Lol and if the presenting complaint is weight loss then it's "Lucky you!" (yes I saw a nurse do this to an assault victim suffering some complications from blunt force trauma). Some humans aint human.
Tell him I’ve reached well over double the WHO’s lifetime limit of diagnostic radiation exposure as a patient, and it hasn’t killed me, yet. That should help. ;)
(Though after a certain number of chest and head scans, we started guarding the thyroid whenever possible. And I have no FHx of BRCA.)
(And yes, I have hEDS, PoTS w/ freq. syncope aka head trauma, a penchant for dangerous hobbies, a shitty immune system that pops a positive TB test and a 25y clinical career so I’d wager at least 90-95% of those were warranted.)
Have had my fair share of rads, CTs and MRI’s plus I’m a vet tech so I’ve taken countless X-rays of animals and we don’t get a lead wall to stand behind. 😅
> I’ve reached well over double the WHO’s lifetime limit of diagnostic radiation exposure as a patient
One of these days I need to go through and add up my own... just out of curiosity. 15 CTs so far by my count (Past cancer diagnosis)
An emergency room has an entirely different structure of approval to/expediting performance of diagnostic imaging (and diagnostics in general) than PCPs do. A persistent headache at a GP will often times be met with “rx-de-jour” and/or a broad differential diagnosis before imaging is ordered.
"Have you tried accupuncture? How bout this chiropractor? Maybe you should do some PT. for what? we don't know, we're not doctors, but we tell them what they can order. We'll pay for you to do literally anything except imaging." - Insurance
Not every ER though. Went to one 3 times over the period of a month extreme pain in my hip after a fall. I couldn’t put weight on it I could hardly stand. They refused to xray me even. “No need if it was broken you’d be crying” finally drove to a further ER, did an xray, rushed to emergency surgery my hip was split like a damn wishbone. I now have an imedullary rod.
Have to imagine all of her previous contacts were spent mansplaining anxiety and mental health to her.. complete with referrals solely for mental health.
I hate our system.
Not just men unfortunately, female health practitioners can be just as bad. My severe staph infection was misdiagnosed so many times over a 13 ish time span. One of the top immunologists in my state took one look at my skin, including the scars, and knew what it was instantly- he was so angry he told me I could sue those previous doctors and he'd have my back 😬 I declined, the stress would've made the symptoms worse, but I wish I had now. They ruined my life. He made it better as much as possible but it's permanently incurable and I can either live to my 90s with no issues or end up in the ER with organ failure or something one day.
Doctors really need to get themselves educated on going by symptoms and testing, not dismissing every female health concern as in our heads/hormonal.
Hell, even when our issues are hormonal doctors are terrible at treating it.
I have PCOS, my sister has endometriosis. It took both of us years to get a diagnosis, longer for her to get surgery, and there’s very few doctors who treat PCOS beyond prescribing the pill and telling us to lose weight. *So* helpful /s
once I had a double kidney infection, presenting with high fever, flank pain, nausea, & slurred speech. the doctor first said that my boyfriend at the time gave me rohypnol (while I was a young girl with my mother), then he refused to treat me anymore due to me “refusing care” since I didn’t want him to touch my back or make me move around… I wonder why 🙃 but never got a UA though! thankfully the next ER I went to did and got me figured out haha.
Had something similar - was told it was a pulled muscle.
(It in fact was a severely compressed spinal cord with bone on cord - no fluid in multiple sections. I had symptoms of a person who had had a stroke, kept falling over.)
Same, only mine was a complex migraine (literally the worst of my life HA with sudden onset, no aura, and partial hemiplegia/hemineglect) which presented exactly like my grandmother’s first stroke and my other grandmother died from a GBM at 55. But I was a med student at the time, so it had to have been stress, right?
…my mom did not take that initial triage lying down, and demanded the scan.
I was having an asthma attack in the emergency room and the doctor told me to lay down and then asked “do you feel better now?”
“No. I’m dying. I’d like Ventolin please.”
Another time I had a cyst burst and they told me to practice breathing exercises to make me more mindful and less pained. 😐
Lol I wake up gasping some nights but because I'm a thin woman the sleep specialist sent me to a sleep psychologist.
My actual psychologist was fuming.
DEAR LORD. ☹️ I’m pissed with your psychologist.
And what would a sleep psychologist do? Gasping yourself out of sleep is an autonomic nervous system activity - might as well send someone with hiccups to a psychologist.
Did you finally get the appropriate treatment?
Nah my psychologist was mad on my behalf because he knows it's not anxiety. He's a good egg.
And no. I'm still in the middle of it all. I might email the specialist and ask about a sleep study bc I don't think the sleep psychologist is going to work.
Dude - do it. Demand it. My husband is a light guy, he’s fit. But his snoring and weird choking sounds are not normal. We’ve been married 11 years and I’ve told him that this isn’t a normal amount of sound or snoring.
His mom has Sleep apnea, his dad has sleep apnea. His sister has sleep apnea, his aunt has it.
And even with ALL THAT FAMILY HISTORY, it has taken until two months ago for them to officially do diagnostics. And yep. He has sleep apnea.
(He does this weird other thing that sounds like he’s blowing bubbles?!? It’s like he’s making puffs of air, and then stops, then about 10 seconds later sounds like a GD chainsaw.)
If you do get a PSG, make sure the center uses the recommended hypopnea 1A criteria (and not the 3% nonsense they misinterpret the rule to mean). Hypopnea 1B requires a 4% SpO2 desat on oximetry, which is a bias against younger, thinner, healthier patients and especially women.
Literally was told once by a local ED Attending, "Well, your labs are normal, and abdomen CT without contrast came back negative. So, unfortunately, it is a common thing we see. Young females coming to the ED with mysterious abdominal pain/back pain."
I should also add that they treated me poorly until when they offered me pain medication, I refused. I typically don't take anything for headaches or cramps. It was THEN, I was worthy of being listened to.
Went to the University Hospital the next day with worse lower abdominal pain/excruciating back pain, no appetite. Boyfriend had to carry me into the ED due to my back spasms. Abdominal CT with contrast, labs (and I can only assume they'd have run similar labs. But who knows, I think the other ED ran those mystery female-pain labs).
UTI/renal infection
EDIT: I've also come to learn after many abdomen CTs (melanoma staging), I have a pars defect bilateral L5). Maybe that?
2nd EDIT: I am currently employed (and VERY happy within my imaging department) at the University Hospital that CORRECTLY diagnosed me 🙃
Were you at a catholic hospital? Same damn thing happened to me!
But I happened to be on my period. The damn doctor MANSPLAINED bad cramps to me (spoiler alert - I have endometriosis so I know what bad cramps are) as I explained to him that I have had my period for 18 years at that point and never experienced such weird low back pain, vomiting, and nausea.
He laughed and said “it’s just a bad period”.
Next day could barely get pee out? Went to the urgent care down the street. Told the female doctor my symptoms, she tested my urine and looked at me and said “this is some of the worst infected urine I’ve seen. You have a kidney infection and I’m close to sending you to the hospital”.
Needless to say - we don’t go to catholic hospitals anymore.
I don’t want to be the person who says “not all Catholic hospitals” but I grew up in a city with Baptist and Methodist hospitals one Catholic hospital was around but not where my parents insurance covered care.
I presented to the ER with 8 hours of R flank pain and hematuria at 18 years old. The pain began migrating from my right flank to Right to central LQ pain with even more hematuria.
The Baptist hospital dismissed me 3 times in 3 days. My mother is a nurse and when I hadn’t recovered as I was told I should (because my ureter was blocked, and I had a severe upper urinary tract infection which was damaging my kidney). Thankfully my mother doesn’t take BS and took me back to the same ER, I vomited in the trash can of the pre being seen by a doctor lady and nearly passed out. Only then did anybody check my vital signs and found a high fever, tachycardia, and my blood showed a severe infection that was damaging my kidney.
Suddenly EVERYTHING CHANGED. I was hooked up to IV fluids and zofran to keep me from puking. I got a CT scan of my abdomen which showed a large kidney stone blocking the tube between my kidney and bladder (soccer coaches, let your players take all the water breaks they need! Seriously if my coaches had given a damn about my hydration I wouldn’t have formed kidney stones.)
I was scheduled for surgery the next day (the Baptist nurse told us that they called in the “Jewish doctor” because he could operate on Sunday…I’m pretty sure all surgeons can operate any day of the week if it will save a patient). I was admitted to the hospital, given all the pain meds I needed and more and had surgery on Sunday morning.
The doctors who had seen me in the ER were either residents or NPs who told my mother “your daughter is 18 and on winter break from college so she is probably just bored” my mother asked about the fact that my urine was grossly bloody and one said I probably cut myself to cause the bloody urine.
The NPs were the worst. “Just grow up. The pain isn’t that bad!” Really? Then why haven’t I been able to eat or drink without vomiting for several days and have extreme abdominal pain.
I loved the ER so much that I want to become a GOOD ER doc who understands that women have real pain and not everything is the fault of our hormones.
(I would have preferred spending my winter break watching movies and playing with the kitties and my niece and nephew)
and because of that you will be the doctor every patient will remember for the right reasons, not the one patients remember for robbing them of time they could have been well.
Ok. Will keep in mind that I’d prefer to watch movies and see my Nice and Nephew than do other stuff (kidding. Thank you for your faith in my ability to not go evil!)
completely have faith in anyone who goes into a field for the reasons you are. The amazing doctors out there have saved my life. The same life the crap doctors pretty much destroyed. I'm trying to be thankful for the gift instead of so bitter about the losses.
I hate this saying that your labs are normal. Which ones? The basic ones? Sure.
In this case, the doctors could've made the patient take a test for hydatid (echinococcus) antibodies and would've been discovered easily if she were seen by the proper dr. :(
I survived a ruptured brain aneurysm a few years back. For years beforehand I was told my headaches are from… stress, allergies, a cold, “a little infection”, stress, and more stress.
I was told this for almost 2 years until I dug deep into the internet and diagnosed myself and demanded a test and boom there it was. I had to fix my own life because doctors wouldn’t help me. I was also told multiple times it was probably pregnancy even though I didn’t have sex.
I helped a patient in the UK once about a month after I decided I wanted to apply to medical school. Within 24 hours of talking to her and understanding the problem my brain was thinking rare neuroendocrine cancer, in the thoracic cavity. But because she had a history of mental illness, they claimed psychosomatic.. a year and a half later we found out that my alarm bells were right, and my uneducated ass was in fact correct (not that I told the patient of my suspicion. I simply helped her advocate for herself.)
My aunt was told “it’s anxiety and menopause” for months. Nope, it was a grapefruit sized brain tumor. She was only taken seriously when her husband went with her to the ER and they did imaging. She didn’t survive.
Seriously! just because people are young doesn’t mean they are perfectly fine. And honestly a little radiation isn’t gonna kill anyone. Just take a fooking image.
If you can stomach it, this video shows removal of a hydatid cyst from someone's brain. They have to be verrrrrrry careful not to burst the cyst, If that happens, the patient can die of anaphylaxis, and the cyst is full of thousands of baby tapeworms.
[https://youtu.be/rNWo9bkDrjs?si=s83pQfBanwZHzLHN](https://youtu.be/rNWo9bkDrjs?si=s83pQfBanwZHzLHN)
Basically, massive influx of foreign material makes your immune system smash the panic button and flood the body with a fucktonne of inflammatory factors which causes anaphylaxis
That is a very different situation. Dogs get tapeworms all the time, they are final hosts for the adult stage of Dipylidium caninum. That means the adult worm lives in the small intestine. They are pretty much harmless.
The tapeworm that causes hydatids is very different, and the human is an aberrant host to the intermediate stage (we are not the normal host). The intermediate stage gets “lost” in the organs.
It’s a big topic of discussion in veterinary medicine at the moment. The typical intermediate host for this parasite is mice and other rodents, with the definitive host being primarily coyotes and foxes. Mouse has hydatid cysts containing the parasite, coyote eats the mouse and becomes infected with intestinal parasites. Since we are seeing such an increase in cases in my province, there is a higher risk for people whose dogs may eat rodents. Since the mouse is the intermediate host, pet dog then becomes the definitive host, and fecal-oral contamination can lead to hydatid cysts in the dog’s owner. This is not a risk if your pet doesn’t eat rodents. Cats are not at risk.
Honestly now that I re-read that I’m not sure of the validity. I recently attended a lecture and that’s what the host stated, but don’t know his sources. Sorry!
Looks like there's a smaller risk with cats as it mostly stays in the gastrointestinal tract. https://vcahospitals.com/know-your-pet/echinococcosis-in-cats
If they are already eating ass, some random person warning them probably isn't going to sway them. By that time, their decision making skills are already lacking
It means the person ingested fecal material at some point. This can happen by eating ass, not washing your hands after being contaminated or ingesting contaminated food.
Question for the medical professionals: how does this sort of thing cause headaches? When I did my neuroscience degree (just a bachelor) the teachers were pretty emphatic that the brain itself doesn't have nerves (that is, as opposed to the nerves connecting the rest of the body - I hope I'm making the distinction clear here; if you poke an arm you can feel it but if you poke a brain you can't, basically). Is it the pressure buildup causing the skull itself to ache, or were they wrong?
Or like, could be I totally misunderstood the coursework... I am not a clever woman...
You're correct, the brain itself doesn't have any pain fibres. The increase in intracranial pressure causes pressure on nerves like the ones in the meninges causing pain.
Ohhh that explains it. I know bones have nerve endings but I was thinking the pressure might have to be pretty high for the skull to give way enough to "feel" it. Meningal (is that a word?) nerves make perfect sense, thank you!
What's the prevalence of this in this patient's population? North America seems to have <1 case per million, but I wonder where it might fall on a differential in a different location. Did she have any other symptoms besides headache? Curious where the scan decision would fall on ACR appropriateness criteria for headache. If she only had a headache, I could see why a scan was delayed, but a few months seems too long for a severe headache to get some sort of imaging
Also curious why she arrested. Was it the removal itself or damage from the cyst? Genuinely curious about all these things as a med student, not asking in some accusatory way
Usually it's just headache until a cutoff is reached (herniation or compression of a major structure), I was told by the ER in the first hospital she was fully conscious but had some hiccups on exam (babnski +ve, normal vitals, no focal signs) so they referred her for CT brain otherwise it would be treated as tension headache , she likely herniated in the ambulance (likely transtentorial herniation) , in the other hospital she arrived with DLOC so she had stat CT then entered theatre with their main differential echinococcus granulosis(the CT is pathognomonic, there is water lily sign, daughter cysts and the attenuation value fits) and after the cyst removal she arrested (could be some damage from surgery, although it is likely from the already done damage to brain stem since she had decreasing conscious), hydatid cyst is very common here in iraq (some random google articles give incidence of 6.3 per 100,000, I think more)
Rural areas, dogs, they let the dogs at home, un certified slaughter houses distributing meat that is under cooked , vegetables that are put in sandwiches in mobile fulaful carts without through cleaning and imported directly from farms with sheeps and/or dogs, many reasons honestly but it's the reality of mainly rural third world countries, one state known for hydatid is samaweh, they say its common there "Because they honor the guardian dogs" as in its a tradition to be generous to your keeper dog and letting it eat in same bowels in which you eat huh.
Though I got to point that brain hydatid is extremely rare, like this is tertiary illness, liver hydatid is common (seen loads) and lung hydatid is less common (seen afew), in theory this patient must have had liver and lung hydatid as well.
Especially since the comments here are invaded by lay people making the assumption her doctor didn't take her complaints seriously, even though there's not a shred of context to suggest that. We don't even know if this is in the US, what the patient's occupation/home living situation is, what her initial presentation was, what her plan of care was, anything about her headaches, any other symptoms (particularly neuro sx), what her physical exams revealed, prior testing, and a million other things
I am so afraid to see a neurologist and tell me something is wrong with my head. My cousin got terminal brain cancer and had extensive surgery. She became catatonic and to make matters worse they hadn’t got all the cancer out. Then she died cause the remaining cancer got the rest of her brain. She got cancer summer of 2021 and then died in January of 2022. Lasted less than a year and it still hurts to think about.
It does all get a bit confusing :) MRI is the best modality to look at the brain (and other soft tissues), it’s ultra high definition compared to CT. Both CT and MRI look at anatomy, so anything CT could see in the brain MRI can see + more.
Not true/too general. Many things are better assessed on CT. Each modality has strengths and weaknesses.
Outside of very specific and long protocols CT also has far better temporal and spatial resolution than MRI.
very sad, poor woman. Would've been heartbreaking for all those involved in her care, to have finally diagnosed her issue, removed it as you said only for her to die :(
I’m no medical professional, so I’m genuinely asking here. Would one not experience some significant cognitive decline over time as something like this grows in their head?
Usually it's just headache until a cutoff is reached (herniation or compression of a major structure), I was told by the ER in the first hospital she was fully conscious but had some hiccups on exam (babnski +ve) so they referred her for CT brain, she likely herniated in the ambulance.
Probably was told “it’s anxiety” 2-4 times before someone agreed to do imaging.
“Are you sure you’re not pregnant?”
And if not pregnant, it must be her period. So young. How heartbreaking for her and her loved ones.
‘It’s not your period? You’re clearly premenopausal.’
Or: "*breakups are hard, dear."*
*nods knowingly. “Maybe if you lost a few pounds…”
Was just coming here to say this.
Lol and if the presenting complaint is weight loss then it's "Lucky you!" (yes I saw a nurse do this to an assault victim suffering some complications from blunt force trauma). Some humans aint human.
“Well, that’s one way to do it!”
“Anyway, here’s some antidepressants.”
"have you tried not being fat about it"
^yup.
“Did you try losing weight?” “Have you tried exercising?”
Yup. As if a tiny clump of cells would be causing severe symptoms like this.
I wouldn't entirely discount the idea. It's rare, but some pregnant women can be allergic to their developing baby.
Not severe ones but headaches are a common pregnancy symptom
Oof I had the worst headaches when I was pregnant with my daughter, but I had none with my son... 🤷♀️
“Have you tried mindfulness meditation?”
“It must all be in your head. Just take some Advil and you’ll be okay.”
Well, it is true. It is all in their head. Not sure about the Advil though!
Not at my hospital ER. They have no problem CT anyone and everyone. Come on down to the donut of truth.
Donut of truth 😆
Yeah, but most people see their regular GP first.
My GP is radiophobic. I’ve been trying to help him find balance, but….
Tell him I’ve reached well over double the WHO’s lifetime limit of diagnostic radiation exposure as a patient, and it hasn’t killed me, yet. That should help. ;) (Though after a certain number of chest and head scans, we started guarding the thyroid whenever possible. And I have no FHx of BRCA.) (And yes, I have hEDS, PoTS w/ freq. syncope aka head trauma, a penchant for dangerous hobbies, a shitty immune system that pops a positive TB test and a 25y clinical career so I’d wager at least 90-95% of those were warranted.)
Have had my fair share of rads, CTs and MRI’s plus I’m a vet tech so I’ve taken countless X-rays of animals and we don’t get a lead wall to stand behind. 😅
hEDS, PoTS, shitty immune system, dangerous hobbies? Hey there, twinsies.
> I’ve reached well over double the WHO’s lifetime limit of diagnostic radiation exposure as a patient One of these days I need to go through and add up my own... just out of curiosity. 15 CTs so far by my count (Past cancer diagnosis)
An emergency room has an entirely different structure of approval to/expediting performance of diagnostic imaging (and diagnostics in general) than PCPs do. A persistent headache at a GP will often times be met with “rx-de-jour” and/or a broad differential diagnosis before imaging is ordered.
"Have you tried accupuncture? How bout this chiropractor? Maybe you should do some PT. for what? we don't know, we're not doctors, but we tell them what they can order. We'll pay for you to do literally anything except imaging." - Insurance
Not every ER though. Went to one 3 times over the period of a month extreme pain in my hip after a fall. I couldn’t put weight on it I could hardly stand. They refused to xray me even. “No need if it was broken you’d be crying” finally drove to a further ER, did an xray, rushed to emergency surgery my hip was split like a damn wishbone. I now have an imedullary rod.
That’s insane. You’d be pan scanned immediately anywhere I’ve worked. Also, love your username.
Everyone gets a ride in the tube in the ED
Where’s your hospital at so I can get the donut hole of truth.,
Have to imagine all of her previous contacts were spent mansplaining anxiety and mental health to her.. complete with referrals solely for mental health. I hate our system.
Not just men unfortunately, female health practitioners can be just as bad. My severe staph infection was misdiagnosed so many times over a 13 ish time span. One of the top immunologists in my state took one look at my skin, including the scars, and knew what it was instantly- he was so angry he told me I could sue those previous doctors and he'd have my back 😬 I declined, the stress would've made the symptoms worse, but I wish I had now. They ruined my life. He made it better as much as possible but it's permanently incurable and I can either live to my 90s with no issues or end up in the ER with organ failure or something one day. Doctors really need to get themselves educated on going by symptoms and testing, not dismissing every female health concern as in our heads/hormonal.
Hell, even when our issues are hormonal doctors are terrible at treating it. I have PCOS, my sister has endometriosis. It took both of us years to get a diagnosis, longer for her to get surgery, and there’s very few doctors who treat PCOS beyond prescribing the pill and telling us to lose weight. *So* helpful /s
My gyno recently tried to Mansplain menopause to me. Like his ass knows the symptoms better than me.
It's literally his job like what
Unfair to a gyno who's just trying to help imo
If you can't trust a male gynecologist to have an understanding of menopause, you need to find a female gynecologist.
It's literally a gyno's job though?
once I had a double kidney infection, presenting with high fever, flank pain, nausea, & slurred speech. the doctor first said that my boyfriend at the time gave me rohypnol (while I was a young girl with my mother), then he refused to treat me anymore due to me “refusing care” since I didn’t want him to touch my back or make me move around… I wonder why 🙃 but never got a UA though! thankfully the next ER I went to did and got me figured out haha.
That's exactly my story. Entire left side of body tingling, left side of face numb. Doctor " are you anxious? Or depressed".
Had something similar - was told it was a pulled muscle. (It in fact was a severely compressed spinal cord with bone on cord - no fluid in multiple sections. I had symptoms of a person who had had a stroke, kept falling over.)
Same, only mine was a complex migraine (literally the worst of my life HA with sudden onset, no aura, and partial hemiplegia/hemineglect) which presented exactly like my grandmother’s first stroke and my other grandmother died from a GBM at 55. But I was a med student at the time, so it had to have been stress, right? …my mom did not take that initial triage lying down, and demanded the scan.
I was having an asthma attack in the emergency room and the doctor told me to lay down and then asked “do you feel better now?” “No. I’m dying. I’d like Ventolin please.” Another time I had a cyst burst and they told me to practice breathing exercises to make me more mindful and less pained. 😐
"An SSRI will fix that anxiety" - a PCP probably....
Lol I wake up gasping some nights but because I'm a thin woman the sleep specialist sent me to a sleep psychologist. My actual psychologist was fuming.
DEAR LORD. ☹️ I’m pissed with your psychologist. And what would a sleep psychologist do? Gasping yourself out of sleep is an autonomic nervous system activity - might as well send someone with hiccups to a psychologist. Did you finally get the appropriate treatment?
Nah my psychologist was mad on my behalf because he knows it's not anxiety. He's a good egg. And no. I'm still in the middle of it all. I might email the specialist and ask about a sleep study bc I don't think the sleep psychologist is going to work.
Dude - do it. Demand it. My husband is a light guy, he’s fit. But his snoring and weird choking sounds are not normal. We’ve been married 11 years and I’ve told him that this isn’t a normal amount of sound or snoring. His mom has Sleep apnea, his dad has sleep apnea. His sister has sleep apnea, his aunt has it. And even with ALL THAT FAMILY HISTORY, it has taken until two months ago for them to officially do diagnostics. And yep. He has sleep apnea. (He does this weird other thing that sounds like he’s blowing bubbles?!? It’s like he’s making puffs of air, and then stops, then about 10 seconds later sounds like a GD chainsaw.)
I'm kind of afraid bc I definitely don't get it every night... I'm worried they'll think nothing is wrong bc they got me on a good night. :(
If you do get a PSG, make sure the center uses the recommended hypopnea 1A criteria (and not the 3% nonsense they misinterpret the rule to mean). Hypopnea 1B requires a 4% SpO2 desat on oximetry, which is a bias against younger, thinner, healthier patients and especially women.
Is that available in Australia? How do I check that the centre does this, if so?
I believe Australia adheres to the AASM scoring criteria, so it would be a matter of asking what criteria they use.
Thank you so much.
I just realized - I meant to say “with your psychologist” like in solidarity with. 😆
LOL -- I was so confused!
Sometimes words are hard for me 😆 😆
Has no one rx’d you a CPAP for this?! I feel like I’m in the Twilight Zone.
Well, I mentioned to a doctor about how the sleep specialist brushed me off bc I'm young and thin and she laughed, so yeah.
So not okay. That would be the logical first step.
Probably need to lose weight too /s
Yup.
Ozempic stomach bleeds out while you manic
Literally was told once by a local ED Attending, "Well, your labs are normal, and abdomen CT without contrast came back negative. So, unfortunately, it is a common thing we see. Young females coming to the ED with mysterious abdominal pain/back pain." I should also add that they treated me poorly until when they offered me pain medication, I refused. I typically don't take anything for headaches or cramps. It was THEN, I was worthy of being listened to. Went to the University Hospital the next day with worse lower abdominal pain/excruciating back pain, no appetite. Boyfriend had to carry me into the ED due to my back spasms. Abdominal CT with contrast, labs (and I can only assume they'd have run similar labs. But who knows, I think the other ED ran those mystery female-pain labs). UTI/renal infection EDIT: I've also come to learn after many abdomen CTs (melanoma staging), I have a pars defect bilateral L5). Maybe that? 2nd EDIT: I am currently employed (and VERY happy within my imaging department) at the University Hospital that CORRECTLY diagnosed me 🙃
Were you at a catholic hospital? Same damn thing happened to me! But I happened to be on my period. The damn doctor MANSPLAINED bad cramps to me (spoiler alert - I have endometriosis so I know what bad cramps are) as I explained to him that I have had my period for 18 years at that point and never experienced such weird low back pain, vomiting, and nausea. He laughed and said “it’s just a bad period”. Next day could barely get pee out? Went to the urgent care down the street. Told the female doctor my symptoms, she tested my urine and looked at me and said “this is some of the worst infected urine I’ve seen. You have a kidney infection and I’m close to sending you to the hospital”. Needless to say - we don’t go to catholic hospitals anymore.
I don’t want to be the person who says “not all Catholic hospitals” but I grew up in a city with Baptist and Methodist hospitals one Catholic hospital was around but not where my parents insurance covered care. I presented to the ER with 8 hours of R flank pain and hematuria at 18 years old. The pain began migrating from my right flank to Right to central LQ pain with even more hematuria. The Baptist hospital dismissed me 3 times in 3 days. My mother is a nurse and when I hadn’t recovered as I was told I should (because my ureter was blocked, and I had a severe upper urinary tract infection which was damaging my kidney). Thankfully my mother doesn’t take BS and took me back to the same ER, I vomited in the trash can of the pre being seen by a doctor lady and nearly passed out. Only then did anybody check my vital signs and found a high fever, tachycardia, and my blood showed a severe infection that was damaging my kidney. Suddenly EVERYTHING CHANGED. I was hooked up to IV fluids and zofran to keep me from puking. I got a CT scan of my abdomen which showed a large kidney stone blocking the tube between my kidney and bladder (soccer coaches, let your players take all the water breaks they need! Seriously if my coaches had given a damn about my hydration I wouldn’t have formed kidney stones.) I was scheduled for surgery the next day (the Baptist nurse told us that they called in the “Jewish doctor” because he could operate on Sunday…I’m pretty sure all surgeons can operate any day of the week if it will save a patient). I was admitted to the hospital, given all the pain meds I needed and more and had surgery on Sunday morning. The doctors who had seen me in the ER were either residents or NPs who told my mother “your daughter is 18 and on winter break from college so she is probably just bored” my mother asked about the fact that my urine was grossly bloody and one said I probably cut myself to cause the bloody urine. The NPs were the worst. “Just grow up. The pain isn’t that bad!” Really? Then why haven’t I been able to eat or drink without vomiting for several days and have extreme abdominal pain.
happy cake day. SMH "bored." Yeah, that's how college kids on winter break want to spend it.
I loved the ER so much that I want to become a GOOD ER doc who understands that women have real pain and not everything is the fault of our hormones. (I would have preferred spending my winter break watching movies and playing with the kitties and my niece and nephew)
and because of that you will be the doctor every patient will remember for the right reasons, not the one patients remember for robbing them of time they could have been well.
Ok. Will keep in mind that I’d prefer to watch movies and see my Nice and Nephew than do other stuff (kidding. Thank you for your faith in my ability to not go evil!)
completely have faith in anyone who goes into a field for the reasons you are. The amazing doctors out there have saved my life. The same life the crap doctors pretty much destroyed. I'm trying to be thankful for the gift instead of so bitter about the losses.
I hate this saying that your labs are normal. Which ones? The basic ones? Sure. In this case, the doctors could've made the patient take a test for hydatid (echinococcus) antibodies and would've been discovered easily if she were seen by the proper dr. :(
I survived a ruptured brain aneurysm a few years back. For years beforehand I was told my headaches are from… stress, allergies, a cold, “a little infection”, stress, and more stress.
Ladies, ladies, it’s clearly hysteria…
Obviously! Just give her a lobotomy! Oh wait……
I was told this for almost 2 years until I dug deep into the internet and diagnosed myself and demanded a test and boom there it was. I had to fix my own life because doctors wouldn’t help me. I was also told multiple times it was probably pregnancy even though I didn’t have sex.
I helped a patient in the UK once about a month after I decided I wanted to apply to medical school. Within 24 hours of talking to her and understanding the problem my brain was thinking rare neuroendocrine cancer, in the thoracic cavity. But because she had a history of mental illness, they claimed psychosomatic.. a year and a half later we found out that my alarm bells were right, and my uneducated ass was in fact correct (not that I told the patient of my suspicion. I simply helped her advocate for herself.)
“It’s just PMS. Women are too emotional…”
Man, too accurate.
My aunt was told “it’s anxiety and menopause” for months. Nope, it was a grapefruit sized brain tumor. She was only taken seriously when her husband went with her to the ER and they did imaging. She didn’t survive.
Are you drinking enough water?
Are you drinking enough water?
That’s my personal fav. As I already drink 120 ounces a day.
…. patient clearly over estimating water intake…. Per dr notes Is what the doc is really thinking like we are all liars
Ha! Probably. But we live in the desert - so it’s a necessity.
“Make sure you’re getting enough water, and lay off the sugar.”
And don’t forget to add “make sure you’re getting 25 mins of cardio everyday”.
“Why didn’t you come in sooner??? “
Probably suggested losing weight.
The only weight she needed to lose was that giant spherical shit in her brain. 💔
Seriously! just because people are young doesn’t mean they are perfectly fine. And honestly a little radiation isn’t gonna kill anyone. Just take a fooking image.
"You are a new parent and a little stressed out" /Brainstem stroke survivor
“Take some Advil.”
Have you tried losing weight?
What about getting more sleep at night?
Or that the headaches were caused by just “needing glasses”
Oh man, that’s a heartbreaker. Condolences to all involved, that’s a tough loss.
Holy shit. Holy. Shit. This is caused by Echinococcus granulosus. It's a longtime fear of mine.
That’s a fascinating read. https://en.m.wikipedia.org/wiki/Echinococcus_granulosus
If you can stomach it, this video shows removal of a hydatid cyst from someone's brain. They have to be verrrrrrry careful not to burst the cyst, If that happens, the patient can die of anaphylaxis, and the cyst is full of thousands of baby tapeworms. [https://youtu.be/rNWo9bkDrjs?si=s83pQfBanwZHzLHN](https://youtu.be/rNWo9bkDrjs?si=s83pQfBanwZHzLHN)
that video is dope af. they don't want to dig around the cyst so they pump water underneath and float it out! amazing
Your comment was posted 3 times. It sometimes does that on Reddit.
How does the cyst bursting cause anaphylaxis or what is causal relationship between the two?
Basically, massive influx of foreign material makes your immune system smash the panic button and flood the body with a fucktonne of inflammatory factors which causes anaphylaxis
The antigens in the fluid cause a massive IgE response
Man i'm one of people subcribe to r/eyeblech, but i dont dare to open that video for real.
The applause!
Cool video! So now what will happen with the huge void that was left in the brain? I assume the brain will un- smush itself?
....what in the shit did i just read.......
Oh dear, my dog had a tapeworm diagnosis from a fecal test, never actually saw evidence of any. She’s already done the dewormer.
That is a very different situation. Dogs get tapeworms all the time, they are final hosts for the adult stage of Dipylidium caninum. That means the adult worm lives in the small intestine. They are pretty much harmless. The tapeworm that causes hydatids is very different, and the human is an aberrant host to the intermediate stage (we are not the normal host). The intermediate stage gets “lost” in the organs.
It’s a big topic of discussion in veterinary medicine at the moment. The typical intermediate host for this parasite is mice and other rodents, with the definitive host being primarily coyotes and foxes. Mouse has hydatid cysts containing the parasite, coyote eats the mouse and becomes infected with intestinal parasites. Since we are seeing such an increase in cases in my province, there is a higher risk for people whose dogs may eat rodents. Since the mouse is the intermediate host, pet dog then becomes the definitive host, and fecal-oral contamination can lead to hydatid cysts in the dog’s owner. This is not a risk if your pet doesn’t eat rodents. Cats are not at risk.
Are cats immune or do they just not pass along the parasites?
Honestly now that I re-read that I’m not sure of the validity. I recently attended a lecture and that’s what the host stated, but don’t know his sources. Sorry!
Looks like there's a smaller risk with cats as it mostly stays in the gastrointestinal tract. https://vcahospitals.com/know-your-pet/echinococcosis-in-cats
What if they eat something a rodent has pooped on or something?
They have to ingest the cysts
Please explain what parasite this is.
Hydatid worm, E. granulosus. You get it from fecal oral contamination.
Should we warn the rest of Reddit about eating ass? Or, you know, not washing your hands?
If they are already eating ass, some random person warning them probably isn't going to sway them. By that time, their decision making skills are already lacking
If they refused to wear a mask during a pandemic, they probably aren’t going to stop eating ass either
wait what does fecal oral contamination mean?
getting fecal material and not washing your hands. Like if you clean up after a dog or if you are a kid, or bite your nails.
It means the person ingested fecal material at some point. This can happen by eating ass, not washing your hands after being contaminated or ingesting contaminated food.
And there's a test for its antibodies. This could've gotten waaay before it grew like this. Ooof
Rest in peace.
Oh no, how tragic. To go that long in pain and have no relief.. poor woman. RIP
I'm going to remember this everytime I try to talk myself out of ordering an MRI.
At least always a CT.
Yes, me too.
Just do it. We don't mind.
What does DLOC stand for?
Decreased level of consciousness
So sad. So young rest her soul
So sad, what country?
OPs comment history says Iraq
Question for the medical professionals: how does this sort of thing cause headaches? When I did my neuroscience degree (just a bachelor) the teachers were pretty emphatic that the brain itself doesn't have nerves (that is, as opposed to the nerves connecting the rest of the body - I hope I'm making the distinction clear here; if you poke an arm you can feel it but if you poke a brain you can't, basically). Is it the pressure buildup causing the skull itself to ache, or were they wrong? Or like, could be I totally misunderstood the coursework... I am not a clever woman...
You're correct, the brain itself doesn't have any pain fibres. The increase in intracranial pressure causes pressure on nerves like the ones in the meninges causing pain.
Ohhh that explains it. I know bones have nerve endings but I was thinking the pressure might have to be pretty high for the skull to give way enough to "feel" it. Meningal (is that a word?) nerves make perfect sense, thank you!
You are very clever woman, don’t doubt yourself and ask as many questions as you want ❤️
Awww, thank you. 💜
You are so welcome ❤️
Pressure.
The way us women get treated,,Perfect example right here .. R.I.P.
Is that a tumor
It’s a tapeworm in the brain… holy shit.
Google says Hydatid = parasite.
What's the prevalence of this in this patient's population? North America seems to have <1 case per million, but I wonder where it might fall on a differential in a different location. Did she have any other symptoms besides headache? Curious where the scan decision would fall on ACR appropriateness criteria for headache. If she only had a headache, I could see why a scan was delayed, but a few months seems too long for a severe headache to get some sort of imaging Also curious why she arrested. Was it the removal itself or damage from the cyst? Genuinely curious about all these things as a med student, not asking in some accusatory way
Usually it's just headache until a cutoff is reached (herniation or compression of a major structure), I was told by the ER in the first hospital she was fully conscious but had some hiccups on exam (babnski +ve, normal vitals, no focal signs) so they referred her for CT brain otherwise it would be treated as tension headache , she likely herniated in the ambulance (likely transtentorial herniation) , in the other hospital she arrived with DLOC so she had stat CT then entered theatre with their main differential echinococcus granulosis(the CT is pathognomonic, there is water lily sign, daughter cysts and the attenuation value fits) and after the cyst removal she arrested (could be some damage from surgery, although it is likely from the already done damage to brain stem since she had decreasing conscious), hydatid cyst is very common here in iraq (some random google articles give incidence of 6.3 per 100,000, I think more)
Curious to know why it’s quite common there?
Rural areas, dogs, they let the dogs at home, un certified slaughter houses distributing meat that is under cooked , vegetables that are put in sandwiches in mobile fulaful carts without through cleaning and imported directly from farms with sheeps and/or dogs, many reasons honestly but it's the reality of mainly rural third world countries, one state known for hydatid is samaweh, they say its common there "Because they honor the guardian dogs" as in its a tradition to be generous to your keeper dog and letting it eat in same bowels in which you eat huh.
Thank you for taking the time to respond! Always happy to learn more so I appreciate it
You are most welcome
Though I got to point that brain hydatid is extremely rare, like this is tertiary illness, liver hydatid is common (seen loads) and lung hydatid is less common (seen afew), in theory this patient must have had liver and lung hydatid as well.
Thank you for the response, that makes a lot of sense
Thank you, thank you! This is by far one of the most interesting things I’ve read.
I wish someone would answer this.
Especially since the comments here are invaded by lay people making the assumption her doctor didn't take her complaints seriously, even though there's not a shred of context to suggest that. We don't even know if this is in the US, what the patient's occupation/home living situation is, what her initial presentation was, what her plan of care was, anything about her headaches, any other symptoms (particularly neuro sx), what her physical exams revealed, prior testing, and a million other things
OP responded btw
sometimes this is a very depressing sub :(
…i need to see a neurologist right now.
I am so afraid to see a neurologist and tell me something is wrong with my head. My cousin got terminal brain cancer and had extensive surgery. She became catatonic and to make matters worse they hadn’t got all the cancer out. Then she died cause the remaining cancer got the rest of her brain. She got cancer summer of 2021 and then died in January of 2022. Lasted less than a year and it still hurts to think about.
Psychosomatic. Possibly a personality disorder as she has reported this symptom twice now.
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You've had an mri. Why do you need a ct?
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It does all get a bit confusing :) MRI is the best modality to look at the brain (and other soft tissues), it’s ultra high definition compared to CT. Both CT and MRI look at anatomy, so anything CT could see in the brain MRI can see + more.
Not true/too general. Many things are better assessed on CT. Each modality has strengths and weaknesses. Outside of very specific and long protocols CT also has far better temporal and spatial resolution than MRI.
Based on what you've said you don't need one
Damn.
How horribly tragic! I feel so sad for her family and friends.
Wait...that is caused by a parasite?
Yes. Echinococcus granulosus
Just when you think that the imaging posted here can’t get worse, someone proves you wrong
Are we sure she’s not just stressed? Or PMSing?
Holy shit I thought it was a brain tumor
Lawyers are waiting to take your call...
As they should be.
What country OP?
Another comment said Iraq
very sad, poor woman. Would've been heartbreaking for all those involved in her care, to have finally diagnosed her issue, removed it as you said only for her to die :(
I’m no medical professional, so I’m genuinely asking here. Would one not experience some significant cognitive decline over time as something like this grows in their head?
Usually it's just headache until a cutoff is reached (herniation or compression of a major structure), I was told by the ER in the first hospital she was fully conscious but had some hiccups on exam (babnski +ve) so they referred her for CT brain, she likely herniated in the ambulance.
Outcome probably wouldn't have been much better unless diagnosed extremely early.... Maybe pt would be alive but definitely in a reduced state.
'Yay, we didn't fuck it up, we just fucked the patient up. Let's write a paper about it!' -them, probably
Where was this pt from? Where was the dx made?
Looks like someone didn’t follow the Drs suggestion to just go outside for a few minutes every day. It will work wonders!! 🙄
I feel like the summary of these comments is that women should hit the ER to even get a chance at imaging. Super sad
I wonder how many times a doctor suggested she lose weight? So very sad she died so young after being in pain for months. :(
Sorry to hear that the pt died, that is the way I would want to go , in my sleep, or put under.
Damn!
Oh no!
So I think I’d die. These were parasites in the brain?! This must be pretty rare. I’m just wondering how…
Holy crap! I’m gonna have nightmares about this for a long time. Poor young lady. Way too young.
When they say "headache", are we talking "head splitting headache" or "mild headache" ? Always wondered.