How am I going to get a sputum sample? Before, I had no trouble with that as I was coughing all the time. I just began using a nebulizer in the AM to see if that would bring up stuff, but so far it has not. If I can not get it myself, will I have to have a bronchoscopy? I dread that as I had it done once, but that was years ago and they used no sedative or anything! Maybe it is less invasive now? Can anyone suggest all the ways to bring up sputum? Before stopping the meds, I do want to know if the MAC has been beaten back. Thanks, Pamela

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@irene5 Irene, you are SO right! No one knows our bodies as well as we do .. and if we don’t advocate for ourselves who will?! A few years ago a what I consider an arrogant anesthesiologist who I feared was not listening to me .. I didn’t listen to my gut feeling and request a different doctor! He “took” me down too quickly .. my blood pressure plummeted .. they had to quickly cancel the procedure and send me home to have to come back a second time. ALL because some doctor thought he was god and would not listen to what I KNEW worked for MY body .. AND I did not listen to my gut feeling. Lesson learned. I now have that on my medical information so any other anesthesiologist KNOWS not to take me down so quickly!

I would recommend good medical records on your computer that you can update/print out and take with you to every medical appointment is one of the best things I have ever done for myself and for my husband! I have yet to have a doctor or medical secy not be VERY impressed with my print out .. I do the headings in one color etc to make things stand out :

WITH THE HEADINGS: At the top I start with all legal info-including insurance policies and numbers-emergency contact-has Health Care Directive/hen current meds/hen over the counter/Surgeries with dates/Health Issues with date diagnosed/Various Vaccinations-Last Eye-Hearing-Dexa-Skin Exam etc with date/meds that DO work for me/med allergies-side effects/list of all doctors with their fax numbers/vitamins currently taking. It does take a bit of work to get this info into a Word document .. but then all you have to do is update it as you go. Then a quick print out before an appointment and you’re ready to go! I have found it is good to print out 2 copies .. the doctor always seems to like to read from one and ask questions .. I like the 2nd copy because I can’t always remember everything .. nice to refer to! If my husband goes to the hospital I print out 6 or 7 copies. Then I hand one to EVERY doctor that comes in .. they seem to LOVE it .. in one document they can see what it takes precious minutes to find in a computer! Hope the above helps someone! Hugs to all! Katherine

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@katemn

Joined: Feb 13, 2017 Posted by @21042, 13 minutes ago
I talked to my pulmonologist on Tues. and i brought up probiotics to her. She said these three antibiotics do not attack the good bacteria in the gut, that they only work for nothing but mac. Did your doctor recommend them? Im so confused. She said they would do nothing. I have been so sick today. An hour after i took my meds last night i vomited it all up and have been sick since. The first day i took all the meds at 9:00 pm. and went to bed. I did fine. I ate at 6:00 pm. Ive never had anything make me so ill. Im so nauseated i cant eat, but i know i cant continue not eating. Also my dr. gave me Ondansetron 4mg. for nausea. Doesnt help a bit.
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@21042 .. Kathi I think you can already tell I am a pretty straight shooter .. I tell it like it is .. so here goes. Your doctor is NUTS .. AND poorly informed!! You can tell her that Dr. Timothy Aksamit at Mayo Clinic, Rochester MN .. a worldwide respected EXPERT on MAC told ME to start on probiotics the FIRST time he started me on antibiotics! Plus if you read through the pages of our Forum you will read how much probiotics are helping our other members. Kathi, do what feels right for you and your body .. BUT I just wonder how many MAC patients your Pulmonologists has treated in the past 12 months?? Sorry, but she just doesn’t seem up to speed enough to help you to your best self.

Please re read the above message from Posted by @pamelasc1, 3 days ago .. might that help you? I feel so bad for you .. BUT do NOT give up .. it is so tough in the beginning but it DOES get better .. just put one foot in front in front of the other. We will all be here for you. I am answering you an the Main MAC Forum .. I want you to get more support from more of our wonderful members! I am sending you a BIG Hug! Katherine

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@pamelasc1, Pamela, that is REALLY interesting! When I am coughing so bad I think my ribs are about to crack .. I just think it must be my Bronchiectasis or Reactive Airway Disease and just put up with it .. Hmm .. I NEED to listen to my own preaching and be my OWN best advocate! I just never thought of things like Pseudomonas .. not to be crude .. but what color was your sputum .. that could be a tip off for the rest of us. Pamela, thank you for this info .. it is helpful for all of us. Hugs! Katherine
http://www.medicinenet.com/script/main/art.asp?articlekey=20161

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Posted by @pamelasc1, 22 minutes ago
Thank you Katherine and Steve for the information as to how best to get the sputum up – lovely subject! – I will ask my doctor about adding the saline to my nebulizer. As to the Aerobika approach: can I purchase this device online or do I have to get a prescription? Pamela

@pamelasc1, Pamela, I wanted to get us back on our own MAC & Bronchiectasis Forum so am going to answer here.

I saw that actually Steve was adding Albuterol to his nebulizer … which opens up the airways .. mention this to you doctor .. that could help also! In terms of he Aerobika .. you can just purchase it online.

I would love @decosmo and @maryjo2sell to jump in with their thoughts .. BECAUSE I took a chance and purchased mine on Ebay for half the price .. just $54 with shipping. BUT with my particular lung situation to get a forceful “flutter” I had to turn the “+” sign to maximum. SO my question to @decosmo and @maryjo2sell .. my Aerobika looked absolutely legit when I compared it to the website https://www.monaghanmed.com/Aerobika .. AND it came with full instruction booklet etc in a plastic bag .. AND it is getting up more sputum than I am able to get up with just my normal coughing .. BUT I am hesitant to recommend this particular Ebay sellar for half the price unless someone who purchased for full price tells me they have NEVER needed to go to the max “+” setting. So I am satisfied with it .. I cleaned it per the instructions .. I used antibacterial dishwash soap .. rinsing VERY carefully and air dry. But I just want to hear from @decosmo and @maryjo2sell and any other Aerobika users. Help! Hugs! Katherine

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Hi all, I’m sure I read somewhere in these posts about whether bottled water; spring or purified, also contained the MAC/MAI bacterium but I can’t find it now. I’m trying to decide if I should get a water cooler. Anyone have any suggestions as to whether spring or purified would be better?
Thanks
Gina

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@ginak Gina, this is just me .. but I think I would definitely NOT get a water cooler! See the below info if mycobacterium is your concern. When I went to a lot of trouble putting in a 4-Stage 0.1 Micron Ultra-Filtration Water Filtration System in my kitchen sink .. I took all the particulars including pictures to my appt with Dr. Aksamit. He IMMEDIATELY pointed out the problem point .. the faucet .. pointing out no matter how carefully I filtered the water “biofilm” would build up on the interior of the faucet. He also followed up with this message to me: Truthfully I do not regret installing it .. it may NOT be perfect but I still think better than the tap water??

Hello Katherine,
Again, apologize for the delayed response. Let me share with you information received from a colleague, Dr. Joseph Falkinham from Virginia Tech University. He is one of the leading experts in the country and world, studying these very issues for many years. I might add that there is no definitive data as to whether any of these home water modifications of exposure will impact the clinical course of pulmonary NTM patients, and if so to what extent. Likewise, it is equally unclear as to what impact these modifications would have on minimizing risk of development of pulmonary NTM disease if changes are made prior to development of disease. Please let me know if additional information is needed or if I can clarify further.
Regards,
Dr. A
(from Dr. Falkinham)
(1) Even with installation of a 0.2 micron meter pore size filter, the house will always have NTM as they are in the pipe biofilms. They grow in the biofilm on nutrients in the filtered water and inoculate the water.
(2) As an alternative, I suggest filters on just those water sources where aerosols can be generated; namely a shower and a water tap in the bathroom…maybe even in the kitchen. Those places should only be used by the NTM patient, not everyone, as the filters are expensive and need regular replacement.
(3) The 0.2 micron filters clog, so it is important to pre-filter the water (1-5 micrometer filters). The larger pore filters are less expensive than the expensive 0.2 micro meter pore size filters.

Gina, I personally have chosen to install the 0.2 micron filters shower heads .. they are costly and must be changed frequently so it is on a shower that only I use. I have on the Forum how to purchase them if anyone is interested. Hope the above information helps someone.

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@katemn

Joined: Feb 13, 2017 Posted by @21042, 13 minutes ago
I talked to my pulmonologist on Tues. and i brought up probiotics to her. She said these three antibiotics do not attack the good bacteria in the gut, that they only work for nothing but mac. Did your doctor recommend them? Im so confused. She said they would do nothing. I have been so sick today. An hour after i took my meds last night i vomited it all up and have been sick since. The first day i took all the meds at 9:00 pm. and went to bed. I did fine. I ate at 6:00 pm. Ive never had anything make me so ill. Im so nauseated i cant eat, but i know i cant continue not eating. Also my dr. gave me Ondansetron 4mg. for nausea. Doesnt help a bit.
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@21042 .. Kathi I think you can already tell I am a pretty straight shooter .. I tell it like it is .. so here goes. Your doctor is NUTS .. AND poorly informed!! You can tell her that Dr. Timothy Aksamit at Mayo Clinic, Rochester MN .. a worldwide respected EXPERT on MAC told ME to start on probiotics the FIRST time he started me on antibiotics! Plus if you read through the pages of our Forum you will read how much probiotics are helping our other members. Kathi, do what feels right for you and your body .. BUT I just wonder how many MAC patients your Pulmonologists has treated in the past 12 months?? Sorry, but she just doesn’t seem up to speed enough to help you to your best self.

Please re read the above message from Posted by @pamelasc1, 3 days ago .. might that help you? I feel so bad for you .. BUT do NOT give up .. it is so tough in the beginning but it DOES get better .. just put one foot in front in front of the other. We will all be here for you. I am answering you an the Main MAC Forum .. I want you to get more support from more of our wonderful members! I am sending you a BIG Hug! Katherine

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Hi there,I had pseudomonas this past fall. I had to have a PICC line inserted & 21 days of IV antibiotics. I’ve been coughing for 10 years now but the pseudomonas cough was quite different. I had a overwhelming amount of mucous when I would lie down for bed. I would wake up “drowning” in mucous in my airways. It was just awful & jarring!!! The sputum had a distinct taste, smell & color (dark gray & dark green). This was when my bronch culture hadn’t completely grown out yet to show the MAC, but the MAC was there during the time that I had the pseudomonas. Yucky stuff & not to be messed with! ~Jen 🙂

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@katemn

Posted by @pamelasc1, 22 minutes ago
Thank you Katherine and Steve for the information as to how best to get the sputum up – lovely subject! – I will ask my doctor about adding the saline to my nebulizer. As to the Aerobika approach: can I purchase this device online or do I have to get a prescription? Pamela

@pamelasc1, Pamela, I wanted to get us back on our own MAC & Bronchiectasis Forum so am going to answer here.

I saw that actually Steve was adding Albuterol to his nebulizer … which opens up the airways .. mention this to you doctor .. that could help also! In terms of he Aerobika .. you can just purchase it online.

I would love @decosmo and @maryjo2sell to jump in with their thoughts .. BECAUSE I took a chance and purchased mine on Ebay for half the price .. just $54 with shipping. BUT with my particular lung situation to get a forceful “flutter” I had to turn the “+” sign to maximum. SO my question to @decosmo and @maryjo2sell .. my Aerobika looked absolutely legit when I compared it to the website https://www.monaghanmed.com/Aerobika .. AND it came with full instruction booklet etc in a plastic bag .. AND it is getting up more sputum than I am able to get up with just my normal coughing .. BUT I am hesitant to recommend this particular Ebay sellar for half the price unless someone who purchased for full price tells me they have NEVER needed to go to the max “+” setting. So I am satisfied with it .. I cleaned it per the instructions .. I used antibacterial dishwash soap .. rinsing VERY carefully and air dry. But I just want to hear from @decosmo and @maryjo2sell and any other Aerobika users. Help! Hugs! Katherine

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Hi Katherine

I cnt get sputum sample even with a test at hospital to force sputum up. Didn’t wrk for me. Diagnosed recently with Mac. Diagnosed already few months ago with bronchioectasis. It seems that a bronchoscope is the only means??? Should I be on a nebulizer with saline to help. Right now I have no symptoms of anything. No cough, little sputum. Use aerobika daily anyway. Pulmologist recently said have lost 1/3 lung capacity. He thinks have had for awhile. Getting referral to infectious disease guy asap. Might end up at Mayo eventually.. our insurance won’t cover. Am from Toronto .

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@katemn

Posted by @pamelasc1, 22 minutes ago
Thank you Katherine and Steve for the information as to how best to get the sputum up – lovely subject! – I will ask my doctor about adding the saline to my nebulizer. As to the Aerobika approach: can I purchase this device online or do I have to get a prescription? Pamela

@pamelasc1, Pamela, I wanted to get us back on our own MAC & Bronchiectasis Forum so am going to answer here.

I saw that actually Steve was adding Albuterol to his nebulizer … which opens up the airways .. mention this to you doctor .. that could help also! In terms of he Aerobika .. you can just purchase it online.

I would love @decosmo and @maryjo2sell to jump in with their thoughts .. BECAUSE I took a chance and purchased mine on Ebay for half the price .. just $54 with shipping. BUT with my particular lung situation to get a forceful “flutter” I had to turn the “+” sign to maximum. SO my question to @decosmo and @maryjo2sell .. my Aerobika looked absolutely legit when I compared it to the website https://www.monaghanmed.com/Aerobika .. AND it came with full instruction booklet etc in a plastic bag .. AND it is getting up more sputum than I am able to get up with just my normal coughing .. BUT I am hesitant to recommend this particular Ebay sellar for half the price unless someone who purchased for full price tells me they have NEVER needed to go to the max “+” setting. So I am satisfied with it .. I cleaned it per the instructions .. I used antibacterial dishwash soap .. rinsing VERY carefully and air dry. But I just want to hear from @decosmo and @maryjo2sell and any other Aerobika users. Help! Hugs! Katherine

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@megan123, Jennifer, question: how did you get diagnosed with MAC? Make SURE your referral to an Infectious Disease doctor is ALSO treating OTHER MAC patients so they know what the heck they are talking about!? ASK them: How many MAC patients have you treated in the past 12 months?! Sorry to be so tough but YOU have to be your own best advocate now in this situation! If you have indeed lost 1/3 of your lung capacity .. YOU have to be your OWN best advocate at this point .. nobody is going to do it for you. Read through the past pages of our Forum ..I promise you .. you will end up knowing more about our shared MAC disease than MANY doctors know! Then do your “due diligence” .. write our a list of questions to ask this new Infectious Disease doctor.

Note what Member @steve1948, said: NEBULIZER WITH ALBUTEROL My doctor prescribed “Sodium Chloride” (which amounts to nothing but a salt solution) to add to my Abuterol in the nebulizer. It definitely makes one cough, and helps a productive sputum for me, not as much as I’d like but every little bit is a blessing. Might you ask your current doctor for this? Definitely the Albuterol would open your airways.

Don’t know if this would help you .. but I found this:
Canadian Citizen
As a Canadian citizen, here are some frequently asked questions for patients from Canada, including what to bring and how Mayo would work with your provincial plan http://www.mayoclinic.org/canada/faq

Jennifer, I do hope some of the above might help you .. know that I am thinking of you .. PLEASE keep us posted! Sending you a hug in this tough time! Katherine

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@katemn

Posted by @pamelasc1, 22 minutes ago
Thank you Katherine and Steve for the information as to how best to get the sputum up – lovely subject! – I will ask my doctor about adding the saline to my nebulizer. As to the Aerobika approach: can I purchase this device online or do I have to get a prescription? Pamela

@pamelasc1, Pamela, I wanted to get us back on our own MAC & Bronchiectasis Forum so am going to answer here.

I saw that actually Steve was adding Albuterol to his nebulizer … which opens up the airways .. mention this to you doctor .. that could help also! In terms of he Aerobika .. you can just purchase it online.

I would love @decosmo and @maryjo2sell to jump in with their thoughts .. BECAUSE I took a chance and purchased mine on Ebay for half the price .. just $54 with shipping. BUT with my particular lung situation to get a forceful “flutter” I had to turn the “+” sign to maximum. SO my question to @decosmo and @maryjo2sell .. my Aerobika looked absolutely legit when I compared it to the website https://www.monaghanmed.com/Aerobika .. AND it came with full instruction booklet etc in a plastic bag .. AND it is getting up more sputum than I am able to get up with just my normal coughing .. BUT I am hesitant to recommend this particular Ebay sellar for half the price unless someone who purchased for full price tells me they have NEVER needed to go to the max “+” setting. So I am satisfied with it .. I cleaned it per the instructions .. I used antibacterial dishwash soap .. rinsing VERY carefully and air dry. But I just want to hear from @decosmo and @maryjo2sell and any other Aerobika users. Help! Hugs! Katherine

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thank you everyone for the useful info on all the ways to get sputum… I agree with the other member that the cough with pseudemonas is very different from the MAC cough – it is much more “violent”, hurts the ribs, and really productive. I could cough up a good one quarter cup of stuff in 15 minutes – color was off white, gray maybe a bit greenish, but mostly grey – and very thick and mucousy… much worse when I first lay down to sleep and would cough violently. It was my GP doctor who ordered the test as my pulmonologist, even though I told him about how much I was coughing, never thought to order the test. So if anyone out there with MAC is still coughing a lot, it can not hurt to have your sputum tested for pseudemonas, just to rule it out. The drug really targets it and it did clear up within 3 weeks. Thank you Katherine for the info on harmonica therapy! Pamela

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Hi Katherine, thanks for your input. I don’t understand though if the water is purified how the bacteria would get in it, but, nonetheless, I will not be taking the chance on the water cooler. I guess I’ll just stick to the bottled water. Thanks, Gina

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@katemn

Posted by @pamelasc1, 22 minutes ago
Thank you Katherine and Steve for the information as to how best to get the sputum up – lovely subject! – I will ask my doctor about adding the saline to my nebulizer. As to the Aerobika approach: can I purchase this device online or do I have to get a prescription? Pamela

@pamelasc1, Pamela, I wanted to get us back on our own MAC & Bronchiectasis Forum so am going to answer here.

I saw that actually Steve was adding Albuterol to his nebulizer … which opens up the airways .. mention this to you doctor .. that could help also! In terms of he Aerobika .. you can just purchase it online.

I would love @decosmo and @maryjo2sell to jump in with their thoughts .. BECAUSE I took a chance and purchased mine on Ebay for half the price .. just $54 with shipping. BUT with my particular lung situation to get a forceful “flutter” I had to turn the “+” sign to maximum. SO my question to @decosmo and @maryjo2sell .. my Aerobika looked absolutely legit when I compared it to the website https://www.monaghanmed.com/Aerobika .. AND it came with full instruction booklet etc in a plastic bag .. AND it is getting up more sputum than I am able to get up with just my normal coughing .. BUT I am hesitant to recommend this particular Ebay sellar for half the price unless someone who purchased for full price tells me they have NEVER needed to go to the max “+” setting. So I am satisfied with it .. I cleaned it per the instructions .. I used antibacterial dishwash soap .. rinsing VERY carefully and air dry. But I just want to hear from @decosmo and @maryjo2sell and any other Aerobika users. Help! Hugs! Katherine

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Hi there.  Diagnosed thru bronchioscopy.  Pulmonary Dr has made no referral to infect…Dr, so I will for a second opinion.  Tk u for your help Katherine.  I am scared about all this.  Your system is better in states. Wait lists for specialists is crazy.
 Just wondering if I can afford Mayo ….hopefully it’s reasonable❤️

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