Frequently Asked Questions
Below are answers to some of our commonly asked questions. The topic links below can help to narrow your search.
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Q: Do you answer email?
A: Yes. We can answer a single simple question or two. We do not treat patients or practice medicine through email. Please allow two business days for our office staff to respond.
Q: Can a patient have a Skype appointment?
A: Yes, we can schedule a consultation by Skype. Dr Ackerley would be able to give you her opinions and recommendations based on information provided. It is helpful to submit a brief but concise medical/ psychological history that can be previewed prior to the consult. This helps to conserve time for you. You can also provide labs/diagnostic tests that are pertinent which you would like to discuss at that time.
Q: Dear Dr Mary, I am sending this email because I need some medical questions answered.
A: Sorry. Our policy is not to answer medical questions by email. Please expect a response from the office within a reasonable period of time or before 48 hours. If you do not here back then contact us again. If there is an emergency please contact your PCP or your local Crisis Center right away.
Q: Can I send you my medical records?
A: Yes. We are able to receive copies of records when sent through a secure system. Files must be legible. Copies made from a cell phone image are not acceptable.
Q: My pharmacy called to say that they faxed a refill request for my prescription several times since yesterday and have still not received an authorization to refill my prescription. What’s happening on your end?
A: We receive a number of requests for refills each day electronically and by fax. After we receive the request your chart needs to be checked to ensure the prescription is correct, that you are due for a refill and that you are a current patient. That takes time, and we request at least 24 hours. After 24 hours it is appropriate to inquire what has happened. Most often the request went to a wrong fax number and we never received it.
Q: My pharmacy called to say that they faxed a refill form for my prescription yesterday and have still not received a call for approval to fill the prescription. I’m wondering if their forms have been received on your end? I am afraid I am going to go into withdrawal if my Xanex (or Ativan, Ambien, Adderall or clonazepam) is not filled right away.
A: We also are aware of potential for withdrawal especially with benzodiazepines so this was taken care of promptly. However because this medicine is a controlled prescription, and certain procedures must be strictly followed, we request in our office procedure notice that we are given 72 hours’ notice for renewal of controlled substances such as benzodiazepines, stimulants and testosterone. Refilling a controlled substance requires a coordination between your doctor (the MA needs physician authorization to refill), the pharmacy, your insurance company and federal regulations. Therefore we cannot ensure 24 hour turnaround with controlled substances. In the future please start the process at least 72 hours prior to when you are about to run out. Also please note that when there is a problem, such as over the weekend, most pharmacies will allow you a three day supply while waiting for physician authorization. In addition stimulants, which are Class 2, currently require a hard copy be written which you must pick up or wait to be mailed.
Q: For some time now, I’ve had slight sensitivities to laundry detergents, some types of industrial cleaners, bleach, etc. Though nothing that has stopped me from being able to live a full active life- just with some slights discomforts from time to time. However, a few weeks ago I had a terrible reaction to what turned out to be my manager’s cologne: burning in my forehead, followed by dizziness, the inability to think, and extreme panic. Then it happened with a co-worker’s perfume… (question continued below)
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During this time I had also started working in a brand new building, just painted, etc. Each time I went in I had some similar symptoms- but not as bad. Over the course of the next few days, this became worse. About a week and a half ago, it became so bad, that I ended up with slurred speech- as well as the aforementioned symptoms. Since then, I seem to react to most soaps, even unscented- ones that I have been using with no problem for some time… I’ve now been out of work for over a week. My body feels okay, but my head feels like I have locked-in syndrome. Stuffed ears, nose, constant pressure around my head, vertigo, anxiety. Is this an issue you think you may be able to help with? You, as well as all of the info on your website, is very appealing to me. Thanks in advance for your consideration.
A: Dr. Ackerley is familiar with these concerns since it is most likely related to biotoxin illness. Biotoxins from mold, Lyme or other pathogens create brain inflammation which affects many things especially the nervous system. (This is a likely cause of MCS but not the only one).
Dr. Ackerley can start the process with a telephone consultation where she can learn more about you so that a proper diagnosis can be determined. She can make suggestions including lab testing for biotoxin illness and other tests. She cannot sign the lab requisition since you would need to see her in person in order to do this. That is a legal requirement. If you have doctor who is sympathetic to your situation you can ask them to sign for testing that Dr Ackerley may suggest. She can also schedule an appointment with you here in Arizona which would establish you as her patient.
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Q: I would like copies of my lab test results from Lab Corp.
A: You are able to view your lab results in a timely manner by establishing a patient portal at Lab Corp. Please go to their website, enter the information they request, and you will have access to all your labs three days after Dr. Ackerley receives them. In addition they will store labs for up to two years, so that you can print them out yourself when you want to show them to another physician. In addition we are able to offer our own patient portal with your lab records if you request it.
Q: How do I get my lab reports?
That’s fairly simple. In Arizona all patients are allowed direct access to their labs three days after the physician receives the final report.
Q: Quest said that they do the MMP9, but there’s a difference in their method versus Lab Corp, e.g. it was something like one lab freezes the blood and the other just refrigerates. So, at which lab should I have the MMP9 done — Quest, Lab Corp, or does it matter for that one?
A: Here is the information for the MMP-9 at Quest. Our understanding is that the MMP-9 at Quest is similar to the one at Lab Corp. We also always recommend faxing/contacting the lab to the draw station several days in advance to make sure they have all the correct reagents. (MMP-9 Quest SST- freeze 41865 / 340 / 780.79 ) Most people who have been working with the Shoemaker Protocol for several years come to learn that getting the labs drawn correctly, and paid for, is a process fraught with frustration and error no matter how carefully one tries to prepare. Be happy if it all goes well the first time.
Q: In addition to being tested for ADH and TGF-BETA1, may I also please be tested for magnesium levels? In previous blood tests taken recently, while there are sodium, potassium, chloride, calcium levels tested, there doesn’t seem to be any result for magnesium levels> I understand a deficiency may also contribute to anxiety?
A: Yes. Dr. Ackerley feels the RBC magnesium, offered by Quest and LabCorp, is the most accurate reflection of your body’s store of magnesium. Since up to 80 percent of all adults are deficient in magnesium she usually requests it.
Q: Do you offer discounted blood tests to patients?
A: The testing with a discount is ordered through our office using a special physician’s discount. It is not an insurance discount. It’s a service we offer for those who need out of pocket payment. We can send you an estimate of the cost for labs run through our physician’s discount portal. It is done through Lab Corp, but is not directly affiliated with them. Some insurance will not cover genetic testing, others decline “experimental”. Paying the discounted price works out much better financially than having your insurance company reject the claim and having to pay LabCorp’s “full retail” price.
Q: Sonora Quest relayed to me this morning that they do not do C4a blood work anymore. I am thinking I will need to do a Lab Corp test (for $500). Thoughts?
A: We offer the C4a test (and other testing) through our discounted physician’s account for $119.00. The test is drawn by Lab Corp. The preferred test for C4a is done only through Quest and National Jewish Hospital. However it has not been available in Arizona since 2013. The LabCorp test can be a reasonable substitute if the phlebotomist handles the sample correctly.
Q: I would be very interested in getting the C4a test through your discounted physician’s account with Lab Corp. I’m grateful for this option! Thank you! How does this normally work? I listed some thoughts below, but await yours.
A: We will send a lab order requisition to you. It needs to be pre-paid to our office. After we order the test you will be entered into the Lab Corp computer system so the lab order we send to you can be presented at any local Lab Corp draw station. We suggest calling the draw station before going to make sure they have the correct vials/preservatives to handle this particular test.
Q: The quick question is: Can I get all of the labs and testing for biotoxins and genetic predisposition through my local MD or do I need to come to you to get it done properly?
A: We can order the testing once you have scheduled an appointment. The tests are specialized and require interpretation, and Dr Mary is certified to do this (as you may know). Since it is a complex illness there are usually other variables involved in making a proper diagnosis and determining treatment(s).
Q: I have an appointment with my PCP. I have to ask him to sign off on Dr. Mary’s lab orders for me for MSH, TGF-BETA1, MMP-9, VEGF Plasma & C4a. Before he signs off on these, he’s going to want an explanation why they are needed. Can you send me something so that I can then at least have something to give him when he asks? Thank you very much for your help.
Q: I would like to have a urine test done for heavy metals. Through lab corp? or is it other avenues? Also, are you able to write me a script for a urine test to be performed if it is done through a lab? If not, do you recommend any company to perform the test?
A: We provide the kit to you. You do the test at home and you send the sample by mail.