Medical Advice Thread - Does this look infected?

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It's hard to suggest a proper course without knowing the exactly fungus and exactly what has failed. If something is truly completely azole resistant and was also resistant to the allylamines &/or butenafine, I'd probably get a specialist involved. If one just keeps throwing things at a fungus you can end up with some really nasty shit and desperate options.
It's a yeast infection under my breasts, that's what a doctor told me from looking at it but they did not test it or tell me the type, just told me to use OTC yeast infection cream. I've not been told I am antifungal resistant, I just want to avoid it or contributing to it or having it happen to me. My GP gave me loprox cream bc I asked and it seems to work if I use it everyday.
 
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It's a yeast infection under my breasts, that's what a doctor told me from looking at it but they did not test it or tell me the type, just told me to use OTC yeast infection cream. I've not been told I am antifungal resistant, I just want to avoid it or contributing to it or having it happen to me. My GP gave me loprox cream bc I asked and it seems to work if I use it everyday.

But it comes back? I wouldn't be too surprised by that. I'd consider Ciclopirox to be underpowered for a persistent topical yeast infection. Ciclopirox does a better job with the tinea family. I'd probably give butenafine a try.
 
But it comes back? I wouldn't be too surprised by that. I'd consider Ciclopirox to be underpowered for a persistent topical yeast infection. Ciclopirox does a better job with the tinea family. I'd probably give butenafine a try.
It only goes away if I use it twice a day like the doctor wrote on the prescription but if I'm lazy it comes right back.
 
It only goes away if I use it twice a day like the doctor wrote on the prescription but if I'm lazy it comes right back.

That would be a good indication that it is being suppressed, but is not actually being cleared. That is a good setup for creating resistance. If possible I'd give topical butenafine or terbinafine a try. BID (Twice a day) for 7 days, if that fails, then give it another week.
 
That would be a good indication that it is being suppressed, but is not actually being cleared. That is a good setup for creating resistance. If possible I'd give topical butenafine or terbinafine a try. BID (Twice a day) for 7 days, if that fails, then give it another week.
Is that OTC in Canada? I saw a derm today and she gave me Canesten with hydrocortisone and said they work better together.
 
The derm also gave me Betaderm for the psoriasis on my elbows and then I was telling her about how I was wondering if I have psoriatic arthritis and she sent a note to the GP to do axial xrays and see a rheumatologist. I feel like I may finally get to the bottom of this.
 
What is an alternative to cruciferous veggies for lowering estrogen?
If you’re a woman: I would confirm levels first with your actual doctor and then consider the progesterone only mini pill or something to stabilize your hormone levels instead of dealing with the cyclical fluctuation that happens naturally pre menopause.

If you’re a guy: I would confirm levels with your doctor and then ask him what to do. I don’t think eating or not eating tons of broccoli and kale will meaningfully affect your estrogen levels or we’d see it happening in people obligated to eat those diets like subsistence farmers.
Don't be fat
  • Don't eat like a retard
  • Get enough high quality sleep (no caffeine after like 1pm)
  • Don't take birth control
  • Don't drink or do drugs
Basically be a normal, heathy person. I haven't run across any over-the-counter pills you can take that will lower estrogen, at least for men. Natural aromatase inhibiters all seem to be bullshit.
All good advice in moderation but I don’t think it’ll target estrogen blood levels specifically. No return should go get a complete hormone panel; estrogen is a downstream end product of FSH so they could have something wrong with their pituitary gland and its regulating hormones and the main symptom is higher estrogen. It would suck to be super focused on trying to reduce estrogen only to learn later you’ve got bigger probs (like a pituitary gland tumor would be a worst-case scenario.)

Disclaimer: this is all cowboy medicine and I’m known for recklessness when it comes to this sort of thing.
 
They think my dad has some type of genetic kidney disease and the doctor is worried for me and my siblings. Is PKD most likely? I looked at my own WGS results and saw 5 benign mutations on the PKD1 gene associated with PKD. But none of them were listed in Clinvar as pathogenic.
Three benign and one unknown on PKD1L1. PKD1L2 has a few missense mutations, one is not conserved, one is moderately and one is highly. But these variants aren't in Clinvar. PKD1L3 has two stop gained mutations, one that is moderately and one highly conserved. then there are 9 other mutations, most are missense and a couple are intron.
PKD1P4 has one splice donor variant. PKD2L2 has a couple missense variants.
Are any of these suggestive of PKD? Is it normal to have this many mutations in PKD genes? Should I just ignore this stuff bc it's not in Clinvar? Is PKD polygenic or monogenic? Would mutations "add up"? Do all PKD genes effect the disease or only some?

The software marks this like it doesn't like it but it is not reported in Clinvar:


1690924694372.png

According to this study, it's mostly caused by variants on PKD1 and PKD2:
Autosomal dominant polycystic kidney disease (ADPKD) is caused mainly by pathogenic variants in PKD1 or PKD2 encoding the polycystin-1 and -2 proteins.
 
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So what's the deal with Q-Tips and ears?

All my life from childhood to adulthood I've been cleaning my ears with them, never had an issue. Like a month or two ago I had to go to an ENT to remove a chunk of wax that was stuck in my left ear, even after trying to use earwax drops to remove it. Thankfully my hearing isn't fucked-up but the girl at the front counter asked me if i was cleaning my ears with Q-Tips, and when I said yes, she said i shouldn't be doing that.

So how exactly do I clean my ears the "right" way if I've been doing it wrong all these years?
 
So what's the deal with Q-Tips and ears?

All my life from childhood to adulthood I've been cleaning my ears with them, never had an issue. Like a month or two ago I had to go to an ENT to remove a chunk of wax that was stuck in my left ear, even after trying to use earwax drops to remove it. Thankfully my hearing isn't fucked-up but the girl at the front counter asked me if i was cleaning my ears with Q-Tips, and when I said yes, she said i shouldn't be doing that.

So how exactly do I clean my ears the "right" way if I've been doing it wrong all these years?
The problem with q-tips are that they can't really scoop the wax, so you often end up pushing it deeper into the canal. This can either cause it to get lodged (like you described), or, in the worst-case, can end up rupturing the eardrum if you push it too hard/deep.

It's generally recommended to flush it with warm water; as that has the least risk of hurting something. You can buy a little bulb thing that can help with that.

You can also buy cleaning kits like this at a pharmacy or something.
90d32daf-2cc4-4fce-add3-bcdee907288a_1.0e18339edd637250022ce0fa38cd82e3.png
Use drops to soften the wax up and the little scoop thing to clear any excess. You just need to be really careful with the scoop as to not push the wax in deeper or hurt something.
 
They think my dad has some type of genetic kidney disease and the doctor is worried for me and my siblings. Is PKD most likely? I looked at my own WGS results and saw 5 benign mutations on the PKD1 gene associated with PKD. But none of them were listed in Clinvar as pathogenic.
Three benign and one unknown on PKD1L1. PKD1L2 has a few missense mutations, one is not conserved, one is moderately and one is highly. But these variants aren't in Clinvar. PKD1L3 has two stop gained mutations, one that is moderately and one highly conserved. then there are 9 other mutations, most are missense and a couple are intron.
PKD1P4 has one splice donor variant. PKD2L2 has a couple missense variants.
Are any of these suggestive of PKD? Is it normal to have this many mutations in PKD genes? Should I just ignore this stuff bc it's not in Clinvar? Is PKD polygenic or monogenic? Would mutations "add up"? Do all PKD genes effect the disease or only some?

The software marks this like it doesn't like it but it is not reported in Clinvar:


View attachment 5245639
According to this study, it's mostly caused by variants on PKD1 and PKD2:

I'm assuming you are talking about ARPKD (Autosomal Recessive Polycystic Kidney Disease) rather than ADPKD (Autosomal Dominant Polycystic Kidney Disease). ADPKD can involve PKD1, PKD2, or PKD3 and has multiple modifier genes that change the phenotypic expression of the disorder. ARPKD is caused by PKHD1 and is monogenic. However, PKHD1 is differentially spliced and is known for having multiple recessive genotypes, sometimes leading to compound heterozygosity which can lead to differences in phenotypic expression. If the pathogenicity of a given mutation is unknown then it is impossible to know if they are synergistically pathogenic or not. As such, you basically can note it, but not much else.
 
I've had a recurring medical issue for the last about 10 years. I'll go through a period of 2 to 6 months of intense, insomnia, stomach pain vomiting, lethargy, diarrhea, and a general disinterest in food, occasional chest pains, and weight loss (in that order ). I've been to nearly a dozen different kinds of specialists, and they're stumped. It'll hit randomly regardless of what my current lifestyle and health choices are. And it doesn't happen during specific part of the year either. It can be anywhere from 10 months to a year and a half between periods of sickness. I go from in pretty decent shape, to looking like I spent time in A POW camp. it's starting to impact both my livelihood and my personal obligations yet again, and this is a particularly poor time to fall ill. Any ideas or suggestions on things to bring up at my next doctor's visit would be greatly appreciated.
 
I've had a recurring medical issue for the last about 10 years. I'll go through a period of 2 to 6 months of intense, insomnia, stomach pain vomiting, lethargy, diarrhea, and a general disinterest in food, occasional chest pains, and weight loss (in that order ). I've been to nearly a dozen different kinds of specialists, and they're stumped. It'll hit randomly regardless of what my current lifestyle and health choices are. And it doesn't happen during specific part of the year either. It can be anywhere from 10 months to a year and a half between periods of sickness. I go from in pretty decent shape, to looking like I spent time in A POW camp. it's starting to impact both my livelihood and my personal obligations yet again, and this is a particularly poor time to fall ill. Any ideas or suggestions on things to bring up at my next doctor's visit would be greatly appreciated.

(I am not a doctor, so this is just internet advice)

The best advice I could give would be to start keeping a general journal to see if you can find a trigger pattern. Just spend 5 minutes once a day writing down the basics of what you ate, your stress level, medication, anything abnormal in your environment, etc, and then the next time it happens, you can look back and see if there's anything leading up to it. You can get apps that help you do that as well. If nothing else, it might rule stuff out.

The fact that you said it started with insomnia is interesting, I assume you've seen a neurologist already? Like I said, I'm just a retard on the internet, but it almost sounds like some sort of nervous system issue presenting as GI problems (as an example of how that could work, insomnia can be part of the prodrome of an abdominal migraine, although I've never heard of one lasting that long)

Do you take any medication during the episodes, and does anything help?
 
I grew up with *ADHD* And medication but I never really believed I had it once my symptoms were greatly reduced after getting off of all meds when I was 15. I'm 27 now, and it's only becoming apparent to me that I may still actually have some symptoms. For example, falling asleep during the day when I have a lull in work. I was working front desk job at a chiro helping move patients between different machines. And occasionally we would get lulls in how many patients there were and how busy we were. I also eat 5 meals a day typically 2-4 hours between each other. I would sometimes fall asleep within 20 minutes of a meal, typically in conjunction with a lull in activity level. I don't want to be medicated again, it fucked with me hard. Does anyone have any suggestions?
 
How is your sleep at night? It's not a panacea, but it's really easy to overlook chronic poor sleep and just see its side effects.
I usually wake up every hour. Roll over and go back to sleep. I've been taking magnesium glycinate to try to get deeper better sleep. Last night was good, had more time between my dinner and actually getting ready for bed so that may be part of it.
 
I've been going through some like lethargic episodes and weird stomach pains and gases shit and doctors tend to just say "oh your just depressed" or it's nothing or your a drunk. Quit drinking and have the same shit going on. I did get some vitamin prescriptions B12 and B12 and d3 which has helped but I've got to have some malabsorption or something going on.

I used to take tremfya for my weird skin but haven't been able to get it lately and I've heard that it also treats some other autoimmune shit so I think that's it but I think my brain hasn't been able to put that sentence together in front of a doctor.

I just hate doctors so much I don't know what to do about it.
 
I've been going through some like lethargic episodes and weird stomach pains and gases shit and doctors tend to just say "oh your just depressed" or it's nothing or your a drunk. Quit drinking and have the same shit going on. I did get some vitamin prescriptions B12 and B12 and d3 which has helped but I've got to have some malabsorption or something going on.

I used to take tremfya for my weird skin but haven't been able to get it lately and I've heard that it also treats some other autoimmune shit so I think that's it but I think my brain hasn't been able to put that sentence together in front of a doctor.

I just hate doctors so much I don't know what to do about it.
Don't go to regular doctors. They're not useful for anything but symptoms that are obviously a specific illness, as well as referring you to other doctors. Look them up yourself. Got gastrointestinal issues? Bing search for a gastroenterologist in your area (and make sure they're covered in your insurance's network). Skin issues? Find a dermatologist. You only go to a regular doctor for things you're certain of, such as having a UTI or getting a recurrent prescription.

falling asleep during the day when I have a lull in work. I was working front desk job at a chiro helping move patients between different machines. And occasionally we would get lulls in how many patients there were and how busy we were. I also eat 5 meals a day typically 2-4 hours between each other. I would sometimes fall asleep within 20 minutes of a meal, typically in conjunction with a lull in activity level. I don't want to be medicated again, it fucked with me hard. Does anyone have any suggestions?
That's not ADHD. That's normal. It's why siestas used to be taken. Stop eating so much. You're not helping your gut, and food makes you want to nap. Fasting makes your mental focus sharper. Find a way to keep your mind busy in those activity lulls too.
 
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