Focal Abdominal Pain in a Post- Menopausal Woman

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree

50 female, menopause and all it's glory.  Had lots of issues over the years.  I've had belly tenderness and pain for 3 weeks now.  Right side below the rib cage and it moves around my back.  I feel like there's a football in there taking up space.  On occasion, a very sharp/knifelike pain in my back on the right.  Over the years I've had off an on issues with my belly on the right.  They tell me it 'must be IBS' and when you can't 'go' or you are passing/puking blood, then is the time to call the doc.  Well, my 'gut instinct' is telling me this isn't a good thing happening.  Should I wait until one of the 3 options happens?  I know that describing belly pain is a nightmare since it could be something totally not 'belly' related.

Gender: Female
How tall are you (feet and inches)?: 5'4"
What is your weight in pounds?: 153
How old are you?: 50

How long has this been going on?: A week or two
Check all symptoms you are currently experiencing:
Abdominal Pain
Diarrhea


Describe associated symptoms not listed above: Belly is tender to the touch just below my right rib cage.  From the belly button on a diagnoal about 2" up. Constant 'discomfort and pressure' which escalates to sharp shooting pain that circles around my right side to my back.  When I breathe in deep, it feels like there is a football stuffed in my belly on the right.  I have a buging disc at C3-4, C5 is crumbling/pinching nerves and there is pressure on my spinal cord at C4-5.  I have been seeing a pain management specialist for 6 years now.  Injections as needed into the C3-4-5 area.

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Increased water and fiber, lower caffeine and alcohol.  Haven't complained to my GP yet.  Trying to walk more.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!):

I have a 5.5 cm hiatal hernia/reflux/Barrett's esophagus  ongoing for 15 years.  I've had a salpingo oopherectomy/hysterectomy thanks to stage IV endometriosis, gallbaldder removed, tonsils are gone and they took the appendix with the removal of the first offspring.  DCIS diagnosis 9/11 (no big deal).  
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Diabetes

Please list any medication allergies that you have : :   Recent bad reaction to sulpha drug for UTI.  Turned beet red and felt as if I was on fire.  Stopped the drug immediately.  Old fashioned penecillin doubles me over with intestinal pain/cramping/diharrhea.

Please list any medications you are currently taking (and dosage if known) ::

Nambumetone  ??mg  2Xday), gambapentin (100 mg 2Xday), albuterol(as needed/not to exceed 2 inhalations 3Xday), advair 100/50  2Xday), citrical-D, vit C, magnesium, skelaxin(as needed ??mg).

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Weekly


I don't want to be labelled a cry baby/whiner/hypocondriac which is what happens as soon as you walk in and you don't obviously have a knife sticking out of your body.  On the other hand, I'm really close to being in a miserable state and realize this is not an ER issue.  If you can at least tell me the best language to use with an MD to describe my pain that would help.  I'll be seeing my oncologist on Friday and he's bound to go poking on my guts.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

A Cold Weather Syndrome.... Very Curious!

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Hi Doctors,

I live in Canada and enjoy running outdoors for exercise. However, whenever I run in cooler temperatures (which for me is anywhere from about 10 to -10 degrees C), I get extreme pain in my ears soon after I start running (maybe 10 minutes into the run - sometimes less!). I always warm up and don't have issues in any other muscles or parts of my body, and I dress warmly, including a fitted headband that completely covers my ears.
 
The pain is debilitating and usually causes me to need to stop running and head home. It does not occur when I run indoors or in warm spring/summer weather. Sometimes it feels like intense pressure in my inner ear, and sometimes it feels like it is just behind my ear. Usually, my jaw also locks and tends to "pop" when I open my mouth. The symptoms take about 20 minutes to resolve. I should also mention that other than this pain, I feel fine while running - to my observation, it is not linked to fatigue.

I was wondering if there's anything I can do to stop this? I really love running but the pain is extreme.

Thanks!
Gender: Female
How old are you?: 21
How long has this been going on?: More than a year

Check all symptoms you are currently experiencing:
Ear/ Nose / Throat
Describe associated symptoms not listed above:

Pain/pressure in both ears on exposure to cold weather while running, even when well-dressed. The pain is debilitating and has at times been severe enough to cause nausea. Does not occur if I am outdoors in the same temperatures while not exercising. However, ears are sensitive to cold in general and I am most comfortable in a hat or headband from November to March. A locked jaw accompanies the pain in my ears. Both resolve in ~20 minutes after coming indoors.

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Wear a headband or skullcap while running. I have been told that I should put cotton balls in my ears but I am confused about why this would help and am more interested in understanding the cause of this issue.



Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days

So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities.

1. What is this?
2. Why does it happen?
3. What steps can I take to reduce or eliminate the symptoms?
_________________________________________________________

Dear Canadian Runner,

I am struggling with this one. I did fine a link on WEB MD but I think the explanation, for what appears to be a fairly common syndrome, is less than satisfactory. My feeling is that your problem may be a combination of extreme sensitivity (because of your particular ear anatomy) of a Cranial Nerve, or, a cold-variant migraine, or, perhaps, some combination of these. Dr SWB is going to weigh in on this a little later today, and since this is right in his wheelhouse I think we will both learn something. Stand by, and thanks for your question.

MDSTAT DOC 1

The Lap Band.... A good solution?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.

I am an obese woman, 45 years old, who has tried a variety of diets and I'm considering the lap-band procedure. I am 5'3" and weigh 260 pounds. The best I ever did in the last ten years was on weight watchers and I got to 190 over 6 months but I put it all back on over the next year. I am strongly considering the procedure. Do you have any opinion on this for me?
Gender: Female
How old are you?: 45
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Psychiatric

Describe associated symptoms not listed above: I am depressed about the way I look.

I am "borderline diabetic" but otherwise quite active and healthy.
 

Check all conditions present in your immediate family... :
Cardiac Disease
Diabetes

Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally  

 

Summary:

 

What is the reality of the long term success with the lap band? Will I stop the yo-yo cycle? Are there any risks associated with the surgery aside from the normal surgical risks?

Calf Spasms.... Why?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Doc(s), I got a question that ya'll might be interested in.

It has to do with my calves, now, I know they're called "the second heart" for a reason, and everything cardiac checks out beautifully on me.

However, there are constant, tiny spasms going on--localized just there, it's almost interesting to watch.

Whenever I'm sitting you can see them (I don't know if they occur while I'm standing, because I can't see them, and I haven't asked anyone to look). They don't bother me, and I can't feel them, but they are there.

I'm just wondering if in your extensive experience and training if there is any kind of odd thing you can think of that can cause this.

I'm great at mineral intake, supplementation (zinc 50mg/day, copper 2mg/day, magnesium 500mg/day), and absorption, and I can tell within 3-4 days if I'm not taking them.

This has been occurring for as long as I can remember post-puberty, also, I get nasty---nasty cramps if I plantarflex, as in within 5 to 8 seconds, I've spent many-a-morning jumping out of bed, putting my hands on a wall to use my weight to dorsiflex, which solves the problem fairly quickly, however once it's started it's crazy sensitive to cramp up again.

I'm not that worried about it, just throwing it out there.

Gender: Male
How old are you?: 25
How long has this been going on?: More than a year


Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Chron's disease (asymptomatic)

Check all conditions present in your immediate family... :

Asthma / Lung Problems
Cardiac Disease
History of Back Pain
Hypertension
Psychiatric Disorders
Please list any medication allergies that you have : : Please do not list any medicines you merely dislike. True allergies produce hives and other symptoms. An upset stomach is not an allergy to a medicine. Thanks!

None.
Please list any medications you are currently taking (and dosage if known) :: Also, please tell us if there is medicine you are supposed to be taking but are not. Thanks!

Adderall 20mg/day. Don't want to take it (but I do), knew I have ADD since I was 17ish, waited till 3 months ago to confront it. Not happy about it. Inattentive and Impulsive, if you need that info.

When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

 Any strange-ass things that can be causing the little firework show on my damn calves.
_______________________________________________________________

I too have had this 'firework show' in my calves and I know when I am looking at it that I am looking at something called MYOCLONUS, but it sounds like in your case this is a persistent and consistent problem. 

So then I wondered if there might be a relation to your Adderall use, and, in fact, two of the side effects are 'nervousness and restlessness', and it's not too hard to imagine that the stimulant effect of the Adderall may, in you, cause the myoclonus. I wonder if you had it prior to using the Adderall? 

One other thing that can cause this is simply overdoing it in the gym or or with running or other sports. Buildup of lactic acid in the muscles will cause the myoclonus, and as you say, it IS interesting to watch, but if it is keeping you awake at night or causing other problems in your life it might be worth talking to your doc. I seriously doubt anyone would want to do an EMG on you at age 25 and it is unlikely that this is the result of some rare medical issue, it is, most likely, due to the Adderall in combination with you keeping yourself in good shape. 

Docs.... what say you?

________________________________________________________

Does Air Travel Make You Sick?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I see you have a doctor who knows about medicine and flying and how they interact and there's a question I just have to ask. Seems like every time I go on a cross-country plane ride I get sick. A cold or a sinus deal. Then I see this stuff called 'airborne', sold in stores.... It's some kind of herbal remedy invented by a teacher (?) who was tired of getting sick on airplane flights. Anyway, why do people tend to get sick when they fly and does this 'airborne' stuff have anything to recommend it?

Gender: Male
How old are you?: 40
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Ear/ Nose / Throat
Describe associated symptoms not listed above: You may also use this area to further explain symptoms checked above.

Just seems to take a few days to recover from an Jet flight.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!):

no major issues

Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Weekly


1. Is there something to the statement that it's easy to catch a bug or virus on a plane?
2. Why do I always feel bad after a flight?
3. Is there anything to do to remedy this, specifically, does that 'Airborne' stuff really work?

________________________________________________________

Our intrepid Space Doc will weigh-in shortly.

As to airline travel, realize this.... even though modern airliners are pressurized, they are pressurized to about 8000 ft AGL (above ground level), so, going up in a commercial jet is putting you, assuming you are a flatlander, in a relatively hypoxic environment for a few hours and much of what you are feeling may be due to Acute Mountain Sickness, which you can read about by clicking the link.

As to the "Airborne" herbal remedy, well, it won't do you any harm... PROBABLY. And if I lined up 100 people and gave them sugar water and told them all they were getting a powerful sleep medicine about 33 of them would go to sleep. This goes for all the 'supplement' market.... We simply have no scientific evidence to validate any of the claims made by these manufacturers, and the FDA is NOT regulating them, so the operative phrases here are 'caveat emptor' and 'placebo effect'.

Thanks for your question and stay tuned....

MDSTAT ER DOC 1

________________________________________________________________

 Dear air traveller:

There have been some studies that have shown a slight increase in sinus and cold symptoms during airplane trips, but this would probably be the same if you were confined in a crowded room anywhere.

As Doc 1 mentioned most planes are pressured to an altitude around 8000 ft which most people can tolerate, although some individuals can have altitude sickness symptoms of fatigue, nausea, headache, and shortness of breath as low as 5000 ft. altitude

I totally agree with Doc 1 that there have been no studies to inddicate the Airborne medication prevents any colds, sinusitis, or bacterial infections, and they have had to settle 2 or 3 lawsuits for false advertising.

However, I have been taking both vit. C (2000mg.) and Vit. E (400-800 i.u.) daily and haven't had a cold or sinusitis in over 10 years. The usual Airborne dose has 1000 mg of vit. C so it would probably be safest to take around 3 doses a day (rather than every 3 hrs) to avoid any possible kidney irritations.

Some people swear by the Airborne so it would probably be worth a try, but there are certainly no guarantees' I also have had a number of patients who have had good luck taking Sinutabs before a flight to keep the sinuses clear

Good Luck! Keep us posted.

Space Doc.

High Blood Pressure, Chest Pain, and All that Jazz.....

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

My question has to do with high blood pressure.  I have been taking my blood pressure with a home wrist machine.  It ranges anywhere between 145/90 and has been as high as 175/110 a few times.  Most of the time it ranges in the 150/100 ish.  This has been going on for about 2 years now.  More recently, I have been experiencing a racing heart when I'm at rest.  It's like my heart goes out of control before it corrects itself back to a normal heartbeat.  Within the last couple of months, I have been experiencing heart burn.  I don't know if it is severe or not because I don't have anything to compare it to as I have never experienced heart burn before.  Lastly, and also within the last couple of months, I have experienced pain under my ribcage in the front and up through my right shoulder-blade.  I don't know if this is all related or a coincidence that these have all happened about the same time.


I have no shortness of breath and can exercise without tiring.   My weight is proportionate to my height (5"3, 125 lbs) so my high blood pressure is not a result of being too heavy.

Gender: Female
How old are you?: 52
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Chest Pain
Palpitations

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: Eat healthy and exercise.  I typically stay away from junk food except for once in a while.  My diet consists of fish and whole foods, not processed.  Fruits, vegetables, brown rice and fish make up most of my diet.  Vegetables are fresh, not canned.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): None.

Check all that apply to you or your immediate family (parents, siblings, grandparents):
Cardiac Disease
Hypertension

Please list any medication allergies that you have : : None.

Please list any medications you are currently taking (and dosage if known) :: Also, please tell us if there is medicine you are supposed to be taking but are not. Thanks! NONE

When was your last menstrual cycle?: I no longer have a menstrual cycle

Are you currently using or do you have a history of tobacco use?: No

Are you currently using or do you have a history of illegal drug use?: No

Please describe your alcohol consumption :: Occasionally

So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response.

My high blood pressure is untreated because I am uninsured.  Until I am covered under insurance again, I would like to know what I can do to help prevent a heart attack.  I realize that I will need to be seen but at the moment, that is not possible.  Other than baby aspirin and my diet/exercise, is there anything else I can do to tide me over until I can be seen?  I'm just looking for some advice that can help tip the odds in my favor until I can be seen by a physician.

_________________________________________________________________


Ma'am,

My board certification is in Emergency Medicine. From our perspective and training EVERYONE has a life threatening condition until we prove they don't. Therefore it is from this perspective of 'worst case scenario' that I am going to provide an initial answer. My colleagues will follow, I'm sure, shortly.

Three things.....

1. You are at risk of heart attack and are having some symptoms that might be angina. Your blood pressure is all over the place, and the device you use may be part of the problem. You can get a three day blood pressure check at the health department or even at the fire station down the street using a manual cuff and a set of real human ears. This average measurement will be much more telling of your real blood pressure. Also, you would feel pretty silly if you showed up in heaven and St. Peter said, "Oh! You are here early!" And you found out that the blood pressure medicine you are now missing costs four dollars for a month's supply, and that a visit with a primary care physician who could give you the once-over and get you back on some inexpensive and efficacious medicines would be about $125. Not trying to scare you, just saying that you have some cardiac risk factors and you are taking a gamble waiting for your insurance.

2. A baby aspirin a day and good diet and exercise is great. Keep doing it.

3. You may have a gall bladder problem causing many of your symptoms. If the sharp pain you get is pain that comes particularly after eating then I am even more suspicious of this. Click on this sentence to learn about the symptoms of gall bladder disease and see if you agree. Now here you are really going to run into a money problem and there's nothing you can do, if you have gallstones, to reverse the process apart from having your gall bladder out. Be aware though, that if I am correct about your gall bladder, that you run the risk of developing Cholecystitis

I am going to make room for my colleagues here. Do not put of a primary care visit for the sake of 'waiting on your insurance'. The cost is less than you think for a one time 'howdy do' and some medication prescriptions. The doc could also get an idea about your gall bladder and could form a plan of action with you were it to become worse suddenly.

Thanks so much for your question!

MD STAT ER DOC 1
______________________________________________________________________

1) YOUR BLOOD PRESSURES : The range you describe is not good. (should be around 130/80). The wrist blood press. cuffs are often inaccurate. You can google mayo clinic wrist blood pressure monitors to see if you are doing measurements correctly. Very likely the family history of hi b.p. is partly responsible for your pressures.

2) RAPID HEART RATE (tachycardia) can be related to hi thyroid levels in the blood &/or some changes in the conduction system of the heart.

3) RIGHT SIDED PAIN UNDER RIBS GOING TO RT. SHOULDER BLADE. Could be gall bladder or liver problems.

4) "HEARTBURN". ( Unrelated to the heart). Stomach and esophageal reflux of acid. Tums or over the counter Omeprazole can help.

5) DIET. Low fat intake and avoiding acidic foods might help gall bladder and heartburn

6) SUMMARY:(a) Bl.Press. needs to controlled!! probably with medication since your weight,exercise and eating habits seem good.
(b) Need heart evaluation! (ekg etc} to check out heart rate & rhythm
(c) Need gall bladder evaluation (ultra sound etc.)
(d) One of our docs has a lot of emergency room experience and maybe he can help out on where to get things done that won't cost you an arm and a leg. I would be quite hesitant to continue on without getting these things checked out.

Good Luck---don't wait too long!!

Space Doc

_______________________________________________________________________

Functional Endoscopic Sinus Surgery.... Worth it?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I have been recommended to have sinus surgery. Something called a "FESS".... I get sinus infections a lot. But I don't know if this is really going to make a positive difference for me and I'm concerned because people tell me the procedure is so painful. Can you docs shed some light on this for me?

Gender: Female
How old are you?: 29
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Difficulty Breathing
Ear / Nose / Throat
Describe associated symptoms not listed above: You may also use this area to further explain symptoms checked above.

Just a chronic cough when I lie down at night. Headahces. Sinus drainage most of the time. Sometimes I get pain in my upper teeth which I'm sold is from the infection.
What have you done so far to remedy this condition? Please include tests and relevant studies here. ENT consult. CT sinuses. Xrays. Antibiotics. Flonase. Claritin. Mucinex. Nasal washes.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Other than this I'm quite healthy

Check all that apply to you or your immediate family (parents, siblings, grandparents):
Cardiac Disease

Not a smoker

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response.


How likely am I to get a good result from this?
Is it a dangerous surgery?
How long till I can resume a fairly normal life after the surgery?

___________________________________________________________________

Ma'am,
Just so happens we have an ENT Surgeon here at MD STAT. I'm going to get him on this question when he can. In the meantime you may want to check out THIS LINK from the American Academy of Family Practice. It's a pretty good summary. Keep checking back with us for more. Thanks for your question.

MD STAT ERDOC !
_____________________________________________________________________

Endoscopic Sinus Surgery (ESS) or Functional Endoscopic Sinus Surgery (FESS) are operations performed using scopes (endoscopes), and special instruments, with the access to the sinuses being from inside the nose (without any external incisions or scars).

FESS can make a very positive difference for some sinus problems.  It can be relatively painless and very safe. The recovery can be quite short (2-3 days).  However, there are several variables that can make one person’s experience, risk, and outcome very different than another’s.  I will discuss some of these further.

First, an understanding of some basic sinus facts is necessary.  The sinuses are air-filled cavities within the bones of our face and skull.  They have a mucous membrane lining that makes mucous which then drains into the nose through very narrow openings. If these narrow openings are “blocked”, mucous will accumulate in the sinuses, and will virtually always become infected if drainage isn’t restored fairly quickly (days/weeks).  When bacterial infection is suspected or confirmed, antibiotic are usually prescribed.  Common sinus infection symptoms include, discolored nasal drainage,  nasal congestion, post-nasal drainage, sinus pressure/sinus headache, upper tooth pain, fatigue, cough, and plugged ears.  Symptoms can vary, often based on the severity of infection and which sinuses are affected.  We have 4 sets of sinuses on each side of our face/head.  These are named as follows:  Maxillary sinuses, ethmoid sinuses (anterior and posterior), frontal sinuses, and sphenoid sinuses.  An internet search of “sinus anatomy” can show you the basic locations of these sinuses.

So, what causes the sinus openings to become blocked?  Inflammation and swelling are the most common reasons for the openings to become blocked.  There are several possible sources of this inflammation.  One of the most common is a viral upper respiratory infection a.k.a. “a cold”.  Environmental allergies (“hay fever”) is another common source of excessive swelling/inflammation.  The swelling of the sinus lining that occurs with bacterial sinus infection can persist for a period of time after the bacterial infection has been treated, leaving the openings still blocked and prone to repeat or further infection.  Very severe and chronic inflammation of the lining can result in “polyps” that can block the sinus openings.  Lastly, some people are born with abnormal nose or sinus anatomy that can make the openings more narrowed or blocked.

If the use of medications (antibiotics, steroids, allergy medicines, etc.) can not successfully resolve the inflammation and get the sinuses to drain and function normally, surgery may be considered.  The basic purpose of the ESS is to create surgical openings into the sinuses so they can drain the mucous they make.  Essentially, chronic sinusitis is a medical problem (treated with medicines) in which surgery can sometime play a role.  Surgery is just one part of the treatment.  How much surgery helps is largely dependent on whether blockage of the sinus is the main problem.  Patients that have medical conditions that result in bad chronic nose/sinus inflammation, or those who have problems with their immune system, are the types of patients who may not benefit as significantly from ESS.

With the above information hopefully understood, I will try to answer you main questions and concerns.

Overall, sinus surgery is quite safe with low rates of complications.  Surgery to open the maxillary and anterior ethmoid sinuses is the easiest and safest.  This limited amount of surgery is often referred to as FESS.  

The frontal sinuses, sphenoid sinuses, and posterior ethmoid sinuses are close to several important structures such as the eye sockets, the optic nerves, and the skull base (thin bone that separates nose/sinuses from the brain.  The proximity of these things to the sinuses put them at potential risk of injury during surgery.  The risk of injury is very low, but important to consider.  Having an experienced and well trained surgeon is also an important consideration.

How much pain you have, and how quickly you can return to normal life, is largely based on how much surgery is being done.  A patient who is only having one maxillary sinus on one side operated on, will have a very brief surgery, very little pain, and a very quick recovery.  On the other hand, a patient who has every sinus, on both sides, operated on, and who also has the nasal septum fixed (septoplasty) and nasal turbinates reduced, will have a significantly longer, more painful surgery, and longer recovery (1-2 weeks, sometimes).  So, these two examples are sort of the two ends of the spectrum.  The amount of surgery performed can vary greatly, so it’s hard to compare what your doctor plans to do with something someone you know had done, unless you know exact details of the extent of surgery planned or performed.  Potential risk or “danger” of the surgery basically follows the same principle, but in the hands of a good surgeon the risk is very low for dangerous complications.

SWB (ENT Surgeon)

"Chyle" and Serum Cholesterol

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : Chyle...this is the condition I was told I have. Can you please tell me if there is anything I should be worried about and if so, is there a cure?

My cholesterol is 205
LDL 102
HDL 89

I'm in pretty good shape and my wife makes me eat all the things that are good for me...which I hate. She's pretty mean. I even have to do the dishes...but I digress.

Gender: Male

How old are you?: 46

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: just found out about it. Not sure what I need to change

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Are you serious? That could take a week!

Check all that apply to you or your immediate family (parents, siblings, grandparents):
None of these

Are you currently using or do you have a history of tobacco use?: Yes

Please describe your alcohol consumption :: Occasionally

So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities.


Is this harmful as in...am I going to die?
Is it curable?
Should I be worried all that much?

__________________________________________________________

Thanks for your question!

These numbers by themselves look quite good. The HDL is great and the LDL is not too bad.... Total cholesterol is slightly high and that's why it is very important to know what your other medical problems are. For instance, if you have diabetes these numbers may need to come down a bit so that you can be properly protected from heart disease. If you are otherwise healthy these numbers are very reassuring. Please let us know in the comment section if you have any chronic medical problems.
MDSTAT_ER_DOC1

__________________________________________________________


I have not seen a response from you sir so let me expand a little bit on your question. To begin with, there are clinical entities that have to do with the accumulation of "Chyle", and these are fairly rare, and are also difficult to treat because they are often associated with Cancer. Just as an example see this LINK here on a chylous effusion in the pulmonary space.

So you can see my confusion.... You tell me you have a condidtion called 'Chyle' and then ask about your cholesterol levels. But IF your question really pertains to cholesterol levels then  my original answer is a solid one, but let me refer you to a good link where the cholesterol issue is explained in simple detail.

"Cholesterol"

Again, if you have further questions please ask them in the comment section below.

MD_STAT_ERDOC_!

"Heartburn?"

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
The email to which we should send notification of your answer: xxxxxxxxxxxx

About once every 60 - 90 days I get heartburn. It is very painful.  I take Target Brand "Antacid tablets" (750mg Calc Carb). But they essentially do nothing. So I take more than the reccomended dosage 1.5 - 2 times the amount (the bottle says 2-4 pills as symptoms occur) I will take 6 - 8 initially.  But because it doesnt do anything I am always tempted to take more if the pain intensifiys.  I usually dont keep track.  I just groan in pain and grab the bottle as quickly as I can and take another tablet.


The bottle says no more than 10 tablets in 24 hrs.


So I have 2 questions.  What happens if you "overdose" on Calcium Carbonate.  (Do you get constipated, do you die, or something in between).  Also, I figure that dosages listed on bottles sold to the general public have to be very conservative, so for a healthy male in his early 40s you could probably double the amount to be entering the risk zone - I am I being a complete idiot? (I know you have to be very careful about what you say in this public forum, but please dont give me the legal answer that I should do just what the manufacturer reccomends, give me the medical one.  If you cant give me a straight answer please just recuse yourself and tell me you feel it would be imprudent to answer). One last thing, assuming I cant down awhole bottle, what else can I do? Some things I have done in the past are sip water to keep acid down, sip milk to keep acid down and neutralize it a bit, eat bread to absorb the acid, writhe around on the floor.

Gender: Male
How old are you?: 41
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Abdominal Pain
Describe associated symptoms not listed above: None
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: Nothing
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Lacerations (kidding - none really)
Check all that apply to you or your immediate family (parents, siblings, grandparents):
None of these
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never


So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities.
: The effects of levels of overdose are the top priority, 2nd would be what else I can do do stop the pain, 3rd priority is what is the dosage that would cause a "real" overdose (vs what the label says) is an overdose).

Blood in the Toilet

 I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : My mother has just been to the bathroom and it is bright red blood. It is as if she is on her cycle. Her belly has not been hurting or has this ever happened before. What could it be?

Gender: Female

How old are you?: 49

How long has this been going on?: A few days

Check all symptoms you are currently experiencing:
Diarrhea

Describe associated symptoms. Her belly has not been hurting or has this ever happened before. What could it be?

Describe associated symptoms not listed above: just went to the bathroom today and that is when it started. Has happened two times already. back to back

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: nothing

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): High blood pressure diabeties high chol

Check all that apply to you or your immediate family (parents, siblings, grandparents):
Diabetes
Hypertension

Please list any medication allergies that you have : : Please do not list any medicines you merely dislike. True allergies produce hives and other symptoms. An upset stomach is not an allergy to a medicine. Thanks!

Please list any medications you are currently taking (and dosage if known) :: Also, please tell us if there is medicine you are supposed to be taking but are not. Thanks!

When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within 8 hours
So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities.
: possible causes, what it is, and how to prevent it

Devic's Disease and It's Relation to Multiple Sclerosis

8 minutes ago

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE. *	Yes, I agree.
The email to which we should send notification of your answer *	XXXXXXXXXXXXXXXX
Ask your medical question here. *	how simalar is Devics disease compaired to MS? I know the treatment is somewhat different. My sister has been dx maybe 2 years.
Gender	Male
How old are you? *	41
How long has this been going on? *	More than a year
Check all symptoms you are currently experiencing	Eye
Describe associated symptoms not listed above	the only symptom she is having now is reoccuring optic neuritis.
What have you done so far to remedy this condition? Please include tests and relevant studies here.	Results of blood tests and Xrays can go here. Results of consultations with specialists as well.
Please list any medication allergies that you have : *	Please do not list any medicines you merely dislike. True allergies produce hives and other symptoms. An upset stomach is not an allergy to a medicine. Thanks!
Please list any medications you are currently taking (and dosage if known) :	Also, please tell us if there is medicine you are supposed to be taking but are not. Thanks!
When was your last menstrual cycle? *	Now
Are you currently using or do you have a history of tobacco use?	No
Are you currently using or do you have a history of illegal drug use?	No
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED? *	Within the next few days
So that we can serve you best, please try to tell us your top three things you wish to be addressed in our response. You will likely get more than you ask for, but we wish to understand your priorities. *	difference in the two diseases and life expectancy.