medical Free Medical Advice

[kix™]

Mejo off topic, baka may kilala kayo med rep from mead johnson. mas cheaper daw bumili straight sa kanila ng mga products (like milk for babies) unlike sa grocery?

 

pag meron pls PM nyo naman sakin if its ok to call or txt him/her. Thanks!

[miggyE]

likes to consult with a tall and beautiful/sexy derma and dentist because it makes visit worthwhile and enjoyable pag maganda ang uma attend sa patient? Do you have anybody to recommend? Thanks a lot.

 

 

SORRY, BUT THIS IS NOT THAT SORT OF FORUM

[omegared]

likes to consult with a tall and beautiful/sexy derma and dentist because it makes visit worthwhile and enjoyable pag maganda ang uma attend sa patient? Do you have anybody to recommend? Thanks a lot.

 

 

You are sick in the head, both. Psychiatrist ata kailangan mo.

[bonito99]

BLOODWORKS LAB

 

For all your STD and/or BLOOD tests.

[keys_mark]

may ma recommend ba kayo na dermatologists ?yun sa groin butt area

[pogingpogi2x]

may ma recommend ba kayo na dermatologists ?yun sa groin butt area

 

skinhouse at mayon

[cocoy0]

mga doc,

 

ask ko lang, everytime I try to strech my left foot, may tumutunog or lumalagutok. btw, last year i had a sprained ankle. ano po kaya ang problem sa foot ko?

 

baka may ligaments ka lang na nangapal. May pain ba na hindi pantay sa kabilang paa if you're exerting yourself?

[SamanthaJones]

Since July my brother's been in and out of the hospital. The first time he got admitted, my bro complained of severe abdominal pain. A few days during confinment, he suffered recurrent fevers and his skin turned yellow. After several test, doctos had to put a stent in his billiary tract because it might be the cause of the infection. All tests were negative for hepa, blood work was ok, in short they weren't really able to give a clear diagnosis of my brother's condition. He had the stent for a month, his health in a way improved however 2 days after the stent was removed, he suffered from recurrent fever again not to mention a sudden drop in his weight from the first time he was hospitalized. Another series of tests were made - mri, ct scan, xrays, blood work, and several other tests but still they can't figure where the infection is coming from since all the test results are normal. Finally 3 weeks in the hospitaln the doctors said that it was a case of TB in the whole abdomen- treatable by anti tb drugs. They also found out that he has abcess in the liver and pancreas. They also inserted another stent on my brother. After almost a month. fever was gone and he was sent home. A week getting discharged, he suffered from severe back pain that he could hardly get up, lost his appetite up to the point that eating even small portions of food would make him vomit. He is now back again in PGH, and the doctors said that the stent they removed from my brother had a new strain of bacteria not previously seen before this admission. Doctors said that current anti biotics that my brother is taking is not enough to k*ll this bacteria as it is too resistant. The bacteria was indentified as enterococcus. Sorry if I had to give you a long narrative though I am not sure if the info I provided is enough but anyway my question is is this type of bacteria something's that still really curable?

Edited November 17, 2012 by SamanthaJones

[SamanthaJones]

HI Doc.. let me answer your questions.

 

1. If they were able to isolate enterococcal bacteria, then there must be a culture and sensitivity report that specifies to which antibiotic that bacteria is sensitive. It may be difficult since there could be resistant strains, but yes, it is curable, provided of course that you give the right antibiotic (easier said than done).

 

 

Yes they have given him 3 new antibiotics. According to them, this drugs are not usually given since these drugs also have the tendency to k*ll the good bacteria. I forgot the names as they are hard to recall but i do remember that they stop the vancomset drug or something that sound like that .

 

2. Yes, there is such a thing as TB of the liver, although we have been seeing less of this during the past few decades. During the time of our mentors, it used to be more common. IT may cause blockage of the intrahepatic bile ducts, which can produce the symptoms that you mentioned. So I agree with the stent.

 

 

My questions are these --

 

1. Have they ruled out cancer? (sorry to be blunt, no other way of saying it). Have they done tumor markers (these are blood tests)? Did they send the stent specimen for cytology as well?

 

I believe so. The doctors are aware that Cancer runs in the family. Mom had Gastrointestinal Ca. Brother had Non Hodgkin's Lymphoma. I believe they ran all sorts of test. that most of the time comes out within the normal parameters.

 

2. Was drainage of the abscess done?

 

Yes, there was. There were absecess in the bile and in the liver. If i am not mistaken.

 

If the pgh people are having a difficult time, then his case must be difficult indeed. Pang grand rounds, as we say.

 

Yes they are. Originally he was admitted at St Lukes then got referred to PGH due to financial constraints. Sad to say. up to this point we are not sure what the real cause of this weight loss. recurrent fever, loss of appetite, jaundiced- like skin, back pain, abdominal pain They have referred him to different specialists - including that of infectious department but still nothing is truly that clear in terms of what my brother's sickness is.

 

 

Now I am no doctor but I do know that infections if left untreated properly will lead to sepsis which is life threatening.

[SamanthaJones]

they probably stopped vancomycin because it could be vancomycin-resistant enterococcus.

 

 

at any rate, let's hope the antibiotics would work and the stent will last without getting blocked. Kase kung barado, then that alone could cause cholangitis, regardless if there are abscesses anywhere.

 

If the abscess was drained and he is on strong antibiotics, then he should improve. THe rate or how fast he responds, of course, could vary though.

 

They have already removed the stent. last week and that's were they found out th enterococcus bacteria.

[SamanthaJones]

then let's hope the ducts would drain properly, without a stent. IF the stent was a source of infection, then tama lang na natanggal.

 

IF the jaundice persists and repeat ercp would still show inadequate drainage, then a stent would have to be re inserted.

Thank you doc. Btw, these are drugs that he was given just now - tigecycline, amikacin, imipenem.aside from that they can't do ctscan on him because he is allergic to the dye given for the scan even if he is given drugs to counter the allergy.

Edited November 17, 2012 by SamanthaJones

[Pidro_Pilyo]

hi ENT practiioners here!

 

when i close my right eye, its feel grainy (like a gain inside) when i role my eyeballs (while close). i have not came into contact with anything, i work in a construction site.

 

thanks.

[SamanthaJones]

How serious is severe sepsis?

[Intuition]

see an ophthalmologist and not an ent.

 

EYE, nose and throat? hahaha

[Pidro_Pilyo]

see an ophthalmologist and not an ent.

 

EENT puede?