Ask MetaFilter questions tagged with MEDICAL and doctor

I don't want to be alarmist, but I also don't want to be stupid.

meese — Sat, 11 May 2013 12:33:40 -0800

Suppose you've noticed a growing red skin blemish on your arm that's irregular, raised, and a little flaky towards the center. At what point do you start to worry it's skin cancer and go see a doctor? So, about a month ago, I noticed this tiny bump on my forearm. I thought it was a pimple, and I picked at it a bit, and it didn't pop. Then it started to get red -- but I figured this was just some reaction to my picking at it. But it kept growing larger. For a while, it looked a lot like a small burn. About two weeks ago, I noticed it had an irregular shape, and just a little bit of flaky skin in the middle. I was worried for a while that it was some sort of fungus or rash, but it doesn't really itch or anything. (It does sting a bit, if I touch it.) Right now, it's a little bit larger than a pencil eraser. It doesn't bleed at all, and it doesn't appear to have any veins in it or anything. (Overall, so far as frightening skin blemishes go, it's been pretty unobtrusive.)

Just this morning, I remembered what I had learned in high school physiology about skin cancer, and it dawned on me that this is a wee bit closer to the description of what to look out for than I'd like. But, this isn't a mole: I never had a mole in this spot of my arm. And, furthermore, it's only been there about a month. That seems like way too short a time frame for skin cancer -- although, I have no idea what I'm talking about.

So, given that I've had this skin blemish only for about a month, and given that I really don't want spend my money and time on going to the doctor just to be told, "Eh, if it's still there after $TIMEFRAME, come back," when should I be thinking about making an appointment with my doctor? Now? A month from now, if the blemish is still there? Six months from now?

HSV Blood Test Paranoia

emoemu — Tue, 15 Jan 2013 00:07:37 -0800

No symptoms present, no evidence of exposure. To blood test or not to test? Per my usual protocol, I went to get comprehensive STD testing before exchanging bodily fluids with a new partner. I have never been offered an HSV blood test before, but I saw a new doctor this time who offered it. She said that typically most doctors do not offer the test unless people show symptoms, but I could get it “if I wanted to.” At first it sounded like a good idea, but the more time she gave me to think about it, the less good it sounded. So I delayed my blood test to give it more thought. Here are my concerns:

I have never shown symptoms of HSV-1 or HSV-2 but the doctor says that does not guarantee a negative result (i.e. Many people are asymptomatic carriers, or just haven't shown symptoms yet.) My major fear is: IF I get a positive result*, my anxiety and hypochondria will control my life, whether or not it is necessary to be concerned. I will worry about developing symptoms on a daily basis, and I will be more afraid of sexual contact than I already am.

However, I realize that STD testing is not really about me. It's mostly about protecting those I am intimate with. But if this is not a standard STD test that everyone would get, that complicates things. And if the stats of how many people are actually infected with HSV are accurate, wouldn't I just be freaking myself out about something that a large number of people have but so few know about?

Although I'm used to being the only “germaphobe” around a sea of saliva exchangers, I don't really think it will be good for me to be one of the only idiots who actually knows their status and gets to worry about it amongst a sea of ignorant folks who choose to live in oblivion to the fact that such a high number of people carry these infections. I've also never required my past partners to get this blood test so now if I get it, I'm pretty sure I'll require that my partner get it too (whether or not it is difficult or expensive for them to get...which it seems like it might be.) But why change my protocol just because someone is offering me something I wasn't offered before? Why become even more of a germaphobe/STD-aphobe than I already am, just because my doctor is offering me that opportunity?

Lastly, does anyone know if a positive result (or even getting the test in the first place) will have an affect on my individual health insurance coverage?

*Since 50-80% of the population has oral HSV-1, I am fairly certain I will test positive for that. Seeing the result on paper may still be somewhat upsetting/concerning/anxiety-inducing, though probably manageable. Since a much lower percentage of the population has HSV-2, and I am pretty careful, I am guessing I will get a negative result for that - and if not, it may cause serious stress - as a positive result for any STD test is wont to do.

Doctor in Minneapolis who takes Aetna?

heliostatic — Fri, 28 Dec 2012 14:44:07 -0800

Looking for a doctor (GP) in Minneapolis. I've just moved to Minneapolis and would like to get a primary care physician. I have the predictable sort of medical needs, and am a reasonably healthy ~30 year old, so no particular specialties or areas of expertise are required. I have Aetna insurance, so someone in network would be preferable.

Polycystic ovaries that are not pathological... what?

jrobin276 — Wed, 17 Oct 2012 14:32:22 -0800

My "ovaries are polycystic, but this is not a significant pathological process" -what? This is a direct quote (and almost the entirety of) a letter my specialist sent me. My follow up isn't for several weeks. Anyone have any idea of what the implications of this are? (We are starting to think about having kids.) I take it this is different that polycystic ovarian syndrome (which I do not have symptoms of)? You might be a doctor, or maybe you just have some personal experience with this? I've done some google/webmd searching but nothing talks about cysts that aren't pathological.

He is a urogynocologist/obstetrician that I've been seeing for urinary tract/bladder pain, which has all but entirely cleared up through trigger point therapy and myofacial release. (YAY) Thanks!

Recommend a family doctor in Vancouver/Burnaby? One that can deal with allergies would be nice.

Hawk V — Wed, 26 Sep 2012 14:09:17 -0800

Anyone recommend a family doctor in Vancouver/Burnaby? One that can deal with allergies would be nice. Or at least give me suggestions on how to get one, because I've never done this before. I've been in Canada since I was a kid, but I've never had a family doctor, and I don't know where to begin. I just grew up as part of an immigrant family that didn't use health services for some reason, and tended to use home remedies or none at all. So now that I'm conscious of the fact that I need a family doctor, I'd like some recommendations or suggestions on how I can get one.

I've been dealing with perennial allergies recently and have been prescribed Nasonex at a walk-in clinic, but I'd like to have a doctor who can help me with my allergies/sinus-type problems on a more regular basis, because I'm still at the stage where I'm still figuring out the right mix of meds and changing up my environment so I can sleep at night and be mostly normal again.

I'd prefer to see a doctor in an area close to public transit, preferably in Burnaby, New West, or East Vancouver. My other preference is for a doctor whose English isn't too heavily accented, or speaks too softly, or is biased against the use of anti-depressants. I am an immigrant myself, but it is always awkward whenever I deal with a doctor who I constantly have to ask to repeat her/himself, I just don't want to annoy him/her. I am also have been prescribed an anti-depressant (and went through some counselling), so I'd rather not deal with a health professional who'd be judgmental about it. Thanks!

I have insurance goddamn it!

showbiz_liz — Thu, 20 Sep 2012 10:20:10 -0800

My doctor's office billed me up front for an IUD and told me I would be reimbursed. Today, after calling them repeatedly, I found out that they have not filed a claim for the device, and they couldn't give me a satisfactory explanation as to why. I have no idea what to do now. On September 4th, I had an IUD placed at this clinic (in New York City where I live). They told me at that time that I would be required to pay $650 up front for the device, and would then be reimbursed by my insurance. They said this was because they bought the devices in bulk and kept them at the office, rather than ordering them individually for patients. I thought this was strange- especially because no mention was made of this on my previous screening visit- but I went ahead and put it on my credit card, assuming I would have my money within a month.

It is now September 20th, they have not filed a claim, and they cannot explain to me why they have not done so. Originally they told me they'd filed it, the insurance company must just not have gotten it yet. I found out today that the insurance company HAD received a claim for the visit, but not the device itself. I called today to ask why, and they said, oh, well, WE'RE not the ones who file a claim for the device! It's the device provider, CVS! Call them and ask why THEY haven't filed a claim yet.

I called them- they have never heard of me, do not have a file for me in their system, and they didn't understand the situation I was describing at all.

I called back and told the clinic this. The clinic told me that 'their supervisor will get back to me'.

What the hell is going on here, and what can I do about it? At this point I would be happy to file a claim myself but I mentioned this and they basically brushed it off. I am scared that they scammed me somehow and I will never be able to file a claim for this, and am out $650 despite being fully insured.

What can I do now, besides just keep calling them every day (as I have done for the past 4 days)? Is there some sort of medical advocacy group I can call? I don't have money for a lawyer!

Doctor, Dentist, Indian Chief

jason's_planet — Sat, 04 Aug 2012 14:05:18 -0800

Good afternoon. I am in the market for a doctor, of the general practitioner variety, a dentist and a new laboratory in NYC. Any referrals you could provide would be greatly appreciated. Now, for the specifics:

All three of these should be located in, or convenient transit rides from, the West Village or Western Queens (i.e. Astoria, Woodside, Sunnyside, Jackson Heights).

1. The doctor must be in the Blue Cross/Blue Shield network. He or she should have decent social and communication skills. I'm looking for someone who views the doctor-patient relationship as a partnership, not the old-timey command-and-control model. The doctor should also be able to respect my decisions not to pursue certain medical choices (i.e. saw palmetto vs. proscar).

2. The dentist should accept Blue Cross and Aetna dental insurance. He or she should also have a positive, or neutral attitude, towards wisdom teeth. The last dentist I visited wanted to extract all of my wisdom teeth, three of which were perfectly healthy, because of an issue with one. When I declined to give permission for this, she wanted me to sit around for a browbeating session from her senior partner in the business. This behavior made me uncomfortable and I don't want to experience it again. So . . . yeah, a good dentist, who takes my insurance and respects my right to make decisions about my oral health.

3. Every few months or so, I have to have blood drawn because of a medication I take. The last two times, I've visited a LabCorp franchise in my neighborhood and had . . . not so great experiences. The first time, they were overwhelmed with walk-ins and disorganized; I wound up waiting much longer than I preferred, even with an appointment. The second time, the phlebotomist treated me with contempt because I was a little anxious about needles. And then he had the nerve to ask me to provide positive feedback for him on the company's website. So . . . I'm looking for a lab where the staff are not pushy, socially challenged assclowns, are organized, and where I won't have to invest forty-five minutes of my day in a five-minute medical errand. (Before I forget: --also in the Blue Cross/Blue Shield network).

These are the three things I need in my life right now. If you can point me in the right direction, I will be very grateful, think warm thoughts of you and maybe even give you a best answer!

Botox injections and neutropenia

conrad101 — Fri, 20 Jul 2012 07:17:09 -0800

Are there risks in having botox injections for a neutropenia sufferer? A relation of mine is determined to have botox injections to get rid of wrinkles, however, they suffer badly from cyclic neutropenia which means that their immune system is often weak and have white blood cell issues and consequently they get infections frequently. I am aware that botox is botulinum toxin and I have kept trying to persuade her to see her doctor before having botox injections, to check whether they are safe for her in light of neutropenia. She is desperate to go ahead with this and it is hard to persuade her to get medical advice on this. From a layman's perspective, I am concerned that this may be dangerous for her. Does anybody with medical knowledge, perhaps haematology, know if this botox is safe for neutropenia sufferers? Many thanks!

Much more pain post spine decompression, why?

Salvatorparadise — Sun, 10 Jun 2012 09:33:49 -0800

Spinal decompression therapy - lots of pain/worsening symptoms afterward. Normal? What next? Hi folks, this Q is for my wife. She has a lot of back pain, but never has had trauma like a car accident or anything. Hasn't done anything that really seems like it would cause it. She is 6' 1". Anyway, she had a bad flare up a few years ago, couldn't walk, stabbing pain in lower back. Got muscle relaxers, laid for a few days. Got better and stayed better.

Fast forward a few years until a few months ago. Lots of pain started again. Much much worse when sitting. She has to sit at her office job. She is also a child/wedding photographer, so lots of moving around. It kept getting worse, not debilitating like before, but pretty bad, especially stabbing pains down leg when sitting at her office. She started last week at a physical therapy/chiropractor place in the same building as her general practitioner doctor, who recommended this place.

He diagnosed her as having thin disks at L4/L5 and at L5/S1. He began decompression therapy, basically a big machine that gently pulls on your body. Session one created soreness, sometimes quite sore, but the back symptom that brought her there was lessened. Session two showed even more improvement. Some soreness and also a few bouts of the real back pain that brought her to the doc, but much less than in past days/week. Then on Thursday a nurse put her on some apparently slightly different machine that does one long pull, rather than staggered pulls. I don't know what these machines are called.

Thursday night she felt very strange/terrible. Almost a shock like feeling like after she did a marathon a few years ago. Friday, lots of low back pain, stabbing pain, pain down the leg. Saturday she HAD to shoot a wedding. It was one of the more tough things I've ever seen someone do. 12 hours. She did it. Had to be lifted into and out of the limo, yelled out in pain once during the shoot! Yike....

So today, she's in a lot of pain as one would expect. Real trouble walking, terrible pain getting into and out of car. She's basically disabled at this moment on the couch.

WTF! This treatment was supposed to help. And did at first . She is taking alleve and is very worried, as am I. She has to go to her office job tomorrow and really needs some muscle relaxers. We called this physical therapist/chiro's he just called back. Said it is a flare up, that muscles get fatigued from this process. Recommended we head over to urgent care to get some strong pain reliever/muscle relaxer/anti inflamatory and then to come in tomorrow to see him.

Has anyone else experienced problems with this type of therapy? Seems that whatever they did thursday caused a major flare up. We really need some answers!!!! Anyway, anyone's thoughts or experiences would be appreciated. Sounds like the chiro thinks this is just a bad flare up. It does seem like that is what it is...

What did the doctor think I had?

smilingtiger — Thu, 10 May 2012 18:39:03 -0800

What is a doctor looking for if he palpates the kidney area and asks if it is painful? I had a slightly strange interaction with an ER doctor last weekend. I went to the emergency room for a non-illness-related reason (I needed help removing a menstrual cup) and the doctor and nurse were very personable and helpful. After taking out the cup for me, the doctor instructed me to get dressed, and left the room. He immediately returned, just as I started to get dressed, and said something like "Can I just check something?" Then he pressed (palpated?) the areas below my ribcage on either side of my belly and asked if it hurt. I was a bit surprised, but said no, and before I could ask him why he was checking, he hurried out of the room. What could he have been checking for? Is it even possible to guess? (I never mentioned any symptoms or said I was feeling unwell.)

How to quickly raise iron levels outside of being hospitalized.

who squared — Tue, 15 Nov 2011 17:40:13 -0800

In the U.S., what options exist for a nearly immediate increase in hemoglobin levels (or iron) outside of a blood transfusion in a hospital? For instance, can doctors give a blood transfusion in their office? Also, I've heard that some type of iron injection is available in the UK but I don't know what is called or whether it is an option available in the US.

What procedure will kill my eye vein?

two lights above the sea — Fri, 11 Nov 2011 11:15:31 -0800

I went to a ENT/facial surgeon recently for something unrelated, and I asked the doctor, who also does facial plastic surgery, what I could do about a large vein I have under my right eye. He had me speak with a woman in the office, and she told me, after looking at my vein(s), about a procedure for veins like mine (not spider veins) wherein they inject saline into the vein and then it goes away. What procedure is that? How much does it cost? Do you have a recommendation for a place in Philadelphia, PA? Just to be clear, I don't have spider veins under my eye. It's a larger, single vein (I have a slightly smaller one under my left eye). I've tried to call the office (seriously, several times) to find this info, but they've been unhelpful. It's bothered me all my life, and it makes me look like I constantly have uneven dark circles. This procedure seems like it would be great! Help me find out what it is. Thank you!

Love your doctor in Portland, OR? Tell me about him/her!

Anonymous — Tue, 20 Sep 2011 19:09:24 -0800

Looking for a doctor / nurse practitioner in Portland, Oregon. I want someone who will work with me, as opposed to running the show. More info inside. I have seen a whole mess of doctors and specialists over the years. I loved my combination of practitioners, but then I moved to Portland.

I am a mid-20s female. My general issues include migraines and anxiety / depression / attention issues.

I'm pretty well-read on my various maladies and want to work with my doctor, as opposed to being talked down to (sadly this has happened to me more than once).

Someone sex-positive who doesn't have a problem with nulliparous women having IUDs would be a huge bonus. Of course, I can always keep going to Planned Parenthood for this stuff.

I would love to find a general practitioner. I also have seen a psych nurse for my "crazy meds" (loved her), a neurologist (we didn't work well together, he was convinced I was drug-seeking and refused to even discuss pain meds), a massage therapist for chronic pain management, an acupuncturist / naturopath...

I certainly wouldn't mind going to an integrated wellness center that has a doctor as well as in-house massage, etc.

And yes, I have insurance—at least I do through the end of the year.

Anon for obvious reasons—I don't go around announcing my anxiety / depression issues to just anyone.

Do you know a good doc in Boulder, Colorado?

iminurmefi — Fri, 12 Aug 2011 08:13:18 -0800

Looking for a good primary care doc in Boulder, Colorado. Any recommendations? Having recently moved, I'm looking for a primary care doctor in Boulder. I'm feeling a bit overwhelmed with the process--it seems like every medical office I see around my house is promoting their doc's special blend of natural / holistic and western medicine. That is definitely not the sort of doc I think I'm looking for.

My dream doctor would be really into evidence-based medicine, have an appreciation for things like national guidelines (for instance, won't be likely to prescribe antibiotics in the first week of a sinus infection no matter how much patients want it), and generally take a conservative approach to practicing medicine. He or she would not be the sort to sell fancy nutritional supplements or vitamins in their office. Bonus points for being able to get short-term appointments for urgent issues (e.g., UTIs) and for having electronic medical records. While I say "dream doctor," in reality I'd be more than happy with an NP or PA or DO that meets the above criteria.

Do you or did you have a doc in Boulder that you loved? Tell me more!

Health professions/schools that do not require any standardized testing to get into?

cruncheweesy — Wed, 22 Jun 2011 08:50:18 -0800

What are other careers similar to a Chiropractor? IE. Health professions/schools that do not require any standardized testing to get into? I'm really doubting my ability to get into allopathic medical school but I would still like to work in a related profession.

I guess my question is two-fold:

1 - what are health careers that don't require standardized testing? I'd still like to be a doctor if possible, like Chiropractors.

2 - What are careers WITH standardized tests that aren't as competitive as medical school? I've also been looking into pharmacy as another avenue.

If it helps, I'm supposed to be applying this year as I graduate next year and would ideally start graduate school in Sept 2012.

Who should I see about the increase in my hypnagogic hallucinations?

patheral — Tue, 10 May 2011 10:19:07 -0800

I know I probably need to see a doctor, but the question is, which kind? I've always had nighttime hallucinations. They don't bother me much because I usually realize I'm still dreaming and go back to sleep. However, the past few months have seen an increase in my nighttime hallucinations. There has been no change in my psyche meds (Seroquel, Topamax & Welbutrin), no change in diet, and no significant change in habits.

Here's what has me worried: the other night I woke up to see a blinking red light on my ceiling, at first I freaked a little because there should be no blinking red light in my room at all, but when I moved my eye, the red light moved as well. Whew, just a hallucination. But then I wondered, why a blinking red light? Then I noticed that something cell-like covered the room (like a snake skin) and that did not move with my eyes, but I still knew it for a hallucination so I shrugged it off and went back to sleep.

When I woke up in the morning, it hit me that the blinking red light was the fourth such hallucination I've had in as many months - the kind that moves with my eye. The other three have taken the form of bugs, two spiders and a bee. Now, I have had floaters in my eyes for years, but it kinda worries me that now my hallucinations are acting like floaters. I've never had that before. Usually my hallucinations are just floaty things that... you know, float. They don't skip around the room with my eyes.

The skin-like hallucination is the third of this kind (the others looked like gauze cloth covering everything) I've had in about four months. I normally do not hallucinate this often, usually it's about once or twice a year.

So, should I see an eye doctor? a neurologist? talk to my psychiatrist? (I have an appointment with the psychiatrist on Friday for a med check). Or just chalk it up to stress and move on?

Oh, I don't have a general practitioner, or health insurance. I'm a grad student and the university's health clinic is fairly useless, which is why I'm asking for y'all's opinion.

Epstein-Barr treatment options?

phunniemee — Sat, 23 Apr 2011 09:50:03 -0800

A friend of mine has a relative with Epstein-Barr. We are looking for information on treatment and doctors in either New York or Chicago. A lot of the information out there for Epstein-Barr seems a little woo-woo, and I'm having trouble finding legitimate resources that have treatment options and doctor referrals.

A possible complication is that the patient also has trouble with UTIs and kidney infections, so is regularly on antibiotics. I don't know what kind.

I've read that low-dose naltrexone can sometimes help symptoms. Does anyone have any experience with that? The most concrete info I can find about it is doctors saying, basically, "yeah maybe."

Any information or doctor recommendations would help tremendously. We're looking for resources in either Chicago or NYC, as those are the easiest for her to get to, but if there's some really awesome specialist living in Houston or something, I want to hear about that, too.

Thanks.

How to find a medical specialist

Anonymous — Wed, 20 Apr 2011 08:02:07 -0800

How does one find a specialist in your area? A friend is trying to locate a doctor who is a specialist in Klinefelter's Syndrome. This sort of crosses all kinds of medical areas: endocrinology, genetics, etc. A surprising number of doctors are unfamiliar with Klinefelter's, even though 1 in 500 men have it. My friend is in Chicago, and other than combing university websites, are there any other resources for locating a specialist in this particular genetic disorder? The AMA's website won't let you get any more specific than "endocrinology."

How to skip the wait for a doctor

hijol — Sun, 10 Apr 2011 15:55:34 -0800

How can I get a quick appointment with a medical specialist? I have gastroparesis and it has recently gotten bad - I am significantly underweight and I am continuing to lose weight because I am not able to take in enough calories. I have gone to a couple of generalist gastroenterologists before but they didn't help me at all. I found some gastroparesis specialists a couple hours away from me, but the next available appointment isn't until the summer. I have done some research and haven't found any other nearby doctors with this specialty. Does anyone know of a strategy I can use to get an earlier appointment? On a related note, any ideas of how to get in to see therapists (psychologists) who are not currently taking patients?

Sensible medical intervention guidelines

kristymcj — Sun, 03 Apr 2011 18:22:42 -0800

I'd like some guidelines on how to be reasonably cautious with my child's health when I can't tell if the nurses are overreacting or not. Three times in my 10-month old's life I've called the nurse line about a concern and have been told to go to take him straight to the ER. The ER is crazy expensive with my insurance, but I'll gladly take him if it's a necessity.

All 3 times I was able to get them to let me take baby to the minor emergency or give it a few hours and call back, but only after pushing them hard.

I'm a first-time parent and in retrospect there was absolutely no reason to go to the ER (or even to the doctor) for any of the issues (vomiting, possible skin infection, fever). I know that doctors HAVE to be cautious for liability purposes.

Moving forward, I'd like some guidelines on how to be reasonably cautious with my child's health and not to crazy overreact.

Is there a consensus regarding antifebrile medication use for mid-grade fevers?

Bugbread — Tue, 08 Mar 2011 03:15:49 -0800

Is there a general consensus in the medical world regarding whether it is better or not to use fever reducing medications (aspirin, acetaminophen, ibuprofen, etc.) for medium-grade fevers? I know that there are medical opinions regarding whether or not to use fever reduction medications for medium fevers, backed up by rational, logical reasoning. The problem is, both from Internet research and consultation with actual doctors, I have heard perfectly cromulent arguments stated by doctors on both sides. So my question isn't really "should they be used" as much as "is there a medical consensus (10/90 or the like) or an overwhelming trend (30/70) or is opinion generally divided (50/50)?" (plus, of course, which sides are which on those divisions).

Help me find an orthopedist in the Bay Area!

mingodingo — Thu, 17 Feb 2011 15:27:36 -0800

Can you recommend a great orthopedist in or around San Francisco? I have a congenital disability that manifests in a number of orthopedic issues, one of which is severe scoliosis. This was partially corrected when I was 11, but I used to visit an orthopedist annually after that just to make sure everything was looking okay. Since I moved to California about five years ago, I've not visited an orthopedist, and it really hasn't been an issue. However, lately I've been having some back pain, and think it might be a good idea to check in with someone.

Sooo, with that TMI background info, my question: Can you recommend a wonderful orthopedist in or around SF that meets the following criteria?

1) Has some pediatric experience, but will accept adult patients (largely as a result of my scoliosis, I am very short-statured which leads to some particular orthopedic complications, so pediatric experience is a plus)

2) Is fairly easy to reach via BART/bus/Muni (it's okay if the person is located in the East Bay or elsewhere, as long as they meet this criterion)

3) Accepts Blue Shield (if you're not sure about this one, no worries, I can check)

Thanks!

House says it's not Lupus, but I disagree.

Anonymous — Tue, 14 Sep 2010 15:25:12 -0800

I have many of the symptoms of Lupus, and my mother has the genetic defects that cause a number of autoimmune diseases including Celiac and Lupus. How do I go to my doctor and insist I get tested without her laughing me out of the office or convincing me otherwise that I don't have lupus? Also, I might be crazy. Obviously, YANA/MD So, for the last year, I've been feeling really crappy in general. Starting in September of 2009, I've been getting recurring infections (yeast and urinary tract), and the doctors have found (so far) no reason for the repeated infections. Within the last 6 months or so, I've been feeling especially weak and tired, extremely light-headed (every time I stand up, my vision blurs to white and I have to brace myself), I've had some joint pain (knees, hips, neck, hands and feet), my hands have been going numb on and off, I've been getting pretty severe headaches/migraines (with a sensitivity to light), fairly severe indigestion (my bowel movements have been all over the spectrum of weirdness and are totally unpredictable with no significant change in diet), lower abdominal pain, soreness/pain on my right bottom rib (where my liver is), and I've had two sores on my lips (I do not have herpes; at least, the strain that they test in the normal STD blood test).

I've had terrible nosebleeds and arrhythmia (and chest pain similar to those with pleurisy) all my life. I've worn a heart monitor for 24 hours when I was a teenager, but they never found anything. My younger sister complained of the same issues, and eventually wore a monitor for a full month, which is when the problem was found. I don't remember what her diagnosis was. Something with "White" in the name.

Recently, my mother was tested for Celiac disease, and it turns out she has the genetic markers for it. Those genetic markers are the same for Lupus, and she once casually mentioned to me that it sounds like the symptoms are similar to a lot of things I've been experiencing.

Possibly also related: within the last 6 months, I've been on many, many, antibiotics, including Diflucan, Cipro, Bactrim, and Flagyl, all of which I've taken at least twice. Could these have caused some kind of antibiotic induced disorder?

So, I know I need to go see my doctor. I have insurance and a PCP. However, I was recently (a month ago) prescribed Lexapro for GAD, and I'm afraid my doctor will think I'm being anxious about this. I HONESTLY feel better about a lot of things in my life. I'm in therapy, which has been amazing. Still, I feel like there is something wrong with me. I really do feel ill. How do I lay this all out for my doctor and ask her to test me without sounding like a hypochondriac? Will she automatically assume that my anxiety hasn't gone away, or chalk it up to my medication? Is it enough that I insist that she test me? Raah, help! I want to feel better. Throw away email: imburningupinside@gmail.com

Help me understand how the Internal Medicine medical boards are scored.

petestein1 — Tue, 17 Aug 2010 10:41:31 -0800

My little brother is re-taking the internal medicine medical boards and I'm trying to get a better understanding of how much he needs to increase his score. So my little brother is re-taking the internal medicine medical boards in a week. He didn't pass the first time due to some pretty extenuating family circumstances that more or less prevented him from studying. I'd like to set his mind at ease that he'll fly by this time. But there's one problem... for the life of me neither of us (or any other doctor's we've spoken to) understand how the test is scored. Here's what we *do* know:

It's graded on a curve and to pass, you need to NOT be in the bottom decile. So 90% of those who take it pass. (Which is pretty scary in its own right.)

He got a breakdown of his decile by various topics (cardiology, neurology, psychiatry, etc.) and while he was 7th decile in his specialty, and 2nd decile in a few other topics, he was 1st decile in most.

That he was in 2nd and 7th decile in a few topics but overall averaged into the 1st decile tells me that he *really* bombed some of those other topics. Or am I missing something?

Unfortunately there's no indication of how close he was to making it into the 2nd decile. Was he 1 question away? 3? 10?

He also got a score of some sort that was approximately 260. (The letter with all these details is MIA) and it said that to pass you need a score of approximately 360.

What this 260 and 360 is based on is a mystery. There are not that many questions and no apparent point value assigned to questions.

So my question is this. How much does he have to improve? Do the 260 and 360 indicate that he needs to get approximately 50% more questions correct? It's seems unfathomable that he could have missed *that* many questions -- especially when ranking in the 7th decile in category and 2nd decile in 2 others -- it would almost mean that the other 10 categories or so were 100% wrong.

Any insight into the arcane scoring system would be much appreciated.

P.S. As a bit of political commentary: the system seems a little broken. I know he's smart and a good doctor. He went to an ivy league undergrad and ivy league medical school. He did his residency and now fellowship at the best hospital in NYC. His patients love him and his co-workers love him. And yet he might not be a doctor because of this one test. I know we want to make sure our doctors know what they're doing, but he's a better doctor than 90% of the doctor's I've run across in my 45 years.

Ow my brain

brainmouse — Mon, 09 Aug 2010 14:04:18 -0800

What information should be included in my headache journal? I've been getting headaches for most of my life, but recently I've had worse and more frequent ones, and among other things my doctor suggested I start keeping a headache journal.

She just gave me a very basic sketch of what should be included in it. I've been looking online for templates, and I don't like any of them, so I'm going to make my own.

So my question is: what information should I include for a single entry in the journal? For things like what I've eaten, how far back should that go (all day, the day before, just a couple hours?). Should I include even minor 5 minute headaches that don't turn into anything? How detailed do I need to be in how bad it is over time (as they get worse and worse and then better and better - just the peak amount of pain or document how long it took to get there?)

I'd like to know answers both from a doctor's perspective (what will be helpful for my doctor to know) and from a patient's perspective (what will be helpful for me to know). If there's any spectacular guide online that you would like to link me to, that would be good too.