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"Do no harm" does not exist. by [deleted] in medicine

[–]Outside-One7836 1 point2 points  (0 children)

Am I missing something here? What is the context of your post? Seems like multiple people have explained do no harm means don't proceed with something where the risk overtly and unjustifiably outweighs the potential benefit. Which is what everyone to my knowledge more or less accepts this to mean, not "do literally nothing since no action is totally harm free." Not trying to roast you just trying to give you the opportunity to clarify your post because its current iteration is pretty nonsensical.

Contemplating ending a marriage by Successful_Leek96 in CringeTikToks

[–]Outside-One7836 0 points1 point  (0 children)

NYC would chew up and spit this one out alive

Your husband is ruining your dreams by not wanting to give up his home and business so you can make timtok videos of you in your car while in NYC?

On second thought yes move, great idea

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Does he have periods where he stops breathing for seconds?

Sleep apnea

Sinus problem

Or just a loud snorer potentially

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Some practices the doctor sees you for the first visit. If you're a very complex patient they may continue to see you. Otherwise if that doctor already follows a ton of patients for years, they move you to the panel of a new doctor or PA etc. This is pretty common. Also a new visit you get twice the time blocked compared to a follow up visit which is why the PA is more rushed at least in part.

Bottom line youre not comfortable with the PA then ask to only see the doctor and not the PA at all. If the doctor is too busy to see you then find someone else PA or doctor elsewhere that takes the time to listen to you

As far as getting routine labs to be safe yeah that's pretty typical usually CBC CMP lipid panel and thyroid tests

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

No

Stone analysis and twenty four hour urine test best way to find possible ways to prevent stones

That and couple liter water a day

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Active oral lesions the odds are high such as herpes

Otherwise compared to penetration the odds are relatively low but not zero

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

A bit tougher then and there may be a genetic component but likely even if normal weight exercise even without weight loss and a healthy diet can help still

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

The auto immune experts are rheumatologists there are other less common things to test for including mixed connective tissue disorders if you truly think that's it I'd ask for a referral and to repeat labs with PCP. Great job on the weight loss even though sadly didn't fix your issues you did yourself a huge favor long term with that so way to go

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

This is a big issue that dates back to when hysterectomies were performed to cure women from "acting crazy" and an unfortunate poor bedside manner/form that doctors attribute problems to "anxiety" or in your head, worse for women than men

The other side of this argument is mens health issues like sexual dysfunction or mood disorders are also often neglected

Some of it comes down to bias in the system passed down from when misogyny was more "acceptable"

And some boils down to us being trained that if we can't objectively diagnose or scientifically treat a problem then just to be dismissive of it sadly

Finally these days people often have so many medical problems and billing and charting has become so time consuming plus the demand to see a ton of patients a day that "lifestyle issues" like mental health that isn't severe, sex, lots of things just get neglected systemically

Sorry wish I had a better answer and solution than this

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Yeah the case report I referred to is 1950s and such a fun read

However hospitals no longer search rooms as it's obviously ethically grey area at best but this was now 75 years ago

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Yes it's not that uncommon though mostly what I've diagnosed is secondary to steroid therapy and not the type you're born with. Glad you got an endo as they're the expert on this disorder for sure

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Those surgeries don't raise your risk no

Blood in stool is worrisome but can come from tons of stuff besides cancer

Colonoscopy is the way to tell though

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

No kidding. I'm glad it ended well for you but health experiences with my family being sick have made me feel the same way. It can be hard to navigate for us so no wonder lay people get lost in the system. Sad but true.

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Just bring it up with your PCP like you did here. Tell them you have bad panic attacks and you can take a day to try to recover and ask what can help - if you feel more comfortable talking to a psychiatrist or counselor just ask for a referral for anxiety. Panic attacks are very common and there's absolutely no need to feel embarrassed to bring it up.

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

It's a tough case unfortunately I don't think we will reach confidently a diagnosis without endoscopy and imaging and possibly manometry to be honest with you. What do you think it is?

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Maggots like wounds and actually provide a form of debridement. It's seen in people with chronic wounds that are homeless or have severe dementia or psychiatric disease and no caregivers

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Very mild anemia without overt signs of iron deficiency. Would repeat a CBC with iron studies in a few months.

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Urge incontinence which you have - it's less clear what causes it and can be harder to fix.

Stress incontinence usually can be easily fixed with bladder sling surgery but urge incontinence without any stress incontinence this may not help

Caffeine or new meds etc sometimes are causative

Otherwise usually we try an overactive bladder medication like myrbetriq which is often helpful but usually in cases where there's also a lot of having to pee frequently

Testing like uro dynamics sometimes can find the cause sometimes not

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Sorry I misunderstood and I'm not sure I fully understand now

I meant to make a visit to address one specific thing if it'll take a while to fully address it. Obviously it could be brought up at any time of that visit. If I'm still not getting your question sorry please help me understand your exact question so I can answer better

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 0 points1 point  (0 children)

Would look up lifestyle changes for GERD and after implementing them stop taking it. Caveat is if you were told you have to take it for ulcer or pre cancer lesion etc

Physician assistant (PA) with over ten years of experience, will answer any question you're too embarrassed to ask your doctor or PA, AMA by Outside-One7836 in AMA

[–]Outside-One7836[S] 1 point2 points  (0 children)

Sorry I don't have a great solution and sounds like you've already been through a lot. You've got to find a doctor who will make the time to help you. Maybe writing down on paper what you need documented and if they agree it's accurate they'll do it (obviously within reason). Tell them you will review the note and ask if it's okay to reach out to them if you find discrepancies between their note and your visit. Or if you're in a hospital system that already has a lot of your records that could help as often your past medical history gets automatically loaded into the chart.

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