What causes elevated homocysteine and lipoprotein levels?
Hello doctor,
I have homocysteine value 23.6 mcmol/L, and lipoprotein 31.5 mg/dL. ECG and TMT are normal. Is it serious? As I smoke, is it normal because of my smoking? Do I need to visit a doctor?
14 Jun 2024 - 1 min read
What could cause weight loss and stomach pain while eating?
Hello doctor,
I have had stomach issues for a long time and had the gallbladder removed around four years back. My stomach issues have gotten worse. Then, ten months back I had started getting this horrible burning sensation on the right side near ribs. The doctor thought it was my liver and did blood work, everything was fine. Then six months back I got to a point where every time I ate I was in extreme pain. I have lost around 60 lbs since then. I went and saw a different doctor, they did blood work which came back abnormal (amylase 24 IU/L, lipase 8 IU/L, narrative current ADA criteria for glucose: normal: 70-99 mg/dL, impaired fasting glucose: 100-125 mg/dL, diabetes mellitus: at or above 126 mg/dL). The diagnosis of diabetes must be confirmed on a subsequent day by measuring fasting plasma glucose, two hour PG or random plasma glucose (if symptoms are present).
Sodium 139 mEq/L, potassium 3.5 mEq/L, chloride 106 mEq/L, carbon dioxide 26 mEq/L, anion gap 7.0 mEq/L, blood urea nitrogen 4 mg/dL, creatinine 0.70 mg/dL, glomerular filtration rate greater than 60 mL/min/1.73 m*2. A persistently reduced GFR is a specific indication of chronic kidney disease. The eGFR calculation has not been validated in patients greater than 70 years. Calcium 9.1 mg/dL (8.4 - 10.5 mg/dL), glucose 88 mg/dL (70 - 100 mg/dL), protein total 6.5 g/dL (6.0 - 8.0 g/dL), albumin 3.9 g/dL (3.5 - 5.0 g/dL), alkaline phosphatase 68 IU/L (40 - 150 IU/L), aspartate aminotransferase 21 IU/L (10 - 40 IU/L), alanine aminotransferase 42 IU/L (6 - 31 IU/L), bilirubin total 0.6 mg/dL (0.2 - 1.2 mg/dL).
Ultrasound impression showed probable cavernous hemangiomas in the left hepatic lobe although the ultrasound appearance is nonspecific. Recommend CT of the abdomen with IV contrast utilizing triphasic hepatic protocol. Then sent for CT and the impression is previous cholecystectomy. The focus of abnormal echotexture on recent ultrasound through the liver is felt to correlate to an area of low attenuation on CT. CT findings are nonspecific. This may represent an atypical hemangioma. Neoplasm is felt less likely. This is well visualized with ultrasound. Short-term follow-up ultrasound in 2 to 3 months recommended to ensure stability. If this is unchanged it can be followed at larger interval increments. Right renal cyst. It states I was given oral contrast, I was not. The doctor had also told me these are something I was born with. I had an ultrasound of liver and they seem nothing on my liver. So is this something I should keep worrying about and get another opinion?
14 Jun 2024 - 1 min read
Red, painful arm after popping blister in Meth addict. Help?
Hello doctor,
My husband is 36 years old. He is fit and healthy and rarely gets sick. But he is a Meth addict. He missed the vein when injecting in the top part of his wrist. The injection site looks like a small ant bite. It formed a water blister that he popped and put Neosporin on. But his hand is red, swollen, throbbing, and warm. He is in agony. He refuses to go to the ER. Is he in danger of dying? What should I do? How can I treat this?
Please help.
14 Jun 2024 - 1 min read
Pain upper abdomen, left chest, shoulder, back. Help?
Hello doctor,
I am 34-year-old female with pain in the upper abdomen, left chest, left shoulder and mostly middle-upper back pain (although back pain has been all over) upon standing, walking and on any exertion. Healthy otherwise and not overweight. I went to the ER yesterday, and they did two ECGs (did come back with an inverted t wave on one lead. They were not worried), did a chest X-ray, d-dimer (I had a DVT 1.5 years ago when I was six weeks pregnant), bloodwork including cardiac enzymes. All are normal. The pain started about two weeks ago, but was just off and on and would go away fairly quickly. I tried working out about 1.5 weeks ago and made it a couple of minutes until the jumping jack warmup. The jumping motion brought on this pressure pinching pain (not the best description, I am sure), but it is subsided when I stopped. The last few months, I have had intense burning pain in my upper middle abdomen that the doctor suspected an ulcer and put me on Protonix. The pain did get better after that, but I still have many flare-ups of that pain. It seems like when I get the chest pains, and I have a lot of upper abdominal pressure. I have to push down on my upper abdomen to help relieve some of the pain, even though the pain is felt more in the upper left chest into my left shoulder and sometimes arm. The upper-middle back pain is new and is hot pressure pain. The chest pains were off and on but have been consistent for almost three days now, but mostly only when I get up to walk around or stand. Just standing still without exertion brings on this intense pain. Sometimes certain sitting positions will carry it on too. I do not feel short of breath, except when the pressure hits. In ER yesterday my stats were good. BP around 100/60 (my norm), HR around 65, and O2 100 %. My respiratory kept alarming though around 8-9 quite a bit.I cannot help be worried about a blocked artery since that seems to be what pops up with chest and back pain. Also PE, but they were pretty confident I did not have to worry about that with normal stats and a negative d-dimer.
13 Jun 2024 - 1 min read
How to treat skin discoloration on buttocks due to scratching?
Hello doctor,
My buttocks are really itching. The skin over the buttocks has become black due to scratching. I suffer from hemorrhoids. Kindly suggest some quick and effective treatment for this condition, or can I do laser therapy? This has been in the same condition for more than four to five months. I am applying Lactocalamine and Vaseline.
12 Jun 2024 - 1 min read
