Medical Questions I'd Like Answered...

Judging__Eagle · Post by **Judging__Eagle** » Sun Sep 13, 2015 3:35 am

[I originally posted this in the "Annoying Questions" thread, as I didn't notice this thread, and didn't realize one for medical concerns existed on MPSIMS. I obviously don't use this sub-forum a lot.]

An immediate family member of mine (my father) suffered a very severe vehicle collision in Peru (breaking: 8 ribs, humerus, tibia, fibula; however, pretty much everything other than the collision itself has been incredibly lucky (no other fractures, no spinal/cerebral injuries); from their being able to contact their worksite via cellphone for help in spite of their immediate injuries & being able to attend the phone when their call was dropped due to poor signal (an event they will likely never recall due to traumatic amnesia), surviving a 4 hour drive across Andean mountain roads to medical care, to being transferred to a first rate private clinic (instead of staying at a public hospital), miraculously surviving intubation linked pneumonia (the clinic director's words to my family)) about 3 months ago; and was finally discharged from the hospital about a week ago.

At our follow up with our family physician yesterday I finally was told that the fungal infection they are taking Voriconazole for is for a strain of Fusarium.

Additionally they are on a daily Vancomysin IV (750 mg in 250 mL NaCl mix) regimen (our wonderful Canadian public health system sends a nurse daily for this); and have a VAC (Vacum Assisted Closure) dressing on their tibia to assist with the healing of their remaining wounds.

The concern that my family has is that the Vancomysin and/or Voriconazole prescriptions may continue indefinately; is it legitimate?

Also, our family physician said that the Fusarium infection is in some manner uncommon (it's likely due to the dirt that got into wounds as a result of rolling off a paved road and down a dirt hill); is that cause for long term concern as well? That is to say, is there a high likelihood that they will be on antibiotics and antifungal medication for the rest of their lives? (most healthcare people we've asked haven't been able to answer one way or the other).

[Related, but non-medical concerns regarding health insurance interfering with treatment, and involvment with the the Ontario Workplace Safety & Insurance Board due to this being a work related injury]

There are other legal and health insurance linked concerns, as well. The insurance company mandated that all "non life or death" treatment be not administered for as much as 11 days; and it is most likely that the Fusarium infection took hold during that time period. Additionally, the Ontario WSIB (Workplace Safety & Insurance Board; a provincial employee insurance institution) is involved, as this injury happened as a result of employment; our family still hasn't signed off on allowing them to sue whoever they need to (and from what the scant legal council we took, it's likely they'll go after someone we don't expect).

Finally, there's the issue of recuperation. Spending five weeks in the first stage of treatment, being uselessly transferred and kept immobile for two weeks before being transfered to a more local hospital, and then only a few more weeks in a hospital's rehabilitation floor; resulted in obvious loss of baseline stamina and body mass. We've were supplementing the hospital diet with high protein vegetable multi-vitamin powder; as well as using Pumpkin seed powder, Hemp seed powder and Brown Rice powder (my brother picked up from the Whole Foods they work at; they've been a vegetarian/vegan weightlifter for about a decade now) to help maintain a high level of protein to rebuild muscle mass. In many ways the supplements to my father's diet have helped (the VAC dressed wound seemed to not have healed very much until after he was getting about 1L of these shakes taken to him daily, but that could be coincidental); and he's actually put on some muscle mass (still very skinny; but he's regaining some portion of the 50+ lbs he lost). Are there other recommendations for diet or exercise that might also help? I've been assisting them with completing the exercises their Physiotherapist outlined; but I've been also showing them the flexion-and-holding exercises that I used to add four inches to my chest (going from 36" to 40" in 3~ months); and I'm considering adding resistance training (yes, weightlifting, but I'd likely start them off with the 1/3 lb locking nut I used to keep the plates on my barbell than an actual weight plate); would resistance training be a useful addition to Physiotherapy?

I'm sorry if this is not a single question, and is instead of a lot of tangentially related questions concerning a specific issue. However it's also sort of a big deal that's made our family change everything else we're doing in order to assist in my father's convalescence (he wants to get back to work, even if taking a shower right now involves an assistant; and their corporations national projects supervisors came to visit them at the hospital telling him they looked forward to putting him into a desk position (no driving on mountain roads) when they recovered).

Prak · Post by **Prak** » Sun Sep 13, 2015 3:44 am

Morat wrote:
Prak wrote:What is the actual physiological cause of the pain and discomfort experienced when a lactose intolerant person eats dairy? Is it a pressure thing from the accumulation of gas? Not that I'm going to do this, but would creating a direct vent for the stomach/intestines, like say through a needle or cutting, resolve the pressure?
The lactose that could have been digested in your small intestine by you and then absorbed (if you were a weird mutant milk-drinker) instead passes intact to your colon where it is then fermented by bacteria. The undigested lactose raises the osmotic pressure, and you end up with more water in your intestines because the water is trying to equalize the amount of stuff dissolved in it on each side of your intestinal membrane. The more dissolved stuff in your intestines, the more water flows in to dilute it. The extra water also expands your intestines, which speeds them along and makes you digest even less stuff. That's where the diarrhea comes from, your shit is liquefied because there's too much water.

The other thing is that much of the byproducts of the fermentation of the lactose are indeed gases. This is where the other symptoms come from. So, theoretically, you could build something that would remove the gases. But you wouldn't be able to solve the diarrhea problem unless you just pumped the rest of it out, too, not just the gases.

Ah, thanks. In the delirious mind of pain I had this morning, I started thinking about having a dragon that unknowingly ate (a lot of) dairy as an encounter in D&D, and instead of being a lethal combat encounter, it's just this massive, miserable firebreathing lizard lying somewhere semi-secluded and flaming anyone who comes too close until the PCs find a way to help him.

It stopped sounding like a good idea once I was finally able to get some sleep and stand up not doubled over in pain from cramps.

Stahlseele · Post by **Stahlseele** » Sun Sep 13, 2015 10:46 am

Birds pooping on you from above is bad enough, can you imagine that from something the size of a dragon? x.x

Prak · Post by **Prak** » Sat Sep 19, 2015 11:12 pm

Last time I weighed myself, I was 344 lbs on the 22nd of August. I just weighed myself today, and the scale said 311.4, and I double checked, weighing myself a second time.

So, essentially, I've lost an average of 1.2 lbs per day, for a total of 33.4, over the last 28 days.

As awesome as that is, I'm a bit concerned, especially since the most athletic thing I've done is get fucked the other day, and that was unusual. I've always heard that more than 2 lbs per week is unsafe.

Should I be concerned, or should I just be happy with losing 30 lbs by doing more baking and going back to school (and thus walking more)?

Kaelik · Post by **Kaelik** » Sat Sep 19, 2015 11:19 pm

A significant increase in how much you walk, if you previously lived entirely sedentary, counts as significant exercise.

erik · Post by **erik** » Sat Sep 19, 2015 11:45 pm

Yah, walking more can do it if you were devoid of exercise.

2lbs per week is mostly a guideline for closer to normal weights. If you didn't lose that weight by starving yourself the you're probably fine. I don't mean this harshly, but you had more weight to lose and it was probably against your baseline metabolism to be at that weight (i.e. it needed an excess of calories with no burning of calories to support maintain weight).

I wouldn't be concerned. I'd take it as a guide and consider taking longer routes to get everywhere for classes on foot. Congrats and keep at it.

Maj · Post by **Maj** » Sun Sep 20, 2015 12:51 am

A pound per day?! I would get your blood sugar checked.

erik · Post by **erik** » Sun Sep 20, 2015 1:06 am

If he hadn't started regular exercise then diabetes could be a likely concern but exercise is sufficient explanation. There's no harm in getting a blood sugar test but at this point and with no other indications (numbness, excessive thirst/urination) I would not be filled with concern. Weight loss with no explanation is what is a concern for diabetes.

Maxus · Post by **Maxus** » Sun Sep 20, 2015 1:15 am

erik wrote:If he hadn't started regular exercise then diabetes could be a likely concern but exercise is sufficient explanation. There's no harm in getting a blood sugar test but at this point and with no other indications (numbness, excessive thirst/urination) I would not be filled with concern. Weight loss with no explanation is what is a concern for diabetes.

At that level of weight, just cutting back on the junk food and going for walks can do it. I weigh a hundred pounds less than Prak (well, less than a hundred pounds less. Like 80 pounds) and can start shrinking if I go cold turkey on soft drinks and sweet tea and just go to work, which involves a lot of walking.

Prak · Post by **Prak** » Sun Sep 20, 2015 2:01 am

Going back to school's been giving me some more walking to do. I was parking across the street from campus and getting at least a good five minute walk from my car to the classroom, and even if that's just a couple times a week, it's something. My lab class in on another campus and up three levels from the parking lot (and taking the elevator makes me feel fatter than I am), so there's that. And running around even a small kitchen baking does give one a certain amount of exercise.

Occluded Sun · Post by **Occluded Sun** » Tue Sep 22, 2015 8:50 pm

Even a seemingly modest amount of exercise is 'worth more' when you're fat. You're moving more mass around.

It doesn't quite seem that the levels of exercise you describe are sufficient to account for your weight loss. But if your diet has also decreased the calories you're consuming, it makes perfect sense.

Prak · Post by **Prak** » Mon Sep 28, 2015 9:27 am

I had a thought earlier while talking to a friend about the mental issues I suspect I have and how being in a relationship helps me a lot in my mental state.

It seems that there is so research being done into Oxytocin as a treatment for depression and anxiety. Is it possible that "serial monogamists," of people who otherwise continually seek out relationships, with the ideal seeming to be getting into a new one right as the old one is ending, or highly promiscuous people are basically subconsciously trying to self medicate with Oxytocin?

Chamomile · Post by **Chamomile** » Thu Nov 19, 2015 6:38 am

So, every November my psyche kind of collapses on itself and I can barely function for a while. If my work/class requires more than a bare minimum investment of effort, it won't happen. Side projects get put on hiatus and sometimes permanently killed.

Right now Plan A for dealing with this problem is to Google around for psychiatrists in my area, find one my insurance covers, and ask them wat do, but considering I'm not in much condition to do effective longterm planning right now I thought it couldn't hurt to crowdsource it.

Korwin · Post by **Korwin** » Thu Nov 19, 2015 7:11 am

How is the weather where you live in November?
For winter depression, I heard day light lambs are a good solution.

Chamomile · Post by **Chamomile** » Thu Nov 19, 2015 8:48 am

On the one hand, November is about when weather goes snowy and dark up here. But on the other, it stays snowy and dark well into April most of the time, but I'm usually okay by mid-December at the latest. Does winter depression work like that?

Hadanelith · Post by **Hadanelith** » Thu Nov 19, 2015 9:45 am

My understanding (I am NOT a doctor) is that Seasonal Affective Disorder can manifest that way, yes. A couple of people I know on the net with SAD swear by sun lamps, so I'd at least look into one. Still, talk with a real doctor before you listen to me.

Korwin · Post by **Korwin** » Thu Nov 19, 2015 9:48 am

Chamomile wrote:On the one hand, November is about when weather goes snowy and dark up here. But on the other, it stays snowy and dark well into April most of the time, but I'm usually okay by mid-December at the latest. Does winter depression work like that?

No glue, it sounds plausible to me, that you acclimate after a while to the darkness.
And around after Christmas the daylight gets longer again.

But no real medical knowledge here...
so hopefully we get someone to pipe in.

Stahlseele · Post by **Stahlseele** » Thu Nov 19, 2015 11:52 am

Korwin wrote:How is the weather where you live in November?
For winter depression, I heard day light lambs are a good solution.

anybody else disappointed, that that link does not lead to tiny adorable lambs that warm you like a little sun?

RobbyPants · Post by **RobbyPants** » Thu Nov 19, 2015 1:43 pm

Korwin wrote:I heard day light lambs are a good solution.

Korwin wrote:No glue, it sounds plausible to me

You make some of the most interesting, one-letter/still-a-word typos.

Maj · Post by **Maj** » Thu Nov 19, 2015 9:23 pm

My guess would be that's autocorrect. And, no Stahlseele - you weren't the only one.

Prak · Post by **Prak** » Thu Nov 19, 2015 9:39 pm

Stahlseele wrote:
Korwin wrote:How is the weather where you live in November?
For winter depression, I heard day light lambs are a good solution.
anybody else disappointed, that that link does not lead to tiny adorable lambs that warm you like a little sun?

Actually, thinking about it, that'd be even better than the glowing lambs I had thought of. A tiny, like, teacup-dog-size lamb, that didn't glow, but was as warm as standing in a beam of sunlight would be marvelous. Because I hate bright light, but a lamb that could just sit on my shoulder and keep me warm would be great.

Stahlseele · Post by **Stahlseele** » Thu Nov 19, 2015 11:26 pm

and tiny lambs are adorable as well.
i second the finding it great.

erik · Post by **erik** » Thu Nov 19, 2015 11:39 pm

Imma just gonna leave this here.

Stahlseele · Post by **Stahlseele** » Thu Nov 19, 2015 11:54 pm

Yeah, i actually remember reading about that.

Korwin · Post by **Korwin** » Tue Nov 24, 2015 2:16 pm

RobbyPants wrote:
Korwin wrote:I heard day light lambs are a good solution.

Korwin wrote:No glue, it sounds plausible to me
You make some of the most interesting, one-letter/still-a-word typos.

I wish I could claim, the auto correct is at fault.
I have no idea, why I allways want to write no glue, when I mean to write no idea...

Is there another translation to "Keine Ahnung"?