Welcome ! I'm Dr. Ahmad and I will be pleased to offer help.. email me: ad_icare@yahoo.com أهلا و سهلا: يسعدنا إنضمامك لنا من خلال صفحتنا على الفيس بوك: استشارة صحية

If you have a question, Dr Ahmad is here for you

Thursday, 8 April 2010



If you have a health question or need a second opinion, please send me an email to: ad_icare@yahoo.com 

Please include all your previous medical history and make sure to mention if you are taking any current medications (name, dose and duration). 

Thank you
Dr. Ahmad

Last edited: 10/2/2014

1,472 comments

  1. i just had a miscarriage at 7weeks, a D and C was done on me, i just want to know the symptoms of uterus perforation after the D and C surgery, iam not bleeding much, its a little blood coming out. help!

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  2. During pregnancy, the uterus becomes softer and that makes it more liable to perforation. If perforated, there will be vaginal bleeding and pain. You need to observe the bleeding and if feel any other general symptoms appear , then you need to go to the emergency room as the cause can be internal hemorrhage. In most cases, the perforation is small and will cause no trouble. You need to ask your doctor if there was a perforation or not, as this will be important if u r thinking for further pregnancies.

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  3. So, I am going crazy! Can someone please help me..
    I was diagnosed with Type 2 Diabetes in October. I got up that morning, went to McDonald's and got a McMuffin and a Regular Coke. I took the blood test and 2 weeks later, they said I have type 2 diabetes because my sugar was 174.

    Wouldn't everyones sugar be 174 after 5 minutes after the healthy food McDonald's has? lol
    So, it's been months now and I have so much trouble keeping my sugar high enough..
    Today is a prime example: I wake up: sugar is 91, I went and got a Sausage, Egg, and Cheese Biscuit from McDonalds with a Hash Brown and Diet Dr. Pepper, and took meds. When I got out of class I was really dizzy, I checked my sugar and it was 77!! I rushed to Jack's and got a Big Bacon and Fry (Diet drink) I checked sugar an hour later and it was 96!!
    So, imagine when I eat right? if I have eggs and a bagel and juice (or fruit), my sugar will be in the 70s or 80s within an hour.

    I have had this problem for a very long time and I just do not understand if I actually have Diabetes, I tell the doctors and they just ignore me. Last time I went to the doctor, I didn't eat and my sugar was 88... They told me I had protein spilling in my urine (150mg) and that I would have dialysis soon and have a short life.

    Can someone help me? I know you'd normally say go to another doctor, but I have no insurance and can't!! Does it sound like I have diabetes? and what's up with the protein in urine.
    Oh just to add I checked ketones and the test was fine.

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  4. It seems that your are active a little bit and that is evidenced by the low sugar level inspite you are diabetic. Try to modulate your diet so that it meets the need of your body.About the protein in urine, that's not good. You need to find the cause because normally there is no proteins in urine. This indicates renal damage. Besides, i recommend u do a glycated hemoglobin level to be able to judge your control over diabetes

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  5. I Think i have underactive thyroid as i have ALL the symptoms ecpecially extreme fatigue and feeling cold all the time when everyone is hot or comfortable, sometimes i get flushes and i get a temperature along with the other symtoms are getting worse.
    I have had blood test with the doctors twice but they have come back normal except for one was a little bit high of 9.
    I'm not sure if i had the TSH test as she didnt tell me which ones i had done but i will find out and if i have'nt i will get it done.
    I also have Polycystic Ovaries on each.
    I also keep skipping periods, my last one was in December Or January and that wasnt for long. I have unexplained wait gain aswell which is another symptom of a underactive thyroid.

    What can i do?

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  6. First of all, it seems u have hypothyroidism as evidenced by the present symptoms. You need to do TSH level , if not done. Hypothyroidism and PCO are related to each other. If hypothyroidism is treated, then PCO can be cured by itself. About your periods, that's a symptom of PCO. You will need to see an endocrinologist for the thyroid problem

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  7. Thanks for replying to me, what does PCO stand for? Is that underactive thyroid?
    And also what happens if i have the TSH test and it comes back normal but i still have these symtoms what can i do or will happen then?

    My sister has overactive thyroid so i think it's in the family somewhere, is it posible to have it even if it doesn't come up in my blood tests? any other tests i could do?

    Also what is an anti body blood test? as my doctor said she will do that next if the contriception patch doesnt help my symptoms?

    Also if i do find out i have thyroid problems, Is there any liquid base medication i could have? As i can't swollow tablets or is tablets the only cure?

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  8. PCO stands ofr polycystic ovary. That's when you have a greater amount of testosterone (male sex hormone), this causes stopping of the period and loss of feminizing characters. This is different from underactive thyroid. I mean an underactive thyroid can lead to PCO.
    If u find TSH normal , then you should do T3 and T4 level. The antibody blood test is done to search for antibodies. Some of the thyroid problems are auto-immune (caused by antibodies that attacks the thyroid gland). The treatment will depend according to the cause of hypothyroidism.

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  9. Question 1)
    What if TSH level and the T3 and T4 come back normal but i still have all the symtoms and are getting worse? What else could i do to find out about this?

    2) IF i have antibodies in my system can that stop the thyroid from showing up in my blood tests?

    3)What causes PCO is it inheritance or is it caused by my thyroid?

    4)Could i have an early menupause? But i am only 19!?

    5) If the tests come back normal, will the endocrinologist run more tests on me to see if i definately have Underative Thyroid?

    Please answer ALL 5 questions, Thank you!

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  10. 1. TSH normal level: 0.4-5.0
    Free T3 normal level: 3.5-6.5 pmol/L (or 230-420 pg/dl)
    Total T3 normal level: 0.9-2.8 nmol/L (or 60-180 ng.dl)
    T4 normal level: 64-154 nmol/L (or 5-12 mg/dl)

    To be able to do the full investigations for testing your thyroid, you need an endocrinologist as he/she will ask for the appropriate tests needed for your case.

    2. Antibodies against thyroid gland can cause a decrease in thyroid hormone levels due to some destruction in the thyroid gland itself.

    3. Genetic factors can play a role in PCO especially in first degree relatives. Besides , hypothyroidism may help PCO to get worse or may be the cause of PCO

    4. This is not early menopause. The PCO is the one who is causing the similar symptoms of menopause. Once, PCO is treated everything will be normal again

    5. Well, i doubt the results will be normal because u r having symptoms. But if that happens then more tests can be done according to the opinion of your endocrinologist

    All questions answered

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  11. Thank you very much for answering my questions, sorry for bothering you with all these questions.

    Does the doctor have to transfer you to the endocrinologist or do you go there yourself?

    Would you say to your doctor to have another lot of blood tests then transfer me to the endocrinologist or shall i ask her to transfer me right away?
    Or wait to see the blood tests come back and if there still normal then ask her to transfer me?

    My doctor said the only one was a bit high was a level of 9 but i can't remeber which test that was for, would you have any idea.

    One more question... I keep having headaches atleast 2 - 3 times a week, is that linked to all my symtoms?

    Also would you have a FULL body CT scan to scan my whole body from head to toe to see if they can find anything that way?

    thanks for your help!

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  12. Or Any type of scan or X-ray? Or would you leave that to the endocrinologist to see what to do?

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  13. It is better to go to an endocrinologist and he/she will order the tests needed. I have no idea about the test, it can be anyone stated above. Headaches can be related to hypothyroidism. I don't see an indication for CT or X-ray for the time being, this will be according to the endocrinologist's opinion.

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  14. Do you need to get your doctor to transfer you?

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  15. I don't know what is the policy in health system where you live. But you need to be treated by an endocrinologist, either by getting transfered or going directly to one. Good luck

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  16. I have recently had issues with concentration, fatigue, slurred speech, once or twice my hands have shook but this is rare, racing thoughts are common, my school work is hard to complete orderly due to my unorganized thoughts. Just this morning I woke up late and rushed around to get ready for my nine o'clock at 8 and ended up missing my actual 8 o'clock. Rapid heart beat is also common.

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  17. To clarify I went to the wrong building at 8.

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  18. Did you have a recent head trauma or any history of disease ?

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  19. This comment has been removed by the author.

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  20. It is an X-ray women have every 3 years to see if they have any lumps in their breasts?

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  21. Actually that's a mammogram. They are not harmful actually they are of great benefits in terms of breast cancer

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  22. what product is best for psoriasis in your scalp?

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  23. I look on a site before about mammorgrams and they said that they was dangerous?

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  24. What is the cause of a blood clot in the stomach? As my nan has a few in her stomach and you can see the lumps outside of the skin.
    Can the injections that the hospitals give you to thin the blood cause that?

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  25. Could you get that site for me. Scalp psoriasis are treated by:
    - keratolytics
    - coal tar
    - corticosteroids
    - Dovonex
    - anthralin

    Actually u need to see a dematologist for that.
    About the lumps these are probably due to injections. What was the injections for ?

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  26. Because she has been in hospital for a few weeks they give all there paitents needles in the belly to stop thrombosis and to thin the blood and to stop blood clots as she is not moving around but the needles have given her blood clots.. How can you get rid of them are are they serious?

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  27. And i can't remember sorry, i think it was naural new site.

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  28. I agree with the opinion of the "American cancer society" and you can read more in here:
    http://www.cancer.org/docroot/ped/ped_20_aetna_mammogram.asp

    The bumps on your nan's stomach are like hematomas (collection of blood under the skin). They will be absorbed by the body in a couple of weeks. If she is still on those injections, advice her not to rub the injection site. Don't worry about it

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  29. It's the place where your nan had injections in, which is the stomach in her case

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  30. I have had insomnia for nearly 20 years now and I have been suffering cronic insomnia for 14 years. I have done evrything I know to solve the problem, but with no success. I have also been to a sleep clinic and even they were unable to help me. They said I had to take sleeping tablets for three days of the week and see a Cogniative Behauviour Therapist, but I could not do this as I could not afford the fees at £25 per time. Can you help. Lillian

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  31. Okay, i will do my best. I will need your cooperation with me so that we can get to good results. Each and every instruction should be done. You will follow these instructions:
    1. Lie down intending to go to sleep ONLY when sleepy. Do not try to fall asleep
    2. Avoid any behaviour in the bed or bedroom other than sleep or sexual activity
    3. Leave the bedroom if awake for more than 15 minutes, and
    4. Return to the bed only when sleepy
    5. Leave the bedroom as soon as you feel clearly awake or experience annoyance over the fact that you are awake
    6. Establish a fixed wake time and eliminate the time u spend in bed without sleeping.
    7. Avoid excess fluids , alcohol , smoking and caffeine in the evening
    8. Don't take your problems to bed
    9. Avoid naps
    10. Avoid clock watching in bed as this will lead to frustration and anger that will interfere with sleep.

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  32. As i'm feeling very fatigue though my thyroid, what can i do in the mean time while the tests are being done to make me feel more awake and active with more energy?

    By the way sorry for all the questions, my mum is using this aswell as me under my name.

    Thanks

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  33. No I have not and no diseases that I know of.

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  34. @kirsty:
    You can increase the iodine intake in your diet as this may help in slight improvement. Actually, iam delighted by the questions i got from your mum. I hope i was helpful to her. You welcome

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  35. @Andrew:
    Okay, the symptoms you wrote are suggestive of hypoglycemia. Did you measure your blood glucose level ? Besides you need to check your blood hemoglobin to exclude anemia

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  36. Hi Dr.Ahmad! I'm the person with H.pylori. I've had it for a while. I have the H pak treatment and will be starting it soon. Lately i've been scared that I might have stomach cancer already. I get bloated frequently, have mild nausea and gnawing stomachache. I also get a strange sensation in my stomach..it feels cold and hot at the same time..tingly too. But that new symptom started about a week ago. Also my diastolic blood pressure's been quite high the past week. I don't know if it's being caused by the h.pylori. So it's possible to develop cancer without ulcers first? Should I get tested for cancer? or should I just take the Hpak and finish the treatment and see how I feel first? Thanks!

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  37. First of all, i would like to welcome you in my blog. I see you are worried that you may be having cancer stomach. Cancer stomach is found most often among people 55 or older. You should start the treatment and then after finishing it, if symptoms are present , then you can think of cancer stomach. Although i find it unlikely for cancer stomach to develop after treating H pylori. I need to know how old are you ? and how did you discover that you have H pylori ?

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  38. Dr. Ahmad, thanks for your reply. I'm 25 years old. I discovered the infection recently by urea breath test because I was having that gnawing stomachache and some heartburn at times. So I should finish the treatment first? I'll do that then.

    I get bad breath frequently despite maintaining my oral hygiene. Could H. Pylori cause bad breath too?

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  39. Cancer stomach is the last thing i will think of in your case. Iam sure everything will be okay after treatment. Yes, H. pylori can cause halitosis. In people with H. pylori there can be intermittent achlorhydria (low or no gastric juice)that can lead to residual food putrefying in the stomach and hence cause halitosis.

    You welcome

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  40. What kind of joint allows your arm to move freely in all directions?

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  41. What kind of joint is your elbow?

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  42. What kind of joint allows the bones in your hand and wrist to move?

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  43. Ans 1: ball and socket joint
    Ans 2: hinge joint
    Ans 3: gliding joint

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  44. Dr. Ahmad, about my stomach pain: it is blunt, very central, and below my belly button. I heard that pain due to the appendix is usually sharp. Is there anything I can do to remedy my pain? I cannot fall asleep.

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  45. Hello,
    there are causes other than appendicitis; bladder infection or cystitis, lower ureteric stones. If it is a stone, then thje following remedy can help: measure exactly 2 fluid ounces of extra virgin olive oil and 2 fluid ounces of freshly squeezed lemon juice, mix it up. Then drink 32 FL OZ of water over the next 3 minutes or so. The repeat it when you get the pains.
    Try that, if pain subsides, then most probably it was a stone. If not then you should take appendicitis as a probable cause for the pain.

    I don't recommend you take any pain killers as the pain can be an indicator for an inflammed appendicitis

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  46. Dr Ahmad

    Im 18, I will be 19 soon, In may to be exact.

    Ive been getting sore sharp pains between my shoulder blades, and my left arm as well as under my armpit.

    Im stressing out about it,am I having a heart attack, I am a female.

    My chloesteral is fine, I checked 3 wks ago

    I have anxiety (runs in my family) and ashtma.

    Could it just be anxiety causing the pain, even thou Im not having an anxiety attack.

    Let me know:)

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  47. I forgot to mention, pain goes In my left leg as well.

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  48. Hello, welcome in here.
    Calm down, this is not a heart attack because heart attack pains are not sharp. You need to reduce the stress and anxiety. The current pain is most probably a muscular one. Try having more rest. Do you have any other complaints ?

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  49. Thank you! :) No, I dont. I honestly thought I was having a heart attack. My arms are somewhat sore too, so. Thank u so much! :) Have a good day.

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  50. Hi,
    I got your response from yahoo answers but I would like to know why is getting blood from your fingertip more accurate than getting it from your arm? It may be more accessible but I have heard that the blood from your fingertips gives you a more recent reading than the blood from your arms or thighs. Is this true?

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  51. Hello, welcome in here,
    Actually blood in the fingertips and palm testing will tell you what is the blood glucose level right now. This is because the rate of flow of blood in them is faster than that in the thigh of forearm. So yes it's more accurate.

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  52. This comment has been removed by the author.

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  53. You welcome. Feel free to ask at anytime.
    Good luck

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  54. Thanks, I don't have diabetes I was just wondering :)

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  55. Thanks God that you don't have diabetes. The goal of this program is to increase the level of awareness about medical issues. If you have any medical question then this is the place to ask about it.
    Wish you the best of luck

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  56. Dr.Ahmad! Hello. This is the person with H pylori again. I started my treatment today. My treatment is for 14 days. 8 pills a day: prevacid, biaxin, 2 amoxcillin pills twice a day. Isn't that treatment too much for 2 whole weeks? I mean i don't know how many antibiotics an adult can take for how long. 14 days does seem a little too long. Am I ok? Thanks.

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  57. Hello,
    The current treatment is good. 2 weeks is the best duration so that you can eradicate H. pylori completely. It seems a lot of medications to you but that's what is needed to eradicate H. pylori.
    Good luck

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  58. I just came here from Yahoo Answers and was just reading through some comments and quite frankly, what you are doing here is amazing. I can't believe you are taking the time to actually help people with your knowledge over the internet. Yahoo Answers is one thing, but this is absolutely remarkable. You are a wonderful person.
    Take care
    Harry

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  59. Thanks for your great inspiring words. I hope i can help anyone in need. You are always welcomed in here. Have a nice day

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  60. I am a 20 year old female. I take metoprolol 50 mg 2 times a day for high blood pressure (it was moderately high like 150/80 range) and tachycardia (like in the 120s). I switched from Atenolol 50 mg in January because it wasn't controlling my bp. Ever since it seems like I have been super tired. I sleep 10-11 hours a night and still sometimes feel like a need to take a nap during the day. I guess I feel like I am drowsy all the time.

    Could the metorpolol cause that? It is controlling my blood pressure now, but I almost hate to take it because I feel like an old person inside of a 20 year old's body. I went to the doctor in March and didn't mention it because I thought it would just get better, but it never did. Plus I hate being that patient who just complains about stuff... but now it is starting to get annoying.

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  61. Hello, i would like to welcome you in here.
    Concering your complaint, let me explain it to you. Metoprolol being a lipophilic beta blocker will cross the blood brain barrier and will exert a sedative effect that causes you to sleep to much. Compared to Atenolol which is not lipophilic so it won't cross the blood brain barrier and won't cause sedation. In your case , Metoprolol is good in terms of controlling the blood pressure and so i recommend you tell your doctor about it and maybe he can lower the dose to decrease the sedation and still maintain a good blood pressure.

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  62. Thanks. It is good to know that I am not just imagining it or that there is a chance that it isn't a coincidence. It seems like I end up at the doctor so much that I hate to go unless I actually need to go!

    Thanks :D

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  63. You welcome :)

    Post here all your medical questions and i shall do my best to get them answered.

    Good luck

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  64. I have one breast bigger than the other, i know everything is a bit bigger than the other like arms legs etc but with my breasts its about a cup size different. I've had it checked about 2 years ago and the doctor said i cant't have surgery to have them the same size untill im 21 as im only 19 but i was about 16 at the time, 20 soon though... And he said just to wait till im 21 to see if it grows the same but it hasnt. i'm wondering do you know what could be the course of it? is it something to do with my low thyroid or not??

    Thanks

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  65. Well, the most probable cause is simply natural variations in the developmental process and normal anatomical variation. I don't think that hypothyroidism can cause that.
    By the way, what happened with your thyroid hormone testing ?

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  66. So is the only cure for it surgury?? and i have not been yet as my doctor isnt there till tuesday.

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  67. You should talk to your doctor about it as he needs to exclude any pathological cause of asymmetrical breasts. If he considers surgery then it is the best option for you.

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  68. Hi Dr. Ahmad! I've had this thing for years. Maybe it's nothing. At night when I lay in bed with my head turned to the side (the opening of my ear is pressed against the pillow), I can hear something pulsating in my ear. It seems to be of the same rhythm as my heartbeat. But it's in my ear. What could that be?

    Thanks.

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  69. Hi,
    actually that's your heart beat. That is normal.

    Iam proud of you that you look for a cause for everything that happens. Keep asking

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  70. This comment has been removed by the author.

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  71. Walaikum al Salam,
    Welcome to my blog and iam pleased to help you with your question.

    Allergies are due to abnormal reaction by the immune system, where the immune system starts to form an immune response against non-harmful agents.

    I don't say you avoid these foods. You can eat some of these in very small quantities.

    If you want to have a baby, then go on. We can't predict whether the baby may have allergies too but you should bear in mind that the child can have other allergies.

    Feel free to post any medical questions in here.

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  72. Yesterday I was diagnosed with hypertension. I am 20 year old. Why could I have this? I *think* it was 140/95. Not too exact sure, will ask next time. Had blood tests today, kidney scan on Monday. What would the next steps for me be?

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  73. Hi, welcome to my blog
    Doctors need to exclude any renal or endocrinal cause for it. If no abnormality appears then it is said to be "Essential hypertension" (no reason can be identified). Most commonly there the cause is renal and that will be excluded when you do the kidney scan. Do you have diabetes ?

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  74. Nope, I do not have diabetes or anything.

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  75. Okay, so lets wait for the results of the kidney scan and then decide accordingly. Feel free to ask about any question you have

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  76. I keep having daily headaches. Is it related to my blood pressure?

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  77. Yes it is. Headaches due to hypertension tend to be severe and persistent. Did your doctor prescribe an anti-hypertensive drug ?

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  78. No, he did not. I probably do not need it or he wants to see the results from blood and kidney scan. The headaches are not severe but they are there. Mainly mild but it's annoying

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  79. Okay, here are some advices in the mean time:
    1. Low fat and saturated fat diet
    2. Low sodium diet
    3. Limited alcohol consumption
    4. Dynamic exercise - at least 30 minutes brisk walk per day
    5. Increased fruit and vegetables consumption

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  80. Hiya you just answered my Q on Yahoo definately not ulcer and everything else is working fine im in alot of pain and because I'm allergic to alot of pain killers I get given morphine when I go to hospital. As the docs can't find anything wrong with me I think thy think im a addict hence the reason I really dont want to go to hospital again! I have been curled up on my sofa now for four days unable to move im barely eating and all I can keep down is water. I have lost 4 and a half lbs in 4 days just don't know what to do. Is billiary cirrohis (apolagies for spelling!) a possibility my aunt had it before she died?

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  81. Biliary cirrhosis is a possibility. Primary biliary cirrhosis seems to run in families, and scientists believe that some people may inherit certain immune system defects that make them more susceptible to the disorder.
    First question: Do your doctor know that your aunt has biliary cirrhosis?

    The following symptoms come with biliary cirrhosis:
    - Fatigue
    - Pruritus
    - Right upper quadrant discomfort
    - Jaundice (yellow dicolouration of the skin and sclera)
    - Dry eyes and mouth
    Second question: do you have any of these symptoms ?

    Third question: did you do liver function tests or abdominal ultrasonography, computed tomography (CT) scanning, or magnetic resonance imaging (MRI)?

    Fourth question: For how long is has there been vomiting of blood ?

    Please include the answers of the above questions in your next post, and your sex and age.

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  82. Im female and 19 been vomiting blood for 7 months Right upper quadrant discomfort
    whhat would that include? certinly fatigue I've so far had internal ultra sound loads of garnacoligy tests inc. swabs, ogd's, my appendix was removed, xrays and ultra sounds. My docter does not yet know about the biliary cirrhosis as I only found out myself today. Just generally alot of pain and as I am allergic to over the counter medicines it seems that I just have to shut up and make do. HELP!!!

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  83. Okay you need to inform your doctor about your aunt that had biliary cirrhosis. Iam suspecting that this is a biliary cirrhosis especially you have a family history of it.

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  84. what happens next if thats what it is?

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  85. If it is primary biliary cirrhosis, you will be put on either medication that will decrease the rate of progress of the disease and steroids, or surgery. Liver transplantation appears to be the only life-saving procedure in primary biliary cirrhosis.

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  86. And if its not biliary cirrhosis? Back to square one! surely it would have shown up on my previous blood tests and the OGD's

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  87. Actually there are other causes for it. Let me ask few questions:
    1. Do you bleed from any other site (yes or no) ?
    2. Do you have fever ?
    3. Has the colour of stool changed (darkened) ?

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  88. stools fine dont bleed from any where else i feel permenently col even though my body is hot although my hands and feet are constantly freezing. I dont know if its related but siince i had a reaction to cyclazine i have had a permenent numbness above my right ankle. My chest is also very tight with sharp pains when i breath is this just because im being sick several times a day?

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  89. Okay, when did you do you appendectomy ?

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  90. November 2009 3 months ater the vomiting of blood started i was discharged and then re admitted the surgeon who saw me in a and e thought it was my appendix but after looking at it found that it wasn't.

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  91. Clarify to me, what happened first, the bleeding or the operation ? Please include full details about it

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  92. The pain started first then bleeding on and off for a couple of months then I had the operation and the blleding continued off on on until january 2010 when it has been every day sometimes only once a day but sometimes all day long the pain has increased dramatically in the last 4 days and so has the vomiting! Feel constantly cold and shivery can't eat alot and fluids is also hard. It hurts to swallow and breathing gives my sharp pains through the chest If I get up and move about my chest gets really tight and painful. Any movement through my abdomen makes me curl up in a ball and cry!

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  93. Okay can you see a doctor immediately and tell him about your aunt. Iam really concerned because the bleeding can get you a shock or even cause anemia

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  94. very hard for me to get to a doc as i cant move really scared about going in to hospital what do you think it could be? my gp put me on nutrient replacement sachet things called dioralite?

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  95. Dioralyte sachets are will help rehydrating your body but you need to treat the cause not the symptom. The most probable diagnosis i have in my mind in primary biliary cirrhosis. You need to do liver enzymes.

    Do you live alone ? Your case is an emergency , if there is nobody there with you call 911

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  96. ok thank you one last question if it was biliary cirrhosis wouldn't it have shown up on previous OGD's blood tests xrays scans etc?

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  97. It should have shown up if only the appropriate tests where done as liver function tests and antimitochondrial antibodies. Also remember that biliary cirrhosis is just a possibility but it can be due to other causes.

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  98. Iam thinking of malaria or leptospirosis. Let's exclude them, maybe we can get to it. I know this is tiring to you but i wish i can help other than sitting infront of my computer useless. Answer the following:
    1. Did you measure your body temperature ?
    2. Where exactly is the pain ?
    3. Do you get paroxysms of fever, shaking chills, and sweats (every 48 or 72 h) ?
    4. When you vomit blood , is it preceeded by blood free vomitus ?

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  99. I havent measured body temp pain is all over my stomach but mainly up near the ribs and upper abdomen. My chest pain goes through the centre of my chest Im constantly cold and have chills mainly at night but have been wrapped up in 8 or 9 blankets for days and I still feel freezing however im sweating beacause my body is hot so just feel cold. Every time I vomit its just blood. No excess food or fluids just blood.

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  100. Can you measure your blood temperature for me, if possible?
    Did you travel before the start of all this ?

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  101. no havent been out of the UK in years. Temp is at 39 C

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  102. Okay i want you to measure your body temperature every 8 hours.
    Did anyone in your family or relatives have something like this ?
    Is there pain now ?
    Is the pain radiating to your back ? Is it to the right or left ? or it is central ? Does the pain increase or decrease during the day or is it constant throughout ?

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  103. I dont think they did. There is alot of pain right now my hands and eet are cold pain in my back is off to the right but slightly on the left as well pain is there all day I suppose it may get a little worse at night but I think I notice it more then as I try to sleep

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  104. Describe that pain to me: is it stabbing, stitching, dull, burning ?

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  105. my tonsils are swollen these past 4 days! it hurts to swallow and eat and to open my mouth all the way and talk! also i almost throw up the other day and my ear hurts and they were bleeding and i keeping getting head aches! also i have noticed im not hungry at all! which is weird im hungry all the time lol! and this year i have gotten sinus infections a lot and my throat has been hurting a lot! so i went to the dr. and he got a test and it came out negative so i don't have a sore throat but he says he has to retest it and he will call us and he told me just to rest and if i get a fever to call him! and i have not gotten a fever but im not feeling better ! im losing my Voice at times and it is still swollen!!!! so what should i do??? what do you think is wroung?? do you think i need my tonsils removed?

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  106. You should have a treatment for your tonsils and sinus infection probably by an antibiotic. Actually you can't get your tonsils removed when they are inflammed. You need to wait till it resolves then consider having a tonsillectomy.

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  107. The pain is kind of like a dull stabbing pain that increases to a huge crampy burning type pain that stabs all the way through my back and stomach when I move. It takes all my energy not to just sit down and cry.

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  108. Is the sweating and chills present all day ? or it occurs in attacks ? Is there mosquitoes in the place you live in ?

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  109. No mosquities chills all day but worse at night

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  110. If its anything the black outs seem to get worse when lying down flat, sitting up slowly and getting up blindness lasts around 10 seconds

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  111. You mean when you lie flat you get a blackout ?

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  112. Yea my head feels like its under a huge amount of pressure and my eyes kind of go blind the only thing I can compare it to is when you stand up suddenly your eyes go dark and you get a bit dizzy its like that but 10 times worse

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  113. Okay do you feel that your abdomen is distended ?

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  114. Do you feel that your belly area distended ?

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  115. Hello Dr. Ahmad, interesting site.
    I have a question about endcrinology. I am a 20 year old male and I believe I have hypogonadism.I went to my GP and an endocrinologist to have hormones tested. Total Testosterone has consistently come in around 300 (in the AM). LH is usually around 3-4 and FSH is consistently below the ref range at 1. The low FSH prompted me to ask doc to check inhibin, but that came back low also (no prob there). The docs do not want to treat me saying I am "within range" but the range includes all ages and does not account for older guys with declining hormone levels. I finally had them check estrogens and total estrogens came in at 200 (range is below 130) and estradiol is within middle of range. I believe the high estrogens are inhibiting GnRH release by the negative feedback.
    It is not accepted practice (by most docs) in the US to prescribe a selective estrogen receptor modulator or an aromatase inhibitor to men for these reasons. I believe an aromatase inhibitor would be the best option to get test and e back in check.
    what do you think of this idea? are there drawbacks of using a selective aromatase inhibitor in men (such as formestane aka 4-hydroxyandrostenedione)? This is a legal aromatase inhibitor in the US. It does have a steroidal structure, but the parent compound does not have any direct hormonal activity other than inhibiting the aromatase enzyme.
    Also, with the short term use of a suicide aromatase inhibitor, do the cells increase production of aromatase enzymes?
    I should mention that thyroid and cortisol are normal and I do not drink alcohol or do any drugs.
    Any help is appreciated.
    Thanks.

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  116. Hello welcome in here,
    Did you discuss taking a selective aromatase inhibitor with your doctor. Did he have a good reason for that ? Aromatse inhibitors are usually good for increasing the gonadotropins and therefore increase the plasma testosterone. But there are side effects that you should be aware of : joint stiffness or joint pain, more heart problems, more bone loss (osteoporosis).

    I recommend you know what is the reason behind not prescribing you one ?

    ReplyDelete
  117. Holz,
    iam suspecting you may have bilharziasis. Answer the following please:
    - Did you notice any yellowish discolouration of your skin and eye sclera from the beginning till now ?
    - Does your belly area pain you on touch ?
    - Do you feel that your foot is oedematous ( to find that , you should press with your thumb on the skin behind the medial malleolus of the foot for 30 minutes, then remove your thumb. Is there a residual impression on the skin ? If yes then there is oedema

    ReplyDelete
  118. Whats oedema ?Little bit of yellowish not on the eyes but the skin everywhere on my stomach hurts to touch will do the foot thing now what is biilharziasis?

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  119. Oedema is water accumulation in the tissue under skin. Bilharziasis is a human disease syndrome caused by infection from a parasitic trematodes of the genus Schistosoma. Do you know where the medial malleolus is ?

    ReplyDelete
  120. dr ahmad i am a 20 year old female and i have a question why do i get the sharp pain under my esophagus and then get diarrhea but i only get the diarrhea when i get the sharp pain in my stomach day i had a little bit of bright red blood on the toilet papper not alot do you know what i should do i just dont want it to be colon cancer also i have lots of mucus in my stool one last thing i had an uti and never took my meds so just wanna throw that in thank you so much

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  121. I asked the endocrinologist what he thinks of trying clomid or tamoxifen and he said he does not give these drugs to men. I did not ask about an aromatase inhibitor. I had the estrogens checked with a family doctor and I have not seen an endocrinologist since that visit, mostly because i doubt that he will try an AI. I have seen 6 doctors in the past couple of months. A pediatrician agreed to a one month trial of androderm, but later decided he did not feel comfortable continuing therapy. After one month of 5mg androderm a day my LH was down to 1. For this I do not want to do TRT.
    I do not think any doctors will be in favor of an aromatase inhibitor.
    DO you know if inhibiting aromatase will upregulate the production of aromatase enzyme? Does the body have a way of doing this or will it simply increase testosterone to increase estrogen? just curious.
    I am thinking about trying the formestane at a low dose to start off. It is also known as lentaron and used over in Europe. It is available as a supplement in the US. Do you think using it could cause permanent hormonal problems?

    ReplyDelete
  122. Hello welcome in here,
    are there any present symptoms of the UTI ? What you are describing seems a dysentery, how long has the blood and mucus been present ?

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  123. what do I need to tell my Gp or A&E when I go to doctors/Hospital?

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  124. well i have always had mucus today was the first time with i had blood but i dont know if its because of the diarrea that i pushed so much that it kinda hurt me there after i poop i feel like palpitation after i poop in my butt first time and a little burning. if i drink water i have no pain with my uti its only when i drink no water and other sugary drinks that i have the pain i was also thinking i might have h.pylori my mom had it thats just me .lol. i have no idea

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  125. @ aromatase inhibitor question:
    About upregulating the enzyme it can happen. You will never know until you try but there is evidence that aromatse inhibitors are usually good for increasing the gonadotropins and therefore increase the plasma testosterone. I recommend you start these under medical supervision

    ReplyDelete
  126. @ Holz:
    You should tell him about your aunt and that you looked on the internet and you suspect that you are having schistosomiasis (bilharziasis). Please keep me updated with all new stuff.
    Good luck

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  127. @ blood in stool question:
    It can be due to hemorrhoids. Besides if you are in doubt about having H pylori then better have a urea breath test. It can be the cause of your sharp pains

    ReplyDelete
  128. will do can't go to gp for 48hrs so no doubt will be on tomorrow drilling you brain i did that foot thing no imprint bit red but thats it. is that good?

    ReplyDelete
  129. Okay it is good. Until then any question you have get it here immediately. Really i can't figure out how a hospital sends you home when they know that you are vomiting blood daily. They should diagnose you first.

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  130. they have sent me home 4 times in 8 months! thats why i dont want to go back i dont see the point. if they will just send me home again.

    ReplyDelete
  131. Is it possible to change that hospital ?

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  132. thank you i just wish i knew what caused the diarrhea thank you so much oh one last question doc i bought align probiotic do you think it maybe helpfull for me

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  133. feb 23 c section
    march 23 gall bladder removed
    april 8 (supposedly my period)
    today, i am cramping (like period cramps,not severe) , having a lil bit of yellow/brown mostly white/yellowish discharge that doesnt stink or anything, and for the past 2 days ive had diarreah on the mornings, and this is exactly what happends when i am going to get my period, could it be that i am having another period!? havent seen blood though

    i take synthroid 50mcg once a day
    keppra 500 twice a day both are under control.

    things out of the ordinary ive done, up and down the stairs with my 2 kids(husband deployed)
    eyes have been itching-taking drops for allergies probably allergic conjjuntivitis

    other than this i feel fine, ive been ok just tired jaja

    p.s.called doc. and the doc. on call called me, and he kinda got mad because it wasnt a emergency :s but for me being alone ,, with my 2 kids i just like to b sure..

    thanx!

    ReplyDelete
  134. Hi welcome in here,
    Did the period come on april 8th ? Do you mean that you have allergic conjunctivitis ?

    ReplyDelete
  135. yes april 8 started. and yes i went to the doc. and he reffered me some drops for allergic conjuntivits.

    ReplyDelete
  136. Okay , you are concerned about the diarrhea now ? please include your complaint

    ReplyDelete
  137. no, im just concerned that i am having symptoms of maybe getting my period again. when i just recently had it. perhaps its normal, since im 8 weeks post partum?

    ReplyDelete
  138. Well menstrual irregularities are common in the postpartum period. Don't worry about it

    ReplyDelete
  139. Back again another restless night sleep cant lie down cant stop crying keep being sick anyone want to trade places? I have change hospitals recently they kept me in for 3 days and said beacuse I wasnt throwing up life blood there was no need to keep me in!

    ReplyDelete
  140. Try putting 2 pillows or more under your back so that you are not completely flat.

    ReplyDelete
  141. ok, will try my best thank you for today dr.

    ReplyDelete
  142. you welcome, i hope i was helpful to you

    ReplyDelete
  143. Hi Doctor, my husband has a lot of symptoms and we keep taking guesses but we can't come up with an answer, we are not in a place where he can see a doctor, can you have a go? we've been everywhere from osteoarthritis to cancer to hypothyroidism.

    Started last September with pain in his right shoulder, he can't lift his arm above shoulder height. Next was chronic constipation, enemas for two weeks to get in under control and major diet changes but it's still a daily problem. He started to lose his hair, he is 57 but he hadn't lost any until then and now he has a definite bald spot. He's tired, all the time, in constant pain and suffers chest pain & shoulder pain, but more like heart burn than a heart attack, he's also tight chested, but as a lifetime smoker he has coughed for a long time anyway, it just seems worse.

    We've varied medications, we started laxatives but stopped as they were causing cramping but no real output, several litres of water a day were more effective, along with fibre, he takes pain killers (paracetamol) and half an aspirin, also Saw Palmetto as he was having slow urine output (this had been going on a while) and also a multi vitamin and Omega3 with glucosamine.

    History wise, he has sever allergies to insect venom and penicillin, he was a heavy drinker until about September 2009 when he stopped suddenly - and it seems all these other things came along as his reward, he says he thinks his heavy drinking was just masking the symptoms, I am not sure. Any ideas? we'll try anything.

    ReplyDelete
  144. Hi welcome in here,

    Concerning your husband, why did he stop alcohol ? The symptoms started after stopping or it was present before stopping alcohol ?

    ReplyDelete
  145. very can i get back to you tomorrow if any change oh and did another temp check 38.9 C

    ReplyDelete
  146. Yes sure, okay try getting more readings and it is better if you record them on a paper so that we can know when is it higher. Good luck

    ReplyDelete
  147. I didn't see these symptoms while he was drinking, not at all. He thinks the alcohol just covered them up - I think, considering how serious it is, that he would have felt the pain even if he was totally drunk. He stopped drinking because he was losing control, he hit me a few times, and he scared himself sober. He had been drinking heavily for perhaps 8 years prior to that.

    ReplyDelete
  148. It can be due to a gastric ulcer or pancreatitis due to prolonged alcohol intake. Did he do any investigations ?

    ReplyDelete
  149. No nothing. His biggest pain is his shoulder pain, we thought perhaps rotator cuff at first since it came on suddenly but it didn't heal and sometimes it is better than other, he's had it for 7 months now, and other days, like today, he feels it in both shoulders. I am washing his hair and doing up his buttons some days, other days he can weed the garden, but he does it in pain. He can't walk far now, an hour out with the dogs and he has to go back to bed.

    ReplyDelete
  150. How is the pain like , is it burning or stabbing or stitching or dull ?

    ReplyDelete
  151. In his shoulders? constant, he says dull now but often sharp.

    ReplyDelete
  152. Does he complain of any other bony or joint pains of other joints ? Is the shoulder pain decreasing, increasing or constant ?

    ReplyDelete
  153. Sue,
    I will not be available for the following 6 hours as it is my sleep time. We will need to continue our talk then.

    ReplyDelete
  154. No, just his shoulders, we looked at rheumatoid arthritis and polymyalgia rheumatica, but they don't match exactly, I appreciate the constipation could be his lack of exercise now and I am trying to make him get up and do more :(

    Any ideas? it's 2am now and I need to go to bed, my son has a trip tomorrow, I'm sorry, I didn't expect you to reply so promptly, I was thinking I'd come back tomorrow and see if you'd had a chance to read or reply. I'll come again in the morning. He really needs to see someone, I've guessed at everything I can guess at but I am lost on this one. It was easy when it was a cut or a headache. Thank you for helping doctor.

    Sue

    ReplyDelete
  155. You welcome,
    Let me tell you my diagnosis i have in mind, the heart burn can be due to gastric ulcer or GERD. Besides the shoulder pain can be due to an alcohol neuropathy but of course there is a list of diseases to be excluded first. Please feel free to ask your questions as long as you have one.

    ReplyDelete
  156. Dr. A, this is not a medical concern, but I need help on a biology project regarding the kidneys, and I thought you might know a little bit about nephron physiology. Do you know what will happen to sodium reabsorption in the kidneys if urea is injected into a person? Will sodium absorption decrease so that more urea can be excreted through the urine, and less sodium, or the opposite? Thanks for your help!

    ReplyDelete
  157. Hello,
    So your question is: What is the effect of high blood urea on sodium reabsorption , right ?

    ReplyDelete
  158. morning Dr hope you are doing well I have had no sleep and pain is worse today than it was yesterday coldness is worse. I did as you asked with regular temp checks and they averaged out at around 37-38

    ReplyDelete
  159. Hi Holz,
    Okay so fever is still there. Are you allergic to all pain-killers, even at paracetamol ?

    ReplyDelete
  160. paracetamol penicillin diclofenac buscopan tramadol cyclazine

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  161. Why not try Ibuprofen ? that is good for the pain and the fever

    ReplyDelete
  162. asprin in it cant take them

    ReplyDelete
  163. No, a drug as Advil is composed of Ibuprofen and diphenhydramine

    ReplyDelete
  164. Yes it is. It is sold under the name "Advil liquid gel" or "Nurofen"

    ReplyDelete
  165. @ College Kid:
    Suppose you have a high protein diet, that will cause high urea formation by the liver. So that will increase blood osmolarity --> ADH secretion -->water reabsorption --> high urea concentration --> more urea diffusion into the medullary interstitium --> more water reabsorption into medullary interstitium --> low urine volume.

    I think high urea level has no effect on Na reabsorption.

    ReplyDelete
  166. hi so i have a question, im a high school anatomy student and im doing my homework, but im stuck can you please help
    the heart is a cone-shaped muscular organ located within the (1). its apex rests on the (2), and its base is at the level of the (3) rib. the superior and inferior vanae cavae empty venous blood into (4). the pulmonary trunk, which divided into the right and left pulmonary arteries and carries blood into the lungs, arises from the (5) the four pulmonary veins empty into the (6)the coronary arteries that nourish the myocardium arise from the (7). the coronary sinus empties into the (8). the chamber that pumps blood into the aorta is the (9)relative to the roles of the heart chambers, the (10) are receiving chambers, whereas the (11) are discharging chambers. the membrane that lines the heart and also forms the valve flaps is called the (12). the outermost layer of the heart is called the (13). the fluid that fills the pericardial sac acts to decrease (14) during heart activity. the heart muscle, or myocardium, is composed of a specialized type of muscle tissue called (15)



    1. thorax (mediastinum)
    2. diaphram
    3.2nd rib
    4.
    5.aorta
    6.pulmonary trunk
    7
    8.right atrium
    9.
    10. superior atria
    11. inferior thick walled ventricles
    12.
    13.
    14 indocardian
    15 myocardian

    thank you so much

    ReplyDelete
  167. a few months ago i took a blood test and when i got the results back it said 90-81 in the white blood cell count i should have 90 . but i only came back with 81 white blood cells .i have never had any sexual kind of contact. what could be the problem ?

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  168. Hello, welcome in here

    number 4: right atrium
    number 5: right ventricle
    number 6: left atrium
    number 7: aorta
    number 8: right atrium
    number 9: left ventricle
    number 10: atria
    number 11: ventricle
    number 12: endocardium
    number 13: pericardium
    number 14: friction
    number 15: specialized cardiac muscle

    ReplyDelete
  169. Hi erene, welcome
    please clarify it to me. what was your value and what was the normal value of the lab ?

    ReplyDelete
  170. The contraction of the ventricles is referred to as (1) , and the period of ventricular
    relaxation is called (2) . The monosyllables describing heart sounds during the
    cardiac cycle are (3) . The first heart sound is a result of closure of the(4) valves; closure of the (5) valves causes the
    second heart sound. The heart chambers that have just been filled when you hear the first heart sound are the(6) , and the chambers that have just emptied are the (7).Immediately after the second heart sound, the (8) are filling with blood, and the(9) are empty. Abnormal heart sounds, or (10) usually indicate valve problems.


    1. systoles
    2. diastole
    3. the first heart sound
    4. mitral & tricuspid valves
    5. aortic and pulmonic valves
    6.
    7.
    8.
    9.
    10.murmur

    can you please help, are the ones i have right??

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  171. Sure, it's my pleasure to help you. The ones i don't include in my answer are right.

    3. lub dub
    6. atria
    7. ventricles
    8. ventricles
    9. atria

    ReplyDelete
  172. From right atrium through the tricuspid valve to the (1- right ventricle), through the (2-pulmonary) valve to the pulmonary trunk to the right and left (3-pulmonary arteries), to the capillary beds of the (4-lungs), to the (5-left atrium), to the (6-left ventricle) of the heart through the (7-mitral) valve, to the (8-aorta) through the (9-aortic) semilunar valve, to the systemic arteries, to the (10-CAPILLARIES) of the body tissue, to the systemic veins, to the (11-inferior vena cave) and (12-superior vena cava), which enter the right atrium of the heart.
    is this right??

    ReplyDelete
  173. What is a frame-shift mutation, and what type of frame-shift mutation is least likely to be harmful?

    ReplyDelete
  174. Hello, welcome in here

    Frameshift mutation occurs when a nucleotide base is either inserted or deleted it disrupts the amino acids coded for from the site of the mutation on to the end of the gene. There are two types of it: insertions and deletions , substitutions. I think the substitution is the least harmful one.

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  175. what acts on fat globules?

    ReplyDelete
  176. Hi,
    If you mean the enzyme then it is lipase

    ReplyDelete
  177. thank you, and also, what acts on sucrose?

    ReplyDelete
  178. and....
    what hormone acts on gastric juice secreting cells at the top of the stomach?

    why is secretin made?

    what hormone causes liver to secrete bile and pancreas to secrete pancreatic juice?

    thanks :)

    ReplyDelete
  179. Hi there Dr. Ahmad, I'm currently doing some medical questions and was wondering if you could help. The situation is a 25 year old woman with iron deficiency anaemia. She is on ferrous sulphate 200 mg three times a day with her haemoglobin concentration measuring 10.2 g/dl. What would be best to increase to the range of what it should be (12-16)? Thanks!

    ReplyDelete
  180. @ Malek:
    1. Gastrin
    2. Secretin stimulates the secretion of bile from the liver. It also increases watery bicarbonate solution from pancreatic duct epithelium. It also reduces acid secretion from the stomach.
    3. Cholecystokinin and Secretin

    You welcome

    ReplyDelete
  181. Hello, welcome in here

    Well the iron level can be increased if she takes a diet naturally high in iron. Foods high in iron include meats, egg yolks, dried beans or peas, green leafy vegetables, dried fruits, nuts and grains.

    ReplyDelete
 

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