Ask MetaFilter questions tagged with diagnosis

Doctor, Doctor, allow me to give you the news...

French Fry — Fri, 06 Nov 2009 10:53:15 -0800

I need help talking to doctors. I never know what to say and don't seem to give the right information. I would like help knowing what kinds of things I should remember to say and how I should say them. I have, over the course of my life, had many doctors and similar problems always come up.

1) I'll have a visit with a doctor and they'll discover a problem, and ask me how long it's been going on. I'll tell them that it is as long as I've been seeing them. That will of course lead to incredulous looks and questions of why I have "never brought it up before" and I honestly have no idea.

2) I'll get sick and go see the doctor. I'll get a diagnosis and prescription. Then when I don't get better I'll go back to the doctor and often it turns out that something I'll casually mention the second (or fifth) visit will instantly cue the doctor in on what's wrong and bang! problem solved.

The first problem has been helped, but not solved, by making lists of things to ask my doctor about. Otherwise I will automatically say "I'm fine"
The second problem is more of a mystery. Patients: what things do you always tell your doctor about if they come up? Doctors: what sort of things do you wish your patients kept an eye on?

Would an AvPD diagnosis be useful?

Andy Harwood — Tue, 13 Oct 2009 09:42:33 -0800

I read the wikipedia page for avoidant personality disorder a few days ago and I was shocked how perfectly it described how I've felt since my mid-teens. I brought it up with my therapist (who I've just started seeing for depression) and he said he didn't think that kind of label was useful. I can see his point but I fit the diagnostic criteria so perfectly that not labeling myself with it seems like denial. Should I seek out a diagnosis or should I work on my problems without putting them in a box?

The doctors won't diagnose his MS (or whatever it is). What can we do?

Anonymous — Mon, 10 Aug 2009 18:17:37 -0800

Would really like to hear from any Mefites who have been through this particular hell. My partner has been suffering for many years from symptoms that we recently realised are a perfect match for MS. Many members of his family, including his father, have MS, and his problems right now are mirroring those his father had that led to his diagnosis. We did some research and he is a perfect, 100% fit to pretty much every online list of MS symptoms. He is in almost constant pain and 90% housebound, has been for many months. After blood tests, a neurologist and a couple of MRIs, he's being told that he is in perfect health, has been prescribed basic vitamins, and told that if the problems persist to come back in four months to get a referral... to a psychiatrist. Needlesss to say, we are both fuming right now. He is in pain. He is suffering. It is NOT in his head. We want to start him on a course of whatever it is he needs so that he doesn't have to be in pain and I don't have to see him in pain.

Details: he has experienced a variety of on-again, off-again ailments for many years. Most prominent are big bathroom problems (constipation/diahrrea on a near-daily basis, even with diet changes), and attacks of crippling pain (he describes it as fire or lightning) and/or numbness in his legs, to the point where stairs and getting up from a seated position are painful and sometimes impossible. Also extreme constant fatigue and short-term memory loss, to name a few.
These problems come and go but the attacks have been getting worse and closer together in recent months.
Doctors (GPs at local walk-in clinic) kept saying he was fine, until finally he got one to do a few more tests - at the point that the rubber hammer to the knee got no response at all twenty times in a row, blood tests were ordered.

- Blood tests came back "fine"; when he pointed out that he was in no way "fine", he got a recommendation to neurologist.
- Neurologist watched him walk, poked him, etc., prescribed a mildly radical change in diet, and sent him for an MRI (head/spine).
- We followed the diet religiously (I made all his food and as he can barely leave the house there's no cheating), miraculously managed to get the MRIs done within the month, and then had to wait another month for the follow-up with the neurologist.

Today the neurologist said that everything looked good and that he could have some vitamins if he wanted. No signs of anything in the MRIs. We asked about the diet, and were told that he could follow it or not, it didn't really make a difference (!). He said to try the vitamins for four months, and then to come back and if he was still having problems then he would refer him to a psychiatrist.

We are.... angry.
It's been such a struggle to even get a doctor to LISTEN, and finally we go the whole route and the end result is a patronizing dismissal. He could barely even get to the doctor's office today because his legs were so bad, with numbness below the knee and pain above it, and he gets a shrug and a pat on the head?!

From all my reading I know that MS often goes undiagnosed for a long time; even my father-in-law got three different diagnoses before he finally got treated for his. I've seen first-person accounts of this same frustration online. We are still both pretty sure that this is MS - with his symptoms that's one of the nicest diagnoses he could get - but WHATEVER it is we want to get him diagnosed and TREATED already! I just don't know where to go from here.

What can we do?
What kind of doctor should we try to see?
What should we be doing on our own while we try to get a medicine man who will actually help him?

What's wrong with my cat?

exogenous — Thu, 09 Jul 2009 04:03:25 -0800

Anemic cat with poor appetite. Had symptoms of kidney (renal) issues but the numbers are now OK. Still no appetite. Diagnosis? The patient is a 11 year old spayed female. Lethargy and lack of interest in food and water slowly developed over a few days and the vet found high creatinine. Treated with fluids and antibiotics and the cat perked up a bit. Urine culture negative (no infection). Cat is hydrated again, creatinine back to normal, but very little interest in food and found to be anemic.

Is this just simple chronic kidney issues or something else? She's visiting an internist today for more testing.

Help me interpret an LED diagnostic sequence

gene_machine — Wed, 08 Jul 2009 04:53:56 -0800

Can anyone interpret this LED diagnostic sequence? My wife's Toshiba Satellite Pro M10 (the one featured previously) was finally dropped on the floor, and now it refuses to power up. I tried it without the battery - still nothing, so I stripped it right down, reseated everything, and put it back together. Still nothing. The left-most LED (the "plug") is now blinking in a diagnostic sequence, but I am at a loss to interpret it. It was giving exactly the same sequence before I took the machine apart ;)

I suspect the motherboards's been damaged, and if that's the case then it's not worth replacing, but I'd like to know why it's complaining in case it's something relatively easy to fix.

I recorded a movie of the LED sequence; apologies for the low quality.

In the red corner, a bad mood. In the blue corner, an even worse mood. FIGHT!

Anonymous — Fri, 19 Jun 2009 22:41:49 -0800

I just got back from a psychiatric evaluation. The diagnostic impression is "chronic major depressive disorder versus dysthymia." What does "versus" mean in this context? You are not a/my psychiatrist. I know I should have asked him when I had the chance, but I was kind of thinking “hmm, I’ll Google that later.” Google didn’t really turn up anything. I could ask him again at my follow-up appointment in a couple of weeks, or I could call the office next week, but I admit I’m curious now.

I have a passing familiarity with the DSM-IV, but I’ve never heard “versus” used like this. My best guess is that, at this point, I seem to fit the criteria for both depression and dysthymia, and my psychiatrist has yet to determine which is a more appropriate diagnosis.

I was diagnosed with dysthymia a few years ago, so I suppose it’s also likely that “versus” means a revision of my previous diagnosis.

Or did I hear him wrong and he said something else?

Is this use of “versus” common in psychology/psychiatry/medicine in general?

If you have any ideas let me know. It’s not a huge deal, but it’s got me wondering. Thanks!

Weird Ailments - Magazine Series?

musofire — Sun, 03 May 2009 12:26:05 -0800

There was a series of articles by doctors (or possibly, a doctor) in a mainstream US magazine, each about a patient who had a weird ailment, usually incorrectly diagnosed at first. What was it?

Diagnosing Schizophrenia

Anonymous — Wed, 29 Apr 2009 12:25:42 -0800

Is there any good data on the sensitivity and specificity of symptoms of schizophrenia in its diagnosis? How often are symptoms like relatively general but nevertheless involved and paranoid delusions, or hearing voices, not symptoms of schizophrenia and/or an 'early-stage' psychotic state?

The delusion that has me concerned in this case centers around the total control of the media by a few very wealthy families whose goal is world domination--it actually has some basis in fact, but comes along with lots of false, paranoid elaborations about how the families installed President Bush into office and have 'armies of people with IQs over 200' who are working to keep the public oblivious of their control. I've seen violently debilitating paranoias in schizophrenia before and this is clearly not that, but in conjunction with hearing voices it has me worried about this person (who is a college-aged male).

Is the Cleveland Clinic in Weston, FL any good?

gibbsjd77 — Wed, 25 Mar 2009 08:49:19 -0800

I desperately need some opinions/help concerning an issue I'm going through. Of course I figured the brilliant collaboration of metafilter would give some insights. Starting in mid February I've been having these episodes that my first neurologist thought were partial seizures (couldn't speak, barely move and respond, things surreal) the only problem with that is they lasted longer than seizures are supposed to (25-50 minutes) The worst part of all this is since this time I have swarming light in my vision all the time as well as a general dizzy/easily overwhelmed feeling. I've been out of work and school due to this and it's driving me nuts. I have had MRI's EEG's and EKG's with nothing coming up bad. I just went to the Cleveland Clinic this week for the first time. Hopefully they'll have some expertise in all this. Basically, I wonder if:
1. Anyone has experienced anything like this? (particularly the swarming light/dizziness)
2. Anyone have anything to say about the Cleveland Clinic in Weston, FL (positive or negative)
3. Any thoughts on diagnosis? (I know you're not doctors, I'm going to doctors and am just desperate to figure this out)
4. Any suggestions on how to get back to normal life? (I am dizzy and easily overwhelmed and basically miserable. I've been this way for weeks now)

I appreciate any help or insight you can give. Thank you for your time.

Please help me diagnose source of pain in shoulder and back.

gwpcasey — Tue, 17 Mar 2009 12:17:09 -0800

What is the most thorough and effective test, or series of tests, I can go through in order to determine exactly what is wrong with my lower back and shoulder? I have had 'issues' with my right shoulder and lower back for 20 and 11 years, respectively. Nobody has ever been able to tell me conclusively what is, or was, wrong with them (the initial trauma to the shoulder was never treated, there was no trauma with my back) and I seem to go through a cycle where I do exercises that work for a while, but eventually new pains and stiffness arise in the vicinity and the nature and severity of the problem changes, from day to day as well as from month to month and year to year.

I'm sick of it and I want to know what the hell is actually wrong in there. Once I know that I, at least, won't have to go through the whole history of the problem(s) every time I see a new physio or doctor or acupuncturist etc. (With everyone coming up with different theories as to what may have gone wrong initially, what's happened since, and what this latest bout of pain is likely due to.)

Is there a test that can thoroughly and accurately look at these specific parts of my body and determine what the actual problem is, both mechanically/structurally, and (as a bonus) in terms of the pain associated with it?

(Please note that I have ultrasounds of my shoulder and x-rays of my back as well as extensive movement tests by various physios, all of which have been inconclusive.)

Many thanks,
G.

Do I have herpes or what?

Anonymous — Sun, 01 Mar 2009 17:09:12 -0800

I know you are not my doctor, but... I have had three outbreaks of something in the last four years, which could be herpes, but so far all the tests say it's not. Any other ideas what I might have? Much much Four years ago, I noticed some discomfort in my vaginal area. It felt dry and a little painful. I thought maybe my boyfriend had cut me with a rough fingernail or something, and didn't really think much of it. A couple days later, I realized I'd developed some small white sores on my labia. They looked like ulcers you might get in your mouth. On each side, there seemed to be one main one and then a scattering of smaller ones around it. At this point I realized it was more than just a cut, and went to the gyno right away, taking an appointment with a guy who was not my regular doctor. The doctor took one look and said it was definitely herpes, sent a swab test off to the lab, and gave me prescriptions for Valtrex and some ointment.

I broke the news to my boyfriend who was so good and supportive about it. He was the only person I'd been with in the last three years, though I'd had three partners before him. He went to his own doctor for a blood test, even though he'd never had any symptoms of herpes. A couple days later I called in for the results of the culture they'd taken, and... it was negative for herpes?! My boyfriend's results were also negative.

A year or so later, I got the same discomfort and sores again. Once again I went to the gyno, seeing my regular doctor this time. She took a look and said it didn't look like herpes at all, and she didn't know why the first doctor had said that. She took another swab culture, which again came back negative.

Just to make double-sure, I got a blood test a few months later after my regular check-up, which also was negative for herpes. So nobody could tell me what I have, but it's not herpes, and I went on with my life.

Last week my husband (same guy - we've since gotten married) and I both came down with the flu. About two days into being sick, I noticed that same feeling I had with previous outbreaks of whatever I have. This time there is one main sore on the right side of my labia, and a smaller one directly opposite it on the left side. The second day was the worst, and they've been improving every day since then and are now almost gone.

Ever since my first (mis)diagnosis, I have read and learned a lot about herpes. From what I've read, there's arguments for and against whatever I have being herpes:

FOR:
- I could have it without transmitting it to my (now) husband, because it's easier for women to contract.
- This last outbreak occurred during a time my immune system was weakened.

AGAINST:
- Sores don't look like herpes, from the photos I've seen and what my doctor said.
- It doesn't hurt to urinate - in fact, it's sort of a relief, because mostly what I feel is dryness.
- The first outbreak is supposed to be the worst and occur shortly after first contracting the virus, but my "first outbreak" was years after being with any guy who could've given it to me.
- Sores clear up in about a week - regardless of whether I use any medication or not. They don't crust or scab over, they just sort of close up.

Could what I have be herpes, even though it doesn't really look or act like herpes, and three tests have come back negative? If it's not, what could it be? My personal theory is that it's some sort of irritation (from detergent, clothing, or even latex condoms?), which leads to dryness, and then the dry labia rubbing against each other irritate each other, causing the sores, which is why they always seem to mirror each other on each side of my labia. Does this sound plausable? Any other theories? Thanks...

What do you do when your loved one's personality alters following a diagnosis?

Anonymous — Tue, 09 Dec 2008 07:57:36 -0800

Have you ever had a long term partner who received a diagnosis and then completely changed? Have they become so obsessed with their condition that they seem to forget you exist at all? Is there light at the end of the tunnel? - (This is pretty long, thanks very much to anybody who takes the time to read this.) My partner and I have been together five years. This year he was diagnosed with Adult Aspergers, almost by accident. What happened was, he said something one day about the way he experiences life and I said, "Haha, that sounds like you've got Aspergers!"
He said, "No I don't", but something twigged in my brain. I realised I'd never read the symptoms in the DSM IV. So I did, and suddenly several of my partner's quirks and habits became clear.

Sure enough, he got diagnosed. I was happy for him. It must be awesome to go 30-odd years feeling different to other people and then finally realise there's a reason for it.

Before the diagnosis, everything was fine. SINCE the diagnosis, everything has changed. He has become obsessed. All he does is read books about Aspergers or log on to his Aspie web community. He only wants to talk to me about Aspergers.

And now, everything in his life is about Aspergers. Every action, every thought, everything in his life, is now new--because it is seen through an Aspergers filter now.

The way we relate to each other has changed so much that I am in shock. I honestly don't know what to think.
The reason I became best friends with him and eventually fell in love with him is because he was such a caring person. I've had mental health problems in the past too, primarily before I knew him, but my partner has always been a shoulder to cry on; he would never turn me away if I was sad.

But since being diagnosed, if I get sad, he says, "I don't understand this."
He says he's got Aspergers and people with Aspergers don't feel empathy like normal people.

But then why did I feel like he was the most empathic person in the world before... for five whole years? Was it a lie?

It honestly seems like he is reading all this material on his condition and "programming" himself like a robot. As though he has some subconscious need to be the most extreme Aspie. It is very disturbing behaviour and most unlike him.

Examples of the way he treated me before:
--Committed to our relationship and our future, and working hard so we could start a family.
--If I needed to talk, he would listen. Even though sometimes he would vague out, he would at least attempt to pretend he was listening :)
--If I cried, he would hug me.
--Talked a lot, and very openly.

Background: for the past 3 years at least, I have been his pillar of strength. I have been a practical, responsible person, studying hard and working to make a future for us. He has been working hard too, but I have at times felt as though I am carrying the "mental" burden of being positive and having a good attitude all the time. (Whereas he tends to get a bit sooky and pessimistic, at which point he comes to me for comfort.)

That was okay by me though. I felt like being the "strong one" earned me a shoulder to cry on, on the rare occasions I did feel sad.
It worked that way for years. I knew I could rely on him, which made it much easier to never get sad in the first place.

But now, he:
--Literally ignores me when I try to talk to him about something. It's almost painted across his face: "I don't have to even bother responding or making a facial expression. I have Aspergers."
--Goes to sleep if I cry.
--Refuses to acknowledge he used to be any different to the way he is now.

I feel like I'm going crazy .. how could I have imagined 5 years of caring behaviour?

Now, no matter what I say to him, he has an excuse (Aspergers-related) for why he can't understand / take the time to listen / care. He likes to list symptoms. It is as though my feelings no longer count, because if it's not Aspergers, it's not real pain.
He seems confused about why I am upset. I asked him directly, tonight: "Do you realise you are acting like you have always been this way? It's like you forget what you were like before the diagnosis." His response: "I don't remember."

There are only two explanations I can think of for all this.
(1.) He could be just going through this overwhelming reflective stage, which, coupled with his inbuilt Aspergers obsessive nature has made him completely self absorbed and utterly convinced that he is more severely autistic than he actually is.
(2.) He is experiencing some subtle personality changes following the diagnosis, but they seem more extreme because he has just happened to also suddenly lose feelings for me at the same time.

For the past few months, we've only managed to get along for short periods of time, a few days in a row maximum. During those more lighthearted times, he will tell me he does love me and everything seems like it might get better.
But then it gets destroyed suddenly, when he decides to start acting socially retarded towards me, for no reason. He gets this blank expression on his face and can't extend the simple courtesy of a response or a smile. (Yet the cat will come in and he will manage a smile.)

In essence, he doesn't seem to acknowledge there is a problem with the relationship. He seems to have a major lack in insight which stuns me because he has always been pretty analytical and self aware.
It's like I can't get through to him anymore. We always communicated so freely. He would never ignore me! Now it happens almost every day. He claims he loves me, but that I just don't understand what it's like to have Aspergers.

But how can somebody get so good at coping with it over 30 years and then suddenly decide "well that was too much work, may as well give up now that I have an excuse!"?

Sometimes I can't help but feel like he's faking it somehow... or milking it. As a teenager, I was diagnosed with depression and an eating disorder and I did get more symptomatic and more self absorbed, almost on purpose. So I understand becoming a bit obsessed with a diagnosis, but I thought that was sort of an normal adolescent self-discovery thing that you get over. My partner is in his thirties.

Extra, perhaps relevant piece of info: Over the years I have teased him about being mildly hypochondriac-- since being diagnosed, he's been way worse. He is convinced he has allergies and has gone on an extreme diet because "it's worth a try to see if he can improve the Aspergers." First he cut out dairy, then he cut out gluten. Tonight he mentioned eating less meat but I told him that was going way overboard and he agreed! Could lack of nutrition be causing/adding to this personality change?

We are going to therapy next week, but I don't know how useful it will be because he is only doing it for me -- he doesn't actually seem to want to actively work on our relationship, he seems too consumed with his own health problems.

Sorry sorry sorry for the length; I know it's probably confused you all - I could go on, but the main question is: Is this type of reaction to a diagnosis common? Does anyone have any experience at all? What's the prognosis? Am I doomed?
Stories about any crazy behaviour following the diagnosis of any condition or illness are be very welcome!

I hope I have accurately conveyed how surprising this is for me. Yes, before the diagnosis he was a bit socially retarded at times, but in a mostly endearing way. You would never have thought there was anything wrong with him beyond a slight tendency towards depression that most introverts or nerds have to some degree. He is/was funny and loyal and caring and nice.

Email me on postdiagnosisshock@gmail.com if you need to.

Real diagnosis in general practice

crapmatic — Mon, 11 Aug 2008 18:41:00 -0800

US doctor question: do general practitioners practice real diagnosis anymore? Every doctor my wife and I have gone to in the past ten years has turned out to be incompetent or disinterested in doing more than the bare minimum. My son has a fever and some other symptoms, and my wife and I were talking about finding a pediatrician. This led to a discussion about whether it's even worth bothering. We both remember that back in the 1970s, doctors (GPs) here in the US seemed to make serious efforts to diagnose colds, flus, and illnesses. My wife recalls it was normal for them to take throat cultures, do bloodwork to check white blood cell counts, temperature, and so forth. She remembers that sometimes the doctor would decide on a diagnosis after the visit (I would assume to go look in a book and research the symptoms). I recall similar experiences.

Fast forward to the late 1990s and 2000s.... when my wife or I have gone in for minor ailments, we've both had the experience of doctors shotgunning our diagnosis: i.e., half-attentively listen to our problems, do a cursory check of the lungs and ears, not do any more physical checks, then just say that some sort of virus is going around. Typically the doctor would then scratch up some Rx's for something like doxycycline, nasonex, and promethazine and bid us adieu. I'm not talking about one doctor... this is the typical sequence with seven doctors we've had in three different places we've lived in TX and OK.

Does our experience agree with anyone else's? Is our memory flawed or has there been some change in recent decades about how GPs approach diagnosis? Is it possible that new doctors are less technically informed than "old school" doctors used to be? Are we supposed to actually ask for a detailed examination (is there some code word)? Is there a trick to increase our odds at finding a doctor willing to check things out completely, for example using a DO instead of an MD or avoiding a multi-doctor practice? Many will say "word of mouth" but I don't trust it since by the reviews I've seen on Google Maps and ratemd.com, people seem to put emphasis on doctor cheeriness, wait time, and submissiveness about wanted prescriptions.

So as things stand now, we want to bring our kid in but we're hesitant about the idea of getting nothing but 5 minutes of time, an antibiotic, and whatever the pharma rep is pushing.

Somehow I suspect that basically I'm asking about shopping for a doctor. I know. But it's hard to call it shopping when I haven't been able to find a good one, ever, and I suspect there is a systemic problem. Maybe my expectations are too high. Please enlighten me.

How can we get our eight-year-old son diagnosed and feeling better?

neilkod — Mon, 11 Aug 2008 10:55:30 -0800

How can we get our eight-year-old son diagnosed and feeling better? (long) Pre-apologies for rambling. Key facts: 1) I'm in perfect health 2) My wife has MS and has been on meds for 4 years and 3) We live in Salt Lake City and face extreme hot and cold temps. We're planning a move from SLC to a more neutral climate.

My eight-year-old son has had a miserable quality of life for the last four years. Through a long diagnostic process including two biopsies, he was diagnosed with Chronic recurrent multifocal osteomyelitis. We've tried MANY treatments for the CRMO pain, none have really worked. Short doses of steroids took the edge off but they're not a long-term solution.

In addition to the lesions on his bones(due to CRMO), he has developed MANY other symptoms, including:
- Constant, constant fatigue
- sensitivity to hot/cold temperatures
- frequent skin lesions
- hip/pelvic pain
- random pain in extremities
- painful urination
- burning sensation in boy parts/bladder
- eye fatigue/pain (vision is manageable but his EP is considered slow)

He's had bone scans that have shown issues in his lower extremities. He shows an elevated SED rate and has high inflammatory markers in blood tests.

One of the first symptoms he showed was dragging his foot when he walks. He also falls down a lot.

Repeated MRI images show multiple white spots(lesions) on his brain. The MRI is repeated every 6 months, the spots have been fairly consistent in size, number, and placement.

He's not exactly sleeping well, and that's also contributing to his poor quality-of-life. He often leaves school early due to pain or unmanageable fatigue. His teachers notice and have been very supportive. He's also developed personality and anxiety issues due to not feeling well and the constant doctors visits and tests. His ability to cope with his symptoms have improved over the last year.

He is under the care of a top-notch Rheumatologist, a respected pediatric neurologist, a team of doctors at the UCSF pediatric neurology institute, and associated other specialists, such as highly specialized optometrists who deal with neurologic issues, as well as a dermatologist.

All of these physicians acknowledge the symptoms and issues, but we can't seem to improve our son's life. Eyedrops here, skin cream there, but there is nothing that explains or ties together all of his symptoms. Its always "take this test or MRI and we'll see in 6 months." The neurologists don't think he pediatric MS but have suggested he try MS meds in the past.

His sensitivities to extreme hot/cold temps, a sometimes-drooping left eye, and the spots on the brain MRI lead us to believe that this issue might have a neurological foundation - the neurologists have tried everything short of interferon medication to treat him. Without a firm diagnosis or explanation, we are not too hot on the idea of giving him interferon due to the side-affects.

Otherwise, my son is bright and motivated-he wants to get out and play, but pays the price in pain and fatigue shortly thereafter. He loves school, loves to read, and simply is frustrated and not understanding with his condition. He has a younger brother in perfect health, he often questions why he shows so many symptoms that his little brother doesn't. Additionally, its been difficult for us to keep our understanding (and sometimes cool) while watching our son be miserable and in pain.

What are we not doing? What could we be doing better? We haven't left too many stones unturned - we've taken him to UCSF to be evaluated; we're contacting other out-of-state facilities as well. He's about to enter the third grade and we don't want him to have a repeat of second grade, where he missed a lot of school due to not feeling well. Are there any types of specialists or conditions that we're not looking into? What do we need to demand more of from our doctors? He's been affected for far too long without any real explanations or effective treatment.

What happened to my heel? It's tingling

0xFCAF — Tue, 05 Aug 2008 00:57:33 -0800

I overtrained. A week later, my heel is still tingly and uncomfortable. What's going on? My left heel has felt tingly and kind of weird for about a week now. It's not really painful, just uncomfortable and annoying. If I'm focusing on something else it's generally ignorable, but when walking I'm leading with my toes to avoid putting pressure on it as it's uncomfortable to land on the heel regardless of the shoes I'm wearing.

Me: Mid-20s, moderately high blood pressure, low body weight, been running for about a year, slight pronator.

Timeline: Two weeks ago on Wednesday I went for a 15-mile run. I'd previously run a few half-marathons and I generally run at least 10 miles / week. I felt pretty much fine afterwards.

I was thinking I was pretty hot shit at that point, so the following Monday I went for a 10-mile run. I don't exactly remember when it started, but sometime after that is when the tingling began. Nothing remarkable happened on this run, but I did feel a bit dehydrated at the end (it was much warmer than the previous run).

Friday night I felt like I had had enough of this and went for my usual ~6 K run at a personal-best pace. Nothing changed for better or worse after it.

Speculative diagnoses I've looked at:
* Plantar fasciitis: It's not really painful, just uncomfortable. No change in symptoms in the morning. Walking or running makes it feel slightly worse.
* Sciatica: The sensation is very localized and there's no numbness.

PainFilter

bad grammar — Sun, 06 Jul 2008 18:04:54 -0800

What have I hurt in my shoulder/arm, and what should I do about it? I know there are a lot of "shoulder pain" questions on AskMe, and most of them refer to rotator cuff injuries. I'm not sure that's what I have.

On Saturday I did a fair amount of heavy lifting (boxes filled with books). On Sunday the pain in my left arm and shoulder became apparent. I am able to raise my left arm in front of me, to my left, and across my body. I can't move my left arm back behind me and raise it without causing pain, and I can't "pull up" from my side with the left arm without causing pain. "Pulling down" motions also hurt. Moving the left arm from the elbow downwards does not cause any pain.

In terms of everyday activity, I can put on a T-shirt without pain, but pulling up my trousers with my left arm is agonizing. I'm learning to do it one-handed. Lying down on my back in bed also hurts unless I lie absolutely flat.

In terms of the degree of pain, this is the worst pain I have felt in recent years (I have not had sports injuries). It is knife-like and makes me feel sick for a moment.

I am 37, Asian/white, female, reasonably fit, but much stronger in the legs (I walk a lot) than in the upper body. I haven't done any upper-body workouts for several years, aside from housework and minor lifting at work (I am a librarian). I am thin and not very muscular.

Should I try to not use this shoulder and arm for a few days and see if it goes away? I am taking Advil and using a cold pack though I'm not sure where to put it; right now the cold pack is in my armpit so I can type. I would prefer to keep going to work, as long as I don't lift anything.

I have a reference to an orthopedic surgeon, though the patient didn't like him much (I have the impression that nobody likes orthopedic surgeons, since they torture their patients). Is it worth trying to get an appointment? I also have a primary care physician. I will be going on vacation in 2 weeks.

What's wrong with my wrist?

anotherpanacea — Sun, 22 Jun 2008 15:28:00 -0800

What's wrong with my wrist? My left wrist hurts, badly, when more than a few pounds of pressure are applied either forward or backward--hyper-flexion in the palmar/volar and dorsal directions. I don't think it's a sprain or a break, because there's no swelling or bruising visible, and I have full range of movement. Similarly, I don't think it's tendonitis because the pain is from pushing, not movement. I can go all day without pain or any special carefulness, and then accidentally lever myself up from sitting and have that horribly painful jolt. Examples of now-impossibly-painful activities: the down position in a push-up, propping my head with my hand.

[Probably irrelevant personal narrative: Several months ago, I tripped while running and landed on my hands. They were badly scraped up, but I was otherwise fine. Since they've healed, there's been a growing 'twinge' in that left wrist. Last month I engaged in lots of heavy lifting while moving and since then that hand has been pretty much useless. Yet despite the fact that I've avoided using it, it doesn't seem to want to get better.]

What's wrong? And, while we're at it, what's the treatment?

Side Pain

davar — Tue, 03 Jun 2008 14:22:32 -0800

Constant pain on left side, sometimes on right side: what's wrong? Three weeks ago my husband felt ill. He had a fever and developed pain in his left flank. His urine was clear (at least from a dip-stick test, it has not been sent to a lab). Our GP diagnosed an adrenal gland infection and prescribed antibiotics.
The fever went away soon, but the pain got worse and he went for blood tests. There were a few elevetad values (d-dimer and CRP) and the doctor was thinking about pneumonia but said to wait if it got worse. The pain got a lot better, but did not go away completely. He went back a few days later and the blood was fine. The lung doctor did not see anything wrong with the lungs.

This was a week and a half ago. The pain is manageable, but it is still there all the time. It gets worse when he takes a deep breath, then he feels a stitching (I hope that that is the right word) pain. Sometimes (a few times a day), unrelated to his breathing, he feels the same stitching pain at his right side as well. The pain is not sensitive to touch or pressure.

He normally is a very healthy man. He is 33 years old and a runner. He was training for a marathon (he is not running now) and never had any injuries. He eats healthy and does not smoke or drink.

The GP says it is probably myositis, which she explained as "muscle ache" and that he should take painkillers (she prescribed Diclofenac).

He will go back again if the pain does not go away, but we wonder if any of you may have any clues to other causes of this pain or other tests that he might want to discuss with the doctor.

Citations or reporting for psychaitric diagnosis in the military?

OmieWise — Sun, 30 Mar 2008 11:06:47 -0800

I'm looking for citations (including reporting) regarding psychiatric diagnosis in the military over the past several years. Asking for a friend: During some extensive reporting last year on military and veteran health care, NPR reported high rates of diagnosis of personality disorders in the military since the Iraq war began. Because personality disorders might be said to be "pre-existing conditions," the military doesn't extend health care benefits to soldiers so diagnosed. However, there is fairly active debate in mental health circles about whether or not PTSD sometimes presents looking like a personality DO.

Does anyone know of any other sources for this information? Books, newspaper, magazine and journal articles would all be great. Anecdotes would be interesting but wouldn't really contribute to solidifying this as citable information.

(I've already searched PubMed.)

Do I still have Anxiety?

Schuby — Mon, 18 Feb 2008 15:59:33 -0800

Do I have anxiety? There really is no simple way to explain this but I'll give it a shot.

My Mom passed away almost two years ago. I fell into constant panic attacks, depression, and other random mental problems. The official diagnosis my therapist gave me at the time was: General Depression, General Anxiety Disorder, Post Traumatic Stress Disorder, and Dependable Personality Disorder.

She told me I have PTSD because I was the one who found my Mom and tried to revive her through CPR. I guess that makes sense...

Anyway, over the past two years I've snapped and gone into multiple panic attacks (one so severe they put me in the hospital) and an "accidental" overdose of Xanax (I say accidental because I wasn't trying to kill myself, at least consciously that is).

However since the Xanax incident I feel a lot better about myself. I'm no longer depressed, I finally got over my Mom's death, and I moved away from my main problem (involving my Father).

I'm tapering off Effexor, starting next week I'm off it for good.

Now here is where my question comes in. I'm no longer depressed, dependent on anyone, or have any sort of plausible traumatic stress I can think of, but am I still anxious?

I ask because once in a while I get paranoid and start asking myself a ton of questions in my head. I can't sit still for a period of time without constantly shaking my foot or playing with my hair or perhaps a pen I'm holding in my hand.

Would this still be considered anxiety? I'm trying to rid of the diagnosis I was given almost two years ago so I can stop worrying about my past and work on the future. I went to a therapist not long ago and his answer was "if you feel like you have anxiety then you have anxiety" which really didn't help my cause.

Questions I ask myself constantly include a sort of paranoid scenario like: Will I ever become a Doctor? Am I going to fail this semester? Do people think I'm good company? Are people talking about me behind my back?

Etc.. Etc..

Thanks.

Shadetree mechanics, lend me yr ear

Chrischris — Mon, 19 Nov 2007 15:56:36 -0800

Gearheads, please help with a diagnosis! 2001 Hyundai Elantra GL 2.0 Automatic

Car runs a little rough (not too noticable, except when I'm in the engine compartment). When I put it in gear, though, the whole car starts to shudder and shimmy, even though I'm not moving at all. When I do try to accelerate the check engine light begins to flash and there is almost no power to accelerate at all. This problem seemed to come out of the blue--car ran fine in the AM and then started this when I tried to go to lunch. I've replaced the pcv valve, put new plug wires on it. I suspect there may be a vacuum leak somewhere, but I'll be damned if I can find it. Engine code reader tells me:

300 Multiple misfires detected
705 Inhibitor (Park/Neutral) Switch Circuit Malfunction

The car has no egr valve (at least thats what autozone and Chiltons tells me) so that can't be it. I just got gas the other day, but I've never seen such a violent and debilitating reaction to bad gas in a car, so I tend to dismiss that as well. New plugs were put in this car about 5000 miles ago (86000 miles on the car total), as well as a new thermostat.

Any ideas what would make the car do this? If there is a vacuum leak and I can't find it by feel, is there any trick to doing so? All advice accepted at this point.

The internets, when it comes to car troubleshooting and decent information, has been terrible.

Sore bum.

Anonymous — Sat, 06 Oct 2007 09:10:55 -0800

My tailbone is killin' me. Help? (detailed - and a little graphic - description inside) Very recently, I have noted a sort of hard inflammation adjacent to my tailbone. The swelling becomes agitated when I sit for long periods of time -- the worse the chair, the worse the pain. This week, at the base of my tailbone, the area has developed a sore -- red, occasionally bleeding. It hurts, and doesn't really heal up well, if at all. I have made an appointment to see my doctor, but can't see him for a few weeks. In the meantime, I'm going a little nuts worrying. Any idea what this could be?

Do I really have gout? And if so...what next?

jennak — Mon, 17 Sep 2007 11:33:31 -0800

I'm a woman in my 20s, and I've been told I have gout. Misdiagnosis? What next? I have been having significant pain in my big toe. Not excruciating, but bad enough that it causes me to limp and I can't stand to even have a bed sheet on top of it.

I thought maybe I had previously broken my toe and perhaps was now dealing with a hairline fracture of some sort, so I went to an urgent care clinic (I couldn't get in to see primary care doc). They took x-rays, which were normal. At that point gout was suspected, and even though my uric acid levels were normal in the blood sample, I was diagnosed with gout.

Given that I'm a woman in her 20s (90% of gout cases affect men - women are typically affected only after menopause), not overweight, not a red meat eater, and consume only 2-3 drinks a month, is it possible that this is wrong and I have bunions or something else?

And if the diagnosis of gout *is* correct, what kind of things do I need to look for and ask my doctor to check out? (The doctor is nice, but not particularly aggressive in treatment.) From what I gather, gout in young women = possible kidney disease.

I finally talked my way into an appointment for tomorrow, and I want to make sure she's taking the right course of action...

Overzealous recommendation of ADD meds?

Anonymous — Thu, 02 Aug 2007 05:57:13 -0800

My partner just went to the doctor for a urinary tract infection and came out with a referral to a psychiatrist and a recommendation to be put on dexamphetamine! This doctor also insists it is important she meets me as well. Is this normal? Background hist:

My partner is 32 years old. In his early twenties he had been diagnosed with depression and trialed on every drug imaginable (none of which worked). Eventually he self-diagnosed as ADD, and spoke about this with a psychiatrist, who agreed and put him on dexamphetamine. I don't think he took it as directed.

I met him when he was 28. From the ages of about 26-30 he was moderately using street drugs and so he stopped going to the psychiatrist for dexamphetamine. Speed was generally his drug of choice and he eventually injected it for around one year, stopping when he was 30. That was when we moved interstate. So one year of extreme, almost daily drug use. Context: he was in the music industry.

Since moving, life is completely different. We're clean living, we dont smoke, we study and work full-time, we do normal people things, and we're happy and functional. We've been this way for 2 years. Neither of us can imagine going back. And it is for this reason, that I am a little iffy about this doctor's recommendation for stimulant drugs to treat his ADD.

I am open to having my opinion changed, if his psychiatrist truly believes he is a "textbook case", just as this doctor seems to. But to my mind, he is functional, calm, perhaps a little vague sometimes, but that is just his personality. In short, there is nothing wrong with him. I concede that he has no concentration for reading, I don't think he has ever read a full book, even though he wishes he could. But I had always put that down to him not developing a love of reading in childhood.

He is doing well at his job, he eats well, sleeps well; it is just baffling me how a doctor could take one look at him and go, YOU NEED MEDICATION! Especially when he was just requesting antibiotics for a UTI.

My partner says she asked for his medical history, which could account for this mystery, because he has always felt extremely comfortable with doctors and is very candid with them. He comes across as very thoughtful and trustworthy but I still have doubts about a doctor who doesn't see his past drug use as a red flag? Am I wrong?

2 years isn't that long ago, is it? Is this woman just some sort of over-prescriber? Even that makes no sense though, because she has to refer him to a shrink. By the way, I asked him if he felt he was "edging" the conversation towards wanting treatment for ADD, and he swears he was not.

I would appreciate any opinion on what is going on here. To what extent should we trust the doctor? I am happy for my partner to try the medication and see if it improves his lifestyle, but I am very concerned that I don't want someone tweaked out in my household! But am I correct in my understanding that if he truly does have ADD, it should just calm him down?

FWIW, he also shares my concerns and he said that he will probably try the medication but discontinue use in the case of adverse changes in personality.

Sorry so long. Any questions, direct them to this throwaway account: dexamWHYaphine@gmail.com

Did my doctor cut me for no reason?

yesster — Wed, 01 Aug 2007 08:54:59 -0800

So the doctor diagnoses me with diverticulitis, and then performs a left sigmoid colectomy on me. Per the normal routine, the section of my colon was sent to a lab for analysis, which said there was no diverticuli present. Does this mean that my doctor's initial diagnosis, and reason for the surgery, was wrong? Would my insurance company want to know this?

I'm not feeling well. I'm not sure if this is due to complications from the surgery, or from a continuation of a problem that the surgery did not correct (since it was to correct a non-existent problem).

I'm primarily concerned with getting a proper diagnosis at some point. I do have a follow-up appointment with this doctor next week. But I'm thinking I should consider a different doctor.

I know you're probably not a doctor or a lawyer or whatever -- just tell me what you would do in this situation.