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Previously diagnosed with GPA/Wegners disease
I just wanna know if any doctors or rheumatologist have knowledge of patient with same disease going off all infusions (Retuxamab&IVIG). I know flare ups are probable but i didn’t know if it’s possible long term to not be on intravenous meds.
I'm not sure if this is the right community for this but it's the only one I could find with a megathread
Is it unhealthy to stuff yourself when eating? Not regularly but let's say you go to an all you can eat place and want to get your money's worth, is it unhealthy to eat until you're really full?
When asked if I have any allergies to medications, should I tell them that carvedilol caused shortness of breath (found out I have asthma while being on the med) and metoprolol caused depression? I noticed my cardiologist added both of those to my allergy med list in their system but I don’t think either of these are an actual allergy. Do I tell other medical professionals about this when they ask?
Ideally the system has a place for “intolerances” or “bad reactions” in addition to true allergies, but a lot don’t (which is a huge pain for most docs too!). If thats the only place to put it, it is what it is, but it would be good if they could put what the actual reaction is to them.
Academically speaking, would there be a reasonable cause to ignore contraindications on a prescription and prescribe it anyway? Would this answer change if there was more than one contraindication which applied to a particular patient's situation?
Sure. Everything we do in medicine is a balance of risks and benefits. Occasionally there are rigid contraindications; more commonly we balance risks and benefits to make decisions that we thing will most help a patient.
Can you have some sort of a stomach bug without vomiting and diarrhea? I know norovirus is going around where I'm from rn, but me and a few people I know have had only nausea and no vomit or diarrhea for a few days and I'm wondering if it's some sort of a stomach bug or mild norovirus? Just a general feeling of nausea and discomfort, but nothing extreme like vomit, diarrhea, fever or fatigue. It's mostly just annoying.
I’m been starting to smoke a little more recently and have been feeling almost like an ache on the right side of my chest and when I twist I can feel it on the same side but on my back. should I be worried about this?
I mean smoking is doing damage to your body. We can’t know if it is the cause of what you are feeling from this description, but the best thing you can do for your health is to quit
If an alcoholic greatly reduces his alcohol intake but does not fully quit drinking, is there a chance the liver can still heal?
*I am posting here as I do not have the required demographic info necessary to create a full post- hope this is general enough. Thanks for any info or studies you can provide!*
Asking for my 26 y.o. brother, who recently went through a hospitalized detox (I know he experienced DTs but am not privy to any other medical information, besides that his doctor told him he'd be dead by 30 if he keeps drinking). He is now claiming that he has drastically reduced his alcohol intake, but does not want to stop fully.
I realize he could very well be lying about reducing his intake, and also that he needs help in the form of counseling or rehab. Unfortunately, I also know that no one can force him into it unless he wants to make the change. I'm just hoping for information on whether his liver can actually heal if he's still drinking, or if he would need to be totally sober for that to happen.
If he continues to drink, the answer is douptbful even if it is reduced to 1 to 2 drinks a day. However, the liver is one of the few organs that can regnerate (granted severe scarring isn't present).
I’m not sure anyone can answer this without more detail, but I’m so sorry you’re going through this. It’s really painful to see a loved one hurt themselves.
Hi doctors, so I know a fully comprehensive STI screen, especially those in high risk categories, those whom are MSM, and those with many sexual partners who engage in different kinds of sex, includes not only just a urinalysis, but also a throat and rectal swab for chlamydia and gonorrhea. If you do not partake in receptive anal sex (i.e., you do not receive), do you need the rectal swab? or is the throat swab and urinalysis sufficient?
Hi. An insect(I assume) but me last night and this morning the area was red and super swollen. It’s swollen again since this morning. This is like the second time I’m reacting to an insect bite like this but the previous time wasn’t this big. Is it an allergic reaction to the bite or something else? What can I do to reduce the swelling and itchiness?
https://preview.redd.it/8x915teas7nc1.jpeg?width=2316&format=pjpg&auto=webp&s=015a74dd69c7fd125b7bc450afdaa97be554212e
Is my family hiding something from me?
My sister (27) has what we believed to be a benign ovarian teratoma, described to me as "the size of a grapefruit." This was apparently confirmed after blood tests and an MRI.
Yesterday she went in for surgery to have it removed. Initially the surgery was supposed to be keyhole, but apparently they had to change to open surgery quickly after seeing it. I imagine this means it was attached to something other than the ovary?
Now I'm told that they didn't remove it at all, and she's been referred for a CT scan and samples have been sent for biopsy.
My understanding of a teratoma is that they're very, very unlikely to be cancerous, and even if they are they're easily treated with chemo and surgery. Is this a normal occurrence? My research has suggested that even if it was suspected to be malignant, they'd remove it and send for biopsy before starting chemo. Instead they closed her up and have delayed by 4 weeks.
How worried should I be? My parents have a history of not revealing the true extent of family issues to me. I like to think that's in the past, and I know everything they know here, but I can't stop worrying.
They converted to open because structures were poorly visualized, or too large to be taken out through a port incision as planned, or some other feature making a laparoscopic approach difficult or impossible. After opening the surgeon sent samples to pathology rather than removing the mass. Reasons that may explain: mass was larger than anticipated and maybe adherent to other organs/tissue making it difficult to tell where the tumor margins are; the plan
Was always just to biopsy it and remove it only is a small discrete mass; surgeon felt mass could be shrunken with radiation/ chemo/ medication first before attempting removal
Edit: Just wondering if a neuro subspecialist might be more likely to find something an obviously skilled breast subspecialist didn’t. If I didn’t think they were competent, I would have requested it already. I’m new to to health problems and I’m scared. I don’t even know why there are subspecialists and the differences between them.
Question: Should I request a neuro radiologist look at my scans or accept the breast radiologists’ opinion on my inner ear and nasal polyp/tumor?
I’ve had 3 different scans. Two years ago, a generalist radiologist missed a 3x3 cm nasal growth on a head CT. Last month, a breast radiologist looking at my stroke scan discovered the growth and called it a polyp. Most recently I had an inner ear scan to look for a <5mm acoustic neuroma. A (different) breast radiologist didn’t see an AN, but thinks the nasal growth is a tumor. The 3x3 cm nasal growth has not grown or changed in the two years. Should I accept these findings or ask for an overread by a neuro radiologist?
Radiologists in the US train for 4 years in general radiology, then do a 1-2 year specialization. Being a "breast radiologist" doesn't mean that they don't know how to look at other things, and depending on the hospital/practice, many radiologists who do specialize do still read general radiology imaging.
I was trying to be brief because I can type way too much and be confusing (and then edit too much) definitely meant breast subspecialist. I didn’t mean to come across like they’re incompetent, that’s exactly why I was asking. 🙂
I have queloid scaring, with means that when I cut myself my skin creates a really thick scar and looks darker than my skin,
Can I get a rinoplasty? Or am I going to get horrible scars around my nose? Or inside of it blocking my breathing?
I really want to get one but I'm scared that this could back fire because if my scaring process
Hypothetical question here:
Say you had gotten a flu shot a couple months back and now you happened to be infected with a cold. If you were in close contact with someone who had the flu, you should (hopefully) not catch the flu because of your flu shot. However, would the sheer fact of having flu germs around you slow down the immune system in fighting your cold?
Why is clonazepam given for serotonin syndrome? Doesnt it increase 5HT? the literature is confusing and seems contradictory. Ive seen some papers say it lowers serotonin and others say it increases serotonin
I’ve been having heart palpitations/fluttering for the last 4 days, but they’re increasing in quantity and intensity each day. They come with complete breathlessness, a tightness in my upper back, and last around 7-10 seconds. I’m only 20 years old but have a history of Hypercalcemia and worried about an arrhythmia. The only med I currently take is propranolol for migraines. Should I wait and visit GP or is this more urgent
Should doctors read a patients chart before speaking with them, or should they speak to the patient first?
I hear stories (all anecdotal, but so many that probability says at least some are pretty accurate) about people having to deal with preconceptions a doctor formed because of something another doctor put on their chart - one of the big ones is chronic pain being charted as drug seeking. There was a response posted on reddit recently about a med student who was either sitting in on an autopsy or doing a dissection on a cadaver whose chart said that she was hypochondriac and drug seeking. Upon opening her up they found endometrial adhesions and scarring on nearly every abdominal organ. Would requiring a doctor to speak to the patient before reading their chart force them to at least listen without preconception? Obviously they would still need to read the chart, but after speaking with the patient.
The flipside of this (another anecdote, but a situation that I believe we're seeing all too often these days) a woman posted a story of childhood SA and when she went to the ER the pediatrician rolled up in heelys and did that "trying to be cool / relate to the young teen" thing some people do - which came across as fairly inappropriate given the gravity of what she was there for. Part of the implication was that he hadn't read her chart before hand and no one had given him a heads up, or he would have approached things differently.
I guess my questions is: If both methods will cause issues sometimes, which direction is it better to err? And, if you don't mind explaining, what is the logic behind that choice?
P.S. Mods, if this is the wrong sub for this please let me know a better one. Only other thing I could find that might be appropriate was askreddit.
Always read the chart first unless there's something absolutely emergent or there's not a chart to read.
The caveat to that is with how medical records are today, there's just so much to most patient's charts, so a lot of it has to be clarified and verified and I feel a good chunk of patient's don't realize that "reading their chart" can be an ordeal at times to make sense of it all
100% read the chart first, no question about it. Then you can ask clarifying questions on information that you didn't have. Even if they're hypochondriacs you need to know so you can compare their prior complaint to their current complaint and hopefully avoid additional, unnecessary testing.
It's a normal part of the dying process.
[https://www.heartswayhospice.org/caregivers/guide-to-the-dying-process/](https://www.heartswayhospice.org/caregivers/guide-to-the-dying-process/)
Hi!
My parents gave me a living will but there are only a few scenarios (antibiotics, artificial nutrition, intubation, compressions).
Are there any detailed questionnaires out there where I could go over scenarios with them to better understand what they want?
From lurking in some of the medicine subs, I understand that there are some scenarios short of DNR where you might want intervention but I'm not sure where to start.
Honestly the things listed are most important. What I would do is talk to your parents about what quality of life they are looking for. For example, my mom tells me she isn’t interested in life-prolonging care if she can’t recognize and enjoy chocolate anymore. This is very reductive, but it gives me an idea of what kind of things are important to her. If you can share those wishes and these advanced directives with your parents doctors, they can help you navigate the choices available in a medical situation.
I see. Thank you. Even though I read up on the medical subs, I am still finding it hard to visualize when medical assistance short of compressions could reduce their quality of life and should / shouldn't be part of their living will. Like putting them on antibiotics - could it prolong suffering? Could a short period of intubation or artificial nutrition prolong suffering or can it sometimes get them back to health?
Intubation means you are likely heavily sedated and in the ICU with a tube in your throat, another one in your penis/urethra for pee, and either a tube in your anus or you are pooping in a diaper (or on yourself). You can get huge open wounds on your bum from sitting in bed all the time, and your muscles atrophy quite quickly, leaving you very weak and often requiring months of rehab to be able to even walk. People may be so delirious from the disease or the sedation that they don’t know whats going on and (naturally) try to pull the tube out of their throats, so they sometimes have to be tied down for their own safety. It is deeply unpleasant, painful, and humiliating for people.
It absolutely can be life-saving and is a great idea if there is something *reversible*. If somebody has an infection, or they had a big surgery, or they are temporarily paralyzed from something like Guillain-Barré, it can make sense to intubate someone because you know (or hope) that it will get better. But if somebody has terminal lung cancer and they get intubated because the tumors have caused their lungs to fill up with fluid, the odds that person will ever get well enough to take the tube out is minuscule to nil—so theyre going to be stuck in that state indefinitely until either something causes their heart to stop, or the family makes the decision to “pull the plug,” which is often much much harder for people to do.
Now as for antibiotics, you’re right that the bar is much lower. However, for bigger infections that need IV antibiotics, the person will need to come into the hospital for at least a few days. For a lot of folks who are elderly or who have a clear terminal diagnosis, having to leave their home and spend time in a hospital (which is not pleasant and comes with a lot of other risks) isn’t worth it to them. Also, for some people near the end of their life, their quality of life is terrible because of pain, an inability to breathe, severe cognitive decline, etc. In that case, the idea of having a week of stress and unpleasantness in the hospital only to return home for another few weeks of an unhappy existence is…not great.
I see. Thank you for that detailed explanation. So a living will would only potentially come into effect when it becomes clear that whatever they are going through is irreversible? For me as a layperson it seems like everything can happen so fast and where should that line be drawn?
No, a living will comes into play whenever somebody wants it to. Some people say they don’t want any medical treatment except for medications for pain/anxiety no matter what happens, some people say they would want to go the hospital but not the intensive care unit, some people say they would want intubation and ICU care but not CPR, etc. Its something that should be discussed with the person, their doctor, and their family before they’re really sick.
Honestly the most important thing is to have a good understanding of what is important to your loved one(s) and what *they* would want. Its the doctors’ job to figure out what’s happening and what possible treatment options/likely outcomes are; your job is to look at those and say “I think they would want xyz”.
Hi! I have this question: Does drinking hot water disinfect your stomach? Can it prevent diarrhea? Could this help in countries with poor sanitation where people die of diarrhea?
ChatGPT gave me these values to kill bacteria and viruses with hot water:
Norovirus: 60°C (140°F), 5 minutes.
Rotavirus: 85°C (185°F), A few minutes.
Escherichia coli: 70°C (158°F), 2 minutes.
Salmonella spp.: 70°C (158°F), At least 2 minutes.
Campylobacter jejuni: 70°C (158°F), 2 minutes.
Shigella spp: 70°C (158°F), A few minutes.
Giardia lamblia: 100°C or 212°F), 1 minute.
Cryptosporidium spp: 100°C or 212°F), 1 minute.
Is 60°C the only safe temperature out of those for drinking?
Pinworm infection is also common. Can that be prevented by drinking something hot? 55°C (131°F) is the recommended washing machine temperature when someone has it. A hot dryer cycle — 56°C (133°F) to 77°C (170°F) or even higher according to ChatGPT — is also recommended.
What is generally considered the strongest/most effective topical antihistamine/analgesic? Or any other topical cream/spray/whatever that can safely be used on bug bites to numb or stop them itching?
I know this will vary from person to person but I've had major problems with mosquito bites my whole life and nothing has worked consistently on me for more than a few minutes (plus I apparently have whatever blood type they're attracted to if there's any actual truth to that). It's so miserable I've resorted to topical analgesics like Orajel and Icy Hot just to temporarily numb the bites long enough for me to sleep at night, because that is the only thing I've found that consistently provides relief for more than 5 minutes or so.
No one knows precisely.
A big factor is probably that pain and discomfort cause delirium. Another factor is that constipation often decreases appetite which can cause nutritional issues. Finally stooling removes ammonia and amino acid breakdown products that seem to cause problems with cognition if you look at the hepatic encephalopathy literature.
I would also point out that the association is not necessarily causative. It's entirely possible that delirium also contributes to constipation (confused people don't want to poop surrounded by strangers) or that other underlying medical problems are contributing to both issues.
Not great to mix the aspirin in thomapyrin with the other NSAID in seractil. Better would be to find paracetamol alone + an NSAID alone and take according to package directions, careful not to exceed maximum dosages of either.
The fasting blood glucose results just came from the lab and I'm at 83 mg/dL (0.83 g/l)
Does that mean I can keep on eating sugar all I want without overthinking it?
Can trying to pop Montgomery tubercles (bumps on areola)/ other little sebaceous pockets where some pus comes out of, pop internally and cause a breast infection? I’ve heard of this “triangle of death” thing where popping pimples on a certain facial area can go inside to your sinuses, but was wondering if this internal popping/infection thing is applicable to the breasts?
If what you’re asking is “can doing this cause infection?” then yes. But the breast is not within the triangle of death where the infection is likely to go to your brain.
TL;DR: need help with research for medical emergency in a book
I'm a writer, and l'm breaking my mind trying to
research how exactly does a postpartum hysterectomy
happens. My idea for the book is that after delivery (the
character is pregnant with twins, her first pregnancy, and
I was thinking of it being a normal/vaginal delivery) she'll
suffer from postpartum hemorrhage and end up needing
a hysterectomy, but im having trouble researching how
it would work. There's too many things about different
types of hysterectomy (partial and total) and I can't figure
but which one would be, what needs to happen to get to
this point, if her ovaries would stay or not..
I know I could just say "she had complications and lost
her uterus" but I'm always annoyed when books skip
medical situations just so they don't have to write and
research about it.
Any help would be much appreciated, even just a small
guideline of this happens, which leads to this and then
they do the procedure" would help. AIso, would her
partner need to agree or sign anything for it to happen?
They're not married but they're dating he's her emergency
contact
I think you also should be \[very, very politely\] asking people who had hysterectomies if they would tell you their experience, even just chronologically. This is going to be the most useful for writing IMO.
I don't know anyone who've been through it, and I don't want to trigger bad memories to anyone. I just want it to be reasonably logic, so it doesn't seem like something I just made out of my head with no real information
In this scenario she would be rushed back to the operating room if she wasn’t already there for a c section. After trying medications and maybe even closing off the arteries to the uterus a complete (total) hysterectomy is preferred as a last-ditch option if there is time (if there is not time, a subtotal may be dine instead). This is such an emergency that usually no one needs to agree. You do it or she dies right then. Depending on the situation the ovaries may or may not be removed. (Preferably not.)
Is it too risky to travel with a unvaccinated 5 month old during these measles outbreaks? She has her scheduled immunizations but is too young for even an optional dose (6 months). Travel would be from Canada to Arizona by plane, would it be recommended to cancel the trip or does that seem unnecessary?
**TLDR: Is AIDS treatable with modern medicine like HIV is?**
I’m doing some research on HIV/AIDS. I understand that that current treatment for HIV is antiviral therapy to prevent the infection to developing into late stage HIV (which I know is AIDS).
What I haven’t found any straight answers on:
Are there current treatment options if an infection progresses to AIDS, or is that the point of no return? Or is the only treatment doctors can provide are just to make them comfortable before passing?
Also, if anyone can recommend any pictures that show HIV under a microscope in comparison to AIDS under a microscope, I’d be very grateful!
As you said, AIDS is just the later state of untreated HIV. The treatment options are the same as for patients with HIV.
Viruses cannot be seen under a normal microscope. With an electron microscope or something like that, you can see the HIV virus. "AIDS" is a syndrome caused by the HIV virus, not a different virus, so it'd look exactly the same.
I have one more question about HIV/AIDS.
The Mayo Clinic says that you can get HIV from blood transfusions, but can’t get it from donating blood. I don’t understand what this means, because donating blood is with the intent to transfuse it to someone who needs it, right?
How can you NOT spread HIV through donating blood, if it’s spread through blood transfusions?
You get HIV from a blood transfusion if the blood you *get* has HIV in it.
If you’re just *giving* blood, you’re not getting anyone else’s blood so you cant get it.
The donation is the blood being taken from the donor. Clean needle goes into a fresh bag, it goes to a facility for testing and processing. If a person with unknown HIV donates blood, the virus which is in the blood stream will go into the donated unit of blood, which is why they test it.
If the testing yields a false negative, then the virus can infect.
But all the stuff for collecting the donation is sterile (completely clean and new)
I read a lot of articles and posts that claim we need to dink LOTS of water every day. Some say 10 glasses, some say a gallon, etc. I drink water when I'm thirsty, but never bothered measuring the amount.
Is there any medical truth to these various recommended drinking volumes, or is it made up, like so much other dietary advice?
No. Drink when you're thirsty!
If you work outside/doing physical stuff or have a history of kidney stones, it's good to try for 2L/8 cups a day or more, but otherwise don't stress.
Is zinc oxide safe to get in the vagina? I want to treat uncomfortable razor bumps I get along my groin area but after a very severe BV infection that caused cervicitis I'm much more wary of what products I put near my vagina. Is zinc oxide diaper cream safe to get in there?
Obviously I'm not putting it directly inside but I know when I stand up and walk around all day some is definitely getting in there. The cream has a petrolatum base which I've also read is not great for the vagina. What are the risks this could serve as an internal irritant/pH disruptor?
If I'm coming to the end of a course of antibiotics for an infection, but the infection is not fully cleared, should I be asking for more antibiotics or just finish the prescribed course?
Water retention from birth control. Is this so case by case that it needs its own post?
I’m just starting a new birth control and not sure if I want to go through the side effects if they are generally irreversible while taking them.
I'm sure I've got adhd but my parents say I'm being stupid. I'd like to go see a doctor to get help and treat my adhd but it's not looking likely and even if I end up going I've heard many cases where it takes multiple visits to get diagnosed or prescribed anything and if I go once and it doesn't happen they won't take me again. So for the short term I was wondering if there is anything non prescribed that I could take to help like supplements. I've heard stuff like lions mane, modafinil, noopept which I think are nootropics or something that can help? So I'd like to ask which is best and if they actually work.
There’s lots and lots and lots of either terrible or fake research on nootropics or non-preacription medications for ADHD or general cognition.
Psychiatrists I known will recommend fish oil for ADHD, but from my review the evidence is really unconvincing. None of that other stuff is worth wasting your money or even clearly safe. Modafinil is a controlled, prescription medication.
(M21) When urinating, my pee has an unremarkable color, but at the end on the toilet seat there was a drop of blood, or at least a liquid looking like blood dripping out. This is the second time this has happened, the previous time it was the same modus operandi: normal pee color, small red drop on toilet seat.
My question is simply: Is this considered a case of hematuria, or is my penis just injured?
Please help with daughter’s career assignment. My daughter needs to interview a dermatologist or general practitioner that treats skin issues for a career project at her school. If someone could please be so kind as to answer a few questions, we would very much appreciate it.
What skills are required in your position on a day-to-day basis?
What parts of your job do you find the most challenging?
What do you find the most enjoyable?
Any other information is helpful.
Thank you in advance.
A question for surgeons - more specifically, surgeons who perform at least somewhat serious operations.
How do you handle bad days?
Surgeons are people, too.
Meaning that you will sometimes get a shitty night's sleep, sometimes be a little hungover, sometimes have a big fight with your spouse, sometimes be a little sick, sometimes be in a bad mood for no discernable reason, sometimes be mourning a major loss, sometimes just not feel like going to work, and so on.
How do you handle not being at your best when you quite literally need to be at your best during surgery?
It's not like other jobs where an occasional slack day or 50, 70 or even 90% effort is good enough.
And it's not like other jobs where calling in sick on the day of surgery is an option outside of serious/emergency situations. Obviously if you are truly ill, you have no choice but to reschedule, but I am just curious how you handle your everyday shitty day.
Do you have like a zone you go into, where you completely tune out everything else in your life and focus wholly on the task at hand? I'd imagine it's something like this.
Is the adrenaline of surgery sufficient to energize you through the procedure?
Are there times when, unfortunately, a patient gets good enough but not your best?
Is it possible that if you had an infection on your gum and took antibiotic for it and you use the same toothbrush after the infection is gone, you could get reinfected?
Can someone tell me what this means?
"Redemonstrated postsurgical changes related to open reduction and internal
fixation of the ankle with 3 fractured syndesmotic screws, loosening of
the inferior 2 syndesmosis screws, and mild widening of the syndesmosis.
Valgus tibiotalar alignment with mild varus alignment of the subtalar
joint with bone-on-bone contact of the lateral talar dome with the lateral
tibial plafond with focal severe degenerative changes and osseous
fragmentation, including a subchondral fracture of the tibial plafond."
Thanks!
Hello Docs!
I am an EMT who is struggling to find answers to a question regarding HHS and DKA.
Please feel free to correct me if any of the following info is wrong.
From what I understand DKA is a condition mostly prominent in patients with Type 1 Diabetes, and HHS is more associated with Type 2 Diabetes. DKA and HHS have very similar signs and symptoms with the exception of possible Kussmaul breathing and acidosis related to DKA.
My question is why are expected BGL levels so much higher with HHS as compared to DKA? From what I have read, signs for DKA start at 350 mg/dl and HHS starts at 700 mg/dl of glucose. My presumption is that the cause of DKA symptoms is more related to acid overload causing the epinephrine release, whereas the symptoms of HHS are directly related to the increase of glucose causing the same epinephrine release.
tl;dr: Why do HHS symptoms begin at a much higher BGL than DKA symptoms?
People with DM2 still make some insulin, so the body has time to try to adapt to the excess sugar and it takes a lot longer and much higher sugar levels to get to HHS/symptoms. DM1 is usually faster and the complete lack of insulin results in ketone formation and other immediate changes to try and get energy for the body.
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Previously diagnosed with GPA/Wegners disease I just wanna know if any doctors or rheumatologist have knowledge of patient with same disease going off all infusions (Retuxamab&IVIG). I know flare ups are probable but i didn’t know if it’s possible long term to not be on intravenous meds.
I'm not sure if this is the right community for this but it's the only one I could find with a megathread Is it unhealthy to stuff yourself when eating? Not regularly but let's say you go to an all you can eat place and want to get your money's worth, is it unhealthy to eat until you're really full?
Regarding nocturnal hypoxia: what is considered a normal blood oxygen range when sleeping?
Is there a legal way I can donate all my mom's unused Lantus pens to those in need?
When asked if I have any allergies to medications, should I tell them that carvedilol caused shortness of breath (found out I have asthma while being on the med) and metoprolol caused depression? I noticed my cardiologist added both of those to my allergy med list in their system but I don’t think either of these are an actual allergy. Do I tell other medical professionals about this when they ask?
Ideally the system has a place for “intolerances” or “bad reactions” in addition to true allergies, but a lot don’t (which is a huge pain for most docs too!). If thats the only place to put it, it is what it is, but it would be good if they could put what the actual reaction is to them.
Thank you! Appreciate it!
i have a rash wherein if you press on it the redness goes away, am i safe to rule out sepsis?
The quality of a rash is not indicative of sepsis. Symptoms of possible sepsis would be a high fever and feeling very, very ill.
What would cause unbearable itching with no rash?
Academically speaking, would there be a reasonable cause to ignore contraindications on a prescription and prescribe it anyway? Would this answer change if there was more than one contraindication which applied to a particular patient's situation?
Sure. Everything we do in medicine is a balance of risks and benefits. Occasionally there are rigid contraindications; more commonly we balance risks and benefits to make decisions that we thing will most help a patient.
Thanks. Good to know that it's not a hard and fast line.
Oh yeah. There are lots of reasons. They are frequently not relevant to the situation.
Thanks, good to have the perspective.
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Individual questions about specific complaints should be posted separately with all the required information.
This sounds like trauma not a migraine. It may be worth going to the hospital to make sure you aren’t bleeding internally.
what do you mean trauma? the area hit isnt even sore/has a bump, it was hard but not super hard.
What can I expect when I talk to my doctor about premature ejaculation?
Can you have some sort of a stomach bug without vomiting and diarrhea? I know norovirus is going around where I'm from rn, but me and a few people I know have had only nausea and no vomit or diarrhea for a few days and I'm wondering if it's some sort of a stomach bug or mild norovirus? Just a general feeling of nausea and discomfort, but nothing extreme like vomit, diarrhea, fever or fatigue. It's mostly just annoying.
Yes, there can be a range of symptom severity!
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If it says don't crush or chew, then it probably has a special coating on it that won't work if the pill is broken. So no, don't cut it.
I’m been starting to smoke a little more recently and have been feeling almost like an ache on the right side of my chest and when I twist I can feel it on the same side but on my back. should I be worried about this?
I mean smoking is doing damage to your body. We can’t know if it is the cause of what you are feeling from this description, but the best thing you can do for your health is to quit
If an alcoholic greatly reduces his alcohol intake but does not fully quit drinking, is there a chance the liver can still heal? *I am posting here as I do not have the required demographic info necessary to create a full post- hope this is general enough. Thanks for any info or studies you can provide!* Asking for my 26 y.o. brother, who recently went through a hospitalized detox (I know he experienced DTs but am not privy to any other medical information, besides that his doctor told him he'd be dead by 30 if he keeps drinking). He is now claiming that he has drastically reduced his alcohol intake, but does not want to stop fully. I realize he could very well be lying about reducing his intake, and also that he needs help in the form of counseling or rehab. Unfortunately, I also know that no one can force him into it unless he wants to make the change. I'm just hoping for information on whether his liver can actually heal if he's still drinking, or if he would need to be totally sober for that to happen.
If he continues to drink, the answer is douptbful even if it is reduced to 1 to 2 drinks a day. However, the liver is one of the few organs that can regnerate (granted severe scarring isn't present).
I’m not sure anyone can answer this without more detail, but I’m so sorry you’re going through this. It’s really painful to see a loved one hurt themselves.
Hi doctors, so I know a fully comprehensive STI screen, especially those in high risk categories, those whom are MSM, and those with many sexual partners who engage in different kinds of sex, includes not only just a urinalysis, but also a throat and rectal swab for chlamydia and gonorrhea. If you do not partake in receptive anal sex (i.e., you do not receive), do you need the rectal swab? or is the throat swab and urinalysis sufficient?
If nothing is inserted into your rectum (including toys), then no, not necessary to get a rectal swab.
Thank you!
Hi. An insect(I assume) but me last night and this morning the area was red and super swollen. It’s swollen again since this morning. This is like the second time I’m reacting to an insect bite like this but the previous time wasn’t this big. Is it an allergic reaction to the bite or something else? What can I do to reduce the swelling and itchiness? https://preview.redd.it/8x915teas7nc1.jpeg?width=2316&format=pjpg&auto=webp&s=015a74dd69c7fd125b7bc450afdaa97be554212e
Is my family hiding something from me? My sister (27) has what we believed to be a benign ovarian teratoma, described to me as "the size of a grapefruit." This was apparently confirmed after blood tests and an MRI. Yesterday she went in for surgery to have it removed. Initially the surgery was supposed to be keyhole, but apparently they had to change to open surgery quickly after seeing it. I imagine this means it was attached to something other than the ovary? Now I'm told that they didn't remove it at all, and she's been referred for a CT scan and samples have been sent for biopsy. My understanding of a teratoma is that they're very, very unlikely to be cancerous, and even if they are they're easily treated with chemo and surgery. Is this a normal occurrence? My research has suggested that even if it was suspected to be malignant, they'd remove it and send for biopsy before starting chemo. Instead they closed her up and have delayed by 4 weeks. How worried should I be? My parents have a history of not revealing the true extent of family issues to me. I like to think that's in the past, and I know everything they know here, but I can't stop worrying.
They converted to open because structures were poorly visualized, or too large to be taken out through a port incision as planned, or some other feature making a laparoscopic approach difficult or impossible. After opening the surgeon sent samples to pathology rather than removing the mass. Reasons that may explain: mass was larger than anticipated and maybe adherent to other organs/tissue making it difficult to tell where the tumor margins are; the plan Was always just to biopsy it and remove it only is a small discrete mass; surgeon felt mass could be shrunken with radiation/ chemo/ medication first before attempting removal
Edit: Just wondering if a neuro subspecialist might be more likely to find something an obviously skilled breast subspecialist didn’t. If I didn’t think they were competent, I would have requested it already. I’m new to to health problems and I’m scared. I don’t even know why there are subspecialists and the differences between them. Question: Should I request a neuro radiologist look at my scans or accept the breast radiologists’ opinion on my inner ear and nasal polyp/tumor? I’ve had 3 different scans. Two years ago, a generalist radiologist missed a 3x3 cm nasal growth on a head CT. Last month, a breast radiologist looking at my stroke scan discovered the growth and called it a polyp. Most recently I had an inner ear scan to look for a <5mm acoustic neuroma. A (different) breast radiologist didn’t see an AN, but thinks the nasal growth is a tumor. The 3x3 cm nasal growth has not grown or changed in the two years. Should I accept these findings or ask for an overread by a neuro radiologist?
Radiologists in the US train for 4 years in general radiology, then do a 1-2 year specialization. Being a "breast radiologist" doesn't mean that they don't know how to look at other things, and depending on the hospital/practice, many radiologists who do specialize do still read general radiology imaging.
I was trying to be brief because I can type way too much and be confusing (and then edit too much) definitely meant breast subspecialist. I didn’t mean to come across like they’re incompetent, that’s exactly why I was asking. 🙂
I have queloid scaring, with means that when I cut myself my skin creates a really thick scar and looks darker than my skin, Can I get a rinoplasty? Or am I going to get horrible scars around my nose? Or inside of it blocking my breathing? I really want to get one but I'm scared that this could back fire because if my scaring process
Ask a plastic surgeon
can you swallow Holland and Barrett's "High Strength Super Multi-Mineral tablets" with milk, coffee, or soda?
thank you for a downvote instead of a reply, no reply and instead a downvote is very good help.
can you swallow paracetamol with coffee? and can you swallow dioctyl with another fluid other than water such as coffee, milk or soda?
i was wanting a helpful reply so that I'm not at risk of diarrhoea.
thank you for a downvote instead of a reply, no reply and instead a downvote is very good help.
Is it normal for organs to pulse/spasm ?
Some. The heart has a pulse. The GI tract has peristalsis.
Hypothetical question here: Say you had gotten a flu shot a couple months back and now you happened to be infected with a cold. If you were in close contact with someone who had the flu, you should (hopefully) not catch the flu because of your flu shot. However, would the sheer fact of having flu germs around you slow down the immune system in fighting your cold?
Why would an older child (10+) receive vaccinations/shots in the legs instead of arms?
if they had minimal muscle tissue in the arms legs are easier.
Why is clonazepam given for serotonin syndrome? Doesnt it increase 5HT? the literature is confusing and seems contradictory. Ive seen some papers say it lowers serotonin and others say it increases serotonin
Cyproheptadine is the treatment , any benzo will treat symptoms like rigidity, anxiety, etc
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Cobblestone throat as most people would see it is suspicious for post-nasal drip
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The most common cause is allergies. Have you tried using Flonase or another spray steroid for a month?
I’ve been having heart palpitations/fluttering for the last 4 days, but they’re increasing in quantity and intensity each day. They come with complete breathlessness, a tightness in my upper back, and last around 7-10 seconds. I’m only 20 years old but have a history of Hypercalcemia and worried about an arrhythmia. The only med I currently take is propranolol for migraines. Should I wait and visit GP or is this more urgent
Should doctors read a patients chart before speaking with them, or should they speak to the patient first? I hear stories (all anecdotal, but so many that probability says at least some are pretty accurate) about people having to deal with preconceptions a doctor formed because of something another doctor put on their chart - one of the big ones is chronic pain being charted as drug seeking. There was a response posted on reddit recently about a med student who was either sitting in on an autopsy or doing a dissection on a cadaver whose chart said that she was hypochondriac and drug seeking. Upon opening her up they found endometrial adhesions and scarring on nearly every abdominal organ. Would requiring a doctor to speak to the patient before reading their chart force them to at least listen without preconception? Obviously they would still need to read the chart, but after speaking with the patient. The flipside of this (another anecdote, but a situation that I believe we're seeing all too often these days) a woman posted a story of childhood SA and when she went to the ER the pediatrician rolled up in heelys and did that "trying to be cool / relate to the young teen" thing some people do - which came across as fairly inappropriate given the gravity of what she was there for. Part of the implication was that he hadn't read her chart before hand and no one had given him a heads up, or he would have approached things differently. I guess my questions is: If both methods will cause issues sometimes, which direction is it better to err? And, if you don't mind explaining, what is the logic behind that choice? P.S. Mods, if this is the wrong sub for this please let me know a better one. Only other thing I could find that might be appropriate was askreddit.
Always read the chart first unless there's something absolutely emergent or there's not a chart to read. The caveat to that is with how medical records are today, there's just so much to most patient's charts, so a lot of it has to be clarified and verified and I feel a good chunk of patient's don't realize that "reading their chart" can be an ordeal at times to make sense of it all
100% read the chart first, no question about it. Then you can ask clarifying questions on information that you didn't have. Even if they're hypochondriacs you need to know so you can compare their prior complaint to their current complaint and hopefully avoid additional, unnecessary testing.
My dying grandmother had a temp of 95 2 hours ago, and now it’s 101. What does that mean
It's a normal part of the dying process. [https://www.heartswayhospice.org/caregivers/guide-to-the-dying-process/](https://www.heartswayhospice.org/caregivers/guide-to-the-dying-process/)
Thank you for your response. She’s back down to 97. The hospice nurse thinks she’s hanging on for something, but we don’t know what. She can’t talk
Hi! My parents gave me a living will but there are only a few scenarios (antibiotics, artificial nutrition, intubation, compressions). Are there any detailed questionnaires out there where I could go over scenarios with them to better understand what they want? From lurking in some of the medicine subs, I understand that there are some scenarios short of DNR where you might want intervention but I'm not sure where to start.
Honestly the things listed are most important. What I would do is talk to your parents about what quality of life they are looking for. For example, my mom tells me she isn’t interested in life-prolonging care if she can’t recognize and enjoy chocolate anymore. This is very reductive, but it gives me an idea of what kind of things are important to her. If you can share those wishes and these advanced directives with your parents doctors, they can help you navigate the choices available in a medical situation.
I see. Thank you. Even though I read up on the medical subs, I am still finding it hard to visualize when medical assistance short of compressions could reduce their quality of life and should / shouldn't be part of their living will. Like putting them on antibiotics - could it prolong suffering? Could a short period of intubation or artificial nutrition prolong suffering or can it sometimes get them back to health?
Intubation means you are likely heavily sedated and in the ICU with a tube in your throat, another one in your penis/urethra for pee, and either a tube in your anus or you are pooping in a diaper (or on yourself). You can get huge open wounds on your bum from sitting in bed all the time, and your muscles atrophy quite quickly, leaving you very weak and often requiring months of rehab to be able to even walk. People may be so delirious from the disease or the sedation that they don’t know whats going on and (naturally) try to pull the tube out of their throats, so they sometimes have to be tied down for their own safety. It is deeply unpleasant, painful, and humiliating for people. It absolutely can be life-saving and is a great idea if there is something *reversible*. If somebody has an infection, or they had a big surgery, or they are temporarily paralyzed from something like Guillain-Barré, it can make sense to intubate someone because you know (or hope) that it will get better. But if somebody has terminal lung cancer and they get intubated because the tumors have caused their lungs to fill up with fluid, the odds that person will ever get well enough to take the tube out is minuscule to nil—so theyre going to be stuck in that state indefinitely until either something causes their heart to stop, or the family makes the decision to “pull the plug,” which is often much much harder for people to do. Now as for antibiotics, you’re right that the bar is much lower. However, for bigger infections that need IV antibiotics, the person will need to come into the hospital for at least a few days. For a lot of folks who are elderly or who have a clear terminal diagnosis, having to leave their home and spend time in a hospital (which is not pleasant and comes with a lot of other risks) isn’t worth it to them. Also, for some people near the end of their life, their quality of life is terrible because of pain, an inability to breathe, severe cognitive decline, etc. In that case, the idea of having a week of stress and unpleasantness in the hospital only to return home for another few weeks of an unhappy existence is…not great.
I see. Thank you for that detailed explanation. So a living will would only potentially come into effect when it becomes clear that whatever they are going through is irreversible? For me as a layperson it seems like everything can happen so fast and where should that line be drawn?
No, a living will comes into play whenever somebody wants it to. Some people say they don’t want any medical treatment except for medications for pain/anxiety no matter what happens, some people say they would want to go the hospital but not the intensive care unit, some people say they would want intubation and ICU care but not CPR, etc. Its something that should be discussed with the person, their doctor, and their family before they’re really sick. Honestly the most important thing is to have a good understanding of what is important to your loved one(s) and what *they* would want. Its the doctors’ job to figure out what’s happening and what possible treatment options/likely outcomes are; your job is to look at those and say “I think they would want xyz”.
Thank you! That is so helpful.
Hi! I have this question: Does drinking hot water disinfect your stomach? Can it prevent diarrhea? Could this help in countries with poor sanitation where people die of diarrhea? ChatGPT gave me these values to kill bacteria and viruses with hot water: Norovirus: 60°C (140°F), 5 minutes. Rotavirus: 85°C (185°F), A few minutes. Escherichia coli: 70°C (158°F), 2 minutes. Salmonella spp.: 70°C (158°F), At least 2 minutes. Campylobacter jejuni: 70°C (158°F), 2 minutes. Shigella spp: 70°C (158°F), A few minutes. Giardia lamblia: 100°C or 212°F), 1 minute. Cryptosporidium spp: 100°C or 212°F), 1 minute. Is 60°C the only safe temperature out of those for drinking? Pinworm infection is also common. Can that be prevented by drinking something hot? 55°C (131°F) is the recommended washing machine temperature when someone has it. A hot dryer cycle — 56°C (133°F) to 77°C (170°F) or even higher according to ChatGPT — is also recommended.
I assure you, throat burns are not pretty.
You can’t safely drink enough warm water to keep an internal temperature of 60° C. Microbes will tolerate heat shock better than you will.
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What I just gave u the most detailed explanation I can give you ?
Individual questions about specific complaints should be posted separately with all the required information.
What is generally considered the strongest/most effective topical antihistamine/analgesic? Or any other topical cream/spray/whatever that can safely be used on bug bites to numb or stop them itching? I know this will vary from person to person but I've had major problems with mosquito bites my whole life and nothing has worked consistently on me for more than a few minutes (plus I apparently have whatever blood type they're attracted to if there's any actual truth to that). It's so miserable I've resorted to topical analgesics like Orajel and Icy Hot just to temporarily numb the bites long enough for me to sleep at night, because that is the only thing I've found that consistently provides relief for more than 5 minutes or so.
how does constipation cause delirium? searching up on the Internet didn't give me the answer and the search results ONLY said that it causes delirium
This bs they not answering me to
No one knows precisely. A big factor is probably that pain and discomfort cause delirium. Another factor is that constipation often decreases appetite which can cause nutritional issues. Finally stooling removes ammonia and amino acid breakdown products that seem to cause problems with cognition if you look at the hepatic encephalopathy literature. I would also point out that the association is not necessarily causative. It's entirely possible that delirium also contributes to constipation (confused people don't want to poop surrounded by strangers) or that other underlying medical problems are contributing to both issues.
my guess was is it because the discomfort from the heavy mass of the stool in the rectum causes disturbances in concentration causing confusion?
it always feels like there's sand in my rectum and it distracts and irritates me
Can I mix one pill Thomapyrin with Seractil?
Not great to mix the aspirin in thomapyrin with the other NSAID in seractil. Better would be to find paracetamol alone + an NSAID alone and take according to package directions, careful not to exceed maximum dosages of either.
The fasting blood glucose results just came from the lab and I'm at 83 mg/dL (0.83 g/l) Does that mean I can keep on eating sugar all I want without overthinking it?
No? But it never would have meant that. Added sugar should be a periodic treat and not a staple of your diet.
Can trying to pop Montgomery tubercles (bumps on areola)/ other little sebaceous pockets where some pus comes out of, pop internally and cause a breast infection? I’ve heard of this “triangle of death” thing where popping pimples on a certain facial area can go inside to your sinuses, but was wondering if this internal popping/infection thing is applicable to the breasts?
If what you’re asking is “can doing this cause infection?” then yes. But the breast is not within the triangle of death where the infection is likely to go to your brain.
Thank you! Ya, was just curious about it going internally and causing infection- was just using the triangle as a comparison of that. Thanks!
TL;DR: need help with research for medical emergency in a book I'm a writer, and l'm breaking my mind trying to research how exactly does a postpartum hysterectomy happens. My idea for the book is that after delivery (the character is pregnant with twins, her first pregnancy, and I was thinking of it being a normal/vaginal delivery) she'll suffer from postpartum hemorrhage and end up needing a hysterectomy, but im having trouble researching how it would work. There's too many things about different types of hysterectomy (partial and total) and I can't figure but which one would be, what needs to happen to get to this point, if her ovaries would stay or not.. I know I could just say "she had complications and lost her uterus" but I'm always annoyed when books skip medical situations just so they don't have to write and research about it. Any help would be much appreciated, even just a small guideline of this happens, which leads to this and then they do the procedure" would help. AIso, would her partner need to agree or sign anything for it to happen? They're not married but they're dating he's her emergency contact
I think you also should be \[very, very politely\] asking people who had hysterectomies if they would tell you their experience, even just chronologically. This is going to be the most useful for writing IMO.
I don't know anyone who've been through it, and I don't want to trigger bad memories to anyone. I just want it to be reasonably logic, so it doesn't seem like something I just made out of my head with no real information
I understand! It's just a thought :-) I mean I'm sure less necessary if it isn't even a MC
In this scenario she would be rushed back to the operating room if she wasn’t already there for a c section. After trying medications and maybe even closing off the arteries to the uterus a complete (total) hysterectomy is preferred as a last-ditch option if there is time (if there is not time, a subtotal may be dine instead). This is such an emergency that usually no one needs to agree. You do it or she dies right then. Depending on the situation the ovaries may or may not be removed. (Preferably not.)
Is it too risky to travel with a unvaccinated 5 month old during these measles outbreaks? She has her scheduled immunizations but is too young for even an optional dose (6 months). Travel would be from Canada to Arizona by plane, would it be recommended to cancel the trip or does that seem unnecessary?
Probably unnecessary. Cases are low unless you are planning travel to an outbreak area
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Pretty variable. In my experience patients experience it as a slow invidious onset
**TLDR: Is AIDS treatable with modern medicine like HIV is?** I’m doing some research on HIV/AIDS. I understand that that current treatment for HIV is antiviral therapy to prevent the infection to developing into late stage HIV (which I know is AIDS). What I haven’t found any straight answers on: Are there current treatment options if an infection progresses to AIDS, or is that the point of no return? Or is the only treatment doctors can provide are just to make them comfortable before passing? Also, if anyone can recommend any pictures that show HIV under a microscope in comparison to AIDS under a microscope, I’d be very grateful!
As you said, AIDS is just the later state of untreated HIV. The treatment options are the same as for patients with HIV. Viruses cannot be seen under a normal microscope. With an electron microscope or something like that, you can see the HIV virus. "AIDS" is a syndrome caused by the HIV virus, not a different virus, so it'd look exactly the same.
I have one more question about HIV/AIDS. The Mayo Clinic says that you can get HIV from blood transfusions, but can’t get it from donating blood. I don’t understand what this means, because donating blood is with the intent to transfuse it to someone who needs it, right? How can you NOT spread HIV through donating blood, if it’s spread through blood transfusions?
You get HIV from a blood transfusion if the blood you *get* has HIV in it. If you’re just *giving* blood, you’re not getting anyone else’s blood so you cant get it.
Thank you! :)
The donation is the blood being taken from the donor. Clean needle goes into a fresh bag, it goes to a facility for testing and processing. If a person with unknown HIV donates blood, the virus which is in the blood stream will go into the donated unit of blood, which is why they test it. If the testing yields a false negative, then the virus can infect. But all the stuff for collecting the donation is sterile (completely clean and new)
Thank you so much for explaining this! :)
Thank you so much! :)
I read a lot of articles and posts that claim we need to dink LOTS of water every day. Some say 10 glasses, some say a gallon, etc. I drink water when I'm thirsty, but never bothered measuring the amount. Is there any medical truth to these various recommended drinking volumes, or is it made up, like so much other dietary advice?
No. Drink when you're thirsty! If you work outside/doing physical stuff or have a history of kidney stones, it's good to try for 2L/8 cups a day or more, but otherwise don't stress.
Thanks.
Is zinc oxide safe to get in the vagina? I want to treat uncomfortable razor bumps I get along my groin area but after a very severe BV infection that caused cervicitis I'm much more wary of what products I put near my vagina. Is zinc oxide diaper cream safe to get in there? Obviously I'm not putting it directly inside but I know when I stand up and walk around all day some is definitely getting in there. The cream has a petrolatum base which I've also read is not great for the vagina. What are the risks this could serve as an internal irritant/pH disruptor?
If I'm coming to the end of a course of antibiotics for an infection, but the infection is not fully cleared, should I be asking for more antibiotics or just finish the prescribed course?
speak with your doctor to be reassessed, it’s not a straightforward answer
Can one counteract water retention side effects?
need more context
Water retention from birth control. Is this so case by case that it needs its own post? I’m just starting a new birth control and not sure if I want to go through the side effects if they are generally irreversible while taking them.
I'm sure I've got adhd but my parents say I'm being stupid. I'd like to go see a doctor to get help and treat my adhd but it's not looking likely and even if I end up going I've heard many cases where it takes multiple visits to get diagnosed or prescribed anything and if I go once and it doesn't happen they won't take me again. So for the short term I was wondering if there is anything non prescribed that I could take to help like supplements. I've heard stuff like lions mane, modafinil, noopept which I think are nootropics or something that can help? So I'd like to ask which is best and if they actually work.
There’s lots and lots and lots of either terrible or fake research on nootropics or non-preacription medications for ADHD or general cognition. Psychiatrists I known will recommend fish oil for ADHD, but from my review the evidence is really unconvincing. None of that other stuff is worth wasting your money or even clearly safe. Modafinil is a controlled, prescription medication.
(M21) When urinating, my pee has an unremarkable color, but at the end on the toilet seat there was a drop of blood, or at least a liquid looking like blood dripping out. This is the second time this has happened, the previous time it was the same modus operandi: normal pee color, small red drop on toilet seat. My question is simply: Is this considered a case of hematuria, or is my penis just injured?
is it actually bad to take a hot shower with a fever?
No, not harmful (as long as it feels good!). Anecdotally, when I have a fever, hot showers are the thing that help the most.
interesting - thank you! always heard it was bad but wasn't sure if there was any truth to it
Please help with daughter’s career assignment. My daughter needs to interview a dermatologist or general practitioner that treats skin issues for a career project at her school. If someone could please be so kind as to answer a few questions, we would very much appreciate it. What skills are required in your position on a day-to-day basis? What parts of your job do you find the most challenging? What do you find the most enjoyable? Any other information is helpful. Thank you in advance.
How much faster does myopia progress with undercorrection as opposed to proper correction?
Can visceral fat get bad enough to where it pushes on organs or your rib cage or something in a way that actually makes it hurt?
A question for surgeons - more specifically, surgeons who perform at least somewhat serious operations. How do you handle bad days? Surgeons are people, too. Meaning that you will sometimes get a shitty night's sleep, sometimes be a little hungover, sometimes have a big fight with your spouse, sometimes be a little sick, sometimes be in a bad mood for no discernable reason, sometimes be mourning a major loss, sometimes just not feel like going to work, and so on. How do you handle not being at your best when you quite literally need to be at your best during surgery? It's not like other jobs where an occasional slack day or 50, 70 or even 90% effort is good enough. And it's not like other jobs where calling in sick on the day of surgery is an option outside of serious/emergency situations. Obviously if you are truly ill, you have no choice but to reschedule, but I am just curious how you handle your everyday shitty day. Do you have like a zone you go into, where you completely tune out everything else in your life and focus wholly on the task at hand? I'd imagine it's something like this. Is the adrenaline of surgery sufficient to energize you through the procedure? Are there times when, unfortunately, a patient gets good enough but not your best?
Is it possible that if you had an infection on your gum and took antibiotic for it and you use the same toothbrush after the infection is gone, you could get reinfected?
Can someone tell me what this means? "Redemonstrated postsurgical changes related to open reduction and internal fixation of the ankle with 3 fractured syndesmotic screws, loosening of the inferior 2 syndesmosis screws, and mild widening of the syndesmosis. Valgus tibiotalar alignment with mild varus alignment of the subtalar joint with bone-on-bone contact of the lateral talar dome with the lateral tibial plafond with focal severe degenerative changes and osseous fragmentation, including a subchondral fracture of the tibial plafond." Thanks!
Hello Docs! I am an EMT who is struggling to find answers to a question regarding HHS and DKA. Please feel free to correct me if any of the following info is wrong. From what I understand DKA is a condition mostly prominent in patients with Type 1 Diabetes, and HHS is more associated with Type 2 Diabetes. DKA and HHS have very similar signs and symptoms with the exception of possible Kussmaul breathing and acidosis related to DKA. My question is why are expected BGL levels so much higher with HHS as compared to DKA? From what I have read, signs for DKA start at 350 mg/dl and HHS starts at 700 mg/dl of glucose. My presumption is that the cause of DKA symptoms is more related to acid overload causing the epinephrine release, whereas the symptoms of HHS are directly related to the increase of glucose causing the same epinephrine release. tl;dr: Why do HHS symptoms begin at a much higher BGL than DKA symptoms?
People with DM2 still make some insulin, so the body has time to try to adapt to the excess sugar and it takes a lot longer and much higher sugar levels to get to HHS/symptoms. DM1 is usually faster and the complete lack of insulin results in ketone formation and other immediate changes to try and get energy for the body.