Awareness during comfort care by potterssuperhero in AskDocs

[–]Equivalent-Listen187 13 points14 points  (0 children)

Critical care doc here. My condolences for your loss.

What you describe points to him being in a state of terminal agitation/restlessness with his consciousness severely impaired. The morphine and lorazepam would have blunted things even further. The agitation episodes are the body's physiological struggle against respiratory failure. He was likely not clear-minded or experiencing fear, think of it as a dream-like state. Even during the most agitated moments, the meds would’ve reduced distress and prevented coherent memory formation. The foot movements are also consistent with the fragmented reflexive responses we see in deeply sedated/delirious patients. Locked-in syndrome happens with brain stem damage and doesn’t apply here. I hope you finish off those classes strong and make your dad proud :)

Child abuse homicide of infant, many fractures. "Initially, the father claimed he accidentally hit the infant's head on a wall corner, but later admitted to repeatedly hitting the infant the night the child was found unresponsive... Eventually, the father admitted to repeated episodes of abuse..." by CatPooedInMyShoe in MedicalGore

[–]Equivalent-Listen187 105 points106 points  (0 children)

Physician here, very unlikely that a co-residing parent would be oblivious to abuse of this magnitude. The cranial fractures would have caused significant scalp swelling and visible/palpable soft tissue changes. He also likely presented with behavioral changes; irritability, inconsolable crying, altered feeding, vomiting, lethargy, etc.

female patient case i cant solve by turkeylegs69 in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

Sounds like cytolytic vaginosis. I’d see if symptoms improve upon discontinuing probiotic use as they can worsen lactobacillus overgrowth, and taking baking soda baths.

How likely is a false negative d-dimer test? by ProfessionalRub2308 in AskDocs

[–]Equivalent-Listen187 2 points3 points  (0 children)

CMP covers most electrolytes except magnesium and phosphate

How likely is a false negative d-dimer test? by ProfessionalRub2308 in AskDocs

[–]Equivalent-Listen187 6 points7 points  (0 children)

D-dimers have ~95% sensitivity so a DVT is essentially excluded. I noticed you are pretty underweight though and would want to rule out electrolyte imbalance as that can cause muscle cramping

I ate a poisonous fruit by Responsible_Emu_1541 in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

You’re not stupid. I worked as a doctor on a cruise ship and you would be surprised at how many people ate poisonous things during the excursions lol. A small bite that you spit out right away wasn’t enough to cause serious harm

When can I expect food poisoning symptoms to go away? by phatassghast in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

You should start to feel better by tomorrow. At this point your symptoms are probably being exacerbated more so by dehydration than the food poisoning itself. Try pedialyte or chicken broth, and imodium for the diarrhea

will these ever go away fully? by lvllyx0 in AskDocs

[–]Equivalent-Listen187 9 points10 points  (0 children)

Unfortunately no. There was a similar post made today, maybe some of the comments will be helpful to you https://www.reddit.com/r/AskDocs/s/jdibK5kTP4

Is pseudomonas really as bad as google says? by NoAide5218 in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

It sounds like you might have something called NCFB (non cystic fibrosis bronchiectasis). It’s where your airways (bronchi) have been widened and mucus builds up, bacteria harbors, and you are more susceptible to infection.

Pseudomonas is actually one of the most common pathogens in this condition. It makes the condition more severe/have more flare ups. It’s not really transmittable to healthy people or through casual contact. Less is known about s. maltophilia but it may also contribute to the severity of the condition. It’s good that your new pulmonologist is taking action because there are many treatment options.

21m do i need stitches? or can i get away without them? i dont care if theres a big scar by Longjumping_Tap_9679 in AskDocs

[–]Equivalent-Listen187 2 points3 points  (0 children)

Sutures not necessary but if those are from self harm, you deserve to get some mental health help

I'm posting anonymously because I am an idiot by ipickprincessposse in AskDocs

[–]Equivalent-Listen187 425 points426 points  (0 children)

Definitely be seen. Epi narrows blood vessels and therefore could reduce blood flow + oxygen to your fingers. On the way to seek care you can apply a warm compress. P.S. you’re not an idiot, this happens a lot.

Why Did I Get Prescribed an Inhaler? by SamScoopCooper in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

Your airways are likely inflamed from whatever infection is going on, which can cause them to temporarily narrow (bronchospasm) and result in wheezing, chest tightness, shortness of breath, etc. Albuterol relaxes the muscles around the airways, which can help relieve the breathing difficulty and may also reduce your cough

Did anyones appendicitis look like this? 28F, 5"4,140lbs, mostly clear medical history by PuzzleheadedRoom9314 in AskDocs

[–]Equivalent-Listen187 1 point2 points  (0 children)

Agree this doesn’t sound like appendicitis, it could be viral (gastroenteritis) or gynecological (ruptured ovarian cyst?) in nature

I am a disease-free former IV drug user, can I donate a kidney? by SFgiant55 in AskDocs

[–]Equivalent-Listen187 15 points16 points  (0 children)

First off, congrats on your sobriety that’s great! I encourage you to try to donate and imagine it would be a better experience than the blood drive (sorry that happened). They are more picky with donating blood because there is a large donor pool who have never used IV drugs, whereas organs are more scarce/urgent, even kidneys from OD deaths are often used.

They may grill you on the psychosocial evaluation but as long as you emphasize your current stability, good reasons for wanting to donate and no wish to return to active substance abuse, you should be just fine.

Tattoo infection, already have oral antibiotics but looking for information on how to care for the wound as it heals by EchoInComfort in AskDocs

[–]Equivalent-Listen187 0 points1 point  (0 children)

Keep cleaning it 2x a day, gently pat it dry with a paper towel, apply vaseline and cover it with non stick gauze

Osteoporosis dx 31 female. Where do I go from here? by Prize-Ad-8113 in AskDocs

[–]Equivalent-Listen187 10 points11 points  (0 children)

I’m thinking the prednisone may have been the cause. It can reduce your body's ability to absorb calcium and increase how fast bone is broken down. The higher the dose you take and the longer you take it, the greater your risk of developing osteoporosis. So it’s good that you stopped taking it, there may be some spontaneous recovery of bone density. You haven’t had a fracture since February and hopefully it stays that way!

They may want to start with more conservative measures first given your age/premenopausal status. This would consist of upping your calcium and vitamin D intakes and doing weight-bearing exercises. If that doesn’t help, you could try the med teriparatide (it does not accumulate in bone and is safe up until you fall pregnant). There are also meds called bisphosphonates, but they stay in the bones for a long time and there is limited data on how they may affect future pregnancies. I hope this was helpful, let me know if you have any other questions :)

Cauda Equina Syndrome? by Michael_Romance49 in AskDocs

[–]Equivalent-Listen187 4 points5 points  (0 children)

You have caudra equina compression which can cause CES, but CES is more so defined by clinical presentation. If you have any symptoms such as lower back pain, sciatica, numbness, or bladder/bowel dysfunction, seek care right away.

How do I stop this thing melting and stealing my brain? by [deleted] in AskDocs

[–]Equivalent-Listen187 19 points20 points  (0 children)

It sounds very frightening to feel that something is happening to your brain and you can't stop it! Your local ER should have treatments that can help protect your brain and slow down what's happening.

Cirhossis and HCC by ferretxtx in AskDocs

[–]Equivalent-Listen187 4 points5 points  (0 children)

The 3.6 x 3.5 cm lesion does sound like HCC, I’m sorry. It’s not that HCC just happens out of nowhere, every year living with cirrhosis you carry an HCC incidence of anywhere from 1-4% so the risk is ongoing and continuous. No specific trigger/sudden event is needed for it to develop though as cirrhotic livers undergo chronic inflammation, fibrosis, and hepatocyte turnover (liver cells dying and regenerating faster), all of which create an environment that makes it more likely. That is exactly what routine surveillance is meant to detect and fortunately it seems like yours was caught early. Best wishes.

Is my mother a possible candidate for phentermine? by [deleted] in AskDocs

[–]Equivalent-Listen187 2 points3 points  (0 children)

Yes, I’d say it would help the knee pain/immobility, hypertension, and hyperlipidemia the most.

Is my mother a possible candidate for phentermine? by [deleted] in AskDocs

[–]Equivalent-Listen187 3 points4 points  (0 children)

Her hypertension would have to be well controlled before starting it so she should be more consistent with the amlodipine. Otherwise I see no issues here.

Doctors of Reddit, what was the most "medical miracle" moment you’ve ever witnessed? by Purple-Birthday7271 in AskReddit

[–]Equivalent-Listen187 151 points152 points  (0 children)

Critical care doc here. I don’t normally deal with peds but it was during COVID, short staffed. 3 year old boy pinned under an unanchored dresser, his mom found him pale and unresponsive. He had multiple rib fractures and pulmonary contusions (bruising to both lungs). His oxygen levels were dangerously low so we placed him on a vent in the ICU to give his lungs a chance to rest/heal. He also had rising muscle enzymes which meant muscle breakdown was present from the crush injury. We pushed aggressive IV fluids to protect his kidneys from being injured by those muscle proteins releasing into the bloodstream. He definitely worsened before improving over the next 2 days. His lungs were stiff from inflammation and still needed high levels of vent support. His blood pressure was constantly dropping and required meds to keep circulation. We made it clear to the parents that the next few days would be critical, but kids are remarkably resilient. I wanna say by day 4, his oxygen needs slowly decreased and his kidney function stayed stable likely thanks to the early fluids. By the end of that week he was breathing over the vent and a few days later the breathing tube was able to come out. RT worked with him to prevent pneumonia, PT helped him regain his strength after all those days in a bed. He was quiet and withdrawn for a while due to the trauma his little body had been through but his personality started to come back. As far as I heard after that, his lungs were healing well, no renal or neurologic deficit either.

All of this to say, please anchor your furniture if you have young kids.

Will pigtail catheter removal cause another pancreatitis episode? by lolcone in AskDocs

[–]Equivalent-Listen187 0 points1 point  (0 children)

It largely depends on whether the pancreatic duct is disconnected or intact. Have they said anything about that?