Multiple Medical Problems and Chest Pain

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Did 100 reps with 30 lbs 2 days ago (not sure if its important or not) Have had a sinus infection for almost 3 wks (dr appt in 2 days) I have back problems and have t4 and flexeril for it. I took them last night in hopes of sleeping better since sinus has been keeping me awake and restless sleeps. When meds kicked in, I got bad chest pains that kept me up all night and had a hard time breathing for 1/2 night. Today it's still sore and sensitive. Area is solar plex/between breasts.. Had this before and dr said was acid reflux. If so why does it happen only occasionally (once every 2 or 3 mos) and cause such pain for 24 hrs ?? I am overweight, had pituitary tumor, have hypothyroidism, celiac (found out in jan), low magnesium. I have had 3 kids as well.

 Gender: Female
 How tall are you (feet and inches)?: 5'3
 What is your weight in pounds?: 186
 How old are you?: 31
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Abdominal Pain
 Difficulty Breathing
 Chest Pain

 Describe associated symptoms not listed above: The difficulty breathing part felt like someone was sitting on my chest.. I know it wasn't the side effect of the meds as I have been on them for a while

What have you done so far to remedy this condition? Please include tests and relevant studies here.
 : I was given reflux meds for a couple wks. That seemed to help at that time as I was getting the pains repeatedly. But now 3 mos later it's back.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): I have a pinched nerve in my lower back as well as arthritis. I can't take anti inflammatories as they caused major weight gain and stomach probs..  I have hypothyroidism, celiac disease, and low magnesium (taking vitamins)Had a pituitary tumor but it seems to be under control, not on meds for it anymore. I have had breast reduction 17 yrs old, surgery on my knee after skiing accident (15yrs), surgery on my armpit as breast tissue left  grew (28yrs),tonsils removed (16yrs), adnoid removed (8yrs)

 Check all conditions present in your immediate family... :
 Asthma / Lung Problems
 Cancer

Please list any medication allergies that you have : : Penicillin - throat swells
Please list any medications you are currently taking (and dosage if known) :: Cytomel 1/3.5 & synthroid 50mcg compounded in one pill .. I take 3.. I also take Tylenol 4 and Flexeril10 mg. I also take daily vitamins, including vitamin b 100 complex, kelp, omega 3-6-9, vitamin c 1000mg, digestive enzymes, vitamin d 25 mcg, magnesium glycinate 600 mg ..and occasionally iron 300mg ( was deficient last yr)

 When was your last menstrual cycle?: 3 weeks ago
 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

The pain causes, what other things it could be ?
 ______________________________________________________

Ma'am, with respect, you have so many issues going on at once here I can't really tie this up nicely. The fact is that your symptoms could be coming from reflux, could be from gallstones, or it could be your heart. There are other possibilites, but these three are top of the list.

The point I guess I would make with you is that in order to GET the diagnosis more work needs to be done.

For instance, withn the chronicity of this, reflux is a likely cause. But you need to be checked for ulcers and you may need to have an upper endoscopy (camera exam of inside of esophagus and stomach).

You are also at the right age for gallstone disease. An ultrasound of the gall bladder is probably needed in your case.

Finally, even though the odds are against this being your heart, it is certainly worth looking at your heart with an EKG and, perhaps, a stress test.

Your other medical problems DO muddy the waters, so perhaps the best advice I could give would be to make sure your doctor is comfortable AND competent to manage a complicated medical patient such as yourself.

There are many unanswered questions in your case. I wish I could help more, but there is much that is yet to be done.

If you have any questions please do ask them below in the comments section.

Beyond Our Scope

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 had lower abdominal pain since I was 15.  The intensity of it fluctuates.  During periods of great stress, it is severe and constant.  I also have Complex PTSD, Fibromyalgia, Diabetes Type 2, Migraines, and mild osteoarthritis in my knees. I have tried many food allergy, food sensitivity diets over the years.  I have learned and practiced many relaxation exercises. I do not feel like I have control over this at least 50% of the time.  Sometimes I can eat anything I want and have no ill effedts.  Other times I eat as well as is possible...and still have great pain, tension, bloating, fluctuating bowel movements. I have been told that I have IBS.   I have tried to accept this.

I have recently read a new book on women's stomach health and it has led me to ask if there is a missing diagnosis. I am female, 55 years old, in full menopause for 3 years, 5'4", 200 lbs.   From age 15 to 50 had various forms of ED-NOS...mostly anorexia binge-purge type.  I used all forms of purging. (over exercise, vomiting, enemas, laxatives.) Any input would be appreciated.
 I know that my case is "complex"  so maybe there are no clear answers.  More importantly I am looking for help on how to reduce the flare-ups once they have begun. Thank you.

 Gender: Female
 How tall are you (feet and inches)?: 5'4"
 What is your weight in pounds?: 200
 How old are you?: 55
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Abdominal Pain
 Diarrhea
 Genitourinary
 Musculoskeletal Pain
 Neurological
 Psychiatric

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): polyps on bladder twice, cystoscopies 4 times. tonsils out at 4 years of age.

Check all conditions present in your immediate family... :
 Diabetes
 Psychiatric Disorders

Please list any medication allergies that you have : : mould and sulpha based antibiotics...cause very severe gastrointestinal upset and headaches.

 Please list any medications you are currently taking (and dosage if known) :: seriquel 400 mg
 Nexium 40 mg
 atenolol 50 mg
 zanaflex 8 mg
 Lyrica 225 mg
 Metformin

 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 :: Never

 How can I lessen the intensity of "IBS" flareups when they occur?
 Do my symptoms really match up with IBS?   Is it possible that there is another condition happenning that is not yet diagnosed?
 Would I maybe also have Endometriosis?
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First of all let me give you some good references.

THIS is good on Irritable Bowel Syndrome.

THIS is good on Endometriosis.

Past this, and I say this with kindness, your complicated medical history makes it impossible, without the aid of testing and examination, to try and untangle your problems. Your issues simply do not lend themselves to an online discussion. Again, my apologies.

 

Chronic Bacterial Vaginosis

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I have been diagnosed with bacterial vaginosis.I have taken the medication prescribed which was flagyl. Not only did I take it once but twice. It has not worked both times. They increased the second dosage and still had not worked. I read if you take folic acid that it will work. However, I have been taking this as well and still no luck. I was wondering could there be an underlying cause for this not clearing up.

 How tall are you (feet and inches)?: 5'3
 What is your weight in pounds?: 250
 How old are you?: 36
 How long has this been going on?: More than a month

 Describe associated symptoms not listed above: just a discharge that is a cloudy color . The doc said it is chronic b.v.

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

 Please list any medications you are currently taking (and dosage if known) :: folic acid 800 mcg.once aday

 When was your last menstrual cycle?: 4 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

___________________________________________

THIS LINK HERE MAY BE OF SOME HELP TO YOU.

I wish I had more information for you but as you can see from the link above, this CAN become a chronid problem.

If you are not currently under the care of a Gynecologist I would highly recommend this.

Also, I see that you have a history of diabetes in your family, and I also see that you are overweight.

If you are pre-diabetic or 'borderline' diabetic this could be contributing to this problem.

While the BV is the issue of concern for you here, with your family history and your current weight you are at high risk for developing TYPE 2 DIABETES.

It is quite possible that if you could get close to your ideal weight, THIS IS HELPFUL, that you might find that your BV problem clears up, and that you would avoid becoming diabetic.

Again, I'm sorry that I don't have a better answer for you. If you have comments or questions please make them in the box below.

PCOS and Type 2 DM

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.

 Gender: Female
 How tall are you (feet and inches)?: 5'8
 What is your weight in pounds?: 181
 How old are you?: 15
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Fever
 Abdominal Pain

 Describe associated symptoms not listed above: tiredness most of the time.

What have you done so far to remedy this condition?

I am doing this fro my 15 yr old daughter. she has been recently diagnosed with type 2 diabetes and PCOS. However, my concern is the everyday abdominal pain with headaches and tiredness. Also frequent low grade fevers ranging from 99-100. She has only had an ultra sound for the stomace and it showed that she was constipated. She is also anemic, and they took her off of her iron pills. She has had h-pylori tests done , amalyse and other tests as well.

 No surgeries.

 Check all conditions present in your immediate family... : Diabetes
 Please list any medications you are currently taking (and dosage if known) :: she takes metformin xlr. was on reg metformin but caused stomach problems on top of the stomach problems she already has.
What could possibly causing this. What can reduce the pain and sleepiness. What other tests could be done. And does she need to be referred to a specialist?

_____________________________________________________________

First of all, if all she has had is an abdominal ultrasound that showed 'constipation', then it did not acheive the results intended, which were to visualize her ovaries. The fact that they said it showed 'constipation' means that the study was sub-optimal.

Unfortunately, PCOS is not in MY particular area of expertise.My gut reaction was that PCOS is poorly understood, and about this I was correct. I did not remember that Type 2 DM was associated with this disorder.

In fact, what I have linked HERE is a very good reference for you to print out and have at hand.

From what you are telling me she is getting a slow workup for her issues. With the H pylori esting and the focus on the stomach and abdomen they are looking for a source of blood loss which could cause her anemia. It sounds as if they have not found it yet.

As you can see from the link, increased or abnormal uterine bleeding uheavy menstrual cycles) can go with this syndrome and may be the source of the anemia. But if they took her off iron pills they are thinking that this is NOT an anemia based on iron deficiency... there ARE other causes.

I do not have any magic answers to her low grade fever, tiredness, and headaches, but would say the following.

If her thyroid function has not been checked it needs to be.

If she does not have a primary care manager that is WELL versed in treating PCOS then she either needs an endocrinologist or a family practitioaer with a concentration endocrine disorders.

The headaches may or may not be related to her PCOS, and doctors always look for a 'unifying diagnosis'... a single diagnosis that explains all symtoms. That being said, the headaches may need an evaluation by a neurologist.

And finally, as hard as this will be for her, she absolutely needs to become VERY aggressive in managing her weight and in maintaining her health. The habits she forms now will either see her thgough a long and healthy life or will set her up for failure.
 
As you can see from the reference, people with PCOS often develop 'metabolic syndrome', as of now a poorly understood cluster of medical problems (including DM) that make heart disease and heart attack a big risk, not now, and not in ten years, but as your daughter gets into her late thirties and onwwards.  
 
It is not clear from your question, but it would seem that things are moving along slowly. If you are not satisfied with the progress so far, do not hesitate to get a second opiniion. A pediatric endocrinologist might be a good place to go for a second opinion.
 
I hope this helps some. Again, this problem is complicated and poorly understood at present. Your daughter is being treated reasonably, but there are unanswered questions. I hope you will drop back by in the comment section and update us on her progress. The comment section is also where you can ask questions about this answer.
 
Thank you and good luck .

 

A 'Knot' Which Causes Nausea

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.


 How tall are you (feet and inches)?: 6'0
 What is your weight in pounds?: 230
 How old are you?: 40
 How long has this been going on?: A week or two
 Check all symptoms you are currently experiencing:
 Chest Pain
 Nausea

My husband has been complaining of a "knot" in his chest, a hair to the right of his xiphoid process. It hurts to push on it and when there's pressure applied it makes him VERY nauseous! He's a very tough man. He's not one to complain of pain at all which worries me enough to come here to you. We've been to the Dr. and she gave him clairatin and omeprazole. Its NOT indigestion! He was in the military so its a VA hospital. His Dr. ordered an ultrasound but haven't gotten a call back yet. Its been two three days. I used to be a paramedic and my first "field impression" is gallbladder. He's miserable! Unlike him! He's also exhausted everyday. Fatigued. Headaches daily.

 What have you done so far to remedy this condition? Please include tests and relevant studies here.
 : Waiting on ultrasound appoint.


 Only meds he's on is Clairatin and Omeprazole.
 Please list any chronic medical problems and also list any prior surgery: No medical problems. Has only had two surgeries. One for wisdom teeth six years ago. Before that three screws in his patella after falling and shattering it. Over all excellent health. Low BP, good heart rate, typical high cholesterol.

 Check all conditions present in your immediate family... :
 Cancer
 Cardiac Disease
 Diabetes
 Please list any medication allergies that you have : : Nka
 Please list any medications you are currently taking (and dosage if known) :: Clairatin 10mg
 Omeprazole 40mg

Periodic tylenol and aleve for headaches and knee pain.
 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?: Yes
 Please describe your alcohol consumption :: Occasionally

I guess I just need to know if I need to FORCE him to the ER because he doesn't want to go. I'm also planning to pressure the VA to get him in sooner.

Gallbladder? Muscular?
____________________________________________________________

So hard to say without an exam. Would be nearly impossible to feel the gallbladder even if it was enlarged or inflamed. I have a very good friend who is a docot for the VA and I understand the delays. It's now up to one year for a hip replacement.

That being said I think the more important thing to realize is that just with what you have told me I do not thing delay is an appropriate thing in your husband's case. He needs that ultrasound but he needs a chest Xray and an EKG and yesterday. He needs a provider to examine him and these days the only place to get answers to complex medical questions in a timely fashion is in the ER.

Also, it's unclear to me from your question above if you are referring to yourself or your husband in many of the questions.

If his pain worsens, if he develops shortness of breath, fever, or vomiting you must get him to the ER. I can't put together this problem very well though I do agree that the Gall Bladder is suspect.

If you sish to clarify your responses or ask further questions in the comment section please feel free to do so.
 

Chicken vs Eye

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I was sitting outside when one of my chickens jumped up on my lap looking for a treat. I did not have a treat to give her. I was looking at her and she was looking at me. She then poked me in my left eye. Chickens are FAST and their strong with their pokes and they are not known for having clean beaks. My whole eye is bloodshot and there was a small pool of blood gathered at the bottom of my eye. I flushed it with saline solution. I can see and it doesn't appear that my eyeball itself is bleeding (except for the fact it is totally red and bloodshot). It doesn't seem to have changed my vision. It's not bleeding anymore though I am not sure where the blood came from as I can't seem to find where the actual wound is. My eye feels like there is something in it but like I said, I can't find the actual wound. It's not really painful but only feels like there is something in my eye.

My question is, is cleaning it with saline solution a good antiseptic? I flushed it for a good 3 minutes (I'm soaked as the solution ran down my face, neck, etc.) What are signs of infection in case I need to be seen?

 Gender: Female
 How tall are you (feet and inches)?: 5"3
 What is your weight in pounds?: 125
 How old are you?: 53
 How long has this been going on?: A few days
 Check all symptoms you are currently experiencing: Eye

 What have you done so far to remedy this condition? Please include tests and relevant studies here.
 Cleaned it with saline solution.

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

 Check all conditions present in your immediate family... :
 Cardiac Disease
 Hypertension
 Please list any medication allergies that you have : : none.
 Please list any medications you are currently taking (and dosage if known) :: Atenolol (50 mg)
 Hydrochlorothiazide (50 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?: No
 Are you currently using or do you have a history of illegal drug use?: No
 Please describe your alcohol consumption :: Rarely

How likely is an infection to my eye despite cleaning it with saline solution? Any other home remedies I should consider? So I am looking for something I should keep a lookout for in case I do need to be seen.

This all took place about an hour or so ago. I stated a "few days" above as your system would not allow me to enter "started today." It repeatedly gave me an error message that I need to enter a value. So while I stated "a few days," that is incorrect. Thanks!
_____________________________________________________

First of all, a prize to you for asking the most unique question to date on our little site here.

Secondly, you are correct to be concerned, and, correct as well that a doctor's FIRST question will be 'how is your vision', and, yours, so far, is unaffected.

Thirdly, and this may go to four, five, six etc... There is no way at this point to prevent infection as the peck of the beak either penetrated deep into or even through the sclera OR it only scratched the sclera and cornea.

I have no doubt that a chicken's beak contains all manner of nasty bacteria, and, since your eye is red and painful you MUST get seen by an eye doctor soon. Visual injuries are, thankfuly, rare, but you have one that could be serious.

As I say above it IS good that your vision is not affected, but there is simply no way to know at this point without a good exam if bacteria have been deposited deep enough into the orbit to cause infection.

IF they have then you will need AT LEAST prescription antibiotic eye drops. You also need a tetatnus shot if you have not had one in the last five to ten years.

Finally, you may well need pain control even if this is simply an abraasion. Abrasions can cause spasm of the ciliary muscle. This is VERY painful and a few days of eye dilation and mild pain medicines could to wonders.

Please do update us on this very unique injury!

Be well.

Post-Opertive Infection With Hardware

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 i had surgery on a heel fracture 2 stainless pins inserted i had 2 cast changes they were on a little over 1 month each. finally cast was off my parents and friends questioned the color of my foot they said it didn't look right but i said doc gave it the ok.the next check up the doctor said now infected. gave me prescription 2 antibioitics 1 cream. my next appointment was 1 week later skin graph doc. at app. doc looked at wound said admit yourself in hosp now. on i.v.s 5 days now on wound vac. can infections become that critical in 1 week. when the cast was 1st off. my heel was extremely painful to touch and yellowish . now i can touch my heel after iv.s it seems to me the infection was overlooked ?

Gender: Male
How tall are you (feet and inches)?: 5 10
What is your weight in pounds?: 148
How old are you?: 52
How long has this been going on?: More than a month

Describe associated symptoms not listed above: had tingling feeling in heel while cast were on i was told bone growing

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

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): need maybe 2 more operations

Please list any medication allergies that you have : : none

Please list any medications you are currently taking (and dosage if known) :: 2 antibiotics per day doxycycline hyclate 100mg

When was your last menstrual cycle?: Now
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 :: Rarely

What can i do if the infection was overlooked some reason i seem to be backpedaling on getting better.

________________________________________

I wish I could give you a definite answer but I can't because your question calls for speculation... guessing on my part. The fact is that you broke your calcaneus. This is from a high energy injury, in other words, an injury with lots of force transmitted to your foot. The repair of this kind of injury is very difficult to start with. The fact is that the surgery you had to repair your broken heel carried with it a known risk of infection to start with. And if your original injury was bad enough to break the skin (an 'open' fracture) then the chance of infection would be even higher. 

But let's assume that there was no infection introduced during your injury or the repair. It is possible that a small break in the skin near the surgical site introduced bacteria deep into the wound. 

The fact that you have metal screws in your foot makes the infection MUCH worse, because now the screws probably have to come out. 

To answer your question about the infection being 'overlooked', it is not that simple. There is no test that tells if there is infection or not. As you learned, a wound infection is diagnosed by physical exam. Lab testing can help, and bone scans and the like are often used to tell if the bone itself is infected, but there is no way to say if it was overlooked. 

If you wish to consult a medical malpractice attorney they can probably answer this better than I can.

Unfortunately, not even your doctors know right now how long this will take to clear and how many operations you might need (though I see you think there are two surgeries upcoming). You had a bad injury that shattered your calcaneus bone. Even without the infection your chance of getting back to near-normal was very low and you would likely have had some pain and lack of ability to fully use your foot for the rest of your life. 

With the infection the end results are unknown at this point. 

I'm not sure if I have answered your question, so if I have not, please respond in the comment section. Good luck.