General Medical issues thread

[Quickstatus]

Medscape reported that Metformin can help reduce long covid

Very dodgy when the endpoint they look at is whether a Dr tells the participant they have "long covid". Who knows what that actually mean. A vague endpoint is problematic.

And it's a "preprint" which means it's has not been vetted through a peer review.

 

[cove]

Thanks @Quickstatus i don’t plan to rely on a thought bubble for medical advice but I will watch out for a real study in the next couple of years.
Have gone back to the pool for exercise and that is pretty good for me. Mrscove walks about 7 kms in the early morning but I don’t want to wear out my knees, hips and ankles.
Many at my pool have a higher scrap value than zero with titanium joints.

 

[JohnK]

Tried deep heat for wife's foot. Nothing. Maybe something wrong with the deep heat. Put a little on my lower back and can immediately feel the burning.

Tried deep heat for wife's foot again next night. Again nothing. Tried deep heat on wife's calf and again nothing. Tried deep heat on wife's elbow and upper arm and this time she can feel the burning.

 

[drron]

@JohnK didn't your wife have problems with feeeling in her legs before? I vaguely remember that. If so the problem almost certainly is a problem of her nervous system and not a problem with the deep heat. She should see a neurologist and probably have nerve conduction studies.

 

[codash1099]

So my plans to resume travel this year have been blown out of the water.

Early February, routine blood tests show severe anaemia so a few days in hospital and an iron infusion. Gastroscopy and colonoscopy to find a cause shows cancer in the stomach. Follow up gastroscopy by an expert in the field showed the cancer can't be removed endoscopically, so looks like surgery will be required. Fortunately, there doesn't appear to have been any spread.

Now waiting to see what the wise men of the profession decree is the best way to go about it. (I have some peculiar anatomy that makes my stomach not easily accessible by laparotomy).

 

[Quickstatus]

makes my stomach not easily accessible by laparotomy

You mean by oscopy rather than otomy?

 

[love_the_life]

So my plans to resume travel this year have been blown out of the water.

Early February, routine blood tests show severe anaemia so a few days in hospital and an iron infusion. Gastroscopy and colonoscopy to find a cause shows cancer in the stomach. Follow up gastroscopy by an expert in the field showed the cancer can't be removed endoscopically, so looks like surgery will be required. Fortunately, there doesn't appear to have been any spread.

Now waiting to see what the wise men of the profession decree is the best way to go about it. (I have some peculiar anatomy that makes my stomach not easily accessible by laparotomy).

Hoping the treatment/surgery is successful and you are able to get back to some travel next year. Have to play it by ear. Good luck.

 

[codash1099]

You mean by oscopy rather than otomy?

No, laparotomy (as in incision into the abdomen). But laparoscopy wouldnt work for this either.

 

[Quickstatus]

laparotomy

sounds difficult.
These days you should be looked after by a multidisciplinary team. Best wishes. Happy to help in any way

 

[MARTINE]

So my plans to resume travel this year have been blown out of the water.

Early February, routine blood tests show severe anaemia so a few days in hospital and an iron infusion. Gastroscopy and colonoscopy to find a cause shows cancer in the stomach. Follow up gastroscopy by an expert in the field showed the cancer can't be removed endoscopically, so looks like surgery will be required. Fortunately, there doesn't appear to have been any spread.

Now waiting to see what the wise men of the profession decree is the best way to go about it. (I have some peculiar anatomy that makes my stomach not easily accessible by laparotomy).

All the very best to you.

 

[JohnK]

@JohnK didn't your wife have problems with feeeling in her legs before? I vaguely remember that. If so the problem almost certainly is a problem of her nervous system and not a problem with the deep heat. She should see a neurologist and probably have nerve conduction studies.

I think we try neurologist next. Yesterday was CT scan lower spine checking for sciatica. I think nervous system issues is not the best outcome as there may not be an easy solution.

I told her to just ignore the pain like I have done most of my adult life but that suggestion did not go down well.

 

[cgichard]

A friend of mine suffered from severe foot pain that prevented him from going to sleep. After many investigations, it was eventually tracked down (by a chiropractor, I think) to pressure on the sciatic nerve following a hernia repair with some kind of mesh.

 

[RooFlyer]

A friend of mine suffered from severe foot pain that prevented him from going to sleep. After many investigations, it was eventually tracked down (by a chiropractor, I think) to pressure on the sciatic nerve following a hernia repair with some kind of mesh.

I've had a double hernia repair (ie both sides), with mesh. Still causes discomfort at the sites 9 months later. Been to a second surgeon (who I have faith in, unlike the first guy) - can't or unwilling to do anything except inject with steroi_. Did that twice, not much change. "Just one of those 5% things ..." Some nerve pinching or pressure somewhere, they say, and no instrument will pick up (unless someone here can suggest). I've argued that they need to have some sort of look, (hi-res MRI??) as it MAY not be the standard "5%" lasting effects thing. Nope.

I said "what's gone in can come out" - nope. Might be worse.

Had large impact on my health - gym/exercise stopped for about 5 months, large weight gain ...

 

[Quickstatus]

what's gone in can come out" - nope.

John Garvey FRACS would disagree. The 5% is about ballpark and is not a small number.

 

[RooFlyer]

The 5% is about ballpark and is not a small number.

May be accentuated by a few ... senior ... surgeons. Neighbour had left side done by X a while ago - no issues. Had right done by the same guy who did mine - now has same issues as me. Second opinion surgeon said he would have done mine keyhole, not open ...

Yes, the orig guy gave the usual disclaimers, warnings ... X% of complications etc etc. But what he didn't say, and I now bitterly resent, is that the complications might be pain/discomfort forever & un-fixable. If told that, I would have shopped around; I knew differences between open & keyhole and the operation wasn't urgent. I don't think that I gave fully informed consent.

GP who referred me to orig surgeon was only in Hobart on 6 month contract. My new GP made the comment that he wouldn't have referred me to the orig surgeon who "takes on too much". My operation occurred at about 11:00 pm.

John Garvey FRACS would disagree.

Is he in Melbourne? Yes, my second opinion surgeon has said there is a clinic in Melbourne where they do 'reversals' but his advice is not to do it.

How the hell is your average patient meant to decide what to do?

 

[RooFlyer]

John Garvey FRACS

Is he in Melbourne?

OK, I looked him up. Sydney. I'll discuss with my GP. An assessment can't be a bad thing to do ...

Oh, the orig surgeon did a job on the nerves as well ....

 

[Quickstatus]

keyhole

Invariably uses mesh.
All inguinal hernia repairs involve some risk of nerve involvement. Mesh or no mesh. Revision surgery and removal of mesh can increases chance. It's not easy to navigate through with the decision making

fully informed consent

There is no such thing in all honesty. It really is a fictional construct made up by lawyers.

I'm not even sure what the answer is but yes removal should be part of the consideration.
Garvey is in the minority however.

 

[JohnK]

@JohnK didn't your wife have problems with feeeling in her legs before? I vaguely remember that. If so the problem almost certainly is a problem of her nervous system and not a problem with the deep heat. She should see a neurologist and probably have nerve conduction studies.

Interesting results from the lower spine CT scan.

Wife has had operation on L4/L5 over 10 years ago and it would appear there are further degenerative changes of L4/L5 that are more than likely causing current issues although there is mention the stenosis is not enough to cause nerve issues.

We're stuck somewhere between a rock and a hard place. I will look for neurologist to visit for conductive studies and that could take some time for appointment but I also think it's worth trying anti-inflammatory treatment and if that does not help then 10mg cortisone daily for 2 weeks.

 

[Flashback]

Invariably uses mesh.
All inguinal hernia repairs involve some risk of nerve involvement. Mesh or no mesh. Revision surgery and removal of mesh can increases chance. It's not easy to navigate through with the decision making

There is no such thing in all honesty. It really is a fictional construct made up by lawyers.

I'm not even sure what the answer is but yes removal should be part of the consideration.
Garvey is in the minority however.

Indeed, I had mine keyhole when I was 18 and that was mesh. Seems to be OK still as far as I know.....

 

[RooFlyer]

Invariably uses mesh.

Oh yes, appreciate that, but with a double, much less invasive. And less likely to have the inguinal nerves cut or traumatised, as with me.