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Thread: Yittz's Clinic!!

  1. #801
    Senior Member HuangYushi's Avatar
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    Quote Originally Posted by Han Solo View Post
    The doctor you saw is funny.
    I hope you mean it in a comical sense.

    Allergic rhinitis is just a broad term that covers hay fever and other symptoms of upper airway symptoms that you have - there can be many, many precipitant.
    Yeah, that's what I learnt from the article I found.

    Try taking some anti-histamine like clarytyne or telfast and see if it works.
    Before going to bed last night, I took the only thing I had at home for a runny/stuffy nose, i.e. Panadol Cold & Flu, which contains pseudoepherine hydrocloride 30mg and chlropheniramine maleate 2mg (besides the paracetamol). I don't know if it worked, but I'm sneezing less today, and the nose has become less runny/drippy. (Didn't take any medicine today).
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    what about SPT, I need my SPT fix ASAP, pretty pleaseeeee...
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  2. #802
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    OK, I would never have thought that alcohol could cure a cold, but after 2 weeks of having this stupid flu, I got wasted last night with some co-workers. I drank so much that I was so sick by the end of the night and passed out. Well, when I woke up this morning, I felt so rejuvenated. My coughs have lessened, my nose stopped running, my voice is less hoarse and I’m finally feeling energized. One of my co-workers said it must be the vodka, who knows?!

  3. #803
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    Shouldn't you be thanking me?
    Due to several complaints, I will stop using the terms "Babe" and "Baby" in reference to our female counterpart. They will now be replaced with "B*tch."

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  4. #804
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    Quote Originally Posted by oGaKirA View Post
    Shouldn't you be thanking me?
    You should be thanking me, dear. Remember vodka next time.

  5. #805
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    Hello,

    May i know what is the treatment for an injured knee medial meniscus? And how do we prevent it in future.. And if it will affect our life as a dancer?

    thank you~*
    ~Pinky **

  6. #806
    Senior Member yittz's Avatar
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    Quote Originally Posted by pinky ballerina View Post
    Hello,

    May i know what is the treatment for an injured knee medial meniscus? And how do we prevent it in future.. And if it will affect our life as a dancer?

    thank you~*
    There's conservative (non-surgical) and surgical treatment. Treatment choice depends on type of tear, other ligament injuries, symptoms and patient factors. Conservative management involves rest, ice and anti-inflammatory/pain meds. This is usually trialed first, but if symptoms don't improve -> surgical treatment. For many cases, surgery is required to prevent the tear increase in size and further damage to the knee.

    Prevention involves a healthy knee - good strength and flexibility, proper shoeware, as well as avoiding activities that could injure it (though that's unlikely for most sportsman). Meniscus tears usually caused by twisting injury.

    You will be out of action a few weeks after meniscal injury. You might be worried about further injuries while performing.

    Best to get a referral to an orthopaedic surgeon from your GP, or talk to fellow dancers who have had taht injury before.
    Last edited by yittz; 12-14-07 at 06:48 PM.
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  7. #807
    Senior Member Jilly's Avatar
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    Hi Doc,

    I have prolactionamoa (micro) and been taking Bromocriptine everyday for the past 4 years. After consulting with my doctor last week, she allows me to temporarily stop taking the medicine and check my prolactin level again 3 months later. Now I hope that I don't have to depend on the drug for the rest of my life, but if I have to take it, is there any long-term side effect of the medicine? What about the prolactinoma itself? Should I be worried about it?

    I've also been having acupuncture sessions for the past 4 months (about 3 times a month). Do you think this will help "balance" my body and suppress my prolactin as my acupuncturist have claimed? Or am I just wasting my money away?

  8. #808
    Senior Member yittz's Avatar
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    Quote Originally Posted by Jilly View Post
    Hi Doc,

    I have prolactionamoa (micro) and been taking Bromocriptine everyday for the past 4 years. After consulting with my doctor last week, she allows me to temporarily stop taking the medicine and check my prolactin level again 3 months later. Now I hope that I don't have to depend on the drug for the rest of my life, but if I have to take it, is there any long-term side effect of the medicine? What about the prolactinoma itself? Should I be worried about it?

    I've also been having acupuncture sessions for the past 4 months (about 3 times a month). Do you think this will help "balance" my body and suppress my prolactin as my acupuncturist have claimed? Or am I just wasting my money away?
    Most microprolactinoma (95%) do not progress to macroprolactinoma (which needs treatment). If you have effects/symptoms from the microprolactinoma, you will need to take the medications. If the effects are minimal, then you can be monitored with the blood tests and imaging.

    The bromocriptine helps reduce the prolactin level and decrease the growth of the secreting cells. There are a few short term side effects, no reported long term ones. Do you feel any different on them? Your doctor will taper you off the meds if your prolactin levels drop to normal.

    There are long term side effects of high prolactin, so it's important to keep it at normal range.

    I do not believe in acupuncture with regards to prolactin level. High prolactin is caused by an active bunch of cells secreting that hormone - not an imbalance that can be solved by sticking needles every week. But that's just my opinion based on what I've been taught. Ask him/her how exactly does acupunture lower prolactin levels.
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  9. #809
    Senior Member Jilly's Avatar
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    Quote Originally Posted by yittz View Post
    The bromocriptine helps reduce the prolactin level and decrease the growth of the secreting cells. There are a few short term side effects, no reported long term ones. Do you feel any different on them? Your doctor will taper you off the meds if your prolactin levels drop to normal.
    Thank you for your prompt reply. Initially, I had trouble breathing at night, but after a few months the problem disappeared. The weirdest thing is that I increase my appetite when one of the side effects listed are loss of appetite. I also feel tired everyday. Is it because of my condition? My doctor said that after taking the meds, my body should return to normal, but I still feel fatique. Is that normal?

    Quote Originally Posted by yittz View Post
    I do not believe in acupuncture with regards to prolactin level. High prolactin is caused by an active bunch of cells secreting that hormone - not an imbalance that can be solved by sticking needles every week. But that's just my opinion based on what I've been taught. Ask him/her how exactly does acupunture lower prolactin levels.
    She said the needles help regulate the hormones (I don't know exactly how though), hence lower the prolactin level as well. Honestly, I'm not a big believer of acupuncture either, but I have to try every way to keep my body healthy, which leads to another question for you. Several months ago, I've also been diagnosed with fibroadenoma and follicular cysts. Why can my body produce so many benign tumors? My biggest concern is that my grandma died of breast cancer. Is there any connection between fibroadenoma and breast cancer? My mom also has endometriosis. What's the difference between follicular cysts and endometriosis?

  10. #810
    Senior Member Jilly's Avatar
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    Post deleted
    Last edited by Jilly; 12-21-07 at 12:23 PM.

  11. #811
    Senior Member yittz's Avatar
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    Quote Originally Posted by Jilly View Post
    Thank you for your prompt reply. Initially, I had trouble breathing at night, but after a few months the problem disappeared. The weirdest thing is that I increase my appetite when one of the side effects listed are loss of appetite. I also feel tired everyday. Is it because of my condition? My doctor said that after taking the meds, my body should return to normal, but I still feel fatique. Is that normal?



    She said the needles help regulate the hormones (I don't know exactly how though), hence lower the prolactin level as well. Honestly, I'm not a big believer of acupuncture either, but I have to try every way to keep my body healthy, which leads to another question for you. Several months ago, I've also been diagnosed with fibroadenoma and follicular cysts. Why can my body produce so many benign tumors? My biggest concern is that my grandma died of breast cancer. Is there any connection between fibroadenoma and breast cancer? My mom also has endometriosis. What's the difference between follicular cysts and endometriosis?

    NP.

    Difficulty breathing at night - need more info, what do you mean by difficulty? just at night? cough? lying down makes it worse/sitting up make it better? how did it come about/go away? I don't think it's related to the prolactinoma or its treatment.

    Appetite - not sure, bromocriptine can cause nausea (but so do many other drugs). Good appetite is good, any weight gain?

    Tiredness - rather a non-specific symptom, could be many other things, could be the drug.

    Symptoms of high prolactin are galactorrhoea, sex hormone imbalances that produce less/no menstruation and other reproduction related symptoms. You probably don't have any of those after the medication. The side effects of bromocriptine are best found on the pharmaceutical drug info that comes with the drug - dizziness, upset stomach, headache, fatigue, vomiting, constipation.

    Breast cancer - family history is important, question is how many relatives and their age of onset. When did your grandma get it, any other close relatives? Fibroadenomas do not increase the risk of breast cancer and are common in young women.

    Ovarian cysts are also really common. Wouldn't worry about them if they are not causing you any symptoms. Endometriosis occurs when cells of the uterus endometrial origin are found elsewhere, such as ovaries and they bleed similarly to how the uterus bleeds during periods but are trapped. Cysts are collections of fluid.

    Haven't done much gynaecology, hopefully Han Solo checks.
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  12. #812
    Senior Member Jilly's Avatar
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    Quote Originally Posted by yittz View Post

    Difficulty breathing at night - need more info, what do you mean by difficulty? just at night? cough? lying down makes it worse/sitting up make it better? how did it come about/go away? I don't think it's related to the prolactinoma or its treatment.
    Just at night. No cough. My nose was so stuffy that I had to breath through mouth. Sitting up makes it better, but there's no way for me to sleep sitting up, right? I don't know how it went away; it just did. But I'm sure it's from the meds cuz I had this problem as soon as I started taking my meds. Oh, before I took Bromocriptine, I was on Dostinex. I had severe allergic reaction (such as rash to name a few) with Dostinex, so my doctor switched it to Bromocriptine.

    Quote Originally Posted by yittz View Post
    Appetite - not sure, bromocriptine can cause nausea (but so do many other drugs). Good appetite is good, any weight gain?
    Yup, I've gained 5 lbs.

    Quote Originally Posted by yittz View Post
    Breast cancer - family history is important, question is how many relatives and their age of onset. When did your grandma get it, any other close relatives? Fibroadenomas do not increase the risk of breast cancer and are common in young women.
    My grandma is the only one in my family that has breast cancer. She got it when she was 60. Good to know that fibroadenoma is nothing serious.

    Quote Originally Posted by yittz View Post
    Ovarian cysts are also really common. Wouldn't worry about them if they are not causing you any symptoms. Endometriosis occurs when cells of the uterus endometrial origin are found elsewhere, such as ovaries and they bleed similarly to how the uterus bleeds during periods but are trapped. Cysts are collections of fluid.
    Do you think the spotting was from the cysts then? But I only have the cysts recently, whereas the spotting has been going on for years.

  13. #813
    Senior Member Jilly's Avatar
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    Hello Doc, I just got my blood test result. My prolactin level is 35. It's not too high, but it's still higher than normal. That number is also when I'm still on medication. Do you think it's still safe to temporarily stop taking the meds and check back 3 months later? On a side note, I got an episode of bad headache within a week I'm off my medication. I hardly ever got a headache, so it's quite concerning.

  14. #814
    Senior Member HuangYushi's Avatar
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    Rotavirus Vaccination

    RotaTeq was made available recently in Malaysia as a vaccine against rotavirus infection in children below 6 years old. There were several cases of rotavirus infection at my workplace this year, and most of the infected children had to be hospitalised.

    According to the RotaTeq website and the US Centers for Disease Control and Prevention (CDC):

    The first dose of RotaTeq® vaccine should be given between 6-12 weeks old and two additional doses are given at 4-10 week intervals. Children should get all three doses before 32 weeks old. There is insufficient data on the safety and efficacy of PRV in infants outside of these age ranges.
    However, as far as I know, the childhood immunisation schedule in Malaysia has not included any rotavirus vaccine. [It does not even make varicella/chickenpox vaccination compulsory, and we had more than 15 cases this year!].

    Therefore, I have a few questions:

    1. Since there is "insufficient data on the safety and efficacy of PRV in infants outside of these age ranges", should parents of the 3- to 6-year-old children at my workplace even ask their family doctors and/or paediatricians about the rotavirus vaccine for the kids?

    2. What else can we (as a school community) do in the event that rotavirus vaccination is not an option for 3- to 6-year-olds, besides educating their kids and their parents on the appropriate hygiene practices to prevent rotavirus infections? As far as I know, most of the infections this year occurred outside the school, i.e. the kids ate contaminated food and/or had contact with infected persons or contaminated surfaces.

    Many thanks in advance.
    Jin Yong's Ode to Gallantry [侠客行].
    Quote Originally Posted by atlantean0208
    what about SPT, I need my SPT fix ASAP, pretty pleaseeeee...
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  15. #815
    Senior Member Han Solo's Avatar
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    Quote Originally Posted by HuangYushi View Post
    Rotavirus Vaccination

    RotaTeq was made available recently in Malaysia as a vaccine against rotavirus infection in children below 6 years old. There were several cases of rotavirus infection at my workplace this year, and most of the infected children had to be hospitalised.

    According to the RotaTeq website and the US Centers for Disease Control and Prevention (CDC):



    However, as far as I know, the childhood immunisation schedule in Malaysia has not included any rotavirus vaccine. [It does not even make varicella/chickenpox vaccination compulsory, and we had more than 15 cases this year!].

    Therefore, I have a few questions:

    1. Since there is "insufficient data on the safety and efficacy of PRV in infants outside of these age ranges", should parents of the 3- to 6-year-old children at my workplace even ask their family doctors and/or paediatricians about the rotavirus vaccine for the kids?

    2. What else can we (as a school community) do in the event that rotavirus vaccination is not an option for 3- to 6-year-olds, besides educating their kids and their parents on the appropriate hygiene practices to prevent rotavirus infections? As far as I know, most of the infections this year occurred outside the school, i.e. the kids ate contaminated food and/or had contact with infected persons or contaminated surfaces.

    Many thanks in advance.
    Hi Yushi,

    Note that i'm not an infectious disease trainee, and my answer is based on what i know of viral gastroenteritis in the young.

    1) Most of the gastroenteritis affecting us are viral infections. In particular, in the young, rotavirus is one of the most common viral gastroenteritis.

    2) The recommended age group for the rotavirus vaccine is due to the fact that the trial validating the vaccine is done at that age group, and also the fact that the younger you are, the more potential complication that you may get from a prolonged severe gastroenteritis --> hence, those may benefit more from the vaccine.

    There doesn't seem to be any reason why the vaccine should not work for an older age group than the recommended age.

    3) For any gastroenteritis, good hand hygeine is important - teaching them about hand washing and eating properly cooked meals.

    In many cases, the main thing in the treatment of viral gastroenteritis is to ensure that the patients do not get dehydration, and maintaining oral hydration with the help of an oral rehydration solution such as gastrolyte etc is helpful. In kids that is not able to maintain adequate oral hydration, they need to be seen by a clinician to be assessed of the need for either nasogastric or intravenous rehydration therapy with hospital admission.

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  16. #816
    Senior Member yittz's Avatar
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    Quote Originally Posted by Jilly View Post
    Hello Doc, I just got my blood test result. My prolactin level is 35. It's not too high, but it's still higher than normal. That number is also when I'm still on medication. Do you think it's still safe to temporarily stop taking the meds and check back 3 months later? On a side note, I got an episode of bad headache within a week I'm off my medication. I hardly ever got a headache, so it's quite concerning.
    Spotting: When in the cycle, how much blood, when it began, any trauma/problems down there?

    There could be many causes (or completely normal), could be hormonal, but doesn't seem to relate to the prolactinoma. Don't think cysts will cause it. Ask your GP if it's causing you concern.

    Breathlessness - wouldn't worry about it.

    Meds - I would follow your docs instructions. It doesn't seem to be causing you to much side effects and you will need it until the prolactinoma disappears. Since your levels are still above normal, I reckon continuing.

    Headache - describe, where, how long, how bad, anything that makes it better/worse. Ask your doctor if going off the meds will cause a headache.
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  17. #817
    Senior Member HuangYushi's Avatar
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    Re: Rotavirus Infection and Vaccine

    Thanks for your help, Han Solo!

    We are starting a new school year in about a week, and I am planning/preparing for a parent education campaign that will hopefully reduce some of the problems that we had with ignorance, apathy and infections this year.
    Last edited by HuangYushi; 12-23-07 at 10:21 PM.
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    Quote Originally Posted by atlantean0208
    what about SPT, I need my SPT fix ASAP, pretty pleaseeeee...
    Soon ... SOON!

  18. #818
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    I have a question about cholesterol - I just got back my blood test and the readings for my cholesterol are:

    VLDL - 15
    LDL - 72
    HDL - 101
    Total - 188

    I got a high flag next to my HDL. From my understanding HDL is "good cholesterol" and it's actually best to have >59, but 101 is quite a bit over 59. Furthermore, my HDL is putting my total cholesterol near 190, which is closer to the 200 mark than I'd like. Plus whenever they calculate your cholesterol level, they seem to always use total cholesterol to determine if your cholesterol is high, so I'm starting to doubt whether you can really never have too much HDL cholesterol.

    Also is there any difference in what determines a person's systolic and diastolic pressure? My blood pressure is 106/80, and I've always wondered why my systolic is lower than the average while my diastolic is pretty much average. I hope JHU is right about their study of how systolic is more important, since I think my diastolic could use some lowering.
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  19. #819
    Senior Member yittz's Avatar
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    Quote Originally Posted by Sparky View Post
    I have a question about cholesterol - I just got back my blood test and the readings for my cholesterol are:

    VLDL - 15
    LDL - 72
    HDL - 101
    Total - 188

    I got a high flag next to my HDL. From my understanding HDL is "good cholesterol" and it's actually best to have >59, but 101 is quite a bit over 59. Furthermore, my HDL is putting my total cholesterol near 190, which is closer to the 200 mark than I'd like. Plus whenever they calculate your cholesterol level, they seem to always use total cholesterol to determine if your cholesterol is high, so I'm starting to doubt whether you can really never have too much HDL cholesterol.

    Also is there any difference in what determines a person's systolic and diastolic pressure? My blood pressure is 106/80, and I've always wondered why my systolic is lower than the average while my diastolic is pretty much average. I hope JHU is right about their study of how systolic is more important, since I think my diastolic could use some lowering.

    On cholesterol:

    Looks good. Wouldn't worry about the high HDL. Your cholesterol is still <200 which is optimal and most of it is made up of HDL. I think a better measurement, rather than total cholesterol, is the ratio between HDL and total cholesterol, your's is clearly optimum.

    According to emedicine, very high HDL can be atherogenic (a risk factor for heart attack), but I doubt 100 fits into that category. Generally speaking the higher the HDL, the more protective it is against coronary heart disease and longer life.

    Causes of high HDL: genetic influences most, female>male, environmental factors -oral estrogen replacement therapy, aerobic exercise, chronic alcoholism, niacin treatment.

    In summary, I wouldn't worry about it, but remember to get it regularly checked. I once freaked out when my LDLs were near 0, but the GP just said chill, everyone is different, the markers are there for the population, each person is different and need to look at the overall picture.


    On BP:

    From emedicine:
    The top, larger number is called the systolic pressure. This is the pressure generated when the heart contracts (pumps). It reflects the pressure of the blood against arterial walls.
    The bottom, smaller number is called the diastolic pressure. This reflects the pressure in the arteries while the heart is filling and resting between heartbeats.

    Like you said, lower pulse pressure (to a degree) is good (your's is 106-80 = 26mmHg) as it conveys a lower risk of heart disease/stroke etc.

    The average for normal population is around 110 over 65. Within the population there are great variations. I wouldn't worry about it. Maybe your great arteries is just very compliant. What's your pulse rate and do you have any symptoms of fainting/dizziness on getting up?
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    Quote Originally Posted by yittz View Post
    chronic alcoholism
    Ah, now I know why my HDL is high

    What's your pulse rate and do you have any symptoms of fainting/dizziness on getting up?
    My pulse is around 60. I haven't had any of these symptoms as of late and I haven't felt like fainting for a couple years now, but I remember a few months ago sometimes when I'd get up from lying on the bed or whatever, my mind would black out for a couple of seconds. I assumed it was because I was eating very little those days (food in rural China sucks). The main reason why I'm concerned about these tests at all is because I don't eat even close to what the food pyramid recommends and caffeine is my best friend.
    I love sleep. My life has the tendency to fall apart when I'm awake, you know? -Ernest Hemingway

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