Medical Questions I'd Like Answered...

tussock · Post by **tussock** » Sun Oct 05, 2014 4:16 am

Computer displays have a colour temperature. Use the 9300 in the daytime and the 6500 for a few hours before bed, or whatever yours is. Get an app to switch it automatically if you can find one. Use a reddish hue bulb in your bedroom and move in there before sleep is due.

Basically tricks some primitive part of your brain into thinking the sun is going down and you'll need to go to sleep soon. Not drinking any caffeine for at least six hours before bed also helps, as does avoiding late snacks and staying at a comfortable temperature. Avoid twitchy computer games or arguments, late news about dangerous or outrageous things.

Basically, think about what would keep your kids up late, and don't do any of that.

Meikle641 · Post by **Meikle641** » Mon Oct 06, 2014 12:20 am

f.lux is a good program for day and night cycles.

radthemad4 · Post by **radthemad4** » Mon Oct 06, 2014 2:13 am

Thanks

fectin · Post by **fectin** » Thu Oct 09, 2014 2:17 am

Assuming you managed to expose yourself to Ebola, what's your likelihood of having a bad time?

Edit: nothing more than curiosity, by the way.

erik · Post by **erik** » Thu Oct 09, 2014 2:53 am

fectin wrote:Assuming you managed to expose yourself to Ebola, what's your likelihood of having a bad time?

Edit: nothing more than curiosity, by the way.

100%. Unless you like the love and attention of being quarantined or the anxiety of worrying if you contracted it.

There's also different flavors of Ebola, with differing levels of infectiousness, but I assume you refer to the "Ebola Virus" (formerly Zaire Ebola Virus) variety in the news because I'm a reasonable person. It's the most dangerous variety of ebola known.

If you mean what are the odds of contracting it based upon exposure, probably depends upon any number of things, mostly what constitutes your level of exposure. It doesn't take a lot of virus particles to infect you, but it isn't easy for you to encounter the virus in a manner in which it could infect you.

So very infectious, but not very transmissable.

[edit: and if you just meant, how fatal is it? something like 50-90%, but that also depends upon level of care. In the U.S. we have a better survival rate but a much smaller sample size]

DSMatticus · Post by **DSMatticus** » Thu Oct 09, 2014 2:59 am

Like erik is saying, that is basically impossible to answer without specifics about the exposure incident. Not all exposure is created equal.

If you definitely have it and are totally going to develop symptoms, it is basically a coinflip whether or not you have a bad time or the worst time. Comprehensive early care helps your odds a lot, so if you plan on catching Ebola try to do so in a region with properly developed medical infrastructure.

radthemad4 · Post by **radthemad4** » Mon Oct 20, 2014 7:26 pm

They're around 10 bucks, so I figured I'd try out some amber sunglasses. I've been using them for a few days (wearing them roughly an two three hours before bed time), and am not entirely sure if they're affecting me (I feel less sleepy during the day these days but it could also be avoiding night carbs, avoiding videogames at night and not staying up ridiculously late). Whether or not they're doing anything, I don't regret the purchase as I kinda like the aesthetic. I had mixed feelings about it in Deus Ex HR, but the real world actually looks kinda nice IMO with this tint.

Starmaker · Post by **Starmaker** » Fri Oct 24, 2014 11:08 am

I've been feeling like I have an alien in my chest for the last month or so. What else could it be?

Username17 · Post by **Username17** » Fri Oct 24, 2014 12:24 pm

Starmaker wrote:I've been feeling like I have an alien in my chest for the last month or so. What else could it be?

Most things in the chest have to do with the respiratory system, the cardiovascular system, or the gastro-intestinal system. But there are of course also spinal issues, rib and muscle issues, and in over ninety percent of the time just for women: breast issues.

So the first question is whether it feels painful or merely obstructive. The second question is whether it is positively or negatively associated with physical activity or eating/drinking. The third question is whether you can see or feel anything or if it's "just a feeling." And the fourth question is whether the alien feeling limits your activities in any way.

Once we get the answers to those questions, it starts hydraing out. The initial description makes me think of asthma, pneumonia, gastro-esophageal reflux disorder, and of course cancer. But you're throwing a pretty wide net and "all signs and symptoms could be cancer" is just sort of universally true.

-Username17

fectin · Post by **fectin** » Fri Oct 24, 2014 1:55 pm

What symptoms aren't a possible sign of cancer?

Username17 · Post by **Username17** » Fri Oct 24, 2014 2:00 pm

fectin wrote:What symptoms aren't a possible sign of cancer?

Literally none. Cancer can mimic any disease state. It's cells bhaving abnormally, and that abnormal behavior could by definition include behavior that would be normal responses to diseases you don't have.

Low blood sugar? Insulinoma. And so on. For literally everything that could possibly be wrong with you.

-Username17

Nachtigallerator · Post by **Nachtigallerator** » Fri Oct 24, 2014 2:31 pm

I was going to post a laundry list of literally everything I could think of relating to "chest pressure" (I think I got to 20 in 2 minutes, not counting various kinds of cancer seperately), but Frank beat me to it. Just adding that if it's persisting for a month, you should get it looked at in person.

The thing about everything being a sign of cancer is irritating, but true. Including "absolutely no symptoms". In the hematology lecture, we saw a patient with rashes, recurrent skin infections, and extreme skin reactions to insect bites - turns out he had chronic lymphatic leukemia with skin involvement.

It's an easier guess if you meet the patient in a hematology lecture, of course.

Starmaker · Post by **Starmaker** » Fri Oct 24, 2014 8:19 pm

It feels like there's a smallish snake crawling up and down my spine from the waist to the base of the skull, coiling and uncoiling, and occasionally falling asleep. It doesn't interfere, and seems uncorrelated, with eating, sleeping, and physical activity. A couple of times per day I feel like coughing out of irritation, but I can suppress it easily, and coughing doesn't actually bring relief.

I'm going to a clinic tomorrow to visit a GP and collect specialist tickets and insurance paperwork (although, if it's gastro-esophageal, insurance will be of no help because there's no way I'm swallowing one of those infernal hoses without general anaesthesia).

Thank you!

fectin · Post by **fectin** » Fri Oct 24, 2014 10:43 pm

I was hoping at least "contusions" or "broken bones" would be not-cancer, but I suspected it would be a very small list.

Username17 · Post by **Username17** » Fri Oct 24, 2014 10:49 pm

fectin wrote:I was hoping at least "contusions" or "broken bones" would be not-cancer, but I suspected it would be a very small list.

Nope. It's called "pathological fractures." That's when the cancer either directly undermines the integrity of the bone or hormonally provokes demineralization that undermines the strength of the bone. It is literally possible for "I fell down and broke my arm" to be a sign of cancer.

-Username17

fectin · Post by **fectin** » Fri Oct 24, 2014 10:59 pm

Amazing.

Grek · Post by **Grek** » Fri Oct 24, 2014 11:25 pm

Nachtigallerator wrote:The thing about everything being a sign of cancer is irritating, but true. Including "absolutely no symptoms".

Going to call bullshit on this right here.

P(no symptoms|cancer) < P(no symptoms|no cancer), and therefore any right-thinking person should conclude that a lack of symptoms in a patient should lower the doctor's confidence in the patient having cancer.

Nachtigallerator · Post by **Nachtigallerator** » Sat Oct 25, 2014 1:19 am

That is true if you approach it from a diagnostic perspective, but I don't see how that perspective is implicit in my statement.

If I made a list of cancers, a number of them would have what boils down to "no clinical signs before it's too late" as their symptoms. If I showed you a perfectly healthy-appearing person, they could still have leukemia hidden in their bone marrow. In that sense, what I said is correct, and I didn't mean it in any other way.

Edit: In retrospect, that was a stupid way for me to put it. What I meant to say is that cancer could indeed have any symptom, including "none at all" even if it's fairly advanced. You're right to point out that a symptom is not the same thing as a sign.

Starmaker · Post by **Starmaker** » Wed Oct 29, 2014 2:44 pm

So after some bureaucratic shenanigans compared to which, to quote John Oliver, waking up as a cockroach is normal, they stuck a hose down my throat and I now have the diagnosis (translation provided by wikipedia):

erosional reflux esophagitis
abnormal relaxation of the cardiac sphincter
mucosal anemia
duodenal ulcer
high stomach acidity, but no h. pylori somehow (???)

What's the general treatment for this? I'm asking because while I'm going to a doctor tomorrow, it'll be my only visit in quite a while and I might not recognize she's talking bullshit right away. To illustrate, I know a lot of people subscribe to the two liters hoax on the advice of their doctors, and in the same clinic, a neurologist I visited on the off chance something's wrong with my spine told me I made up the chest pain for attention because I wasn't getting enough dicking; if people like that work in the clinic, the possibility of lower-flying bullshit to fly under the radar is rather high.

Username17 · Post by **Username17** » Wed Oct 29, 2014 5:38 pm

Erosions, also called ulcerations, normally happen in the GIT for one of two reasons: either the area is being exposed to more acid than it can handle with a combination of mucous protection and cellular replacement, or h. pylori infestation. If you have h. pylori, you can get some pretty serious GI bleeds, but the cure is also really simple: you take a course of antibiotics and move on with your life.

If you don't have a bacterial cause, then you're looking at a mismatch between acidity and the lumen's ability to protect itself. For the esophagus, that's really any amount of acid, because the esophagus isn't really supposed to get stomach acid in it. A poor cardiac sphincter (called such because it's on the side of the stomach next to the heart, not because it has blood running through it) will allow stomach acid to go up the esophagus where it causes erosion of the esophageal wall. If stomach acid is high, it can penetrate the mucus of your stomach and cause erosions there, but it can also damage the duodenum if the acid is enough to overwhelm the bile and pancreatic juice in the duodenum and remain acidic.

Anyway, what you're probably looking at is an acid reducer. The go-to medicines these days are proton pump inhibitors. They reduce the amount of acid in the stomach, which in turn will reduce the damage you get to the duodenum and esophagus and allow healing to catch up and hopefully surpass erosion. For someone of your size, you'll probably get like 20 mg of esomeprosol, to be taken once a day about half an hour before your first meal.

And yes, I have pretty much the same thing myself (although not the duodenal ulcer part). PPIs will make you fart to a degree you never thought possible. Not stinky farts, but like enough gas passing out of your rectum that you wouldn't have thought it possible for your intestines to physically fit it all in. Embarrassing, but it really does beat bleeding to death.

-Username17

Post by **fbmf** » Wed Oct 29, 2014 9:20 pm

My mother has been diagnosed with (her words, dictated to me from the paper she received from her doctor) "Foci of the T2 hyperintensity are present in the periventricular and deep white matter of the bilateral cerebral hemispheres, suggestive of demyelinating changes, likely from chronic microvascular angiopathy".

What the hell does that even mean?

Game On,
fbmf

Username17 · Post by **Username17** » Wed Oct 29, 2014 10:32 pm

fbmf wrote:My mother has been diagnosed with (her words, dictated to me from the paper she received from her doctor) "Foci of the T2 hyperintensity are present in the periventricular and deep white matter of the bilateral cerebral hemispheres, suggestive of demyelinating changes, likely from chronic microvascular angiopathy".

What the hell does that even mean?

Game On,
fbmf

OK, first off "T2" refers to a kind of MRI imaging. It's one of the kinds of images that an MRI machine can spit out, and it happens to be good at spotting white matter lesions (also a bunch of other things, but white matter lesions is what we're looking at right now).

The white matter of the brain is the region that has relatively more axons (the tubes that run between nerve cells) and relatively less cell bodies. It's white because of the oil-rich material that runs around the axons called myelin. The myelin acts kind of like the insulating coating on a wire and improves the electrical conduction down the axon. Demyelination is when the cells that provide the myelin sheaths are damaged or destroyed - and the result is kind of like stripping wires in your house. It causes poor conduction in impulses between nerve cells and sometimes short circuits.

There is white matter in every part of the brain, because there are axons running from every nerve cell body. If there are lesions bilaterally in the cerebral hemispheres, that means that both the right brain and the left brain have lesions in them.

Microvascular angiopathy is disease of the little tiny blood vessels that do the door to door work in bringing blood to where it's needed. Like the capillaries under your fingernail - if you press on your fingernail, it forces blood out of the microvasculature, turning that area of the nail white. And when you remove the pressure, blood flows back into those capillaries and your nail turns pink again. Now there's also microvasculature in pretty much every other part of your body, but you can't see it nearly as well in most places. So if there's inflammation or pressure on those little blood vessels in the brain, then blood won't go through and the cells downstream of that will suffer.

So put that all together and they did an MRI and found that there were little areas in a bunch of places on both sides of the brain where the myelin had been damaged. And their hypothesis is that there is some kind of problem with the tiny blood vessels that feed the myelinating cells in those areas. And they are guessing that it's an ongoing process that has been going on for a long time and is still ongoing (hence: chronic).

Now here's the part where you stop freaking out: about a third of healthy elderly people have demyelinating lesions in their white matter. Just like you can totally strip a wire and still run power through it (at a mere increased risk of burning down your house), most axons will still function (albeit slightly slower) with the myelin stripped off. It's not ideal, but the brain is pretty plastic and performs workarounds for that sort of thing all the time.

Hope that helped.

-Username17

Chamomile · Post by **Chamomile** » Thu Oct 30, 2014 12:59 am

Starmaker wrote:in the same clinic, a neurologist I visited on the off chance something's wrong with my spine told me I made up the chest pain for attention because I wasn't getting enough dicking;

Does he just hate having your business or something? I cannot imagine how stupid he has to be to say this to a customer even if he sincerely believes it. Doesn't seeing fewer patients give him less money? So if someone is fabricating medical problems for him to examine, doesn't that work out great for him?

fectin · Post by **fectin** » Thu Oct 30, 2014 1:35 am

Myelin is stupidly complex, especially in the brain. Learning how it worked was so stupidly hard that half the people in the major which had to do that switched majors between first and second semester of my senior year, and that was in peripheral nerves where it mostly doesn't do any signalling.

That's not to contradict Frank, just to emphasize that your nervous system is stupidly complex, but also stupidly robust.

Occluded Sun · Post by **Occluded Sun** » Thu Oct 30, 2014 3:01 am

Chamomile wrote:Does he just hate having your business or something? I cannot imagine how stupid he has to be to say this to a customer even if he sincerely believes it.

I don't know where Starmaker lives, but at this point in time, medical patients aren't the customers almost everywhere in the developed world. It's the people/organization who pay who are the customers.