Medical Questions I'd Like Answered...

Count Arioch the 28th · Tue Dec 10, 2019 7:32 am

FrankTrollman wrote:Weird side question: if your GGT is up and your ALT and ALP are normal, is your PSA up?

-Username17

Your guess is as good as mine, that's not something that was tested.

erik · Post by **erik** » Sat Dec 28, 2019 2:34 pm

Ghost dammit. ProTip: Never google something health related on a lark when feeling crappy.

erik: "LOL. Hey google, is my brain draining out my nose?"

google: "Surprisingly plausible!"

Maj · Post by **Maj** » Sun Dec 29, 2019 5:50 am

Right? I remember googling things to unstuff a nose and I ended up with congestive heart failure. I tend to use European websites when I want to look up health information now because they're much less hysterical.

DrPraetor · Post by **DrPraetor** » Mon Dec 30, 2019 12:50 am

https://www.youtube.com/watch?v=9oFQzvPUzeU

https://www.youtube.com/watch?v=3obig1XeOlw

Libertad · Post by **Libertad** » Mon Dec 30, 2019 7:58 am

Which country has the best healthcare system?

Username17 · Post by **Username17** » Mon Dec 30, 2019 10:35 am

Libertad wrote:Which country has the best healthcare system?

Depends on what you value. Just for starters, are you concerned about cost? Because Cuba gets absolutely ridiculous value for their economic investment, getting overall unexceptional Western outcomes with a very small amount of money. That would make them the best per dollar, but whether that's even a question that concerns you is an open question. There's also a question of how much you care about how much the users of the system like it. Because the Dutch fucking love their system, while the French get mildly better outcomes on slightly less money; but the French hate everything because they are French.

Direct comparison of healthcare systems is harder than you'd think. People do a lot of things that shorten their lives that aren't directly related to the healthcare system and some populations genuinely are genetically healthier than others (although healthcare systems and environment play such a large part that this is really hard to prove with the data we have). Also, health coverage has to cover people and also regions. It's much easier to provide healthcare to a city than it is to provide healthcare to a countryside. So countries like Canada, Australia, and the United States are operating with a restriction that they are also attempting to provide healthcare to people who live in the proper wilderness while countries like Hong Kong and San Marino just don't.

A broad characterization is that more government controls leads to lower costs. Across the board. No question. The more involved the government is with healthcare the less the total costs are. This can go overboard, the UK spends less than 8% of GDP on its NHS and that's too little.

-Username17

Fwib · Post by **Fwib** » Mon Dec 30, 2019 1:59 pm

Libertad wrote:Which country has the best healthcare system?

I know I learned that I knew a lot less than I might have thought about various national health care systems watching Healthcare Triage's series on them: https://www.youtube.com/playlist?list=P ... g_KkYfJ6oF

Iduno · Post by **Iduno** » Wed Jan 22, 2020 9:02 pm

My knees are bad, and are only likely to get worse.

Kneecaps slide side-to-side when the knees bend, which is apparently not normal or good.

Therefore, I'll be needing a cane in not too long. Why do some canes bend so you center of the force you put on it is right above the straight part of the cane, while other handles are off to the side?

Maj · Post by **Maj** » Thu Jan 23, 2020 12:28 am

They didn't offer you physical therapy?

Iduno · Post by **Iduno** » Thu Jan 23, 2020 1:38 am

Maj wrote:They didn't offer you physical therapy?

No, I don't have one of the good HMOs. I was told that if I exercise enough, I will be in less pain, and when it gets too bad, they'll replace my knees. It was fairly expensive to get that, and I know better than to mention it possibly being work-related. Insurance and the employer refuse payment if it's work-related.

Maj · Post by **Maj** » Thu Jan 23, 2020 2:12 am

I had a roaming patella (and the exercises were also mostly the same for my son's Osgood-Schlatter's). I think I still have the how-to sheets that they gave me. Do you want me to scan them in and send you the exercises? With those and YouTube you can probably do your own physical therapy. Just remember to do them until it's hard to do, but don't push yourself much past that or you might hurt yourself.

Username17 · Post by **Username17** » Thu Jan 23, 2020 11:28 am

Iduno wrote: Therefore, I'll be needing a cane in not too long. Why do some canes bend so you center of the force you put on it is right above the straight part of the cane, while other handles are off to the side?

Different walking sticks are for different things. The most basic question is whether you're using the stick to offload weight from your legs or to maintain balance. Transfering weight wants to push down as directly as possible into the shaft. Offsetting torque wants the stick farther away for leverage.

-Username17

Iduno · Post by **Iduno** » Thu Jan 23, 2020 2:02 pm

FrankTrollman wrote: Different walking sticks are for different things. The most basic question is whether you're using the stick to offload weight from your legs or to maintain balance. Transfering weight wants to push down as directly as possible into the shaft. Offsetting torque wants the stick farther away for leverage.

-Username17

Interesting. It's mostly trying to get up stairs with two bad knees. Luckily, one is usually better than the other.

Maj wrote:I had a roaming patella (and the exercises were also mostly the same for my son's Osgood-Schlatter's). I think I still have the how-to sheets that they gave me. Do you want me to scan them in and send you the exercises? With those and YouTube you can probably do your own physical therapy. Just remember to do them until it's hard to do, but don't push yourself much past that or you might hurt yourself.

Actually, that sounds good. Thank you.

Woot · Post by **Woot** » Tue Feb 11, 2020 2:05 pm

Thoughts on the Chinese coronavirus?

deaddmwalking · Post by **deaddmwalking** » Tue Feb 11, 2020 2:54 pm

Woot wrote:Thoughts on the Chinese coronavirus?

First off, it's probably not as dangerous as you're being led to believe. That does not mean it isn't dangerous and that you should ignore it, but a narrative of 'we're all going to die' gets more clicks than a reasoned analysis.

Currently, we don't yet know how contagious it is. Some diseases you can spread before you show symptoms - others spread when a jerk coughs all over you at point blank range. Regardless, like with most diseases, proper hygiene and frequent hand-washing are important.

Based on known cases and the number of deaths, approximately 2% of patients die. This number is probably significantly higher than the actual mortality rate. Many people have probably had the coronavirus WITHOUT symptoms that were serious enough to require hospitalization and confirmation of the virus - lots of people who thought they had a cold or mild flu actually had this and are basically fine.

Like any respiratory illness, some people are much more likely to die than others. The part that makes these diseases scary is that some otherwise healthy people will die. Most often, it is because those people didn't respond to their symptoms appropriately. If you feel sick, even if you think it's minor, it's probably worth talking to your doctor. In the past two weeks I've had Type-A Flu followed by a Strep infection and my doctor has seen exactly that pattern. Get treatment where appropriate and don't just assume that you'll get better on your own - while it may be true the risks are significant enough that it's worth seeking medical attention.

Iduno · Post by **Iduno** » Tue Feb 11, 2020 5:40 pm

Also, as a virus, antibiotics won't help. People will still use antibiotics to cure it.

DSMatticus · Post by **DSMatticus** » Tue Feb 11, 2020 10:34 pm

deaddmwalking wrote:Based on known cases and the number of deaths, approximately 2% of patients die. This number is probably significantly higher than the actual mortality rate. Many people have probably had the coronavirus WITHOUT symptoms that were serious enough to require hospitalization and confirmation of the virus - lots of people who thought they had a cold or mild flu actually had this and are basically fine.

China is absolutely manipulating its own statistics because of course they are, and there really haven't been enough cases outside of China to say anything with confidence. The people with guestimates are making the best of data everyone knows isn't completely accurate. This is definitely a case where the sampling bias cuts both ways.

That said, China would look very different right now if this were truly another Spanish flu, and even the Spanish flu failed to be the end of civilization. I suppose there's always the chance it'll pull a smallpox and just absolutely fucking murder populations that haven't built up a resistance from fighting its cousins, but I doubt it - that's the sort of thing you'd expect to happen in the age of sail and not the age of jet engine.

Captain_Karzak · Post by **Captain_Karzak** » Wed Feb 12, 2020 3:21 am

Sorry if this is incoherent. I'm out of med doses for the day.

On the advice of my psychologist, I went to see a psychiatrist yesterday for diagnosis and pharmacological treatment of suspected ADHD (inattentive presentation). I was told to expect a lot of testing and review of documentation (work/grade performance) to determine if had this condition.

Instead it was a weird session and I dunno if the psychiatrist really believed me, but he prescribed me 15 days of adderall (15 mg immediate release, 1 tablet per day) after asking me in depth about my symptoms and several questions checking for contraindications.

So I walked out with a prescription for a schedule 2 med, but I am still unclear whether I have ADHD! I guess he'll tell me when I see him again in 16 days????

Unlike my antidepressants whose effects have been so subtle / insufficient that I can't tell if they do anything, the adderall had substantial effect when I took it this morning.

One one hand, I felt a weird sort of calm that is hard to describe, on the other hand I felt much happier. I've been depressed so long that I don't remember what it felt like to not be depressed. So I don't know if my affect was euthymic or euphoric [I have no friends so I can't easily get any feedback on this].

I also felt more sociable and better able to focus (able to read my textbook). I met with my psychologist in the morning before peak drug levels, and she seemed okay with the effect it was having on me. A few hours later I met with the school nutritionist and I think I came off a bit... odd. She seemed concerned. I dunno why.

That was hours ago though and I am sooooooo sleeeeepppy now and posting on TGD instead of doing my reading for my midterm tomorrow. Oh man this took me a long time to write.

Is all this normal? I am confused by what I have read online because it is such an abused drug and I am uncertain about my diagnostic situation. And if it is normal, when I go back to the psychiatrist, should I ask to try different ADHD meds, or just focus on titrating the adderall? Cause I don't understand how my psychiatrist determines which of the various ADHD meds is right for me without seeing how they each affect me.

phlapjackage · Post by **phlapjackage** » Wed Feb 12, 2020 3:33 am

Woot wrote:Thoughts on the Chinese coronavirus?

If I can be selfish for a moment...living here, it's been great, in that things have been so quiet and peaceful. No/few people or cars on the road. No construction at 3am. For an introverted shut-in like me, having an iron-clad excuse not to leave the apt has been great.

Maj · Post by **Maj** » Wed Feb 12, 2020 5:39 am

Captain_Karzak wrote:Is all this normal? I am confused by what I have read online because it is such an abused drug and I am uncertain about my diagnostic situation. And if it is normal, when I go back to the psychiatrist, should I ask to try different ADHD meds, or just focus on titrating the adderall? Cause I don't understand how my psychiatrist determines which of the various ADHD meds is right for me without seeing how they each affect me.

If it causes you no major side effects, AND it helps you, there isn't really much need to go trying a lot of medications. Most doctors use Adderall first because it's so effective.

My husband had ADHD, and my son has it. Ess was able to take Adderall, but my son was not. It made Gi waaaay over emotional, and he wet the bed, and so he had to try something else (methylphenidate, aka Ritalin). Ess' only side effect was a massive cleaning spree. Needless to say, absolutely no one considered that a problem.

From what we went through, psychs want to make sure they're not over-diagnosing. We scored, though, when we were talking to my mother-in-law about what Giovanni was going through... She started commenting about how similar Gi's behavior was to my husband's when he was a kid. Having a letter from her about Ess' issues in childhood went a long way toward cinching the diagnosis. If that is available to you (teachers or parents or whatever), then I recommend you get that - part of ADHD diagnosis is presentation of symptoms before puberty.

If you're unsure about your diagnosis, go read about it. Do a self-assessment to see what they're looking for (like this one in PDF format).

Good luck.

Captain_Karzak · Post by **Captain_Karzak** » Wed Feb 12, 2020 6:52 am

Maj wrote: If it causes you no major side effects, AND it helps you, there isn't really much need to go trying a lot of medications. Most doctors use Adderall first because it's so effective.

Thank you, Maj!

It's just that the realization that so much of my dysfunction could be alleviated by ADHD meds makes me really really want to optimize my choice of medication. There's no easy way to predict their efficacy without trying them.

I did very little to advocate for my treatment of my depression and as a result I've gone long periods of time with meds that have little to no discernible effect. I don't want my diffidence to undermine my treatment of ADHD as well.

These symptoms that pharmaceutical stimulants alleviate have been such a huge drag on my ability to succeed at anything in life and now it seems that if I can get the right drug at the right dose I don't have to be such a loser anymore.

Maj · Post by **Maj** » Wed Feb 12, 2020 7:15 am

I cannot personally relate to how you feel. I have only watched two people bloom because we realized there was a medication to help alleviate a problem they suffer from. It was life-changing for all of us. I hope the best for you.

Since you don't have a strong history of self-advocating, I'd like to suggest a tool for checking in with yourself. There is a questionnaire that I have to turn in every time my son has an ADHD medication change. I fill out one, and his teachers fill out another.

While I know that self-assessment isn't always the most accurate or easy thing, the assessment at least gives you behaviors and activities that are most commonly affected by your medication. Maybe using these as prompts so you can gauge how well your medication is working, and how that changes over time, will help you have something to take in hand to your doctor so you can advocate for yourself better. Here's a link to the PDF version of Vanderbuilt Assessments. ALL of the different versions (six in total) are there - some include side effects and some don't - but I wouldn't think that you'd need to use all of them. Maybe just one. Or part of one and part of another.

Stahlseele · Post by **Stahlseele** » Wed Feb 12, 2020 3:39 pm

As for the Corona Virus:
Right now, it dominating the news and stopping people from reporting on this seasons Flu Outbreak is for the most part the biggest issue.

In Germany Alone, i find numbers of 1800 in Hamburg alone and 35000+ in the whole of Germany.
This could be a much bigger and potentially more dangerous epidemic and nobody in the news is talking about it.
The fact that both it and the Corona Virus have broadly similar symptoms and potentially the same end does not make it much better either . .

Username17 · Post by **Username17** » Wed Feb 12, 2020 3:51 pm

Influenza killed more people than firearms last year. It will kill more people than firearms next year too.

-Username17

Stahlseele · Post by **Stahlseele** » Wed Feb 12, 2020 4:54 pm

And nobody bats an eye.
Untill we get one where our innoculations do not work anymore.
Then we may just be facing an actual extinction event pandemic.