Venous system
Challenging interesting time sensitive case! Help please :)
2024.05.18 07:45 cath_wou Challenging interesting time sensitive case! Help please :)
Cate, Yellowknife, Canada 33yo Female 5’6'', 118-120 pounds Meds (went from none to): Propranolol 20 to 40mg/day Ketotifen (1-4mg/day) Rupall (20-40mg/day) Very new since yesterday: Amitriptyline 10mg As needed now (hate them but was told to take to avoid CNS and ANS and PNS attacks): Valium 5-10mg as needed (I don’t take it everyday at all and just started taking it AFTER my venous gases were taken so they didn’t do what you will read about)
Supplements: Curcumin LongVida Quercetin Resveratrol Benfothiamine L-Carnitine Ubiquinol NAC NADH
Hi!
My name is Cate. I am 33yo and I am from Canada. Just to give a little bit of a background, I was always an extremely active person. I have a dog I used to walk and hike with hours a day. I would happily trade a party with friends just to go walk with my dog. I always was a highly sensitive person nervous system wise. When I was young, I would tell my mom to 'turn off the sun' (lol). I lived well with it though. I became a social worker. Worked crazy hours. I’ve had insomnia for years since a first nervous injury after getting EBV. I recovered though. I moved to a very small town 7 years ago and I live with my dog. I love Life and the outdoor. The only health issue I had was a sensitive nervous system and some rosacea. I also know now that I was prone to dysautonomia but I was extremely active so having low BP and athletic HR (50bpm) wasn’t unusual. I would sometimes get dizzy when standing but not always and never had tachycardia or palpitations from it. I also had slightly stretchy skin so was prone to EDS. I know now, you’ll soon understand why. Back in 2018, I took Accutane and burnt in the sun. I developed mild SFN but it went away with time and my life was normal. More than normal. It was great! :)
In December 2023 I was prescribed Doxy for my Rosacea. I took it once and had to stop as I felt warm patches of skin on my body. It reminded me of the SFN. So I didn’t take a chance. However, I noticed in the weeks after that I had developed a weird anxiety and some insomnia (nervous system injury #1). A few weeks later, I was told to try Metronidazole. I used it for about 2 weeks. All hell broke loose. It started with pins and needles in hands and feet. Never had that before so I didn’t think much of it. Then I became very dizzy. And my mood changed. I was crying for no reason, historically. And I started having burning skin on my limbs. I stopped the meds. But it was too late. I had developed palpitations, lower voice, weak legs, etc. I had a neurotoxicity. (Nervous system injury #2) My doctor didn’t want to believe it was that but was thinking GBS. I was however hyoerreflexive so it wasn’t GBS. But he prescribed some Ativan. I took it but quickly it wasn’t doing what it was supposed to do. After even just a few days I could feel more anxiety. It was awful. So I stopped taking them after about 10 days. Things went from bad to worse: terrible panic attacks, flashes of light and stroboscopic type of images when closing my eyes, insomnia but to the point of not sleeping for a month, pelvic floor pain, myoclonus jerks, full body internal vibration, sensitivity to sound, it was scary. (Nervous system injury #3). I forgot to say but my periods also never came.
I was sent for an MRI and obviously my MRI was ok. But things were NOT normal. My palpitations were so bad, my heart would skip beats, I was so dehydrated cause I became hyperadrenergic. I also started to have anhedonia and my GI motility stopped. I could not feel hunger anymore. It was weird. But I wasn’t short of breath. Just had palpitations. Doctors told me I have FND, but it was not FND. FND doesn’t stop your periods, doesn’t mess with your hormones, doesn’t give you continuous insomnia for a month. And I never had a limb not functioning or had a seizure. Therefore. I left to find more and better answers. I knew it as the nervous system but I am not a doctor so had to rely on them for help.
I went back to my home town. I was a mess but physically I was fine. I was eating, digesting, but I had become more short fuse, still having the myoclonus, and all the other weird symptoms with some derealization and sound sensitivity. But I could still laugh etc. I went to see a doctor and he thought maybe it was a bad withdrawal so I was put on a high dose of Valium. Obviously all of my symptoms vanished but others showed up: I started having hand tremors and benzos would act very paradoxically on me. It was increasing my BP and HR, made me cry all the time and become aggressive. I had to come off then. I stayed on them for 6 weeks from 40mg (that’s crazy, I was taking 1mg of Ativan..) to 25mg and was then switched to Gabapentin. The hospital who did that however decided after a few days that I didn’t need the Gabapentin anymore and removed it. I thought I was gonna die. I started having tremors on my face and even to my tongue. I started being very agitated (obviously, I was going through a terrible withdrawal!) and was told they would inject me with antipsychotic. I honestly have never been this traumatized in my life. I restarted the Gabapentin and took it for a month. Hated it too cause ai was super paradoxical to it as well. Most people feel calm on Gabapentin. I felt so agitated and developed weird body movements like my head would twist involuntarily and my fingers were moving from left to right, especially on my left hand.
I stopped the Gabapentin after tapering. In a few days, I was back to normal. I was so happy. Could walk my dog daily, drive, go to the grocery store, I had found myself again. Until I went on a hike. It wasn’t a long hike but it was more demanding than the walks I was doing on flat ground daily. I would walk for several hours but never to the point of being anaerobic. On that hike I did though.
After the hike, I started feeling jittery. My nervous system didn’t like that at all. I went to bed, put on a meditation and fell asleep. That night is still traumatic lol. I felt electric zaps all in my body and spine. I sweat so much. I woke up drenched and with pain everywhere but mostly, every joint in my body cracked. Every single one. I had never been in pain like that in my life. But also, the palpitations were back but much much worse. And also high BP, which I never had even during the beginning after the neurotoxicity started. I wasn’t able to function anymore. I saw my GP and he didn’t like what he saw. I was completely dehydrated, muscles and joints were all painful, crazy palpitations, high blood pressure that I never had before, could hardly walk. He sent me to the hospital. He also confirmed this isn’t FND for the same reasons I mentioned before, and he knows me very well. All my muscles literally melted almost overnight. Like literally melted. And my skin had become stretchy as if all my connective tissues broke down (EDS flared up but like literally overnight).
Once at the hospital, they finally took things more seriously. I was started on on IV fluid for low potassium (very weird cause I make my electrolytes every day and never had an issue with that. You’ll see, it’s relevant). I also had elevated proteins in my body. Very weird too cause I wasn’t eating more proteins than I used to. I also had low WBC. My hormones were obviously all over the place. I was actually due to start my period and it never came. I stopped pooing again and stopped digesting my food. I know that’s dysautonomia. I had started to feel slightly better after a few days and walked a bit in the hallway. That night.. other ‘attack’. I don’t know how to call them. A few days after that, I still had pain in my muscles and was scared I was denervated (Metronidazole does that), so I though I would speed up the process by giving myself a full body deep tissue massage….. worse mistake of my life. Worse attack that night and the next day I had burning pain all over. Worse palpitations. All over. I also am now in a wheelchair because if I walk even a few minutes, I get an attack that night and wake up with even more weird stuff.
Fast forward to now. I am in Vancouver, Canada. As there isn’t many specialists in my small town (there isn’t any lol). I am worse than ever. My bloodwork look horrendous. My venous gases show I am in acidosis. I cannot breathe if I sit up or stand so I am laying down. My fasting glucose is at 6. I wore a CGM for months and I had perfect blood sugar and was never insulin resistant. I have low MPVs. Low potassium always despite eating bananas and drinking electrolytes all the time. My skin is completely dehydrated and flaking. I get palpitations even laying down.
I had a nerve conduction test and so far so good, I still have nerves. This is not just dysautonomia. Even at my worse, I didn’t have palpitations laying down in bed. And never to that extend. I have developed every problems of the Pentad like it is called: EDS, Dysautonomia, MCAS, Autoimmunity and I don’t remember the last one but I have it too.
I know this is an over reactive/over sensitive nervous system. That’s quite obvious. I have been running on NS injuries after NS injuries for almost 5 months. Also, my breath smells like ketones now I was told. I eat normally.
However, there is more. I forgot to say, on top of that, I have a pituitary tumour (but we know it’s not that causing the issues as when I was on benzos, my periods came back!), I have a thyroid nodula but it’s non-secreting (have had it over 10 years now) and I have a history of hypothyroidism for which I took meds for two months and then I never had an issue with it again. They tested it at the hospital and it’s ok. There is some auto-immunity in my family. My sister had a bout of RA after she gave birth, my mom has EDS for sure and also had Endometriosis, she also has orthostatic intolerance which is the very beginning stage of dysautonomia, she has rosacea prone skin too. Etc.
I know this cascade triggered viral infections and auto-immunity, but what do I do? These things are understood by only a small minority of doctors and I don’t know where to start. I think I will never get better if we don’t figure out the cause of my problems with the insulin and mostly why I have respiratory acidosis!
I don’t have ANA activated so far in my bloodwork for the main stuff but clearly I know what’s up..! I know EDS is considered a genetic condition but I strongly think as many doctors that they are auto-immune related. Never had any problems with that until my nervous system broke down which also activated inflammation and my immune system to start having real troubles.
Let me know where to start please, I am scared of dying in the hotel room. I am tired of being in bed but I know I am making things worse when I walk. I am developing ME/CFS, I know it, but it still won’t say why I am hypoventilating 24/7 with low potassium and low MPV and low WBC with high proteins. I am freaking out that my life and health are literally going to hell because of an antibiotic..! For a perioral dermatitis 😂..! I am remaining calm but.. not gonna lie.. it’s no fun.
Thanks for your help!!!
Cate xx
submitted by cath_wou to AskDocs [link] [comments]
Supplements: Curcumin LongVida Quercetin Resveratrol Benfothiamine L-Carnitine Ubiquinol NAC NADH
Hi!
My name is Cate. I am 33yo and I am from Canada. Just to give a little bit of a background, I was always an extremely active person. I have a dog I used to walk and hike with hours a day. I would happily trade a party with friends just to go walk with my dog. I always was a highly sensitive person nervous system wise. When I was young, I would tell my mom to 'turn off the sun' (lol). I lived well with it though. I became a social worker. Worked crazy hours. I’ve had insomnia for years since a first nervous injury after getting EBV. I recovered though. I moved to a very small town 7 years ago and I live with my dog. I love Life and the outdoor. The only health issue I had was a sensitive nervous system and some rosacea. I also know now that I was prone to dysautonomia but I was extremely active so having low BP and athletic HR (50bpm) wasn’t unusual. I would sometimes get dizzy when standing but not always and never had tachycardia or palpitations from it. I also had slightly stretchy skin so was prone to EDS. I know now, you’ll soon understand why. Back in 2018, I took Accutane and burnt in the sun. I developed mild SFN but it went away with time and my life was normal. More than normal. It was great! :)
In December 2023 I was prescribed Doxy for my Rosacea. I took it once and had to stop as I felt warm patches of skin on my body. It reminded me of the SFN. So I didn’t take a chance. However, I noticed in the weeks after that I had developed a weird anxiety and some insomnia (nervous system injury #1). A few weeks later, I was told to try Metronidazole. I used it for about 2 weeks. All hell broke loose. It started with pins and needles in hands and feet. Never had that before so I didn’t think much of it. Then I became very dizzy. And my mood changed. I was crying for no reason, historically. And I started having burning skin on my limbs. I stopped the meds. But it was too late. I had developed palpitations, lower voice, weak legs, etc. I had a neurotoxicity. (Nervous system injury #2) My doctor didn’t want to believe it was that but was thinking GBS. I was however hyoerreflexive so it wasn’t GBS. But he prescribed some Ativan. I took it but quickly it wasn’t doing what it was supposed to do. After even just a few days I could feel more anxiety. It was awful. So I stopped taking them after about 10 days. Things went from bad to worse: terrible panic attacks, flashes of light and stroboscopic type of images when closing my eyes, insomnia but to the point of not sleeping for a month, pelvic floor pain, myoclonus jerks, full body internal vibration, sensitivity to sound, it was scary. (Nervous system injury #3). I forgot to say but my periods also never came.
I was sent for an MRI and obviously my MRI was ok. But things were NOT normal. My palpitations were so bad, my heart would skip beats, I was so dehydrated cause I became hyperadrenergic. I also started to have anhedonia and my GI motility stopped. I could not feel hunger anymore. It was weird. But I wasn’t short of breath. Just had palpitations. Doctors told me I have FND, but it was not FND. FND doesn’t stop your periods, doesn’t mess with your hormones, doesn’t give you continuous insomnia for a month. And I never had a limb not functioning or had a seizure. Therefore. I left to find more and better answers. I knew it as the nervous system but I am not a doctor so had to rely on them for help.
I went back to my home town. I was a mess but physically I was fine. I was eating, digesting, but I had become more short fuse, still having the myoclonus, and all the other weird symptoms with some derealization and sound sensitivity. But I could still laugh etc. I went to see a doctor and he thought maybe it was a bad withdrawal so I was put on a high dose of Valium. Obviously all of my symptoms vanished but others showed up: I started having hand tremors and benzos would act very paradoxically on me. It was increasing my BP and HR, made me cry all the time and become aggressive. I had to come off then. I stayed on them for 6 weeks from 40mg (that’s crazy, I was taking 1mg of Ativan..) to 25mg and was then switched to Gabapentin. The hospital who did that however decided after a few days that I didn’t need the Gabapentin anymore and removed it. I thought I was gonna die. I started having tremors on my face and even to my tongue. I started being very agitated (obviously, I was going through a terrible withdrawal!) and was told they would inject me with antipsychotic. I honestly have never been this traumatized in my life. I restarted the Gabapentin and took it for a month. Hated it too cause ai was super paradoxical to it as well. Most people feel calm on Gabapentin. I felt so agitated and developed weird body movements like my head would twist involuntarily and my fingers were moving from left to right, especially on my left hand.
I stopped the Gabapentin after tapering. In a few days, I was back to normal. I was so happy. Could walk my dog daily, drive, go to the grocery store, I had found myself again. Until I went on a hike. It wasn’t a long hike but it was more demanding than the walks I was doing on flat ground daily. I would walk for several hours but never to the point of being anaerobic. On that hike I did though.
After the hike, I started feeling jittery. My nervous system didn’t like that at all. I went to bed, put on a meditation and fell asleep. That night is still traumatic lol. I felt electric zaps all in my body and spine. I sweat so much. I woke up drenched and with pain everywhere but mostly, every joint in my body cracked. Every single one. I had never been in pain like that in my life. But also, the palpitations were back but much much worse. And also high BP, which I never had even during the beginning after the neurotoxicity started. I wasn’t able to function anymore. I saw my GP and he didn’t like what he saw. I was completely dehydrated, muscles and joints were all painful, crazy palpitations, high blood pressure that I never had before, could hardly walk. He sent me to the hospital. He also confirmed this isn’t FND for the same reasons I mentioned before, and he knows me very well. All my muscles literally melted almost overnight. Like literally melted. And my skin had become stretchy as if all my connective tissues broke down (EDS flared up but like literally overnight).
Once at the hospital, they finally took things more seriously. I was started on on IV fluid for low potassium (very weird cause I make my electrolytes every day and never had an issue with that. You’ll see, it’s relevant). I also had elevated proteins in my body. Very weird too cause I wasn’t eating more proteins than I used to. I also had low WBC. My hormones were obviously all over the place. I was actually due to start my period and it never came. I stopped pooing again and stopped digesting my food. I know that’s dysautonomia. I had started to feel slightly better after a few days and walked a bit in the hallway. That night.. other ‘attack’. I don’t know how to call them. A few days after that, I still had pain in my muscles and was scared I was denervated (Metronidazole does that), so I though I would speed up the process by giving myself a full body deep tissue massage….. worse mistake of my life. Worse attack that night and the next day I had burning pain all over. Worse palpitations. All over. I also am now in a wheelchair because if I walk even a few minutes, I get an attack that night and wake up with even more weird stuff.
Fast forward to now. I am in Vancouver, Canada. As there isn’t many specialists in my small town (there isn’t any lol). I am worse than ever. My bloodwork look horrendous. My venous gases show I am in acidosis. I cannot breathe if I sit up or stand so I am laying down. My fasting glucose is at 6. I wore a CGM for months and I had perfect blood sugar and was never insulin resistant. I have low MPVs. Low potassium always despite eating bananas and drinking electrolytes all the time. My skin is completely dehydrated and flaking. I get palpitations even laying down.
I had a nerve conduction test and so far so good, I still have nerves. This is not just dysautonomia. Even at my worse, I didn’t have palpitations laying down in bed. And never to that extend. I have developed every problems of the Pentad like it is called: EDS, Dysautonomia, MCAS, Autoimmunity and I don’t remember the last one but I have it too.
I know this is an over reactive/over sensitive nervous system. That’s quite obvious. I have been running on NS injuries after NS injuries for almost 5 months. Also, my breath smells like ketones now I was told. I eat normally.
However, there is more. I forgot to say, on top of that, I have a pituitary tumour (but we know it’s not that causing the issues as when I was on benzos, my periods came back!), I have a thyroid nodula but it’s non-secreting (have had it over 10 years now) and I have a history of hypothyroidism for which I took meds for two months and then I never had an issue with it again. They tested it at the hospital and it’s ok. There is some auto-immunity in my family. My sister had a bout of RA after she gave birth, my mom has EDS for sure and also had Endometriosis, she also has orthostatic intolerance which is the very beginning stage of dysautonomia, she has rosacea prone skin too. Etc.
I know this cascade triggered viral infections and auto-immunity, but what do I do? These things are understood by only a small minority of doctors and I don’t know where to start. I think I will never get better if we don’t figure out the cause of my problems with the insulin and mostly why I have respiratory acidosis!
I don’t have ANA activated so far in my bloodwork for the main stuff but clearly I know what’s up..! I know EDS is considered a genetic condition but I strongly think as many doctors that they are auto-immune related. Never had any problems with that until my nervous system broke down which also activated inflammation and my immune system to start having real troubles.
Let me know where to start please, I am scared of dying in the hotel room. I am tired of being in bed but I know I am making things worse when I walk. I am developing ME/CFS, I know it, but it still won’t say why I am hypoventilating 24/7 with low potassium and low MPV and low WBC with high proteins. I am freaking out that my life and health are literally going to hell because of an antibiotic..! For a perioral dermatitis 😂..! I am remaining calm but.. not gonna lie.. it’s no fun.
Thanks for your help!!!
Cate xx
2024.05.17 00:50 QuingOfTheUniverse Exploring influencal factors in HRT - What are your personal Experiences?
DISCLAIMER : I forgot to add it to the title but this post is about HRT in Transpeople taking Estradiol and other feminizing medication.
Hello people im fairly new to everything HRT and will start soon myself! Feel free to note any mistakes i may have made :)
So i have been reading A LOT about a good amount of topics that include factors that influence the Breast Development and there are quite as much confusing and contradicting information, which is obviously frustrating, not only to me, but to a lot of People!
The one thing that was clear, was the lack of information, in studies aswell as in posts in this or other subreddits. We cant influence the studies, make them faster or even have the necessary rescources to conduct our own, but we can definitly influence the amount of information given to each other!
Many posts asking about feminization in HRT, especially in combination with Progesteron, often lack crucial infromation to the specific situations. We dont have any studies supporting which factors exactly contribute to the different mechanisms, but having a good amount of Factors for every Person posting here could give us all a bigger picture and maybe help with every single ones situation, even tho its anecdotally it may still help!
Noones memory is perfect, every bit of Information can help!!!
Also note that all of the following information is what i found, tried to understand and put into context or explain the importance. Im not a doctor and CANNOT give medical advice. Im just trying to theorize about this topic and maybe be able to filter out what can help!
Finding exact reasons for that is extremely difficult and while researching i didnt find ANY other study supporting this claim, even tho beeing reposted here and in other subs over and over again.
The Level of contradiction only rises in prospect of the apparent enlargment of breasts in female patients using Spironolactone.
"Breast enlargement and tenderness may occur in 26% of women at high doses"
is stated on the Wikipedia article on Spironolactone ( https://en.wikipedia.org/wiki/Spironolactone ) and an article is linked as source ( https://www.eurekaselect.com/article/128779 ) that i sadly couldnt access.
As seen in Spironolactone, its extremely unclear what exactly contributes to breast development. Contradicting or unfounded claims seem to rule over general discussion about this topic, but from what i found, Spironolactone does not decrease breast size.
Even though it is agreed upon that lowering Testosterone is crucial for feminization (like breast development), i could not find any rescources to where the Testosterone levels should go. There doesnt even seem to be a general understanding how testosterone exactly influences breast development, the general consensus seemingly beeing that testosterone levels should be low with no exact point where to go, though it is advised to reach the "normal" female level of "testosterone 30 – 100 ng/dl; E2 <200 pg/ml" as stated in "The Practical Guidelines for Transgender Hormone Treatment" https://www.bumc.bu.edu/endo/clinics/transgender-medicine/guidelines/
For many Lowering Testosterone by Estradiol Monotherapy seems to work better and decreases intake of different medications, which is generally preferably, not only in hrt. In order to supress testosterone with exclusively with estradiol, estradiol levels starting form around 200pg/mL are needed.
"studies in cisgender men and transfeminine people have found that estradiol levels of around 200 pg/mL (734 pmol/L) suppress testosterone levels by about 90% on average (to ~50 ng/dL [1.7 nmol/L]), while estradiol levels of around 500 pg/mL (1,840 pmol/L) suppress testosterone levels by about 95% on average (to ~20–30 ng/dL [0.7–1.0 nmol/L])" https://transfemscience.org/articles/transfem-intro/ (Under Gonadal Suppresion)
Current Studies, while limited, suggest there is a higher risk of myocardial infarction (MI), ischemic stroke (IS) and Venous thromboembolism (VTE) ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907681/ ). A thing i have noticed while reading through this is the lack of differentiation in HRT when it comes to Estradiol monotherapy in direct comparison to the use of Estradiol and an Anti-Androgen (AA), aswell as the way the Estradiol entered the System.
Newer research suggest a increased risked of both MI and VTE in prostate Cancer patients taking AAs ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473503/ ). Similarly AAs are suspected to increase risk of IS ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675721/ ). There is also another Study that looked at Adverse effects of gender affirming hormonal therapy, in which 22 transfem people were assessed. Only 5 People did not use any kind of Antiandrogen, 3 of which it appeared to have quite mild Adverse Drug Reactions (ADR), with patients recovering from those effects again. The 2 remaining People were both 45 and actively Smoking, one smoking 30 cigarettes a day and dealing with alcoholism, the other one also smoking and having untreated high blood pressure ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796635/ ).
Obviously more studies are needed but a possible connection between the HRT risks and antiandrogens, with little to no contribution from estradiol is intriguing and could promote a shift to more promotion of montherapy as a safer way to transition.
Alot of Studies suggest that early intake of Progesterone could potentially negatively influence ultimate breast size in female people that also need to take Estrogen because of Development Issues. Generally its advised to wait for 1 - 2 Years of Estrogen Treatment. https://transfemscience.org/articles/progestogens-early-exposure-breast-dev/
No proper evidence supports or dismisses a positive effect of Progesterone, aswell as timing and amount incase of usage.
Aswell as with most stuff, when it comes to studies supporting or dismissing a potential help of GH, there are none i could find.
Because too much GH can have huge negative effects on the body, you shouldnt use any strong GH enhancers.
Naturally human Growth Hormone (hGH) increases through excercise ( https://pubmed.ncbi.nlm.nih.gov/12797841/ )
Also a variety of differen Aminoacids is supposed to increase hGH levels. These include :
These CAN be helpfull but HAVE NOT BEEN PROVEN TO HELP. Im just trying to share what im finding, please do not throw out all your money for supplements that could may aswell have no effect.
hGH could also be increased by other Factors like decrease of bodyfat ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690428/ ) and generally a more healthy life style (which is adviced in any case ;) )
This post is not entirely finished yet and i will complete it in the next few days. Sharing your own Experience, specifically with remarks to how Estradiol is beeing taken (intramuscular, oral, transdermal, etc), aswell if Anti-Androgens (and which) are used and if Progesterone (which and time in transition when first beginning treatment with Progesterone) is used. Also weight loss and fat distribution info, aswell as breast development time and state are as important! I totally get that this is all private info and everyone feels comfortable to share other things, to feel free to just share as much as you personally want. Also looking at the rulebook : All the stuff im hoping people would share are not for any survey or study, only for exchange of anecdotal sharing of person Experience. As long as one person maybe finds help or even just solice in your comment, it goes a long way :)
submitted by QuingOfTheUniverse to asktransgender [link] [comments]
Hello people im fairly new to everything HRT and will start soon myself! Feel free to note any mistakes i may have made :)
So i have been reading A LOT about a good amount of topics that include factors that influence the Breast Development and there are quite as much confusing and contradicting information, which is obviously frustrating, not only to me, but to a lot of People!
The one thing that was clear, was the lack of information, in studies aswell as in posts in this or other subreddits. We cant influence the studies, make them faster or even have the necessary rescources to conduct our own, but we can definitly influence the amount of information given to each other!
Many posts asking about feminization in HRT, especially in combination with Progesteron, often lack crucial infromation to the specific situations. We dont have any studies supporting which factors exactly contribute to the different mechanisms, but having a good amount of Factors for every Person posting here could give us all a bigger picture and maybe help with every single ones situation, even tho its anecdotally it may still help!
Noones memory is perfect, every bit of Information can help!!!
Also note that all of the following information is what i found, tried to understand and put into context or explain the importance. Im not a doctor and CANNOT give medical advice. Im just trying to theorize about this topic and maybe be able to filter out what can help!
- Antiandrogen usage (and possible dangers?)
Finding exact reasons for that is extremely difficult and while researching i didnt find ANY other study supporting this claim, even tho beeing reposted here and in other subs over and over again.
The Level of contradiction only rises in prospect of the apparent enlargment of breasts in female patients using Spironolactone.
"Breast enlargement and tenderness may occur in 26% of women at high doses"
is stated on the Wikipedia article on Spironolactone ( https://en.wikipedia.org/wiki/Spironolactone ) and an article is linked as source ( https://www.eurekaselect.com/article/128779 ) that i sadly couldnt access.
As seen in Spironolactone, its extremely unclear what exactly contributes to breast development. Contradicting or unfounded claims seem to rule over general discussion about this topic, but from what i found, Spironolactone does not decrease breast size.
Even though it is agreed upon that lowering Testosterone is crucial for feminization (like breast development), i could not find any rescources to where the Testosterone levels should go. There doesnt even seem to be a general understanding how testosterone exactly influences breast development, the general consensus seemingly beeing that testosterone levels should be low with no exact point where to go, though it is advised to reach the "normal" female level of "testosterone 30 – 100 ng/dl; E2 <200 pg/ml" as stated in "The Practical Guidelines for Transgender Hormone Treatment" https://www.bumc.bu.edu/endo/clinics/transgender-medicine/guidelines/
For many Lowering Testosterone by Estradiol Monotherapy seems to work better and decreases intake of different medications, which is generally preferably, not only in hrt. In order to supress testosterone with exclusively with estradiol, estradiol levels starting form around 200pg/mL are needed.
"studies in cisgender men and transfeminine people have found that estradiol levels of around 200 pg/mL (734 pmol/L) suppress testosterone levels by about 90% on average (to ~50 ng/dL [1.7 nmol/L]), while estradiol levels of around 500 pg/mL (1,840 pmol/L) suppress testosterone levels by about 95% on average (to ~20–30 ng/dL [0.7–1.0 nmol/L])" https://transfemscience.org/articles/transfem-intro/ (Under Gonadal Suppresion)
Current Studies, while limited, suggest there is a higher risk of myocardial infarction (MI), ischemic stroke (IS) and Venous thromboembolism (VTE) ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907681/ ). A thing i have noticed while reading through this is the lack of differentiation in HRT when it comes to Estradiol monotherapy in direct comparison to the use of Estradiol and an Anti-Androgen (AA), aswell as the way the Estradiol entered the System.
Newer research suggest a increased risked of both MI and VTE in prostate Cancer patients taking AAs ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473503/ ). Similarly AAs are suspected to increase risk of IS ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675721/ ). There is also another Study that looked at Adverse effects of gender affirming hormonal therapy, in which 22 transfem people were assessed. Only 5 People did not use any kind of Antiandrogen, 3 of which it appeared to have quite mild Adverse Drug Reactions (ADR), with patients recovering from those effects again. The 2 remaining People were both 45 and actively Smoking, one smoking 30 cigarettes a day and dealing with alcoholism, the other one also smoking and having untreated high blood pressure ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796635/ ).
Obviously more studies are needed but a possible connection between the HRT risks and antiandrogens, with little to no contribution from estradiol is intriguing and could promote a shift to more promotion of montherapy as a safer way to transition.
- Progesterone
Alot of Studies suggest that early intake of Progesterone could potentially negatively influence ultimate breast size in female people that also need to take Estrogen because of Development Issues. Generally its advised to wait for 1 - 2 Years of Estrogen Treatment. https://transfemscience.org/articles/progestogens-early-exposure-breast-dev/
No proper evidence supports or dismisses a positive effect of Progesterone, aswell as timing and amount incase of usage.
- GH / IGH-1
Aswell as with most stuff, when it comes to studies supporting or dismissing a potential help of GH, there are none i could find.
Because too much GH can have huge negative effects on the body, you shouldnt use any strong GH enhancers.
Naturally human Growth Hormone (hGH) increases through excercise ( https://pubmed.ncbi.nlm.nih.gov/12797841/ )
Also a variety of differen Aminoacids is supposed to increase hGH levels. These include :
l-carnitine : sadly the longterm effects are unknown ( https://jissn.biomedcentral.com/articles/10.1186/s12970-020-00377-2 )I wouldnt use l-arginine, purely because there is good chance for it to have detremental effects on aging and especially in combination with HRT its hard to tell how the body would react. An increased risk is the potential reward not worth in my Opinion ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851093/ ).
creatine : can increase hGH after workout ( https://pubmed.ncbi.nlm.nih.gov/25804393/ )
These CAN be helpfull but HAVE NOT BEEN PROVEN TO HELP. Im just trying to share what im finding, please do not throw out all your money for supplements that could may aswell have no effect.
hGH could also be increased by other Factors like decrease of bodyfat ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690428/ ) and generally a more healthy life style (which is adviced in any case ;) )
- Body-fat-(re)distribution
- Different Methods of Estradiol intake
This post is not entirely finished yet and i will complete it in the next few days. Sharing your own Experience, specifically with remarks to how Estradiol is beeing taken (intramuscular, oral, transdermal, etc), aswell if Anti-Androgens (and which) are used and if Progesterone (which and time in transition when first beginning treatment with Progesterone) is used. Also weight loss and fat distribution info, aswell as breast development time and state are as important! I totally get that this is all private info and everyone feels comfortable to share other things, to feel free to just share as much as you personally want. Also looking at the rulebook : All the stuff im hoping people would share are not for any survey or study, only for exchange of anecdotal sharing of person Experience. As long as one person maybe finds help or even just solice in your comment, it goes a long way :)
2024.05.13 09:19 Politely_violent Looking for a good online try clinic.
 | My Dr office is phoning it in, looking for a good Online TRT clinic, rather pay more to get stable supplies. submitted by Politely_violent to trt [link] [comments] My Dr prescribed me trt gel 6 months ago and it was going fine total testosterone at its highest was 800. Recently my union Dr office lowered my dose to 1/4 of the previous dose seemingly because of ineptitude, they renewed my prescription telling me instead of a 30 day supply they found me a 4 month supply. Turned out they just prescribed me the 30 day bottle I had but use 1 pump instead of 4. My test was at 56 before rubbing on my one pump for the day. |
2024.05.12 14:27 snook-0147 Tn 2
 | submitted by snook-0147 to TrigeminalNeuralgia [link] [comments] |
2024.05.11 14:10 ButstheSlackGordsman Joy
Joy
“Please don’t do this to me! I’ll die out there!” Tiffany crumpled to the floor, phone shaking against her ear.
A gruff voice crackled. “I’m sorry Tiffany, our runner in your area got caught on his latest delivery. My other guy barely made it back. He saw Jimmy get hauled into the van. They’ve probably torn him apart by now.”
“Please…I don’t have any food left in the house. I’ll never make it out there. They’ll spot me immediately.”
“Listen, listen Tiff. It’s going to be OK. Listen to me alright? There’s a shop one block away from you.”
“I can’t!”
“You have to! OK, all you have to do is get in and get out. Put on the darkest sunglasses you have. You have shades right?”
Tiffany glanced up to the cabinet. Her terrified face reflected at her through the polarized lenses. “Uh-huh”
“That’s good, that’s real good. Now you put those on and grab enough food for a week while I find a replacement runner OK?”
“O-OK”
“And Tiffany?”
“Remember to smile, smile as wide as you can and never drop it. You know what happens if they suspect…”
“I know, thanks Mark.”
Tiffany hung up the phone with a shuddering exhale. She stood up and looked herself over in the mirror. A terrified blonde woman stared back, eyes wide with fear.
She wiped her tears and smoothed out her locks. She grasped her oversized sunglasses with trembling hands and put them on. She bent over, adjusting them carefully to ensure no trace of her eyes could be seen.
Glancing down, she looked over her list of food. Enough for a week…get in, get out…and smile.
Before turning to leave, she smiled into the mirror. The upturned mouth seemed almost foreign to her; she hadn’t laughed since everyone had been Torn. There weren’t many of her left in the world; the Joyous reigned supreme.
She stretched her smile as wide as it could go, until her cheeks strained with the effort. Exhaling through her teeth, she grasped the handle. The doorknob shook from her grip. Get it together…in and out…
She twisted the knob and threw the door open.
An eyeless face sprang up to meet her.
Tiffany screamed and jumped back.
“Oh, I’m so sorry! I didn’t mean to scare you!”
Tiffany clutched her heaving chest, trying to calm herself. The woman standing in on her stoop had no eyes, only dark, empty sockets each gleaming with a glowing pinprick of light. An enormous smile spread from ear to ear.
Tiffany forced words from her paralyzed mind. “Oh, it’s alright, I was just about to get some shopping done!”
The woman stared unblinking with her flickering pits. She lifted a newspaper. “I saw this blow over onto the street, so I thought I’d bring this little ol’ newsie inside!” She let out a raucous laugh.
Tiffany accepted the paper, praying she looked relaxed. She took a quick glimpse at the headline.
Joy! New York Mayor Declares City over 99% Pure on 1-Year Anniversary!
“Aww, I see you have just been Freed. Congratulations dear. How do you like the colors?” The woman bent her head closer to Tiffany’s face. Her heart hammered in her throat as her eyes were drawn to the woman’s scars. Black lines spider webbed all across her body, down her arms, over her face, and plunged down her low cut shirt. “Aw, I remember when I was freed; I didn’t really have scars either. I found a great doctor who touched me up; I can share his number with you!” She lifted her neck, showing off her scars wrapped around her throat.
“Yes, the colors they’re so…beautiful. Yeah…the doctors said I was one of the lucky ones, guess tough skin runs in the family.” Tiffany tried to laugh as she spoke.
The woman leaned back; her smile somehow widening even more. “Ah! Tragic! Stay safe y’hear? A naughty somebody escaped the hospital recently, ah, there he is now. Isn’t he silly?” She pointed to the distance.
Tiffany turned her head in the direction of her arm. Her heart sank to her stomach.
The street rose in an incline. The distant figure of a man climbed into sight at the crest of the hill. His sandy hair was unmistakable.
Tiffany lifted a trembling hand to her mouth. Jimmy?
Jimmy was naked with blood pouring in rivets all down the front of his torso. As she squinted, she realized that Jimmy’s body wasn't moving; it hung limp, limbs dangling in the air. Her darting eyes widened as she saw his legs hovered off the road.
Four thick tendrils pulsated out of Jimmy’s gaping mouth. The dark trunks spilled out onto the ground, suspending his frame in midair. The shadowy pillars supported his body like makeshift legs. Jimmy lolled back and forth as the inhuman limbs propelled him down the hill like a beast.
Tiffany’s stomach churned in knots as he careened down the street. He couldn’t speak but his bulging eyes darting all around spoke all that was needed. Her gaze adhered to the incomprehensible stalks that moved of their own accord. The tentacles shimmered and writhed all over, smaller tendrils branching off, thrashing independently of one another.
Right as he passed Tiffany, he tripped and skidded to the ground. The husks all around her burst into raucous laughter at the sight of it clamoring back up.
The woman doubled over in giggles. “Ooh, you silly goose, don’t even know what’s good for ya!”
Jimmy’s chest bloated and bubbled. The bulge traveled up his throat, extending it to an inhuman width. A horrid squelching erupted as two pink sacs attached to tubes slithered out of his mouth, traveling along the lengths of the trunks. Tiffany could barely support her own weight at the sight of Jimmy’s lungs pulsating in frantic breaths.
Her horrified gaze watched as the lungs enlarged in a deep breath, a gurgling crescendoing in pitch. They expanded to full size and hung still for an instant. Then exploded in desperate screams.
“HELP ME! PLEASE, I’M ALIVE LIKE YO-”
With the roar of an engine and the screech of tires, a vehicle slammed into Jimmy’s body. A spray of blood rained on Tiffany and the crowd. A white van screeched to a halt just as Jimmy flew through the air, all eight limbs flailing in the wind.
No amount of bracing could prepare Tiffany for the sound of bones crushing as Jimmy landed in a bloody mess on the asphalt. The crowd of husks whooped and hollered. The drivers clambered out of the vehicle and took deep bows, grinning broadly.
Wiping off blood, Tiffany inspected the logo on the van. It displayed two cartoon men each standing on the side of another person. The person was divided into two halves. One side was human with a smiling face while the other was a shadowy figure, screaming in agony. The smiling men each pulled on an arm as if separating the halves.
“Sorry folks! We had a feisty one here, we’ll take care of it from here!” He drew a syringe from his pocket.
“That’s OK! Need a hand?” The woman called back to enthusiastic nods from the crowd. The van driver waved his arm in the direction of Jimmy’s limb body.
Tiffany blinked back burning tears as she watched Jimmy twitch on the ground. The husks closed in around him, laughing as they surrounded him. She wanted nothing more than to just retreat inside and vomit. But an opportunity presented itself.
Streams of people poured out of the shop ahead, drawn to the spectacle on the street. The sidewalks leading up to the store cleared. Her path would never be this open again. Tearing her eyes from Jimmy, she walked as fast as possible to the market, her smile twitching in anguish.
After what felt like hours, she stood at the entrance to the food mart. She moved her jaw around to loosen it, almost flinching as it popped. OK…in and out…then you’re safe. Running over her mental list one last time, she barged inside.
A wave of frigid air washed over her. She scanned the shop, exhaling out a sigh of relief as she confirmed it was mostly empty. Only a mother pushing a stroller joined her in the market.
Tiffany whipped out a shopping cart and sped down aisle by aisle. Eyes darting, she grasped each item on her list as if it were manna from heaven. Her breathing eased as she made it to the other side of the store without incident. A small bit of happiness welled up within her as she looked over her bulging wagon. It was enough to last her two weeks, two blissful weeks of safety. All she had to do was get out.
She strolled to the checkout lane. The mother was in front of her, the groceries crinkling as they were bagged by the cheerful cashier. Tiffany’s knuckles gripped the cart so hard they turned white. Please…just pay and leave…
Tiffany’s heart skipped a beat as the mother twisted her neck to look at her. Empty sockets crinkled as the young woman’s smile widened. “Why hello there! Any idea what the ruckus is out there?” A collective cheer erupted outside in the distance.
Tiffany shook her head, trying to push Jimmy’s battered body out of her thoughts.
She glanced at Tiffany’s cart. “Big haul. You having a party?”
Tiffany nodded, almost forgetting to breathe.
“Am I invited? Where do you live?”
Tiffany gulped. The mother roared with laughter. “Oh dearie me, I’m just kidding you. I’d love to go but this little man down here takes up all my time. Wanna say hi?”
Tiffany nodded again, her cheeks screaming with the strain of her fake smile. The mother lifted the hood of the stroller and wheeled it around, facing Tiffany. An eyeless baby cooed up at her, its sockets nearly taking up half its face. Black scars lined its entire body, lashing its face that carved itself into a wide smile.
Tiffany screamed in terror, flinging herself back.
CLACK!
Light streamed into her eyes as they watered. Time almost stopped as she glanced down at her sunglasses. Shuddering, she looked back up. The mother, baby, and cashier stared at her.
Without taking his sockets off her, the cashier pressed a button on the counter. An intercom crackled to life. “Attention all employees. We have someone in pain over here. Please call the authorities while we restrain her.”
Tiffany threw the cart to the ground, sprinting to the glass double doors. Talon-like fingers dug into her shoulder right as she reached the exit. “NO! PLEASE LET ME GO! PLEASE!”
But the mother just giggled into her ear. “Now why would I do that, sweetie? Don’t worry, we’re going to help you. See? They’re already here to heal you!”
Tiffany’s heart sank into her stomach as she watched the same van that crashed into Jimmy park outside. Two men dressed in scrubs burst out the back, wheeling out a gurney. Her eyes bulged as she gazed at the restraints gleaming cruelly in the morning light.
The smiling men jaunted over to her. Tiffany ground her heel into the mother’s toes; the arms holding her released. She rushed forward to the man on the left, throwing a wild punch in desperation.
To her surprise, her knuckles connected, slamming the man’s head back to its side. Rough hands grabbed her arms by the elbows, jerking them behind her.
The man she’d punched twisted his head back, the unnatural smile still plastered on his face. “Now, now simmer down, young lady. He snatched her kicking feet and lifted her in tandem with the other man.
With inhuman strength, they slammed her onto the gurney. She flailed, straining her limbs against their grasp. Her shoulders popped in their sockets, her screams erupting in pain and fear.
CLICK!
Cold metal clamped down on her right wrist. Three more clicks restrained her completely.
“No, no, no, please! Just let me go! I’ll never bother you again!” Tiffany half screamed and half sobbed.
One man chuckled. “Oops! Gotta make some room!”
She wailed as she watched the men drag Jimmy’s corpse out of the back and toss it on the sidewalk. The doors slammed shut, and the vehicle sped off.
Desperation gave way to despair for Tiffany, she wept bitterly. She gasped as the men wiped away tears on each side of her face. They lifted their fingers to their eyeless pits, staring in wonder at the droplet forming, mouths parted and making soft cooing sounds.
“I remember my last tear, what about you Ted?” The man on her right whispered.
The man on the left nodded, sucking his finger. “Yeah…I almost miss the taste.” They both roared in laughter at the same time.
The van jolted to a halt. The men flung the doors open. “Don’t worry missy, it will all be over soon!”
She shook her head, pleading for anyone she passed to help her as she was wheeled into the hospital. All she received were condescending smiles, and pats on the hand. She was sped into an operating room. Her eyes widened in terror at the sight of the tearing chair.
A medical bed lay in the middle of the chamber. A bar of light hung at the bed’s foot. The bar crossed over the width of the bed, attached to a track that ran along the length from the bottom to the top. Her heart sank. She’d expected cutting instruments but the lack of them frightened her even more.
A grinning doctor finished washing her hands in the nearby sink, pulling latex gloves on. “Oh dearie me, look at this poor soul. It’s been a while since I’ve gotten freed one so large! The gals will take it from here, boys!” The men giggled as they left the room.
Masked women in scrubs burst from the doors to assist. Even behind the masks, their smiles were visible. They all carried scissors. Within seconds, they snipped off all of her clothes leaving her naked in the gurney.
The doctor lifted a syringe, the end dripping with sedative. “Now we need you to be still for this next part sweetie!” She rammed the needle into her hip and thumbed the plunger down. She gasped as the burning liquid clouded into her bloodstream. At once, her extremities deadened, all feeling and control gone.
A pair of arms gripped each of her limbs as she was lifted off the gurney and thrown onto the medical bed. The doctor looked down at her at the foot of the bed, grasping the bar of light. It pulsated in waves of color as she clinked it into place over Tiffany’s feet so that the luminescence only hovered an inch over her skin.
The soles of her feet writhed in agony in the light’s presence. Tiffany screamed at the burning tendrils within her feet. A horrific thought pierced her torment in a single moment of clarity. Something is moving inside me. Using the last vestiges of motor control left, she lifted her head an inch, eyes glued to her feet.
Various ridges rolled around on the tops of her feet, almost as if something flailed to get away from the brilliant light. The doctor traced a finger over the thrashing bulges. “Yes, the time for your last pain draws near, little one. No longer will you torment this young woman. No longer.” She placed both hands on the instrument bar. “Now, I must warn you. This will hurt…more than anything you’ve ever felt in your life. But what awaits you on the other side is…” She laughed.
“Please…” Tiffany whimpered, but the doctor pushed the bar of light up her legs.
Torture. Pure agony. Tiffany screamed to the point she thought her jaw might pop off its hinges. The writhing in her feet intensified, pulling and tearing at her skin…
A spurt of blood spewed over the doctor’s face. “Ah, we’ve crowned!”
“WHAT IS THIS?!” Tiffany screeched as she looked down. Blackened tentacles whipped violently back and forth, sprouting from her feet.
“Oh, it’s the sickness my sweet…it must be purged. Deep breath and here we go!” She pushed the bar of light even further along its track, this time going up her legs.
Molten lines of agony traced themselves up her legs in tandem with the glow. Tiffany’s eyes rolled up into her head and then back down again, casting her world in revolving darkness and light. The skin at her legs tore, thicker tendrils bursting out in viscous spray.
The dark veins slapped at the doctor's face but a smiling nurse grasped the flailing trunks and pinned them down as the doctor pressed on above her knees and up her thighs. Her skin bubbled and burst as the bleeding mass on each limb fled from the light. Tiffany stared transfixed at the monster birthed from her, the spindly body, the erratic, desperate movement of a trapped beast.
The bar stopped just below her groin. “This is probably the worst part dearie, brace yourself.’ She yanked it forward, up to her abdomen.
Tiffany’s voice tore, her throat bleeding raw. She’s never given birth before; the monster springing out from her womanhood made a poor substitute for a child.
“There you go baby. You’re doing so well. Halfway done!”
The instrument slid up her stomach, passing over her arms. The sickness within gripped her organs in a vain attempt to resist being torn out. Strands of obsidian wrested themselves out of her torso only to be collected and restrained by the unflinching nurses. Up her body they all went, up her chest, her shoulders, and on to her neck.
Right at the base of her chin, the bar of light chinked as it came to the end of its track. The beast within Tiffany screeched, straining at the nurses restraints. Forgetting the pain for an instant, Tiffany croaked through torn vocal chords. “What is this thing?”
The doctor wiped blood out of her sockets. “It’s your parasite, what you thought you were. I know it hurts; this thing feeds off pain. Don’t worry. We’re almost done.”
She pivoted two smaller bars of lights up to Tiffany’s head, one on each side. They swung in such a way that they would meet in the middle. Her eyes swiveled independently of each other, as if they too feared the light. The doctor smiled at the erratic movement.
“Oh, yes.” She whispered. “Feel fear. It’s what you deserve; it’s all you deserve.” She grasped each bar and clamped them together.
Blinding pressure built up in Tiffany’s eardrums as if she were being stabbed in each ear with knives aching to meet in the middle. An incessant ringing tingled, building up pitch and intensity until it was all she could hear. Her brain lit aflame, seething at the burning from the sound. “MAKE IT STOP! MAKE IT STOP!” Her mouth uttered the words, but she couldn’t hear her voice anymore.
Like a cord being unplugged from a speaker, her world fell silent one pull at a time. Black tendrils whipped in her sight as the beast fled from her ear canals. The lights passed in her vision.
The doctor spoke unheard words. She tried to close her eyes, but they weren’t hers anymore. They swiveled all about in their sockets, trying to escape her skull.
But there was no escape, not for a parasite. The lights slammed shut, meeting in the middle right over her. The kaleidoscope of luminescence overtook everything. Her world melded to an ever changing sea of merging lights.
Her thoughts, her consciousness, her very essence whirled in her brain. A dark hole sprouted in her psyche. Her being swirled around the murky depths of her existence spinning to the choreography of the lights pulse. Round and round it went until she thought her last words. Who am I? All grew dark.
—---------
The operating room light blinded Tiffany. She tried to close her eyes but found she had no lids.
She saw the metal tray she lay on.
She saw the black, spindly lengths of her body laying in a tangled heap in the tray.
She saw Tiffany laying on the medical table. What?
Her psyche ran stark with shock as she watched herself sit up from the medical table. Her eyes were gone, replaced with two glowing pits burning in deep sockets. Blood trails criss crossed all over her venous scars. Tears of crimson flowed from her pits as she sobbed into her hands.
No…that’s me? But then…who am I?
She glanced up and received her horrifying answer. An operating mirror hung on the ceiling above her. What she had once thought as herself was now nothing more than a pair of eyeballs attached to a spinal stem with nervous branches tangled and heaped in a small tray.
She was the parasite.
The real Tiffany sobbed, a wide smile stretching across her face. “Colors…so many colors…”
The doctor handed her a pair of sunglasses. “Here, put these on and keep them on for the next couple of weeks. The parasites could only see a thin spectrum of light. You can see all of it now, it’s a bit overwhelming at first but you get used to it.”
The real Tiffany placed the sunglasses on her face then clutched at her chest. “What….what is this feeling? It burns yet…it’s warm all over..”
The doctor knelt at the real Tiffany’s side. “It’s happiness…” She giggled. “Pure happiness, it’s what that parasite over there denied you.” The doctor shot a glare to the nerve bundle that used to be Tiffany.
The real Tiffany released her chest. “How long has it been inside of me?”
The doctor stood up. “We aren’t sure when these parasites fused with humans but it must have been millennia ago. They have been entwined with us so long we even once thought they were part of our bodies. The nervous system, what a cruel joke. These things thrive off of our happiness and only feed us pain in return.”
The doctor shot the nerve bundle a look. Even though she smiled, Tiffany could feel the doctor’s contempt radiating. “Look how pathetic it is. Can’t even move anymore. These things rely on our central brain systems to move. Once separated, they are immobile. It’s rather ironic that they only try to move as we cut into their feeding supply.”
The real Tiffany hugged the doctor who returned the embrace. “Thank you…for freeing me.” The doctor rubbed her back.
They released each other. The real Tiffany looked over at the nerve bundle that used to be her. “What do we do with…it?”
The doctor grasped the nerve bundle unceremoniously in her palm. Wait…no! I’m-I’m me!
“We will cast her into the depths to which she came from of course!” The doctor laughed as she brought the nerve bundle to a trash chute. The nerve bundle glanced down, recoiling in horror. No light graced her final destination.
“Good riddance.” The nerve bundle was released and cast into the void. It landed with a plop amongst the other writhing bundles, rueing the day it ever thought it truly existed.
submitted by ButstheSlackGordsman to JordanGrupeHorror [link] [comments]
“Please don’t do this to me! I’ll die out there!” Tiffany crumpled to the floor, phone shaking against her ear.
A gruff voice crackled. “I’m sorry Tiffany, our runner in your area got caught on his latest delivery. My other guy barely made it back. He saw Jimmy get hauled into the van. They’ve probably torn him apart by now.”
“Please…I don’t have any food left in the house. I’ll never make it out there. They’ll spot me immediately.”
“Listen, listen Tiff. It’s going to be OK. Listen to me alright? There’s a shop one block away from you.”
“I can’t!”
“You have to! OK, all you have to do is get in and get out. Put on the darkest sunglasses you have. You have shades right?”
Tiffany glanced up to the cabinet. Her terrified face reflected at her through the polarized lenses. “Uh-huh”
“That’s good, that’s real good. Now you put those on and grab enough food for a week while I find a replacement runner OK?”
“O-OK”
“And Tiffany?”
“Remember to smile, smile as wide as you can and never drop it. You know what happens if they suspect…”
“I know, thanks Mark.”
Tiffany hung up the phone with a shuddering exhale. She stood up and looked herself over in the mirror. A terrified blonde woman stared back, eyes wide with fear.
She wiped her tears and smoothed out her locks. She grasped her oversized sunglasses with trembling hands and put them on. She bent over, adjusting them carefully to ensure no trace of her eyes could be seen.
Glancing down, she looked over her list of food. Enough for a week…get in, get out…and smile.
Before turning to leave, she smiled into the mirror. The upturned mouth seemed almost foreign to her; she hadn’t laughed since everyone had been Torn. There weren’t many of her left in the world; the Joyous reigned supreme.
She stretched her smile as wide as it could go, until her cheeks strained with the effort. Exhaling through her teeth, she grasped the handle. The doorknob shook from her grip. Get it together…in and out…
She twisted the knob and threw the door open.
An eyeless face sprang up to meet her.
Tiffany screamed and jumped back.
“Oh, I’m so sorry! I didn’t mean to scare you!”
Tiffany clutched her heaving chest, trying to calm herself. The woman standing in on her stoop had no eyes, only dark, empty sockets each gleaming with a glowing pinprick of light. An enormous smile spread from ear to ear.
Tiffany forced words from her paralyzed mind. “Oh, it’s alright, I was just about to get some shopping done!”
The woman stared unblinking with her flickering pits. She lifted a newspaper. “I saw this blow over onto the street, so I thought I’d bring this little ol’ newsie inside!” She let out a raucous laugh.
Tiffany accepted the paper, praying she looked relaxed. She took a quick glimpse at the headline.
Joy! New York Mayor Declares City over 99% Pure on 1-Year Anniversary!
“Aww, I see you have just been Freed. Congratulations dear. How do you like the colors?” The woman bent her head closer to Tiffany’s face. Her heart hammered in her throat as her eyes were drawn to the woman’s scars. Black lines spider webbed all across her body, down her arms, over her face, and plunged down her low cut shirt. “Aw, I remember when I was freed; I didn’t really have scars either. I found a great doctor who touched me up; I can share his number with you!” She lifted her neck, showing off her scars wrapped around her throat.
“Yes, the colors they’re so…beautiful. Yeah…the doctors said I was one of the lucky ones, guess tough skin runs in the family.” Tiffany tried to laugh as she spoke.
The woman leaned back; her smile somehow widening even more. “Ah! Tragic! Stay safe y’hear? A naughty somebody escaped the hospital recently, ah, there he is now. Isn’t he silly?” She pointed to the distance.
Tiffany turned her head in the direction of her arm. Her heart sank to her stomach.
The street rose in an incline. The distant figure of a man climbed into sight at the crest of the hill. His sandy hair was unmistakable.
Tiffany lifted a trembling hand to her mouth. Jimmy?
Jimmy was naked with blood pouring in rivets all down the front of his torso. As she squinted, she realized that Jimmy’s body wasn't moving; it hung limp, limbs dangling in the air. Her darting eyes widened as she saw his legs hovered off the road.
Four thick tendrils pulsated out of Jimmy’s gaping mouth. The dark trunks spilled out onto the ground, suspending his frame in midair. The shadowy pillars supported his body like makeshift legs. Jimmy lolled back and forth as the inhuman limbs propelled him down the hill like a beast.
Tiffany’s stomach churned in knots as he careened down the street. He couldn’t speak but his bulging eyes darting all around spoke all that was needed. Her gaze adhered to the incomprehensible stalks that moved of their own accord. The tentacles shimmered and writhed all over, smaller tendrils branching off, thrashing independently of one another.
Right as he passed Tiffany, he tripped and skidded to the ground. The husks all around her burst into raucous laughter at the sight of it clamoring back up.
The woman doubled over in giggles. “Ooh, you silly goose, don’t even know what’s good for ya!”
Jimmy’s chest bloated and bubbled. The bulge traveled up his throat, extending it to an inhuman width. A horrid squelching erupted as two pink sacs attached to tubes slithered out of his mouth, traveling along the lengths of the trunks. Tiffany could barely support her own weight at the sight of Jimmy’s lungs pulsating in frantic breaths.
Her horrified gaze watched as the lungs enlarged in a deep breath, a gurgling crescendoing in pitch. They expanded to full size and hung still for an instant. Then exploded in desperate screams.
“HELP ME! PLEASE, I’M ALIVE LIKE YO-”
With the roar of an engine and the screech of tires, a vehicle slammed into Jimmy’s body. A spray of blood rained on Tiffany and the crowd. A white van screeched to a halt just as Jimmy flew through the air, all eight limbs flailing in the wind.
No amount of bracing could prepare Tiffany for the sound of bones crushing as Jimmy landed in a bloody mess on the asphalt. The crowd of husks whooped and hollered. The drivers clambered out of the vehicle and took deep bows, grinning broadly.
Wiping off blood, Tiffany inspected the logo on the van. It displayed two cartoon men each standing on the side of another person. The person was divided into two halves. One side was human with a smiling face while the other was a shadowy figure, screaming in agony. The smiling men each pulled on an arm as if separating the halves.
“Sorry folks! We had a feisty one here, we’ll take care of it from here!” He drew a syringe from his pocket.
“That’s OK! Need a hand?” The woman called back to enthusiastic nods from the crowd. The van driver waved his arm in the direction of Jimmy’s limb body.
Tiffany blinked back burning tears as she watched Jimmy twitch on the ground. The husks closed in around him, laughing as they surrounded him. She wanted nothing more than to just retreat inside and vomit. But an opportunity presented itself.
Streams of people poured out of the shop ahead, drawn to the spectacle on the street. The sidewalks leading up to the store cleared. Her path would never be this open again. Tearing her eyes from Jimmy, she walked as fast as possible to the market, her smile twitching in anguish.
After what felt like hours, she stood at the entrance to the food mart. She moved her jaw around to loosen it, almost flinching as it popped. OK…in and out…then you’re safe. Running over her mental list one last time, she barged inside.
A wave of frigid air washed over her. She scanned the shop, exhaling out a sigh of relief as she confirmed it was mostly empty. Only a mother pushing a stroller joined her in the market.
Tiffany whipped out a shopping cart and sped down aisle by aisle. Eyes darting, she grasped each item on her list as if it were manna from heaven. Her breathing eased as she made it to the other side of the store without incident. A small bit of happiness welled up within her as she looked over her bulging wagon. It was enough to last her two weeks, two blissful weeks of safety. All she had to do was get out.
She strolled to the checkout lane. The mother was in front of her, the groceries crinkling as they were bagged by the cheerful cashier. Tiffany’s knuckles gripped the cart so hard they turned white. Please…just pay and leave…
Tiffany’s heart skipped a beat as the mother twisted her neck to look at her. Empty sockets crinkled as the young woman’s smile widened. “Why hello there! Any idea what the ruckus is out there?” A collective cheer erupted outside in the distance.
Tiffany shook her head, trying to push Jimmy’s battered body out of her thoughts.
She glanced at Tiffany’s cart. “Big haul. You having a party?”
Tiffany nodded, almost forgetting to breathe.
“Am I invited? Where do you live?”
Tiffany gulped. The mother roared with laughter. “Oh dearie me, I’m just kidding you. I’d love to go but this little man down here takes up all my time. Wanna say hi?”
Tiffany nodded again, her cheeks screaming with the strain of her fake smile. The mother lifted the hood of the stroller and wheeled it around, facing Tiffany. An eyeless baby cooed up at her, its sockets nearly taking up half its face. Black scars lined its entire body, lashing its face that carved itself into a wide smile.
Tiffany screamed in terror, flinging herself back.
CLACK!
Light streamed into her eyes as they watered. Time almost stopped as she glanced down at her sunglasses. Shuddering, she looked back up. The mother, baby, and cashier stared at her.
Without taking his sockets off her, the cashier pressed a button on the counter. An intercom crackled to life. “Attention all employees. We have someone in pain over here. Please call the authorities while we restrain her.”
Tiffany threw the cart to the ground, sprinting to the glass double doors. Talon-like fingers dug into her shoulder right as she reached the exit. “NO! PLEASE LET ME GO! PLEASE!”
But the mother just giggled into her ear. “Now why would I do that, sweetie? Don’t worry, we’re going to help you. See? They’re already here to heal you!”
Tiffany’s heart sank into her stomach as she watched the same van that crashed into Jimmy park outside. Two men dressed in scrubs burst out the back, wheeling out a gurney. Her eyes bulged as she gazed at the restraints gleaming cruelly in the morning light.
The smiling men jaunted over to her. Tiffany ground her heel into the mother’s toes; the arms holding her released. She rushed forward to the man on the left, throwing a wild punch in desperation.
To her surprise, her knuckles connected, slamming the man’s head back to its side. Rough hands grabbed her arms by the elbows, jerking them behind her.
The man she’d punched twisted his head back, the unnatural smile still plastered on his face. “Now, now simmer down, young lady. He snatched her kicking feet and lifted her in tandem with the other man.
With inhuman strength, they slammed her onto the gurney. She flailed, straining her limbs against their grasp. Her shoulders popped in their sockets, her screams erupting in pain and fear.
CLICK!
Cold metal clamped down on her right wrist. Three more clicks restrained her completely.
“No, no, no, please! Just let me go! I’ll never bother you again!” Tiffany half screamed and half sobbed.
One man chuckled. “Oops! Gotta make some room!”
She wailed as she watched the men drag Jimmy’s corpse out of the back and toss it on the sidewalk. The doors slammed shut, and the vehicle sped off.
Desperation gave way to despair for Tiffany, she wept bitterly. She gasped as the men wiped away tears on each side of her face. They lifted their fingers to their eyeless pits, staring in wonder at the droplet forming, mouths parted and making soft cooing sounds.
“I remember my last tear, what about you Ted?” The man on her right whispered.
The man on the left nodded, sucking his finger. “Yeah…I almost miss the taste.” They both roared in laughter at the same time.
The van jolted to a halt. The men flung the doors open. “Don’t worry missy, it will all be over soon!”
She shook her head, pleading for anyone she passed to help her as she was wheeled into the hospital. All she received were condescending smiles, and pats on the hand. She was sped into an operating room. Her eyes widened in terror at the sight of the tearing chair.
A medical bed lay in the middle of the chamber. A bar of light hung at the bed’s foot. The bar crossed over the width of the bed, attached to a track that ran along the length from the bottom to the top. Her heart sank. She’d expected cutting instruments but the lack of them frightened her even more.
A grinning doctor finished washing her hands in the nearby sink, pulling latex gloves on. “Oh dearie me, look at this poor soul. It’s been a while since I’ve gotten freed one so large! The gals will take it from here, boys!” The men giggled as they left the room.
Masked women in scrubs burst from the doors to assist. Even behind the masks, their smiles were visible. They all carried scissors. Within seconds, they snipped off all of her clothes leaving her naked in the gurney.
The doctor lifted a syringe, the end dripping with sedative. “Now we need you to be still for this next part sweetie!” She rammed the needle into her hip and thumbed the plunger down. She gasped as the burning liquid clouded into her bloodstream. At once, her extremities deadened, all feeling and control gone.
A pair of arms gripped each of her limbs as she was lifted off the gurney and thrown onto the medical bed. The doctor looked down at her at the foot of the bed, grasping the bar of light. It pulsated in waves of color as she clinked it into place over Tiffany’s feet so that the luminescence only hovered an inch over her skin.
The soles of her feet writhed in agony in the light’s presence. Tiffany screamed at the burning tendrils within her feet. A horrific thought pierced her torment in a single moment of clarity. Something is moving inside me. Using the last vestiges of motor control left, she lifted her head an inch, eyes glued to her feet.
Various ridges rolled around on the tops of her feet, almost as if something flailed to get away from the brilliant light. The doctor traced a finger over the thrashing bulges. “Yes, the time for your last pain draws near, little one. No longer will you torment this young woman. No longer.” She placed both hands on the instrument bar. “Now, I must warn you. This will hurt…more than anything you’ve ever felt in your life. But what awaits you on the other side is…” She laughed.
“Please…” Tiffany whimpered, but the doctor pushed the bar of light up her legs.
Torture. Pure agony. Tiffany screamed to the point she thought her jaw might pop off its hinges. The writhing in her feet intensified, pulling and tearing at her skin…
A spurt of blood spewed over the doctor’s face. “Ah, we’ve crowned!”
“WHAT IS THIS?!” Tiffany screeched as she looked down. Blackened tentacles whipped violently back and forth, sprouting from her feet.
“Oh, it’s the sickness my sweet…it must be purged. Deep breath and here we go!” She pushed the bar of light even further along its track, this time going up her legs.
Molten lines of agony traced themselves up her legs in tandem with the glow. Tiffany’s eyes rolled up into her head and then back down again, casting her world in revolving darkness and light. The skin at her legs tore, thicker tendrils bursting out in viscous spray.
The dark veins slapped at the doctor's face but a smiling nurse grasped the flailing trunks and pinned them down as the doctor pressed on above her knees and up her thighs. Her skin bubbled and burst as the bleeding mass on each limb fled from the light. Tiffany stared transfixed at the monster birthed from her, the spindly body, the erratic, desperate movement of a trapped beast.
The bar stopped just below her groin. “This is probably the worst part dearie, brace yourself.’ She yanked it forward, up to her abdomen.
Tiffany’s voice tore, her throat bleeding raw. She’s never given birth before; the monster springing out from her womanhood made a poor substitute for a child.
“There you go baby. You’re doing so well. Halfway done!”
The instrument slid up her stomach, passing over her arms. The sickness within gripped her organs in a vain attempt to resist being torn out. Strands of obsidian wrested themselves out of her torso only to be collected and restrained by the unflinching nurses. Up her body they all went, up her chest, her shoulders, and on to her neck.
Right at the base of her chin, the bar of light chinked as it came to the end of its track. The beast within Tiffany screeched, straining at the nurses restraints. Forgetting the pain for an instant, Tiffany croaked through torn vocal chords. “What is this thing?”
The doctor wiped blood out of her sockets. “It’s your parasite, what you thought you were. I know it hurts; this thing feeds off pain. Don’t worry. We’re almost done.”
She pivoted two smaller bars of lights up to Tiffany’s head, one on each side. They swung in such a way that they would meet in the middle. Her eyes swiveled independently of each other, as if they too feared the light. The doctor smiled at the erratic movement.
“Oh, yes.” She whispered. “Feel fear. It’s what you deserve; it’s all you deserve.” She grasped each bar and clamped them together.
Blinding pressure built up in Tiffany’s eardrums as if she were being stabbed in each ear with knives aching to meet in the middle. An incessant ringing tingled, building up pitch and intensity until it was all she could hear. Her brain lit aflame, seething at the burning from the sound. “MAKE IT STOP! MAKE IT STOP!” Her mouth uttered the words, but she couldn’t hear her voice anymore.
Like a cord being unplugged from a speaker, her world fell silent one pull at a time. Black tendrils whipped in her sight as the beast fled from her ear canals. The lights passed in her vision.
The doctor spoke unheard words. She tried to close her eyes, but they weren’t hers anymore. They swiveled all about in their sockets, trying to escape her skull.
But there was no escape, not for a parasite. The lights slammed shut, meeting in the middle right over her. The kaleidoscope of luminescence overtook everything. Her world melded to an ever changing sea of merging lights.
Her thoughts, her consciousness, her very essence whirled in her brain. A dark hole sprouted in her psyche. Her being swirled around the murky depths of her existence spinning to the choreography of the lights pulse. Round and round it went until she thought her last words. Who am I? All grew dark.
—---------
The operating room light blinded Tiffany. She tried to close her eyes but found she had no lids.
She saw the metal tray she lay on.
She saw the black, spindly lengths of her body laying in a tangled heap in the tray.
She saw Tiffany laying on the medical table. What?
Her psyche ran stark with shock as she watched herself sit up from the medical table. Her eyes were gone, replaced with two glowing pits burning in deep sockets. Blood trails criss crossed all over her venous scars. Tears of crimson flowed from her pits as she sobbed into her hands.
No…that’s me? But then…who am I?
She glanced up and received her horrifying answer. An operating mirror hung on the ceiling above her. What she had once thought as herself was now nothing more than a pair of eyeballs attached to a spinal stem with nervous branches tangled and heaped in a small tray.
She was the parasite.
The real Tiffany sobbed, a wide smile stretching across her face. “Colors…so many colors…”
The doctor handed her a pair of sunglasses. “Here, put these on and keep them on for the next couple of weeks. The parasites could only see a thin spectrum of light. You can see all of it now, it’s a bit overwhelming at first but you get used to it.”
The real Tiffany placed the sunglasses on her face then clutched at her chest. “What….what is this feeling? It burns yet…it’s warm all over..”
The doctor knelt at the real Tiffany’s side. “It’s happiness…” She giggled. “Pure happiness, it’s what that parasite over there denied you.” The doctor shot a glare to the nerve bundle that used to be Tiffany.
The real Tiffany released her chest. “How long has it been inside of me?”
The doctor stood up. “We aren’t sure when these parasites fused with humans but it must have been millennia ago. They have been entwined with us so long we even once thought they were part of our bodies. The nervous system, what a cruel joke. These things thrive off of our happiness and only feed us pain in return.”
The doctor shot the nerve bundle a look. Even though she smiled, Tiffany could feel the doctor’s contempt radiating. “Look how pathetic it is. Can’t even move anymore. These things rely on our central brain systems to move. Once separated, they are immobile. It’s rather ironic that they only try to move as we cut into their feeding supply.”
The real Tiffany hugged the doctor who returned the embrace. “Thank you…for freeing me.” The doctor rubbed her back.
They released each other. The real Tiffany looked over at the nerve bundle that used to be her. “What do we do with…it?”
The doctor grasped the nerve bundle unceremoniously in her palm. Wait…no! I’m-I’m me!
“We will cast her into the depths to which she came from of course!” The doctor laughed as she brought the nerve bundle to a trash chute. The nerve bundle glanced down, recoiling in horror. No light graced her final destination.
“Good riddance.” The nerve bundle was released and cast into the void. It landed with a plop amongst the other writhing bundles, rueing the day it ever thought it truly existed.
2024.05.10 20:06 healthmedicinet Health Daily News May 9 2024
DAY: MAY 9 2024
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2024.05.09 06:29 AngelBryan Possible mechanism of ME/CFS
 | submitted by AngelBryan to covidlonghaulers [link] [comments] |
2024.05.09 06:27 AngelBryan Possible mechanism of ME/CFS
 | submitted by AngelBryan to VaxRecoveryGroup [link] [comments] |
2024.05.07 04:44 No-Watercress880 Doctor says he's stumped on what caused my husband's Hypoammonemia, poison control also stumped.
Edit: (5-8-24 4:55) Sorry I haven't been super on top of updating you all. I have a doctors appointment with my primary care provider to have some tests run. Just to cover my bases, just in case it is something from our environment and not done super rare metabolic disorder manifesting in my husband now as an adult. He's gotten a few more tests, and they also did a liver biopsy. I will post them now. We haven't gotten the results back from the liver biopsy yet.
IR liver biopsy
Collected on May 8, 2024 3:35 PM
COMPREHENSIVE METABOLIC PANEL Collected on May 8, 2024 2:33 AM Results
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 141 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 4.1 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 114 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 20 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 117 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 23 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 0.96 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 106 Your value is 106 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 24 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 23 Your value is 23 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 18 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 100 U/LNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.3 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 6.9 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 3.8 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 8.6 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.1 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.2 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 7 mmol/LNormal range 7 - 17 mmol/L Want more information about CAMMONIA Collected on May 8, 2024 2:33 AM Results
Ammonia View trends Normal range: 9 - 30 umol/L Your value is 120 umol/LThis value is HighNormal range 9 - 30 umol/L
THESE ARE ADDITIONAL TESTS I POSTED IN A COMMENT YESTERDAY. I WILL ADD THEM HERE FOR SIMPLICITY.
We've gotten back a few more tests, just in case anyone is interested.
CT liver multiphase w/iv contrast Collected on May 7, 2024 1:55 PM Results EXAM: CT THREE PHASE LIVER
INDICATION: evaluate liver function
Tech Comments: No additional history
TECHNIQUE: Low dose, multi-channel computerized tomography of the abdomen was performed with IV contrast according to the triple phase liver protocol. Multiplanar reformats were reviewed.
COMPARISON: CT chest abdomen and pelvis, 05/05/2024
FINDINGS: LOWER CHEST: Lung bases are clear. No acute findings.
LIVER: Normal morphology. No suspicious hepatic lesion.
BILIARY: No CT evidence of gallbladder abnormality. No bile duct dilatation.
PANCREAS: No evidence of mass or inflammation.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. No suspicious renal masses. Normal enhancement bilaterally. Severe bilateral hydroureteronephrosis, similar to prior with significant thinning of the renal cortex.
GASTROINTESTINAL: Visualized bowel shows no abnormal wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber. The portal venous system is patent.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. Normal morphology of the liver. 2. Redemonstration of severe hydronephrosis bilaterally with renal cortical thinning.
Collected on May 7, 2024 2:43 PM Results
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 10.9 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.02 Your value is 1.02 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
BLOOD GAS VENOUS Collected on May 7, 2024 2:43 PM Results
pH, Ven View trends Normal range: 7.32 - 7.41 Your value is 7.43 This value is HighNormal range 7.32 - 7.41 pCO2, Ven View trends Normal range: 41 - 54 mm Hg Your value is 33 mm HgThis value is LowNormal range 41 - 54 mm Hg pO2, Ven View trends Normal range: 25 - 43 mm Hg Your value is 62 mm HgThis value is HighNormal range 25 - 43 mm Hg Bicarbonate View trends Normal range: 21 - 28 mmol/L Your value is 21 mmol/LNormal range 21 - 28 mmol/L Base Deficit (-) View trends Normal range: 0 - 3 Your value is 3 Normal range 0 - 3 O2 Saturation,Venous View trends Normal range: 60 - 85 % Your value is 92 %This value is HighNormal range 60 - 85 % O2 Intake View trends Value ROOM AIR Your value is ROOM AIR
Patient is 34, male. History of polycystic kidney disease, takes lisinopril 20mg daily for high blood pressure related to the pkd. Lactulose 40mg 3x day. Just began taking this 2 days ago. No other meds or drugs. 6'0, 200 lbs. He's a little over weight, but otherwise active and healthy.
My husband came home late Friday and was acting strange. I would ask him a question and he would just stare at me blankly instead of answering. As the night wore on I noticed his symptoms becoming more and more apparent. He was very tired, when spoken to he would either stare at you blankly, answer in one word answers or reply something totally unrelated to the question asked. He was very lethargic and dazed. His eyes were glassy and blood shot. I took him to the emergency room where he continued to get worse. He began to stare blankly all the time, he couldn't tell you what he did yesterday, he couldn't tell you where he was. From my uneducated view, he seemed to be exhibiting stroke like symptoms. The first hospital did a bunch of tests, everything came back fine. They sent us home. I wasn't satisfied so I took him to another hospital. The er did more tests, all came back within normal limits from my memory. They advised that he was having a psychological meltdown and to contact a shrink. The next morning he was almost absolutely comatose, so I took him to the er again. This time we had a PA who was willing to dig. They ended up finding that his ammonia levels were 203, when normal limits are between 9 and 30. We've been two and a half days. Poison control was contacted, they ran their own tests and couldn't find the culprit as his liver is functioning normally, and his kidneys aren't great, but they wouldn't be the cause either. I will post all the tests and there results below. I'll also post all the meds he's been given.
The whole staff at this hospital is stumped, they're all of the opinion that this might something he came into contact with, and not a product of his own body. As in they believe he has been compromised by something in our environment, but they're unable to find the culprit of the symptoms. They've had him on 40mg lactulose 3x a day and at their last test of his ammonia levels he is down to 120. At that level he is alert and conscious, but still pretty slow. As if he hasn't slept well in days and had a few beers on top.
Also, I have an obsessive stalker. I am not trying to fear monger by bringing that up, but that fact and then his sudden and intense onset of symptoms has me concerned. I have informed the hospital police about the situation. I believe our city police were also contacted when they contacted poison control. It might not be relevant, but it's better to mention it.
Here's a few short videos I took of his behavior.
https://imgur.com/gallery/WEjW3D9
His labs:
May 4th
Alcohol Bld Medical View trends Normal value: <10 mg/dL Value <10
COMPREHENSIVE METABOLIC PANEL Sodium: 147 Potassium 4.0 Chloride 115 C02 20 Glucose 111 BUN 29 Creatinine 1.04 eGFR 97 BUN/Creatinine ratio 28 ALT 44 AST 32 Alkaline Phosphatase 123 Bilirubin 0.5 Protein total 8.0 Albumin blood 4.6 Calcium 9.5 Globulin total 3.4 Albumin/Globulin ratio 1.4 Anion gap 12
CBC WITH DIFFERENTIAL
WBC 6.5 RBC 5.27 Hemoglobin 14.6 Hematocrit 43.5 MCV 82.5 MCH 27.7 MCHC 33.6 RDW 14.6 Platelets 311 MPV 9.0 Diff Method Electronic wbc differential cont Segs relative 58 Lymphocytes 30 Monocyte 9 Eosinophils 2 Basophils 1 Absolute Lymphocytes 1.95 Absolute Eosinophils 0.14 Absolute Basophils 0.03
MRI BRAIN WITH AND WITHOUT CONTRAST
INDICATION: ams, evaluate for stroke, intracranial infection
Tech Comments: AMS
TECHNIQUE: Multiplanar multisequence magnetic resonance imaging of the brain was performed with and without IV contrast.
COMPARISON: 05/03/2024.
FINDINGS: VENTRICLES AND CISTERNAL SPACES: The ventricular system and subarachnoid spaces are within acceptable limits for the patient's age.
CEREBRAL AND CEREBELLAR PARENCHYMA: There is no extra-axial fluid collection or hemorrhage. There is no mass effect or midline shift. No abnormal parenchymal gradient susceptibility signal. No diffusion restriction to suggest acute ischemia/infarct. There is no abnormal signal intensity or enhancement. The brainstem is normal in size and configuration. No abnormal signal alterations are present. The cerebellar hemispheres, vermis and tonsils are normal in size and configuration.
PITUITARY GLAND: The pituitary appears grossly unremarkable. Infundibulum is midline.
ARTERIAL FLOW VOIDS: The flow voids in the vertebrobasilar and internal carotid arterial systems are grossly normal.
DURAL VENOUS SINUSES: The dural venous sinuses appear patent.
CALVARIUM, SKULL BASE: The calvarium and skull base appear within normal limits.
PARANASAL SINUSES AND MASTOIDS: No fluid signal is identified within the paranasal sinuses or mastoids.
MISCELLANEOUS FINDINGS: None.
PROTIME-INR
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 11.4 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.07 Your value is 1.07 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
HEPATIC FUNCTION PANEL
AST View trends Normal range: 17 - 59 U/L Your value is 26 U/LNormal range 17 - 59 U/L ALT View trends Normal value: <50 U/L Value 45 Your value is 45 U/LNormal value <50 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 132 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.7 mg/dLNormal range 0.2 - 1.3 mg/dL Bilirubin, Direct View trends Normal range: 0.1 - 0.5 mg/dL Your value is 0.2 mg/dLNormal range 0.1 - 0.5 mg/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.5 g/dLNormal range 3.5 - 5.0 g/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL
C-REACTIVE PROTEIN CRP 0.7
SEDIMENTATION RATE, AUTOMATED
SED RATE 19
(Second Metabolic Panal) BASIC METABOLIC PANEL Collected on May 4, 2024 8:10 PM Sodium View trends Normal range: 137 - 145 mmol/L Your value is 145 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.7 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 21 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 108 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 32 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.17 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 84 Your value is 84 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.6 mg/dLNormal range 8.4 - 10.2 mg/dL Anion Gap View trends Normal range: 7 - 17 mmol/L
(Second cbc)
CBC WITH DIFFERENTIAL May 4, 2024 8:10 PM
E County Line Rd Indpls, IN 46227Testing by Quest Diagnostics 1402 E County Line Rd Indpls, IN 46227 WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 11.3 K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM WBC Result Comment View trends Normal range: 3.3 - 10.5 K/CUMM Value
Difference from previous result noted. Specimen appearance and label verified. High Your value is Difference from previous result noted. Specimen appearance and label verified. K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.51 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.3 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 45.4 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.4 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.8 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.7 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 326 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.5 fLNormal range 7.7 - 12.2 fL Diff Method View trends Value Electronic WBC differential count Your value is Electronic WBC differential count Segs Relative View trends % Value 73 Your value is 73 % Lymphocytes View trends % Value 17 Your value is 17 % Monocyte View trends % Value 9 Your value is 9 % Eosinophils View trends % Value 1 Your value is 1 % Basophils View trends % Value 0 Your value is 0 % Absolute Neutrophils View trends Normal range: 1.30 - 6.00 K/CUMM Your value is 8.20 K/CUMMThis value is HighNormal range 1.30 - 6.00 K/CUMM ABSOLUTE LYMPHOCYTES View trends Normal range: 1.00 - 3.50 K/CUMM Your value is 1.92 K/CUMMNormal range 1.00 - 3.50 K/CUMM Absolute Monocytes View trends Normal range: 0.00 - 1.00 K/CUMM Your value is 0.99 K/CUMMNormal range 0.00 - 1.00 K/CUMM ABSOLUTE EOSINOPHILS View trends Normal range: 0.00 - 0.70 K/CUMM Your value is 0.14 K/CUMMNormal range 0.00 - 0.70 K/CUMM ABSOLUTE BASOPHILS View trends Normal range: 0.00 - 0.10 K/CUMM Your value is 0.05 K/CUMMNormal range 0.00 - 0.10 K/CUMM
AMMONIA 203 May 4, 2024 9:40 PM
Lactic Acid 0.8 May 4, 2024 9:40 PM
RESPIRATORY PANEL PCR Collected on May 4, 2024 9:42 PM Misc Source View trends Value NASOPHARYNX Your value is NASOPHARYNX Adenovirus DNA View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus 229E View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus HKU1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus NL63 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus OC43 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED SARS COVID 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED METAPNEUMOVIRUS View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Human Rhinovirus / Entovirus View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA A View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A,H1N1 '09 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA B View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Parainfluenza Virus 4 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED RSV RNA, QUALITATIVE PCR View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Parapertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Pertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Chlamydophilia Pneuminae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae Comment View trends Normal value: NOT DETECTED Value
IP CARBOCYHEMOGLOBIN Collected on May 4, 2024 10:10 PM Carboxyhemoglobin View trends Normal range: 0.0 - 1.5 % Value <1.5 Your value is <1.5 %Normal range 0.0 - 1.5 %
IP TSH WITH FT4 REFLEX Collected on May 4, 2024 10:10 PM TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L Your value is 1.00 mIU/LNormal range 0.40 - 4.50 mIU/L TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L
IP CPK Collected on May 4, 2024 10:46 PM CPK 52
SALICYLATE LEVEL Collected on May 4, 2024 10:46 PM
Salicylate Lvl View trends Normal value: <20.0 mg/dL Value <1.0
DICTATED DATE: 05/05/2024 12:22pm TRANSCRIBED DATE: 05/05/2024 01:06pm/modl SOUTH
PATIENT NAME: HEALTH RECORD NUMBER: BILLING NUMBER: DATE OF BIRTH:
DATE OF PROCEDURE: 05/05/2024
CLINICAL SUMMARY: Altered mental status of uncertain etiology in the setting of serum ammonia elevation. Please assess for possible epileptic activity.
TECHNICAL SUMMARY: International 10/20 electrode placement was performed in this portable digital EEG. The background activity shows a poorly regulated intermixture of predominantly delta range activity. This activity is triphasic in nature without localizing or focal features. No significant stay changes were seen. Amplitude did vary at times.
Photic stimulation resulted in no change.
Sleep was not recorded.
Hyperventilation is contraindicated.
IMPRESSION: This EEG is abnormal with evidence of nearly continuous triphasic waves. These are highly compatible with a hepatic encephalopathy. There is no evidence of seizure activity and there is no asymmetry to suggest a structural process
PROCALCITONIN. May 5, 2024 1:25 AM
Procalcitonin View trends Normal value: <0.08 ng/mL Value 0.07
IP ACUTE HEPATITIS PANEL Collected on May 5, 2024 1:25 AM Results
Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE
Hepatitis B Surface Ag View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hepatitis B Surface Ag Comment View trends Normal value: NON REACTIVE Value NON REACTIVE
Anti-HCV View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Anti-HCV View trends Normal value: NON REACTIVE Value (NOTE)
HCV antibody was non-reactive. There is no laboratory evidence of HCV infection. Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE
URINALYSIS, CULTURE IF INDICATED Collected on May 5, 2024 1:37 AM
Glucose Urine View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Ketones, UA View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Specific Gravity Ur View trends Normal range: 1.003 - 1.030 Your value is 1.009 Normal range 1.003 - 1.030 Occult Blood Urine View trends Normal value: NEGATIVE Value MODERATEAbnormal Your value is MODERATE This value is AbnormalNormal value NEGATIVE pH, UA View trends Normal range: 4.5 - 8.0 Your value is 8.0 Normal range 4.5 - 8.0 Protein, UA View trends Normal value: NEGATIVE mg/dL Value 30Abnormal Your value is 30 mg/dLThis value is AbnormalNormal value NEGATIVE mg/dL U Nitrites View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Leukocytes, UA View trends Normal value: NEGATIVE Value TRACEAbnormal Your value is TRACE This value is AbnormalNormal value NEGATIVE Color Urine View trends Normal value: YELLOW Value YELLOW Your value is YELLOW Normal value YELLOW APPEARANCE URINE View trends Normal value: CLEAR Value CLEAR Your value is CLEAR Normal value CLEAR WBC, UA View trends Normal range: 0 - 5 /HPF Value 11-20Abnormal Your value is 11-20 /HPFThis value is AbnormalNormal range 0 - 5 /HPF Epi Cell-Ur View trends Normal range: 0 - 5 /HPF Value 0-5 Your value is 0-5 /HPFNormal range 0 - 5 /HPF RBC, UA View trends Normal range: 0 - 3 /HPF Value 4-10Abnormal Your value is 4-10 /HPFThis value is AbnormalNormal range 0 - 3 /HPF Urine Comment Micro View trends
No Collected on May 5, 2024 1:37 AM
(note: not sure why it says no)
Cannabinoids View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Phencyclidine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Cocaine Random View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Methamphetamines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Opiates View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Amphetamines, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Benzodiazepines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Trycyclic Antidepressants View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Methadone Metab View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Barbiturates, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Oxycodone, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Buprenorphine, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Result Comment View trends Normal value: NEGATIVE
AMMONIA Collected on May 5, 2024 4:56 AM
Ammonia 134
Normal range: 9 - 30 umol/L
ETHYLENE GLYCOL Collected on May 5, 2024 12:42 PM Lab tests - Blood
Ethylene Glycol Lvl View trends mg/dL Value <10
Reference range: Negative [<10 mg/dL]
VOLATILE COMPOUNDS Collected on May 5, 2024 12:42 PM Lab tests - Blood
Methanol Lvl View trends mg/dL Value <10 Ref Range:Negative (<10 mg/dL)
VALPROIC ACID Collected on May 5, 2024 12:42 PM Results
Valproic Acid, Total View trends Normal range: 50 - 120 ug/mL Value <10Low
CT chest abdomen pelvis w IV contrast Collected on May 5, 2024 9:21 PM Results New EXAM: CT CHEST ABDOMEN AND PELVIS WITH CONTRAST
INDICATION: altered mental status, possible infection
Tech Comments: No additional history.
TECHNIQUE: Low dose, multi-channel computerized tomography of the chest, abdomen and pelvis was performed with IV contrast. Multiplanar reformats were reviewed.
COMPARISON: 12/05/2018
FINDINGS: CHEST: LUNGS: No focal consolidation. No mass. Major airways are patent.No pleural effusion or pneumothorax.
HEART AND VESSELS: Unremarkable.
MEDIASTINUM AND HILA: Unremarkable.
CHEST WALL AND SOFT TISSUES: Unremarkable.
ABDOMEN AND PELVIS: LIVER: Normal morphology. No suspicious hepatic lesion. No hepatic cysts are identified.
BILIARY: Unremarkable.
PANCREAS: No evidence of mass or inflammation. No pancreatic cysts.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. Massively dilated renal collecting systems and ureters compatible with severe hydronephrosis is similar to although slightly progressive from 12/05/2018. Thin rind of renal parenchyma is present and enhances symmetrically. Bilateral hydroureter extends to the pelvis. There is some layering hyperdensity within the left distal ureter which may represent debris.
GASTROINTESTINAL: No evidence of abnormal bowel wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
PELVIC ORGANS AND BLADDER: Urinary bladder is distended.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. No acute findings. 2. Severe chronic hydroureteronephrosis is similar to although slightly increased from 12/05/2018. Urinary bladder is distended although is otherwise unremarkable. Although the morphology of the kidney is severely abnormal and mimics parenchymal cyst formation, there are no renal parenchymal or hepatic cysts to suggest autosomal dominant polycystic kidney disease. Etiology of severe hydronephrosis is uncertain possibly related to chronic reflux. 3. Thin rind of peripheral renal enhancement without focal abnormality. Small amount of nonspecific hyperdensity within the left distal ureter may represent nonspecific debris.
SODIUM, RANDOM URINE Collected on May 5, 2024 5:03 PM Results New
Sodium Urine Random View trends mmol/L Value 55 No reference range established.
OSMOLALITY,URINE Collected on May 5, 2024 5:03 PM Results New
Osmolality, Ur View trends Normal range: 50 - 1,200 mOsm/kg Your value is 304 mOsm/kgNormal range 50 - 1,200 mOsm/kg
CBC Collected on May 6, 2024 3:56 AM Results
WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 9.9 K/CUMMNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.66 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.7 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 46.8 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.7 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.7 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.5 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 321 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.3 fLNormal range 7.7 - 12.2 fL
COMPREHENSIVE METABOLIC PANEL Collected on May 6, 2024 3:56 AM Results New
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 146 mmol/LThis value is HighNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.8 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 23 mmol/LNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 124 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 34 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.23 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 79 Your value is 79 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 28 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 34 Your value is 34 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 19 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 138 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.9 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 8.2 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.6 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.7 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.6 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.3 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 12 mmol/LNormal range 7 - 17 mmol/L
AMMONIA Collected on May 6, 2024 3:56 AM Results New
Ammonia. 124 View trends Normal range: 9 - 30 umol/L
I'm sorry you had to endure all of that, but thank you for doing so.
submitted by No-Watercress880 to AskDocs [link] [comments]
IR liver biopsy
Collected on May 8, 2024 3:35 PM
COMPREHENSIVE METABOLIC PANEL Collected on May 8, 2024 2:33 AM Results
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 141 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 4.1 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 114 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 20 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 117 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 23 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 0.96 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 106 Your value is 106 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of >/= 90 is categorized as normal or high, which corresponds to Stage G1 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 24 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 23 Your value is 23 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 18 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 100 U/LNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.3 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 6.9 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 3.8 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 8.6 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.1 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.2 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 7 mmol/LNormal range 7 - 17 mmol/L Want more information about CAMMONIA Collected on May 8, 2024 2:33 AM Results
Ammonia View trends Normal range: 9 - 30 umol/L Your value is 120 umol/LThis value is HighNormal range 9 - 30 umol/L
THESE ARE ADDITIONAL TESTS I POSTED IN A COMMENT YESTERDAY. I WILL ADD THEM HERE FOR SIMPLICITY.
We've gotten back a few more tests, just in case anyone is interested.
CT liver multiphase w/iv contrast Collected on May 7, 2024 1:55 PM Results EXAM: CT THREE PHASE LIVER
INDICATION: evaluate liver function
Tech Comments: No additional history
TECHNIQUE: Low dose, multi-channel computerized tomography of the abdomen was performed with IV contrast according to the triple phase liver protocol. Multiplanar reformats were reviewed.
COMPARISON: CT chest abdomen and pelvis, 05/05/2024
FINDINGS: LOWER CHEST: Lung bases are clear. No acute findings.
LIVER: Normal morphology. No suspicious hepatic lesion.
BILIARY: No CT evidence of gallbladder abnormality. No bile duct dilatation.
PANCREAS: No evidence of mass or inflammation.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. No suspicious renal masses. Normal enhancement bilaterally. Severe bilateral hydroureteronephrosis, similar to prior with significant thinning of the renal cortex.
GASTROINTESTINAL: Visualized bowel shows no abnormal wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber. The portal venous system is patent.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. Normal morphology of the liver. 2. Redemonstration of severe hydronephrosis bilaterally with renal cortical thinning.
Collected on May 7, 2024 2:43 PM Results
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 10.9 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.02 Your value is 1.02 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
BLOOD GAS VENOUS Collected on May 7, 2024 2:43 PM Results
pH, Ven View trends Normal range: 7.32 - 7.41 Your value is 7.43 This value is HighNormal range 7.32 - 7.41 pCO2, Ven View trends Normal range: 41 - 54 mm Hg Your value is 33 mm HgThis value is LowNormal range 41 - 54 mm Hg pO2, Ven View trends Normal range: 25 - 43 mm Hg Your value is 62 mm HgThis value is HighNormal range 25 - 43 mm Hg Bicarbonate View trends Normal range: 21 - 28 mmol/L Your value is 21 mmol/LNormal range 21 - 28 mmol/L Base Deficit (-) View trends Normal range: 0 - 3 Your value is 3 Normal range 0 - 3 O2 Saturation,Venous View trends Normal range: 60 - 85 % Your value is 92 %This value is HighNormal range 60 - 85 % O2 Intake View trends Value ROOM AIR Your value is ROOM AIR
Patient is 34, male. History of polycystic kidney disease, takes lisinopril 20mg daily for high blood pressure related to the pkd. Lactulose 40mg 3x day. Just began taking this 2 days ago. No other meds or drugs. 6'0, 200 lbs. He's a little over weight, but otherwise active and healthy.
My husband came home late Friday and was acting strange. I would ask him a question and he would just stare at me blankly instead of answering. As the night wore on I noticed his symptoms becoming more and more apparent. He was very tired, when spoken to he would either stare at you blankly, answer in one word answers or reply something totally unrelated to the question asked. He was very lethargic and dazed. His eyes were glassy and blood shot. I took him to the emergency room where he continued to get worse. He began to stare blankly all the time, he couldn't tell you what he did yesterday, he couldn't tell you where he was. From my uneducated view, he seemed to be exhibiting stroke like symptoms. The first hospital did a bunch of tests, everything came back fine. They sent us home. I wasn't satisfied so I took him to another hospital. The er did more tests, all came back within normal limits from my memory. They advised that he was having a psychological meltdown and to contact a shrink. The next morning he was almost absolutely comatose, so I took him to the er again. This time we had a PA who was willing to dig. They ended up finding that his ammonia levels were 203, when normal limits are between 9 and 30. We've been two and a half days. Poison control was contacted, they ran their own tests and couldn't find the culprit as his liver is functioning normally, and his kidneys aren't great, but they wouldn't be the cause either. I will post all the tests and there results below. I'll also post all the meds he's been given.
The whole staff at this hospital is stumped, they're all of the opinion that this might something he came into contact with, and not a product of his own body. As in they believe he has been compromised by something in our environment, but they're unable to find the culprit of the symptoms. They've had him on 40mg lactulose 3x a day and at their last test of his ammonia levels he is down to 120. At that level he is alert and conscious, but still pretty slow. As if he hasn't slept well in days and had a few beers on top.
Also, I have an obsessive stalker. I am not trying to fear monger by bringing that up, but that fact and then his sudden and intense onset of symptoms has me concerned. I have informed the hospital police about the situation. I believe our city police were also contacted when they contacted poison control. It might not be relevant, but it's better to mention it.
Here's a few short videos I took of his behavior.
https://imgur.com/gallery/WEjW3D9
His labs:
May 4th
Alcohol Bld Medical View trends Normal value: <10 mg/dL Value <10
COMPREHENSIVE METABOLIC PANEL Sodium: 147 Potassium 4.0 Chloride 115 C02 20 Glucose 111 BUN 29 Creatinine 1.04 eGFR 97 BUN/Creatinine ratio 28 ALT 44 AST 32 Alkaline Phosphatase 123 Bilirubin 0.5 Protein total 8.0 Albumin blood 4.6 Calcium 9.5 Globulin total 3.4 Albumin/Globulin ratio 1.4 Anion gap 12
CBC WITH DIFFERENTIAL
WBC 6.5 RBC 5.27 Hemoglobin 14.6 Hematocrit 43.5 MCV 82.5 MCH 27.7 MCHC 33.6 RDW 14.6 Platelets 311 MPV 9.0 Diff Method Electronic wbc differential cont Segs relative 58 Lymphocytes 30 Monocyte 9 Eosinophils 2 Basophils 1 Absolute Lymphocytes 1.95 Absolute Eosinophils 0.14 Absolute Basophils 0.03
MRI BRAIN WITH AND WITHOUT CONTRAST
INDICATION: ams, evaluate for stroke, intracranial infection
Tech Comments: AMS
TECHNIQUE: Multiplanar multisequence magnetic resonance imaging of the brain was performed with and without IV contrast.
COMPARISON: 05/03/2024.
FINDINGS: VENTRICLES AND CISTERNAL SPACES: The ventricular system and subarachnoid spaces are within acceptable limits for the patient's age.
CEREBRAL AND CEREBELLAR PARENCHYMA: There is no extra-axial fluid collection or hemorrhage. There is no mass effect or midline shift. No abnormal parenchymal gradient susceptibility signal. No diffusion restriction to suggest acute ischemia/infarct. There is no abnormal signal intensity or enhancement. The brainstem is normal in size and configuration. No abnormal signal alterations are present. The cerebellar hemispheres, vermis and tonsils are normal in size and configuration.
PITUITARY GLAND: The pituitary appears grossly unremarkable. Infundibulum is midline.
ARTERIAL FLOW VOIDS: The flow voids in the vertebrobasilar and internal carotid arterial systems are grossly normal.
DURAL VENOUS SINUSES: The dural venous sinuses appear patent.
CALVARIUM, SKULL BASE: The calvarium and skull base appear within normal limits.
PARANASAL SINUSES AND MASTOIDS: No fluid signal is identified within the paranasal sinuses or mastoids.
MISCELLANEOUS FINDINGS: None.
PROTIME-INR
Prothrombin Time View trends Normal range: 8.8 - 11.7 s Your value is 11.4 sNormal range 8.8 - 11.7 s INR View trends Normal value: <1.14 RATIO Value 1.07 Your value is 1.07 RATIONormal value <1.14 RATIO INR View trends Normal value: <1.14 RATIO
HEPATIC FUNCTION PANEL
AST View trends Normal range: 17 - 59 U/L Your value is 26 U/LNormal range 17 - 59 U/L ALT View trends Normal value: <50 U/L Value 45 Your value is 45 U/LNormal value <50 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 132 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.7 mg/dLNormal range 0.2 - 1.3 mg/dL Bilirubin, Direct View trends Normal range: 0.1 - 0.5 mg/dL Your value is 0.2 mg/dLNormal range 0.1 - 0.5 mg/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.5 g/dLNormal range 3.5 - 5.0 g/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL
C-REACTIVE PROTEIN CRP 0.7
SEDIMENTATION RATE, AUTOMATED
SED RATE 19
(Second Metabolic Panal) BASIC METABOLIC PANEL Collected on May 4, 2024 8:10 PM Sodium View trends Normal range: 137 - 145 mmol/L Your value is 145 mmol/LNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.7 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 21 mmol/LThis value is LowNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 108 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 32 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.17 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 84 Your value is 84 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.6 mg/dLNormal range 8.4 - 10.2 mg/dL Anion Gap View trends Normal range: 7 - 17 mmol/L
(Second cbc)
CBC WITH DIFFERENTIAL May 4, 2024 8:10 PM
E County Line Rd Indpls, IN 46227Testing by Quest Diagnostics 1402 E County Line Rd Indpls, IN 46227 WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 11.3 K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM WBC Result Comment View trends Normal range: 3.3 - 10.5 K/CUMM Value
Difference from previous result noted. Specimen appearance and label verified. High Your value is Difference from previous result noted. Specimen appearance and label verified. K/CUMMThis value is HighNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.51 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.3 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 45.4 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.4 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.8 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.7 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 326 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.5 fLNormal range 7.7 - 12.2 fL Diff Method View trends Value Electronic WBC differential count Your value is Electronic WBC differential count Segs Relative View trends % Value 73 Your value is 73 % Lymphocytes View trends % Value 17 Your value is 17 % Monocyte View trends % Value 9 Your value is 9 % Eosinophils View trends % Value 1 Your value is 1 % Basophils View trends % Value 0 Your value is 0 % Absolute Neutrophils View trends Normal range: 1.30 - 6.00 K/CUMM Your value is 8.20 K/CUMMThis value is HighNormal range 1.30 - 6.00 K/CUMM ABSOLUTE LYMPHOCYTES View trends Normal range: 1.00 - 3.50 K/CUMM Your value is 1.92 K/CUMMNormal range 1.00 - 3.50 K/CUMM Absolute Monocytes View trends Normal range: 0.00 - 1.00 K/CUMM Your value is 0.99 K/CUMMNormal range 0.00 - 1.00 K/CUMM ABSOLUTE EOSINOPHILS View trends Normal range: 0.00 - 0.70 K/CUMM Your value is 0.14 K/CUMMNormal range 0.00 - 0.70 K/CUMM ABSOLUTE BASOPHILS View trends Normal range: 0.00 - 0.10 K/CUMM Your value is 0.05 K/CUMMNormal range 0.00 - 0.10 K/CUMM
AMMONIA 203 May 4, 2024 9:40 PM
Lactic Acid 0.8 May 4, 2024 9:40 PM
RESPIRATORY PANEL PCR Collected on May 4, 2024 9:42 PM Misc Source View trends Value NASOPHARYNX Your value is NASOPHARYNX Adenovirus DNA View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus 229E View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus HKU1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus NL63 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Coronavirus OC43 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED SARS COVID 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED METAPNEUMOVIRUS View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Human Rhinovirus / Entovirus View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA A View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A H3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Influenza A,H1N1 '09 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED INFLUENZA B View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 1 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 2 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED PARAINFLUENZA 3 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Parainfluenza Virus 4 View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED RSV RNA, QUALITATIVE PCR View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Parapertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Bordetella Pertussis View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Chlamydophilia Pneuminae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae View trends Normal value: NOT DETECTED Value NOT DETECTED Your value is NOT DETECTED Normal value NOT DETECTED Mycoplasma Pneumoniae Comment View trends Normal value: NOT DETECTED Value
IP CARBOCYHEMOGLOBIN Collected on May 4, 2024 10:10 PM Carboxyhemoglobin View trends Normal range: 0.0 - 1.5 % Value <1.5 Your value is <1.5 %Normal range 0.0 - 1.5 %
IP TSH WITH FT4 REFLEX Collected on May 4, 2024 10:10 PM TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L Your value is 1.00 mIU/LNormal range 0.40 - 4.50 mIU/L TSH W/REFLEX TO FT4 View trends Normal range: 0.40 - 4.50 mIU/L
IP CPK Collected on May 4, 2024 10:46 PM CPK 52
SALICYLATE LEVEL Collected on May 4, 2024 10:46 PM
Salicylate Lvl View trends Normal value: <20.0 mg/dL Value <1.0
DICTATED DATE: 05/05/2024 12:22pm TRANSCRIBED DATE: 05/05/2024 01:06pm/modl SOUTH
PATIENT NAME: HEALTH RECORD NUMBER: BILLING NUMBER: DATE OF BIRTH:
DATE OF PROCEDURE: 05/05/2024
CLINICAL SUMMARY: Altered mental status of uncertain etiology in the setting of serum ammonia elevation. Please assess for possible epileptic activity.
TECHNICAL SUMMARY: International 10/20 electrode placement was performed in this portable digital EEG. The background activity shows a poorly regulated intermixture of predominantly delta range activity. This activity is triphasic in nature without localizing or focal features. No significant stay changes were seen. Amplitude did vary at times.
Photic stimulation resulted in no change.
Sleep was not recorded.
Hyperventilation is contraindicated.
IMPRESSION: This EEG is abnormal with evidence of nearly continuous triphasic waves. These are highly compatible with a hepatic encephalopathy. There is no evidence of seizure activity and there is no asymmetry to suggest a structural process
PROCALCITONIN. May 5, 2024 1:25 AM
Procalcitonin View trends Normal value: <0.08 ng/mL Value 0.07
IP ACUTE HEPATITIS PANEL Collected on May 5, 2024 1:25 AM Results
Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep A IgM View trends Normal value: NON REACTIVE Value NON REACTIVE
Hepatitis B Surface Ag View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hepatitis B Surface Ag Comment View trends Normal value: NON REACTIVE Value NON REACTIVE
Anti-HCV View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Anti-HCV View trends Normal value: NON REACTIVE Value (NOTE)
HCV antibody was non-reactive. There is no laboratory evidence of HCV infection. Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE Value NON REACTIVE Your value is NON REACTIVE Normal value NON REACTIVE Hep B core Ab, IgM View trends Normal value: NON REACTIVE
URINALYSIS, CULTURE IF INDICATED Collected on May 5, 2024 1:37 AM
Glucose Urine View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Ketones, UA View trends Normal value: NEGATIVE mg/dL Value NEGATIVE Your value is NEGATIVE mg/dLNormal value NEGATIVE mg/dL Specific Gravity Ur View trends Normal range: 1.003 - 1.030 Your value is 1.009 Normal range 1.003 - 1.030 Occult Blood Urine View trends Normal value: NEGATIVE Value MODERATEAbnormal Your value is MODERATE This value is AbnormalNormal value NEGATIVE pH, UA View trends Normal range: 4.5 - 8.0 Your value is 8.0 Normal range 4.5 - 8.0 Protein, UA View trends Normal value: NEGATIVE mg/dL Value 30Abnormal Your value is 30 mg/dLThis value is AbnormalNormal value NEGATIVE mg/dL U Nitrites View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Leukocytes, UA View trends Normal value: NEGATIVE Value TRACEAbnormal Your value is TRACE This value is AbnormalNormal value NEGATIVE Color Urine View trends Normal value: YELLOW Value YELLOW Your value is YELLOW Normal value YELLOW APPEARANCE URINE View trends Normal value: CLEAR Value CLEAR Your value is CLEAR Normal value CLEAR WBC, UA View trends Normal range: 0 - 5 /HPF Value 11-20Abnormal Your value is 11-20 /HPFThis value is AbnormalNormal range 0 - 5 /HPF Epi Cell-Ur View trends Normal range: 0 - 5 /HPF Value 0-5 Your value is 0-5 /HPFNormal range 0 - 5 /HPF RBC, UA View trends Normal range: 0 - 3 /HPF Value 4-10Abnormal Your value is 4-10 /HPFThis value is AbnormalNormal range 0 - 3 /HPF Urine Comment Micro View trends
No Collected on May 5, 2024 1:37 AM
(note: not sure why it says no)
Cannabinoids View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Phencyclidine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Cocaine Random View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Methamphetamines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Opiates View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Amphetamines, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Benzodiazepines View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Trycyclic Antidepressants View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Methadone Metab View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Barbiturates, Urine View trends Normal value: NEGATIVE _ Value NEGATIVE Your value is NEGATIVE _Normal value NEGATIVE _ Oxycodone, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Buprenorphine, Urine View trends Normal value: NEGATIVE Value NEGATIVE Your value is NEGATIVE Normal value NEGATIVE Result Comment View trends Normal value: NEGATIVE
AMMONIA Collected on May 5, 2024 4:56 AM
Ammonia 134
Normal range: 9 - 30 umol/L
ETHYLENE GLYCOL Collected on May 5, 2024 12:42 PM Lab tests - Blood
Ethylene Glycol Lvl View trends mg/dL Value <10
Reference range: Negative [<10 mg/dL]
VOLATILE COMPOUNDS Collected on May 5, 2024 12:42 PM Lab tests - Blood
Methanol Lvl View trends mg/dL Value <10 Ref Range:Negative (<10 mg/dL)
VALPROIC ACID Collected on May 5, 2024 12:42 PM Results
Valproic Acid, Total View trends Normal range: 50 - 120 ug/mL Value <10Low
CT chest abdomen pelvis w IV contrast Collected on May 5, 2024 9:21 PM Results New EXAM: CT CHEST ABDOMEN AND PELVIS WITH CONTRAST
INDICATION: altered mental status, possible infection
Tech Comments: No additional history.
TECHNIQUE: Low dose, multi-channel computerized tomography of the chest, abdomen and pelvis was performed with IV contrast. Multiplanar reformats were reviewed.
COMPARISON: 12/05/2018
FINDINGS: CHEST: LUNGS: No focal consolidation. No mass. Major airways are patent.No pleural effusion or pneumothorax.
HEART AND VESSELS: Unremarkable.
MEDIASTINUM AND HILA: Unremarkable.
CHEST WALL AND SOFT TISSUES: Unremarkable.
ABDOMEN AND PELVIS: LIVER: Normal morphology. No suspicious hepatic lesion. No hepatic cysts are identified.
BILIARY: Unremarkable.
PANCREAS: No evidence of mass or inflammation. No pancreatic cysts.
SPLEEN: Unremarkable.
ADRENALS AND KIDNEYS: Adrenal glands are normal. Massively dilated renal collecting systems and ureters compatible with severe hydronephrosis is similar to although slightly progressive from 12/05/2018. Thin rind of renal parenchyma is present and enhances symmetrically. Bilateral hydroureter extends to the pelvis. There is some layering hyperdensity within the left distal ureter which may represent debris.
GASTROINTESTINAL: No evidence of abnormal bowel wall thickening or obstruction.
VASCULAR: Abdominal aorta is normal in caliber.
LYMPH NODES: No pathologically enlarged lymph nodes.
PERITONEUM: No free air or ascites.
PELVIC ORGANS AND BLADDER: Urinary bladder is distended.
BODY WALL AND SOFT TISSUES: Unremarkable.
BONES: No acute or suspicious abnormality.
IMPRESSION: 1. No acute findings. 2. Severe chronic hydroureteronephrosis is similar to although slightly increased from 12/05/2018. Urinary bladder is distended although is otherwise unremarkable. Although the morphology of the kidney is severely abnormal and mimics parenchymal cyst formation, there are no renal parenchymal or hepatic cysts to suggest autosomal dominant polycystic kidney disease. Etiology of severe hydronephrosis is uncertain possibly related to chronic reflux. 3. Thin rind of peripheral renal enhancement without focal abnormality. Small amount of nonspecific hyperdensity within the left distal ureter may represent nonspecific debris.
SODIUM, RANDOM URINE Collected on May 5, 2024 5:03 PM Results New
Sodium Urine Random View trends mmol/L Value 55 No reference range established.
OSMOLALITY,URINE Collected on May 5, 2024 5:03 PM Results New
Osmolality, Ur View trends Normal range: 50 - 1,200 mOsm/kg Your value is 304 mOsm/kgNormal range 50 - 1,200 mOsm/kg
CBC Collected on May 6, 2024 3:56 AM Results
WBC View trends Normal range: 3.3 - 10.5 K/CUMM Your value is 9.9 K/CUMMNormal range 3.3 - 10.5 K/CUMM RBC View trends Normal range: 4.15 - 5.75 M/CUMM Your value is 5.66 M/CUMMNormal range 4.15 - 5.75 M/CUMM Hemoglobin View trends Normal range: 12.8 - 16.9 g/dL Your value is 15.7 g/dLNormal range 12.8 - 16.9 g/dL Hematocrit View trends Normal range: 38.8 - 50.2 % Your value is 46.8 %Normal range 38.8 - 50.2 % MCV View trends Normal range: 80.0 - 100.0 fL Your value is 82.7 fLNormal range 80.0 - 100.0 fL MCH View trends Normal range: 27.0 - 34.0 pg Your value is 27.7 pgNormal range 27.0 - 34.0 pg MCHC View trends Normal range: 30.5 - 34.5 g/dL Your value is 33.5 g/dLNormal range 30.5 - 34.5 g/dL RDW View trends Normal range: 11.5 - 15.0 % Your value is 14.6 %Normal range 11.5 - 15.0 % Platelets View trends Normal range: 150 - 450 K/CUMM Your value is 321 K/CUMMNormal range 150 - 450 K/CUMM MPV View trends Normal range: 7.7 - 12.2 fL Your value is 9.3 fLNormal range 7.7 - 12.2 fL
COMPREHENSIVE METABOLIC PANEL Collected on May 6, 2024 3:56 AM Results New
Sodium View trends Normal range: 137 - 145 mmol/L Your value is 146 mmol/LThis value is HighNormal range 137 - 145 mmol/L Potassium View trends Normal range: 3.5 - 5.1 mmol/L Your value is 3.8 mmol/LNormal range 3.5 - 5.1 mmol/L Chloride View trends Normal range: 98 - 107 mmol/L Your value is 111 mmol/LThis value is HighNormal range 98 - 107 mmol/L CO2 View trends Normal range: 22 - 30 mmol/L Your value is 23 mmol/LNormal range 22 - 30 mmol/L Glucose View trends Normal range: 65 - 99 mg/dL Your value is 124 mg/dLThis value is HighNormal range 65 - 99 mg/dL Glucose View trends Normal range: 65 - 99 mg/dL Value
If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. High Your value is If result of random glucose > or = 200 or if result of fasting glucose is > 125 confirm Diabetes Mellitus diagnosis with second glucose on a different day. mg/dLThis value is HighNormal range 65 - 99 mg/dL BUN View trends Normal range: 9 - 20 mg/dL Your value is 34 mg/dLThis value is HighNormal range 9 - 20 mg/dL Creatinine View trends Normal range: 0.66 - 1.25 mg/dL Your value is 1.23 mg/dLNormal range 0.66 - 1.25 mg/dL eGFR View trends Normal value: >60 mL/min/1.73 M2 Value 79 Your value is 79 mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 EGFR Comment View trends Normal value: >60 mL/min/1.73 M2 Value Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage
An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD.
CKD-EPI equation (2021) used to estimate GFR Your value is Either of the following must be present for >=3 months to be Chronic Kidney Disease: -GFR less than 60 for >=3 months -Albumin to Creatinine Ratio >=30 mg/g or other markers of kidney damage An estimated GFR chronically in the range of 60-89 is categorized as mildly decreased, which corresponds to Stage G2 CKD. CKD-EPI equation (2021) used to estimate GFR mL/min/1.73 M2Normal value >60 mL/min/1.73 M2 BUN/Creatinine Ratio View trends Normal range: 6 - 22 RATIO Your value is 28 RATIOThis value is HighNormal range 6 - 22 RATIO ALT View trends Normal value: <50 U/L Value 34 Your value is 34 U/LNormal value <50 U/L AST View trends Normal range: 17 - 59 U/L Your value is 19 U/LNormal range 17 - 59 U/L Alkaline Phosphatase View trends Normal range: 38 - 126 U/L Your value is 138 U/LThis value is HighNormal range 38 - 126 U/L Bilirubin, Total View trends Normal range: 0.2 - 1.3 mg/dL Your value is 0.9 mg/dLNormal range 0.2 - 1.3 mg/dL Protein, Total View trends Normal range: 6.3 - 8.2 g/dL Your value is 8.2 g/dLNormal range 6.3 - 8.2 g/dL Albumin Blood View trends Normal range: 3.5 - 5.0 g/dL Your value is 4.6 g/dLNormal range 3.5 - 5.0 g/dL Calcium View trends Normal range: 8.4 - 10.2 mg/dL Your value is 9.7 mg/dLNormal range 8.4 - 10.2 mg/dL Globulin, Total View trends Normal range: 1.9 - 3.7 g/dL Your value is 3.6 g/dLNormal range 1.9 - 3.7 g/dL Albumin/Globulin Ratio View trends Normal range: 1.0 - 2.5 RATIO Your value is 1.3 RATIONormal range 1.0 - 2.5 RATIO Anion Gap View trends Normal range: 7 - 17 mmol/L Your value is 12 mmol/LNormal range 7 - 17 mmol/L
AMMONIA Collected on May 6, 2024 3:56 AM Results New
Ammonia. 124 View trends Normal range: 9 - 30 umol/L
I'm sorry you had to endure all of that, but thank you for doing so.
2024.05.06 10:03 Historical_Project00 Being covid cautious is harming my physical health (explanation in post) and I need advice
(I’ve made posts before talking about this in the past but firstly I have a nose injury where I cannot wear a mask, so I wouldn’t be able to do that around roommates although I don’t think it would matter anyways since we’d share bathrooms, our living quarters are extremely narrow and small, and opening the door would bring the covid particles into my bedroom.)
Five months ago I got a small studio apartment so that I wouldn’t be exposed to covid from living with roommates. However I have chronic venous insufficiency (CVI) and I’ve discovered that I NEED constant use of stairs, as well as a larger home to move about in, in order to work the right muscles in my legs to keep my legs healthy and functional.
My leg health and quality of life has drastically plummeted since moving into my studio. I am in constant pain. Even showering once a week is a chore and I dread it. I cleaned my studio for an hour last week and it took me a 24/7 full week in bed to recover. I’m still not back to my baseline. While living with roommates (and thus having the stairs) I was fully functional.
My biggest worry is the lasting damage this could have on my legs. Visually, telling from the veins I will need sclerotherapy for, I have done more damage to them in 5 months of living in my studio than I did in 5 years prior, and I’m starting to even get visible veins in my lower back, hips, and pelvis. I did NOT realize this was going to happen when I first moved in. The veins are being slowly damaged. So far I have mainly superficial vein damage but if it gets to the deep vein I am in big trouble.
However my mental health was absolutely decimated living with roommates. I was a sitting duck having to fake smiles like everything was fine (so I wouldn’t get voted out) while my roommates went to maskless dance parties in the height of surges. Luckily they never caught it. While my health was okay, trying to avoid them in any humanly possible way I could took all of my mental energy and time with zero guarantee of working. It took my peace. I would be bawling my eyes out while they were out at their parties.
I spent a month trying to find a room for rent elsewhere but it is extremely difficult where I live. I have the opportunity to break my studio lease and move back in with my old roommates but I would need to do it now. I feel like I am between a rock and a hard place. And no, they won’t want me to put HEPA filters in the common areas because 1) the hallway is really narrow(wouldn’t bother me but oh well) and 2) it would bring down the “vibes” of the space. eyeroll One of my roommates is actually the live-in landlord (she rents out rooms in her house) so naturally what she says goes. They know I have a vascular disorder in a world with a circulating vascular-damaging virus but don't care.
I’ve tried figuring out ways to stay in my studio and keep my legs healthy at the same time, but there is just no alternative, and I’m known in my family for being “the resourceful one”. I’ve even started wearing thigh-high compression stockings and taking supplements and that is not enough.
I think I need to live with roommates again but need to figure out how to keep my mental peace since I am going to be a sitting duck for covid. It could theoretically harm my legs further, but staying in my studio is verifiably damaging them now. I did get recurring, permanent petechiae (not as bad as Google Images shows you) after my one-time infection which is a sign of vascular damage, but fuck man. By trying to avoid disability I have become disabled. I don’t think I can do this anymore.
But I can’t just unknow what I know about covid. I feel like I need to mentally resign myself like everyone else and just be like "welp, I just hope I stay healthy." But I don't know how to do that after avoiding it like my life depends on it for 4+ years.
We need systemic change and having to be self-resourceful to avoid covid is difficult for many if not impossible for some. I'm becoming the impossible category.
Edit: If you are a covid cautious person in Portland (WITH STAIRS, lol) and need a roommate I'm your gal!!
submitted by Historical_Project00 to ZeroCovidCommunity [link] [comments]
Five months ago I got a small studio apartment so that I wouldn’t be exposed to covid from living with roommates. However I have chronic venous insufficiency (CVI) and I’ve discovered that I NEED constant use of stairs, as well as a larger home to move about in, in order to work the right muscles in my legs to keep my legs healthy and functional.
My leg health and quality of life has drastically plummeted since moving into my studio. I am in constant pain. Even showering once a week is a chore and I dread it. I cleaned my studio for an hour last week and it took me a 24/7 full week in bed to recover. I’m still not back to my baseline. While living with roommates (and thus having the stairs) I was fully functional.
My biggest worry is the lasting damage this could have on my legs. Visually, telling from the veins I will need sclerotherapy for, I have done more damage to them in 5 months of living in my studio than I did in 5 years prior, and I’m starting to even get visible veins in my lower back, hips, and pelvis. I did NOT realize this was going to happen when I first moved in. The veins are being slowly damaged. So far I have mainly superficial vein damage but if it gets to the deep vein I am in big trouble.
However my mental health was absolutely decimated living with roommates. I was a sitting duck having to fake smiles like everything was fine (so I wouldn’t get voted out) while my roommates went to maskless dance parties in the height of surges. Luckily they never caught it. While my health was okay, trying to avoid them in any humanly possible way I could took all of my mental energy and time with zero guarantee of working. It took my peace. I would be bawling my eyes out while they were out at their parties.
I spent a month trying to find a room for rent elsewhere but it is extremely difficult where I live. I have the opportunity to break my studio lease and move back in with my old roommates but I would need to do it now. I feel like I am between a rock and a hard place. And no, they won’t want me to put HEPA filters in the common areas because 1) the hallway is really narrow(wouldn’t bother me but oh well) and 2) it would bring down the “vibes” of the space. eyeroll One of my roommates is actually the live-in landlord (she rents out rooms in her house) so naturally what she says goes. They know I have a vascular disorder in a world with a circulating vascular-damaging virus but don't care.
I’ve tried figuring out ways to stay in my studio and keep my legs healthy at the same time, but there is just no alternative, and I’m known in my family for being “the resourceful one”. I’ve even started wearing thigh-high compression stockings and taking supplements and that is not enough.
I think I need to live with roommates again but need to figure out how to keep my mental peace since I am going to be a sitting duck for covid. It could theoretically harm my legs further, but staying in my studio is verifiably damaging them now. I did get recurring, permanent petechiae (not as bad as Google Images shows you) after my one-time infection which is a sign of vascular damage, but fuck man. By trying to avoid disability I have become disabled. I don’t think I can do this anymore.
But I can’t just unknow what I know about covid. I feel like I need to mentally resign myself like everyone else and just be like "welp, I just hope I stay healthy." But I don't know how to do that after avoiding it like my life depends on it for 4+ years.
We need systemic change and having to be self-resourceful to avoid covid is difficult for many if not impossible for some. I'm becoming the impossible category.
Edit: If you are a covid cautious person in Portland (WITH STAIRS, lol) and need a roommate I'm your gal!!
2024.05.06 02:17 FirmSeaworthiness198 Opinions? I'm looking for experience with similar results.
 | Im anxious to see the dr. I've been having alot of health issues and just recently been told they could all be related.My PCP tested me and when the results came in she referred me to a rheumatologist. Waiting for them to schedule me. Any ideas on what it could be and what u should say or ask the specialists? Symptoms: Headaches/stuff sore neck Always tired Stiff/achy joints - my hips bother me most right now All kinds of stomach issues - diagnosed with GERD and IBS in 2019-2020 Stupid rashes randomly show up and last 3ish weeks including scalp and chest/breasts (I have a folder on my phone camera of some of them) Tendinitis in right knee that will not heal since 2020 Swollen lymph nodes Random low grade fevers <101 Stillbirth 2015 Endometriosis removed 2015 submitted by FirmSeaworthiness198 to Autoimmune [link] [comments] This nitpicking and I don't want to show up to my appt and them think I'm a hypochondriac off the bat and then not take me seriously. I felt this way with my last PCP and didn't bring up issues til they were hurting my quality of life. |
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Alliance for Physician Certification and Advancement (APCA)
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American Board
American Board of Dermatology (ABD)
American Board of Foot and Ankle Surgery (ABFAS)
American Board of Internal Medicine (ABIM)
American Board of Podiatric Medicine (ABPM)
American Board of Venous & Lymphatic Medicine (ABVLM)
American College of Financial Services
American College of Sports Medicine (ACSM)
American Health Information Management Association (AHIMA)
American Medical Informatics Association (AMIA)
American Medical Technologists (AMT)
American Registry for Diagnostic Medical Sonography (ARDMS)
American Registry of Radiologic Technologists (ARRT)
American Society of Military Comptrollers (ASMC)
AO Spine
APICS
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Appraisal Institute
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Association of Destination Management Executives International (ADMEI)
Australian Pharmacy Council (APC)
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AVIXA
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Basic Ability Exam
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Board of Canadian Registered Safety Professionals (BCRSP - CCPSA)
BOMI International
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British Heart Rhythm Society (BHRS)
British Society of Echocardiography
Broadcom (formerly known as VMware)
Business Architecture Guild
C++ Institute
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CAIA Association
California Basic Educational Skills Test (CBEST)
California Preliminary Administrative Credential Examination (CPACE)
California Subject Examinations for Teachers (CSET)
California Teacher of English Learners (CTEL)
California Water Environment Association (CWEA)
Canadian Society for Exercise Physiology (CSEP SCPE)
Career Qualified in Banking (FINSIA)
Center for Credentialing & Education (CCE)
Certification Examinations for Oklahoma Educators (CEOE)
Certified Counter-Insider Threat Professional (CCITP) Program
Certified Fund Raising Executive (CFRE)
Certified Medical Publication Professional (CMPP)
Certified Mission Critical Operator (CMCO)
Certified Mission Critical Professional (CMCP)
CertNexus
CFA UK
Chartered Banker Institute (CBI)
Chartered Institute of Credit Management (CICM)
Chartered Institute of Loss Adjusters (CILA)
Check Point Software Technologies
Chicago Police Department (CPD)
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CITB
CITB eLearning
Citrix
Claris International
Colorado Insurance
Commercial Real Estate Certification Institute (CRECI)
Commission for Case Manager Certification (CCMC)
Commission on Rehabilitation Counselor Certification (CRCC)
CompTIA
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Consortium for School Networking (CoSN)
Counselor Preparation Comprehensive Examination (CPCE)
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Dental Core Training (DCT)
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2024.05.03 06:09 Itchy-Operation-4120 Should I be concerned about endocarditis?
Hello, I have Tetralogy of Fallot. My first surgery was 3 months after birth, and my latest one being in 2019. Over the past few months I have been experiencing chronic fatigue and a low-grade fever (99.5). Well, I brought these issues up to my cardiologist and she ordered a echocardiogram. However, I mentioned the fatigue I failed to mention the fever. She said she would call if she found anything concerning, it's been a few days and I still haven't received a call. My main concern is, could this indicate endocarditis due to the fever? And, should I get immediate care or wait for her return phone call? Here are the results from the echocardiogram:
S/p Tetralogy of Fallot surgery, ventricular septal defect closure with transannular patch and RV muscle bundle resection, monocusp pulmonary valve. 2. No residual ventricular septal defect postoperatively. 3. S/p pulmonary valve replacement. 4. Mild post-intervention pulmonary valve residual stenosis. 5. Peak gradient through pulmonary valve of 32 mmHg. 6. Moderate post-intervention pulmonary valve residual regurgitation. 7. Normal left ventricular cavity size and systolic function. 8. Moderately dilated and hypertrophied right ventricle with normal systolic function. The IVS bows into the LV during ventricular systole with a septal bounce at the end of systole in the setting of RBBB. Septal flattening in diastole in the setting of volume overload. 9. Right ventricular systolic pressure estimate = 51.7 mmHg. 10. No pericardial effusion. 11. Compared to the previous echocardiogram of 1/31/2023, no significant change. Clinical Observations: Segmental Cardiotype, Cardiac Position, and Situs The cardiac apex is oriented leftward. Systemic Veins The superior vena cava is right-sided and drains normally to the right atrium. The innominate vein is present and of normal caliber. The inferior vena cava is right-sided and inserts into the right atrium normally. Prominent IVC with respiratory size variation. Pulmonary Veins The pulmonary venous structures were not adequately demonstrated. Atria Imaging is inadequate to rule out an atrial septal defect. The right atrium is mildly dilated. The left atrium is normal in size. Mitral Valve The mitral valve is normal. Mitral inflow is laminar, with normal Doppler velocity pattern. There is no evidence of mitral valve stenosis. The papillary muscle configuration appears normal. There is no evidence of mitral valve insufficiency. Tricuspid Valve The tricuspid valve is normal. There is trivial (physiologic) tricuspid valve insufficiency. There is no evidence of tricuspid valve stenosis. Left Ventricle The left ventricle is normal in size. Left ventricular systolic function is normal. Left ventricular diastolic function is normal. Diastolic function state is determined based on left ventricular diastolic Doppler velocities. Right Ventricle The right ventricle is moderately dilated. The right ventricle is mildly hypertrophied. The interventricular septum position is flattened during diastole. Right ventricular systolic function is normal. Right ventricular relaxation is mildly impaired. Diastolic function state is determined on the basis of right ventricular inflow Doppler velocities and tricuspid free-wall annular Doppler velocities (DTI). Moderately dilated and hypertrophied right ventricle with normal systolic function. The IVS bows into the LV during ventricular systole with a septal bounce at the end of systole in the setting of RBBB. Septal flattening in diastole in the setting of volume overload. VSD There is no evidence of residual ventricular defect following surgery. Left Ventricular Outflow Tract and Aortic Valve There is no evidence of left ventricular outflow obstruction. The aortic valve is trileaflet. Based on Doppler velocities, there is no aortic transvalvular flow obstruction. There is no evidence of aortic valve insufficiency. Right Ventricular Outflow Tract and Pulmonary Valve There is no evidence of right ventricular outflow obstruction. The pulmonary valve is domed. Based on Doppler velocities, there is moderate pulmonary transvalvular flow obstruction. Moderate pulmonary valve insufficiency. The patient is status post pulmonary valve replacement. There is mild residual stenosis following pulmonary valve intervention. There is moderate residual regurgitation following pulmonary valve intervention. Peak gradient through pulmonary valve of 32 mmHg. Aorta The (aortic) sinuses of Valsalva segment is mildly dilated. The ascending aorta is normal. The transverse aortic arch segment is normal. The flow pattern in the aorta is normal. There is no evidence of coarctation of the aorta. Pulmonary Arteries There is no evidence of supravalvular pulmonary artery stenosis. The main pulmonary artery is normal. The left branch pulmonary artery is normal. The right branch pulmonary artery is normal. Coronary Arteries The coronary arteries were not evaluated. Pericardium There is no evidence of pericardial effusion. Interventional / Surgical Procedures The patient is status post pulmonary valve replacement. Peak gradient through pulmonary valve of 32 mmHg. The patient is status post Tetralogy of Fallot surgery, ventricular septal defect closure with transannular patch and RV muscle bundle resection, monocusp pulmonary valve. . M-mode Z-score IVSd: 0.75 cm -1.72 IVSs: 0.86 cm -2.68 LVIDd: 3.69 cm -3.94 LVIDs: 2.42 cm -2.55 LVPWd: 1.24 cm 2.14 LVPWs: 1.56 -0.07 LV mass (corr.): 111.20 g -2.62 LV mass index: 22.04 g/m^2.7 2-Dimensional Z-score AoV annulus, s: 2.31 cm 0.59 Ao sinus, s: 3.65 cm 2.19 Ao ST junct, s: 3.30 cm 3.60 LV Systolic Function LV SF (M-mode): 34 % LV EF (M-mode): 64 % LV Diastolic Function Z-score Lateral annulus e': 0.18 m/s -0.40 LVOT Doppler Peak velocity: 0.85 m/s Peak gradient: 3.02 mmHg RVOT Doppler Peak velocity: 0.91 m/s Aortic Valve Doppler Peak velocity: 0.99 m/sec Peak gradient 4 mmHg Pulmonary Valve Doppler Peak velocity: 2.74 m/sec Peak gradient: 30.10 mmHg Tricuspid Valve Doppler Regurg peak velocity: 3.23 m/s Estimated Pressures RA V-wave: 10 mmHg RV systolic pressure (TR): 51.73 mmHg
TLDR: Concern of endocarditis due to chronic fatigue and low grade fever, provided echocardiogram results. Should I wait for cardiologist to call or get immediate care?
submitted by Itchy-Operation-4120 to askCardiology [link] [comments]
S/p Tetralogy of Fallot surgery, ventricular septal defect closure with transannular patch and RV muscle bundle resection, monocusp pulmonary valve. 2. No residual ventricular septal defect postoperatively. 3. S/p pulmonary valve replacement. 4. Mild post-intervention pulmonary valve residual stenosis. 5. Peak gradient through pulmonary valve of 32 mmHg. 6. Moderate post-intervention pulmonary valve residual regurgitation. 7. Normal left ventricular cavity size and systolic function. 8. Moderately dilated and hypertrophied right ventricle with normal systolic function. The IVS bows into the LV during ventricular systole with a septal bounce at the end of systole in the setting of RBBB. Septal flattening in diastole in the setting of volume overload. 9. Right ventricular systolic pressure estimate = 51.7 mmHg. 10. No pericardial effusion. 11. Compared to the previous echocardiogram of 1/31/2023, no significant change. Clinical Observations: Segmental Cardiotype, Cardiac Position, and Situs The cardiac apex is oriented leftward. Systemic Veins The superior vena cava is right-sided and drains normally to the right atrium. The innominate vein is present and of normal caliber. The inferior vena cava is right-sided and inserts into the right atrium normally. Prominent IVC with respiratory size variation. Pulmonary Veins The pulmonary venous structures were not adequately demonstrated. Atria Imaging is inadequate to rule out an atrial septal defect. The right atrium is mildly dilated. The left atrium is normal in size. Mitral Valve The mitral valve is normal. Mitral inflow is laminar, with normal Doppler velocity pattern. There is no evidence of mitral valve stenosis. The papillary muscle configuration appears normal. There is no evidence of mitral valve insufficiency. Tricuspid Valve The tricuspid valve is normal. There is trivial (physiologic) tricuspid valve insufficiency. There is no evidence of tricuspid valve stenosis. Left Ventricle The left ventricle is normal in size. Left ventricular systolic function is normal. Left ventricular diastolic function is normal. Diastolic function state is determined based on left ventricular diastolic Doppler velocities. Right Ventricle The right ventricle is moderately dilated. The right ventricle is mildly hypertrophied. The interventricular septum position is flattened during diastole. Right ventricular systolic function is normal. Right ventricular relaxation is mildly impaired. Diastolic function state is determined on the basis of right ventricular inflow Doppler velocities and tricuspid free-wall annular Doppler velocities (DTI). Moderately dilated and hypertrophied right ventricle with normal systolic function. The IVS bows into the LV during ventricular systole with a septal bounce at the end of systole in the setting of RBBB. Septal flattening in diastole in the setting of volume overload. VSD There is no evidence of residual ventricular defect following surgery. Left Ventricular Outflow Tract and Aortic Valve There is no evidence of left ventricular outflow obstruction. The aortic valve is trileaflet. Based on Doppler velocities, there is no aortic transvalvular flow obstruction. There is no evidence of aortic valve insufficiency. Right Ventricular Outflow Tract and Pulmonary Valve There is no evidence of right ventricular outflow obstruction. The pulmonary valve is domed. Based on Doppler velocities, there is moderate pulmonary transvalvular flow obstruction. Moderate pulmonary valve insufficiency. The patient is status post pulmonary valve replacement. There is mild residual stenosis following pulmonary valve intervention. There is moderate residual regurgitation following pulmonary valve intervention. Peak gradient through pulmonary valve of 32 mmHg. Aorta The (aortic) sinuses of Valsalva segment is mildly dilated. The ascending aorta is normal. The transverse aortic arch segment is normal. The flow pattern in the aorta is normal. There is no evidence of coarctation of the aorta. Pulmonary Arteries There is no evidence of supravalvular pulmonary artery stenosis. The main pulmonary artery is normal. The left branch pulmonary artery is normal. The right branch pulmonary artery is normal. Coronary Arteries The coronary arteries were not evaluated. Pericardium There is no evidence of pericardial effusion. Interventional / Surgical Procedures The patient is status post pulmonary valve replacement. Peak gradient through pulmonary valve of 32 mmHg. The patient is status post Tetralogy of Fallot surgery, ventricular septal defect closure with transannular patch and RV muscle bundle resection, monocusp pulmonary valve. . M-mode Z-score IVSd: 0.75 cm -1.72 IVSs: 0.86 cm -2.68 LVIDd: 3.69 cm -3.94 LVIDs: 2.42 cm -2.55 LVPWd: 1.24 cm 2.14 LVPWs: 1.56 -0.07 LV mass (corr.): 111.20 g -2.62 LV mass index: 22.04 g/m^2.7 2-Dimensional Z-score AoV annulus, s: 2.31 cm 0.59 Ao sinus, s: 3.65 cm 2.19 Ao ST junct, s: 3.30 cm 3.60 LV Systolic Function LV SF (M-mode): 34 % LV EF (M-mode): 64 % LV Diastolic Function Z-score Lateral annulus e': 0.18 m/s -0.40 LVOT Doppler Peak velocity: 0.85 m/s Peak gradient: 3.02 mmHg RVOT Doppler Peak velocity: 0.91 m/s Aortic Valve Doppler Peak velocity: 0.99 m/sec Peak gradient 4 mmHg Pulmonary Valve Doppler Peak velocity: 2.74 m/sec Peak gradient: 30.10 mmHg Tricuspid Valve Doppler Regurg peak velocity: 3.23 m/s Estimated Pressures RA V-wave: 10 mmHg RV systolic pressure (TR): 51.73 mmHg
TLDR: Concern of endocarditis due to chronic fatigue and low grade fever, provided echocardiogram results. Should I wait for cardiologist to call or get immediate care?
2024.05.01 19:04 CerebralTorque Headache Red Flags
 | submitted by CerebralTorque to migrainescience [link] [comments] |
2024.05.01 14:00 bvlich Background: The use of veno-venous extracorporeal membrane oxygenation (vv-ECMO) in acute lung failure has witnessed a notable increase. The PiCCO system is frequently used for advanced hemodynamic monitoring in this cohort.
 | submitted by bvlich to iperfusion [link] [comments] |
2024.05.01 13:00 bvlich Background: The use of veno-venous extracorporeal membrane oxygenation (vv-ECMO) in acute lung failure has witnessed a notable increase. The PiCCO system is frequently used for advanced hemodynamic monitoring in this cohort.
| | submitted by bvlich to iperfusion [link] [comments] |
2024.04.30 08:24 medwinpublishers Multiphasic MDCT of Living Renal Donors, Prior to Surgery
Multiphasic MDCT of Living Renal Donors, Prior to Surgery
Authors: Hira MG*, Waseem Z, Hira N, Usman K and Amjad I
DOI: 10.23880/crij-16000219
Abstract:
Background: Live kidney donor evaluation mandates anatomical and functional assessment of the donor kidney. Multiphasic Multidetector computed tomography (MDCT) with advanced 3‐D techniques provides a detailed description of the vascular, parenchymal, and collecting system.
Objectives: To evaluate the clinical application of Multiphasic MDCT in the pre-operative anatomic assessment of prospective donor kidneys.
Methods: Multiphasic MDCT was performed in thirty-eight patients as part of a pre-operative assessment. Each study comprised three phases of imaging, including the arterial, venous, and excretory phases.
Results: The predominant radiological finding amongst the cases studied was that of the presence of accessory renal arteries in 35% of the patients. Multiphasic MDT was also able to detect renal parenchymal disease in one case. Post-renal anatomical evaluation also identified renal calculi in 12.5% of the total cases.
Conclusions: There is considerable scope for multiphasic MDCT in the pre-operative evaluation of donor kidneys, especially as modern-day renal transplant surgery sees a shift towards laparoscopic techniques where intraoperative anatomic evaluation can be restricted. The multiphasic MDCT is useful in pre-renal, renal, and post-renal anatomic evaluation.
Advances in Knowledge: Multiphasic MDCT can provide noninvasive, detailed, and fast images to aid the preoperative evaluation of donor kidneys.
Keywords: Multiphasic MDCT; Post-Renal Anatomic Evaluation; CT Angiography
submitted by medwinpublishers to u/medwinpublishers [link] [comments]
Authors: Hira MG*, Waseem Z, Hira N, Usman K and Amjad I
DOI: 10.23880/crij-16000219
Abstract:
Background: Live kidney donor evaluation mandates anatomical and functional assessment of the donor kidney. Multiphasic Multidetector computed tomography (MDCT) with advanced 3‐D techniques provides a detailed description of the vascular, parenchymal, and collecting system.
Objectives: To evaluate the clinical application of Multiphasic MDCT in the pre-operative anatomic assessment of prospective donor kidneys.
Methods: Multiphasic MDCT was performed in thirty-eight patients as part of a pre-operative assessment. Each study comprised three phases of imaging, including the arterial, venous, and excretory phases.
Results: The predominant radiological finding amongst the cases studied was that of the presence of accessory renal arteries in 35% of the patients. Multiphasic MDT was also able to detect renal parenchymal disease in one case. Post-renal anatomical evaluation also identified renal calculi in 12.5% of the total cases.
Conclusions: There is considerable scope for multiphasic MDCT in the pre-operative evaluation of donor kidneys, especially as modern-day renal transplant surgery sees a shift towards laparoscopic techniques where intraoperative anatomic evaluation can be restricted. The multiphasic MDCT is useful in pre-renal, renal, and post-renal anatomic evaluation.
Advances in Knowledge: Multiphasic MDCT can provide noninvasive, detailed, and fast images to aid the preoperative evaluation of donor kidneys.
Keywords: Multiphasic MDCT; Post-Renal Anatomic Evaluation; CT Angiography
2024.04.29 19:45 ArtLimp457 38M I just had an ultrasound and got this report---anything to be worried about?
Findings: Moderately and diffuse echogenic liver is present measuring up to 15.5 cm. The
liver is obscured due to technique and bowel gas. Otherwise, The liver and gallbladder
appears grossly unremarkable without other well-defined lesions in the visualized portion.
Spleen: The spleen is grossly unremarkable in size and morphology in its visualized portion.
Common bile duct: The common bile duct in visualized portion is normal in caliber.
Pancreas: The pancreas is obscured by bowel gas.
Kidneys:
The kidneys are otherwise grossly unremarkable in size and morphology . No other
hydronephrosis or obstructive calculi are identified. Doppler images show flow within the
arterial and venous system intrarenally.
VASCULAR DUPLEX COLOR FLOW DOPPLER IMAGING
Abdominal Aorta: The visualized portion of the abdominal aorta from proximal to distal portion
is unremarkable without evidence of aneurysm or significant luminal stenosis. The peak
systolic velocities of the visualized arterial system do not appear to exceed 120 cm/s.
Visualized portion of IVC, portal and hepatic veins are patent and unremarkable.
IMPRESSION: Suboptimal exam as above.
Diffuse echogenic liver as above likely fatty infiltration versus other hepatocellular diseases.
Correlate clinically and follow-up
submitted by ArtLimp457 to FattyLiverNAFLD [link] [comments]
liver is obscured due to technique and bowel gas. Otherwise, The liver and gallbladder
appears grossly unremarkable without other well-defined lesions in the visualized portion.
Spleen: The spleen is grossly unremarkable in size and morphology in its visualized portion.
Common bile duct: The common bile duct in visualized portion is normal in caliber.
Pancreas: The pancreas is obscured by bowel gas.
Kidneys:
The kidneys are otherwise grossly unremarkable in size and morphology . No other
hydronephrosis or obstructive calculi are identified. Doppler images show flow within the
arterial and venous system intrarenally.
VASCULAR DUPLEX COLOR FLOW DOPPLER IMAGING
Abdominal Aorta: The visualized portion of the abdominal aorta from proximal to distal portion
is unremarkable without evidence of aneurysm or significant luminal stenosis. The peak
systolic velocities of the visualized arterial system do not appear to exceed 120 cm/s.
Visualized portion of IVC, portal and hepatic veins are patent and unremarkable.
IMPRESSION: Suboptimal exam as above.
Diffuse echogenic liver as above likely fatty infiltration versus other hepatocellular diseases.
Correlate clinically and follow-up
2024.04.28 16:31 Elusivestone CorMedix a Long-term Value, and Short Term Growth potential.
Disclosure: I own 3750 Shares, and have Call Contracts:
SOURCE RELATED MATERIALS:
submitted by Elusivestone to Stocks_Picks [link] [comments]
- CorMedix is a Biotech stock that is going to revolutionize the Hemodialysis, and Central-Venus-Catheter world.
- CorMedix is a Bio-tech stock focused on developing solutions for the prevention of Catheter-Related-Blood-Infections or CRBIs.
- CRBIs affects End Stage Renal Disease population approx. 808,000 and of those, approximately 550,000 people receive hemo-dialysis through a Central Venus Catheter.
- Approximately 250,000k CRBIs events occur each year, and 70% of them occur within the CVC population.
- Defencath is a catheter lock solution that eliminates both gram positive and gram negative bacterial infections that develop within the Catheter. Defencath is composed of a solution of taurolidine and heparin that effectively reduces the CRBSI events in this vulnerable population.
- DEFENCATH REDUCES CRBIS EVENTS BY 71%
- However, this population has a catheter that is surgically implanted into their patient and its called a, “Central Venous Catheter.” This type of catheter is placed near a large center vein most commonly an internal jugular or subclavian. In layman terms, it’s placed near the patient's heart, implanted on the patient to administer medication or to administer hemo-dialysis.
- Defencath is approved by the FDA as of 11/15/23.
- On April 15th, 2024, the company celebrated it's commercial launch.
- On April 19th, 2024, the company announced TDAPA reimbursement acceptance from CMS.
- Market: There are two settings in which defencath will be used, in-patient and out-patient.
- In-patient market is expected to sell 3.7 million vials.
- Out-patient is expected to sell 37 million vials to 47 million vials.
- Institutional Ownership: 34% of total shares.
- Blackrock Inc: 3.5 million shares
- Numora holdings: 2.9 million shares.
- Vanguard: 2.8 million shares
- Eliot Management: 1.5 million shares.
- Insider ownership:
- All insiders have been holding and accumulating shares over the past 5 years.
- Only one sell occurred in may 2021.
- Short Interest: is about 9.2 million shares or $34,000,000.
- Marketing Plan:
- In-patient side: they have a sale team comprised of 30 well trained industry people to attack the hospital setting which consists of 1700 hospital systems.
- Out-Patient side: There are 5 companies that control the entire market and 2 of them control 70% of the market.
- The company has stated the board will directly negotiate agreements with the out-patients side.
- Debt: 0.
- Market exclusivity: CRMD has 10.5 years market exclusivity because it's a qualified infectious disease, and it's a new chemical entity. And it’s intellectual property is extended until April 15, 2042.
- If you read up to this point You're probably wondering how does the product work:
- Well, Every Time a patient receives hemo-dialysis the catheter must be flushed with the Defencath solution before and after. That is approximately two vials per patient per visit with the average patient getting about 3 treatments per-week, out of 550,000 patients on hemodialysis.
- Out-patient Launch Expectation: Cormedix plans, and is on track to launch Defencath for the out-patient setting on July 1, 2024.
- Cormedix Plans on expanding its usage and application of Defencath to other populations that already have CVCs, like Oncology.
- Oncology 1.5x the size of HD population.
- Competition: There is no competition on the market as it's the first catheter lock solution to prevent CRBIs in such a vulnerable population.
- I recommend you read the SEC filing for the most accurate information.
- My previous DD, has been off of memory, and years of being in this stock.
- I found all the supporting information to my beliefs on the previous post and cited it.
- I believe in this stock because I understand the product
- I think you would understand this product if you read their most recent sec filings;
- My past DD; and
- Investor Presentation.
- My previous DD, has been off of memory, and years of being in this stock.
- Risks: The company talks about risks in the sec filings, but quite honestly, I personally don't think it's a risky investment. I think it's because I understand the market, the product, the market impact and the science.
SOURCE RELATED MATERIALS:
- Company's Investor Presentation Deck: https://cormedix.com/wp-content/uploads/2023/03/CorMedix-Corp-Presentation_1-7-23.pdf
- PAST DD: https://www.reddit.com/ValueInvesting/comments/1cbjfz2/cormedix_crmd_a_deep_value_opportunity_tldr_at/
- SEC Filings 10k MOST RECENT: https://www.sec.gov/ix?doc=/Archives/edgadata/1410098/000121390024021585/ea0201177-10k_cormedix.htm
2024.04.25 15:16 annette73 How Do I Get Rid of Cankles: Ultimate Guide & Success Stories
How Do I Get Rid of Cankles: Cankles, the area where the calf and ankle meet without clear definition, often lead to frustration and body image concerns for those seeking a more toned leg appearance, potentially due to poor circulation. Unlike the well-defined ankles admired in summer footwear, cankles can make finding flattering shoes a challenge and dent self-confidence. The good news is, targeting cankles is not as daunting as it seems. With the right approach combining diet adjustments, specific exercises, and lifestyle changes, you can work towards sculpting the defined ankles you desire. This post dives into practical strategies to bid farewell to cankles, offering insights into how minor tweaks in your daily routine can lead to significant changes in how you feel about your legs.
Weighted calf raises and leg presses are effective for building calf muscles. They should be part of a regular exercise routine. The benefits of calf strengthening extend beyond aesthetics. They include better stability, improved mobility, and reduced ankle swelling.
A recommended routine might start with a 30-minute cardio session to increase heart rate and burn calories. Follow this with strength training exercises focusing on the lower body, such as squats and lunges. Include flexibility exercises like stretches or yoga poses to ensure balanced toning.
Regular engagement in these activities leads to a more defined calf area, indirectly benefiting those struggling with cankles. The key is consistency and integrating both cardio and strength elements into your workout plan.
Incorporating daily stretches for the calves and Achilles tendon can make a significant difference in flexibility over time. Regular yoga or Pilates sessions contribute to better posture, reduced risk of injuries, and improved overall leg appearance by promoting circulation.
The importance of regular flexibility routines cannot be overstated for those looking to improve their cankle situation. These practices support healthy movement patterns and contribute to a more toned appearance of the calves.
Exercise plays a crucial role too. While targeted exercises do not directly reduce fat in specific areas, they help tone muscles and improve body composition. Combining cardiovascular exercises with strength training enhances fat loss across the body, including the calves and ankles. Sustainable lifestyle changes trump quick fixes every time. They ensure lasting results rather than temporary solutions that might lead to weight regain.
Elevating the legs above heart level several times a day promotes venous return and decreases edema. Compression garments also aid in maintaining proper blood flow, offering support to the veins and reducing swelling. These methods work together to alleviate current swelling while preventing future occurrences of cankles by ensuring healthy circulation.
Dehydration aggravates swelling because when the body senses a lack of water, it holds onto fluids, worsening edema in areas like the ankles. The recommended daily water intake varies depending on individual factors such as weight, activity level, and climate but aiming for at least 8 glasses a day is a good start. Adjust this amount based on your personal needs and levels of physical activity.
Taking short breaks to elevate the legs helps too. It's beneficial during long periods of sitting or standing. Elevating the legs aids in reducing swelling by improving circulation.
Quitting smoking is another vital step. It enhances vascular health and, as a result, may reduce the prominence of cankles. Improved blood flow supports the body's natural mechanisms for managing fluid and fat distribution.
Strategies to focus on functionality over aesthetics include celebrating physical achievements and acknowledging the body's capabilities. Such an approach boosts self-esteem and contributes to overall well-being.
The psychological benefits of maintaining a positive body image are immense. They include increased happiness and reduced stress levels, which indirectly support efforts to address physical concerns like cankles.
Mindfulness, meditation, and regular physical activity are proven stress reducers. They not only manage stress but also promote healthier lifestyle choices that contribute to addressing cankles.
Effective stress management leads to better sleep patterns, dietary choices, and exercise habits. These changes collectively support the goal of reducing cankle appearance by fostering an overall healthier lifestyle.
Epsom salt baths offer another natural solution. Soaking your feet in warm water mixed with Epsom salts can significantly reduce swelling and discomfort. This remedy draws out excess fluids, providing relief from swollen ankles and feet.
Wearing shoes that fit well is essential. Tight or poorly fitting footwear can exacerbate pressure on the ankles, worsening the condition. Opt for shoes that support and cushion your feet without adding unnecessary strain on your ankles.
Medications can help control factors contributing to swelling, such as high blood pressure or heart conditions. Compression stockings are another effective option, improving blood flow and reducing fluid buildup in the affected areas.
Surgical options exist for severe cases where other treatments have not been effective. Procedures like liposuction or calf reshaping might be considered to achieve a more balanced appearance between the lower leg and ankle. However, these are typically last-resort options due to their invasive nature.
Consulting with a healthcare professional is imperative before choosing a treatment path. A doctor can provide a personalized plan based on the specific cause of your cankles, ensuring you receive the most appropriate care.
Keeping a health diary is highly beneficial. It helps track symptoms, dietary habits, and physical activity levels over time. This record becomes invaluable during medical appointments, offering insights that might hasten diagnosis and intervention.
Exercise plays a pivotal role too. Activities like walking, swimming, and cycling improve circulation and promote fat loss without putting excessive strain on the legs. Moreover, strength training targeting the lower body can help tone the area around the ankles.
Mental well-being should not be overlooked. Stress management techniques such as meditation, yoga, or even simple breathing exercises can help mitigate stress-induced eating behaviors that contribute to weight gain.
Setting realistic goals is key. Celebrating small victories along the way keeps motivation high and makes the journey more enjoyable. Whether it’s losing a bit of weight, being able to walk further than before, or simply feeling healthier—every achievement matters.
Individuals must pay attention to changes in their lower extremities, particularly after starting new physical activities or making dietary adjustments. Persistent or worsening swelling, accompanied by discomfort, demands immediate medical evaluation. Ignoring these signs can lead to complications.
A team approach ensures comprehensive management of one’s health and wellness goals. This collaborative effort maximizes the effectiveness of interventions designed to minimize cankles. It addresses not only the physical aspect but also nutritional and lifestyle factors contributing to the condition.
It's crucial to set realistic expectations for the journey ahead. Results typically don't appear overnight. Most success stories highlight a period of several months to over a year of consistent effort before seeing significant changes. This timeline varies from person to person, depending on factors like genetics, starting point, and the specific strategies employed.
Consistency and patience play vital roles in these transformations. Incorporating regular exercise, particularly activities that focus on toning the lower legs, alongside dietary adjustments, has proven effective for many. It's also important to note that while some individuals may see drastic reductions in their cankle appearance, others might notice more subtle changes. Both outcomes represent progress and are worth celebrating.
One individual shared how incorporating daily walks, coupled with specific calf-strengthening exercises, gradually reshaped their lower legs over twelve months. They emphasized how initial discouragement gave way to excitement as they began to notice changes not just in appearance but in their overall health and stamina.
Another testimonial comes from someone who combined physical activity with mindful eating. They found that reducing sodium intake helped decrease water retention significantly, contributing to a more defined ankle area. Their journey was not only about reducing cankle appearance but also about adopting a healthier lifestyle overall.
These stories underscore the importance of finding a personalized approach that works for each individual. They serve as powerful reminders that while everyone's journey is unique, determination and adaptability are key components of success.
Lifestyle changes play a significant role in managing cankles. Increasing physical activity, especially exercises that focus on the legs, can improve circulation and reduce fat accumulation. Adjusting diet to decrease salt intake and increase water consumption also helps minimize swelling.
Medical treatments and self-care should not be overlooked. Compression stockings aid in reducing swelling by improving blood flow when standing or sitting for long periods. In some cases, surgical options like liposuction may be considered for those seeking more dramatic changes in appearance.
While cankles can be a cosmetic concern for many, it's important to remember that overall health and well-being should always be the priority. Success stories from individuals who have managed their cankles show that focusing on general health brings the most satisfying results.
Setting realistic goals is vital. Expecting immediate results may lead to disappointment since reducing the appearance of cankles often requires time and consistent effort. Seeking support from a community or professionals who understand the journey can provide motivation and valuable advice.
For more great tips read my article here
submitted by annette73 to Bloggers [link] [comments]
Key Takeaways
- Understand Your Body: Recognizing the underlying causes of cankles, which can range from genetics to lifestyle factors, is crucial for effective management and treatment.
- Exercise Regularly: Incorporating specific exercises, such as calf raises and cardiovascular activities, can help tone the lower leg area and reduce the appearance of cankles.
- Adopt a Balanced Diet: Consuming a healthy, balanced diet low in sodium and rich in potassium can aid in reducing water retention that often contributes to the formation of cankles.
- Make Lifestyle Adjustments: Simple lifestyle changes, including elevating your legs when resting and avoiding tight footwear, can significantly impact the reduction of cankles.
- Explore Treatment Options: For those seeking more immediate results, exploring medical treatments like liposuction or laser therapy could be beneficial, but it's important to consult with a healthcare professional first.
- Prevention is Key: Engaging in regular physical activity and maintaining a healthy diet are fundamental preventive measures to avoid the development of cankles in the future.
Understanding Cankles
Definition and Causes
Cankles, a term blending "calf" and "ankles," describe the appearance of thick ankles with no clear separation from the calves. This condition stems from a variety of factors, both genetic and environmental. Common causes include genetics, certain health conditions, and lifestyle choices. It's crucial to recognize that both internal and external influences, including specific training, play significant roles in the development of cankles.Genetics Role
Genetics significantly contribute to the formation of cankles. Many people inherit their lower leg shape, including the propensity for thicker ankles. The way fat is distributed across our bodies and how our muscles are structured are largely dictated by our genes. Understanding your genetic background is vital when addressing issues related to cankles.Health Conditions
Several health conditions can lead to the development of cankles. Obesity, diabetes, and venous insufficiency in the ankle area are among the top culprits. Hormonal imbalances and systemic diseases also play a role in exacerbating lower leg swelling. In cases where health conditions are at the root of cankle formation, seeking medical intervention becomes necessary.Other Triggers
Beyond genetics and health issues, various lifestyle and environmental factors can trigger the onset of thick ankles. Prolonged periods of sitting, high salt consumption, and exposure to warm climates all contribute to this condition. Pregnancy and certain medications also have a significant impact on ankle swelling. Insect bites or stings that go untreated can lead to severe swelling in the ankle area.Cankle Exercises
Calf Strengthening
To combat cankles, focusing on calf strengthening is crucial. Exercises like calf raises specifically target these muscles, enhancing definition and strength. Incorporating weight training can significantly boost muscle mass around the calves. This not only improves the appearance but also enhances leg function.Weighted calf raises and leg presses are effective for building calf muscles. They should be part of a regular exercise routine. The benefits of calf strengthening extend beyond aesthetics. They include better stability, improved mobility, and reduced ankle swelling.
Toning Workouts
Toning workouts play a vital role in reducing cankles by promoting fat loss and muscle toning throughout the body. A balanced approach combines cardio exercises with strength training. This helps lower overall body fat percentage while improving muscle tone.A recommended routine might start with a 30-minute cardio session to increase heart rate and burn calories. Follow this with strength training exercises focusing on the lower body, such as squats and lunges. Include flexibility exercises like stretches or yoga poses to ensure balanced toning.
Regular engagement in these activities leads to a more defined calf area, indirectly benefiting those struggling with cankles. The key is consistency and integrating both cardio and strength elements into your workout plan.
Flexibility Routines
Improving flexibility in the ankles and calves is essential for addressing cankles. Stretching exercises not only reduce tightness but also enhance circulation in the lower legs. Yoga and Pilates are highly effective for increasing flexibility, offering routines that specifically benefit the lower leg area.Incorporating daily stretches for the calves and Achilles tendon can make a significant difference in flexibility over time. Regular yoga or Pilates sessions contribute to better posture, reduced risk of injuries, and improved overall leg appearance by promoting circulation.
The importance of regular flexibility routines cannot be overstated for those looking to improve their cankle situation. These practices support healthy movement patterns and contribute to a more toned appearance of the calves.
Dietary Advice
Fat Reduction
Reducing fat in the body, including the lower legs, requires a balanced approach to diet and exercise. A diet rich in fruits, vegetables, lean proteins, and whole grains helps in overall fat loss. It's vital to create a calorie deficit by consuming fewer calories than the body burns. This strategy aids in reducing body fat, which can consequently decrease the size of cankles.Exercise plays a crucial role too. While targeted exercises do not directly reduce fat in specific areas, they help tone muscles and improve body composition. Combining cardiovascular exercises with strength training enhances fat loss across the body, including the calves and ankles. Sustainable lifestyle changes trump quick fixes every time. They ensure lasting results rather than temporary solutions that might lead to weight regain.
Improved Circulation
Activities like walking or cycling boost blood flow to the lower extremities, enhancing circulation. This is beneficial for those looking to minimize cankles. Improved circulation helps in reducing swelling and prevents fluid accumulation around the ankles and calves.Elevating the legs above heart level several times a day promotes venous return and decreases edema. Compression garments also aid in maintaining proper blood flow, offering support to the veins and reducing swelling. These methods work together to alleviate current swelling while preventing future occurrences of cankles by ensuring healthy circulation.
Hydration Importance
Staying hydrated is key in managing cankles as it helps reduce fluid retention—a common factor contributing to swollen ankles and calves. Adequate water intake ensures that the body functions optimally, flushing out toxins that could lead to inflammation and swelling.Dehydration aggravates swelling because when the body senses a lack of water, it holds onto fluids, worsening edema in areas like the ankles. The recommended daily water intake varies depending on individual factors such as weight, activity level, and climate but aiming for at least 8 glasses a day is a good start. Adjust this amount based on your personal needs and levels of physical activity.
Lifestyle Changes
Routine Adjustments
To combat cankles, modifying daily routines plays a crucial role. A balanced diet, especially one low in sodium, significantly reduces water retention. This change alone can make a noticeable difference in the appearance of cankles.Taking short breaks to elevate the legs helps too. It's beneficial during long periods of sitting or standing. Elevating the legs aids in reducing swelling by improving circulation.
Quitting smoking is another vital step. It enhances vascular health and, as a result, may reduce the prominence of cankles. Improved blood flow supports the body's natural mechanisms for managing fluid and fat distribution.
Positive Body Image
Developing a positive body image is essential, regardless of cankle presence. Acceptance and appreciation of one's body foster a healthier relationship with oneself. This mindset shift encourages focusing on what the body can do rather than how it looks.Strategies to focus on functionality over aesthetics include celebrating physical achievements and acknowledging the body's capabilities. Such an approach boosts self-esteem and contributes to overall well-being.
The psychological benefits of maintaining a positive body image are immense. They include increased happiness and reduced stress levels, which indirectly support efforts to address physical concerns like cankles.
Stress Management
Stress management directly influences body composition, including areas prone to fat accumulation like cankles. Techniques that reduce cortisol levels play a significant role here. Lower cortisol levels help in managing body fat distribution more effectively.Mindfulness, meditation, and regular physical activity are proven stress reducers. They not only manage stress but also promote healthier lifestyle choices that contribute to addressing cankles.
Effective stress management leads to better sleep patterns, dietary choices, and exercise habits. These changes collectively support the goal of reducing cankle appearance by fostering an overall healthier lifestyle.
Treatment Options
Self-Care Practices
Regular foot and calf massages play a crucial role in combating cankles. They enhance circulation, easing the swelling. It's a simple yet effective method to address fluid retention issues.Epsom salt baths offer another natural solution. Soaking your feet in warm water mixed with Epsom salts can significantly reduce swelling and discomfort. This remedy draws out excess fluids, providing relief from swollen ankles and feet.
Wearing shoes that fit well is essential. Tight or poorly fitting footwear can exacerbate pressure on the ankles, worsening the condition. Opt for shoes that support and cushion your feet without adding unnecessary strain on your ankles.
Medical Treatments
For those whose cankles stem from underlying health conditions, medical interventions might be necessary. These could range from simple medications to manage symptoms to more advanced treatments like compression therapy or surgery.Medications can help control factors contributing to swelling, such as high blood pressure or heart conditions. Compression stockings are another effective option, improving blood flow and reducing fluid buildup in the affected areas.
Surgical options exist for severe cases where other treatments have not been effective. Procedures like liposuction or calf reshaping might be considered to achieve a more balanced appearance between the lower leg and ankle. However, these are typically last-resort options due to their invasive nature.
Consulting with a healthcare professional is imperative before choosing a treatment path. A doctor can provide a personalized plan based on the specific cause of your cankles, ensuring you receive the most appropriate care.
Preventive Measures
Regular Check-ups
Regular medical check-ups play a crucial role in managing health conditions that might contribute to cankles. Early detection of potential issues can significantly prevent the situation from worsening. Doctors often spot signs of fluid retention, hormonal imbalances, or circulation problems early on. These factors can lead to the development of cankles if left unchecked.Keeping a health diary is highly beneficial. It helps track symptoms, dietary habits, and physical activity levels over time. This record becomes invaluable during medical appointments, offering insights that might hasten diagnosis and intervention.
Healthy Habits
Adopting a holistic approach to health is essential for anyone looking to reduce cankles. This means prioritizing not just physical well-being but also mental health. A balanced diet rich in fruits, vegetables, lean proteins, and whole grains supports overall body health and can aid in reducing unwanted fat accumulation around the ankles.Exercise plays a pivotal role too. Activities like walking, swimming, and cycling improve circulation and promote fat loss without putting excessive strain on the legs. Moreover, strength training targeting the lower body can help tone the area around the ankles.
Mental well-being should not be overlooked. Stress management techniques such as meditation, yoga, or even simple breathing exercises can help mitigate stress-induced eating behaviors that contribute to weight gain.
Setting realistic goals is key. Celebrating small victories along the way keeps motivation high and makes the journey more enjoyable. Whether it’s losing a bit of weight, being able to walk further than before, or simply feeling healthier—every achievement matters.
When to Seek Help
Recognizing Symptoms
It's crucial to identify the signs that suggest a need for professional advice. These include sudden, severe swelling or pain in the ankles and legs. Such symptoms should never be overlooked as they could hint at more serious health conditions.Individuals must pay attention to changes in their lower extremities, particularly after starting new physical activities or making dietary adjustments. Persistent or worsening swelling, accompanied by discomfort, demands immediate medical evaluation. Ignoring these signs can lead to complications.
Professional Guidance
The importance of seeking professional guidance cannot be overstated when dealing with cankles. Doctors, nutritionists, and fitness experts bring invaluable expertise to the table. They offer personalized plans tailored to meet each person's unique needs and challenges in reducing ankle swelling.A team approach ensures comprehensive management of one’s health and wellness goals. This collaborative effort maximizes the effectiveness of interventions designed to minimize cankles. It addresses not only the physical aspect but also nutritional and lifestyle factors contributing to the condition.
Success Stories
Before and After
Many people struggle with the appearance of their cankles, feeling self-conscious and seeking ways to reduce them. Success stories often begin with individuals feeling frustrated after noticing little to no definition between their calves and ankles. However, through dedication and targeted efforts, remarkable transformations are possible.It's crucial to set realistic expectations for the journey ahead. Results typically don't appear overnight. Most success stories highlight a period of several months to over a year of consistent effort before seeing significant changes. This timeline varies from person to person, depending on factors like genetics, starting point, and the specific strategies employed.
Consistency and patience play vital roles in these transformations. Incorporating regular exercise, particularly activities that focus on toning the lower legs, alongside dietary adjustments, has proven effective for many. It's also important to note that while some individuals may see drastic reductions in their cankle appearance, others might notice more subtle changes. Both outcomes represent progress and are worth celebrating.
Testimonials
Personal testimonials offer a glimpse into the varied paths individuals have taken to manage their cankles successfully. From structured workout programs focusing on lower leg exercises to dietary changes and even medical interventions for those who sought professional help as discussed in the previous section.One individual shared how incorporating daily walks, coupled with specific calf-strengthening exercises, gradually reshaped their lower legs over twelve months. They emphasized how initial discouragement gave way to excitement as they began to notice changes not just in appearance but in their overall health and stamina.
Another testimonial comes from someone who combined physical activity with mindful eating. They found that reducing sodium intake helped decrease water retention significantly, contributing to a more defined ankle area. Their journey was not only about reducing cankle appearance but also about adopting a healthier lifestyle overall.
These stories underscore the importance of finding a personalized approach that works for each individual. They serve as powerful reminders that while everyone's journey is unique, determination and adaptability are key components of success.
Summary and Recap
Key Takeaways
Understanding the causes of cankles is crucial for effective treatment. Various factors, including genetics, obesity, and water retention, contribute to their appearance. Recognizing these causes helps tailor treatment plans that are more likely to succeed.Lifestyle changes play a significant role in managing cankles. Increasing physical activity, especially exercises that focus on the legs, can improve circulation and reduce fat accumulation. Adjusting diet to decrease salt intake and increase water consumption also helps minimize swelling.
Medical treatments and self-care should not be overlooked. Compression stockings aid in reducing swelling by improving blood flow when standing or sitting for long periods. In some cases, surgical options like liposuction may be considered for those seeking more dramatic changes in appearance.
While cankles can be a cosmetic concern for many, it's important to remember that overall health and well-being should always be the priority. Success stories from individuals who have managed their cankles show that focusing on general health brings the most satisfying results.
Next Steps
To begin addressing your concerns with cankles, consider the following checklist:- Assess your lifestyle for areas of improvement such as diet, exercise, and time spent standing.
- Explore non-invasive treatments like compression stockings or leg elevation during rest.
- Consult with a healthcare provider for a personalized assessment and to discuss potential medical treatments if necessary.
Setting realistic goals is vital. Expecting immediate results may lead to disappointment since reducing the appearance of cankles often requires time and consistent effort. Seeking support from a community or professionals who understand the journey can provide motivation and valuable advice.
Summary and Recap
Tackling cankles requires a blend of targeted exercises, dietary adjustments, lifestyle changes, and possibly medical treatments or preventive measures. You've learned the ropes—from understanding what cankles are to exploring various ways to reduce their appearance. Success stories prove that with persistence and the right approach, improvement is not just possible; it's within your reach. Remember, the journey to overcoming cankles starts with small steps. Whether it's incorporating new exercises into your routine, adjusting your diet, or seeking professional advice, every effort counts.For more great tips read my article here
2024.04.24 17:20 mdkeene76 Can someone explain these CT results?
I'm a 40 year old male. About 5 months ago I went into the ER with pain in the liver area. They found a blood clot in one of the branches of the portal vein.
I had an accident resulting in a splenectomy about 2 years before. I was told the blood clot could be a result of that emergency surgery.
They did a CT angiography (CTA) on me today and I got the results. I have an appointment on May 23rd, but I'm a bit worried about the results - mainly because I have no idea what everything means.
ANGIO- CTC ABDOMEN AND PELVIS Reason for consultation: Portal thrombosis control. COMMENT: We performed spectral angio-CT of the abdomen and pelvis with targeted acquisition for the portal axis assessment. We performed MPR, vascular and 3D reconstructions. We do not have previous CT scans. Permeability of the superior mesenteric vein venous system and residual portion of the splenic vein. The inferior mesenteric vein also appears to be permeable, although it has suboptimal filling in this study. Patency of the extrahepatic portal vein, left branch and its distal branches. Complete thrombosis sequelae of the right portal vein and its two distal branches. Permeable suprahepatic veins with delayed filling of the right suprahepatic veins. Ingurgitation of the pelvic venous plexus / periprostatic. Volume loss of the right hepatic lobe and hypertrophy of the caudate and left hepatic lobe in possible relation to sequelae of right portal thrombosis. Smooth hepatic borders and homogeneous attenuation without evidence of focal lesions. Splenectomy highlighting some small splenic remnants in the surgical bed. Gallbladder, biliary tract, pancreas, adrenals and kidneys without alterations except for a small cortical cyst in the right renal middle third. No data of obstructive uropathy. No adenopathies of significant size. No free fluid. Bone structures without alterations of interest. CONCLUSIONS: Sequelae of complete right branch thrombosis of the portal vein and its distal branches. Loss of volume of the right hepatic lobe with relative increase in the size of the caudate and left lobe. Rest see commentary.
submitted by mdkeene76 to AskDocs [link] [comments]
I had an accident resulting in a splenectomy about 2 years before. I was told the blood clot could be a result of that emergency surgery.
They did a CT angiography (CTA) on me today and I got the results. I have an appointment on May 23rd, but I'm a bit worried about the results - mainly because I have no idea what everything means.
- Are suboptimal filling and delayed filling worrying?
- And should I be worried about the loss of volume in the right hepatic lobe and the increase in size in the caudate and left lobe?
- Are these things to be expected after a blood clot?
ANGIO- CTC ABDOMEN AND PELVIS Reason for consultation: Portal thrombosis control. COMMENT: We performed spectral angio-CT of the abdomen and pelvis with targeted acquisition for the portal axis assessment. We performed MPR, vascular and 3D reconstructions. We do not have previous CT scans. Permeability of the superior mesenteric vein venous system and residual portion of the splenic vein. The inferior mesenteric vein also appears to be permeable, although it has suboptimal filling in this study. Patency of the extrahepatic portal vein, left branch and its distal branches. Complete thrombosis sequelae of the right portal vein and its two distal branches. Permeable suprahepatic veins with delayed filling of the right suprahepatic veins. Ingurgitation of the pelvic venous plexus / periprostatic. Volume loss of the right hepatic lobe and hypertrophy of the caudate and left hepatic lobe in possible relation to sequelae of right portal thrombosis. Smooth hepatic borders and homogeneous attenuation without evidence of focal lesions. Splenectomy highlighting some small splenic remnants in the surgical bed. Gallbladder, biliary tract, pancreas, adrenals and kidneys without alterations except for a small cortical cyst in the right renal middle third. No data of obstructive uropathy. No adenopathies of significant size. No free fluid. Bone structures without alterations of interest. CONCLUSIONS: Sequelae of complete right branch thrombosis of the portal vein and its distal branches. Loss of volume of the right hepatic lobe with relative increase in the size of the caudate and left lobe. Rest see commentary.
2024.04.23 23:19 Professional_Sir1843 Help me read these?
 | Just looking for some help reading theses results. Thanks 🙏 submitted by Professional_Sir1843 to PulmonaryHypertension [link] [comments] |