BG Medical Random Question Thread

[kuronosan]

It's doable at any age, I think the oldest in my class was 42, former investment banker prior to pursuing medicine. The biggest consideration for most older med students isn't whether they are capable of doing it, but the debt you have at the end. Assuming you go into a well-paying specialty, you should be able to live like a resident even when you're an attending and pay off your debt quickly as long as you avoid lifestyle bloat.

I've been told live like a resident and I'll be fine. Wise words.

[Boyiee]

Does that mean be poor?

[kuronosan]

Yes. It means live off of a salary of about 4000/month while you earn about 12000/month.

[Boyiee]

Gross couldn't do that now.

[Tyche]

One of my nocturnist friends paid off his loans in 2 years. He worked a ton. He still does. Like 25 days a month, he'll do 20 straight 12 hour shifts without blinking. It's insane. He lived in a single bedroom apartment while he did this. Single. No kids. He's no longer single though, and has a kid (slept with a nurse, got her pregnant, be careful of that trap!). His first big purchase was a Cervelo P5x.

Also, 12k a month seems on the very lower range of physician salaries. NPs pull close to that. 10k a month here is pretty standard starting NP pay.

[Boyiee]

I got a house (soon to be a second) kid etc it would be impossible leave my job for that dream right now.

On the plus side I already got a nurse pregnant so I'm ahead of the game.

[Tyche]

Tell her to become an NP. 1/2 the salary, 1/5 the debt, 1/10th the stress.

[kuronosan]

Tell her to become an NP. 1/2 the salary, 1/5 the debt, 1/10th the stress.

Basically.

[Psion]

more migraine questions!

background: my migraines (at least i assume they're migraines, more below) started when i was around age 10 or so. they started around once or twice a week in frequency, with them getting greater in frequency and severity over time as i got older. i didn't know what excedrin was until my teens, so i pretty much wound up throwing up once or twice a month whenever the pain got bad enough - namely, whenever the migraine appears on my right side of my head, which is much less frequent. it usually appears on the left side, and medicine usually tackles the issue. when it's on the right side, excedrin may or may not work, and if it happens to hit both sides of the head at once, it almost never does. (this rarely happens, usually 1-4x a year.)

at this point, however, my migraines on the left side of the head appear almost daily. they strike at almost a certain time like clockwork now, usually a few hours after waking up, though rarely i wake up with a migraine or some days i get lucky and nothing happens. it's more likely nothing happens on my days off, and more likely i get a migraine if a thunderstorm is approaching for some reason it feels like. i do drink plenty of water, i do not drink soda due to taking topamax - which is why i wonder if they're even migraines, as it does not seem to affect the frequency i'm getting migraines. i take 100 mg of topamax twice daily. any caffiene i get is due to excedrin only, pretty much.

as far as the pain itself goes, it's also accompanied by neck pain and tightness, in the back left of the neck between the shoulder and the base of the spine, the upper middle back of the shoulder, and lower left back, as well as the left temple and left jawline up to the left ear. my left foot sometimes gets a bit numb or tingly too sometimes, but that might be either the topamax (a common symptom) or too tight shoes and being on my feet all day (i have extremely wide feet, and even wide shoes are too tight usually - they usually aren't numb if i'm barefoot, just occasional tingle sometimes.) i do notice that having empty bowels does relieve a lot of the migraine issues... but the problem is maintaining empty bowels. when i say empty, i mean completely empty - nothing in the large intestine at all, not just the final bit. that's why i feel like the problems seem to start at work, because that's when they seem to start piling up with shit, and why the problem tends to go away soon after dinner, because that's when most of my bowel movements start happening. also why i tend to have less issues on days off, because i can at least try and use the restroom more on those days off. it's not IBS because i've already had a colonoscopy and no polyps were found and the biopsies came out fine.

now, the last month or so, i've also noticed another symptom, and this is where i'm starting to get worried - directly under my left eye, i've noticed there's a sort of faint ticking pulse that shows up most of the time. it was never there before, but it shows up now, even right when i wake up. it's extremely fast too, almost 3-4 "pulses" per second or so, which seems much faster than my heartrate, that's usually 68-80 bpm. not only that, there's also another tic that sometimes shows up at the left side of my mouth at the bottom corner, that beats to the same tempo.

these were never there before, and i'm not a guy who stresses out all the time or gets nervous or is constantly hyped on energy drinks. i also get 8-10 hours sleep every night consistently, and that's not changed... is this something to be very concerned about? have i finally figured out what's causing all the pain in my head?

oh and also, i should probably mention i still have a mild cough once in a while since mid-febuary that hasn't gone away. just the occasional dry cough here and there at night mainly. not sure if that's related, but i do need to bring that up with my doctor since it really should've gone away by now.

[kuronosan]

Topiramate is a dirty drug and I hate it.

A lot of folks report muscle twitches while taking it so the answer is I don't know, you'll need to talk to your neurologist about other options.

The twitches are probably benign, and you probably have migraines. Hard to tell from one post and no other knowledge. Everything you describe, though, seems very migraine-ey.

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[Psion]

the twitches i've never had until the last few weeks - i've never had them in my life. likewise, the migraines have been getting worse in severity and frequency the last month or so. it's almost daily now. before it was 3-5 days a week. it makes me worried, especially with all this talk of covid and blood clots and the fact i work as a cashier, so i'm kind of at high risk of exposure. i'm already obese at 240 lb. (used to be 265 lb, but the topamax and metformin slow release have caused me to lose weight over the last 5 months or so.) i also have issues with speaking, namely i tend to misspeak a lot. as in, i stumble and fumble my words, say the wrong word or say words out of order, or jumble numbers when speaking. it's not a huge deal, but i've always had the issue since i was little, and the topamax may or may not have made it worse... but it's always been there, and i feel like it's been getting worse over time.

i'm just wondering if i should be worried about tiny strokes or blood clots here.

oh, and i'm not sure how accurate the meter on my s7 is, but ive been measuring my O2 saturation rate with it periodically since april, and it fluctuates between 94-99% usually. often its around 96%, sometimes it's dipped as low as 93%, and once it even shot as low as 89%, despite being at rest. i don't like the looks of this persistent mild cough. >:(

[kuronosan]

You need to see a neurologist. Get a head scan if you're worried.

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[Heavencloud]

more migraine questions!

background: my migraines (at least i assume they're migraines, more below) started when i was around age 10 or so. they started around once or twice a week in frequency, with them getting greater in frequency and severity over time as i got older. i didn't know what excedrin was until my teens, so i pretty much wound up throwing up once or twice a month whenever the pain got bad enough - namely, whenever the migraine appears on my right side of my head, which is much less frequent. it usually appears on the left side, and medicine usually tackles the issue. when it's on the right side, excedrin may or may not work, and if it happens to hit both sides of the head at once, it almost never does. (this rarely happens, usually 1-4x a year.)

at this point, however, my migraines on the left side of the head appear almost daily. they strike at almost a certain time like clockwork now, usually a few hours after waking up, though rarely i wake up with a migraine or some days i get lucky and nothing happens. it's more likely nothing happens on my days off, and more likely i get a migraine if a thunderstorm is approaching for some reason it feels like. i do drink plenty of water, i do not drink soda due to taking topamax - which is why i wonder if they're even migraines, as it does not seem to affect the frequency i'm getting migraines. i take 100 mg of topamax twice daily. any caffiene i get is due to excedrin only, pretty much.

as far as the pain itself goes, it's also accompanied by neck pain and tightness, in the back left of the neck between the shoulder and the base of the spine, the upper middle back of the shoulder, and lower left back, as well as the left temple and left jawline up to the left ear. my left foot sometimes gets a bit numb or tingly too sometimes, but that might be either the topamax (a common symptom) or too tight shoes and being on my feet all day (i have extremely wide feet, and even wide shoes are too tight usually - they usually aren't numb if i'm barefoot, just occasional tingle sometimes.) i do notice that having empty bowels does relieve a lot of the migraine issues... but the problem is maintaining empty bowels. when i say empty, i mean completely empty - nothing in the large intestine at all, not just the final bit. that's why i feel like the problems seem to start at work, because that's when they seem to start piling up with shit, and why the problem tends to go away soon after dinner, because that's when most of my bowel movements start happening. also why i tend to have less issues on days off, because i can at least try and use the restroom more on those days off. it's not IBS because i've already had a colonoscopy and no polyps were found and the biopsies came out fine.

now, the last month or so, i've also noticed another symptom, and this is where i'm starting to get worried - directly under my left eye, i've noticed there's a sort of faint ticking pulse that shows up most of the time. it was never there before, but it shows up now, even right when i wake up. it's extremely fast too, almost 3-4 "pulses" per second or so, which seems much faster than my heartrate, that's usually 68-80 bpm. not only that, there's also another tic that sometimes shows up at the left side of my mouth at the bottom corner, that beats to the same tempo.

these were never there before, and i'm not a guy who stresses out all the time or gets nervous or is constantly hyped on energy drinks. i also get 8-10 hours sleep every night consistently, and that's not changed... is this something to be very concerned about? have i finally figured out what's causing all the pain in my head?

oh and also, i should probably mention i still have a mild cough once in a while since mid-febuary that hasn't gone away. just the occasional dry cough here and there at night mainly. not sure if that's related, but i do need to bring that up with my doctor since it really should've gone away by now.

idk what's causing your symptoms but a negative colonoscopy does not mean you don't have IBS. maybe you meant IBD.

[zoobernut]

idk what's causing your symptoms but a negative colonoscopy does not mean you don't have IBS. maybe you meant IBD.

What is the difference between IBD and IBS? That was never clear to me when I was diagnosed with IBS.

[Heavencloud]

What is the difference between IBD and IBS? That was never clear to me when I was diagnosed with IBS.

IBD = inflammatory bowel disease. e.g. crohns/ulcerative colitis. BAD diseases. Needs steroids/immunosuppressives etc.
IBS = irritable bowel syndrome, dx of exclusion, aka we don't know why you have these symptoms but try x y z. not life threatening.

[Psion]

kurosan, do you know if one of topamax symptoms is... i'm not sure how to describe it really. three or four times now in the last two months, when talking to a customer, they would talk, and when they were talking, all of a sudden i'd get this weird feeling from their voice, almost like it was slightly too loud and reverbating, and a weird sense of... something. kinda almost reminded me of my character when they get the Echo coming on, then shake it off, lol. lasts almost as long too, just a second then gone. it seems to be triggered by someones voice, and it's really rare.

wondering since you mentioned how it was a dirty drug, so thought maybe you'd know if that might be another side effect or not.



i do know i get occasional flare ups of eczema or psoriasis or w/e, though i've not seen much of it lately. usually it shows up along the underside of my belly or lower arm as a flaking red patch, though right now i have one on the inside of my big toe. at least i think its that. doesn't itch, but it's peeling and red, been that way for months. so IBS wouldn't surprise me. sometimes i think my body hates itself, no matter how often i tell it to play nice.

[Fondue]

I think thats the mushrooms bro

[zoobernut]

IBD = inflammatory bowel disease. e.g. crohns/ulcerative colitis. BAD diseases. Needs steroids/immunosuppressives etc.
IBS = irritable bowel syndrome, dx of exclusion, aka we don't know why you have these symptoms but try x y z. not life threatening.

Thanks that is what I thought but I just wanted to confirm.

[Psion]

er, just noticed another symptom - the inner part of my left ear was flushed pink this evening. it went away after an hour or so, but only the left ear was like that - the right ear was perfectly normal colored. i wasn't lying on my side or anything either, just on my back, and was turned toward the right if anything, since that's the direction my computer is in.

[kuronosan]

No. I'm not aware of that being a thing on topiramate.

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