medical Free Medical Advice

[ermita rojo]

Multiple MRCP's, maybe 4 or 5, CA markers, all normal.

 

 

ok. for a while i thought i read ERCPs were done, and not MRCPs.

 

 

makes a difference

[omegared]

Yes and yes, 4-5 MRCP's over the years, 3 ERCP's that I know. He was seen in other practice past 3-4 years before I found him again in my service.

[nouseforaname]

Hi,

 

Just want to ask something about tubercolosis. 2 years ago, i had a bad cough. There are spots of blood in my cough. Then i went for a checkup and the doctor said the blood that i saw was from my throat because of the roughness and the cough was because of mycoplasma. I was treated with medicine back then, and it went away. Now, i have been coughing bad again. My throat was the one triggering the cough. It's very itchy. It's been 3 weeks since i started coughing again. Yesterday, i went to the doctor and got an xray. Now my problem is this,the xray technician told me that i had a healed tb scar probably for 2 years now. I am shocked because i was never been diagnosed and i don't have any symptoms...now i am very worried. Am i still going to have a tubercolosis even if it's already healed? And is it possible that the TB healed itself? Please help me. Thanks.

[miggyE]

chances are, you had PTB previously as a child. childhood PTB is quite common in this country, and is usually treated early. its just that it is often referred to as Koch's Infection or Primary Complex, and this is why most people don't realize that this is a childhood form of PTB.

 

PTB rarely heals by itself and usually spreads over time. and, no, regular antibiotics don't work on PTB. only a few do, and you have to take them as a group over a period of months.

 

to be safe, bring the Xray to a Pulmonologist and get yourself a true consult. not to demean the xray techs here, but i would rather you see a true MD.

 

and, bilib ako ha! Xray Tech na marunong magsabi kung ilang taon na ang healed scar! i wonder what the markers are to determine age of the scar tissue without having to do a biopsy? once scar tissue forms, it is usually permanent.

[nouseforaname]

Ganun ba? Is it possible na since nagkamycoplasma ako dun ko sya nakuha? Magpapasecond opinion ako, very worried lang ako na if ever tb scar nga yun, hindi na ako makakapagtrabaho. Next week magpapasputum test ako. Hindi rin masabi ng doktor kung tb scar yun kaya sabi magpatest pa daw ako. Totally curable ba sya? Sana nga hindi TB scar yun. Tinest ako for infection, cbc ok naman naman ang result. Maraming salamat sa response! Will it be reactivated again?

[omegared]

Ganun ba? Is it possible na since nagkamycoplasma ako dun ko sya nakuha? Magpapasecond opinion ako, very worried lang ako na if ever tb scar nga yun, hindi na ako makakapagtrabaho. Next week magpapasputum test ako. Hindi rin masabi ng doktor kung tb scar yun kaya sabi magpatest pa daw ako. Totally curable ba sya? Sana nga hindi TB scar yun. Tinest ako for infection, cbc ok naman naman ang result. Maraming salamat sa response! Will it be reactivated again?

[omegared]

Let's keep it simple. Nagpa physical ka for work, X ray mo may shadow sa apex, there's a presumptive diagnosis of PTB dahil sa high incidence ng TB sa Pilipinas.

1. Wala ka pang TB, pag sputum mo may stained na bacteria, wala ka pa ring TB malamang lang, pagmerong culture na, may TB ka, then may TB ka.

2. Unfortunately over 30 days bago mafinalize ang culture so for practical purposes, if the sputum is positive for acid fast bacili, you will be presumed to have PTB until proven otherwise and should be treated. Paglabas ng culture, kahit negative, dahil nakakalhati ka na ng treatment ipapatapos na lang sa yo yun.

3. If you have an old Xray to compare, at pareho ang hitsura ng shadow, I will wait for acid fast to be positive, pagnegative, follow up Xray ka na lang. I will not treat, some will do PPD, pero dahil high risk ka because it's endemic, if negative, it will be presumed that it was a false negative anergic reaction. If the shadow has not changed and negative sputum mo, at negative PPD mo, at asymptomatic ka, I will not treat, although majority of docs will treat.

Now, kung may RNA, DNA probe or Quantiferon tests na available, it will be easier to decide.

But Im the more dont treat doc and wait than treat unless it's life threathening illness that cannot wait. If asymtomatic, I dont see urgency to treat at this point.

[nouseforaname]

Let's keep it simple. Nagpa physical ka for work, X ray mo may shadow sa apex, there's a presumptive diagnosis of PTB dahil sa high incidence ng TB sa Pilipinas.

1. Wala ka pang TB, pag sputum mo may stained na bacteria, wala ka pa ring TB malamang lang, pagmerong culture na, may TB ka, then may TB ka.

2. Unfortunately over 30 days bago mafinalize ang culture so for practical purposes, if the sputum is positive for acid fast bacili, you will be presumed to have PTB until proven otherwise and should be treated. Paglabas ng culture, kahit negative, dahil nakakalhati ka na ng treatment ipapatapos na lang sa yo yun.

3. If you have an old Xray to compare, at pareho ang hitsura ng shadow, I will wait for acid fast to be positive, pagnegative, follow up Xray ka na lang. I will not treat, some will do PPD, pero dahil high risk ka because it's endemic, if negative, it will be presumed that it was a false negative anergic reaction. If the shadow has not changed and negative sputum mo, at negative PPD mo, at asymptomatic ka, I will not treat, although majority of docs will treat.

Now, kung may RNA, DNA probe or Quantiferon tests na available, it will be easier to decide.

But Im the more dont treat doc and wait than treat unless it's life threathening illness that cannot wait. If asymtomatic, I dont see urgency to treat at this point.

alright. maraming salamat po! natakot lang kasi ako

[bigsam]

high blood pressure is a bitch!

 

starting 5 years ago, i became very active and started healthy eating. since then i have lost 70lbs (from 250 to 180lbs).. i don't smoke, drink, i avoid processed food, i avoid fried foods, i do a lot of cardio (bike, run, swim) and weights.. but still i have high bp, 130/110.. now i have to take maintenance meds.

[lolxes]

high blood pressure is a bitch!

 

starting 5 years ago, i became very active and started healthy eating. since then i have lost 70lbs (from 250 to 180lbs).. i don't smoke, drink, i avoid processed food, i avoid fried foods, i do a lot of cardio (bike, run, swim) and weights.. but still i have high bp, 130/110.. now i have to take maintenance meds.

maybe may history ang family mo for that

[miggyE]

i agree with archerrin123, whats your family history? how about your cholesterol levels?

 

although both do not give the whole picture, it could help point an MD in the right direction.

[bigsam]

i haven't checked my cholesterol level.. but i assume it's OK.. i had a medical check up for employment abroad. i dont know if that included cholesterol check.

 

BUT family history is the main factor for me.

[omegared]

If you are less than 40 years old, there is 10% chance that there is a reason for having high blood pressure and some of these can be fixed, if you are over 40, there is 99% chance that your hypertension is called essential, basically you are born with it.

[Genesis_MD]

Diagnosis of PTB may not always be based on chest xray nor sputum smear. Clinically, based on signs and symptoms one may be diagnosed by a competent physician without any test, hence, may be started on full course treatment.(Bacteriologically-confirmed vs Clinically-diagnosed)

[omegared]

Diagnosis of PTB may not always be based on chest xray nor sputum smear. Clinically, based on signs and symptoms one may be diagnosed by a competent physician without any test, hence, may be started on full course treatment.(Bacteriologically-confirmed vs Clinically-diagnosed)

What's your advice for Bigsam?