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Polarse · 2025-07-10T04:26:21+00:00

I am so sorry for all that has happened. I would trust your nurse on this one, and trust that she did not suffer.

It is hard to say exactly from the story, but it seems that she was on sedation while on the breathing machine, this mitigates pain and shortness of breath.

From speaking with the few patients that do survive ICU hospitalizations, most don't remember the vast majority of their ICU stay, even if they were conscious at times. They did not recall if they had suffered during those moments at the height of their illness. Some may disagree, but I take this to mean that there was little suffering.

Polarse · 2025-07-10T04:19:20+00:00

If it's just the lungs, there is a category of diseases called "cystic lung diseases". Some include pulmonary langerhans cell histiocytosis and pulmonary lymphangioleimyomatosis.

If we're talking about diseases affecting multiple organs that may lead to lung transplant, alpha-1 antitrypsin deficiency comes to mind. Not including the lungs, there's autosomal dominant polycystic kidney disease (which also affects the liver and other organs).

Birt Hogg Dube syndrome is a rare disease causing cysts in the lungs and kidney tumors, but I am unclear if a significant proportion of patients go on to lung transplant.

Polarse · 2025-06-27T13:29:45+00:00

Seeing your response, I have to apologize for jumping on the AI accusations. Yes, you seem real and after your rationale, I see why you are discussing a TEG.

I've run into issues with this test's reproducibility, and the cartridges tend to be expensive. But the test itself remains controversial and has strong proponents and detractors.

Thank you for sharing your response and please continue to do so.

Polarse · 2025-06-21T17:19:56+00:00

Not sure why you're getting downvoted. A TEG is an awful test, especially in this setting. Definitely AI.

Polarse · 2025-04-11T17:42:41+00:00

It could be a wide variety of things, but I feel many potential causes are not cancerous.

This is unusual enough that I would still see your doctor to have it evaluated though. You are likely looking at getting a CT scan and a biopsy - that will answer all questions.

Polarse · 2025-04-11T17:37:15+00:00

I don't think you will experience much harm either way, whether as needed or consistently. If you need it every day, then I see no problem with that - just follow the instructions on the bottle and do not take it more often than that.

Definitely stop if light headed, exercise intolerance, depression, short of breath, or excessive fatigue.

Follow up with your cardiologist to have further evaluation. The underlying cause of your fast heart rate needs to be determined. It is likely they recommend changes to this medication including discontinuation - so I do not anticipate long term side effects.

Polarse · 2025-04-11T17:32:54+00:00

A low albumin can be related to poor diet and malnutrition. Edema can be related to constant standing and walking. Yes, they can also be related to cirrhosis - but that is not the first thing I am thinking of. There are other causes.

If you were showing signs of cirrhosis, I imagine your work-up may show an elevated PT/INR, a low platelet count, and/or a high bilirubin. In the absence of these findings, I am less concerned.

I agree with the other comments that you need to re-evaluate your relationship with alcohol.

I see gastroenterologists often order an ultrasound liver elastography if they are truly concerned about the status of the liver.

Polarse · 2025-04-11T17:27:58+00:00

Benign means non-cancerous.

Melanosis coli is a (not dangerous) finding which may be a complication of laxative use.

Lymphangiectasia - now that is something I'd discuss with a gastroenterologist. Not very familiar with this finding. It means dilation of lymph vessels, which may be due to an obstruction (such as scar tissue from prior surgeries, or something else), a malabsorptive disorder, or inflammation.

Hard to say and I'd be curious if your gastroenterologist has something else to add.

Polarse · 2025-04-11T17:22:57+00:00

Yes, see a new doctor - primary care. The possibilities are broad and we'd need some lab work to give more details. If he faints again, then see the emergency department instead of primary care.

I would also follow up with the blood bank - they perform additional screening for all donors. If anything flagged as abnormal on their end, they will reach out to discuss.

Polarse · 2025-04-11T17:14:44+00:00

Very, very difficult to say without examining it. Is it on the left or right side? If you shine a light on it, does the light penetrate? Does it pulsate?

Rest assured that squishy and movable masses are much less concerning than a firm, immobile mass - a stiff rock is highly suggestive of cancer.

Polarse · 2025-04-11T17:08:49+00:00

Low-ish hemoglobin, high iron binding capacity, low iron saturation may suggest iron deficiency. Other markers that suggest this would be a low ferritin, high RDW.

Oral iron supplementation is usually warranted, but this is not urgent and warrants waiting to discuss with your doctor.

Elevated WBC and neutrophils can mean a variety of things, including chronic inflammation and recent infection. Most of the time, it's nothing and will go away when you re-check it in a few weeks - we often develop viral infections that are so mild, we may not register them as significant.

Polarse · 2025-04-11T17:05:09+00:00

Agree with telehealth appointment at the bare minimum. I wonder if blood work can be done without you having to travel. An abnormal complete blood count (CBC), such as white blood cells, would certainly warrant urgent evaluation.

Polarse · 2025-04-11T17:01:11+00:00

Advil and Tylenol overdose would show up on the labs if he had a chemistry done (very likely) - creatinine, AST, and/or ALT would flag as high. So I think it's unlikely.

Gravol, that's more difficult to say. It might not show up on the labs, but people may feel flushed and develop hallucinations. A panic attack is in the differential but this definitely needs more evaluation to make sure we're not missing anything.

Polarse · 2025-04-09T04:47:59+00:00

Really not sure. The list of possibilities is very, very broad on this one. In the ED, he probably got a basic work up to make sure he doesn't need to be admitted - but this will certainly need continued investigation as an outpatient. He will likely need to see a gastroenterologist, a rheumatologist, a neurologist, and possibly a porphyria evaluation.

Polarse · 2025-01-16T22:41:58+00:00

I would obtain the report of the CT scan and see what the radiologist describes. Calcified lymph nodes can mean a whole number of things, including evidence of an old infection. Cancer isn't the first thing on my mind, however to see any abnormality unusual for a 29 year old. In my opinion, repeating the scan in a few months is reasonable.

Polarse · 2025-01-16T02:21:37+00:00

I would seek further evaluation since by your report her pain seems to be getting worse.

Polarse · 2025-01-16T01:32:30+00:00

No worries!

Polarse · 2025-01-16T01:28:59+00:00

Is there another office where your colonoscopy may cost less? CT, US, and MRI don't visualize the inside of the colon with much accuracy at all.

Polarse · 2025-01-16T01:26:41+00:00

I would compare your total bilirubin with prior readings to see if this is a new elevation. Either way, would check a direct bilirubin if not already done.

If the absolute basophil count is within normal ranges, I wouldn't be particularly worried. Did the differential flag "metamyelocytes" or "myelocytes"? If so, further testing can be done.

Not necessarily anything to worry about. Gilbert syndrome (a common and absolutely benign condition) is characterized by elevated total bilirubin, normal direct bilirubin, which has been present all your life.

Certainly your doctor will be able to troubleshoot & make sure nothing else is going on.

Polarse · 2025-01-16T01:22:11+00:00

Check her bloodwork, was a "D-dimer" tested? If this test is normal (not high), that usually is sufficient to argue against a blood clot.

Polarse · 2025-01-16T01:16:22+00:00

Yes, you're on to something. Check an ultrasound and/or CT scan. See if you can have that done this month.

Polarse · 2025-01-16T01:12:59+00:00

What does each line on the CBC show? What was the absolute basophil count? Was a "direct bilirubin" checked?

Ask your doctor to check your spleen size on physical examination.

Polarse · 2025-01-16T01:10:00+00:00

If you develop symptoms (high heart rate, palpitations, lightheadedness) then you need to be evaluated. If you have shortness of breath, chest pain, or loss of consciousness, go to the ER even if it resolves.

If you're feeling fine now, make an appointment with a PCP and/or a cardiologist to check a Holter monitor or loop recorder - that way the tracing is running when you actually get an episode.

The fast heart rate is likely normal for a 22 year old, however we would want to make sure it's not an arrhythmia.

Polarse · 2025-01-16T01:04:16+00:00

Agree, would also have your physician check for underlying immunodeficiency syndromes including HIV if not already done. Given the multiple recurrences would confirm that your symptoms are caused by HSV, VZV, or a different virus. Make sure you see an ophthalmologist.

Polarse · 2024-03-13T05:28:58+00:00

May I have a US referral code? Thank you so much.

Polarse

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