Jag, Have A Med Question. Bump When Around
| Adventurous cordovan persian sanctuary | 09/09/24 | | spectacular medicated site | 09/10/24 | | Adventurous cordovan persian sanctuary | 09/10/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Coiffed nofapping stage | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | Coiffed nofapping stage | 09/11/24 | | Adventurous cordovan persian sanctuary | 09/11/24 | | ...,,..;...,,..,..,...,,,;.., | 09/18/24 | | jag | 09/20/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | spectacular medicated site | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | garnet hideous lettuce knife | 09/11/24 | | Startling Milk Mediation | 09/11/24 | | spectacular medicated site | 09/11/24 | | spectacular medicated site | 09/11/24 |
Poast new message in this thread
|
Date: September 10th, 2024 6:03 PM Author: Adventurous cordovan persian sanctuary
had annual physical and bloodwork. HGB was 13.7 (range is 14-18), and WBC is 4.1 (4.5-11). gp then said he's ordering a vitamin test. vitamin text shows serum iron at 60 (65-175) and % saturation at 17% (20-50).
he said i'm slightly anemic and should do a colonoscopy to rule out internal blood loss.
is he right or, or is this CYA defensive medicine?
fwiw, i don't eat much red meat (once every 2 weeks). i told him this and he said only a true vegan diet would make you anemic.
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48071460) |
|
Date: September 11th, 2024 6:48 PM Author: spectacular medicated site
this is an incomplete iron study. I'd need to see a TIBC and a ferritin to distinguish whether you have iron deficiency or anemia of chronic disease. if your ferritin is below 30, then you definitely are iron deficient.
but let's assume you do have iron deficiency anemia. it's very very unlikely to get this from diet alone, regardless of red meat intake. if you drink an abnormal amount of tea, perhaps this could explain it (it can reduce iron absorption). and i'm supposing that you don't have celiac or gastritis or whatever that can readily explain iron deficiency.
so for someone who is otherwise healthy and has no obvious cause of iron deficiency, i would agree with a referral to a GI. i wouldn't call this CYA, it's basically standard of care
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078095) |
|
Date: September 11th, 2024 6:54 PM Author: Adventurous cordovan persian sanctuary
here's the complete iron data:
serum iron 60 (65-175) [low]
TIBC 361 (165-502)
% saturation 17% (20-50) [low]
ferritin 194.7 (21.8-274.7)
folate level 8.8 (7-31.4)
B12 354 (213-816)
didnt know you needed all that. pls proceed, doc. tyia...
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078130) |
|
Date: September 11th, 2024 8:06 PM Author: spectacular medicated site
do you have an MCV available as well?
this is actually somewhat interesting. your ferritin levels are not what i would expect for iron deficiency. this is an inconclusive result. it could very well be iron deficiency with a confounding elevated ferritin in the setting of chronic inflammation. you could ask for a "soluble transferrin receptor" lab test, which would elucidate if you truly have iron deficiency anemia.
or it could be that you have both iron deficiency anemia *and* anemia of chronic disease/inflammation. you might see this in the setting of occult bleeding and inflammation from inflammatory bowel disease or colon cancer. there is no lab test that can easily determine this scenario, but a serum hepcidin level may help. alternatively, you could opt for a therapeutic trial of iron supplementation -- if iron studies improve, then it was just iron deficiency and nothing else is going on hematologically.
but this won't change management for you. if you have iron deficiency, you need to figure out why, and you'll still end up with an endoscopy.
excuse all the jargon. in short, we can wax poetic about your iron studies all we want, but all roads seem to end in a probe up your ass.
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078434) |
|
Date: September 11th, 2024 8:26 PM Author: spectacular medicated site
no it doesn't change anything
yeah it's flame
pick a good GI doc, not just someone who rushes through the exam to stack more procedure fees in a day
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078530) |
|
Date: September 11th, 2024 8:28 PM Author: Adventurous cordovan persian sanctuary
my jew GP recommended two, one a jew boomer and other a fat white woman. jew boomers are the ideal. how do i really know if he's good?
are there risks with a colonoscopy? can they tear your colon?
is it really worth the risk?
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078542) |
|
Date: September 11th, 2024 8:46 PM Author: Adventurous cordovan persian sanctuary
i've had some sort of jewish gut disease at times. like 8 yrs ago, i had incredible stomach pains and eventually a specialist thought it was stomach ulcers and gave me carafate and it made it better. at 2 other times since when i had similar severe stomach pains.
is stomach ulcers = gastritis?
could this be causing the labs?
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078632) |
|
Date: September 18th, 2024 8:20 PM
Author: ...,,..;...,,..,..,...,,,;..,
UPDATE: i had a consult with the GI doc - the jew boomer. he says that the labs arent so deeply concerning since they're just a bit low and the ferritin is normal, and thinks it's premature to do a colonoscopy. he suggested i do a stool test, try to eat more red meat, and repeat the bloodwork in a month. he said that given my age and no family history of colon cancer, and if the stool test is fine and the bloodwork is better in a month, there's a very low probability he'd find anything in a colonoscopy.
he said he's happy to do the colonoscopy if i want, either now or after the stool and repeat bloodwork, but he knows nobody wants them. he said i can do it for peace of mind, but doing it for peace of mind doesn't mean there's a necessary clinical reason to do so.
i told him that my GP said that even one low result from the bloodwork would be concerning and worth testing even if the bloodwork is normal later on -- where it's unexplained why that low result happened. he didn't seem concerned.
he's an old-school boomer solo. i guess he's not under pressure from a big group to crank out procedures.
you think he's wrong? i don't see why he'd be full of shit. seems like he doesn't practice defensive medicine like the rest of them.
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48106314)
|
Date: September 11th, 2024 9:36 PM Author: garnet hideous lettuce knife
Jag, I need help too
My mom passed out in her bathroom for some unknown reason and broke c4 c5 vertebrae with "stable" fractures. After a helicopter flight to a hospital they sent home after 24 hours with a neck brace and a 3 week follow up.
She's 60 years old. This was the 3rd time she has had these fainting episodes in the last couple months and she never had then before. What should we be doing.
Ty bro
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078781) |
|
Date: September 11th, 2024 9:46 PM Author: spectacular medicated site
man syncope and "dizziness" workups were the bane of my existence
i'd need a LOT more info about her to give a focused answer to this
but basically you need to find out if she's passing out because of her heart, her brain, vasovagal, metabolic (blood glucose etc), or orthostatic hypotension
i can't imagine they didn't thoroughly investigate this stuff, and you don't always uncover an etiology
what kind of doctors was she seen by (other than ortho)
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078817) |
|
Date: September 11th, 2024 9:49 PM Author: garnet hideous lettuce knife
Should we be worried any more about the neck fractures? Should I get a second opinion?
I don't have any of the details because we're just now getting medical records, but what you are saying sounds good and reasonable. The tests from the hospital (MRI, blood work, ECG) were OK, but they did make a referral to a cardiologist. I'm taking her to that Friday.
Thanks again.
(http://www.autoadmit.com/thread.php?thread_id=5591377&forum_id=2...id.#48078823) |
|
|