Yittz's Clinic!!

[Han Solo]

Hey Han

Have a patient (YTZ), 20yo male. He presented with mildly low body temperature (30dC) and freezing chills projecting from his palm. He was bitten by an ice worm. He proceeded to practice yoga which he thinks slowly neutralised the cold poison. He claims that he has frozen a flowing river due to the sudden depression of his body temperature. Although he feels fine now, he's worried about long term effects of the cold poison and the temporary sub-zero temperature he experienced earlier.

Possibility of brain damage? (although his owner Ah Zhi says that was present before the cold poison)

Any discussion on wuxia would not be answered seriously on this thread.

FYI, in my hospital, we are part of a trial where patients with cardiac arrest is purposely being cooled down in order to induce hypothermia, this is meant to decrease brain injuries.

I would speculate that while the cold nature may help to reduce the body's overall metabolism i.e. reducing the overall anti-oxidants and other injuries to the body, it may also meant that some of the body's enzymes are not performing at optimal efficiency. This may lead to YTZ not being able to generate the strongest internal energy possible; although conversely, it meant that he was able to take in more injury from others and poisons.

An unwanted side-effect for some is that the temperature will encourage mass production of spermatozoa, thus making him very fertile. Not good for a wuxia hero.

Han Solo

[Extremer88]

Sorry, u got me confused. U woke up while having breakfast i.e. u were having breakfast when u were sleeping?

Seriously, it depends.

Are you eating in a good sitting posture?
Are you having any abdominal pain or burning sensation?

Han Solo

Oops. Sorry for my over-reliance on Singlish. What I mean is I'm having trouble digesting the food that I ate during morning breakfast, feels sort of nauseous and queasy, and having difficuty in comfortably swallowing the food.

[Han Solo]

Do you feel the food being stuck somewhere?
Are you eating much faster in the morning compared to your other meals?

I'm presuming that there's no pain with swallowing.

It is somewhat odd that it occurs only in the morning.
I can't quite explain it as yet.

Han Solo's wild hypothesis of the day: Morning sickness?

Han Solo

[chuy605]

Doc, can you answer any question about Dog's health?

[Han Solo]

Sorry, no can help. Not a vet by training.

[yittz]

Do you feel the food being stuck somewhere?
Are you eating much faster in the morning compared to your other meals?

I'm presuming that there's no pain with swallowing.

It is somewhat odd that it occurs only in the morning.
I can't quite explain it as yet.

Han Solo's wild hypothesis of the day: Morning sickness?

Han Solo

Can guys get morning sickness?

[yittz]

Doc, can you answer any question about Dog's health?

I can go ask my vet friend if you like.

To Han:

Can chronic hay fever cause constant (like daily) production of phlegm flowing from back of the nasal cavity to the throat? Can it be something else (kinda thick, no blood, worse in mornings, generally no colour, sometimes brown in the morning, no other symptoms)? Also if I don't have sneeze attacks or itchy/red nose, why is it still hay fever?

It's really uncomfortable, those nasal sprays don't seem to help either (does it matter if I used it intermittently instead of as daily). Any other treatments?

This time it's not YTZ.

[Han Solo]

Can guys get morning sickness?

Nope. Morning sickness refers nausea by pregnant females especially in the first trimester.

[Han Solo]

I can go ask my vet friend if you like.

To Han:

Can chronic hay fever cause constant (like daily) production of phlegm flowing from back of the nasal cavity to the throat? Can it be something else (kinda thick, no blood, worse in mornings, generally no colour, sometimes brown in the morning, no other symptoms)? Also if I don't have sneeze attacks or itchy/red nose, why is it still hay fever?

It's really uncomfortable, those nasal sprays don't seem to help either (does it matter if I used it intermittently instead of as daily). Any other treatments?

This time it's not YTZ.

Doesn't seem to be hay fever, seems more like post-nasal drip.

How long has it been going on for?

If it is post upper respiratory tract infection, i.e. post common cold, then it should settle by itself.

If it is prolonged, then your doctor should have a look with a possible ENT review.

Han Solo

[patricia n]

deleted this post....thanks for answering the questions...i will do a more indepth research on this topic now. and forget about the pediatric clinic...i realized that if any member has any peds question in this forum, it would be better to bring the pt to see a pmd because kids are not as strong as adults are.

[Han Solo]

1) How likely is a patient become symptomatic from the TB?
It will depends on the immune status of the patient, and the virulence of the TB. It is a balance of these factors, rather than any specific factors that will cause this.

You tend to see many CXR with old TB apical scars, and when you question the patients, they do not recall having any TB symptoms.

The distinction that you wanted to make is primary TB, reactivation TB and miliary TB -- being primary TB usually affecting the hilar lymph nodes and usually asymptomatic, reactivation TB causes the classical apical scarring, GOhn bodies etc and is usually the one where you get the fever, rigors and hemotypsis and miliary TB is wide-spread disseminated TB to the rest of the lungs, kidneys, bones etc

2) Latent -> Active TB?
As above. The fight between the innate immune functions vs the virulence burden. Not all latent TBs will be activated later in the life.

3) TB pulmonary reactivation without symptoms?
Very unlikely.

4) Need to cauterize for hemotypsis in TB?
Nil need for that. Rarely ever done.

5) Widespread TB in immunocompetent hosts?
Very unlikely. However, it is possible with very virulent TB with those that are multi-drug resistance. Also it may be possible that they have something that affects the body's immune status without the patient recognising it.

6) TB in literature?
FYI, TB was known as "the consumption" in the Renaissance Europe/Victorian England. It literally consumes the patient, with the wasting at the end of the disease. There's some poets whose name escapes me which was famed for their vitality and artistic sanguinity when they are infected with TB.

Han Solo
P/s: answers are from memory only. Nil external sources search. May contain grave errors.

[chuy605]

I can go ask my vet friend if you like.


This time it's not YTZ.

ok, yeah so my question is that there are some black stuff inside my dog's eye and i think because of that he can't see clear. The black stuff is inside the eye ball not out side, if you know what i mean. So can you ask ur vet friend if there any thing i can get to get to help my dog. Thanks

[yittz]

Apparently TB is a 'sexy' disease in the past, because it made them look pale and frail - ethereal like a fairy.

To Han: Is it rhinitis? I think it's a post nasal drip. 3-4 years. ENT is ear-nose-throat? Thanks.

[Han Solo]

Apparently TB is a 'sexy' disease in the past, because it made them look pale and frail - ethereal like a fairy.

To Han: Is it rhinitis? I think it's a post nasal drip. 3-4 years. ENT is ear-nose-throat? Thanks.

3-4 years! That's certainly not post-iinfectious as i imagined.

I just got up from bed, i might need to think about this and look this up from the book b4 replying further.

Han Solo

[TommyH]

Han Solo I have a question but I'm not sure if this is the place to ask it. But since I see you answering medical questions then you must have deep knowledge on this topic.

What affects the stamina and strength of people? Why do people lose stamina and strength as they age?

What cause the bones to shrink so that your face starts wrinkling?

[xcutie]

Dr. Han:

Something must be wrong with me.. last summer, i ran/jogged a mile almost everyday. after summer ended, i ran less often (1-2 times per week). for the past few months, i've started to run the same amount and i've even started swimming for one hour, every other day.

i thought that i'd become more fit with this exercise routine, but it seems like whenever i try to run (to catch the bus, to rush to school, or running a mile in gym class), i start to huff and puff.. i always have to stop and it seems like i can't catch my breath. some of my friends don't workout at all, but they seem to be more fit than me!

why's this happening?

*sorry if this post was kinda confusing and hard to understand..

[Han Solo]

Han Solo I have a question but I'm not sure if this is the place to ask it. But since I see you answering medical questions then you must have deep knowledge on this topic.

What affects the stamina and strength of people? Why do people lose stamina and strength as they age?

What cause the bones to shrink so that your face starts wrinkling?

1) Stamina depends on the ability of the heart to pump blood into the circulation and the lungs to deliver O2 into the bloodstream, and also the muscles to work properly. An efficient system will deliver the adequate blood and O2 into the peripheral muscles and extract the wastes, preventing the buildup of lactic acids in order to maximize the body's energy's ultilization.

As people age, the lungs forced expiratory volume decreases, the hearts ejection fraction decreases, the muscles are less bulky --> decreased stamina.

2) Face wrinkles because the skin loses elasticity of the youth, it became thinner, the subcutaneous structures also changes. It got nothing to do with the bones!!

Han Solo

[Han Solo]

Dr. Han:

Something must be wrong with me.. last summer, i ran/jogged a mile almost everyday. after summer ended, i ran less often (1-2 times per week). for the past few months, i've started to run the same amount and i've even started swimming for one hour, every other day.

i thought that i'd become more fit with this exercise routine, but it seems like whenever i try to run (to catch the bus, to rush to school, or running a mile in gym class), i start to huff and puff.. i always have to stop and it seems like i can't catch my breath. some of my friends don't workout at all, but they seem to be more fit than me!

why's this happening?

*sorry if this post was kinda confusing and hard to understand..

Do you get short of breath when you start jogging?

If not, i can't quite understand it except if you are jogging with a slower pace than when when you chase the bus.

Maybe you should also incorporate some phases into your jogging where you accelerate for short durations as well.

Add: Do you have asthma as well?

Han Solo

[TommyH]

1) Stamina depends on the ability of the heart to pump blood into the circulation and the lungs to deliver O2 into the bloodstream, and also the muscles to work properly. An efficient system will deliver the adequate blood and O2 into the peripheral muscles and extract the wastes, preventing the buildup of lactic acids in order to maximize the body's energy's ultilization.

As people age, the lungs forced expiratory volume decreases, the hearts ejection fraction decreases, the muscles are less bulky --> decreased stamina.

2) Face wrinkles because the skin loses elasticity of the youth, it became thinner, the subcutaneous structures also changes. It got nothing to do with the bones!!

Han Solo

I just recently made a character at the Create Your Own Wuxia Character Game #2 and she's 126 with the youth, beauty, and stamina of a young lady. I stated the reason for this is because she absorbs the internal power from martial artists and it helps her heart and internal organs. Does it make any sense?

[xcutie]

Do you get short of breath when you start jogging?

If not, i can't quite understand it except if you are jogging with a slower pace than when when you chase the bus.

Maybe you should also incorporate some phases into your jogging where you accelerate for short durations as well.

Add: Do you have asthma as well?

Han Solo

yeah, my shortness of breath forces me to stop so i can't even run a few steps.. i've never had asthma, and neither did anyone in my family. is it possible that i suddenly got asthma?