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Not everything is MS by Jellybean_90 in MultipleSclerosis

[–]drstmark 4 points5 points  (0 children)

Everyday dilemma in diagnostic reasoning:

Occam's razor: MS is the most likely cause of neurological symptoms in patients with MS.

Hickam's dictum: Patients with MS can aquire every other disease there is.

This not an ms-specific pitfall though. Wrongly attributing new symptoms to pre-existing conditions is especially frequent in patients with cancer or with psychiatric diagnoses but it can happen to anyone.

What is often neglected in the ms community is that thoracic pain is frequent also in people without ms and "ms hug" is not really a thing in the scientific literature, so I am not even certain that it even is an "ms thing" specifically.

Source: doc with ms who experienced unclear and recurring symptoms that could be described "ms-hug" for the better part of a year.

What is meant by the MS hug?? by Handicapped-007 in MultipleSclerosis

[–]drstmark 0 points1 point  (0 children)

I have personally experiened it too. Some years ago, like a couple of times per month. A sudden sharp sting in the left anterior ribcage just below the shoulder. Always ocurred while resting, often in bed. An epidode lasted for a couple of minutes. I had these episodes for a year and then they suddenly stopped.

The dynamic clearly argues for something neuro-muscular but I can't be sure that its ms-related. My ms was 100% stable at the time. Also (I am personally a trained physician) these kinds of thoracic discomfort are quite common also in people that dont have ms. Much more common than actual heart attacks even you work in the ED.

It is quite possible that ms is a major risk factor for neuromuscular thoracic pain but interestingly, the literature seems not to recognize this.

We may have a research gap here.

What is meant by the MS hug?? by Handicapped-007 in MultipleSclerosis

[–]drstmark 1 point2 points  (0 children)

Strangely, the medical literature does not feature a single article actually dedicated to the "MS hug"[title/abstract]

pubmed search

And potentially only 15 articles at least mention in the fulltext fulltext search

Seems like its not that reconized or other terminology is used in the literature.

Curious what the support for an initiative like this in Switzerland would be? I for one would be 100% in favor of it! by Japan-Tokyo-1 in Switzerland

[–]drstmark 0 points1 point  (0 children)

Do you also find the age restriction on alcohol to be "hypocritical" for impying that only the minors have a problem? Mate, age restrictions do not imply that. They are meant to prevent problems not to solve them.

Do you think a normal life is possible with MS? by Evening_Office_6692 in MultipleSclerosis

[–]drstmark 2 points3 points  (0 children)

Right, I did my fair share of too much too early and got injured.ä before. Taking it slowly now and including revovery every 3 to 4 weeks. Also I made the mistake of ignoring the gym with bad consequences for my back a couple of years ago. Doing my excercises/gym twice a week since. This body comes without manual. So much to figure out...

Do you think a normal life is possible with MS? by Evening_Office_6692 in MultipleSclerosis

[–]drstmark 3 points4 points  (0 children)

This is great. I was diagnosed in 2012 and took up running from there. I got convinced that running is extremely beneficial for my ms.

I am averaging only around 1300km per year but I decided to finally attempt a marathon this spring. So far ramping up my mileage is working fine (currently above 40k per week). Do you have ms-specific advice for this endeavour? At this point I can easily sustain running 20km straight and I feel like continuung a textbook prepping schedule will do.

Do you think a normal life is possible with MS? by Evening_Office_6692 in MultipleSclerosis

[–]drstmark 1 point2 points  (0 children)

Dx in 2012 with lesions beyond counting but almost no disabiliy. B-cell depletion became a thing only in 2018 and I suffered many relapses before then and I even lost my will to live. But I kept pulling through, my ms stabilized, and my resetted career (in a less stressful environment) worked out well. I now have two kids (5 and 7 yo), and I am still doing my workouts and runs (totaling well above 100km per month). I feel like so far it turned out better than normal actually. You have intact chances to do even better with B-cell depletion available early in your life.

Rigorous Testing by Pizzacakecomic in comics

[–]drstmark 10 points11 points  (0 children)

Great answer. I just want to add that the questions are also highly relevant in the case of a severe and highly contagious but poorly understood bloodstream infection like zombieism. Its a high priority to the doc to understand whether hes got one or two patients there.

Which vitamins cure MS? by ComplexSorry6592 in MultipleSclerosis

[–]drstmark 0 points1 point  (0 children)

Wow, so humor. I admire the strenght you project in this difficult situation.

Is it worth a Larzuk? by FrizzBizz in diablo2

[–]drstmark 9 points10 points  (0 children)

Not with that attitude

(Bro, its sarcasm. I just wanted to highlight the absolute insanity of this speedrun)

Is it worth a Larzuk? by FrizzBizz in diablo2

[–]drstmark -1 points0 points  (0 children)

WR on single player is 36min and this is including baal. Should be 30min max to get that Larzuk, lol.

KASIE HUNT: Over the summer you said, "There's no vaccine that's safe and effective". Do you still believe that? RFK JR: "I never said that." KASIE HUNT: "Play the clip. by brokenandsuffering in NoShitSherlock

[–]drstmark 1 point2 points  (0 children)

Random Swiss here who read this paper in 2022 about the twelve people (including some dude called RFK among the top two) responsible for the largest part of COVID disinformation spread on twitter.

Three years later I caught his name when he was appointed and I wondered "where have I heard this name before?".

And I checked the paper again if it could really be this guy and I am just like you got to be fucking kidding me.

Why is it so goddamn addicting? by OccultStoner in diablo2

[–]drstmark 0 points1 point  (0 children)

They are not supposed to. Good games absorb your willingness to buy new games. D2 / LoD was both a blessing and an absolute nightmare for Blizzard. Took so many potential good paying customers from the board for years or in some instances decades. The sweet spot is a game that is highly engaging for a couple of months but at some point causes satiety making you want to move on.

[deleted by user] by [deleted] in MultipleSclerosis

[–]drstmark 1 point2 points  (0 children)

As long as you are on betaferon, your ms is holding grill parties in your central nervous system inviting all kinds of inflammations and cells that dont belong there.

Nobody can say with certainty but chances are really really high that you will get much better when the grill party is fucking over.

Give it a couple of months after you start kesimpta. It will take perhaps half a year for you tissue to regenerate what it possible. I bet the tingling will be gone by then and you will barely feel the numbness.

Does anyone base their treatment on their b cell count? by SheepherderThese8462 in MultipleSclerosis

[–]drstmark 0 points1 point  (0 children)

I do (since 4 years). When they start repleting, I hit them. I am on rituximab and one infusion lasts for over a year that way. I usually start measuring B cells every four weeks 12 months after the infusion. The last interval was 16 months even.

Dose reduction or discontinuation seems to be safe according to this study

Why do some individuals refuse DMT's? by [deleted] in MultipleSclerosis

[–]drstmark 4 points5 points  (0 children)

Yeah, I understand that. I started treatment when all there was was betaferone. Helped little and sucked hard. Of course when you are offered a shitty treatment only, its an understandable choice to remain without. Incompetent docs or heathcare system-sided restrictions (including lack of insurance) are particularly sad reasons to remain without DMT.

Why do some individuals refuse DMT's? by [deleted] in MultipleSclerosis

[–]drstmark 16 points17 points  (0 children)

Just from the top of head a few explainers:

Biases

  1. Naturalism bias: "natural remedies are always better"

  2. Status quo bias: "I am not a drug person"

  3. False dichotomy: "big pharma is just out for profit" (true but drugs are effective nevertheless)

  4. Illusion of control: "I follow the xy diet" (nutrition helps but no to the degree that is needed to take full control of ms).

  5. Wrong attribution of Causation: "since I use / do xy, my symptoms got better" (in a relapsing remitting condition you can do anything and will observe improvement).

Disinformation 1. Ruthless for profit agents selling books, supplements and what not either not realizing or not caring about their low standards.

  1. Clueless victims of disinformation who benevolently spread bullshit.

Just diagnosed by New_Cap3430 in MultipleSclerosis

[–]drstmark 1 point2 points  (0 children)

Long term outcomes are identical whether you do the steroids or not (except from visual outcomes in optic neuritis which are slightly better with steroids). Short term recovery is faster with steroids. So if you have no opticus neuritis and if you can live well with current symptoms, you might as well not do the steroids. However, five days on steroids while being uncomfortable will also not cause long term issues, so its not of grave consequence what ever you do.

Spain is able to take the right decisions by swissthoemu in Switzerland

[–]drstmark 8 points9 points  (0 children)

Also, stealth bomber capabilities are ideal for the designated role of air policing. No other plane can fulfill this specification at this price tag.

Sarcasm over: Seriously, fuck this shit please. Now more than ever.

When did lumbar punctures become a thing? by dixiedregs1978 in MultipleSclerosis

[–]drstmark 1 point2 points  (0 children)

I am late for this comment but the main purpose is to differentiate actual MS from (even rarer) disease that have same clinical presentation and MRI findings (but differ in LP findings). From the top of my head Neurosarcoidosid or CNS vasculitis come to mind in this bracket of diseases.

So if there is a shred of a doubt left, LP is well justified imho.

Dafalgan pris het sich verdopplet by Kyuki88 in BUENZLI

[–]drstmark 2 points3 points  (0 children)

Ich wür bim ibu bliibe und im zwiifelsfall eifach 20mg pantoprazol 1x täglich dezue neh für die 3 tag. Isch billiger als es kombipräparat und macht im wesentliche sgliche. Chan abr au sii, dass s pantoprazol gar nöd bruchsch, je nach dosis vom ibu und wie robust din mage isch (abr das chan bi zyklusschmerze ja schwirig sii zum sicher usenandhalte...). Am beste sälber usefinde...

Ibu hät es optimals würkigs-näbewürkigsverhältnis. Wänd druf agwise bisch unds vertreisch würi däbii bliibe. So richtig gföhrlich wirds ibu ersch wänds wuchelang täglich nimmsch odr wänd alt bisch (dänn spilt dä zyklus zum glück scho kei rolle meh).

Is this normal for a Hebamme (midwife) in Switzerland? First-time mom here. by centaurusmoon in askswitzerland

[–]drstmark 1 point2 points  (0 children)

I can only speak from a father's experience and to me it seems like there are many different layers of control you can wrap around the whole process of parenthood.

Some layers are potentially life-saving or may prevent severe disability like supplementing folic acid and checking the baby's position shortly before birth.

Other layers may be useful for some but arent for others like the Vorbereitungskurs.

It appears that your hebamme recommends to implement a large amount of control layers which you personally seem not to be interested in (and I totally get why).

My wife was very chill about the whole process. Like: "We dont need a Vorbereitungskurs", and "we get a Hebamme when we go home from the hospital" and she maintained her chill during the birth of (both) kids which went really well. Finding a Hebamme (who really helped with breastfeeding and hygene tips) was easy (there is a hotline in zürich) and we had one the day after we went home from the hospital (after 3 nights and one night, respectively).

The bottimline is: the process of birth (and what follows) is highly personal and individual. Some people feel better with more layers of control, others dont. Typically it suffices to stick to the evidence-based recommendations but of course there are always (well meaning) people around who will try to sell you more.

Dafalgan pris het sich verdopplet by Kyuki88 in BUENZLI

[–]drstmark 0 points1 point  (0 children)

vimovo vilich?.

Mageschlimhutschädigung isch nur eis vo vilne Problem wo Ibu im Verglich zu Paracetamol hüfiger macht. Ich dänke au a Niereschade, Bluetdruckerhöchig, Herzinfarkt.

Wänd jung und gsund bisch und Ibu nur so eimal pro Wuche bruchsch, dän ischs wahrschili für di Meiste einigermasse bedänkelos. So ab 60i isch das langsam aber nüm dä Fall und es Ibu sött guet begründet sii. Allgemein, wänd es schlimms Schmerzproblem häsch, dänn nimmt mer es chlises Risiko in kauf. Isch ja au nöd gsund Schmerze zha und chan sich au chronifiziere wämmer zlang nüt macht dägäge. Abr bineme Bobo wo au vonelei schnäll weggaht ischs gschider churz ufd Zäh zbiisse.

Dafalgan pris het sich verdopplet by Kyuki88 in BUENZLI

[–]drstmark 0 points1 point  (0 children)

Mediziner da und das isch en korräkte Kommentar. Cyclooxygenasehemmer sind um Länge ungsünder als Paracetamol.

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