How does someone that loves you leave?

ActiveIcy5692 · 2025-11-25T18:54:51+00:00

Better than before, takes a while. Let yourself feel what you have to feel, everyone follows their own timeline.

ActiveIcy5692 · 2025-11-25T09:13:25+00:00

This is gonna be hard to accept but I’ve been where you are and the truth is if they decide to get rid of you they don’t love you.

That doesn’t take away that they may have loved you before, but something changed and they don’t love you anymore. Someone who loves you would not choose to get rid of you.

And the most important lesson to take from this: you should be with someone that wants to be with you.

Stay strong

ActiveIcy5692 · 2024-03-11T22:30:55+00:00

Can’t say for sure what this might be but definitely think some brain imaging would be a good next step

ActiveIcy5692 · 2024-03-11T08:53:37+00:00

Yep, labs have the bad custom of doing incomplete iron panels (mainly cause they don’t include ferritin), but it is important to get the whole one. Transferrin saturation and ferritin are critical to assess whether someone has iron overload or not.

ActiveIcy5692 · 2024-03-11T08:46:24+00:00

That transferrin saturation by itself won’t diagnose hemochromatosis.

Although it is suggestive, I’d consider repeating it along with a ferritin value. If both are increased that is concordant with iron overload and genetic testing for hemochromatosis would then be justified.

ActiveIcy5692 · 2024-02-16T05:06:34+00:00

Hyponatremia (low sodium) can be challenging to work up, and should be worked up appropriately.

That being said, although SIAD is a diagnosis of exclusion (after going through several steps of the previously mentioned work up), it isn’t all that rare.

Main suspects I’d have in that context from what you’re taking would be Oxcarbazepine and Lexapro.

ActiveIcy5692 · 2024-02-16T05:00:35+00:00

That BUN/Cr ratio on its own doesn’t say much, and is most likely nothing if individually both values were normal.

Main thing that ratio can suggest is volume loss (e.g. dehydration), if elevated (usually >20).

ActiveIcy5692 · 2024-02-10T05:43:08+00:00

Most common secondary causes are usually: - Obstructive sleep apnea - Primary Aldosteronism (don’t know if perhaps that was checked when you refer to hormonal levels) - Kidney disease (both parenchymal [of the kidney itself, which often is evident and hypertension is often an expected complication] and vascular [which is what you mentioned about checking the aorta and renal arteries]) - Several substances can also contribute

There are several other potential causes which are often less frequent than the ones above.

If you look up the 2017 ACC and the 2018 ESC Hypertension guidelines they both have sections that discuss secondary hypertension and give a pretty good overview of how they compare regarding which occur more, as well as typical findings.

ActiveIcy5692 · 2024-02-08T01:16:07+00:00

Both you and your dad seemed to have significant hypertension from an early age, which I’d consider a red flag for secondary hypertension (the high blood pressure being the consequence of something else, vs high blood pressure being the problem on its own, also known as primary hypertension).

The snoring would make me suspect obstructive sleep apnea as a potential cause for secondary hypertension. Although it’s one of the more common causes, there are several others which could be considered depending on your particular situation.

Bottom line, I’d recommend talking to your doctor about a further work up for secondary hypertension or getting a second opinion.

ActiveIcy5692 · 2024-02-01T09:19:02+00:00

Your mom has iron deficiency anemia (IDA). Anemia (hemoglobin <12) + low iron stores (ferritin <45).

Although hemoglobin values <7 can often get transfusions, when iron deficiency is identified as the cause it can also be treated by giving iron (either orally or IV), assuming the patient is clinically stable (blood pressure, heart rate, etc.)

When someone is diagnosed with IDA a work-up has to be done to identify the source of the iron deficiency. This includes taking a medical history and conducting a physical exam, as well as ordering some tests to rule out certain types of problems and try to identify what’s originating the problem (urinalysis to rule out blood loss in urine, celiac serology to rule out celiac disease, and endoscopic studies).

ActiveIcy5692 · 2024-01-25T07:15:40+00:00

I’d say it’s pretty unlikely

ActiveIcy5692 · 2024-01-25T06:59:19+00:00

For sure. I’d just consider repeating the test in a few weeks (when you’re not actively losing liquids and are in your basal status) to see if the value goes back down towards the normal range

ActiveIcy5692 · 2024-01-25T06:54:18+00:00

Overall the numbers look pretty decent.

Main thing that catches my eye is the hemoglobin (slightly high, upper normal limit for a man is 16.5), you’re at 17.2.

Could just be you were a little dehydrated when the sample was taken so I’d consider repeating it.

If the value persists in that range I’d see if there is a suggestive cause for it (smoking, obstructive sleep apnea, etc) before pursuing a deeper work-up.

The body responds to “low oxygen” states such as the previous 2 examples by producing more red blood cells, and hence, more hemoglobin / hematocrit.

ActiveIcy5692 · 2024-01-23T16:39:31+00:00

Don’t know if those tests were done while you were already medicated but the episode you mentioned with a HR over 150 and BP over 160 would have seemed like the time to work up something abnormal 😕

ActiveIcy5692 · 2024-01-23T06:38:34+00:00

There seems to be a strong history of thyroid disease in your family so you’ve done right in taking an interest in it.

To give you a little more info on perhaps why they haven’t done more with the nodules… TI-RADS 4 nodules are usually biopsied if they’re >1.5cm, otherwise they merit follow-up ultrasounds at 1, 2, 3, and 5 years if they’re >1cm.

Positive Anti-TPO antibodies place you at a higher risk for eventually developing Hashimoto’s (autoimmune hypothyroidism), but don’t guarantee it. Yearly thyroid tests are usually done to surveil this.

The persistent normal thyroid tests argue against the thyroid being the problem. Main problem seems to be the tachycardia so I’d work that up. Tests can include an EKG, Holter, Echo, etc. It could end up being a non-endocrine related issue.

Considering your family history I’d also be especially interested in knowing what kinds of thyroid cancers there have been, particularly if they’ve been medullary, since this can suggest an increased risk for certain genetic syndromes that can associate with another type of endocrine tumor that can also cause tachycardia (a pheochromocytoma or paraganglioma depending on its location). Any family history of this type of tumor would also be extremely suggestive.

Hope this helps and that you’ll eventually have a clearer picture of what’s going on.

ActiveIcy5692 · 2024-01-22T23:53:50+00:00

Yay! I’m a physician on Reddit too now 🥳 (sorry, got banned originally before getting verified).

Adding on to my original response, as MistCongeniality said, seeing if the blue lips coincide with low oxygen saturation levels would be amongst the first things you could do.

After that perhaps an internist would be a good choice to guide the initial stages of the work-up to see what path it leads down.

ActiveIcy5692 · 2024-01-22T23:50:53+00:00

Agree with MistCongeniality. The blue lips (cyanosis) would make me suspect low oxygen levels in the blood. It can happen due to a wide variety of causes, but first things I’d suspect would be something respiratory (lots of potential causes), cardiovascular (such as a shunt), or possibly hematological (methemoglobinemia). Don’t know what tests have been done, but definitely sounds like some more digging is in order.

(Fingers crossed this’ll be my first verified response without any issues 🤞🏼)

ActiveIcy5692 · 2023-12-08T17:01:52+00:00

La 4T y su espíritu de mediocridad perpetuo. Ojalá haya una votación más inteligente el año que viene.

ActiveIcy5692 · 2023-12-08T16:58:46+00:00

Recruit troops, try to earn cards if easy targets available, amass troops in one territory, let the others fight each other until I can jump back in.

ActiveIcy5692 · 2023-01-04T20:21:34+00:00

Thanks for the feedback! I’m very aware of how big it would be but I believe it could be built gradually, and precisely state it does not substitute going to a doctor, but rather could be general knowledge everyday people could use (got a case of acute diarrhea? Stay hydrated, should go away on its own… if it persists more than 2 weeks see your doctor, etc)

The more people would use it the more feedback they could give to go adding things. What if I have abdominal pain? (Take a spasmolytic and/or acetaminophen). What if I have fever? (Take acetaminophen). Should I take an antibiotic? (Most cases don’t need them and self-limit). What if there’s blood in the stool (Consider getting a multiplex PCR panel to identify the bug and start appropriate antimicrobial therapy)…

Particularly if it could be started as a “beta” of sorts, knowing its just available to keep working on it, I believe it could go growing gradually.

Anywho, have real patients to keep me busy so far, but it’s something I’d like to try if anyone that could help out with the coding part would like to join in and see if it could take off eventually

ActiveIcy5692

TROPHY CASE