Posts by vividsailor7

Olivia Robinson7 said:So, here's the deal: I've got this unused referral sitting right here on my desk for a dermatology appointment.
My referral expired because it had an expiration date on it. Seriously? What is even the point of issuing one if it just becomes useless paper after a certain amount of time? It’s incredibly frustrating.

I’ve been scheduled for an appointment this coming Monday—and before you ask, no, I didn't expect it to happen this fast, so don't even start with the "why didn't you know" comments—but there's a massive problem. I haven't been able to get a hold of my doctor to get my referral renewed in time. Now what?

I remember this one time I went in there and practically begged them to extend it. And what does she do? She literally takes out a piece of WHITE-OUT, scribbles right over the date on my referral, and looks me dead in the eye and says, "There. Now it doesn't have a date..." Unbelievable.

So, now I’m sitting here wondering—what do you all think? Should I just go ahead and pull the trigger on this? I’m based in Chicago, but my doctor is over in Karlovac, so honestly, it doesn't make any sense for me to trek all that way just to have him shut me down because of some corrector issues. It feels like a total waste of time. 😢

Thanks for the reply!

That’s just standard practice when you're working with a corrector—you just have to go back in and hit it with the stamp again.

Taylor Doyle4 said:Last night was a nightmare. I woke up after barely two hours of sleep feeling like I was actually suffocating. I used to deal with asthma—specifically bronchitis—but I honestly think I outgrew it because it was all psychosomatic. That said, chronic rhinitis and nasal congestion have always been my shadow. It’s probably allergies, though doctors here in the States can never pin down exactly what triggers it. When I’ve got a real cold, it’s heavy and yellow, 🙂 but even when I'm healthy, it stays white; even in the summer, though it's slightly better when I'm near the coast. Anyway, last night my nose was completely blocked right as I was drifting off, but I tried to just push through it. For the last six months or so, I’ve been battling panic attacks, but ever since I discovered those breathing techniques, things have stabilized. They actually work. But I heard somewhere that you can have a panic attack in your sleep, too. And that’s exactly what happened. I was dreaming about this random guy—total stranger, clearly made up—and he was telling me some story about being stuck somewhere and spending three months in the hospital, and how his buddy stopped wearing his ball chain (you know, those metal necklaces guys wear) after that. Dreams are nonsense, I get it, they don't make sense, but the moment he mentioned that chain, I started choking. It was terrifying. A genuine, physical sensation of being strangled. I couldn't even speak; I just grabbed my throat, gasping for air. It was incredibly violent. I jolted awake and sat straight up (I usually sleep on my back without a pillow because of my spine issues) just trying to suck in oxygen like a maniac. My nose was still totally stuffed, and there was this phlegm in my throat I couldn't cough up—I had to do that weird clearing thing, you know, *ahem*. I ended up using some saline spray to clear my nose and cleared my throat in the bathroom. I was also burping a lot—could that be from swallowing air while gasping? I was too scared to go back to sleeping on my back, so I curled up on my right side with a pillow. (If it’s just a sleeping position issue, I could stick to that, but then I end up rolling onto my stomach and my back is absolutely trashed the next day). Is it possible the nasal congestion actually obstructed my airway? Look, I am an incurable hypochondriac, 🙂 and please, for the love of God, don't start lecturing me about sleep apnea. I don't snore, and from what I've gathered, people with actual apnea struggle for years without even realizing it.
By the way, sometimes if I drink milk—like, from a carton rather than a glass—it feels like it’s going straight into my lungs 😕 because I get this freezing sensation in my chest. Again, I'm reminding you: I am a massive hypochondriac.

Coughing? Wheezing? Any improvement? What kind of treatment were you on? Did you manage to clear it?

Tyler James5 said:So, how does the diagnosis actually go down? And what’s the deal with treatment, besides just the whole "fix your life" speech? I get the obvious stuff—cutting back on carbs and hitting the gym harder—but I'm looking for something more specific than that...

...

To hit that diagnosis, you generally need to be looking at central obesity, a messed-up Lipid profile, insulin resistance (hyperinsulinemia), impaired glucose tolerance or Type II diabetes, hypertension at any stage, and hyperuricemia.
The goal is treating all those individual issues. For extreme obesity, we're talking pharmacological options like Orlistat or even surgical interventions. For a bad Lipid profile, you've got hypolipidemics—statins—and if the triglycerides are through the roof, then fibrates. For insulin resistance, you use biguanides like Metformin. As for Type II diabetes, it depends on whether you're insulin-dependent; then it's Metformin, alpha-glucosidase inhibitors like acarbose, or reduced-insulin derivatives like sulfonylureas and repaglinide. There are other types of antidiabetics out there, but they haven't been studied enough or they come with side effects that are still being looked into, such as rosiglitazone, pioglitazone, sitagliptin, or vildagliptin.
Regarding hypertension—you really ought to avoid beta-blockers and diuretics if possible. Instead, you have ACE inhibitors like Ramipril or Lisinopril, calcium channel blockers like Amlodipine or Lacidipine, or angiotensin II antagonists like Losartan or Valsartan. If someone can't tolerate ACE inhibitors, alpha-blockers like Doxazosin are an option, and they actually have a nice hypolipemic effect too.
For hyperuricemia, you use Allopurinol.

Sarah Garcia84 said:Thanks for getting back to me. Since I've been dealing with some heart issues lately, my doctor gave me a referral for a cardiologist. It’s marked specifically for a specialist consultation, but does anyone actually know what that entails? Is it just an EKG and an echocardiogram, or is there more to it?

It's just the consultation. You have to request an EKG separately, and a TTE is a whole different thing altogether.

Dennis Evans59 said:Look, I’ve been going through this absolute nightmare every single morning for days now. It’s even worse because—God help us all across the Middle East—it’s a workday. I wake up, brush my teeth, do that deep, throat-scratching cough that makes my throat feel raw, clear my sinuses, and then spend time hacking up slime into the toilet. Then I spend the next hour basically using half a roll of toilet paper just to clear my nose, too. A few times there's actually been blood mixed in—dark red streaked with green. It is exhausting. Honestly, it’s gotten to the point where I’m making jokes with my sister about it; I’ll blow my nose into a tissue and tell her, "Look, a butterfly!" because some clump of mucus actually looks like a butterfly. I'm literally out here trying to find shapes in my phlegm just to cope...

Last Saturday (or maybe it was Thursday, depending on if you're reading this in 2015 or found me via Google), I caught some kind of bug. My throat was killing me, and since I had been traveling in the heat, I ended up running a fever and throwing up once. I feel better now, but this congestion won't go away... I don't have the time to deal with doctors right now, so is there any simple way to get rid of this? Thanks 😁 (And no, I don't smoke. I'm 15, I haven't touched a cigarette)

I honestly didn't catch the point here, and frankly, those little "butterfly" impressions are completely useless.

Hypoglycemia isn't actually a symptom of metabolic syndrome.

Amy Adams95 said:Thanks for getting back to me.
Look, I’m telling you exactly what I told you before. If this isn't clear enough for you, then I don't know what to say. I’m sorry, but I don't have his lab results right here—the man keeps them hidden from all of us! It would be so much easier if I could just lay out everything for you; I’d probably get a more concrete answer, and you wouldn't be left in the dark either. I realize that without those numbers, we're all just guessing, but honestly, I’m at my wits' end! Anyway, thanks.

Well, if you don't even know the facts, then I have no idea what kind of answer you're looking for.

Maria Fisher46 said:Listen, Jessica Fowler4,
............................!

Regarding metabolic syndrome—specifically looking at what Betty Hughes6 mentioned—I’ve gone back through my own previous posts where I addressed this exact topic. But let’s be clear: it should have been obvious from reading the very first post. Even if someone hasn't posted much here, I don't have the luxury of time to comb through thousands of individual comments just to find a specific thread, especially when I've already covered similar ground recently. Honestly, I doubt any other doctor here would bother doing that either.
That being said, I’m assuming these lab results were taken while the patient was on metformin.
Regardless, my stance remains unchanged.
As for the diagnostic criteria, setting the fasting glucose threshold at 5.6 mmol/l for metabolic syndrome? In my opinion, that's just not realistic. It would be much more sensible to set it between 6 and 6.5 mmol/l.
For everything else, I'm in total agreement with my colleague.

Paul Morgan said:The tick bit me about ten days ago, and yeah, I pulled it out right then. Since then, I’ve been traveling through Chicago and barely got any sleep. When I finally got back, I was just exhausted. Everything seemed fine at school too, but then a massive downpour hit me on the way home, so I decided to lie down for a bit. Once I woke up, my nose started running, my throat felt terrible, the whole works. I slept all day yesterday, and now I'm popping some DayQuil because it feels like a straight-up cold. Will this actually help or am I just wasting my time? What do you guys think—should I go see a doctor?

I’m honestly worried we might be looking at KME tick-borne meningoencephalitis here. That said, it’s probably just a standard virus or a common cold, but seriously—don't play games. Go see a doctor immediately just to make sure nothing weird is going on.

Amy Adams95 said:The chest X-ray report just mentions visible scarring from previous bouts of pneumonia.
As for the coughing, I realize a cough might be "normal" in some contexts, but he is coughing up half a cup of blood every single day. Even on 1g antibiotics (Augmentin 1g), his fever stays stuck at 100.4 to 101.3 degrees Fahrenheit, and the coughing hasn't let up one bit—his condition isn't improving at all.
He was also diagnosed with angina pectoris a long time ago.

They’ve sent him for tests for every possible ailment, ranging from pneumonia to suspected tuberculosis. They even checked his liver, kidneys, and prostate, and everything came back fine then. Nothing changes; they just run the same repetitive tests over and over without finding anything new. Now, they’ll likely send him for more TB testing because they still suspect it could be tuberculosis.

He used to smoke a long time ago (they told me he went through three packs a day), but he hasn't touched a cigarette in about 20 years.

That C34 code is probably just something the primary care physician noted; those doctors can write whatever they want on a referral.
Honestly, I am done dealing with this. You people just toss out data whenever you feel like it instead of actually answering the questions I have laid out—questions that, in my opinion, are extremely clear. I used to try harder to help, but why should I make myself a target and get dragged into this nonsense for no reason?
Besides, you claim the X-ray only shows scarring from a prior pneumonia, so where on earth are you getting this idea about lung tumors?

Lisa Turner46 said:I need to see a hematologist, so I was wondering which hospital in Chicago I should go to and how long the wait is. Thanks.

Go to Rebro or Mercury.

Lisa Turner46 said:I had my blood drawn, just like I do every year since I'm on birth control, so I go once a year for a standard CBC checkup. Actually, this is only my first year on them. Here are the results:
.............................
TIBC 41 ( 49 - 75)

Well, this could potentially fit the profile of hemochromatosis. That’s actually relatively straightforward to manage through phlebotomy, but you have to run a full workup first.
Transaminase levels, Hepatitis B and C screening, Iron, UIBC, ferritin, glucose, and genetic testing.

Steven Brown28 says:
Hey everyone. So, my mom's stepfather (69) has been sick for quite a while now. It's primarily a cough; he's been coughing for years, sometimes even daily. But lately, things have taken a turn for the worse.
He recently had some lung scans done at the local VA hospital, and they noted this on his report:

Dx 1: C34
Dx 2:
Dx 3:
......................

He had blood work done today, and here is what it looks like:

WBC - 14.0 (3.4-9.7)
Eosinophils - 1.6 (0-7)
Basophils - 0.5 ( 0-1)
Neutrophils - 70.8 (44-72)
Lymphocytes (%) - 20.9 (20-46)
Monocytes (%) - 6.2 (2-12)
CRP - 85.5 (b>
.................... 🙂

You haven't really provided much useful information here—specifically regarding the chest X-ray findings? Or so I assume. That’s the critical part, because right now, "C34" doesn't tell us anything specific.
What's the next step from Abbott Laboratories? What follow-up tests are planned? Any underlying conditions? Possible therapy?
As for the coughing, believe it or not, people cough every single day.
Your impressions don't mean much.
And, obviously, he really needs to quit smoking.
The blood work clearly points toward a bacterial infection.

Lisa Turner46 said:Can someone please actually answer me?

Seriously, did anyone even bother to read the very first post??☕

David Jones45 said:Look, I know I’m being a pain in the neck here, but can someone please explain what hemoconcentration actually means?

It means thicker blood. Period.

Paul Ramirez59 said:Hello there,
..............................................

Your results look normal, aside from some slightly off lipid levels, which you can easily manage through diet. Check out the nutritional guides on the CVS Health website; they have plenty of resources there to help you get things back on track.

shadowridge11 said:Is there anyone living near Madison Square Garden who would be up for a ninety-minute walk every day? Gender doesn't matter...

I would honestly love to hear from people who have cycled through both healthy weights and being overweight over the years—those of you where the scale is constantly fluctuating (just like it is for me)...
How do you actually tackle the issue? How do you solve it, and what kind of toll does it take on you, both mentally and physically?

In my opinion, my current struggle with weight is tied directly to the emotional pain I'm dealing with... I find myself reaching for food whenever I feel like I’m backed into a corner with no way out. But look, this isn't new; I've had issues before, and I've successfully dropped a ton of weight in the past. Granted, I didn't do it the "healthy" way, but I got the job done.

Why on earth isn't there a free support group in Washington, D.C., specifically for weight loss, similar to how they have groups for alcoholics or other addicts?..
Do you think anyone can actually help you lose weight, or does it just require that sudden mental "click"—that moment of clarity I experienced every time I managed to shed the pounds?
Thanks!
🙂

Of course they exist. There's an AA-style support group right over by Grand Central Terminal.

David Jones45 said:How dangerous is this, really?

Look, it’s definitely not nothing to brush off. But before anyone starts panicking, you have to get those tests rerun. Lab errors happen more often than people care to admit, even at top-tier facilities.

Austin Reed20 said:Look, my lab results show DHEA-S is consistently 50% above the upper limit—both times I checked, eighteen months apart. It’s also weird: my ACTH is hitting the bottom of the range while cortisol is scraping the ceiling. That's just my layperson's take, but listen to the symptoms. I am positive this is adrenal-related. I get these surges of adrenaline that hit me at random points during the day, or even stay with me all day, followed by these sudden, massive energy crashes. We're talking five to ten minutes before I'm totally wiped out, and it can last anywhere from half a day to weeks. Just total exhaustion mixed with that "wired and tired" feeling. Honestly, it's wrecking my mental clarity, which is the biggest issue for me in life. It's hard to prove the adrenaline spikes without more complex testing... you just have to take my word for it. I've used various substances in the past, so I know what I'm talking about. Are you telling me I'm just making this up? Am I supposed to just accept that everything is "fine" and live with some vague diagnosis like metabolic syndrome? Or should I just go see a psychiatrist and start popping happy pills? Or maybe actually put in the work to figure out what is wrong with me...

And on top of that, my FSH has been sitting right at the low end of the limit both times, too. Great. Just great...

My answer remains the same.
May the gods of luck be with you /if they even care/

David Jones45 said:My apologies, I didn't read the first post.

I'm 41 years old. Up until now, I haven't had any major health issues aside from anxiety. My blood work from late August 2011 was perfect, but we just had a corporate wellness screening at work, and these are the values that have my doctor concerned:
RBC 7.11
Hemoglobin 212
Hematocrit 0.641
RDW 15.6
Platelets 98
MPV 10.9
Monocytes 12.8
Neutrophils 1.84
All other values are normal
My doctor told me to go back and redo the blood panel.
Thanks for the reply

You absolutely need to repeat those tests. Those numbers are seriously high—it looks like hemoconcentration.

Austin Reed20 said:It’s a long story. It's been dragging on for two years.
............................this whole mess could cost me my job, my house, maybe even my wife...

Look, believe it or not, I am not about to sit here and read through an endless wall of text unless we are talking about actual lab results. From what I can gather, you keep insisting the issue lies with the adrenal glands, but for heaven's sake, the labs look perfectly normal.
Can someone please explain what specifically is wrong with the adrenals? And why on earth are you bringing up a psychiatrist as an "alternative" option?
May the Good Lord help you—if He even can.

David Jones45 said:I got my results back yesterday and my doctor really spooked me. My hematocrit is high at 7.11 and hemoglobin is 227, but my platelets are low at 98. Can anyone tell me what this might mean?

Go back and read the very first post. And what exactly did your doctor say to you?

Kate Newman2 said:I'm pregnant and currently on Lovenox (low molecular weight heparin) 0.6, twice daily. I just had blood work done this morning and these are the results:

PT clotting time 90 (60.00 - 240.00 sec)
BT clotting time 320 (300.00 - 720.00 sec)
pT 10.00 (10.30 - 13.20 sec)
INR 0.91 (0.00 - 1.25)
aPTT 117.6 (73.00 - 150.00)
PLT platelets 167 (144.00 - 400.00)

Are these results okay, considering I'm already on medication? What should I do next?

In my opinion, they look fine. /I don't have much experience with this, though/, so maybe someone else here can provide more insight.

Brenda Alvarez24 said:Any comments? Insulin resistance?
Also, what does Type N mean on a lipid panel (Fredrickson)? Last time it said Type U, but now it says Type N.

I have no idea why they would be taking you off Metformin.🤷 🤷
It looks like there’s some very mild resistance here, but honestly, since you’re responding so well to Metformin, I’d say sticking with the current treatment plan is definitely the way to go.
Type N—which just means everything is looking normal.

Austin Reed20 said:estradiol 116 (28 - 156)
testosterone 19.32 (9.90 - 27.8)
prolactin 271 (98 - 456)
LH 3.67 (1.7 - 8.6)
FSH 2.89 (1.5 - 12.4)
DHEA-S 11.72 (2.6 - 7.7)
cortisol 499.6 (171 - 536)
ACTH 3.0 (1.6 - 13.9)
TSH 2.45 (0.27 - 4.2)
T4 96.5 (66 - 181)
T3 1.61 (1.3 - 3.1)

Taken at 8 AM fasting after a good night's sleep. 30-year-old male, 180 lbs at 6'1".

I've got some kind of "metabolic syndrome" going on, and the worst symptoms are this massive brain fog—just feeling stupid, unable to concentrate or remember anything—plus this constant lethargy and weakness.
I've recently started taking thyroid hormone, Synthroid; my T4 and T3 were sitting right at the bottom edge before, and TSH was a bit high, so the pills are working, at least on paper. I guess I just have to wait for it to actually kick in.

What’s really eating at me is that when the thyroid acts up, the adrenals often go down with it. I feel them working all day long (that gut-wrenching sensation you get before a huge exam or an adrenaline rush—except this lasts for hours). I also frequently feel hyper and wired; I know the feeling well because I'm no stranger to illegal substances.
Oh, and my blood pressure is relatively high, though my heart rate is usually low. On average, I'm looking at 150/90 with a pulse of 50-60... sometimes it even dips to 30 bpm. It's not like I can't recover after physical exertion—my BP doesn't go crazy then—actually, it settles down after exercise... the pressure drops and the heart rate rises... but while I'm resting, the pressure stays high, my pulse is slow, and I get very frequent palpitations. So, I'm worried about the ACTH and adrenal hormones. Cortisol is quite high, and DHEA-S is 50% above the upper limit (I checked DHEA-S a year and a half ago, and it was also 50% over the limit back then).
Also, if I eat carbohydrates, my stools become watery and they burn like hell in my ass. That seems to be another symptom. Usually, things are regular, but carbs make everything move too fast... maybe not all the time, I haven't quite figured it out yet, but basically, I just purge everything immediately.
My hair is thinning too; it looks like male pattern baldness but it's more diffuse, which is suspicious since my family doesn't deal with diffuse thinning.
And yeah, I've had dry, flaky skin my whole life, and there's almost no hair on my lower outer legs and stuff like that.

Should I get my adrenals checked, or are these high adrenal hormones just a consequence of poor thyroid function that will level out once the therapy works? The only thing I don't get is how this happens without the pituitary/hypothalamus involvement—usually, the pituitary tells the adrenals to shut down, so why won't they here?

The low FSH is also worrying me because I want to start having kids soon, and this could be a problem... is that linked to the thyroid?

Thanks for the answers..

Just write out your symptoms, blood pressure, and heart rate clearly in five lines. And please, stop with the wild theories; your labs look fine.
Elevated adrenaline is seen in pheochromocytoma—which is an adrenal tumor—so don't go hallucinating problems when your results are within range.
You’d probably be jumping for joy if they told you, "Sir, you have a liver tumor," wouldn't you?

Terry Reed13 said:Fine then. Whatever.

I noticed some of my numbers weren't hitting those "ideal" targets, so I was feeling a bit thrown off... ........................

The labs look fine to me.