General Medical issues thread

[Flashback]

Until statins came along, H2 receptor antagonists (ranitidine etc) then proton pump inhibitors (omeprazole etc) were the best-selling worldwide drugs
Upper gastrointestinal symptoms are very common and medicines effective at making people feel better. However they are probably overpresribed as some people improve and never stop taking them to see.
There is of course the bacterial component to ulcers.
Together these advances forced many upper gastrointestinal surgeons to restructure their business

Indeed and when I moved to the UK the Dr noted I shouldn't have been on them long term and should try to stop etc. However, did it for 2 weeks and was absolute hell, so Dr booked me in for another gastroscopy and it confirmed that indeed it was still in a not good state. They've offered surgery but from what I've researched it may/may not add long term benefit and if anything may add some complications so it was a hard pass on that one for me.

 

[tgh]

With short stem Barretts from a mismanaged youth , I have been on a steady diet of ppi's for at least 30 years.
The erosion is quite stable and I have managed to lower the dosage, but the Gastro(longword) would be quite annoyed with me if I stopped
Reflux is fairly easy to understand and manage, so I live happily with my cross in the absence of other more debilitating afflictions

 

[Pushka]

With short stem Barretts from a mismanaged youth , I have been on a steady diet of ppi's for at least 30 years.
The erosion is quite stable and I have managed to lower the dosage, but the Gastro(longword) would be quite annoyed with me if I stopped
Reflux is fairly easy to understand and manage, so I live happily with my cross in the absence of other more debilitating afflictions

Same. On prescribed pantoprazole for years now. Being on a blood thinner I can't risk erosion.

 

[chelzmalee]

Well, at 33, yesterday I was blessed with my first set of dentures. Had to lose 2 bottom front teeth due to bone loss. It's been an odd 20 hours or so - I had braces and retainers as a teen so I know the feeling of something foreign, it'll be interesting how it goes long term. Unfortunately implants just aren't in the budget.

I have an acrylic denture at the moment, but the the dental (guy who makes the dentures? not sure what he's called) said I can move to a chrome one, which will be thinner. Probably what I will end up doing. Right now, it's T-3 until I can take the denture out, wash everything out and brush my teeth properly. Good thing it's a work from home day

 

[Flashback]

We are pleased to confirm the details of your Hand Therapy clinic assessment

What pray tell does hand therapy entail, one wonders? My broken finger seems to be getting more sore rather than....... less? Is that part of the healing process?

 

[prozac]

General interest for anyone with a PM. There is a safeguard built in that will place the PM into Safe Mode if something untoward happens like being too close to a strong magnetic source or getting an electric shock. In safe mode the PM will only operate at 70bpm regardless of activity and will stay in safe mode for 10-20 minutes. These figures may vary between manufacturer.
Yesterday I was up a ladder doing electrical work when I took a whack. I continued on but a few hrs later was feeling tired so I had a look back through my heart rate to see what might be going on. At around 1030hrs you can see clearly the PM going into safe mode for a while. Well I found it interesting.

 

[Katie]

Rightio, my ongoing adventures continue. Kinda forgot to take Nexium for a few days over the weekend, not a good idea. Felt awful on Monday morning. Still really need to start looking at my diet.

Saw the endocrinologist this week. I mentioned I'd passed my numbers past my uncle, an endocrinologist in Sydney, and he wasn't too worried, so I wasn't too worried. Went through the results of the blood test she had me take; as I'd had the iron infusion in mid-Feb, it might be affecting some of my numbers, so she wants me to have another blood test in a month's time.
Maybe a throat scan and bone density test down the track. And maybe I just have high calcium levels in my blood.

Vit D levels were up, I blamed walking the dog as I've been taking no supplements. Though it was bloody dark by Qld standards when we got outside at 5:20 AM this morning.

At the end, she asked me what my uncle's full name was, as she might have heard of him. I told her. She responded "Oh, he's famous!". I said, "Yes".
I rang him later that night to tell him, which gave him a chuckle. He asked me what her name was, but as she's trained up here at UQ and not down in Sydney, he didn't know her. I guess she's not as famous as he is.

The endo was really lovely.

 

[Quickstatus]

PM

If you change it to PPM the medicos here will quickly recognise it.

PPM is the recognised abreviation (at least in the medical world) for permanent pacemaker.
That magnet mode you describe is available in all PPM. It is activated by putting a magnet over the pacemaker - it is often used during surgery where electrocautery is used in the vicinity of the PPM which can cause the PPM to do weird and potentially dangerous things such as ventricular fibrillation and even an electrical reset.

Here is an article about Magnet mode in PPM and how it specifically affects various PPM brands but basically the application of a magnet causes the PPM to default to an asynchronous mode- which means it will pace at a set rate irrespective of what the heart does.

In your case , the alternative explanation is that your PPM did not into a "safe" mode. It could have actually stopped pacing and you were actually running off your own heart rhythm which made you feel off?. Have you checked with your PPM guy?

 

[prozac]

If you change it to PPM the medicos here will quickly recognise it.

PPM is the recognised abreviation (at least in the medical world) for permanent pacemaker.
That magnet mode (VOO/DOO) you describe is available in all modern PPM. It can also be activated by putting a magnet over the pacemaker - it is often used during surgery where electrocautery is used in the vicinity of the PPM.

Here is an article about Magnet mode in PPM and how it afttects various PPM brands.

Thanks QS, I understand quite alot due to the pacemaker not working properly for 1st 3 months after implant and having a permanent weekly consult during that period to try to get it working properly and for a few months after. The pacemaker tech used to give me homework every week. Very switched on fella. You probably know who it is if I mention he is 6'7". I can calculate the desired heart rate when making changes to the settings etc and can explain terms such as substrate to re-entry, etc.. I posted for the general interest of others with a pacemaker who possibly are not aware of this function.
Oh, and the it wasn't the pacemaker that was faulty, just me.

 

[Quickstatus]

Very switched on fella. You probably know who it is if I mention he is 6'7"

For those who dont know, @prozac mentions the PPM tech - everyone who has a PPM is allocated a PPM tech who oversees the overall PPM checks during the life of the PPM in conjunction with your heart doc (assuming the person outlives the PPM ) - the checks and any modifications are all free (paid for in the initial PPM)

I don't know the PPM people as we are in different areas. But I agree they are usually very clued up about their product. We even got one to give a tutorial to the medical trainees.

These days the modern PPM have bluetooth connection to a phone app which can periodically upload your PPM data to your PPM tech guy.

 

[k_sheep]

If you change it to PPM the medicos here will quickly recognise it.

I quickly recognised it thanks to context, but will admit "PM" in my field is normally a post mortem examination! So ... yeah too many acronyms!

 

[Quickstatus]

yeah too many acronyms!

AFF is ALL about abbreviations and acronyms!!!

 

[TheRealTMA]

AFF is ALL about abbreviations and acronyms!!!

YMSTBICNPC!

 

[andye]

AFF is ALL about abbreviations and acronyms!!!

AFF is not just the Accor loyalty programme...

 

[Quickstatus]

will admit "PM" in my field

It didnt actually cross my mind - good pick up!

 

[mrsterryn]

Having been on blood pressure and cholesterol reduction pills with no change in dosage for some years the darn diabetes ones have been a struggle.
Gone into yet another medication in conjunction with the others of truclity and my sugars are down to 5.6 after ten weeks of it
Doctor is much happier.

 

[Quickstatus]

truclity

There are some really good hypoglycaemics on the market

Trulicity is in the GLP1 class and others such are Jardiance are in the SGLT2 class

They have even been shown to reduce BP, cardiovascular risk reduction and in the case of GLP1 stroke risk reduction. These seem to be unrelated to the glucose lowering effect.

 

[Katie]

The teen tested positive to Covid on Sunday. Have just taken Mr Katie to Prince Charles for a PCR test, and I had one as well. He's got early cold signs, and I have a slight sore throat. I figure if our day 0 for quarantining has to be reset, let's try to get all positive together. And then the teen can emerge from their bedroom.

 

[Pushka]

Covid running a bit rampant in the family at the moment and one member who has lupus and immune suppressed (has had four Covid vaccinations) has needed the antibody infusion for Covid in hospital. Also on blood thinners, but warfarin, saw their INR shoot up to 8 with it ( risk of hemorrhage) Needed VitK to reverse it but couldn't access any being late Sunday and the Covid clinic at the hospital didn't have any system in place to administer it. They are better now but they described the fatigue with Covid being very different to the usual fatigue associated with auto immune illnesses.

 

[Quickstatus]

Needed VitK to reverse it but couldn't access any being late Sunday and the Covid clinic at the hospital didn't have any system in place to administer it

Seems odd. Something like that would be an emergency treatment at the local emergency department