General Medical issues thread

[andye]

I

And doesn't the B1 help the numbers too?

I'm not aware that it does
Thiamine is often given to heavy drinkers when they come into hospital as there are two dangerous neurological conditions (Wernicke's encephalopathy and Korsakoff's psychosis) that can result from severe B1 deficiency.
However, the reason heavy drinkers are at risk of B1 deficiency is if they getting all their calories from booze (steak in a can) or forgetting to eat.
Many junior docs prescribe thiamine when patients are drinking half a bottle of wine a night and eating well. Combination of sheltered lives and not understanding the physiology

 

[Pushka]

The standard teaching is anything above the cutoff for the lab.
As per @Quickstatus, I don't think your doctor is being unreasonable if he/she is entirely satisfied that your symptoms are explained by a respiratory infection. It's just that ordering the d-dimer has instead of the intention of reassuring him/her (had the test been normal) it has made things more complicated.

I’ve read the same thing about testing ANA. Once it’s positive it can unleash the requirement to test for so many rheumatic type illnesses. Only test for ANA if the physical symptoms demand it.

 

[prozac]

I

I'm not aware that it does
Thiamine is often given to heavy drinkers when they come into hospital as there are two dangerous neurological conditions (Wernicke's encephalopathy and Korsakoff's psychosis) that can result from severe B1 deficiency.
However, the reason heavy drinkers are at risk of B1 deficiency is if they getting all their calories from booze (steak in a can) or forgetting to eat.
Many junior docs prescribe thiamine when patients are drinking half a bottle of wine a night and eating well. Combination of sheltered lives and not understanding the physiology

So I shouldn't worry about the thiamine, my behaviour is perfectly normal?

 

[andye]

So I shouldn't worry about the thiamine, my behaviour is perfectly normal?

For the alcohol questions, I have a "Normal for Northern Beaches" understanding of what I'm being told

 

[QF WP]

So @andye how's your post-op recovery going?

 

[Pushka]

Other liver function test trivia:

= raised GGT

We can tell if you have been a naughty boy or girl.

I'm always very mindful of that and plan blood tests accordingly. . Never do a test on a Monday And I don't eat chocolate the night before for the glucose test.

Post automatically merged: Jul 25, 2024

I suspect you are right but there's many things to consider.

I complained of coughing for 8+ weeks and pain up near the collarbone. No other pain. No sign of chest tightening.

The pain up near collarbone I've had for a long time. It comes and goes. I can feel severe inflammation there which can make it very uncomfortable.

I don't know why Doctor ordered d-dimer. Suspicion of DVT? We've had 4 CT scans in the past 2 years include Doppler checking for DVT and no sign of DVT. The Last CT scan for DVT was February this year. Legs do swell but I've had venous insufficiency for a long time.

I do suffer from severe chronic inflammation. Everywhere. This has been known for a long time. This shows up in the blood test but there's also signs of infection both in the lungs which has responded to antibiotics and signs of urethritis for which were taking antibiotics now.

We'll see where this leads and it will be interesting to see if the doctor does follow up. All he mentioned today was if lungs get worse or pain in collarbone gets worse to present to emergency.

I mentioned aspirin and he agreed so I'll take some aspirin daily. Hope nothing serious.

If you'd had Covid and you mention coughing then this messes with coagulation and I know of a couple of even fit healthy people like this who ended up with a PE. The inflammation markers you mentioned up thread seem normal.

 

[Quickstatus]

And doesn't the B1 help the numbers too?

Not the GGT

 

[JohnK]

If you'd had Covid and you mention coughing then this messes with coagulation and I know of a couple of even fit healthy people like this who ended up with a PE. The inflammation markers you mentioned up thread seem normal.

If I had covid then it was not noticeable. I'll stick with Novid. Possibly a virus with a nagging cough that lasted 8+ weeks with phlegm and no phlegm and phlegm again etc but no other symptoms or even fever. Confusing.

Previous full blood count was normal beginning of May and now both AST and ALT elevated. Liver is fighting some sort of infection or inflammation. For the past 3 weeks I can feel severe discomfort in my body from the inflammation.

Anyway looks like 10 Keflex tablets have been helping with urethritis as the stinging has gone. I may need 10 days treatment and then ask to repeat full blood count to see if liver returns to normal.

Old age with these chronic conditions aint fun at all.

 

[andye]

So @andye how's your post-op recovery going?

Thanks
After being very sore at Moore Park watching the Wallabies at the weekend, I'm now down to paracetamol (and low dose apixaban to prevent DVT) only and can manage indoors without crutches. Minimal swelling around the knee.
The brace keeps slipping down especially walking around at work but I'm good at keeping the leg straight.
Virtual clinics for my Western Sydney hospital are going ok.
Do get tired. I'm still 3 weeks away from doing any physio and have about another 9 weeks to go in the brace.

 

[QF WP]

I can relate to the reduction in pain medication, down to 2 Panamax morning and night. Good outcome so far

Damn that annoying slipping brace - for me it was the bandage I had over the dressing so people wouldn’t see the dressing which had plasma and blood oozing into it for the first couple of weeks. Generally had to reset the bandage daily.

Tiredness - yep, the body lets you know when you’ve unwittingly overdone it. Family had never seen me fall asleep in my reclining chair - but did 3 times in early evenings in the first couple of weeks. Age sucks when it comes to the healing process.

Hope Miss & Mrs Andye have been looking after you. That first couple of weeks when you can’t do anything is frustrating for everyone.

I finally found a solution for having showers again - a cast protector. Sponge baths just haven’t cut it. Wrapping my leg in 2 places with cling wrap wasn’t working very well - legs too hairy for grip. Found a full leg cast protector - although it looks like a giant condom. But it’s been working and just fits above the skin graft.

 

[prozac]

I can relate to the reduction in pain medication, down to 2 Panamax morning and night. Good outcome so far

Damn that annoying slipping brace - for me it was the bandage I had over the dressing so people wouldn’t see the dressing which had plasma and blood oozing into it for the first couple of weeks. Generally had to reset the bandage daily.

Tiredness - yep, the body lets you know when you’ve unwittingly overdone it. Family had never seen me fall asleep in my reclining chair - but did 3 times in early evenings in the first couple of weeks. Age sucks when it comes to the healing process.

Hope Miss & Mrs Andye have been looking after you. That first couple of weeks when you can’t do anything is frustrating for everyone.

I finally found a solution for having showers again - a cast protector. Sponge baths just haven’t cut it. Wrapping my leg in 2 places with cling wrap wasn’t working very well - legs too hairy for grip. Found a full leg cast protector - although it looks like a giant condom. But it’s been working and just fits above the skin graft.

I think I have used masking tape to seal upper edge.

 

[prozac]

 

[JohnK]

Went to GP this morning. We're doing d-dimer again and cough has been back for 3-4 days so now in the 10th week.

Is it possible there's a tiny clot already in lungs causing cough? May have to do CTPA depending on this result. If anyone has done this test is it possible to be heavily sedated (like laughing gas) so that you do not remember anything?

Just the thought of doing this test is causing me stress.

 

[Quickstatus]

If anyone has done this test is it possible to be heavily sedated (like laughing gas) so that you do not remember anything?

Its a simple CT scan with contrast injected into the vein.

 

[Pushka]

Went to GP this morning. We're doing d-dimer again and cough has been back for 3-4 days so now in the 10th week.

Is it possible there's a tiny clot already in lungs causing cough? May have to do CTPA depending on this result. If anyone has done this test is it possible to be heavily sedated (like laughing gas) so that you do not remember anything?

Just the thought of doing this test is causing me stress.

It's not that bad at all and likely the XRay people won't do that. The worst feeling is that you are going to pee but that passes quickly and it's a known event.

 

[JohnK]

Its a simple CT scan with contrast injected into the vein.

So simple means no need to go into CT scanner tunnel for around 10 minutes?

Are there any alternatives that do not involve severe anxiety/panic?

 

[Quickstatus]

So simple means no need to go into CT scanner tunnel for around 10 minutes?

I think will only take 5-10 min in CT tunnel. They will ask you to hold your breath with each CT run.
Often get a metallic taste when they inject the dye

Are there any alternatives that do not involve severe anxiety/panic?

Alternative is don't do the test. But as your d-dimer went up this is the necessary next step.

 

[JohnK]

I think will only take 5 min in CT tunnel


Alternative is don't do the test. But as your d-dimer went up this is the necessary next step.

We'll see about CT. My body does not handle enclosed spaces.

Several diseases are characterised by low-grade chronic inflammation and thus high D-dimer; the most common are autoimmune diseases and diabetes.

What does that mean? I have had both for 20+ years, autoimmune condition is 40+ years. So D-dimmer may always have been high not just a recent elevation? Hope reading returns back to normal if there is such a thing as nornal.

 

[Quickstatus]

We'll see about CT

The CT tunnel is a lot wider than MRI. Have you had a CT before?

What does that mean?

Means just that. As expplained before, there are other causes for an elevated D-Dimer especially a slightly elevated one. No it does not mean your D-dimers is permanently elevated

 

[drron]

We'll see about CT. My body does not handle enclosed spaces.



What does that mean? I have had both for 20+ years, autoimmune condition is 40+ years. So D-dimmer may always have been high not just a recent elevation? Hope reading returns back to normal if there is such a thing as nornal.

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