- Joined
- Apr 30, 2021
Atypical antipsychotics like Risperidone are good for both rage in retarded autists and irritability in high functioning autists.
Medical Advice Thread - Does this look infected?
- Thread starter MysticLord
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⚙️ Performance issue identified and being addressed.
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- Joined
- Sep 25, 2021
At one point in my life I found a lump on my testicle. This was many years ago. I went to a urologist and didn't understand his goofy accent. It turns out the lump was benign and it was operated on. During a follow-up appointment he was talking in his silly accent and I was just mindlessly saying "yeah" at the pauses. It turns out he was saying my foreskin was slightly stiff and he offered to remove it. I could still get my foreskin back to clean but it was uncomfortable. So I just mindlessly agreed to a circumcision without realizing it. Me, being young at the time, was too embarrassed to admit I hadn't understood what he said so I went along with it just assuming he needed to do a revision on the first surgery.
So to answer your question. After the surgery I was like what the fuck my foreskin is gone but was too embarrassed to say anything. At night, a nurse would wake me up every few hours to look at my dick and "make sure it was healing". Then early in the morning I got morning wood and split my sutures. If you go to get a circumcision and you've gone through, or at least have started puberty then ask if they can do something to stop random nighttime boners.
The moral of the story is it's better to risk appearing racist than just agreeing to a circumcision without realizing it.
I hope this answers your question.
- Joined
- May 5, 2022
Okay, I don't trust anywhere else (ironic) with this because fucking doctors and the medical industry have screwed my family over more than once.
I have what seem to be seizures or TIAs randomly currently, but the neurologist blows it off since I'm "young and shouldn't have any issues". Basically, prolonged stress will cause me to loose control of my right eye, and I get disorientated with vertigo. Thankfully I know when I get these attacks since I have a gut feeling the day I wake up.
Now here's the kicker, I had a life threatening infection that had me hospitalized from a sinus that went into the brain when I was younger, but I don't have any lasting damage. Eye doctor said eye+nerve is physically "fine". Head and neck CT show fine except for minor chronic sinus blockage on right ethmoid and sphenoid sinus. Contraindicated for MRI.
Aside from another neurologist/ENT, what else should I see?
The cardiologist believes it to be a heart issue, and wants to do an invasive trach ultrasound to confirm the lack of a small hole in the right chamber causing clots to form. Any thoughts on if I'm being fleeced and bullshitted or actually possible? Prefer not to do it if possible.
Summary for me:
Age<30, no elevated blood tests, healthy BMI, asymptomatic hypo-tension (95/45) and normal heart rate. ECG and EKG normal.
I have what seem to be seizures or TIAs randomly currently, but the neurologist blows it off since I'm "young and shouldn't have any issues". Basically, prolonged stress will cause me to loose control of my right eye, and I get disorientated with vertigo. Thankfully I know when I get these attacks since I have a gut feeling the day I wake up.
Now here's the kicker, I had a life threatening infection that had me hospitalized from a sinus that went into the brain when I was younger, but I don't have any lasting damage. Eye doctor said eye+nerve is physically "fine". Head and neck CT show fine except for minor chronic sinus blockage on right ethmoid and sphenoid sinus. Contraindicated for MRI.
Aside from another neurologist/ENT, what else should I see?
The cardiologist believes it to be a heart issue, and wants to do an invasive trach ultrasound to confirm the lack of a small hole in the right chamber causing clots to form. Any thoughts on if I'm being fleeced and bullshitted or actually possible? Prefer not to do it if possible.
Summary for me:
Age<30, no elevated blood tests, healthy BMI, asymptomatic hypo-tension (95/45) and normal heart rate. ECG and EKG normal.
Does anyone know how to deal with a severe chemical allergy? I cannot stand perfume or gas fumes since it causes an immediate headache and vertigo, but no anaphylaxis. This is why I don't have a social life because lol try explaining that one to women.
- Joined
- Apr 30, 2021
Okay @Manul Otocolobus, I got an 8am cortisol test but it's normal. I think she said 4.5 and the cut off was 5.5. My CRP went way down to 15 but she said some of the white blood cells are still elevated but not enough that she'd be concerned bc most of my tests have it.
My dad just got out of the hospital for 5 days (luckily he's fine) bc he had a heart attack and turns out he has hypertrophic cardiomyopathy.
They did like a billion tests like ekgs, echo, heart biopsy and lots of blood work. Apparently this condition is often genetic with autosomal dominant inheritance. I don't think they did genetic tests. It would be nice to know if my fatigue is related to my heart somehow. Or maybe it's caused by a de novo mutation that's harder to pass on? Or drug use (he's an ex-addict)?
Do any medfags know about or have some experience with this heart condition? Or just read any interesting research on it?
I might scan the notes the doctor gave with redacted personal info.
I've had an EKG once just to rule out fatigue caused by heart problems but it was normal. I feel a lot worse when I'm moving so maybe I should do a hotler test? I've been told my heartbeat is very fast.
His grandmother had one of the first pacemakers in the world when it was still experimental. She had 5 daughters and a doctor literally told her she should have never given birth bc of the strain on her heart and is lucky she survived childbirth.
My dad just got out of the hospital for 5 days (luckily he's fine) bc he had a heart attack and turns out he has hypertrophic cardiomyopathy.
They did like a billion tests like ekgs, echo, heart biopsy and lots of blood work. Apparently this condition is often genetic with autosomal dominant inheritance. I don't think they did genetic tests. It would be nice to know if my fatigue is related to my heart somehow. Or maybe it's caused by a de novo mutation that's harder to pass on? Or drug use (he's an ex-addict)?
Do any medfags know about or have some experience with this heart condition? Or just read any interesting research on it?
I might scan the notes the doctor gave with redacted personal info.
I've had an EKG once just to rule out fatigue caused by heart problems but it was normal. I feel a lot worse when I'm moving so maybe I should do a hotler test? I've been told my heartbeat is very fast.
His grandmother had one of the first pacemakers in the world when it was still experimental. She had 5 daughters and a doctor literally told her she should have never given birth bc of the strain on her heart and is lucky she survived childbirth.
- Joined
- Apr 30, 2021
OK here is his discharge info I converted to text and deleted the identifying info. Tried to format it less retarded but idk how. Can anyone explain this in plain English?
Admission Diagnosis: ?7ACS
Diagnosis Responsible for the Greater Part of Patient's Length of Stay: Cardiomyopathy
Discharge Diagnoses: Cardiomyopathy NYD, ? Takotsubo vs HCM
Normal coronary artery on cardiac cath
Allergies: No Known Allergies
Past Medical/Surgical History, Co-Morbid Illness and Risk Factors:
1. Ex-smoker quit 4 years ago
2. Abdominal Migraines
3. COPD
4. Para ophthalmic ICA aneurysm awaiting surgery
5. Abdominal hernia
6. GERD
Brief Summary of Course in Hospital: 57 year old man with history of abdominal migraine and PO
intolerant. His symptoms include being unable to eat, has made him lose 30 Ibs past year or so. Over past week, increasing episodes of nausea and vomiting, eventually presented to. ECG showed deep T wave inversion diffusely. Trop elevated at 140's range. Transferred to cardiology for further work up and management.
His presentation did no tfit with ACS clinically. Plavix stopped. ASA continued and ACEI added.
Echo done with contrast injection. The apex appears hypertrophied, measuring upto 1.7 cm. Mildly reduced left ventricular systolic function. LVEF 50% Hypokinesis of distal segments. Myxomatous mitral valve leaflets. Trace mitral regurgitation. Cardiac cath showed normal coronaries.
He was feeling fine, ambulating with no issues. His ASA stopped and started on low dose beta blocker.
His diagnosis possible Takotsubo vs Hypertrophic cardiomyopathy.
We will discharge him today on June 29th. Blood work sent for SPEP and Free Light Chain. Wewill arrange outpatient cardiac MRI to further evaluate for possible HCM. We will arrange follow up with doctor in 4 months with Hotler monitor.
Allergies
No Known Drug Allergy(---)
Complete List of Discharge Medications Medication Status Rationale for drug addition / change Prescription Prescription
Quantity Repeats
Amitriptyline HCl Tab Unchanged = a
20 mg po HS
bisOPROLOL Fumarate Tablet New Cardiomyopathy 90 Day(s) —_‘|--------
2.5 mg po once daily
Budesonide-Formoterol 200/6mcg Pwd Inh |Unchanged eo
2 inhalation inh QID -SYMBICORT
Buprenorphine-Naloxone SLTab8mg/2 |Unchanged aennnn eas
mg
16/4 mg SL once daily
Multiple Vitamins with Minerals New supplement 90 Day(s) --------
1 tab(s) po oncedaily
Pantoprazole Sodium EC Tab Unchanged fe a
40 mg po BID
Perindopril Tab New Cardiomyopathy 90 Day(s) --------
2 mg po oncedaily
Thiamine Mononitrate Tab New Suplement for 3 more days then stop |3 Day(s) nono
300 mg po oncedaily for 5 days See MAR
for start/stop date
Ondansetron Tab Unchanged ——
8 mg potid prn —s
Discontinued Home Medications Rationale For Discontinuation
* Discharge Planning - Preliminary Copy.**
1. Chest and abdomen X-Ray
INDICATION:Intermittent vomiting for year. Ongoing for the last week. No stomach pains. 30 pound weight loss in last year.
FINDINGS: CHEST: Norma lcardiomediastinal and hilar contours. There is subsegmental
atelectasis/parenchymalscarring in the right middle lobe. No consolidation or mass lesion. No pleural abnormality.
ABDOMEN:The bowel gas pattern is unremarkable with no evidence of bowel wall edema, dilatation, perforation or mass lesion. No urinary tract calcifications.
IMPRESSION:No diagnostic features in the abdomen. Subsegmentalat electasis/scarring right middle lobe.
This has been demonstrated on prior CTs in 2021 and 2020.
2. Echo
INTERPRETATION SUMMARY Contrast injection was performed. The apex appears hypertrophied, measuring up to 1.7 cm. Mildly reduced left ventricular systolic function.
LVEF 50%
Hypokinesis of distal segments. Myxomatousmitral valve leaflets. Trace mitral regurgitation. Consider a
diagnosis of hypertrophic cardiomyopathy. No prior study for comparison.
LEFT VENTRICLE Normal left ventricular size. There is concentric left ventricular remodeling. The apex
appears hypertrophied, measuring up to 1.7 cm.Left ventricular systolic function is mildly reduced. Ejection
fraction by Simpson's 49.8 %. Grade | diastolic dysfunction. Normal left atrial pressure. The distal segments
are hypokinetic.
RIGHT VENTRICLE Normalright ventricular size and systolic function.
ATRIA Normal left atrial size. Normal right atrial size. No obvious communication between the atria.
MITRAL VALVE The mitral valve leaflets appear myxomatous. Trace mitral regurgitation.
TRICUSPID VALVE Structurally normal tricuspid valve. Trace tricuspid regurgitation. There is insufficent
tricuspid regurgitation to assess right ventricular systolic pressure.
AORTIC VALVE Structurally normal aortic valve. No aortic regurgitation is present.
PULMONIC VALVE Pulmonic valve partially visualized. No obvious abnormalities noted. There is no
pulmonic valvular stenosis. Trace pulmonic valvular regurgitation.
GREAT VESSELS Theaortic root is normal size. The ascending aorta is normal size.
PERICARDIUM/PLEURAL There is no pericardial effusion.
3. Cardiac cath showed normal coronaries.
Operations and Procedures:
Not Applicable
Complications: Not Applicable
Outcome of Care and Condition Upon Discharge or Transfer: ambulating with no symptoms
Follow-up Plan, Recommendations and Pending Results at Discharge:
Follow-up Action Date for Action Action Status Person Responsible for
Action
Family physician 1-2 weeks To Be Arranged By Patient
Holter 3 months
Recommendations:1. Low salt diet
2. On Beta blocker and ACEI currently. Both at low dose which can be increased as tolerated.
3. We will arrange follow ups as mentioned above.
Pending Results at Discharge:
SPEP Free Light Chain
Patient Goals / Preferences of care: FULL CODE
Education and Instructions Given to Patient, Family or Authorized Representative: See medical
attention if chest pains, fainting or near fainting.
Medication on Discharge (DMR): Attached
Admission Diagnosis: ?7ACS
Diagnosis Responsible for the Greater Part of Patient's Length of Stay: Cardiomyopathy
Discharge Diagnoses: Cardiomyopathy NYD, ? Takotsubo vs HCM
Normal coronary artery on cardiac cath
Allergies: No Known Allergies
Past Medical/Surgical History, Co-Morbid Illness and Risk Factors:
1. Ex-smoker quit 4 years ago
2. Abdominal Migraines
3. COPD
4. Para ophthalmic ICA aneurysm awaiting surgery
5. Abdominal hernia
6. GERD
Brief Summary of Course in Hospital: 57 year old man with history of abdominal migraine and PO
intolerant. His symptoms include being unable to eat, has made him lose 30 Ibs past year or so. Over past week, increasing episodes of nausea and vomiting, eventually presented to. ECG showed deep T wave inversion diffusely. Trop elevated at 140's range. Transferred to cardiology for further work up and management.
His presentation did no tfit with ACS clinically. Plavix stopped. ASA continued and ACEI added.
Echo done with contrast injection. The apex appears hypertrophied, measuring upto 1.7 cm. Mildly reduced left ventricular systolic function. LVEF 50% Hypokinesis of distal segments. Myxomatous mitral valve leaflets. Trace mitral regurgitation. Cardiac cath showed normal coronaries.
He was feeling fine, ambulating with no issues. His ASA stopped and started on low dose beta blocker.
His diagnosis possible Takotsubo vs Hypertrophic cardiomyopathy.
We will discharge him today on June 29th. Blood work sent for SPEP and Free Light Chain. Wewill arrange outpatient cardiac MRI to further evaluate for possible HCM. We will arrange follow up with doctor in 4 months with Hotler monitor.
Allergies
No Known Drug Allergy(---)
Complete List of Discharge Medications Medication Status Rationale for drug addition / change Prescription Prescription
Quantity Repeats
Amitriptyline HCl Tab Unchanged = a
20 mg po HS
bisOPROLOL Fumarate Tablet New Cardiomyopathy 90 Day(s) —_‘|--------
2.5 mg po once daily
Budesonide-Formoterol 200/6mcg Pwd Inh |Unchanged eo
2 inhalation inh QID -SYMBICORT
Buprenorphine-Naloxone SLTab8mg/2 |Unchanged aennnn eas
mg
16/4 mg SL once daily
Multiple Vitamins with Minerals New supplement 90 Day(s) --------
1 tab(s) po oncedaily
Pantoprazole Sodium EC Tab Unchanged fe a
40 mg po BID
Perindopril Tab New Cardiomyopathy 90 Day(s) --------
2 mg po oncedaily
Thiamine Mononitrate Tab New Suplement for 3 more days then stop |3 Day(s) nono
300 mg po oncedaily for 5 days See MAR
for start/stop date
Ondansetron Tab Unchanged ——
8 mg potid prn —s
Discontinued Home Medications Rationale For Discontinuation
* Discharge Planning - Preliminary Copy.**
1. Chest and abdomen X-Ray
INDICATION:Intermittent vomiting for year. Ongoing for the last week. No stomach pains. 30 pound weight loss in last year.
FINDINGS: CHEST: Norma lcardiomediastinal and hilar contours. There is subsegmental
atelectasis/parenchymalscarring in the right middle lobe. No consolidation or mass lesion. No pleural abnormality.
ABDOMEN:The bowel gas pattern is unremarkable with no evidence of bowel wall edema, dilatation, perforation or mass lesion. No urinary tract calcifications.
IMPRESSION:No diagnostic features in the abdomen. Subsegmentalat electasis/scarring right middle lobe.
This has been demonstrated on prior CTs in 2021 and 2020.
2. Echo
INTERPRETATION SUMMARY Contrast injection was performed. The apex appears hypertrophied, measuring up to 1.7 cm. Mildly reduced left ventricular systolic function.
LVEF 50%
Hypokinesis of distal segments. Myxomatousmitral valve leaflets. Trace mitral regurgitation. Consider a
diagnosis of hypertrophic cardiomyopathy. No prior study for comparison.
LEFT VENTRICLE Normal left ventricular size. There is concentric left ventricular remodeling. The apex
appears hypertrophied, measuring up to 1.7 cm.Left ventricular systolic function is mildly reduced. Ejection
fraction by Simpson's 49.8 %. Grade | diastolic dysfunction. Normal left atrial pressure. The distal segments
are hypokinetic.
RIGHT VENTRICLE Normalright ventricular size and systolic function.
ATRIA Normal left atrial size. Normal right atrial size. No obvious communication between the atria.
MITRAL VALVE The mitral valve leaflets appear myxomatous. Trace mitral regurgitation.
TRICUSPID VALVE Structurally normal tricuspid valve. Trace tricuspid regurgitation. There is insufficent
tricuspid regurgitation to assess right ventricular systolic pressure.
AORTIC VALVE Structurally normal aortic valve. No aortic regurgitation is present.
PULMONIC VALVE Pulmonic valve partially visualized. No obvious abnormalities noted. There is no
pulmonic valvular stenosis. Trace pulmonic valvular regurgitation.
GREAT VESSELS Theaortic root is normal size. The ascending aorta is normal size.
PERICARDIUM/PLEURAL There is no pericardial effusion.
3. Cardiac cath showed normal coronaries.
Operations and Procedures:
Not Applicable
Complications: Not Applicable
Outcome of Care and Condition Upon Discharge or Transfer: ambulating with no symptoms
Follow-up Plan, Recommendations and Pending Results at Discharge:
Follow-up Action Date for Action Action Status Person Responsible for
Action
Family physician 1-2 weeks To Be Arranged By Patient
Holter 3 months
Recommendations:1. Low salt diet
2. On Beta blocker and ACEI currently. Both at low dose which can be increased as tolerated.
3. We will arrange follow ups as mentioned above.
Pending Results at Discharge:
SPEP Free Light Chain
Patient Goals / Preferences of care: FULL CODE
Education and Instructions Given to Patient, Family or Authorized Representative: See medical
attention if chest pains, fainting or near fainting.
Medication on Discharge (DMR): Attached
- Joined
- May 5, 2022
@Sparkling Yuzu
Can't quote the post (too long) but I see a few things (I am volunteer EMS so take my word with salt versus our more experienced medical here):
-Collapsed lung portion
-Heart issues due to thickening of heart and reduced blood flow (49.8%, normal is 50+ iirc, could be within error).
-"Regurgitation" as in backflow to the heart. Minor but still present and can cause unwanted clot issues. My grandparrent died from this is how I know
-"Myxomatousmitral valve leaflets", Aka, the mital valve is prolapsing (the valve sags/falls out of normal position)
- "FULL CODE" Heart stopped beating/ no breath at one point and EMS was going to have a bad day.
tl;dr Body having issues with Heart issues from age + unhealthy diet + smoking & weakness of the blood vessel in brain that would cause a hemorrhagic stroke (Para ophthalmic ICA aneurysm). The Aneurysm isn't a problem until it is, then, well... Good luck because EMS can't really do much and you'd better hope ER is close by.
It sounds like Leafland medical is a shitshow and a half, I can't wait until I have to go bribe doctors again when I'm back in asia for work.
Can't quote the post (too long) but I see a few things (I am volunteer EMS so take my word with salt versus our more experienced medical here):
-Collapsed lung portion
-Heart issues due to thickening of heart and reduced blood flow (49.8%, normal is 50+ iirc, could be within error).
-"Regurgitation" as in backflow to the heart. Minor but still present and can cause unwanted clot issues. My grandparrent died from this is how I know
-"Myxomatousmitral valve leaflets", Aka, the mital valve is prolapsing (the valve sags/falls out of normal position)
- "FULL CODE" Heart stopped beating/ no breath at one point and EMS was going to have a bad day.
tl;dr Body having issues with Heart issues from age + unhealthy diet + smoking & weakness of the blood vessel in brain that would cause a hemorrhagic stroke (Para ophthalmic ICA aneurysm). The Aneurysm isn't a problem until it is, then, well... Good luck because EMS can't really do much and you'd better hope ER is close by.
There are long term heart monitors up to a month (at least in burger land), you generally put them on the chest and press a button if you feel uncomfortable and it logs data to a phone and records it. This may or may not be helpful if your cardio suspects you have an arrhythmia but cannot reproduce it.
Also, I have been told ( @Manul Otocolobus correct me if this is bullshit) that sometimes a non-invasive ultrasound does not get a properly clear picture of the heart and if cardio suspects "small" holes in the heart they will order a Transesophageal echocardiography (Getting an medical probe shoved down your throat).
Have you tried genetic testing? There is a chance they could ID the issues from a DNA test sometimes with specific autoimmune diseases that are inherited.
Also, I have been told ( @Manul Otocolobus correct me if this is bullshit) that sometimes a non-invasive ultrasound does not get a properly clear picture of the heart and if cardio suspects "small" holes in the heart they will order a Transesophageal echocardiography (Getting an medical probe shoved down your throat).
Have you tried genetic testing? There is a chance they could ID the issues from a DNA test sometimes with specific autoimmune diseases that are inherited.
It sounds like Leafland medical is a shitshow and a half, I can't wait until I have to go bribe doctors again when I'm back in asia for work.
- Joined
- Jun 23, 2015
The initial clinical trials of suramin looked promising.
- Joined
- Apr 30, 2021
Thank you so much for your response, this makes sense. Part of his lung has collapsed? He has pretty bad COPD I think. I'm getting private WGS from an American company called Nebula Genomics. I doubt public healthcare would cover gene testing unless you have Huntington's or a potato baby.
He was supposed to get surgery for his aneurysm in January but hasn't yet bc there is a backlog of 2500 surgeries in my province bc of covid. He's going to get laparoscopic surgery putting in a coil and stents. She said the aneurysm is a "not the biggest she's ever seen, but a healthy size" lol.
He has a Hotler coming up in a few months. I think that's what you mentioned about pressing a button on his chest. He's also 6'1 and only 132 pounds which is pretty thin. Only good news is no plaque in his arteries.
- Joined
- May 5, 2022
Ah, the button on chest is a Holter, newer version in the US use a phone and a button to press to record "snapshots" only. I know those can be suggested for someone like you who said they couldn't detect arrhythmia (some only trigger under stress, etc).
That backlog in Canada makes me hate government even more. Ironically in the US the major hospitals are still running covid bullshit so we have a pretty bad backlog too. Last I checked neurology/cardiology is about 6 mo out.
In the EMS world we would approach your father with a lot of caution because he could "crash" really fast. The only other one that we would slightly panic faster (And laugh at) would be the 500 lbs death fat with multiple organ failure and covid.
In re your issues. Have you had surgery before? I have medial implants (5 metal + 7 silk based) in the body from two diferent serious injury, and my inflammation levels are always elevated after the metal implants. Some people just react differently than others.
- Joined
- Apr 30, 2021
Only a really minor surgery to remove a microperforate hymen (hymenectomy). I don't have any implants. I've had guttate psoriasis since I was 5 though so maybe it's that? It's usually triggered by strep throat but I think mine was from chicken pox. My issue is really bad chronic fatigue. It was diagnosed as CFS but I'm not sure I'm really convinced of that being a legit diagnosis.
- Joined
- May 5, 2022
I'm not convinced of CFS either. It's one of those diagnosis to throw at the wall to see what sticks like fibromyalgia. I'm a believer that usually CFS is the result of other issues, be it mental, physical, neurological.
I wonder if you have something embedded into the body or a long term infection with minimal symptoms? I got better after my doctor figured out I had a chronic (non symptomatic) infection of the auditory tube.
I knew a lad who had pencil graphite stuck in both hands from being stabbed and when they removed it several years later he got much better, lol.
Since when did the farms have so many women? I remember this site being sausage fest in 2014 in and around the time LTG got his shit pushed in by Viscant.
- Joined
- Aug 4, 2021
There are no known autism medications. All pharmaceutical treatments for autism either involve treating comorbid conditions or sedation. The antipsychotics for severe autists don’t really do much besides making them too tired to rage.
- Joined
- Apr 30, 2021
The treatment for autism is a high dose of barbiturates.
Manul Otocolobus
kiwifarms.net
- Joined
- Nov 2, 2021
The only known treatment for Autism that has any real data behind it is ABA therapy. The only other one that had any real chance of success, interestingly, was r-Baclofen. The initial clinical data was really impressive, but only for some people. For others, it did nothing. Then the company stopped the clinical trials. People who were helped by it were really pissed. The thing is, it was just what is called in chemistry an "optically pure" version of an already existing drug on the market, Baclofen. Regular Baclofen is 50% r-Baclofen & 50% l-Baclofen. The l-Baclofen just acts as a muscle relaxer, Until the autism study the r-Baclofen was thought to be just junk. So, if one finds relief with r-Baclofen, then taking regular Baclofen will work just as well, and you get muscle relaxation as a bonus.
Manul Otocolobus
kiwifarms.net
- Joined
- Nov 2, 2021
Huh, why contraindicated for MRI? The ultrasound is legit. The name of the procedure is a Trans-esophageal Echocardiogram (TEE). What he is talking about is a class of disorders known as Atrial Septal Defects (ASD), specifically something called a PFO (Patent Foramen Ovale). A PFO can cause clots to form that can lead to TIAs. The best way to detect a PFO is a TEE. I'd do it. The risk of not doing it is that you could have a stroke if this is indeed the cause of the syndrome you are seeing. If you are concerned about TIAs one thing you can do is start taking a single baby aspirin (81 mg) each day. This can attenuate the risk of clots from a PFO quite a bit, and if you actually see an improvement, that would be a strong vote for it actually being a series of TIAs from a PFO rather than anything else since of the various possibilities the only thing that would be helped by an 81 mg aspirin is a PFO. You shouldn't do this if you have a known bleeding problem, if you have a known aspirin sensitivity, if you have something known as eosinophilic asthma, etc... generally if you are sensitive to aspirin, you typically know it.
Since the symptoms are only related to times of stress, it could be TIAs, caused by increase in blood pressure/heart rate, but the fact that the symptoms are so very specific every time and would be rather atypical for a TIA makes me think that isn't quite as likely as other possibilities. It could be a focal seizure, but the fact that the symptoms are consistent each time, and very specific also make this less likely. There is no kind of seizure I have ever heard of that presents like this. I think its most likely that you have a very specific type of migraine known as an Acephalgic Migraine. It is a migraine that is not associated with an actual headache, but typically involves other atypical symptoms. a common one is it impacting the function of one eye, usually on the side of the brain where the migraine is happening. It can involve a loss of vision and/or oculomotor dysfunction. Vertigo is also a common symptom. Other common symptoms are disorientation, and a general feeling of being unwell (sorta like the very start of a cold or flu). It is not uncommon for people with acephalgic migraine to be misdiagnosed as having TIAs or seizures because few medical practitioners are aware of acephalgic migraines except for migraine specialists. One of the well documented triggers for acephalgic migraine is stress, so everything fits relatively well together, which is why I beileve this potential is greater than the other possibilities. You may want to ask your neurologist to either investigate this or ask for him to refer you to someone who is a specialist in migraines.
As far as a "severe chemical allergy". You don't have a true allergy. What you have is a well known, classic example of an olfactory migraine. Migraines can be triggered by stress as well as exposure to certain things. Very strong olfactory stimulants, such as perfume, are a well documented trigger. People that have one type of migraine are prone to the presentation of other types. This is a strong vote for the fact that you are likely to have acephalgic migraines is because you already have another presentation. The good thing is that the treatment for chronic acephalgic migraines are likely to also cure you of your olfactory sensitivity. So, you will likely kill two birds with one stone.
The first line treatment for both types of migraine is Topiramate. It tends to work quite well, and generally doesn't have many adverse effects. It is actually a repurposed anticonvulsant (anti-seizure) medication that is very mild. So, regardless of whether you are having minor seizures or migraines, this mediation may actually work. One of the potential adverse effects that is more common is weight loss. This typically isn't a problem for most people since most individuals could afford to lose a little weight, but being a height-weird proportionate person, that might be an issue, depending on where on the BMI scale you fall. Also, the fact that you have a history of hypotension, with weight-loss potentiating hypotension, that could also be an issue that has to be considered. The other potential adverse effect of Topiramate that is a reason for discontinuation is that for some people, such as myself (I have a long history of migraine) taking it can shave about 30 points off your IQ. You literally feel retarded. The actual mechanism behind this isn't well understood. They think the way that Topiramate slows down neural transmission for some people has an adverse impact on so called "processing power". Unfortunately this isn't an adverse effect that will go away or get better with time. The only solution is to discontinue the medication. If Topiramate fails or needs to be discontinued due to adverse effect, there are other medications that can be tried, and they also happen to be in the anticonvulsant family. So, again, if the issue you are having is focal seizures or acephalgic migraine, it could treat either. One medication I would strongly caution if they suggest you try is Lamotrigine. It can work when nothing else does. However, it has an abnormally high rate of a particular adverse effect known as Stevens-Johnson Syndromes (SJS). This is where the epithelial layer (the outside layer of your dermis [skin]) actually falls off, all over your body. Yes, it is just as horrifying as you are probably imaging, but also worse than you think. Epithelium doesn't just cover your outside, it also lines various places as well as being the outside layer of your major organs. So, the lining of various things, and the outside layer of your major organs also peels off. Yes, it is just as painful and disabling as it sounds. Just about no one who experiences it gets through it without some time of permanent damage. As such, I don't suggest anyone try Lamotrigine unless they are well and truly desperate.
Last edited:
Manul Otocolobus
kiwifarms.net
- Joined
- Nov 2, 2021
It's probably the psoriasis, Fatigue, even severe, can be associated with psoriasis. Are you on any chronic treatment currently for the psoriasis? If you have a positive Epstein-Barr virus titre, CFS isn't that unlikely, but is extremely unlikely without it.
As far as you father's current situation, you mentioned he was an addict. If I may ask, what was he addicted to? Going by his meds, I'm guessing opiates. If so, then you don't have much to worry about concerning his cardiac situation having an impact on you in the future. Hypertrophic cardiomyopathy (HCM) can have many origins. If it was idiopathic, meaning it has an unknown origin, then there would be a reason to be concerned one could be looking at a de novo autosomal dominant mutation. However, de novo HCM almost always presents in the 2nd to 4th decade of life. For it to happen at his age would be extremely unusual. Going by his medical and medication history, between the COPD (which appears to be rather severe given that he is experiencing atelectasis) and likely prior opiate abuse, this is very likely where his HCM originated. One of the lesser known consequences of opiate (and cocaine) addiction for the general public is HCM, leading to cardiac failure (HF). Opiates and cocaine have a very specific pattern of damage they do to the heart which is colloquially known as "coke heart" since it was originally seem with chronic cocaine abuse. It is characterized by cardiac microangiopathy (damage to the small blood vessels of the heart) and cardiac scarring at the cellular level. This causes loss of functional cardiac myocytes (heart cells). At the start, nothing seems to be wrong, but eventually one loses enough cardiac myocytes that the heart starts to compensate through a hypertrophic process (making the fibres that the cells control larger so they can try to pump more blood) but, unlike skeletal muscle, it isn't very successful except with very minor hypertrophy. As more cardiac myocytes are lost, and the hypertrophic process continues, it becomes a degenerative myopathy. With hypertrophy of the fibres each cardiac myocyte has to work harder until they start to die from overwork, which then leads to more hypertrophy as the others have to pick up the slack, and so on and so forth. This is why HCM leads to HF, unless it is treated.
The good news is that his HCM was caught very early. His ejection fraction (EF), which determines how well the heart is generally functioning as far as sending blood to the rest of the body is very mildly reduced, very close to normal. If he sticks to his medications, at this early of a stage, I would expect him to do very well. There is no reason to think that this won't be a serious problem for a long time. HCM cam be very well controlled, especially this mild, with medications with no trouble. I just have to stress that he absolutely must take his medications exactly as directed. It would be best if he took them at the same time every single day, they tend to work best this way. His adherence to his medications will be what dictates how well he does with his HCM.
Last edited:
- Joined
- Apr 30, 2021
Thank you, very helpful.
I've read about pso causing fatigue. I asked my doctor about EBV virus testing but she said it would be useless bc it wouldn't give any actionable info. My CRP is finally down to 15 now though and my b12 is now low end of normal so I'll ask her about MAA testing. I have never been on any immune altering drug except for topical cortosteroids and vitamin d, but I forgot what that's called, I think it's Dovobet. I stopped it over 10 yrs ago bc I read it causes stretch marks. She said my pso is well managed with just my skin care with regular moisturizers like Cerave and oatmeal and it's not covering enough of my body to have Otezla covered. And I'm on public insurance which only covers it for psoriatic arthritis not only psoriasis. She said pso arth is hard to diagnose and it would take 2 yrs to see a rhem and they might blow me off.
I know he did cocaine and opioids cus he admitted he used to do "eight balls", I think they're called, which are a mix of cocaine and opioids. I know he for sure did percocets too. I think he had done drugs since at least when my brother was born (he's 19) bc that's when he got arrested for drug trafficking and found his drug dealer friend.
People have told me "he's a pillhead" long before he admitted it to my mom. My mom is a very nice and trusting person so she believed him all these yrs when he said "it's just weed". But she finally started to become highly sus, even to her, when he did retarded shit like spill air freshener beads and try to eat them off the floor, take all the pots and pans out of cupboard and put them in the oven and then take all the knives from the drawer and hide them too, while saying there are people coming to get him. He also tried to feed our dogs little bits of toilet paper (not used) and got mad when I said that's not a treat.
What is atelectasis? I think you're right about it being severe COPD. He also lied to the doctor IMO, he hasn't stopped smoking for 4 yrs, only like a yr and only bc I warmed him up to the idea of vaping so he replaced smoking with vaping. He was a very heavy smoker, he smoked one or two packs a day and that was since he was in his 20s. I remember him taking little blue puffers when I was a kid which he said were for asthma but I think that was probably the early stages of his COPD. When he was in the hospital, the nurse said he can take 4 doses of Symbicort a day if he wants. He has never seen a pulmonologist and only sees the family doctor who completely manages it and goes by a "COPD Action Plan", which I'm pretty sure means they give him steroids and antibiotics when he gets sick without needing to make an appointment. I think he doesn't want to hear how bad his lung function is or thinks it's unfixable so there's no point.
I'm glad his heart is near-normal and they caught it early!
I'm getting WGS from Nebula Genomics anyways, so I guess I'll find out if I have any of the known HCM mutations or not. I hear the NHS does it sometimes but my doctor said here in Canada or at least where we are, they usually do a test of specific genes. I really hope he gets the coil surgery soon so I don't have to worry about it rupturing and killing him.
Manul Otocolobus
kiwifarms.net
- Joined
- Nov 2, 2021
Thank you, very helpful.
I've read about pso causing fatigue. I asked my doctor about EBV virus testing but she said it would be useless bc it wouldn't give any actionable info. My CRP is finally down to 15 now though and my b12 is now low end of normal so I'll ask her about MAA testing. I have never been on any immune altering drug except for topical cortosteroids and vitamin d, but I forgot what that's called, I think it's Dovobet. I stopped it over 10 yrs ago bc I read it causes stretch marks. She said my pso is well managed with just my skin care with regular moisturizers like Cerave and oatmeal and it's not covering enough of my body to have Otezla covered. And I'm on public insurance which only covers it for psoriatic arthritis not only psoriasis. She said pso arth is hard to diagnose and it would take 2 yrs to see a rhem and they might blow me off.
I know he did cocaine and opioids cus he admitted he used to do "eight balls", I think they're called, which are a mix of cocaine and opioids. I know he for sure did percocets too. I think he had done drugs since at least when my brother was born (he's 19) bc that's when he got arrested for drug trafficking and found his drug dealer friend.
People have told me "he's a pillhead" long before he admitted it to my mom. My mom is a very nice and trusting person so she believed him all these yrs when he said "it's just weed". But she finally started to become highly sus, even to her, when he did retarded shit like spill air freshener beads and try to eat them off the floor, take all the pots and pans out of cupboard and put them in the oven and then take all the knives from the drawer and hide them too, while saying there are people coming to get him. He also tried to feed our dogs little bits of toilet paper (not used) and got mad when I said that's not a treat.
What is atelectasis? I think you're right about it being severe COPD. He also lied to the doctor IMO, he hasn't stopped smoking for 4 yrs, only like a yr and only bc I warmed him up to the idea of vaping so he replaced smoking with vaping. He was a very heavy smoker, he smoked one or two packs a day and that was since he was in his 20s. I remember him taking little blue puffers when I was a kid which he said were for asthma but I think that was probably the early stages of his COPD. When he was in the hospital, the nurse said he can take 4 doses of Symbicort a day if he wants. He has never seen a pulmonologist and only sees the family doctor who completely manages it and goes by a "COPD Action Plan", which I'm pretty sure means they give him steroids and antibiotics when he gets sick without needing to make an appointment. I think he doesn't want to hear how bad his lung function is or thinks it's unfixable so there's no point.
I'm glad his heart is near-normal and they caught it early!
I'm getting WGS from Nebula Genomics anyways, so I guess I'll find out if I have any of the known HCM mutations or not. I hear the NHS does it sometimes but my doctor said here in Canada or at least where we are, they usually do a test of specific genes. I really hope he gets the coil surgery soon so I don't have to worry about it rupturing and killing him.
I have to disagree with her about the EBV virus titre. An antibody test? Yes, that would likely be worthless, since more than 50% of the typical population has antibodies to the EBV virus. But, an EBV virus titre detects actual active virus, which is found in people with CFS, and is never found in people that don't have it.
If they won't cover Otezla, I wouldn't recommend any other treatment. The rest are too dangerous for the benefit. PSO arthritis isn't terribly difficult to diagnose with radiographs. PSO arthritis typically shows up in very specific areas. If you do radiographs and detect degeneration in those areas, it's PSO arthritis. Simple plain-film radiographs are simple, quick, easy, and carry no risk. Her position on it is sort of negligent. PSO arthritis can be active for years before it presents actual symptoms, and at that point the pre-existing damage can be somewhat severe. The approach for public-insurance is infuriating. It's better to investigate before it is potentially a problem, especially when the diagnostic imagine is so simple. It's not like the damage can be reversed, and any disability and/or the person experiences is permanent. Why prevent something when you can spend much more treating it in the future, right?
Atelectasis is where the functional units of the lung, the alveoli, are stuck to themselves. In the lungs it is a sign of severe hypoventilation (not enough air flow) through an area or a partial collapse (where there is no airflow) of the lung. With COPD it can be seem with more severe disease or exacerbations. It's a rather poor diagnostic sign. Unfortunately, COPD is "unfixable" and for most people at this level, can be progressive, even if the aggravating force is removed. He should absolutely be under the care of a pulmonologist, this advanced stage of COPD should not be managed by a GP. His care is likely less than optimal as a result. A pulmonologist would be able to better provide appropriate treatment and is aware of the most recent innovations regarding COPD, of which a GP is likely unaware.
Targeted gene testing isn't uncommon when it comes to things like HCM since it is typically a result of a mutation in specific genes, but it can miss the more unusual mutations that are less known or possibly unknown. The sooner he gets the surgery for the aneurysm, the better. The use of steroids for his COPD is a risk for his aneurysm since they tend to increase blood pressure. It is a difficult balance between treating severe COPD and an aneurysm due to the fact that they require contradictory treatment.
- Joined
- Apr 30, 2021
How long do you think he can live with all the health things he's dealing with? I'm hoping at least 65. Is there anywhere in particular radiographs should be done to look for pso arth, what is the most likely place to find it? I did damage the ligaments in my foot falling down the stairs last yr and went to emerg and got a foot xray and they said it looked all good. Not sure if it was foot and ankle or just foot, but I hurt the top of my foot falling. It hurt so bad I thought it was broke, which is why I went to the hospital.
I will call the GP office Monday and ask for a referral to pulmonary for him. It was very rare he even agreed to go to the doctor while he was having that heart attack but I guess he felt so damn shitty he agreed and it's really lucky he did. I feel you on the negligent thing. There is a long waiting list in my province to get a GP so I can't switch her, but I do feel she undermines my concerns a lot. I'm actually on public disability for chronic fatigue. I just want answers you know? I agree prevention is much better than letting it cause damaging and then finally treating it.
I will call the GP office Monday and ask for a referral to pulmonary for him. It was very rare he even agreed to go to the doctor while he was having that heart attack but I guess he felt so damn shitty he agreed and it's really lucky he did. I feel you on the negligent thing. There is a long waiting list in my province to get a GP so I can't switch her, but I do feel she undermines my concerns a lot. I'm actually on public disability for chronic fatigue. I just want answers you know? I agree prevention is much better than letting it cause damaging and then finally treating it.
- Joined
- May 5, 2022
Thanks for the reply. I've been told that "You don't fit the standard presentation for anything so we must use an exclusionary diagnosis".
In re: MRI contraindication. I have several surgical implants that are full metal in the joints and they told me they will not do an MRI due to risk of it moving and tearing my axillary artery (how accurate this is, I do not know). I can feel the metal pulling if I walk close to large magnets like a cyclotron
In re chemical allergy:
I pretty sure I am allergic (swelling, contact dermatitis) with certain plastics with specific coloration . Specifically, I am allergic to the plastic of older hasbro board games. I got a friend to do a double blind with a set I haven't seen before and couldn't see while picking up and it was 100% the same symptoms every time I picked up gold/pink colored plastic. So I keep a pair of gloves when I have to pick up stuff like that now.
I took a look at the Acephalgic Migraine and it fits my symptoms pretty well. Usually induced by a atmospheric pressure drop/olfactory trigger. First come Neck stiffness, yawning with a sense of foreboding followed by blindness in one eye, vertigo, sensitivity, confusion, and jaw pain/ grinding on the same side as the eye (I don't have tetnus I'm 100% sure). The only thing that doesn't fit is an extreme shooting pain through the top/front of the head. My usual go to test is to try and walk up a set of stairs, if I fall or stumble I know I'm going to get a bad day.
Are cluster headaches possible at the same time? I had for the longest time severe cluster headaches misdiagnosed (?) as trigeminal neuralgia when I was a child. Went into remission after I got the hospital stay (see earlier post) from the infection but got replaced by this shit after my surgical implants (I was sedated for an extended period of time for both). Not sure if the fact I travel a lot with a 12 hour time difference for work/life since I was in my very young also affects this.
@Sparkling Yuzu see spoiler please.
First off, I hope you get better since your issues seem much more severe than mine.
I'm sorry but does that affect you in employment/social life? Or is it one of those things that you don't tell employers? I don't qualify right now (no diagnosis) but I did when I was younger. I remember seeing the absolutely disgust and contempt of the adults me around thinly veiled as help, or teachers deliberately giving me a hard time and my peers being judgemental (not that I cared about the latter) because my disability wasn't "visible" that left me with lifelong hatred of the public sector (esp education) that isn't volunteer because of this and I refuse to state that I have had or have (If I get disability) because of this. Just curious if anyone else has had this issue in life.