I honestly think the actual root cause of GERD goes undiscovered in at least 90% of cases—it's just a total mystery... sure, there are these relatively proven comorbidities or what people like to call "risk factors," but at the end of the day, those are still just risk factors, nothing more. It’s like how someone can smoke their entire life away and then get hit by a bus at 94, while someone else breathes nothing but fresh air their whole life only to be taken out by lung cancer at 40... I don't even know what else to tell you besides—shit happens...
Anyway, there's already a massive thread dedicated to GERD so there’s really no point in me just repeating everything, especially since there are plenty of people in that discussion way smarter than I am...
Look, I have to tell you straight—acid reflux, stomach issues, laryngopharyngeal irritation, and everything else listed here have been part of the same big entity under the Republican Party umbrella for ages now. There’s really no logical reason to separate them... To be honest, treating GERD as its own narrow thing—just limited to backflow in the lower esophagus—is more of an exception than the rule if you ask me. You’ve got to distinguish actual GERD from just simple heartburn, because not all heartburn qualifies as GERD, and I honestly don't see why you're stressing over whether a doctor writes LPR or GERD on your chart. The treatment is going to be identical either way since the root cause is the same... And if we're being logical about it, for anything to splash up from your esophagus into your throat, it has to originate in the esophagus first, which means you basically have to have GERD to even have "LPR"... if there's no GERD, there's nothing to reflux in the first place...
This whole obsession with renaming things and splitting everything into tiny sub-categories—just enough to fuel a dozen PhDs and hundreds of niche case reports—has become incredibly trendy lately. Of course, actually proving that separating these things makes any sense for diagnosis or treatment is usually impossible, but you'll see semi-professional journals churning out these long articles across several issues, always accompanied by a chorus of supportive comments from the same little circle of researchers who conducted the studies...
Bottom line—don't let this nonsense get to you. Just an FYI, though: if an ENT notices hoarseness or what they call "posterior laryngitis," or if someone has asthma that can't be linked to allergies or an infection, the standard move is to automatically refer them to a gastroenterologist. At least, that's how it works on my checklist, and look, I'm certainly no world-class specialist, but I know enough to say... you should keep that in mind...
They’re going to run all the tests they deem necessary based on what an infectious disease specialist thinks is the right move...
Now, about mono... In theory, you should be able to spot it on a standard blood count, but there are always exceptions to the rule, and sure, liver enzymes can spike too, but clearly that wasn't the case here if his labs came back clean—honestly, there are probably a hundred different infectious things it could be even if you aren't running a fever, but it looks like my colleague is actually taking this seriously and is following a methodical process to track down whatever is causing your issues...
We’re talking about everything from various coagulopathies—you know, those clotting disorders—to all sorts of autoimmune diseases, certain infections, and even hematological issues involving blood cells or bone marrow tissue... basically, without a full blood panel in hand, there is absolutely zero point in just sitting here making guesses...
If you’re already turning down medication right out of the gate—I mean, what kind of help are you actually looking for here, or what exactly do you expect people to suggest?
Honestly, this whole thing just sounds incredibly bizarre to me... Clindamycin has to be taken 3 to 4 times a day because its half-life is so short, so unless they’ve come up with some sort of ultra-extended-release formula that I’m completely unaware of, you shouldn't be having any issues after about 3 or 4 days—assuming you're actually following a proper treatment plan, but if you aren't... then why on earth aren't you?
Hearts? Sure, you can get an EKG done—but honestly, it might not even pick up any damage at all. You could go for an echocardiogram or maybe some specialized cardiac imaging to see if there’s a specific section that isn't pumping quite right... but then again, those might miss things too. In the middle of an acute heart attack, they can run radionuclide scans using isotopes that track metabolic activity to pinpoint actual damage, though I'm not entirely sure how effective that is once you're dealing with old scarring (probably not much)... but look, all of this—aside from the basic EKG stuff—really needs to be hashed out with a cardiologist, because I'm definitely no expert here...
Look, syncope—or what most people just call collapsing—is basically that momentary blackout or sudden loss of muscle tone where you just... well, you drop. You lose your balance entirely. Usually, once you actually hit the floor and lie down, things snap back to normal pretty much instantly, mostly because your blood pressure stabilizes and gets that circulation back to your brain where it needs to be... though, honestly, there are a million different reasons why this happens, ranging from totally harmless quirks to stuff that’s actually pretty serious...
Then you've got PTSD, or Post-Traumatic Stress Disorder. It's a psychosomatic syndrome that, true to its name, kicks in as a reaction to intense, acute stress. It doesn't even matter what the specific trigger is, really; the only thing that matters is that the event was perceived by your brain as being traumatic enough to set everything off...
Look, there’s absolutely no point in even starting to guess until we know for sure which metal we're dealing with here, seriously... though if you aren't seeing any other symptoms yet, my first instinct would be to go looking for cadmium...
First off, you’ve got to figure out exactly what kind of metal we’re even dealing with here, because until that's settled, trying to pin down where it actually came from is just a total shot in the dark...
I honestly don't know if there's any actual medical harm involved, but I do know one thing for sure—if I'm driving around with the windows rolled down, my ears start aching like crazy... 😁
That second one looks like it's for an endocrinologist, I assume, since you've got separate referrals for the lab work and then a separate one for the specialist itself...
It might just be a matter of stress, honestly, though I can't really give you a straight answer on those other points without digging much deeper into everything first... anyway, don't even sweat the details when you're explaining things, because let's be real, sexuality is just a standard part of being human, and there isn't a single thing about it that should bother any of us, so there's absolutely no reason for you to feel awkward or like this is some huge burden to carry...
The formatting on this is all over the place, honestly... why don't you just scan the whole thing and lay it out properly so we can actually see what we're dealing with in black and white? It’s nearly impossible to make sense of anything when your commentary is cluttered in there like this, though I suppose you're totally within your rights to demand a full breakdown from the hospital if the billing looks even slightly suspicious to you...
Well, this is a start, I guess. Your doctor probably asked you to pull every single thing possible from the lab to see if there’s even a fighting chance of sniffing out what's actually causing all your issues, though honestly, you'll likely end up needing to get your thyroid hormones checked next...
For a scar like that, you don't even need to go out and buy special treatments if everything stays dry... just make sure you keep it covered from the sun this summer and you'll be fine...