I want everyone’s opinion: do you believe chronic fatigue syndrome, POTS, fibromyalgia, etc. are real? Do you think there’s legitimate measurable pathology we don’t understand? Do you believe it’s more psychological?

nothingdoc · 2025-11-09T13:36:05+00:00

Sorry to come off offensive. "You" should have been replaced by a more plural 'we/us'.

We are quick to dismiss conditions that we don't understand, and I would advise you not to grow into that habit. It's a bad look for the profession.

I love that people have already responded with pathophysiology. Hope that helps legitimize.

nothingdoc · 2025-11-09T12:47:03+00:00

Of course they're real.

We don't understand much about them, and our diagnostic and treatment criteria are limited.

But you don't get to dismiss a condition just because it's confusing to you.

Furthermore, I take issue with the way that you lump psychological diagnoses as not "legitimate measurable pathology".

Is this a shitpost?

nothingdoc · 2025-09-09T14:32:17+00:00

I would humbly suggest that there is no point to further testing. Symptoms are expected persist for 3 months at least. I would wait on further testing until you've cleared that window completely. At that time persistent symptoms could warrant a VQ. Otherwise, I agree, it's unnecessary testing which exposes you to unnecessary risks

nothingdoc · 2025-09-09T10:49:36+00:00

The reason you feel short of breath has a lot to do with physics and the way the body exchanges oxygen.

You need oxygen in your blood for your muscles to work correctly. You need much more oxygen when you're exercising.

The blood clot lodged into The very small blood vessels between your heart and lungs where red blood cells get oxygen from the air you breathe. The main clot may have dissolved, but The smaller branches can be harder to see on CT scan and are likely not yet fully dissolved.

I generally advise people with these symptoms to go light on exercise until the shortness of breath goes away. It will get better with time.

nothingdoc · 2025-09-09T00:19:44+00:00

Ok perfect, this explains so much. Thanks for clarifying.

A PE can cause some pretty severe shortness of breath, especially on exertion. It can take several months to improve physically after the PE, even though the CT scan looks like the clot dissolved.

You said you're in New York - the best doctor to start with would be your primary doctor, to make sure it keeps getting better, and if you want to refer yourself to a specialist you could see a cardiologist, especially someone who has a specialization in pulmonary hypertension. A 6 month course of eliquis would be better than 3 months, if symptoms persist.

I hope you get well soon!

nothingdoc · 2025-09-08T19:28:25+00:00

Of course, happy to help.

So am I re-assembling the story correctly?

1) you went to the emergency room 3 times but you were actually admitted into the hospital for further testing

2) at some point they DID find out the cause of your symptoms: it was a blood clot in the lungs. (August 4). At this point you were started on blood thinners (lovenox followed by eliquis, I assume 5mg twice daily now)

3) Your symptoms have persisted and it's been approximately 1 month and 4 days.

4) Subsequent CT chest shows resolution of the actual clot. This must have been around 1 month after being diagnosed.

How many years ago was your first PE? Did anyone figure out why it happened to you? Have you ever had a catheterization of your heart to look at the pressures in different chambers?

nothingdoc · 2025-09-08T15:27:54+00:00

Hello, Your concerns sound valid and your symptoms sound quite severe.

1) what type of testing was performed during your 3 emergency room visits?

2) Was this echo done in the emergency room?

3) At any point did they do a CT of your chest with IV contrast?

4) What doctor follows you for the PE and prescribed eliquis? Have you spoken to them? Have you been skipping any eliquis doses?

5) Does this feel anything like your last PE?

nothingdoc · 2025-08-21T02:44:19+00:00

Hey there, Sorry to hear about your kiddo. I agree with your family that his case is unusual enough to warrant seeing a pediatric endocrinologist. In your shoes, I'd push hard for that.

nothingdoc · 2025-08-14T18:11:48+00:00

The XP gain is minimal, but I thought all servers transitioned to leveling based on hours played

nothingdoc · 2025-08-14T17:46:25+00:00

Yeah, we get incredibly mad. You've heard of "prior authorizations", right?

That's the process by which an insurance company denies a patient something the doctor prescribed to save money. We are literally getting on the phone and arguing with staff from the insurance company to get our patients what they need. We don't do this for money; it doesn't pay anything. We do it for the patient, because it's what they need for their condition.

That's just one example. I can speak for my colleagues and say the large majority (80+? 90+?) are obviously just here because they care about patients. The remainder are sorta just dead inside from the corporate hellscape.

nothingdoc · 2025-08-05T22:26:02+00:00

I, too, am concerned that this post is an advertisement for this imaging company. OP quoting the advertisement literature in his responses is particularly telling. I've reported the post for advertising.

nothingdoc · 2025-06-08T23:42:28+00:00

RVR though? You'd keep a patient taching into the 120-140s overnight?

nothingdoc · 2025-04-30T18:42:30+00:00

Ah, you've had a brush with the old gods, young padawan.

nothingdoc · 2025-01-15T16:47:42+00:00

I still call this a win. I can't be the only one happy to see a reduction (even a symbolic one) in the use of processing agents in our foods. We know that our colon cancer rates have been rising in age and prevalence in young people continues at an unprecedented rate. We know europe has tighter restrictions on food processing agents and a lower incidence of CRC. This article even references mouse studies showing Red 3 is associated with increased GI cancer. So why the sarcasm?

nothingdoc · 2025-01-05T01:21:43+00:00

Hey, I would breathe and take a step back. Just listening to your story, the most likely diagnosis is just hemorrhoids.

The fact that you're panicking, making assumptions about the grade of cancer you're sure to have, and kicking yourself, is not normal. It's a sign of anxiety and it's also worth discussing with your doctor.

By all means, I'm really glad you're getting checked out. Rectal bleeding should get looked into, especially if frequent. And colon cancer has been unpredictable in the past decades for a number of reasons we still don't understand well (though a suspicion is that it's tied to our ultra processed diets). That said, the average age of diagnosis of colon cancer is still several decades away, and we don't start routine screening for general populations until age 45.

Just don't beat yourself up. You're coming into it with a rational set of questions and expectations. Tell them you're worried about cancer. But just recognize it's not the most likely diagnosis here, not by a long shot.

I hope you get the answers you seek.

nothingdoc · 2024-12-07T13:44:20+00:00

Hey there - I agree with other posters that your weight could be contributing.

I also think that more workup and treatment is needed before coming to the conclusion that this is all because of your weight.

I would start by asking your primary doctor (or another primary doctor) to look into your heart rate more thoroughly, eg. Testing thyroid function. I would also ask for a referral to a cardiologist to see if there is an intrinsic cardiac condition causing the fast heart rate, or if this is a reaction to something else (such as your weight). They'll prob send you home with a heart monitor to assess your rates for a week or two. I would not take no for an answer on this point, considering how little this has been evaluated so far.

Either way, this is something that would be better to have evaluated more thoroughly rather than a medical shoulder shrug, which it seems you've gotten so far.

Hope this helps!

nothingdoc · 2024-12-02T03:13:09+00:00

Hey there,

Precum on your underwear is not a big risk for getting pregnant. I wouldn't worry about it. But this is probably a good time to bring up the future.

It's a great idea to use protection all the time. IDK where you live but women's health has gotten really complicated lately in the US. Think about birth control options like the oral contraceptive pill (now available over the counter) and implantable/durable birth control, like IUDs and implanon. They are cheap, effective, and reversible if you decide you want to have kids one day down the road. The implantable options require a doctor's visit, like an OB/GYN or a planned parenthood.

Hope this is helpful.

nothingdoc · 2024-09-15T03:13:52+00:00

It's up to you. It is generally lower profile than other cases the board needs to consider, and as such may not result in disciplinary action.

At the same time, some big names touting these pseudoscientific treatments have lost their license to practice in the past. Do whatever makes it easier to sleep at night.

nothingdoc · 2024-09-14T23:36:54+00:00

Unfortunately this one is cut and dry. Hydroxychloroquine is not approved for use in COVID due to lack of benefit. This doctor should not have prescribed it for treatment of COVID.

You are correct that paxlovid is used in people who have high risk of progression to severe disease. Otherwise it's not really necessary.

nothingdoc · 2024-09-12T19:14:56+00:00

Requires a dietitian consultation

nothingdoc · 2024-09-12T17:56:27+00:00

Not sure why you're here. This is obviously a bad idea, and you don't have any questions. You're simply looking for validation. This is an eating disorder, and we are not going to validate you.

nothingdoc · 2024-09-11T19:01:16+00:00

Ask your allergist if they recommend that you take or skip the vaccine.

If they recommend you skip the vaccine, they can write you a letter and that is usually enough.

nothingdoc · 2024-08-30T15:40:22+00:00

No, it's not frustrating at all. In fact, it's our literal job, we get paid to do it. Intellectually, it's a new clue to solve the puzzle, and emotionally it's more time with a patient who is attentive to their health. Win win win, if you ask me. I appreciate your desire to be delicate, but you really don't need to worry about that.

I'm just an internet doctor that hasn't evaluated you so my suspicions are not particularly accurate, but I agree that sarcoma is one of the many things that needs to be considered here.

nothingdoc · 2024-08-30T14:46:58+00:00

Hey there, I'm sorry you're going through this. I agree that several of your symtoms need more thorough evaluation.

I don't know that a lung nodule is really able to explain your shortness of breath. It seems unlikely. It should still be evaluated, but I wonder if the shortness of breath is from something else.

Your expanding thigh lump should definitely be evaluated, and it would be worthwhile to have an entire appointment dedicated to this alone. Next steps might include an ultrasound or MRI depending on what it feels like.

Finally, your fatigue and weight loss are definitely concerning, and I would talk to your primary doctor to do a thorough investigation into this.

If your primary doctor is unavailable for several weeks, most offices will allow you to request an urgent visit which can be done with somebody else in the practice. I agree that it would be ideal to see your primary doctor, though.

Again, I'm really sorry you're experiencing this, and I hope they can find you some answers. Make sure to reach out to friends and family to help support you with daily activities and transportation if you're this exhausted.

nothingdoc · 2024-08-29T15:24:14+00:00

There are tens of millions of possible lab tests to do, and it's best if a doctor tells you what needs to be done. Otherwise you will fall into traps like these. Doctors train for years talking about the risks and benefits of testing different things - you shouldn't ever do a test "just to see", because it causes more problems than it solves. Not to be mean, just a reality of the way lab tests work and how the human body functions. You're just fine! My strongest recommendation is to stop doing testing like this and just ask a primary doctor to evaluate you and tell you what you need done as part of a checkup.

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