General Medical issues thread

[Quickstatus]

Understood. Hope my throat infection is not that serious.

Think I need to consider having tonsils removed.

I believe the data supporting tonsillectomy as a treatment for chronic pharyngitis in adults is poor. But I'm not an ENT surgeon

Do you get other symptoms with sore throat?

 

[JohnK]

I believe the data supporting tonsillectomy as a treatment for chronic pharyngitis in adults is poor. But I'm not an ENT surgeon

Do you get other symptoms with sore throat?

Sore tongue usually comes with sore throat and also dry throat/mouth where I feel I need to keep drawing saliva causing tongue to hurt even more.

I am not a fan of operations but these throat infections are depressing. I don't want to go through the February/March infection again. That was the worst throat infection I have ever experienced. And it is now around 4 weeks for current infection.

 

[TheRealTMA]

Sore tongue usually comes with sore throat and also dry throat/mouth where I feel I need to keep drawing saliva causing tongue to hurt even more.

I am not a fan of operations but these throat infections are depressing. I don't want to go through the February/March infection again. That was the worst throat infection I have ever experienced. And it is now around 4 weeks for current infection.

Persistent throat infections should not be taken lightly. Just throwing another self medicated antibiotic at the problem is not useful but more likely leading to further problems by generating bacteria in your system that become resistant. I appreciate that you are concerned and worried, as most of us would be. Why don't you follow up your concerns with proper medical advice? Instead of seeking advice on AFF? If your current GP is not doing the job, get a referral to another or a physician who can diagnose the issues.

 

[drron]

The 5 most useless things to do in Infective diseases-
　

1
[FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium]Do not use antibiotics in asymptomatic bacteruria
[/FONT][/FONT][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium]
[/FONT][/FONT]2
[FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium]Do not take a swab or use antibiotics for the management of a leg ulcer without clinical infection
[/FONT][/FONT]3
[FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium]Avoid prescribing antibiotics for upper respiratory tract infection
[/FONT][/FONT]4
[FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium][FONT=ITC Stone Sans Std Medium,ITC Stone Sans Std Medium]Do not investigate or treat for faecal pathogens in the absence of diarrhoea or other gastro-intestinal symptoms
[/FONT][/FONT]5 In a patient with fatigue, avoid performing multiple serological investigations, without a clinical indication or relevant epidemiology

https://www.asid.net.au/documents/item/1183

 

[Pushka]

That's an interesting read drron. The rheumatologist has said that once she gets the test results that confirm an auto immune illness (in my case, ANA and APS - 2 positive lupus anticoagulant tests) (and obviously relevant confirmed clinical symptoms) and she has made the diagnosis then she does not test them again as multiple repeat tests complicate rather than help. She does however test every 4 months the associated inflammatory markers and kidney/liver functions and other antibody panels.

 

[JohnK]

Why don't you follow up your concerns with proper medical advice? Instead of seeking advice on AFF? If your current GP is not doing the job, get a referral to another or a physician who can diagnose the issues.

Not seeking advice on AFF. Good to hear the experience of others. Someone at work yesterday mentioned their husband had tonsils removed at 43 years of age and it was one of the best things they have done.

I have been getting multiple infections for over 30 years. I have been on immunosuppresants for the past 18 years. When I had Chicken Pox 7 years ago I also had a chest infection and a urinary tract infection that also affected the gall bladder. I was in hospital for 11 days on antibiotics and anti-viral medications.

What else needs investigating?

 

[drron]

The pneumonia was quite probably due to the chickenpox virus-commonly a complication of chickenpox in an adult who is immunocompromised.Also in those people quite often fatal so I think the urine and gallbladder problems may not have been much to do with your length of stay in hospital.
Varicella pneumonia in adults | European Respiratory Society

The course of Varicella appears to be more aggressive in immunocompromised hosts. In a recent series on human immunodeficiency virus-infected patients from South Africa, seven of 12 patients who were hospitalised with chickenpox developed clinically severe pneumonia and, despite receiving antiviral within 12 h of admission, three (43%) died 21. A review of 38 cases of adult renal allograft recipients with disseminated Varicella infection, reported in 15 different studies, found that of the 29 patients with primary Varicella, 29% developed Varicella pneumonia and the overall mortality was 34%. However, the mortality from 1981–1990 was 53% and from 1990–2000 was 22% 23. The improvement in mortality rate was most likely to have been influenced by the availability of specific antiviral therapy, since antiviral therapy was used in 33% of cases before 1990 and 74% of cases after 1990.

You may well be left with an abnormal chest X-ray so if anyone mentions spots on your lungs tell them you had pneumonia at the same time as chickenpox.

 

[Quickstatus]

Not seeking advice on AFF. Good to hear the experience of others. Someone at work yesterday mentioned their husband had tonsils removed at 43 years of age and it was one of the best things they have done.

I have been getting multiple infections for over 30 years. I have been on immunosuppresants for the past 18 years. When I had Chicken Pox 7 years ago I also had a chest infection and a urinary tract infection that also affected the gall bladder. I was in hospital for 11 days on antibiotics and anti-viral medications.

What else needs investigating?

Sorry to hear JohnK, thats a tough gig!

BTW any cough or runny nose, sore enlarged glands in the neck?

 

[Hvr]

A concerning report:

http://www.theage.com.au/national/c...iller-fentanyl-20170718-gxdrv6.htmlAustralian hospitals are being forced to ration a painkiller used in millions of operations each year because a major supplier cannot keep up with demand.


The shortage of the powerful painkiller fentanyl could potentially endanger patients, experts say, and is one of a growing number of critical shortages being reported across the nation, including for first-line antibiotics and chemotherapy drugs.

Hopefully no one here needs any of these drugs soon.

 

[Quickstatus]

A concerning report:



Hopefully no one here needs any of these drugs soon.

the story has been spun to create a mountain out of a molehill
thrre is a shortage not due to demand but with a manufacturing issue affecting normal supply
There are suitable alternatives . Some other drugs are affected as well

 

[docjames]

the story has been spun to create a mountain out of a molehill
thrre is a shortage not due to demand but with a manufacturing issue affecting normal supply
There are suitable alternatives . Some other drugs are affected as well

There are suitable alternatives in many circumstances, but for some patients it will create issues with switching, as well as confusion increasing the risk of drug errors.

It's a much bigger issue recently with antibiotics (some critical antibiotics have been unavailable, leading to use of much broader spectrum alternatives - which comes with it's own issues including resistance, side effects etc...).

The whole sourcing of drugs remains an issue in Australia - often only one supplier and the regulatory environment makes it difficult to quickly source like-for-like replacement.

 

[Quickstatus]

The critical shortages of antibiotics are
IV metronidazole (flagyl)
IV vancomycin

then vaccines
tetanus
engerixB - Hep B
meningoccal B

these are nationwide...

i have not included others

 

[docjames]

The critical shortages of antibiotics are
IV metronidazole (flagyl)
IV vancomycin

then vaccines
tetanus
engerixB - Hep B
meningoccal B

these are nationwide...

i have not included others

These are some of them. There have been a number of others with, lets say, "fluctuating" supply over the last 18 months or so.....

 

[JohnK]

Sorry to hear JohnK, thats a tough gig!

BTW any cough or runny nose, sore enlarged glands in the neck?

Had cough and blocked nose last month. Not sure about glands. The right tonsil is inflammed quite badly. Not sure if this is same infection or a continuation of first.

Saw GP yesterday. He mentioned that 90% of tonsilitis infections are viral and generally clear up in 7-10 days. Mine has now been going for close to 4 weeks and is getting close to the 6 weeks of February/March. Has responded to the Amoxyl but still not quite right. Perhaps it's viral but this now a long time. Going onto Augmentin Forte.

P.S. I am now also experiencing Burning Mouth Syndrome which I believe is stress related. Talk about kicking someone when they are down. Not fun.

 

[Quickstatus]

No one known much about BMS. Some say manifestation of oral thrush but I think scant evidence for it.
There is some evidence that it's a neuropathic pain in the mouth.
Not really stress related.
Neuropathic pain means pain originating from the nerves - theory is that past painful episodes have caused the pain nerves to overreact and now they are causing pain all on their own.

Usually sore throat assoc with cough, runny nose, eyes = viral.
Usually bacterial pharyngitis is associated with enlarged painful glands in the neck and almost always no cough, runny nose. If no glands = usually viral.

 

[JohnK]

Not sure what causes BMS but it is awful. Mouth is dry and painful. Have been sucking on lollies all day. Tried Fungilin yesterday and my mouth/mind totally rejected it. I can try some Nilstat when I go home. Also I think I have a couple of Flucanazole tablets somewhere.

This isn't just a sore throat. It's swollen tonsils but not sure if the glands are swollen as well. Not sure where to check.

 

[Quickstatus]

I doubt its fungal in origin but given prior history of fungal its not unreasonable. The swab should tell. If no fungus stop the antifungals.

May have to try Lyrica - speak with GP

 

[JohnK]

I doubt its fungal in origin but given prior history of fungal its not unreasonable. The swab should tell. If no fungus stop the antifungals.

May have to try Lyrica - speak with GP

The weird thing is BMS only surfaces when I have some form of tonsilitis. I was fine last week. But the past few days have been torture. I suspect it was BMS that caused the severe panic attacks in February/March.

Think dad has been on Lyrica or is still on it.

 

[Pushka]

Augmentin gives me the worst headache ever.

 

[love_the_life]

Daughter took one dose of Lyrica and had such a bad reaction; never again, won't touch it.