General Medical issues thread

[Siebert]

It's amazing how these things seem to come in clusters. One injury is manageable, then suddenly everyone around you has a trip to A&E for something different. Hopefully the next update is about holidays instead of hospitals.

 

[JohnM]

PJM and I are due to depart on a 7-week trip to Africa in two weeks, with my brother and SIL and two other friends. We are all in our 60-70's and wanting to do as much as we can while we can.

My parents are long gone. Realistically, that's a relief when travelling.

PJM's mother long ago passed, but her father is 92 and is really in very good health but is terribly lonely and has 'had enough'. We saw him today and he said "just [expletive] do it" in relation to our travel.

My SIL's mother is also about 92-93, but she is fading. Thankfully, they have recently managed to get her into care as she was assessed as not capable of staying alone in her home where she has been since the 1950's (husband passed away in the 1970's) and recently had to spend some weeks in a hospital geriatric ward, which was very stressful for SIL, given the loomimg trip.

Not easy.

 

[Beer_budget]

Three weeks battling RSV, and I seem (knock on wood) to finally be on the mend. It's always doubly exciting in the later stages; with a compromised immune system, there's always an anxious watch and wait for signs of secondary infection, and I also have to come off my immunosuppressive meds while sick to reduce that danger, which leaves me at risk of a flare up, especially when it's been this long.

@Seat0B I'm so sorry to read about your mum. UTIs are terrifying with how fast they can spiral. I hope you are taking good care of yourself through all this.

 

[Seat0B]

Good news for me today - had a bone density scan 12 months after starting post+menopausal HRT for osteopenia and I have increased bone density in hip by 6.9% and spine by 8%. Yay. It’s working. Still have osteopenia, but better than before. Doc said still gains to be made for another 12 months or so.

 

[Quickstatus]

osteopenia

Better than -porosis
What Vitamin D and calcium brand are you on?

 

[Katie]

Good news for me today - had a bone density scan 12 months after starting post+menopausal HRT for osteopenia and I have increased bone density in hip by 6.9% and spine by 8%. Yay. It’s working. Still have osteopenia, but better than before. Doc said still gains to be made for another 12 months or so.

Hope I can get similar results! Have upped my dietary calcium and Vitamin D after a parathyroid scan showed all 4 glands were enlarged, not what the endo was expecting.

 

[Seat0B]

Better than -porosis
What Vitamin D and calcium brand are you on?

Not taking either - my blood tests did not reveal a Vitamin D deficiency (repeatedly the same over several years) and my doc said calcium not needed as dietary was sufficient and my bone turnover markers have also increased. Should I be asking more questions about this?

 

[Quickstatus]

Not taking either

If D levels and Ca intake is sufficient, then my understanding is no need if not on the treatments for -porosis like Aclasta etc.

No strong evidence for supplements if not D deficient and Ca intake sufficient. Dietary Ca intake can be difficult to estimate so some just take D+Ca just to make sure.

Some General info

 

[Seat0B]

If D levels and Ca intake is sufficient, then my understanding is no need if not on the treatments for -porosis like Aclasta etc.

No strong evidence for supplements if not D deficient and Ca intake sufficient. Dietary Ca intake can be difficult to estimate so some just take D+Ca just to make sure.

Some General info

That is really interesting and useful info. Based on everything, I’d say I don’t need supplemental Vit D and Ca at this point as I do eat the recommended amounts of milk, yoghurt and cheese most days plus I am taking all my various pills with custard now due to the chronic cough issues.

 

[prozac]

That is really interesting and useful info. Based on everything, I’d say I don’t need supplemental Vit D and Ca at this point as I do eat the recommended amounts of milk, yoghurt and cheese most days plus I am taking all my various pills with custard now due to the chronic cough issues.

Why custard? I've read natural yoghurt is best food for calcium conversion.
I know that being male gives me an advantage but just letting you know I was a minor celebrity for a day when I was in hospital during cancer treatment. After I had a bone marrow biopsy every specialist I encountered delighted in telling me I had the bones of a 20yr old.

 

[Quickstatus]

Why custard?

Contains milk and cream as main ingredients

had the bones of a 20yr old

Yes to get the bone marrow they would have to manually drill through the surface of the bone. That is the hardest part of the bone - the cortex

 

[Seat0B]

Why custard? I've read natural yoghurt is best food for calcium conversion.

Just because it takes about 50-100ml to get all the pills down and yoghurt (natural or flavoured) brings on my reflux much more than custard. And custard because with my larygeal/oesophageal issues, the pills often stick or bump around on the way down if taken just with water and make me cough until I vomit, whereas the thicker liquid helps them go down and stay down. I do use yoghurt if custard is not available, but it isn't as good/easy for me.

I do eat yoghurt as a salad dressing or sometimes a small amount as a snack. Mainly I drink milk in porridge or in milky coffees like lattes/flat whites, chai lattes etc or milk shakes as I cannot abide the taste of plain milk - a hangover from lukewarm milk, almost curdled, being force fed to me at recess at school in the 1960s. And I never met a cheese I didn't love at first sight. So dietary calcium is fine for me.

 

[Seat0B]

Yes to get the bone marrow they would have to manually drill through the surface of the bone. That is the hardest part of the bone - the cortex

I found the bone marrow biopsy part of my leukaemia diagnosis was pretty painful. They (medical team) tried to tell me it was not too bad, but I had ongoing mild pain in the area for 7-10 days afterwards as well as some quite sharp pain at the time it was done. Felt like I was being stabbed repeatedly with a skewer or knitting needle. I know it is a necessary part of diagnosis but it is not something I really want to repeat any time soon.

Having a blood cancer is highly not recommended for anyone who can't deal with needles as you have to endure a LOT of blood draws, cannula insertions and relocations and all round it's a rather sharp and unpleasant experience. And there is a definite hierarchy of skill in drawing blood - at the very top are the phlebotomists from the pathology labs, and at the very bottom, nervous junior doctors who take three goes in three different sites on day 5 of your protocol and still don't manage to draw enough blood

 

[Quickstatus]

very bottom, nervous junior doctors

Hint: Ex medical students start their doctor career in mid January to early Feb.

 

[Seat0B]

Hint: Ex medical students start their doctor career in mid January to early Feb.

good to know!! I will for sure try to time my end of remission relapse to some point late in the year
Actually, I think I am just going to refuse to have blood taken outside the normal path lab rounds unless it's a dire emergency.

 

[andye]

Very junior doctors have limited phlebotomy experience these days.

I remember doing the 6.30 blood round of all my patients when an intern. You needed to be reasonably proficient to survive.

It was onerous and the introduction of phlebs/nurses with extended roles for routine testing has been a positive thing in general.

 

[Quickstatus]

I remember doing the 6.30 blood round of all my patients when an intern

Yes, I had to get all the bloods done, all the clerking of the admissions, and get upto speed with all the patients, before the consultant does rounds.

So much better when blood collectors were introduced.

 

[MARTINE]

Yes, I had to get all the bloods done, all the clerking of the admissions, and get upto speed with all the patients, before the consultant does rounds.

So much better when blood collectors were introduced.

And I wonder how many of those pre admission assessment blood tests we did were even reviewed before surgery? In the 80’s we even admitted pts overnight before (what is now) a day case!

 

[Quickstatus]

pre admission assessment blood tests

Im sure a lot of those tests were not necessary but as interns who didnt know better and run off our feet we didnt want to have to redo blood collection because the drs wanted something we didnt collect for.

 

[prozac]

I found the bone marrow biopsy part of my leukaemia diagnosis was pretty painful. They (medical team) tried to tell me it was not too bad, but I had ongoing mild pain in the area for 7-10 days afterwards as well as some quite sharp pain at the time it was done. Felt like I was being stabbed repeatedly with a skewer or knitting needle. I know it is a necessary part of diagnosis but it is not something I really want to repeat any time soon.

Having a blood cancer is highly not recommended for anyone who can't deal with needles as you have to endure a LOT of blood draws, cannula insertions and relocations and all round it's a rather sharp and unpleasant experience. And there is a definite hierarchy of skill in drawing blood - at the very top are the phlebotomists from the pathology labs, and at the very bottom, nervous junior doctors who take three goes in three different sites on day 5 of your protocol and still don't manage to draw enough blood

One ICU stay the phlebotomist stood on the urinary catheter when they went to take bloods!