General Medical issues thread

[Quickstatus]

@JohnK and your head will not be enclosed by anything

 

[JohnK]

The CT scanner is a big donut. It is not a tunnel or tube. The table moves you through it. Not claustrophobic at all.

Sorry Doc but totally disagree. I've had CT scans in the past and they are extremely claustrophobic. It may be shaped like a doughnut but the tube still spins around you while you slowly go through it. From memory the tube is only a few centimetres from my face.

Due to tight space, some patients may experience high levels of anxiety and fear, making it difficult for them to stay still

I remember last one was a couple of years ago at Greenslopes when I had CT of the left leg and it wasn't required that I fully go inside the tube but still had to do the CT scan twice.

My behaviour may well be irrational but unfortunately it is what it is. I can take 2-3mg of Xanax but that's not as good as being sedated.

GP said he cannot help if I cannot do the CT scan.

 

[Quickstatus]

My behaviour may well be irrational but unfortunately it is what it is

Not uncommon to be claustrophobic.
Suggest have a prior discussion with radiology . They will have solutions.

 

[Pushka]

Sorry Doc but totally disagree. I've had CT scans in the past and they are extremely claustrophobic. It may be shaped like a doughnut but the tube still spins around you while you slowly go through it. From memory the tube is only a few centimetres from my face.



I remember last one was a couple of years ago at Greenslopes when I had CT of the left leg and it wasn't required that I fully go inside the tube but still had to do the CT scan twice.

My behaviour may well be irrational but unfortunately it is what it is. I can take 2-3mg of Xanax but that's not as good as being sedated.

GP said he cannot help if I cannot do the CT scan.

Unless they are scanning your head then I wouldn't thing it woukd be inside the donut at any time. They focus on the area defined by the requesting doctor and nothing more.

 

[andye]

Claustrophobia can be a real problem for people. CT is much better than MRI but I have run into people like you @JohnK and know it's not in your control. As it's a scan of your chest, your face will be near the doughnut but shouldn't be right inside. I'd suggest having a go with valium as full sedation has its own risks and is a bit of a pain to sort out

 

[JohnK]

So d-dimer reading yesterday was 0.57 down from 0.74 the week before.

My choice is present to emergency and do the CTPA or low dose Xarelto 10mg for around 3 months. (Obviously Xarelto comes with some risks)

I don't know what any of this means so for now I have chosen Xarelto.

 

[andye]

My perosnal advice would be to get the CTPA. I would usually advise full-dose xarelto if treating for a presumed PE. Another option is to do a nuclear medicine VQ scan which isn't at all claustrophobic but can be difficult to interpret and doesn't always give definite results
Changes in d-dimer don't really mean much (in my opinion)

 

[RooFlyer]

I was supposed to have 15 minutes in an MRI. They gave me headphones with music of my choice and I just closed my eyes and relaxed. Unfortunately, I got a cramp in my leg after 10 minutes and had to squeeze the stop thing.

 

[andye]

I was supposed to have 15 minutes in an MRI. They gave me headphones with music of my choice and I just closed my eyes and relaxed. Unfortunately, I got a cramp in my leg after 10 minutes and had to squeeze the stop thing.

Hopefully they will have acquired enough sequences to give some information at least

With my leg MRI I was told ( by a radiographer I know well) that I was a "wriggler". The later sequences were pretty blurry to my eye. I've had quite a few MRIs before and stayed very still. This time I was shivering as it was chilly, possibly with some pain on top

 

[Pushka]

So d-dimer reading yesterday was 0.57 down from 0.74 the week before.

My choice is present to emergency and do the CTPA or low dose Xarelto 10mg for around 3 months. (Obviously Xarelto comes with some risks)

I don't know what any of this means so for now I have chosen Xarelto.

I've been on Xarelto for 8 years now. 20 mg. Will be for life. It's at the top end of the PBS price. The main issue is bruising and the steroi_s don't help that problem either. Just be careful around sharp things. You will have bruises in places and you can't image why . Oh. I have to get monthly blood tests (not because of Xarelto but for steroi_ and PMR monitoring. ). I look like a druggie one week a month.

Post automatically merged: Jul 30, 2024

I was supposed to have 15 minutes in an MRI. They gave me headphones with music of my choice and I just closed my eyes and relaxed. Unfortunately, I got a cramp in my leg after 10 minutes and had to squeeze the stop thing.

I've never had an MRI but it seems from all who have that it isn't a pleasant experience - at all!

 

[Pushka]

On blood tests. Have to have them monthly. No need to fast. The thing I hate is the waiting room. I go to a Path lab that loads results to my health. Many don't.

Today arrived at 9.15am and waiting room for Drs and Path was full. Hoping it was only for Docs. I was 12. After ten minutes they called - 7 . At 15 minutes a pop that's 90 minutes wait. I had stuff to do. So I replaced my number and walked out. Returned at almost exactly 90 minutes later and the next number to be collected was - 13! Yeah. And no 12 who'd collected my original number was just walking out. I went straight in. Winner strategy. But weird that there had only been one other patient in that 90 minute block.

 

[RooFlyer]

Hopefully they will have acquired enough sequences to give some information at least

Just! it was of the entire pelvis area, looking for the reason of post hernia operation continuing pain, with side issue of checking on the progress of my osteoarthritis in the SI joint etc.

 

[drron]

Before I canon this trip I had a total body MRI. Luckily for the first time ever my familiar tremor didn’t play up and I actually went to sleep.

I have worked for a nuclear medicine physician and have performed the procedure for diagnosis of PE. He did a ventilatory scan as well as a perfusion scan to increase the accuracy. The usual problem reading the scans is obstructive aiways disease. The major problem now is that most nuclear medicine procedures are done by radiologists not nuclear medicine physicians.

And don’t be scared of the “nuclear “ is dangerous. I had radium implanted into my foot 77 years ago and I am still here.

 

[ellen10]

I went to pathology today. Fasting before test. Pathology opened at 7.30. went at 8.10am and only waited 6 mins. They had 11 before me. So good strategy to go a bit after the rush. They had two operators working.

 

[JohnK]

Changes in d-dimer don't really mean much (in my opinion)

Thank you for the wonderful opinions/suggestions and same for all the doctors on here. I'm just trying to understand what's going on to make an assessment.

I'm not doing private CTPA. I don't know what it costs but I'm not paying out of pocket. If I had to do CTPA I'd do it via Emergency for free but I don't know how long I'd be in Emergency so may leave that for now.

If CTPA shows clot in lungs then what next? Anti-coagulant? What if no clot in lungs? Preventative anti-coagulant for life?

If changes in d-dimer don't mean anything then why worry? Doctor has sent updated results. Baseline d-dimer is <55 mg/L and last weeks reading was 0.70 and yesterday's reading was 0.57! I have taken aspirin the past few days so that may helped.

ALK Phosphotase has increased again but ALT is back down <7 which is low. GGT and AST have both gone down.

C-reactive protein has gone from 3.2 back to 1.1!

Fasting cholesterol is 3.7 with triglyceride 1.0!

I don't know what to do. I'm not sure about CTPA if d-dimer returns to normal. I would like another d-dimer reading next week or the week after. My GP said check again in 3 months.

 

[andye]

If CTPA showed clot it would be full dose anticoagulant for 6 months at least. If no clot, no meds needed (whatever the d-dimer)

When I said changes on d-dimer don't matter, what I meant was that if it's above the normal range it's abnormal (some different age cut-offs for age though).

Small increases in LFTs are not uncommon. I don't tend to do anything except observe until they are double normal range (unless the patient it significantly unwell and its a clue or it's persisted for several months)

Both CRP results are essentially normal

Cholesterol very good

Hope things go well for you. Sounds like you are getting a bit better

 

[JohnK]

Here's something I didn't think about.

I had a headache yesterday and didn't take anything for it and headache continues today. I started Xarelto last night but this is not the cause of the headache.

So what can I take for headache while on Xarelto? Aspirin and Nurofen are out of the question as they could cause bleeding. Panadol is useless. I can try 2 Panadeine Forte but can't remember if this did anything for headaches.

Anyone on Xarelto or similar have a secret remedy for headaches?

 

[RooFlyer]

Anyone on Xarelto or similar have a secret remedy for headaches?

Nothing wrong with taking Nurofen for me. If you are particularly worried, take it with some food. An/or lie down in quiet.

While on Xarelto, I regularly take Nurofen anytime and occasionally NSAIDs (Celebrex etc, with food) with blessing of my GP.

 

[andye]

Here's something I didn't think about.

I had a headache yesterday and didn't take anything for it and headache continues today. I started Xarelto last night but this is not the cause of the headache.

So what can I take for headache while on Xarelto? Aspirin and Nurofen are out of the question as they could cause bleeding. Panadol is useless. I can try 2 Panadeine Forte but can't remember if this did anything for headaches.

Anyone on Xarelto or similar have a secret remedy for headaches?

Paracetamol or panadeine are the usual recommendations but if dont work for you, a couple of nurofen are unlikely to cause too much bleeding risk especially as you are on low dose and your kidney funtion is ok. It's chronic use or when current active bleeding that its a no-no.

People on anticoagulants should be careful with headaches that aren't usual for them. Incidence of intracerebral bleed on xarelto etc is lower than warfarin but still a consideration

 

[JohnK]

Paracetamol or panadeine are the usual recommendations but if dont work for you, a couple of nurofen are unlikely to cause too much bleeding risk especially as you are on low dose and your kidney funtion is ok. It's chronic use or when current active bleeding that its a no-no.

People on anticoagulants should be careful with headaches that aren't usual for them. Incidence of intracerebral bleed on xarelto etc is lower than warfarin but still a consideration

Kidney function is OK but there may be something wrong with kidneys.

Had white blood cells and red blood cells in urine sample last week. Doctor said this is more than likely related to infection.

Doctor rang this morning and still a lot of flora in urine sample and now no white blood cells but still red blood cells in urine. I can't think of anything that may be causing it. Internal bleeding? Kidney issues?

Doctor said we'll repeat d-dimer in 2 weeks and another urine sample. If still have red cells in urine may need Kidney ultrasound.

The headache cannot be due to Xarelto as I had headache during the day and my first Xarelto was last night. I was stressed 2 nights ago and noticed that I took 3 x 300mg Aspirin about 6:30pm Monday night and at around 8:00pm had a headache. Not sure headache was there already or developed between 6:30pm-8:00pm. Anyway same sort of headache has continued on and off. Top of left eye felt swollen and now right side base of back of head just above neck. More than likely tension headache.

Difficult trying to deal with all of these issues even if they seem minor to many. Funny thing is Glucose is 5.0 and the blood test mentioned no sign of diabetes and I'm supposed to have type 2 diabetes so under control as well as cholesterol.