General Medical issues thread

[Flyfrequently]

I am in day-oncology having a rituximab infusion. Woman a couple of chairs up is talking loudly on her phone which she has switched to speaker, volume turned up. I am captive to her inane family life.

Not sure whether to do hugs for you or sad face because of that woman @prozac
Hope today goes well for you

 

[prozac]

Not sure whether to do hugs for you or sad face because of that woman @prozac
Hope today goes well for you

Thanks @Flyfrequently , @Pushka , et al. Just had a visit from an AFF member which was very nice. This is more effective than jungle drums.

 

[andye]

Thanks @Flyfrequently , @Pushka , et al. Just had a visit from an AFF member which was very nice. This is more effective than jungle drums.

Good to drop in and see/distract you @prozac
Keep on getting better

 

[MARTINE]

Thanks @Flyfrequently , @Pushka , et al. Just had a visit from an AFF member which was very nice. This is more effective than jungle drums.

Hope you shouted at each other

 

[prozac]

Hope you shouted at each other

Finished now. When I got out of my chair I turned to look at her. She seems quite nice. Just proves looks can be deceptive.

 

[LinaLee]

She's on another call now ... apparently had a wonderful dinner last night.

Oh yes. Just adds to the stress especially if you just want to not be there mentally. Mine was about all the treatment she had to go through so far….

So sorry you’re subjected to that. Not fun. Not sure what you can do. Maybe bring your own noise cancelling headphones.

 

[Himeno]

Stupid migraines.

Got a migraine on Tuesday night. The worst of it cleared up quickly and I went to work as normal on Wednesday.
migraine came back Wednesday night. It was at "workable" levels on Thursday morning so I went to work.
Lasted 90 minutes before it was to bad to keep going and was given a lift home (rather then 20-30 mins on a bus then depending on timing a 15ish min walk or another 5ish min bus)
Felt good enough to go to work on Friday. Made it as far as the bus stop (1.3km walk) and was getting dizzy. Went to the walk in center instead and got Friday and yesterday off.
Spent Friday getting dizzy when I moved around. Improved yesterday, then headache and some aura returned last night.
Dizziness returned this morning after the walk to the bus, so back to the walk in center. Nurse said to go to hospital if it gets worse.
Called into work and was told to have Wed off as well as wasn't working Thurs anyway due to the public holiday and store only open half the day.

Have been getting migraines for about 15 years. Have never gotten dizzy from them. I normally get the headache (amount of pain varies), aura, nausea, vomiting (sometimes), and photophobia.

 

[prozac]

Stupid migraines.

Got a migraine on Tuesday night. The worst of it cleared up quickly and I went to work as normal on Wednesday.
migraine came back Wednesday night. It was at "workable" levels on Thursday morning so I went to work.
Lasted 90 minutes before it was to bad to keep going and was given a lift home (rather then 20-30 mins on a bus then depending on timing a 15ish min walk or another 5ish min bus)
Felt good enough to go to work on Friday. Made it as far as the bus stop (1.3km walk) and was getting dizzy. Went to the walk in center instead and got Friday and yesterday off.
Spent Friday getting dizzy when I moved around. Improved yesterday, then headache and some aura returned last night.
Dizziness returned this morning after the walk to the bus, so back to the walk in center. Nurse said to go to hospital if it gets worse.
Called into work and was told to have Wed off as well as wasn't working Thurs anyway due to the public holiday and store only open half the day.

Have been getting migraines for about 15 years. Have never gotten dizzy from them. I normally get the headache (amount of pain varies), aura, nausea, vomiting (sometimes), and photophobia.

I got migraine for 40yrs. Eventually a neurologist prescribed me naprosyn which I would take (and then lie down for a while) when I felt an attack starting or after it started. Was great at helping control it. I no longer have migraines but feel your pain, they are very debilitating.
You can test if it works for you without a script by buying a pack of Naprogesic. Same ingredient (naproxsen sodium) in a smaller pack.

 

[Pushka]

Stupid migraines.

Got a migraine on Tuesday night. The worst of it cleared up quickly and I went to work as normal on Wednesday.
migraine came back Wednesday night. It was at "workable" levels on Thursday morning so I went to work.
Lasted 90 minutes before it was to bad to keep going and was given a lift home (rather then 20-30 mins on a bus then depending on timing a 15ish min walk or another 5ish min bus)
Felt good enough to go to work on Friday. Made it as far as the bus stop (1.3km walk) and was getting dizzy. Went to the walk in center instead and got Friday and yesterday off.
Spent Friday getting dizzy when I moved around. Improved yesterday, then headache and some aura returned last night.
Dizziness returned this morning after the walk to the bus, so back to the walk in center. Nurse said to go to hospital if it gets worse.
Called into work and was told to have Wed off as well as wasn't working Thurs anyway due to the public holiday and store only open half the day.

Have been getting migraines for about 15 years. Have never gotten dizzy from them. I normally get the headache (amount of pain varies), aura, nausea, vomiting (sometimes), and photophobia.

I'm wondering if the migraine and dizziness are two different issues. Currently I'm experiencing flash moments of vertigo too. I had it significantly a couple of years ago. Maybe there's some viral thing going around?

 

[drron]

It all depends what you mean by dizziness. Getting people to actually describe dizziness is essential. I can still remember a few of the most unusual such as the gentleman who described his dizziness as the heart pounding very fast in his chest.
Generally 2 major types. Light headedness and Vertigo.
Vertigo is the head spinning and usually related to ear or brain stem problems. Migraine though can be accompanied by vertigo or light headedness.

 

[Quickstatus]

dizziness

Unfortunately its a very inaccurate word which mean different thigs to different people

When patients say they are light headed, i try to use other terms such as "fuzzy head" , "woozy head", feeling drunk, feeling drugged, about to faint....
This is quite different to the world spinning from side to side as per @drron

One unusual one was a ward nurse calling me at 3am saying my 90 yr patient rang their daughter who then rang the ward RN . The daughter said mum is dizzy when in reality she was in acute delirium and hallucinating after a broken hip was fixed earlier that evening

 

[drron]

My best early morning call was when doing the night Sydney Inner West GP night locum service back in 1970. A family rang saying their father had a severe chest pain and come urgently. When I arrived the cause was obvious with a kitchen knife protruding from his chest.
The side story is even better. I ran a red light across Parramatta road. Got pulled over by the police and said I was on an urgent call to a man with chest pain and they let me go. The patient was beyond any medical help so I called the police. the same car responded. They did say to me that they hadn't really believed my story until now.

 

[prozac]

Good to drop in and see/distract you @prozac
Keep on getting better

I was surprised when you turned up. Don't normally have visitors, well ok never. Was good to catch up.

 

[andye]

I was surprised when you turned up. Don't normally have visitors, well ok never. Was good to catch up.

Usually have a clinic elsewhere on Friday morning but was on-call so the stars aligned

 

[Quickstatus]

locum

I only ever did one locum. That was in Brewarrina when i had 2 weeks leave from RNSH when i was a registrar. it was during the floods in the 1990s
It was an eye opener from the cloistered routine of a tertiary hospital
The roads to Bourke which was the nearest large(r) hospital were blocked by the floods. I had a few obstetric patients who has to be transferred there but had to go via Byrock.
Lots of Aboriginal patients for whom it was useless giving them a prescription as they would not fill it. Basically we had them come in everyday and the little town hospital if you could call it that dispensed the pills for the day. Lots of violence/alcohol especially on Thursday which was when the govt gave out free money (pensions and similar). I visited some of the Aboriginal houses which were invariably trashed. A sad state of affairs which i dare say continues today in various forms

A few of my consultations were in the one pub which was interesting. I could never get a quiet pint.

The most urgent one was a Quinsy (tonsillar abscess) which had to be flown out by RFDS as it had the potential of blocking the breathing


They gave me a car - it was likely the only car that would not be stolen as it was the Doc's car - everyone knew the Doc's car.
It was interesting but sobering at the same time but i think i was a little out of my depth.

 

[andye]

I'm wondering if the migraine and dizziness are two different issues. Currently I'm experiencing flash moments of vertigo too. I had it significantly a couple of years ago. Maybe there's some viral thing going around?

In my (hospital-based) experience, migraine is the 3rd commonest cause of true vertigo (illusion of spinning) with 1. BPPV (benign paroxysmal positional vertigo if you ask) 2. Vestibular neuronitis (often post-viral) 4. Stroke 5. Menieres disease 6. Others including acoustic neuroma and cerebellar problems being the differentials

I spend a fair bit of time ruling out stroke in people with vertigo without clear-cut evidence of vestibular disturbance but if there are no associated other stroke symptoms (speech disturbance, double vision, visual loss, unilateral weakness, sensory loss or limb clumsiness) it's very unlikely (<5%).

If like you, the vertigo is intermittent and recurrent, especially with migrainous symptoms you can be reassured it won't be a stroke

 

[prozac]

In my (hospital-based) experience, migraine is the 3rd commonest cause of true vertigo (illusion of spinning) with 1. BPPV (benign paroxysmal positional vertigo if you ask) 2. Vestibular neuronitis 4. Stroke 5. Menieres disease 6. Others including acoustic neuroma and cerebellar problems being the differentials

I spend a fair bit of time ruling out stroke in people with vertigo without clear-cut evidence of vestibular disturbance but if there are no associated other stroke symptoms (speech disturbance, double vision, visual loss, unilateral weakness, sensory loss or limb clumsiness) it's very unlikely (<5%).

If like you, the vertigo is intermittent and recurrent, especially with migrainous symptoms you can be reassured it won't be a stroke

MrsProzac is seeing an ENT this week to confirm and hopefully reposition the inner ear crystals. I hope this resolves her vertigo.

 

[Quickstatus]

reposition the inner ear crystals

Called the Epley manouvre IIRC. Also: Canalith repositioning procedure
Does not involve aromatherapy, chakras, pyramids, or tarot card reading by a gypsy

 

[andye]

MrsProzac is seeing an ENT this week to confirm and hopefully reposition the inner ear crystals. I hope this resolves her vertigo.

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

 

[Pushka]

In my (hospital-based) experience, migraine is the 3rd commonest cause of true vertigo (illusion of spinning) with 1. BPPV (benign paroxysmal positional vertigo if you ask) 2. Vestibular neuronitis (often post-viral) 4. Stroke 5. Menieres disease 6. Others including acoustic neuroma and cerebellar problems being the differentials

I spend a fair bit of time ruling out stroke in people with vertigo without clear-cut evidence of vestibular disturbance but if there are no associated other stroke symptoms (speech disturbance, double vision, visual loss, unilateral weakness, sensory loss or limb clumsiness) it's very unlikely (<5%).

If like you, the vertigo is intermittent and recurrent, especially with migrainous symptoms you can be reassured it won't be a stroke

I find with having a DVT, then diagnosed with APS and being on 'blood thinner' that the very mention of stroke sends shivers down my spine. And my instant thought with this vertigo. I've tried to move the crystals but no success although vertigo did relent after a few weeks.