BG Medical Random Question Thread

**Byrthnoth** · 2022-11-10 18:41

I did the tennis ball PT stuff as a kid but it didn't help anything and not running for two weeks was really what fixed it in the end.

**Astylla** · 2022-11-10 20:07

Originally Posted by Byrthnoth

I did the tennis ball PT stuff as a kid but it didn't help anything and not running for two weeks was really what fixed it in the end.

Going on 3 months and been using the tennis ball plus frozen ice bottles/icing with zero improvement. Pain level stays at an 7/8 with random bouts of "shocks" through the heel.

I was very active at work previously, around 7 miles walking a day not including overtime and on weekends hiking and walking 4 to 10 miles a day too. Now I'm at maybe 3 miles a week due to pain. It takes about 20 to 30 minutes each morning to be able to walk without limping and stairs are hell but no elevator at home so 2 flights everyday.
They want me to use it less..but still have to walk far from my car to work and at home stairs so..feels like this is going nowhere.

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**Byrthnoth** · 2022-11-11 07:53

Yeah, sounds like you had it worse than I did anyway. Mine was mostly a weird "I have radiating pain/numbness when running up hills" and normal walking around was fine. I was also like 16, though.

**Elizara** · 2022-11-11 11:43

Do you mean Tarsal Coalition? Then yes, tho mine seems milder than yours. I've been having to grit my teeth and bear it; for me it's more of a nasty, won't-go-away ache radiating from ankle to the top of my foot. Been having the problem since I was in middle school.

My suggestion is to go to a sporting goods store and get a ankle brace with straps and laces to see if that'll help. Also, think about finding a orthopedic doctor; you'll hate me for this but worse case you may have to get surgery, which won't be fun and will put you on crutches for 6 months, from my research, which is why I'm resisting it.

Since mine has been more of a mild thing unless I overdo walking, I may not get surgery unless it gets worse. Being on crutches for 6 months is not my idea of fun!

**Meresgi** · 2022-12-14 12:41

my CPAP burned up in the fire at my old house at start of Nov. Apparently my insurance has "no exceptions" when it comes to replacing the units and won't cover it. Best part is they aren't even the original insurance I got the unit with. I got it in July of 2021 with Bluechoice, swapped to UHC in June of 2022 and UHC maybe paid off like $200ish left on the unit but are claiming it's a "new unit" according to them.

**Gredival** · 2023-01-26 20:29

Finally popped hot for COVID. I'm in the middle of lethargy that makes me tired but too sore to sleep for extended periods.

Also body can't tell if it is too warm or too cold.

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**kuronosan** · 2023-01-26 21:03

It's just latency.

**gaira** · 2023-02-27 19:59

long shot and i know i should ask elsewhere but anyone have experience with ECT? prospect has me scared shitless

**kuronosan** · 2023-02-27 20:21

I know most everything you need to know about it.

**Tyche** · 2023-02-27 21:25

Originally Posted by gaira

long shot and i know i should ask elsewhere but anyone have experience with ECT? prospect has me scared shitless

I'm sure this is probably rhetorical, but I assume you've failed just about every other therapy? TMS, Ketamine/spravato, etc?

Once it gets to the point of needing something like Ketamine or TMS, and certainly ECT, I tap out and get them to an actual doctor to review things and make sure I didn't miss something...but I am curious as to what your provider has done to get to the point of considering ECT.

**gaira** · 2023-02-27 22:48

not familiar with TMS nor has my psych mentioned it, but they did mention ketamine

its been a ~20 year bout vs. depression and more recently anxiety and other issues that meds haven't helped with, have tried dozens at this point
(untreated for most of those years not to give wrong impression)

**Tyche** · 2023-02-28 00:02

I can't speak for Ketamine infusions, my health system doesn't do them. We do spravato (esketamine). It's a nasal spray. I'm not saying it's 100% by any stretch, but I have seen quite a number of treatment resistant depression cases that have failed multiple meds and med combinations respond very well to it. If they've mentioned it, I think it would be worth getting more information on how it could benefit you and if your psychiatric provider feels it would be safe to try it before ECT.

As far as ECT specifics, Kuro has the training and education to give you more on that. It's not my wheelhouse as an NP at all.

**kuronosan** · 2023-02-28 06:55

Ketamine requires monitoring during treatments and sometimes maintenance therapy but is otherwise safe and achieves pretty good results, but long term it depends on the patient and their specific situation. I have several patients that do it and are doing fine.

TMS is like a lighter version of ECT where they use magnetic frequency to achieve the same result, but it requires daily treatments and obviously the absence of significant amounts of metal in your brain. It's also pretty effective and has less risk of the amnestic side effects, doesn't require a surgical bay or anesthesia, and is usually well-tolerated. The drawbacks are slower remission and not every place or hospital even offers it because the equipment and training to use it are expensive.

Both procedures are more expensive on average than ECT, depending on insurance.

ECT is the most effective of all of these, for now, but also with higher risks. Amnesia is the most common risk but isn't always long term and typically only involving the time around the procedure. You could have a reaction to the anesthesia, which is less common but requires hospital admission. You can't drive yourself home either, but you only have to go 3 times a week. Average number of sessions is usually 6 and by that time about 80-85% of people have a pretty significant response. Rarely, your blood pressure can shoot up but they'll treat it.

So I guess if you're wanting a quick summary:

Ketamine is really good, but can be expensive. Spravato is better than infusions.

TMS is hard to find, but strikes the best balance and is the safest of all of these. It's also considered less effective and requires daily visits.

ECT is considered the best and most effective and is usually well-covered by insurance, but carries the most risks compared to the others because it's a surgical procedure.

**gaira** · 2023-02-28 10:13

thanks guys for the info i appreciate it

**Botosi** · 2023-07-13 07:54

My wedding's in 3 weeks and I got this red bump/blistery looking thing right under my eye. ... I really really want it gone. Any recommendations or even wtf it is? It doesnt hurt/itch at all - i dont feel it...

**Salodin** · 2023-07-13 07:57

Potato quality, but if it's anything like the small pimple thing I had on my eyelid long ago, roll it between your fingers to pop it and it'll heal away on its own

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**kuronosan** · 2023-07-13 12:09

Looks like a stye. Warm compress should help.

**Astylla** · 2023-07-19 09:41

Styes are annoying but my late mom had them a lot. A warm black tea bag was her go to remedy amd seemed to work very well.

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**Meresgi** · 2023-07-19 12:26

Originally Posted by Astylla

Styes are annoying but my late mom had them a lot. A warm black tea bag was her go to remedy amd seemed to work very well.

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Glad I read this, I have a couple and my doc was like "yup those are just there now"...gonna try this

**Tyche** · 2023-07-20 10:55

Kuro, have you jumped on this Freed.AI train? It's apparently all the rage right now. $100 a month and AI will listen to your appointment and then generate a detailed and organized H&P or progress note. I haven't tried it, but if it's half as good as everyone says, it'll be hugely beneficial. I can focus on the patient instead of jotting short form notes during the interview and I'll save hours per week if I just need to make small edits to the note instead of generating entire narratives on my own.

We are 100% getting replaced in the next 25 years lol.