Posts by Nicholas Myers

Dana Morris2 said:Alright, I’m looking for some insight here.
A few days back, I started experiencing this sensation—for the very first time in my life—of pain wedged right between my eye and my eyebrow whenever I look up or shift my gaze.
It feels as though there’s some kind of foreign object lodged in my right eye, though I’ve inspected it thoroughly and see nothing.
My vision has become slightly blurred, though it hasn't reached a level that feels truly alarming yet; I've been spiraling down internet rabbit holes suggesting it might be glaucoma, which is a prospect I am desperately hoping isn't the case.
If it actually is glaucoma, I'm facing the terrifying possibility of losing my sight entirely. To make matters worse, my specialist only makes visits to my town once every five weeks.
So, I am reaching out to anyone who has dealt with this specific issue, or perhaps something even remotely similar, to see if you can offer any clarity.

Dear lady,

When dealing with this kind of pain, the specifics matter. Is it dull or sharp? Constant or throbbing? Is it just one eye or both? Are there visual disturbances before or during the episodes? Do colors seem faded? Does it feel like there's a curtain, spots, or holes in your field of vision? What does the eye look like externally—is it red? Are the pupils equal in size? Is this the first time this has happened? Any other symptoms, like light sensitivity, respiratory issues, or neurological problems? Are you currently taking any medications?

Pain behind the eye can stem from relatively benign sources, such as tension headaches or even a migraine (though migraines usually involve one-sided pain, nausea, vomiting, and sensitivity to light or sound; you might also see flashes or zig-zag lines beforehand, though vision typically clears during the actual headache). Then there are the more serious possibilities: an acute spike in eye pressure due to acute glaucoma (which usually involves intense deep pain, very poor vision, significant redness, a non-reactive pupil, and a hard feeling in the eyeball, often accompanied by nausea), optic neuritis (vision loss paired with pain that worsens when moving the eye, along with faded colors), or even inflammation of the periorbital sinuses. There's also a whole laundry list of other potential causes.

Pain can also originate on the surface of the eye. This includes things like blepharitis, conjunctivitis, foreign bodies in the conjunctiva or cornea, keratitis, corneal erosions or ulcers, or general surface injuries. That type of discomfort is typically described as burning, stinging, a gritty sensation like sand in the eye, itching, or dryness.

As for pain specifically triggered by eye movement, that can be caused by optic nerve inflammation, inflammation of the external eye muscles, or foreign objects affecting the cornea or conjunctiva.

I strongly advise you to schedule an appointment with a physician for a proper exam.

Best regards. 🙂

Anthony Gonzalez11 said:Hey everyone

My name is Anthony Gonzalez11 and I'm new here. I was wondering if anyone has gone through something similar to what we're facing? Is this something you can actually overcome? My Daughter is 35 years old
She’s got two boys, 3.5-year-old twins. Last year, she caught CMV, but for some reason, doctors couldn't figure out what was wrong with her for an entire year. Sadly, during that wait, the CMV attacked her eye, and she lost vision in one eye. It took them eight months just to finally pin down exactly what was happening. Her immune system was already pretty weak to begin with. We started working on boosting her immunity, and her fever issues have stabilized, which is good. But now, she’s starting to lose vision in the other eye too. According to the latest tests, the CMV is dormant right now. Has anyone else dealt with this? If not, does anyone have any advice on how to handle this kind of thing?

Thanks so much in advance

Hello,

Given that the thread title is "Cytomegalovirus in children," and it seems you are describing an adult, please correct me if I've misunderstood.

Regarding adults, it is extremely rare—highly unusual, actually—for a generally healthy individual to develop a CMV ocular infection severe enough to cause vision loss.

Was the person you mentioned otherwise healthy? Are there underlying conditions? Is she on any specific medications? Has she had an organ transplant? Has she received a comprehensive evaluation from an infectious disease specialist and an internist?

Regarding her treatment so far, has she received any intravitreal injections?

Nicole Lee4 said:Given what’s been said—that this value, or any other, might not necessarily point to arthritis—I don't quite see the utility of the test itself.
Thanks a lot.

The question you've raised is an interesting one, though the answer is fairly complex. I'll keep this brief to avoid drifting off-topic.

Context is everything when testing for RF. There is a massive difference between running an RF test on a generally healthy individual presenting with minor joint pain—lacking inflammation or other markers of autoimmune disease—versus testing someone where there is already a high clinical suspicion of a rheumatic condition.

To put it simply, if an RF result comes back negative, the likelihood that the person is actually disease-free is relatively high (literature suggests upwards of 80%). However, that percentage shifts depending on the clinical picture—essentially, how likely it was that the patient had rheumatoid arthritis based on their symptoms and physical exam before the lab work even came back.

For instance, if a physician estimates a patient's baseline risk for rheumatoid arthritis at 10%, and then the RF test returns negative, that risk doesn't stay at 10%; it drops to roughly 3%. (Source: Shmerling RH, Delbanco TL, How useful is the rheumatoid factor? An analysis of sensitivity, specificity, and predictive value).

Keith Chavez8 said:I’m looking for anyone with a grasp of Latin medical terminology to help me decode this diagnosis:

Hypertransaminases et hyperdehydrogenases acidi la

Thanks in advance.

The diagnosis falls under code R74.0, specifically Hypertransaminases et hyperdehydrogenases acidi lactei (LDH). In plain English, that translates to elevated levels of transaminase and lactate dehydrogenase (LDH).

Essentially, this means blood work showed high values for certain "liver enzymes"—specifically AST and ALT—as well as an elevated level of the enzyme known as LDH.

What you're likely wondering is why these numbers are off, what they actually point to, or if they suggest a specific underlying condition.

Unfortunately, this single data point doesn't provide those answers. Please check the instructions in the first post of this thread and expand your query with more details; that way, someone might actually be able to assist you.

Best regards. 🙂

Nicole Lee4 said:Hi,
does anyone know what a rheumatoid factor value of 10 means?
The reference range goes up to 14, so does that mean mine is "good"?

thanks

The reference range is 14 mIU/L or less. Since yours is 10 mIU/L, the result would be considered negative.

A positive result—meaning elevated levels—can be seen in various conditions, most notably rheumatoid arthritis, though it can also appear in other illnesses or even in a small number of healthy individuals at lower levels.

While a negative result is common in healthy people, a negative finding alone (being below that 14 mIU/L threshold) cannot rule out a disease like rheumatoid arthritis.

For a more thorough interpretation, please read the first post and follow the provided instructions.

Best regards. 🙂

Perhaps we're looking at lipomas—clumps of fatty tissue—though I can't think of any other immediate culprits. That said, lipomas near the eyelid are incredibly rare, so I doubt that's the case here. There are fat pads, of course, which can swell and give the illusion of a puffy eyelid, but that doesn't seem to fit this description.

If you feel the need, you could upload a photo. However, judging a medical issue via an online forum is a stretch; things often look entirely different in person. Plus, a digital image won't allow anyone to actually feel the texture or examine the area up close.

Robert Taylor4 said:Hey everyone, I’ve noticed these tiny bumps on my upper eyelids. They look a bit like small warts, but they don't feel right—they're soft, almost like fatty tissue because if I apply pressure, it feels like the contents shift inward. Has anyone dealt with this before? What could cause it?
I have three on one eye and two on the other...

They might not be xanthelasma. Based on that description, it sounds like something else entirely. If we're talking about tiny white spots about 1-2 mm wide—like the head of a pin—it could be milia. Slightly larger, firmer skin-colored or pale nodules might be syringomas. Small, indented skin lesions could be molluscum contagiosum, whereas xanthelasma usually presents as yellowish-orange flat patches, not individual bumps. Yellowish bumps might point toward xanthomas. Of course, there's always the possibility it's something else altogether.

The range of possibilities is broad, but it sounds most like some sort of cystic change. Your best bet is to have an ophthalmologist or a dermatologist take a look to confirm what you're actually dealing with.

restlessangler said:What about taking Dilantin long-term? Someone mentioned they've been on it for years without issue, but I’ve read elsewhere that it can be hard on the liver (if memory serves).

When treating headaches, continuous, long-term use of Dilantin isn't typically the standard protocol. The goal is for the medication to thin out the frequency, shorten the duration, and dial down the intensity of the attacks.

Usually, after a few months, you evaluate how well the drug is working. From there, doctors consider a gradual taper to phase it out.

Before starting Dilantin, it's wise to get baseline labs—specifically a full blood count and liver function tests, along with other routine screenings. While on the medication, periodic monitoring is necessary, primarily focusing on complete blood counts (keeping a close eye on white blood cell and platelet levels) and liver enzymes.

For most people, the drug is well-tolerated.

As long as you stay on top of those regular check-ups, there shouldn't be much cause for concern.

rapidtrucker90 said:Thanks a lot for the reply. 👍

It’s possible it’s due to birth control; I’ve been on them for years now (about 6 years), but I plan to take a break once I finish this pack..

If you are taking oral contraceptives, then total T3 and T4 levels aren't reliable indicators; you need to measure free T4 and free T3 instead.

I strongly suggest you inform your doctor at the Mayo Clinic about your medication. Birth control affects thyroid hormone readings, which can lead to these kinds of confusing results.

Best regards. 🙂

rapidtrucker90 said:I had my thyroid levels checked yesterday and picked up the results today.

It reads like this:
TSH ref. interval 0.35-4.94 ------ mine is 5.264
T3 ref. interval 0.89-2.44 ------ mine is 2.75
T4 ref. interval 62.68-150.84 ------ mine is 107.11

So, TSH and T3 are elevated. My doctor couldn't quite explain it; he said the combination is unusual
since both of those are high. 😕
He gave me a referral to go to the Mayo Clinic.

Does anyone here know more about this, or perhaps dealt with similar results? 🤷

Thanks in advance. 😉

Hello,

The constellation of these results is indeed odd. However, what stands out is that these appear to be total T4 and T3 levels, rather than free levels (fT4 and fT3).

Total thyroid hormone concentrations depend heavily on protein carriers. Certain conditions can raise total hormone levels not because the thyroid itself is overactive, but because there is an increase in these carrier proteins. Common causes include taking oral contraceptives or estrogen, pregnancy, or certain genetic factors.

Ultimately, the clinical picture matters most—your symptoms and any medications you might be taking. I expect the Mayo Clinic will want to repeat the tests and check your free hormone levels and antibodies.

Best regards. 🙂

It sounds like your primary care physician is quite level-headed and has managed to connect some important dots.

The headaches you're describing seem to share characteristics with tension headaches. These can often overlap with other types, including the ones you're managing with Carbamazepine. Stress, frustration, poor posture while working, and general physical tension are all major contributors here. Taking acetaminophen is a sensible move.

Hopefully, the upcoming test results and a second opinion will provide the clarity you're looking for.

Best regards. 🙂

You can get a referral for a lymph node biopsy directly from your primary care physician; I don't believe you need a hematologist's sign-off for that specific test.

Regarding those headaches—what are we actually looking at here? Is the pain dull or sharp? Does it throb, or is it more of a steady, constant pressure? Where exactly is it hitting? Is it bilateral, or just one side? How long does an episode last, and do you experience any warning signs beforehand? Also, are you dealing with nausea, light sensitivity, or sound sensitivity while it's happening?

The thread has drifted down to page two.

Regarding the introduction of Carbamazepine: given that standard painkillers haven't done the trick, moving in this direction seems both logical and justified. If you tolerate the medication well and see an improvement in your headaches, then it was a smart move. Generally speaking, when dealing with headaches, the protocol is to start with analgesics—moving from milder to stronger options—before pivoting to other drug classes if those fail (for instance, switching to triptans for migraines or anticonvulsants for dysrhythmic headaches). It’s essentially a progression from "simpler" to "more complex" treatments, if I may use a crude analogy, though where one drug sits on that spectrum is always subject to debate. Let's not get bogged down in semantics, though.

An abnormality in an EIA doesn't inherently signal pathology; the person interpreting the results is correct there. However, when paired with your specific headaches, it provides enough evidence to support a diagnosis of dysrhythmic headache, which your primary care physician seems to have identified accurately.

You should definitely follow up with your doctor regarding the suggestions made by Kate Collins67 (specifically the testing and the immunology consult). Your physician also needs to check your lymph nodes, as the hematologist advised, and if they remain persistent for this long, a biopsy should certainly be performed.

I hope you find some answers soon.

Best regards. 🙂

From what I gather, you can't just order medication from overseas via mail. If Customs intercepts the package, it won't be delivered because individuals aren't permitted to import drugs through the postal service. However, regarding travelers crossing the border personally, the rules are different (source: IRS):

Travelers may bring finished medications for personal use, provided the quantity covers no more than a 30-day supply. These must be approved by the manufacturer's country authorities, and you must carry valid medical documentation, such as a physician's statement or medical records.

Based on that, it looks like you could legally purchase a prescription in Austria and bring it back into the US, as long as you have the paperwork proving a doctor prescribed it. That said, it might be wise to check directly with an IRS agent or a Customs official. It's better to get a definitive answer so you can travel without worrying about your medication being seized.

Kyle Lee7 said:a) Almost always, because they are in the building where I've lived since I was five years old. Everyone there knows me, and they're often willing to let me grab something without a prescription upfront because they KNOW I'll bring the script by the next day (this obviously applies to my regular medications; they wouldn't just hand me something totally new if I walked in asking for it for the first time).
b) Yes
c) Huh? I mean, shouldn't everyone working there have completed pharmacy school?
d) Quick and clear advice/recommendations, but above all, I just want them to have what I came in for.
e) Waiting in line, especially during flu season, or when they don't have my specific medication in stock.
f) A 9, refer to point e.

As for other pharmacies, I've had both great and somewhat less-than-great experiences.

There was this one pharmacy on an island we visit; the woman was incredibly friendly and eager to help, but her final advice was actually *not* to go to the clinic, even though my condition was clearly worsening. She had this negative view that they’d just jab me with injections that she claimed were "very harmful." Look, lady, I know they carry risks, but I also know my medical history makes me a chronic patient, and I wasn't about to gamble with an allergic reaction to an insect sting that might pass in three days for someone else but could land me in the hospital.

On the flip side, I had a wonderful experience with a pharmacy in Ozalj. After two or three different places told me the product I needed was out of stock due to a shortage, I called them. A very kind woman (her name is Jane, and I'd like to thank her again here) took it upon herself to call around for me. She quickly found out where they had it in stock and even offered to order it for me so it would be ready tomorrow morning if I couldn't make it in.

Third example: a late-night emergency pharmacy. I was losing my mind from a bladder infection, having just arrived back from a trip, and I already had to head back out at six in the morning. It wasn't my first time dealing with this, so I knew exactly what I needed. I told the woman just to give me the meds—that I'd leave any ID (driver's license, credit card, insurance card, whatever) and bring the prescription in later. But it was a hard "no." No, no, and no. I had to go to the ER. Okay, I get that they have strict rules, but I was dead tired in the middle of the night and had to go to the ER, wake up the doctor on call who gave me a pale look for waking him up over a bladder infection, wait for him to scribble a script and go back to sleep, and then I had to head right back to the pharmacy to get... that.

I've witnessed similar scenarios on multiple occasions, across several different pharmacies.

It always boils down to the same thing: a pharmacist advising patients to disregard their doctor's orders. They claim prescribed medications are unnecessary, or suggest they wouldn't take them personally, or recommend altering the dosage or the schedule entirely. I even heard a case where a patient was told not to bother seeing a doctor at all because they won't provide anything "spectacular" anyway.

It wasn't happening to me, of course, but I've stood there waiting my turn and overheard these exact types of recommendations more than once. Whether it's a coincidence, I don't know.

To me, it's completely unacceptable. Sure, there are times when a doctor prescribes the wrong dose and a pharmacist catches the error and flags it—that's their job. But there are plenty of other instances where pharmacists overstep into medical territory where they simply don't belong.

I’d like to touch upon the points regarding the headaches, the neurological exam, the EIA, and the Carbamazepine.

Dear restlessangler, there is a specific category of headaches known as dysrhythmic headaches. These can manifest in various ways—typically resembling migraine patterns—but they carry one distinct hallmark: abnormal findings on an EIA (usually involving dysrhythmic changes). If all imaging results come back clear, we classify this as a primary headache.

Unfortunately, science still hasn't provided a definitive explanation for why these headaches occur. That is likely why you haven't received a concrete answer to your questions about the underlying cause. What we do know is that these headaches often respond remarkably well to medications from the anticonvulsant class. That is precisely why Carbamazepine was prescribed. Patients are sometimes confused, wondering why they are being given such a medication if they haven't been diagnosed with epilepsy. However, an epilepsy diagnosis isn't a prerequisite for this treatment; these drugs are utilized for various other conditions as well.

Whether the headache is a symptom of an underlying disease or a standalone issue doesn't change the clinical approach much. From a treatment standpoint, the goal remains the same: if standard analgesics fail and there is a dysrhythmic finding on the EIA, we move to an anticonvulsant.

Generally speaking, I agree with Kate Collins67; seeing an immunologist is essential. It would also be wise to complete some diagnostic testing while waiting for that appointment.

Furthermore, the facial rash shown in the photo looks somewhat atypical for seborrheic dermatitis. It wouldn't hurt to seek a second opinion from a dermatologist.

Regarding the lymph nodes—are they still swollen?

Best regards. 🙂

Kimberly Young2 said:'Hi everyone,
does anyone know what ALT means on a blood test?
Everything else is within range, except this one—the limit is 10-36 and I'm at 9.😕

Hello,

Your post was moved from the "Thyroid" thread, so you likely missed the opening post which outlines how to format questions here.

To get an interpretation of your results, please refer to that first post and provide more context.

That said, an ALT value that is slightly low like yours generally holds no clinical significance.

Still, I suggest following the instructions in the initial post.

Best regards. 🙂

Dear,

Your inquiry doesn't clarify if you've seen an internist—specifically an immunologist. From what I gather, a dermatologist ruled out a systemic connective tissue disease, but that really should be the call of an immunologist.

The facial changes you described, and those visible in the photo, don't look like classic seborrheic dermatitis. Of course, without a physical exam, it would be reckless of me to claim that definitively. Also, whether someone in your family has had this condition isn't a deciding factor in diagnosing seborrheic dermatitis, so don't rely on that family history to determine what you're dealing with.

The differential diagnosis for red facial lesions is vast. However, in your case, certain systemic signs stand out—everything from swollen lymph nodes to weight loss. It’s logical to ask if there is a systemic disease at play. It could be several unrelated issues, but based on your description, they feel interconnected.

With photosensitive reactions (you mentioned a "sun allergy"), itching is quite common, and typically, it's more intense than the discomfort usually associated with Lupus.

I also want to point out that systemic Lupus (SLE) isn't the only form of the disease. Yes, with modern updates to ANA testing methods, there is a small chance of an SLE diagnosis even if the ANA comes back negative. That said, false negatives happen, and immunology is full of surprises. If there is strong suspicion of SLE, regardless of a negative ANA, it would make sense to run an ENA screen to look for other antibodies, along with the other tests already suggested, like complement levels.

There are specific types of lupus—such as subacute cutaneous lupus, discoid lupus, or lupus erythematosus tumidus—where the ANA might not be positive, yet other antibodies can be detected.

A skin biopsy is a vital piece of the diagnostic puzzle. It would be wise to have a dermatologist with significant experience in this area evaluate whether a biopsy is necessary.

Regarding the lymphadenopathy: you haven't mentioned how large the lymph nodes are or if they've been biopsied/aspirated, nor what those results showed.

Try to track down the records from your hospital stay. There might be more information hidden in those files.

Steven Castillo78 said:Hey there.
I've been wondering about that thing they do when you enter 7th grade—you know, that test where they prick your arm with a needle, inject some liquid, and then you have to wait a couple of days before they check the results.
I've got two quick questions regarding this.
1. What’s the actual name of that test?
2. How does the process work if you actually need the vaccination versus if you don't?
Cheers, hope I made sense and clearly explained what I'm looking for.

The answer is already covered in this thread, so I won't repeat it unnecessarily. Here it is:

granitebadger25 said:James Wilson15

Kids get their tuberculosis vaccinations right in the maternity ward... if the vaccine triggers an appropriate response, you'll just see a small scar left behind (check your right upper arm and you'll see the little vaccination scar).
In a vaccinated population like ours, the PPD test is relatively non-specific. For me personally, it doesn't always indicate actual exposure to infection, nor does it necessarily prove whether the vaccination was effective, even though people often interpret it that way. However, if PPD testing is performed regularly in such a population—as is standard for school-aged children—then a significant increase in the PPD reaction can be an indicator of exposure, though still not definitive proof of active infection.
The test is read by checking for swelling (not redness) at the injection site (on the inner side of the right forearm) 72 hours after the PPD is administered.
0-4 mm = negative reaction
5-15 mm = positive reaction
> 15 mm = hyper-reactor

A negative reaction, even with a visible BCG scar on the arm, does not mean the vaccination failed, although pediatricians frequently re-vaccinate those kids just to be safe. A negative reaction often occurs following a minor viral infection and might simply reflect an individual's cytokine profile.

A positive reaction is most common in a vaccinated population like ours, and it is considered normal (which is the case with your children).

For hyper-reactors—especially those who have transitioned into this category since their last PPD test—additional testing is required. This shift suggests the possibility that these children were exposed to the tuberculosis bacillus in the interim.

One quick addition: the protocol generally calls for vaccinating "non-reactors" (those students with a negative reaction, specifically under 5 mm) during the 7th grade.