Posts by Kevin Garcia12

For that first morning urine sample, you’re supposed to do the "midstream" thing, where you let a little bit out first to clear the way before you start collecting the actual sample...

Look, you only need to be heading to an urgent care clinic for antibiotics if you start seeing red streaks creeping up your arm toward your body, or if there's actual pus or blood oozing from the wound, or if the finger is throbbing with intense pain and swelling, or if you’ve got a high fever kicking in alongside any of those symptoms... that's when you worry. If it's just looking a bit green, don't freak out, because once your immune system gets its act together, it'll clear that discoloration right up—it's just your macrophages doing their job, picking up the debris and hauling it off to the liver to be processed... 😁

Look, if you’re seeing green, don't freak out—it’s actually totally normal. It’s just what happens when the hemoglobin in your red blood cells starts breaking down, so there's really nothing to worry about...

Honestly, you really ought to sit down with a physiatrist about this whole thing because physical therapy isn't exactly my area of expertise, so I have no clue how much they can actually accomplish... I mean, it’ll definitely help ease any pain you're dealing with if that's what's bothering you, but whether it can actually straighten out a curvature? I highly doubt it, especially not when you're lugging around 45 pounds, though it certainly won't make things worse, so it might be worth a shot...

It’s tough...

Basically, it all comes down to how old you are, because if you're younger, you might be able to partially correct things through physical therapy or maybe even using some braces, but if we're talking about actual scoliosis, surgery is usually the only way to get any real results... though that’s definitely not for everyone and it’s certainly no minor procedure...

If this is really eating at you, my best advice is just to go see an orthopedic specialist and have a real conversation with them to see what kind of options are actually on the table for you...

Everything the ladies on this forum have pointed out is spot on, and honestly, blood pressure is almost certainly what's going on here... it can even make you pass out if it drops too low. If that happens again, just get yourself straight onto a couch or a bed, lie completely flat, and have someone prop your feet up on a pillow for at least ten minutes or so. If things settle down quickly after that, then 99% of the time it’s definitely your blood pressure, though obviously, the smartest move would be to actually get a reading right then...

I’m not going to get dragged into some endless debate about what someone did or didn't do, or what they should have done versus what they actually did...

So, I'll just lay out exactly how I handle things when there's pain in the kidney area—basically, once I determine that's the logical culprit...

Step zero: we check for a fever (if necessary, even in the middle of a rush) just to see what kind of fire we're fighting and how intense it is...

First off—effective, immediate pain management. The pain shouldn't be unbearable, period. If I can't manage to take the edge off for you, then you're heading to the hospital. What they decide to do once you're there isn't my call and I can't control it, but I'm certainly not sending anyone home in agony—unless they specifically ask to leave—just like I wouldn't send someone bleeding all over the ER floor, and I'm definitely not sending you to wander around a lab if it can be avoided. If it's strictly for technical reasons, I'll just bully the lab techs into coming over to the clinic to draw your blood while you're right here on my IV...

Second—if the lab and X-ray are open during normal business hours, you take my (emergency clinic) referral straight to the lab for bloodwork and a urine sample. If the lab is closed, I'll rely on those quick urine dipstick tests we have here in the clinic; they aren't quite as precise as a full lab panel, but they get the job done...
As for X-rays, it's case by case; I don't typically order them for simple colic...

Third—once I figure out whether an infection or a kidney stone is the more likely candidate, we go one of two ways...
a) Infection—antibiotics and a follow-up with your primary care doctor in 3 to 7 days (depending on the specifics). If it's just a bladder infection, that might be the end of it, but if it's kidney-related, your GP will tell you when to come back in, and the plan is usually to give you a referral for a follow-up urine test at a proper lab... And obviously, if you're hurting, you're getting pain meds, that goes without saying...
b) Kidney stones—I'll write you prescriptions for pain relief (though, unfortunately, they don't work the same way for everyone), and if you can't manage the pain at home, you head straight to the hospital—specifically the emergency urologist...

Regarding bacterial resistance, cultures, and all that—as an emergency provider, I don't run cultures and I can't even order them because, by definition, this is emergency care—it doesn't make sense to wait. However, in special circumstances, I've been known to refer patients with urinary tract infections to Infectious Disease specialists so they can do whatever needs to be done there, but those are exceptions, not the rule...

Bottom line: if after two rounds of antibiotics and a maximum of 20 days the urine results haven't cleared up and the symptoms haven't subsided, you absolutely need a culture and sensitivity test. As far as any regulatory inspector is concerned, I don't see how anyone could find fault with a procedure that follows basic medical common sense...

Chlamydia isn't just one thing; it’s actually an entire family of bacteria, and there are several different strains that can mess with humans—you've got trachomatis, Psitaci, and more recently, people have been talking about pneumoniae, so any one of those could be what we're looking at since they all have their own specific subtypes...

Basically, those last two are respiratory chlamydias, which means they can easily spread to your eyes just like a ton of other bacteria and viruses do—they travel up through the tear ducts from the nose, so you don't necessarily need to freak out about that part. I mean, obviously getting checked out by your gynecologist is a smart move to stay on top of things for your own long-term health and peace of mind, but it doesn't have to be this huge, terrifying source of infection... 😉