BG Medical Random Question Thread

[Gredival]

Anyone taking Crestor as a statin? New PCP wants me on 5mg since LDL has been way too high for past year (160ish). Was hoping change of diet and other stuff might help but no way i'm gonna get down 100pts just from diet alone. I've heard horrible shit about statin side effects but I guess taking some Coq10 helps to offset the muscle pains?

I take atorvastatin which is the generic for lipitor I think, also a small dose, and never had side effects

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[Melena]

I take atorvastatin which is the generic for lipitor I think, also a small dose, and never had side effects

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I'm on that as well. No side effects either.

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[Meresgi]

Looks like it's just the generic which I guess is rosuvastatin calcium.

[NotGreyheim]

Asking here on the off chance someone can interpret the results of a spinal MRI I had last week, only because I still haven't heard from my doctor and it sounds pretty bad. I'm wondering what would be an appropriate level of freaking out. Copied and pasted from my results:

Spoiler: show

T12-L1, L1-2, and L2-3: Mild facet arthropathy.

L3-4: Shallow disc bulge with endplate spurring and mild facet arthropathy
results in mild bilateral foraminal stenosis.

L4-5: Disc bulge with a central annular tear and protrusion, endplate spurring,
and mild facet arthropathy results in mild spinal canal stenosis and mild left
foraminal stenosis.

L5-S1: Mild facet arthropathy.

[Salodin]

Looks like you got a case of a fucked up back

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[NotGreyheim]

Yeah, I suspect that I injured it back around 2017. There's been some pain, but it was mostly manageable until a couple months ago. I've had xrays over the years, but I guess they never turned up anything concerning.

[Tyche]

Asking here on the off chance someone can interpret the results of a spinal MRI I had last week, only because I still haven't heard from my doctor and it sounds pretty bad. I'm wondering what would be an appropriate level of freaking out. Copied and pasted from my results:

Spoiler: show

T12-L1, L1-2, and L2-3: Mild facet arthropathy.

L3-4: Shallow disc bulge with endplate spurring and mild facet arthropathy
results in mild bilateral foraminal stenosis.

L4-5: Disc bulge with a central annular tear and protrusion, endplate spurring,
and mild facet arthropathy results in mild spinal canal stenosis and mild left
foraminal stenosis.

L5-S1: Mild facet arthropathy.

He hasn't called because the reading itself is not a freak out situation. There are a lot of factors though, such as if these are acute findings from trauma, your age, your symptoms, etc. Unless you're having significant lower extremity symptoms (leg numbness, tingling severe pain, etc), I'd be shocked if it even requires any intervention like surgery or a brace. My guess would be pain control and therapy. With foriminal stenosis, you're looking for nerve root compression. There was none noted. The canal stenosis is mild and no cord compression is noted. That's all good news.

Perfect back scans do not really exist and if that was my scan as an almost 40 year old guy, I'd be like "eh, guess I am getting old".

[NotGreyheim]

I appreciate the response. I have had numbness and tingling in my legs/feet, which is why I had the EMG that I posted about a little ways up. The part I was concerned about mostly was the L4-L5. I've had a few courses of PT over the years, with minimal results. I'm also currently on oral morphine for the pain, but it doesn't seem to be helping much.

As for other symptoms:
Constant lower back pain, about 6/10
Difficulty bending down to pick things up off of the floor
Unable to remain standing for longer than a few minutes due to pain
Unable to get out of bed when I wake up due to pain if I sleep on my left side
More recently started having pain if I lay on my right side

38M btw

[Tyche]

L4-5 and L5-S1 are the most common levels for those injuries. They should be able to correlate the pain and numbness to the data in the MRI. I am still skeptical that neurosurgery would want to do anything significant. Nothing in the MRI seems super alarming to me, but I don't get paid a million a year to make that call. I wouldn't freak out. 2-sided coin though, nothing really changes if neurosurgery does nothing. You wouldn't be spending all this money on tests if you didn't want it fixed. My experience (which is limited to 1 group of surgeons) is that operative procedures are reserved for the worst cases and not done proactively to prevent the worsening of the disease unless there's concern the worsening is imminent and potentially debilitating. With your numbness, tingling, and pain, they very well may intervene. I don't think the group I worked with would. But regardless, not a "freak out" situation nor does it appear emergent.

As a general rule to other readers...

When a test or lab is ran which does show something is significantly "off", you will generally know quickly. If a radiologist gets a scan that indicates emergent intervention is needed, the radiologist or someone from his staff will call the doctor that ordered it to report the results to an actual person. Same goes for crazy labs. If a patient has a potassium of 6.5 or your blood cultures grew gram positive cocci, the lab will call a staff member or a doctor and that doctor would intervene at that time.

Few exceptions. Sometimes before docs break news to patients, they may get additional tests. Common with oncology where initial tests like X-rays and CTs may not give a full or accurate picture.

[Byrthnoth]

Yeah, basically everyone over 30 is going to get "stenosis" somewhere on a scan like that. If you want to freak out about something, freak out that they probably didn't find any smoking guns for your symptoms. Opening up your back with a scan like that would basically be exploratory imo, and remember kids, back surgery tends to only pay off for back surgeons.

[NotGreyheim]

That's all great to know. I really appreciate the insight. My doctor actually just called finally, and told me I have arthritis (not entirely surprising) and mild canal stenosis (which was in the findings). Followup scheduled for the 27th. I've heard of spinal stenosis before, but don't exactly know what it means. And yeah, hopefully it leads to *something* that helps with my symptoms.

[Tyche]

Stenosis is simply narrowing. A disc shifted and caused the hole that the spinal cord passed through to narrow. Doesn't mean it's pushing on the cord or compressing the cord or that the disc is unstable. The hole just isn't as big and it's something to keep tabs on if symptoms progress.

Imagine drilling a hole down a stack of blocks. The blocks are your vertebrae. The hole is the "canal". If you push a block in any direction (simulating a disc bulging into it), the canal gets narrowed. That's canal stenosis.

[Byrthnoth]

Spinal stenosis is a narrowing of the spine. If the spine narrows too much, it can rub on or pinch the spinal cord, which can cause numbness/etc. or motor problems.

You can look at the dermatomes corresponding to the spinal cord segments to guess whereabouts you should expect damage given your symptoms, with the understanding that in biology +/- 1 from the textbook is pretty close: https://www.spine-health.com/conditi...spinal-segment

[NotGreyheim]

That's all great to know. I really appreciate the insight. My doctor actually just called finally, and told me I have arthritis (not entirely surprising) and mild canal stenosis (which was in the findings). Followup scheduled for the 27th. I've heard of spinal stenosis before, but don't exactly know what it means. And yeah, hopefully it leads to *something* that helps with my symptoms.

Just wanted to give an update on this. I was able to reschedule my appointment to this past week due to a cancellation, so we were able to come up with a gameplan moving forward. I also saw my MRI, and instead of the normal circular shape, my spinal canal was a triangle with each side curving inward (think 3 semicircles). I'm currently scheduled for a steroid injection, and if (when, if my history is any indicator) that doesn't help we go back to the drawing board.

[Cream Soda]

Having trouble breathing is a really bad combo for my already poor sleep conditions. havne't gotten any sleep all night

[Salodin]

Having trouble breathing is a really bad combo for my already poor sleep conditions. havne't gotten any sleep all night

Humidifier? This cold weather we're having really dries me out to

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[Cream Soda]

Humidifier? This cold weather we're having really dries me out to

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By florida standards, yes; but since i spent all that time in new hampshire working outdoors 7 days a week, Florida isn't cold to me anymore. It's 53 degrees out and i'm in a tank top and shorts. NH i was in like 3 layers of everything + a scarf

[Emphasis]

This was pretty dope.

https://apnews.com/article/free-medi...61bcd1b6ea1905

$1B donation makes New York medical school tuition free and transforms students’ lives

Ruth Gottesman, a former professor at the Albert Einstein College of Medicine and the widow of a Wall Street investor, announced Monday that she is donating $1 billion to the school in the Bronx. The gift means that four-year students immediately go tuition free, while everyone else will benefit in the fall.

The donation is notable not just for its size — possibly the largest to any U.S. medical school, according to Montefiore Einstein, the umbrella organization for Albert Einstein College of Medicine and the Montefiore Health System — but also because the school is located in one of the most impoverished parts of the city and the state of New York.

[kuronosan]

No, but it will get infected because it's an organ that catches all the shit that could make you sick.

[Salodin]

I should have had my tonsils taken out, but I was a poor boy with no insurance. It eventually settled down in adulthood, but I'd go talk to a Dr. Sometimes tonsils are just prone to overreacting.

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