General Medical issues thread

[SuePa]

Have you tried doing an Epley (treatment for BPPV) to reset the crystals at home?

Home Epley Maneuver

The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV). You can do this exercise at home.

www.hopkinsmedicine.org

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://m.youtube.com/watch%3Fv%3DxTnV3m4bWDg&ved=2ahUKEwiigvPuodOFAxU2sFYBHUpSAM0Qo7QBegQIDBAG&usg=AOvVaw1ex7lEPR8YgvdnxMSm0GjT

I have a friend who needed to do that. She was told to keep it up every few weeks and to use a higher pillow to change her sleeping position. She hasn't had vertigo since (about 6 months, so far).

 

[prozac]

Have you tried doing an Epley (treatment for BPPV) to reset the crystals at home?

Home Epley Maneuver

The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV). You can do this exercise at home.

www.hopkinsmedicine.org

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://m.youtube.com/watch%3Fv%3DxTnV3m4bWDg&ved=2ahUKEwiigvPuodOFAxU2sFYBHUpSAM0Qo7QBegQIDBAG&usg=AOvVaw1ex7lEPR8YgvdnxMSm0GjT

No, because I figured you had to do it either side to side (transverse?) or vertically and perhaps mixing up the way it is done might not be a good idea. I am pretty good on my own ailments but don't want to go messing with MrsP. I actually had no idea what it was until last week when GP mentioned it.

Might be back there this week as I am due to have an IVIG. My immunity has been low for too long. All those plasma donations I gave should give me some credit with the blood-bank.

 

[andye]

No, because I figured you had to do it either side to side (transverse?) or vertically and perhaps mixing up the way it is done might not be a good idea. I am pretty good on my own ailments but don't want to go messing with MrsP. I actually had no idea what it was until last week when GP mentioned it.

I have had people feel very dizzy and nauseated during the Epley so perfectly reasonable approach for you to take @prozac.
If people to want to give it a try, you can usually tell which direction to do it by seeing which side makes you feel more dizzy when you do the first bit

(And in true medical parent fashion, I did carry out the manoeuvre on mstrandye3 when he actually turned out to have a rugby-related concussion)

 

[SuePa]

This was what my friend was given. It may be helpful for someone.

 

[prozac]

I have had people feel very dizzy and nauseated during the Epley so perfectly reasonable approach for you to take @prozac.
If people to want to give it a try, you can usually tell which direction to do it by seeing which side makes you feel more dizzy when you do the first bit

Do the eyes flicker one way or the other depending upon which way procedure should be performed?

Post automatically merged: Apr 21, 2024

This was what my friend was given. It may be helpful for someone.

There are some good youtube vids explaining how to perform it too.

 

[andye]

Do the eyes flicker one way or the other depending upon which way procedure should be performed?

If you see flickering (nystagmus) when the first part is done, it's pretty certain it's BPPV and the Epley has a decent chance of working

 

[drron]

As a Junior doctor until 1974 you were on a very low salary and lots of hours. To have a decent standard of living quite a few of us did the night time GP call roster. One nights pay was more than I earnt in a week. I only did one week as a country locum but it was in Cobar. A one doctor town with a GP who fancied his hand as a surgeon. Every now and then he would persuade one of the young ones to come up and give anaesthetics for him. I was in my second year but had just done an anaesthetics term with a good teacher. Everything went smoothly until the Thursday when a woman presented with obstructed labour. Normally such a case was sent to Dubbo by road. Of the last 5 cases 3 mothers had died and there were no surviving infants. So I had my hands well and truly twisted. Ended up doing a great job even if I have to sy so much myself.

Result both mother and baby survived. That night at the RSL and again on the Friday night I didn't have to buy a drink and had to turn a few down.
But the most memorable part was that Mrsdrron came up for the weekend and we were allowed to take his wife's new red 240oz out for a drive to Wilcannia and back. We then continued our holiday to Adelaide via Broken Hill driving my Datsun 1800. Great little car.

 

[OZDUCK]

I had BBPV about 10 years ago and tried the Epley exercises at home. Whether it worked or the problem resolved itself I can't be sure. But the vertigo slowly faded away and I have not had a recurrence so far. My first event was when going to bed and putting my head back onto the pillow.

 

[prozac]

... My first event was when going to bed and putting my head back onto the pillow.

MrsP gets it when she rolls over in bed or sits up, etc

 

[Pushka]

MrsP gets it when she rolls over in bed or sits up, etc

Oh yes. Turning head in bed. It comes on at other times too. Randomly.

 

[Quickstatus]

anaesthetics term with a good teacher.

Bookalil/Joseph?

 

[blackcat20]

I get vertigo, though haven't had a decent episode in ages. I seem to get a run of them, and get a fuzzing in one ear that feels like someone is pouring lemonade in. ENT has investigated but nothing obvious.

 

[trooper]

Well. All booked in for the Prostate surgery in July. Or to give it the full title (IIRC) A robotic laparoscopic radical prostatectomy A bit scary but what can you do....shrug! Not much of a 'trip", it's only the other side of town... but as costly as a nice longhaul return Biz class jaunt! Absolutely positive I am simply joining a rather large club....have a good base level of fitness/health so fingers crossed.

 

[OZDUCK]

Well. All booked in for the Prostate surgery in July. Or to give it the full title (IIRC) A robotic laparoscopic radical prostatectomy A bit scary but what can you do....shrug! Not much of a 'trip", it's only the other side of town... but as costly as a nice longhaul return Biz class jaunt! Absolutely positive I am simply joining a rather large club....have a good base level of fitness/health so fingers crossed.

How everything goes well for you.

 

[Pushka]

Well. All booked in for the Prostate surgery in July. Or to give it the full title (IIRC) A robotic laparoscopic radical prostatectomy A bit scary but what can you do....shrug! Not much of a 'trip", it's only the other side of town... but as costly as a nice longhaul return Biz class jaunt! Absolutely positive I am simply joining a rather large club....have a good base level of fitness/health so fingers crossed.

It seems like most join this club rather than not. Best wishes for the surgery and for the therapy for post surgery.

 

[anat0l]

I have a heart condition that had me stented about 3 years ago and now am taking heart failure medication (not necessarily because I'm in direct trouble, but because the general advice is to just keep taking it, even after recovery). This includes aspirin for blood thinning. I recently had a ECG and ejection fraction is still around 65%.

I'm looking at travel to South America and one of the routings due to flight award availability will route me through Bogota. My main concern is whether or not I should avoid this - stopover or transit at all - due to the high altitude and possibility that my body and heart won't tolerate it.

I see that the altitude of Bogota airport is about the same (about 100 m higher) than standard pressurisation of aircraft. I guess acclimatisation time at Bogota will help - how long should this be? I'm not fit so climbing is not going to be my thing...

For what it's worth, I see that there will never be a possibility that I can visit Macchu Picchu, let alone visit parts of Peru (e.g. Cusco).

 

[prozac]

I have a heart condition that had me stented about 3 years ago and now am taking heart failure medication (not necessarily because I'm in direct trouble, but because the general advice is to just keep taking it, even after recovery). This includes aspirin for blood thinning. I recently had a ECG and ejection fraction is still around 65%.

I'm looking at travel to South America and one of the routings due to flight award availability will route me through Bogota. My main concern is whether or not I should avoid this - stopover or transit at all - due to the high altitude and possibility that my body and heart won't tolerate it.

I see that the altitude of Bogota airport is about the same (about 100 m higher) than standard pressurisation of aircraft. I guess acclimatisation time at Bogota will help - how long should this be? I'm not fit so climbing is not going to be my thing...

For what it's worth, I see that there will never be a possibility that I can visit Macchu Picchu, let alone visit parts of Peru (e.g. Cusco).

65% is a good ejection rate. My post chemo recovery, following heart damage, is 60% which I am told is normal, and now everything is settling in I do not have any issues.

 

[drron]

My last 10 years in private practice were mainly dealing with heart failure patients. In view of my travel profile I had quite a few who wanted to travel to altitude. The only one I said definitely no to was a fellow who wanted to climb Everest.
OK’d him to go to Kathmandu though. It’s not that high.
The official advice from the Heart Failure Society of America was to avoid any altitude higher than 4500 metres and think hard if over 3500 metres.

So Bogata at 2640 metres should be fine with your heart failure. But be sure you are not susceptible to altitude sickness. This is not related to heart failure.

Cusco is ~ 3400 metres so not contraindicated. However Mrsdrron does get altitude sickness so we arranged to be driven to the Sacred Valley immediately. The altitude there was 2800 metres. She felt a little tired and less energy but was fine after a couple of days. So when we went to Machu Picchu at 2400 metres she was fine.

So put the Sacred Valley and Machu Picchu back on your bucket list. I wouldn’t put the walk into Machu Picchu on that list though.

Your EF is fine so you should be quite OK.

 

[Pushka]

My last 10 years in private practice were mainly dealing with heart failure patients. In view of my travel profile I had quite a few who wanted to travel to altitude. The only one I said definitely no to was a fellow who wanted to climb Everest.
OK’d him to go to Kathmandu though. It’s not that high.
The official advice from the Heart Failure Society of America was to avoid any altitude higher than 4500 metres and think hard if over 3500 metres.

So Bogata at 2640 metres should be fine with your heart failure. But be sure you are not susceptible to altitude sickness. This is not related to heart failure.

Cusco is ~ 3400 metres so not contraindicated. However Mrsdrron does get altitude sickness so we arranged to be driven to the Sacred Valley immediately. The altitude there was 2800 metres. She felt a little tired and less energy but was fine after a couple of days. So when we went to Machu Picchu at 2400 metres she was fine.

So put the Sacred Valley and Machu Picchu back on your bucket list. I wouldn’t put the walk into Machu Picchu on that list though.

Your EF is fine so you should be quite OK.

I get altitude sickness. The first time was on the fast elevator in Chamonix, Aquille du Midi at around 3,800 metres. Ascent was rapid. I thought that was why. I couldn't walk a straight line. Headache. My legs felt like they were concrete and heart was pounding. I experienced it again last December up Mt Titlus which is 3,200 metres. It's an awful feeling and you know immediately you need to go down. It was felt after 30 minutes or so after the cable cars.

From my experience I think 3000 metres is the limit.

 

[Quickstatus]

prostatectomy

The surgery has progressed to a point that most patients have only mild pain and it's a 1-2 night stay for most. Typically only Panadol when home.

Worth making sure bowels are empty and diet in the week prior is not gas forming. Basically follow the "low residue diet" for the 3 days before a colonoscopy. Some blokes seem to develop a lot of gas and surgery slows down the gut trapping the flatus and causing bloat.