My Health Weblog

Patient: My son has suffered daily for the past 3 years with itching over his entire body and at one point covered in hives. He has seen just about every type of doctor except an immunologist. He is currently being treated by a dermatologist in NYC and has been for the past year. He has been on a regiment of antihistamines which have run their course it seems. He just started a prescription for Cellcept. After reading the possible side effects I have been totally freaked out. He started taking this 3 days ago and this morning said he feels worse than ever. His entire body from the top of his head to his feet is bothering him. At one point this dermatologist said his body was producing antibodies that were attacking an infection that was not there. Does this sound right to you, and should he be seeing perhaps an immunologist ? I am sick just watching him suffer every day, going broke with endless medications that don’t seem to work and may possibly do more damage.PLEASE HELP!

Doctor: Hello & welcome to Health.is.edu ,

Just wanted to know of a few things before we deal with your answer:

How old is your child

Has any trigger point evaluation been done for him

Any other illness

Have you sought a second opinion

Thanks.

Patient: Hello Dr. James

My son is 27 years old. He has had numerous blood work tests, only factor out of range was TSH at 6.83, done by a few different doctors; GP, another dermatologist who gave him steroids that didn’t work, many topical cortisones until they realized it was systemic. He has been tested for allergies, tried a bland diet of chicken, rice and water for 6 weeks, with no change. Otherwise healthy thank God except for slight thyroid deficiency which he is being treated for with 50 mcg of Levothyroxine.

Doctor:  Your son has ‘chronic urticaria’, which is not amenable to steroids. It is time that why it happens – the ‘trigger’ should be searched and excluded. For this allergen testing is required and common allergens will be tested one by one. Hopefully one shall be found and thereafter your son will be free from chronic urticaria. Sometimes it becomes difficult to know the precise cause and then maybe he will have to see an immunologist.

I am placing a link from the Mayo Clinic’s site on the subject which will provide you more authenticated information. Please have a look.

http://www.mayoclinic.com/health/chronic-hives/DS00980

Best wishes.

Patient: Is it legal for doctors to write out prescriptions for people they have never met in person, but the doctor has their medical history faxed to him and then they speak over the phone about the issues? Is this a legal way to obtain a prescription?

Optional Information

Age: 34, Male, Alaska

Already Tried: Reading different laws passed by the courts and such. It seems this is an iffy area, but if the doctor does have a copy of a persons medical records and then has a telephonic conference it almost sounds like this is starting to be taken as a bona fide doctor/patient privilege

Doctor: well it depends on the doctor . some would nt give prescription unless they have seen the patient . other may give out prescription if the patient are referred by some fellow doctor. for an altogether new patient no one should give out prescript.

Patient: would you write the prescription after just a phone visit. Society is getting crazy with all this technology. I could basically have a doctors visit in my house over my web cam.

Doctor: no, i dont.

Patient:  I wasnt asking you to. I was just curious to know where you stood on the issue. It seems to be a good sized battle these days in the courts. People are entering pleas of guilty or not guilty on video court. It just seems like that is the way we are moving in society. So I guess there is no exact right or wrong on that yet? Its just about how you feel ethically doing it at this time and as it becomes more common practice those barriers will break down and it will be normal.

Doctor: well i dont think this will be allowed in near future as the laws are becoming more strict and less freedom for physicians to do what ever they like. ..Continue reading..

Patient: been taking 50 mg,of zoloft for 2 years for depression,stop taking the meds 3 days ago.now experiencing some headaches,light headiness.,my doctor never put me on a wean off process,any suggestions to speed up this process of recovery?

Optional Information
Gender: Male
Age: 52

Doctor: It is strange that your doctor did not taper you off of the medications. Coming off of SSRIs fast like this can lead to withdrawal symptoms – ex upset stomach, headaches, anxiety, etc. I would suggest to consult with the prescribing physician and definitely report your symptoms.

Here is a link to a Traditional Chinese medicine interpretation of the process (yet, I would stick with the Western view on this one-hence the need to taper off of the medication appropriately and monitoring by a physician)

http://www.itmonline.org/arts/ssri.htm

Patient: I guess i need a new doctor,i have called the md,a couple of times,as has the pharmacy,to renew,the meds. No response.already 4 days without the zoloft,and my question is,we have talked about me discontinuing these.if this is ..Continue reading..

Patient: I am a teacher and one of my students was diagonised with swine flu. She recently returned back to school today and I had close contact with her today now I have a head ache and feel hot does t his mean that I now have it I also feel like I wnt to throw up

Optional Information
Age: 31; Female, New York
Already Tried: Drinking water and eating I also an breast feeding mom should I breast feed tonight my child is 10 months what should I take

Doctor: Hello,
Id like to help you with this but I need more information. How many days was she absent? You said she recently returned to school…how many days has she been there prior to you having this headache?

How old is she?

And what are you feeling besides a headache and hot…do you have any fever?

Please check and tell me what your temperature is.
Thanks for clarifying,
Sincerely,
Dr. james

Patient: It is an after school dance class and she was absent about two week if you count weekends I would say about 14 days. Today is the second day she is back and today is the day I felt the headake I was with her for two hours and then I started feeling th hot about an hour after I was with her. She is 11 years old and I am 31 year old I feel like I am going to th row up at any minute. I am very concerned since I have an 10 month old in the house and it is coming up for the time I breast feed. Should I do that I just took two teaspoons of therau flu my temp is 98.5 ..Continue reading..

Patient: I am a registered nurse who holds a BA in Community Health from CUNY NYC, and a BS in Nursing from Columbia U. in NYC in 1989. I graduated with honors from Columbia. Since that time I have not worked, as I cared for my family. During my time at home, I have done significant and important charity work and have been on the board of a nurses PAC and other organizations. At this point I would like to enter the work force. Any ideas on what a “resume” should look like for me to use in applying for work that is not in bedside nursing?

Doctor: Hi there

What type of job are you looking to attain? (what field) or do you know yet?

Patient: I think that I would like to go into occupational health or some other areas where I would be treating basically well people who are having a problem related to something. Also, I would consider teaching health education in some capacity. I might want to begin part-time if that were possible, but ..Continue reading..

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Patient: I dont know if my question is beyond the expertise of some of the Dr on this board. If not I apologize. I was told yesterday that I am a carrier of the Alpha 1 tris gene. My phenotype is pi mz. I had the test due to elevated liver functions without any cause. numerous MRI ultrasounds and dozens of whacky blood tests. My Dr who is a pulmonary specialist and gp sent me to a liver specialist in mt sinai hospital nyc. Where I was tested. My gp Dr states that being a carrier is of no real risk to me, just that I should not smoke. He said that my body does produce enough AAT My range is 88 mg ref 82 to 169. I read that being a carrier can increase my chances of getting lung disease. I had the flu last week and still have a cough for about two weeks .My Dr says it can take sometime and the cough has nothing to due with my results. The liver specialist said in the report that he has seen in some cases increased fibosis in setting like mine. would the Mri and ultrsound showed this. My alt 93

Doctor:
Thank you.

Your gp is correct, as long as you don’t smoke your chances of developing COPD is not increased. Dr Seersholm wrote a 2004 article that addressed this specific topic. His research showed that people with pimz did not have an increase incidence of lung disease as long as they did not smoke. The reason is because a pimz still has, at a minimum 60% AAT. This is enough to stave of lung disease in someone with A1AT def. The cough, is a response that can last for weeks to even a month or longer. The reason is not the lungs (in this case) but the bronchi. The cough is often the very last thing to leave or get better. This is seen in almost all cases of any respiratory issue. Since your numbers are good I would not worry that all of a sudden you developed a lung disease. As for the liver, the MRI or ultrasound would have shown fibrosis of the liver. Your clotting factors would be out of whack. Your protein would be low. It doesn’t appear that this is the case. I would have to agree with your gp on the lung issue and would say that your hepatologist (liver doc) may have seen some cases of worsening, but I guarantee you this was the ..Continue reading..

Patient: I have old (2005) 25MG effexor and wish to use it,….is it safe? does it change in composition or in strength?

Optional Information
Gender: Female
Age: 85
Already Tried: Using effexor to reduce hot flashes. Am currently using 80Gm CMPD Progesterone 5% and over the counter Estroven. used these for 30 days with no results, what period of time before I see a change? Very hard and repeat flashes throught the day and night. Any other recommendations? I have not used the effexor only once along with the progesterone. use the P cream twice /day. Hot flashes destroying my life. I can’t believe I am subject to hot flashes at the age of 83 though 85+1/2 HELP !!

Doctor: Hello,

Medications such as Effexor have an expiration date – and drugs from 2005 would now be expired. They lose their effectiveness – so they would not work. The strength decreases and it would do you no good.

If you used this effectively before, you can call your doctor and see if they would represcribe it – they will usually require an office visit, but if it helps – that’s worth it!

Patient: Yes,….the effexor did NOT work before, either, but I was willing to try it aain if it was still good. I have been told over many many yrs that old meds should be avoided.

I need help in finding a med that will help with these Hot Flashes that are destroying my everyday life !!! If you canot tell me an alternative or answer how long to take the progesterone before I get any relief,…you have not helped me a bit.The Dr seems at his wits end in his attempt to prescribe anything that will help.

Doctor: Regarding your hot flashes: treatment usually consists of Hormone Replacement Therapy. If you’ve tried both oral and transdermal patches and those have not worked – you may want to try the following:

Some research suggests that soy may have some benefit for reducing hotflashes and ..Continue reading..

Patient: Until the past couple of years she was very active, but the fatigue prevents her from exercise, she says. She also has much stiffness in her body and joints. N.B: This is really my sister, living in California; not me. I live in NYC and see her only once or twice a year, and I get worried.

Doctor: Well controlled diabetes should not cause constant severe fatigue. This should be evaluated further by doing blood test. She should have her hemoglobin checked, her thyroid function checked. These are the first two tests that I would like to do in her case.

Regards

Patient: My question is about the swine flu virus. I live in New York (an area where many cases of swine flu have been reported), and I’m about to travel abroad to see my family, which includes a 3-year old kid. Almost all of the cases of swine flu in that country have their origin in someone who contracted the virus either in NYC or on an airplane.

I intend to stay away from them for a few days, just to make sure that I didn’t catch anything in NY just before leaving or on the airplane. My question is: How many days do you think I should avoid having contact with them? What is the incubation period of swine flu? Are 3 or 4 days enough, or should I wait for 7 days (assuming I have no symptoms, of course)?

Also, does one HAVE TO have a high fever to suspect swine flu, or can one have swine flu without a fever? In other words, is NOT having a fever a guarantee that you don’t have the swine flu?

Optional Information
Gender: Male
Age: 30
State/Country: Massachusetts
Already Tried: I have no symptoms of flu.

Doctor: The typical incubation period of swine flu is around 2 days with a maximum of 4 days in some cases. But is is best to avoid contact with another person for a period of 7 days because it is still thought that a person can remain contagious for a period of about one week or so.

You MAY or MAY NOT have fever. Even if you do not have fever you will have symptoms such as nasal congestion and ..Continue reading..