Weekly Discussion/General Questions Thread - January 03, 2022

  1. Help with really dry and sensitive itchy skin. As the cold January weather has started so has my dry and itchy skin. Any tips on how to handle? I have a ketoconazole shampoo and dermatology/eczema relief lotions. Itch is all over body currently and especially bad in crease areas. 24 male.

  2. Stay warm! even wear gloves and socks indoors and to bed if you have to. Cold causes vasoconstriction, which in turn will make dry skin even worse. Apply the lotions as often as needed, even if it is 10 times a day (not the steroids obviously, the neutral lotions).

  3. I hope this allowed. But other subs are full of debates and I’m not doing that. So I’m asking professionals. I’m friends with someone who is fully vaccinated, and has only not been boosted because they are significantly older, and not used to having to figure out how to discern misinformation on the internet (didn’t use the internet much at all before the pandemic). But they’re a very reasonable person and if I can show medical studies from a reliable source that getting boosted helps prevent severe illness, they’ll be open to getting boosted. Basically looking for sources to explain to a friend who doesn’t use the internet enough to navigate so much information without getting confused and overwhelmed, that the booster is worth getting.

  4. Do covid vaccine boosters affect bloodwork results if the bloodwork (like esr, crp, cbc for rheum) are drawn a day or two after the booster? Wondering if the inflammation markers might be altered.

  5. CRP and white count maybe a little bit, but certainly not a lot, and not if you aren't experiencing any side effects.

  6. Well, it's your story. Write it however your fictional infection works. If the problem infection is like rabies, I'm not sure an amputation would help, since rabies doesn't circulate via blood or lymph vessels. It spreads directly through the nerves to the brain. If your infection of concern is like a diabetic foot infection, it's weeks or months before amputation is discussed, depending on the organisms, blood flow, response to antibiotics, and whether the infection involves the bone. If the problem is a severely mangled limb (like a limb that was crushed by a speeding train or a wood chipper, for examples), then there's no chance of repairing it, so amputation is before infection could set in, typically within hours or a day, usually to control bleeding.

  7. Is ingesting Neosporin bad? I put some in a cut that is near my lip, and I think some may have gotten into my mouth. Is this a big deal?

  8. I have medical anxiety (I have blacked out just going to get a strep test; I have mild panic attacks at my yearly physical; it has been this way my whole life). I think I need to make an appointment with a colorectal doctor for a probably minor issue. However, my anxiety about doctors in general, and then the sensitive nature of the issue (for me. I know this is their specialty and it's not an issue for them) has me in just heightened anxiety/stress/panic. And I haven't even talked to them yet--I just filled out the form online and even that took a lot of work.

  9. A lot of people have bad anxiety about medical care. It’s incredibly common and you are not alone here. Not everyone is able to casually chat with the phlebotomist while getting blood drawn. Some people are white-knuckling it the whole time. I’d tackle this in chunks.

  10. Drugs of abuse tend to have rather unpleasant withdrawal symptoms, even if they're (at least initially) enjoyable while the patient is taking them.

  11. Super quick question, how do I stay hydrated when I have a sore throat? I have a cold from being outside in the snow and now it hurts when I swallow water

  12. There are some sprays that can help anesthetize your throat so you can drink a little more easily. May e a friend can go to the store and grab you one? It’s best you stay home while you are sick. In addition, honey teas can be soothing for sore throats. A quick note: your illness is from a virus or (less likely) bacteria. Being outside in snow does not cause colds.

  13. I did a Google Scholar search on this topic: "can woman have laser lithotripsy ureteroscopy removing ureter and kidney stones without anesthesia"

  14. Stones in the kidney itself are rarely removed because they rarely cause trouble there and are very close to delicate organs (the kidney nephrons). When people talk about painful kidney stones they generally mean stones that have migrated to the ureter.

  15. What is the medical community's general consensus on treatment with LLLT? (low level laser therapy)?

  16. I think I agree with the statements on wikipedia: evidence does not support benefits for all the things it is being touted for, but it may be helpful for some of them. The jury is still out. With that said, the sheer amount of things it can reportedly treat has my pseudoscience hackles up.

  17. If two boosted people in the same household both test positive for Covid, should they still isolate from each other to avoid increasing viral loads?

  18. Hi! I’m curious. I’m 31 F and I recently had a craniotomy for a brain abscess and then they found a pulmonary avm which was embolzied. How rare is this? Docs seemed to get real interested and as me questions about my experience lol.

  19. Is there a particular brand of FFP3 brand that people can recommend for good value/protection to protect YOURSELF from coronavirus while working in a retail store?

  20. When I suspect one, but don’t have itching and burning, my doc tells me to use a Boric suppository for 7 days. Within the first 12 hours I notice it’s nearly gone because it’s actually BV. CVS has a yeast infection detection kit, called Health Feminine Screening Kit.

  21. My understanding is that the liver can process a certain amount of alcohol (about 8g of 10mL of ethanol per hour, depending on weight, body fat, and other factors), while other parts of your body can also metabolize some. Does that mean that if you drink less than what your body can process, there are no health consequences? Or is there brain and other damage even with a sip, particularly to those under ~25 with still developing brains?

  22. alcohol is toxic regardless of how drunk you get. For example: people who regularly use a mouth wash with alcohol have a higher risk of developing oral cancers.

  23. So with COVID I have had some people make the claim that they are around a person who was positive for less than 15-20 minutes and had a mask/were 6 feet away so they couldn’t of got Covid. This seems obviously false, but why would they even make this claim? Is there any good evidence I can share that would refute their claims?

  24. It's not a high risk exposure, but the chance is not zero. There was a recent study on how well masks protect, but I can't find it just now and I don't have the time to properly look for it. Just try google scholar, it's the scientific side of google. Or

  25. The risk is highest if >20 minutes and/or maskless, but not 0 is those criteria aren’t met. What they are describing is defined as “close contact” by the CDC. However, even contact that is not close contact can result in SARS CoV-2 transmission. Here is a report of someone with omicron who may have been infected from across a hallway while picking up a meal tray (a short exposure period).

  26. I am not aware of any legal action that has ever been taken following advice received on this sub. That would not be easy either, because nobody knows which physician belongs to which account (or if they are even in the same country)

  27. Dermo prescribed Doxycycline to me for a potential bacteria thing I got going on. I'm kind of scared to take it after reading some stories online. Also, 1 in 100 will be allergic?

  28. If the derm says you need it, just take it. People without issues aren't likely to post their experience online so I whouldn't put to much trust in those stories. You can become allergic to any drug, but most antibiotic allergies aren't of the anaphylactic kind, people just get a rash.

  29. I haven't seen the show but there are thin sheets that act as protective barriers that may have been in use back then; They were issued to us when I was a surf lifesaver although I never had to use one as we always had a mask. Generally any in hospital arrest will occur with a bag-value mask these days because they're above every bed.

  30. If the parents consent, can children be organ donors? If so, do they have to be organ donors to other children? And if a child receives an organ, does the organ stay the same size as the child grows, or does it grow with them?

  31. Children's organs can be donated after death. There are occasional cases when children can be donors to family members, usually siblings, but because children, especially very young children, can't given informed consent the ethics can be challenging.

  32. What is a good blood pressure monitor to get? I've always had slightly high bp when I go see a doctor. So I want to monitor at home to see if it makes a difference. I notice a few different styles. Some that pump. Some you wear on the wrist. I probably don't want to pay top dollar for an Omron or something.

  33. One of these that have been independently validated. Also, go for upper arm vs wrist, it's harder to screw up upper arm measurements! Also, be sure to use good technique (go on YouTube and look up good BP technique).

  34. I’ve been listening to The Drive podcast by Dr. Peter Attia and I absolutely love it and want to learn more. However I have no medical background as I only have a degree in engineering.

  35. I think you're better off narrowing down the search to a specific topic. Medicine is very broad. The emperor of all maladies is a very interesting book about cancer for example. I also learned from Fat: the Secret Organ. It's a book about obesity and how to fix it, written for the broad public.

  36. I don't think many people remember their childhood vaccinations, besides maybe Gardasil. Without any memories to compare to, the normal symptoms of vaccination/immune response seem like a really big deal. A lot of people feel crap after TDaP and shingles vaccines, too, for example.

  37. Yes and no. It's more dangerous because gastric cancer can present as gastric (antral) ulcers. There's protocol to follow-up on gastric ulcers to make sure it's not cancerous. From a bleeding standpoint, my experience is that duodenal ulcers tend to bleed more heavily when it does, usually because it can involve the GDA.

  38. as long as your stool consistency is in the normal healthy range I would not be worried about an increased frequency - but i'm assuming this is a 1-3 variation, not an extreme swing

  39. Not after the fact. It's a short period of stroke symptoms without signs of damage on brain imaging. If it's caused by atherosclerosis you would see that on the work-up of the carotid artery for example.

  40. Yes, there can be a biphasic reaction but it is very rare, and usually not severe. It is the reason why we treat with both epinephrine and steroids.

  41. People can occasionally have a further anaphylactic response if the stimulus is still present and the adrenaline has worn off however this is fairly rare. Provided someone has good initial treatment and the stimulus has been removed there are no long term effects except the risk of recurrence if the stimulus is encountered again

  42. Is any particular COVID vaccine (or combination of vaccines, for countries administering those) known with some reliability to be more effective against Omicron?

  43. They don't necessarily go through different trainings, at my medical school for the first 2 years medicine and dentistry have a shared core. Mostly, dentistry is considered a field of medicine. Some significant contributions to medicine have been made by dentists - the first public demonstration of inhaled anaesthetic - at the Ether Dome on Ether Day, was performed by a Dentist.

  44. If a patient had to be put in a medically induced coma that lasted 3 days after open heart surgery, how long might it take for them to be able to be weaned off the ventilator if things go well?

  45. It reqlly depends on the situation. In this case the best estimate will be from their doctor. Medically-induced comas after heart surgery are not typical.

  46. If i have a anaphylaxis reaction to blueberry pop tarts immediately after eating one but i can can you a gfuel energy mix with blueberry powder in the mix and not have a reaction?

  47. NAD; Could be a wound, or worse, an infection from your habit of scratching them inside. You don't mention anything to hint at it, but it may even be TMJ issues, for all we know. Although TMJ typically presents with more jaw symptoms (locking, clicking), a pain seemingly from deep inside the ear is (atypically, I think) the only symptom or the only noticeable symptom in some cases. TMJ is strongly suspected if the pain worsens with certain oral postures.

  48. Are there any advantages to becoming a physician outside of prestige for people pursuing most non surgical specialties in the US nowadays? Why go through the hellish rigorous training of MD/DO over NP/PA?

  49. What is the best treatment for chronic strain/sprain? Are there any studies you recommend referring to for treatment/prognosis for the average patient?

  50. This question has a different answer for each body part of type of injury. So the best treatment is to start with a physician &/or P.T. or O.T. who knows how to evaluate and manage that problem.

  51. Are there any long-term negative consequences of chronic orthostatic hypotension? I.e., if you experience this daily over several years, is it possible to end up with some amount of brain or vision damage resulting from lack of perfusion?

  52. Should someone go to ER is they tried a Kardia device and it says “possible atrial fibrillation” but then doing it again shows it’s normal?

  53. Probably not. Automated readings even hospital-quality ECG devices are notoriously terrible. It might be reason to get a real ECG done at some point in the near future, but it's not an emergency. Without any symptoms, atrial fibrillation isn't an emergency, although it is something that should be treated.

  54. Every ENT will tell you not to put Q-Tips in your ear. It's not that rare to damage ear drums with those things, and it's even more common to squish wax into worse positions where it causes more problems.

  55. One trick to avoid sleeping on your back is to put a few tennis balls or similar uncomfortable items in a tube socks and pin it to the middle of the back of your PJs. Most people can't sleep if the roll onto the tennis balls. Croquet or field hockey balls are harder and much more difficult to lie on. I don't know if golf balls would work. A basketball would be hard to attach, but would be quite difficult to roll onto.

  56. I cut myself while shaving and I washed the cut with soap and water. I then applied Neosporin. However I don’t want to put a bandaid on the area, it’s too close to my lip, it would feel uncomfortable. Do I need a bandaid or can I just let it stay as is?

  57. If someone gets hit in the chest by something but don't show symptoms right away, is it recommended to call an ambulance or is just heading to a clinic or hospital with a friend to watch you fine? Before anyone worries, it's just a hypothetical.

  58. Hit by what? Bodies are evolved to protect hearts and lungs well; that's what our ribs and sternum are for. You can get hit in the chest hard enough to get knocked down and it'll hurt but it's not something likely to cause delayed problems.

  59. Is there ever a situation where a blunt hit to the chest can cause a heart attack? This is for a story I'm writing. Just in case it helps, the character involved has a type of cardiomyopathy too.

  60. Obviously if someone gets hit hard enough to cause physical trauma to the heart it could be fatal, but it can also (rarely) cause death from cardiac arrhythmia even when it’s not a super strong hit. This is a phenomenon called

  61. If it is making you feel severe enough distress you are suicidal, or if you are in a manic phase where you are worried you are a danger to yourself or others because you cannot control your behaviour. Also if you have reason to suspect an immediately life-threatening or severe physical issue going along with it, like severe pain.

  62. Can I get vaccinated for COVID-19 booster shot, and get vaccinated for flu and pneumonia vaccine a couple of days later?

  63. By all means drink cold water if it makes you feel good (hydration is important) but it won’t work to reduce your fever. Fevers happen when your body’s internal thermostat gets reset—so it will bring itself back to a higher temperature.

  64. Generally speaking, is the risk of developing an autoimmune reaction (be it temporary or developing an autoimmune disorder) from a COVID-19 Infection pretty much mitigated as long as you are vaccinated? or can a Covid infection fully vaccinated, and even boosted, still cause the body to overreact like this?

  65. Generally speaking, being vaccinated prevents nearly all of the serious or severe manifestation of a disease, including autoimmunity. Assuming that a vaccinated person has a competent immune system and has responded to the vaccine with B-cell and T-cell memory immunity, they should not develop any significant adverse immune responses if they get infected. This is true of Covid-19 and Covid-19 vaccines.

  66. Is there any concern about taking an herbal sedative like chamomile tea a few hours before taking Doxepin for insomnia? Would that be too sedating?

  67. That's not a generally answerable question. Herbal supplements are different and have different interactions. I don't know of any data on chamomile.

  68. Hello :) A few hours ago I got cold sores / herpes exposure because someone with a cold sore on their lip accidentally „spit“ while talking and it landed in my eye :( can I do anything or should I just wait and hope?

  69. Is three PCR tests within 16 days too many? I got one on December 21st, because I knew I was going to Christmas Eve and Christmas Day parties. It was negative.

  70. If your symptoms are gone or almost gone, you’re not considered infectious after 10 days from when you started to feel sick.

  71. This is a controversial area, and there’s no definitive answer. There’s very little evidence of COVID spreading well via surfaces, but washing hands regularly is pretty easy/harmless and certainly won’t increase transmission.

  72. I heard somewhere (I think from a sex ed class years ago) that there are risks to having unprotected sex with someone who is HIV positive even if you are HIV positive yourself.

  73. HIV has many variants of mutations and has continued to mutate. It's one of the reasons that making a vaccine has been so difficult despite decades of efforts to get a successful product.

  74. Most important thing to follow is oxygen—if he feels short of breath or you can get a pulse oximeter and it’s below 94% consistently, go to ER.

  75. What conditions can a doctor rule out DIFINITIVELY when they do a physical exam on the abdomen (including the pressing and tapping) based on the general complaint of abdominal pain?

  76. There no conditions that can be ruled out 100%, except for silly examples like ruling out obesity in someone that’s really thin or ruling out a stab wound if there’s no wound. The physician has to take the history, the overall appearance of the ptient, the physical exam, and any labs and/or imaging into account to decide what’s what.

  77. Technically it refers to any hair loss, but it’s often used to refer to alopecia areata, which is an autoimmune disease that attacks the hair follicles.

  78. Why is lead testing not a part of regular screenings? We know lead is a huge problem in the us, we know it's harmful impacts. But as far as I can find there's only some very loosely enforced requirements for children to be lead tested.

  79. Entirely depends on the condition. Many patients with epilepsy have completely normal EEGs unless they’re actively seizing.

  80. How are temporal lobe seizures distinguished from anxiety? For example, one who has random deja vu episodes how would a clinician distinguish between if these are anxiety induced or epileptic in nature? Curious been reading up in temporal lobe epilepsy and seems like there is a large overlap in symptoms.

  81. It would be based on the history, the specifics of the symptoms, and, if they were suspicious enough, of testing like EEGs to see if there are abnormalities, especially during an episode.

  82. MS and MRI diagnosis. Would an MRI read differently each day depending on the level of symptoms shown, or would the MRI read the same for a patient on a good and bad day?

  83. Depends on the type of MRI. Some types of MRI are quite good at spotting areas of inflammation, so they could conceivably change day to day. More structural images will show changes, but more likely over a span of months years—like

  84. It’s possible that people could have hormonal disorders that would result in greatly decreased libido, and long-term chronic psychiatric or neurological issues could also cause that. But there’s a pretty wide variation in “normal” sex drive, and for the vast majority of people with a low sex drive there’s not likely to be a clear medical issue.

  85. Can COVID-19 hypothetically be prevented with a blood transfusion from someone who has immunity due to prior infection to someone with no immunity? Would it be feasible?

  86. There was a point where that’s essentially what we were doing but it wasn’t blood cells it’s was the serum (the fluid that supports the cells) we now have monoclonal antibodies so we don’t need that so much. Also blood transfusions typically utilize “packed red cells” which contain very little antibody. So not just from a transfusion

  87. This question made me realize that NONE of my doctor friends take that any of that stuff. I don't know many dieticians, but one registered dietician that I do know has a practice focused on athletic performance. She does not suggest anything besides better food choices and timing of food intake.

  88. Yes—inflammation is a very complex process that, at its simplest, involves blood vessels opening up around a site of injury/infection/etc so white blood cells and nutrients can flood the area and clean up dead tissue, kill microorganisms, promote healing, etc. This creates the classic “cardinal signs” of inflammation—redness, heat, pain, and swelling (rubor, calor, dolor, and tumor in Latin).

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