General Medical issues thread

[pagingjoan]

My sauerkraut is made by Woolies and yes chilli is exactly how I like sauerkraut.
Not sure if raw though. Edit it says living on the bottle

Edit: Say what?

 

[Quickstatus]

Edit: Say what

It’s alive!!! Living Sauerkraut

(“The Goods” Brand)

 

[Pushka]

Rheumatologist appointment today. Ended up being a long one. I’d had a negative Covid test done yesterday because once again I had a throat like I was trying to swallow marbles. Fourth time in about 5 months. I’d not had a GP visit about it because well, I’d put it off in a Covid world. Hmmm. She was happy to check my throat and feel for lymph glands. I can never feel these except when swallowing but she could feel several swollen ones. She said I need to see an ENT as soon as I could via GP.

Can’t see GP until 27th and i didn’t dare ask why it was happening. Thoughts?

She has just three patients with APS (it’s a little rare) who are supposed to have had Pfizer. All of us had AZ.

 

[drron]

@Pushka had you told her about how you got your second AZ.My contact I talked to on Tuesday and she was saying she has had 3 patients with APS from South Australia having 2 doses of AZ.Plus a few more from other states.

 

[Pushka]

@Pushka had you told her about how you got your second AZ.My contact I talked to on Tuesday and she was saying she has had 3 patients with APS from South Australia having 2 doses of AZ.Plus a few more from other states.

Yep. I was one and niece the other plus an unknown. I know she is close to SA CHO. Niece told her we’d both had it a few weeks ago.

The neighbour also with APS had Pfizer last week. His wife is hanging out in vain for Pfizer too. He knows I get frustrated with her.

 

[Quickstatus]

3 patients with APS from South Australia having 2 doses of AZ

Translation: people with an autoimmune disorder called anti phospholipid syndrome (APS) with history of thrombosis (blood clots - especially venous blood clots) should be offered PZ instead of AZ.

Some APS don’t manifest thrombosis but in other ways such as second trimester miscarriages, high number of first trimester miscarriages or premature births. Also preeclampsia. However, even those without history of thrombosis are generally thought to be at significantly higher risk of it.

APS is likely under diagnosed and I wonder of any of the known AZ related TTS cases also have some undiagnosed autoimmune tendencies. We know there is a female preponderance with APS and other autoimmune diseases. Slightly less with Covid/AZ related TTS

The AZ exclusion refers to APS with thrombosis but should really be any APS

I always recommend any women with the above pregnancy difficulties should have autoimmune tests and depending on results see a haematologist.

 

[Pushka]

Translation: people with an autoimmune disorder called anti phospholipid syndrome (APS) with history of thrombosis (blood clots - especially venous blood clots) should be offered PZ instead of AZ.

Some APS don’t manifest thrombosis but in other ways such as second trimester miscarriages, high number of first trimester miscarriages or premature births. Also preeclampsia. However, even those without history of thrombosis are generally thought to be at significantly higher risk of it.

APS is likely under diagnosed and I wonder of any of the known AZ related TTS cases also have some undiagnosed autoimmune tendencies. We know there is a female preponderance with APS and other autoimmune diseases. Slightly less with Covid/AZ related TTS

The AZ exclusion refers to APS with thrombosis but should really be any APS

I always recommend any women with the above pregnancy difficulties should have autoimmune tests and depending on results see a haematologist.

I don't know about the other man but I had a DVT in the jugular vein and Niece in her pelvis. She was expecting almost every day to get a DVT somewhere as her markers were very high but that doesn't always mean a clot will follow. We don't do the normal calf/PE thing. Mum also had autoimmune issues, (that's our inheritance line) but was never assessed other than for thyroid, and she had a stroke. I Also had pregnancy issues but APS wasnt even clinically discovered until the mid '80's so too late for me. My niece and I have parallel medical histories, even had the same laminectomy in our thirties. I do know the three of us are all on anticoagulants, Im on Xaretlo and niece and the other guy on warfarin.

The three of us, being in 1b were early to receive the vaccination and before ATAGI updated their advice re APS. Thanks to drron we got it sorted.

 

[Quickstatus]

tricky issue with lots of ethical dilemmas

(Re availability of Medicare to people who don’t follow health recommendations)
Apologies I’ve moved it here to get out of the covid rhetoric.

Should there be an ethical dilemma?. It’s a dilemma if a line is drawn in the sand.

If someone crashed their car while speeding should they be Medicare eligible?
What about someone who treats their condition say cancer with natural remedies then gets worse?
A homeless alcoholic who keeps drinking and then gets brain damage?
A woman who decides against medical advice and has a home birth, and then gets torrential bleeding?
Here is a new one which still hypothetical : what about the elderly who does not want euthanasia and prefers to keep medical intervention going?

If we are going to have a safety net, I think it’s best to have one without holes???
There is already rationing of health care but it tends to be centred upon futility /efficacy of care of treatment rather than centred upon personal decisions

 

[CaptainCurtis]

After my stress test-induced SVT episode about 3 weeks ago, I went in for my ablation on Wednesday afternoon. For those that may not have seen my previous posts, a 'delta wave' was an incidental finding on an ECG a couple of months ago while being investigated and ultimately diagnosed with pericarditis following a Pfizer jab.

It's interesting because I distinctly recall coming back from a number of runs/bushwalks over the last few years feeling dizzy and lightheaded. Never bad enough to think it was anything sinister - I always put it down to it being a hotter day, running harder etc etc. Ultimately, the cardiologists believe I had been having these tachycardic episodes for years without releasing it. Apparently I am fairly lucky that nothing more serious happened.

Anyway, the procedure was a success - they managed to find and ablate the extra pathway. Four hours all up, the location of the pathway was left-sided, so a transseptal puncture (providing access to the left atrium) was required with a transoesophageal echocardiogram.

I woke up from the anaesthetic feeling absolutely fine. I had to lie flat for about 10 hours with a clamp on the incision site as there was a lot bleeding. Finally then managed to stand-up and walk around and was discharged home about 4 hours later (Thursday lunch).

All I can say is that modern medicine is truly amazing - the fact that they can work on my heart, accessed through the groin via miniscule catheters, and then wake up 4 hours later feeling basically normal blows my mind.

 

[prozac]

After my stress test-induced SVT episode about 3 weeks ago, I went in for my ablation on Wednesday afternoon. For those that may not have seen my previous posts, a 'delta wave' was an incidental finding on an ECG a couple of months ago while being investigated and ultimately diagnosed with pericarditis following a Pfizer jab.
... All I can say is that modern medicine is truly amazing - the fact that they can work on my heart, accessed through the groin via miniscule catheters, and then wake up 4 hours later basically normal blows my mind.

You certainly have all the nomenclature down pat.

All my procedures were through the wrist which as you say is amazing medicine. I even had an IVUS inserted through the wrist. That is an intra vascular ultra sound to give superior imaging inside the heart. Great images but my surgeon had so much stuff in there the LAD dissected.

All the best with your recovery and improvements.

Incidentally I was in Bunnings yesterday and the tall fit looking 60's fella walking toward me was lightly rubbing his upper chest. I asked him if he felt ok. He said yes, why, so I told him this is what my wife tells me I do not long before a heart attack etc. I never had any uncomfortable feelings just this odd chest rubbing. He introduced himself, shook my hand and thanked me. I hope he gets himself checked.

 

[CaptainCurtis]

You certainly have all the nomenclature down pat.

I did a lot of reading before the procedure, I find it all truly fascinting. Knowledge is power afterall.

All the best with your recovery and improvements.

Thank you

 

[drron]

@CaptainCurtis there was a silver lining to your vaccine experience.

@prozac that is great work on your part.You could well have saved a life.

 

[prozac]

@CaptainCurtis there was a silver lining to your vaccine experience.

@prozac that is great work on your part.You could well have saved a life.

I hope there is nothing wrong with him, but I do hope he follows up. He was just using his finger tips which is what I do for no apparent reason every time prior to an event. I don't know if this is a recognised sign?
I half expected him to tell me to bugger off but he was very friendly.

 

[RooFlyer]

I’ve had ‘swarms’ of mostly atrial, but also ventricular ectopic heart beats since I had a couple of afib episodes a few years ago. Started getting more this year: I was surprised when the specialist said they were different conditions, or at least caused by different locations in the heart and connecting veins and arteries ( all my terminology here).

Got much worse, or at least abundant a month or so ago. A week when there would be an hour or so of a beat followed by an atrial ectopic pair, and much irregularity otherwise. Doesn’t seem to be harmful other than feeling a bit uncomfortable. Didn’t stop my gym work.

Calmed down a lot in the past week.

Going to see specialist soon to see if medicine needs rejigging, but I’ve never been able to find out what causes the onset of these ‘swarms’ of ectopics. Diet? Hormone imbalance? Electrolyte imbalance? Booze? ( I threw in the booze as an obvious one, but I was still getting the ectopic swarms when u was off the grog for 6 months earlier this year).

I trust my specialist of course, but any informed ideas as to what might trigger markedly increased ectopic activity, on a day or months time scale? Just ideas that I might be able to follow up for my own interest.

 

[prozac]

I’ve had ‘swarms’ of mostly atrial, but also ventricular ectopic heart beats since I had a couple of afib episodes a few years ago. Started getting more this year: I was surprised when the specialist said they were different conditions, or at least caused by different locations in the heart and connecting veins and arteries ( all my terminology here).

Got much worse, or at least abundant a month or so ago. A week when there would be an hour or so of a beat followed by an atrial ectopic pair, and much irregularity otherwise. Doesn’t seem to be harmful other than feeling a bit uncomfortable. Didn’t stop my gym work.

Calmed down a lot in the past week.

Going to see specialist soon to see if medicine needs rejigging, but I’ve never been able to find out what causes the onset of these ‘swarms’ of ectopics. Diet? Hormone imbalance? Electrolyte imbalance? Booze? ( I threw in the booze as an obvious one, but I was still getting the ectopic swarms when u was off the grog for 6 months earlier this year).

I trust my specialist of course, but any informed ideas as to what might trigger markedly increased ectopic activity, on a day or months time scale? Just ideas that I might be able to follow up for my own interest.

Thiamine. Betavit (vitamin B1) costs six bucks a month, take one morning and night. Check with drron first.
Also magnesium, or lack of it, affects the electrical system conduction.

 

[Quickstatus]

atrial ectopic pair

There are premature atrial contractions and premature ventricular contractions.
You can’t actually feel the atrial contraction only the ventricular contraction.

Or Likely an extra ventricular contraction after an extra atrial electrical impulse

Sometimes the Heart rate drops a beat rather than an extra.
Sometimes it’s AF rather than just ectopics

Causes:
Hypertension
Preexisting heart disease
Alcohol
Stimulants - caffeine, cocaine, nasal decongestants
Exercise
Fatigue, lack of sleep
Anxiety
mRNA CovidJabs
And Getting old @RooFlyer

Need ECG as baseline

Thiamine

Which is also good for alcoholic types

 

[prozac]

...


Which is also good for alcoholic types

Which is the secondary reason I take it, it masks my blood tests I am still drinking (though much less). My cardio said take one every morning. I figure another one at night when I do my drinking won't hurt either and my bloods are looking much better!

 

[Quickstatus]

masks my blood tests I am still drinking (though much less)

No we can tell from blood tests with or without thiamine
Reason for Extra Thiamine

Have a guess what blood test gives a hint of alcohol intake. It’s not blood alcohol level
I do concede there is no blood test that measures the quality level of the consumed alcoholic beverage

 

[prozac]

LFT. CDT.
It will also show up in the albumum/globulum ratio?

 

[drron]

Ah ectopic heart beats.Poorly understood in a practical sense.
When I began practicing medicine in 1970 we were very concerned with ventricular ectopics.It was thought they were quite dangerous especially occurring after a heart attack.So it was routine to give drugs to reduce the number of VEBs.
But came the late 80s and a trial was done to investigate the effect of treating VEBs - the CAST trial.Contrary to expectations although drugs could reduce the number of VEBs mortality was increased by medication so not surprisingly the drugs went out of favour.

Cardiac Arrhythmia Suppression Trial - Wikipedia

en.wikipedia.org

Both ventricular and supraventricular ectopics can be felt.The great majority however are not felt.In fact if holters are done on healthy 16 year olds up to 50% have at least some VEBs during the day. 1-2% have ventricular bigeminy - periods where every second beat is a VEB.That study has been done a few times.
(Sobotka et al. 1981)

I ran a holter service to the North Burnett region of QLD for about 10 years.Rare was the holter monitor without a single ectopic beat.

The problem is there are circumstances where especially VEBs are a bad sign.If they occur predominantly with exercise or even worse after exercise they are an indicator of an increased risk of sudden death.

Frequent Ventricular Ectopy after Exercise as a Predictor of Death | NEJM

Original Article from The New England Journal of Medicine — Frequent Ventricular Ectopy after Exercise as a Predictor of Death

www.nejm.org

There is a long list of things that can cause an increase in ectopic beats.One of the most common is caffeine.Not only in coffee or tea but also chocolate.

Feeling ectopics is a different list.I remember well a fellow who said he felt every ectopic beat he had so I did a holter.He confidently said he had 13 in the 23 hours recorded.In fact he had over 30000 - they were all supraventricular ectopics.
So who feels ectopics.One of the most common things is a medical illness especially a cardiac event.Once you begin feeling them they often persist.Emotional factors are also common but not exclusively of a negative nature.A nurse at a private hospital in QLD won a lotto first division prize and for several weeks after felt numerous ectopics.A holter a year later when no symptoms still showed roughly the same frequency of VEBs.