Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My (35m) heartrate is not going down after recovering from a respiratory virus.I'm 35, male, 5'11 and 215lbs. I was fighting a respiratory virus for the last 2 weeks. My symptoms are basically gone at this point, but my RHR has not recovered. It is normally around 62bpm and has been stuck around 92bpm for the last few days. I understand that it can be elevated while fighting an illness, but I expected it to return to normal as I got better. I do not drink caffeine, alcohol, or take any medications that could raise it. I have an appointment to get a Holter monitor for an unrelated sinus arrhythmia in a couple weeks and I'm concerned it might skew the results. The only thing I can think of is I haven't been eating much in the last couple weeks due to a sensitive stomach so I don't know if the lack of nutrients might be causing something to be going on. I've been drinking lots of water as well.. ### Response: Give it a few months to reset.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 26F - little streaks and spots of blood in phlegm but no symptomatic respiratory/sinus/throat illness and no coughing26FWhen I brush my teeth, I suck the mucus in my throat out into my mouth and spit into the sink. For the past few days, I've noticed bright red spots and streaks within the mucus. Not too much but it's there. I have had no recent infections or illnesses. No recent coughing or sore throat either. Everything sinus or respiratory has been normal. I used to vape and smoke between 18-23 years of age, and the volume of air I can take in during a deep inhale has shortened as a result of the smoking/vaping based on my subjective, highly inconclusive observations.Have been experiencing noticeable and moderate ongoing fatigue as well.. ### Response: Not concerning. Congratulations on being nicotine free though! your body thanks you..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My disease may have caused respiratory involvement.Hello, I am 28 years old male 165cm 22kg Malay. I have been diagnosed with rare disease named Congenital Fiber Type Disproportion Myopathy in 2010. I also suffered Combined Scoliosis and Lordosis and has to use wheelchair. The scoliosis made my left lung smaller than my right lung. I refused spine surgery as I deemed the risks outweighed the benefits. I discontinued medical checkup in 2011 as there's no other treatment available. My skeletal muscles is progressively weaken over the years. Since last month after recovered from a flu, I've been having daytime sleepiness despite 7-9 hours of sleep. I also frequently woke up from a dream with a headache. Rarely, I woke up choked or gasping for air. I also has multiple awakening at night. My Gp prescribed me with 0.25mg Alprazolam few days ago to help me sleep better. I did get uninterrupted sleep, but it did not help with daytime sleepiness. I stopped Alprazolam after I read about the withdrawal symptom. I planned to schedule an appointment with sleep specialist. I'm afraid my disease has respiratory involvement.. ### Response: Your post raises concern for chronic hypercapnic respiratory failure  basically you skeletal disease causing chest wall restriction leading to hypoventilation. A benzo (such as alprazolam) would acutely worsen this, not surprised things got worse. Strongly recommend you see a pulmonologist asap. You probably need something like nocturnal BIPAP to blow off CO2 and improve your symptoms..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can someone explain "respiratory failure" to me?30F, persistent pneumonia and shortness of breath. Sp02 sits at around 88 but as low as 50 on exertion.I have been treated at an outpatient clinic and visited by nurses daily, I have been given oxygen to use at home. My doctor said I have respiratory failure but I am unsure if this is just a general term, or if it means my lungs are dying, or something else?The term "failure" makes it seem serious/life threatening but I have not had anything explained to me.Should I be worried?. ### Response: Respiratory failure usually has a different meaning than being used here - what's the clinical situation causing this?Respiratory failure is often technically defined as either low oxygen levels or high carbon dioxide levels due to your lungs not working as well as they should. You can have acute respiratory failure, like if you get pneumonia or have an asthma attack; you can also have more chronic respiratory failure where your lungs dont work as well in generallike with emphysema.Its hard to know whats going on in your exact condition and what the prognosis is without more informationbest thing to do is ask your doc.In your case respiratory failure is defined by your need for oxygen -- chronic hypoxic respiratory failure. "Failure" in this situation means your lungs aren't working well enough on their own to sustain your life, so you need the oxygen. If your lungs weren't failing you wouldn't need oxygen.Should I be worried?That's a very common question on this sub, and often it's not answerable over the internet. In your case I'd certainly be worried. It sounds like you are quite young for having developed chronic respiratory failure, and it doesn't sound like you have a clear diagnosis (probably meaning there isn't a clear treatment plan going forward). You should keep asking questions to your doctors until you get answers; and if you haven't seen a pulmonologist yet you should seek one out ASAP. "Persistent pneumonia" isn't a diagnosis..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: 27F Overweight  dizzy, nauseous, weak, sleepy, and seeing some black spots from time to time  respiratory acidosis?It's been a month since I've been having these weird symptoms  headaches, dizziness, nausea, weakness (specially on the legs), faintness. I feel confused some times as well.I also have bad GI problems such as bad absorption, diarrea, and/or constipation depending on the date.After 5 trips to the ER with pain on the left part of my chest, and confirming that my heart was fine, all I got diagnosed with was anxiety and POTS.But today I did some blood tests and my Bicarbonate levels were low (20; normal range is 22-29).Could I have respiratory acidosis although my oxygen levels are 95% and up?Or is this more a metabolic thing?I do feel like I can't breathe properly recently.. ### Response: Your bicarbonate level is fine. It was maybe outside of the lab reference range, but it's nothing to worry about at all.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Sorry for doubting, but  Are you 100% sure? I have my doctor's appointment on Monday. I just want to know if this is something treatable, or if I should go to the ER.. ### Response: Yeah it's fine, not at all urgent..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I don't have kidney problems that I know of.But do you think my lungs are alright? Could it wait till Monday to check? I feel I can't breathe properly, but just because I'm terrified of not breathing properly.. ### Response: Youve been to the ER 5 times. I would assume they checked your oxygen levels and someone listened to your lungs..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yes, they have listened to my lungs several times, but they have never said anything bad there. My oxygen levels are always 95%+.I just had an abdominal ultrasound scan and aside from some fat in my liver and some bile salt in my vesicle, they didn't find anything. No comment on any acid in my stomach whatsoever.I also had a chest X-ray plaque and they didn't say anything bad was going on in my lungs.I have high uric acid  9.0 (limit is 5.7).Is it safe for me to sleep today and tomorrow and wait till my Monday appointment?. ### Response: Do you have kidney problems? Did anyone suggest baking soda or tums? Do you eat a lot of meat?.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Getting circumcised. What else can I say was done at work as an excuse?EDIT: Wow thanks for all the replies!TLDR: whats a fairly minor procedure with a ~2 week recovery time that I can say I had done instead of a circumcision?  Im a 34 year old male and I have to get circumcised for medical reasons (phimosis and frenuloplasty that didnt work)I have a physical job as a Paramedic, so will be on alternate duties in the office for a couple weeks. Ive done so before with a busted ankle.However Ill be working around people who are medically trained to various levels, and theres always ice breaker conversations about how you ended up in alternate duties. Well Id rather not tell Carol from accounts about my dong, so is there another procedure I could say I had done that isnt as embarrassing?I could say its none of your business or similar, but that might make things awkward and probably make it obvious its dick related.Im thinking of saying an inguinal hernia repair? Seems like a similar recovery time, a bit tender below the belt kinda thing??Any other ideas?Thanks docs!. ### Response: Tell people you had macropenis and that you had to have a surgical reduction, since it was just too big..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Doesn't HIPPA protect him from having to tell his work anything more than that it's a medical issue. ### Response: No, thats not HIPAA. HIPAA prevents healthcare providers from telling anyone at work if they ask. Your employer does have limited rights to information for sick leave and I think most privacy is under the ADA..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yes, that you're having surgery not what the surgery is for.The point was that their job has no right to ask specifics. ### Response: No. HIPAA is concerned with covered healthcare entities not disclosing your medical information to other people without your information. It doesn't address your coworkers asking about your surgeries..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: O I get that but that not the fkn point I'm trying to make.. ### Response: HIPAA does NOT protect him from his employer asking about medical conditions. This is more of an ADA issue if anything.HIPAA has nothing at all to do with this situation..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: It does if they call my doctor to ask. Hippa protect any thing about my health being shared. ### Response: HIPAA says your doctor can't disclose that info. It doesn't say they can't call and ask.I can call and ask your doctor. If he tells me, he's committed a HIPAA violation. Not me.HIPAA has nothing to do with OP's responsibility (or lack thereof) to disclose medical information to his employer. Neither are HIPAA bound entities..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Inguinal hernia seems like a good excuse. Same region, common in men, not very invasive surgery similar to circumcision. ### Response: No, OP doesnt need an explanation, they said as much. But OP also said they would rather have a simple excuse on hand that doesnt raise any eyebrows rather than tell someone its none of their business and invite scrutiny. Some people are more comfortable with that than others..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I'm not sure, my dad had one and was advised no heavy lifting for six weeks post op. ### Response: I would say testicular torsionNo guy is asking any questions after that.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I disagree. If I didnt already know what it was, Id definitely ask what it is haha. ### Response: I think hernia is fine.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: One of my sons had to have surgical repair for penoscrotal webbing, sounds somewhat similar, and I also didnt feel comfortable blasting private details about that around casually. we made similar jokes about it being a penis reduction. But usually I just said he had a urological surgery/procedure and left it at that. If some asshole really tries to pry about details after that then they deserve the nunya response. Edited to add- he was about a year old when he had surgery, so different in that regard but still not comfortable telling people details about my babys private part situation. ### Response: Hernia repair is fine.However honestly if it was me, I would just be up front about it.You're having a medical procedure to correct a problem with your health, and your coworkers are healthcare workers.If carol from accounting gets nosey, just offer to show her before and after photos! (But don't really, because you would totally get in trouble.).


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Dont tell them you are getting circumcised. Medical co-workers can be the worst.. ### Response: Thats your approach which is fine. But OP made it clear theyd be more comfortable if they just had an easy excuse that doesnt raise eyebrows. OP shouldnt have to explain themselves, but not everyone is comfortable with that.Id go with hernia.Is there a reason why you have to give the info in the first place?"I'm on alternate duties for medical reasons" should be more than enough for anyone who isn't your doctor. Honestly "I'm on alternate duties" with no further details whatsoever is a complete sentence already.You can say hernia repair if you want, not saying you can't, but it's a bit bizarre to me that you've been put in a position where you feel like you have to reveal more than you wanted to or make something up just for an ice breaker with Carol from Accounting. An ice breaker should be, like, "what tv shows are you watching recently" or "what's your favourite meal"! Not "please explain something potentially very personal"..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: NAD ... Tell'em you had a hysterectomy, and then grin and walk away.I get that you'll need to say something because people are like that. But it's not up to you to tell. I, personally, head for "humor" to shut it down.. ### Response: Since this has nothing of an actual repercussion medically, you could try saying something in line of abscess drainage or an excision of lipoma/sebaceous cyst, etc.,.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Honestly, just say that you had to have a procedure done that you'd rather not talk about. I work in the medical field too and I have never had anyone push after saying that.. ### Response: Vasectomy, cord lipoma removal.Where I am, hernia repair earns you 4-6 weeks of light duties..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: respiratory/co2/bipap/desatrespiratory/co2 retention/bipap/desatsHello everyoneI am a caregiver to my 47y male [5'11 155lbs, Caucasian, no alvohil quit smoking in 2020 after 22 years of cigarettes and lots of cannabis, on 60mg sildenafil 3x a day; inhaled treprostinal, b1, Folic acid, vit d, calcium, o2 and temporarily prednisone after hospital] partner with CHF, pulm hypertension, and copd emphysema. DX in 2018. Was put on 3L of o2 24/7 in 2020 and then May of this year began having frightening symptoms which turned out to be CO2 retention. He's been to the hospital 3x in 5 weeks, been intubated once and on hospital bipap twice. We have our own bipap bit it's part of the philips recall so until we became aware of this co2 problem, we weren't using it. The dr recommended we do as it was riskier without it.However everytime I would put him on it, he would desat 10-15% and hold there. I thought it was the machine, the mask, the toxic fumes from the recall, etc. I have now rented a machine, have a new mask, and when he got out of the hospital o2 sats were good while on it. However its now been 2 weeks, although using it every day and trying to keep him out of the hospital his CO2 has built back up judging by his symptoms.Been trying to use the bipap anyway and just fight to keep o2 sats up, had a mask leak the other day , finally got the new part and it doesn't seem to be leaking anymore but still he desats 30%, it seems like it takes some time (hr , hr and a half) to burn off the first layer of co2 before he can stabilize o2 sats so just been trying to get him over that hump.When o2% drops it seems to get stuck like airway is closed or diaphragm paralyzed! If I crank the o2, sometimes it works to help his sats cycle up, but mostly not. I haven't been able to keep Bipap on more than hhr at a time the last day as it drops under 80, and a couple times under 70. Trying to do some research and my theory was a bronchospasm but his inhalers (prosir snd combivent) and/or breathing treatment of a Ipratropium bromide/albuterol seem to make his sats worse than before use.Last night it cycled down to mid 70s on the bipap for the 5th or 6th time but wouldn't come up and I pulled him off, put him back on the cannula. However the spasm continued once he was off it, no matter how much I cranked the o2, it would cycle down to 70s or low 80s and sit there awhile. Then it might cycle up but fall right back down. He was making efforted breaths, with a high respiratory rate. Took ages before this cycle stopped and his o2 sats stabilized in 90s.My question is does this sound like a bronchospasm? Hypopnea? Paralyzed diaphragm? Just recently got a wellue o2 ring and have noticed so me drops to 78% out of nowhere, when he's just sitting and it will hold there for 10-30 seconds and then go up. I've actually noticed on the chart a couple days ago, it happened 3x, almost exactly 10 minutes apart while on bipap so was wondering if it was related to the heart cycle. Don't know if these events are even related/the same thing.Any insights? I can't keep him on the bipap/can't get out the co2 when I can't keep his o2 up!! I was gonna leave in the cannula and just hold the bipap mask up to his face tonight so it's easy to remove if o2 starts falling but still may help trigger some deep exhales to blow off co2? Is this a good idea or not? To kind of spot treat without strapping everything on that's difficult to get off, switch over to cannula if sats drop?I'm at the end of my rope, haven't slept more than 1 hr increments for months, i really don't want him going hmback to the hospital they always seem to break something else on him!! The drs cant understand the anount of damage to his lungs for his age/history. Are there diaphragm exercises to strengthen? Does it sound like a spasm? Any theories or information helps!. ### Response: Most likely the oxygen supply is decreased due to high pressures inside the mask during inspiration. Do you have a second oxygen supply and nasal cannula? If so, put on a nasal cannula under the BiPAP mask and run it at 8-15 L/min. This will help provide a higher amount of oxygen during inspiration..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yeah one of the doctors suggested that, we did try that a couple weeks ago and it didn't help, we didn't have a proper dual ventilation setup so the mask didn't seal as the cannula was in the way. When his CO2 is low he's able to stay above the 90s, even a few days ago when it was high but not too high, as long as I held the mask on when there was a leak he was staying in the 90s but given that this happens desat after the BiPAP is off I feel like there's some other explanation like his lungs are freaking out. ### Response: I have to disagree. I would try to find a dual ventilation setup to try..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I will try anything but respectfully how do you account for the desat cycle to 70s for an hr and a half after thr bipap is off?. ### Response: Could be entirely unrelated to the desaturation when putting the BiPAP on..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Yeah I'm wondering that, bc it just happened, just not as long or as low and he hasn't had the bipap on for 12 hrs. I'm wondering if the bipap exacerbates it but there's another issue like diaphragm or bronchospasm.. ### Response: I wouldn't think bipap would exacerbate it. I do think there's likely another reason for his desats, like bronchospasm. Not likely a diaphragm problem. Follow up with his doctor..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: If it is a broncospasm should the Ipratropium bromide/albuterol nebulizer treatment and/or proair albuterol inhaler and/or combivent inhaler (Ipratropium bromide/salbutamol) make it better or worse? I've read some conflicting things and the neb used to help his o2 sats , I would use it before bipap but now with the heavy co2 , all those treatments seem to make his sats worse by 5%+.. ### Response: It should make it better. It sounds like he's needs to see a doctor.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I (63m) was diagnosed with ALS about 8 weeks ago. Needless to say, this has been a devastating diagnosis for me and for my spouse. Symptoms started 2 years ago with diffuse cramping, and minor dyspnea upon exertion. The cramping continued, then I developed more dyspnea, and then fine motor skill weakness in left>right hand. An EMG in March of this year showed major motor neuron issues, and the suspected MND was confirmed as ALS by two specialists. I am 5'9, 170 lb. I am on riluzole and Relyvrio, still waiting on the Radicava because the fucking insurance company is taking its sweet time and would probably prefer that I die in the meantime so that they don't have to pay for it. Here's my issue: my main symptom, which has slowly progressed, then more quickly starting in Feb of this year, is respiratory muscle weakness (diaphragm and chest wall muscles). I cannot breathe lying flat, and have to use a BiPap machine at night or I get hypercapnia. I am increasingly fatigued during the day, and often short of breath even just moving around the house or doing simple chores. I can walk a mile slowly, but have to take a break halfway, and it's taxing. I understand from my voluminous reading about this shitty disease that most people die from respiratory failure at the end, and that that is usually the last set of symptoms they get. Respiratory muscle weakness is more rare as a presenting symptom. Given that it's really the first major problem I am having, my fear is that it's going to be the thing that takes me out, and that it could happen rather quickly. I am trying to get my affairs in order, have an advanced directive on file with my PCP and am doing all other estate planning and power of attorney, etc., as fast as I can. I do not want tracheostomy or gastrostomy under any circumstances, I do not want to simply exist hooked up to machines. Quality of life is paramount, and my spouse has agreed to all of my wishes. We do not have children. How will it end when it ends? I am still relatively mobile and can use my limbs and hands, no real issues with voice or swallowing. I imagine that at some point I will simply not be able to breathe any more without the NIV, and that even that will not work at some point. What I am unsure of is what it looks like getting to that point, and what happens when I simply can't breathe any more and an NIV doesn't work. I want to go quietly and easily, without struggle. Do I state that I want continuous deep sedation at some point, and if so, when? Any guidance or feedback at all is welcome.. ### Response: One of the worst diseases. I'm so sorry OP.I can promise you that there is no reason you should in any way be suffering physically at the end of life. You will not stop receiving treatment. We cannot treat ALS but we can treat pain, shortness of breath and anxiety/fear very very effectively. Your ALS neurologist or pulmonologist should be able to put you in touch with a hospice program and I think talking to them may reassure you.Opiates for instance are almost always successful at relieving shortness of breath and pain. Benzodiazepines are sometimes used for anxiety. These are given in doses of whatever you need to be comfortable. With a good hospice plan you should have nothing to worry about as far as untreated symptoms.The setting is also a consideration. Home hospice can be challenging mostly from a care standpoint. Often patients with ALS already have in place a high level of care at home and can stay there with a few hours a day of hospice nursing. If the nursing needs are significant or can't be met, the other option is to choose to do what is called inpatient hospice. This is in a setting that is more like a hotel than a hospital, visitation restrictions are (in general) quite relaxed, and there is 24 hour nursing care. They are very focused on quality end of life treatment.You are dealing with your own mortality and grief. This is more than enough. What you shouldn't be fearful of is feelings of pain or shortness of breath. I suggest meeting with the hospice people in the near future even if you are not yet ready for this. They can answer questions and plan about how you want this to be done..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Upper respiratory culture came back and the results are confusing.I am a 33 year old female. Weight: 160 Height: 53 Medications: Modafinil Smoking: Yes, about a pack a day.Was seen at walk in clinic on the 9th of October for what appears to be a Virus. Swollen lymph node on the left side of my face, under my jaw and just to the left of my chin. Sore throat, dry cough, lethargy, headache, muscle pain, and fever that sticks around 101 and comes down occasionally. OTC wasnt really helping. On the fourth day of this now. Chest discomfort started today.Covid pcr came back negative. Rapid strep test came back negative.My upper respiratory culture came back today and these results are what is confusing me. I cannot get a hold of anyone at the clinic who can tell me something so attempting to get an idea of if I should continue to call or if its nothing.This is the only information on the culture.TEST: Upper Respiratory Culture1COLLECTED DATE/TIME: 10/9/22 8:30 PMFINAL REPORT: MANY MIXED RESPIRATORY FLORAINTERPRETIVE DATA: 1ALI Microbiology uses MALDI-TOF mass spectrometry on the Bruker Microflex as its primary method for identifying bacteria and yeast. This test was developed and its performance characteristics determined by ALI. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.. ### Response: Usual disclaimer: no one can provide specific medical advice for a person or condition without an in-person interview and physical examination, and a review of the available medical records and recent and past testing. This comment is for general information purposes only, and not intended to provide medical advice. No physician-patient relationship is implied or established.MANY MIXED RESPIRATORY FLORAThis simply means that the bacteria found in your culture are typical bacteria found in everyone. No predominant pathogen (disease-causing organism) was found.Generally speaking, respiratory cultures of outpatients are not useful. Rarely do they produce actionable information..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My asthma is so badly controlled and my specialist isnt giving me other options, is there anything else I can try?Im 28F and Ive tried so many different asthma treatments and I constantly sound like this https://imgur.com/a/RkAF2MC , right now Im having no real bad coughing fits or terrible difficulty breathing, it gets worse but I really dont know what else I can do to just breath normal. This is what Ive tried with my pulmonologistVentolin Symbicort Spirivia Montelukast Xolair (stopped this bc side effects were bad) Dupixent (taking bi weekly)I take prednisone probably once a month at this stage.Ive seen an allergist and use all hypoallergenic products/bedding etc. I have an air purifier in my room. I wear a mask out doors because of air pollution in the city. Ive tried taking anti histamines and they dont make any difference.I dont or never haved smoked. I try to keep active and live a healthy lifestyle for the most part.What else can I do? My doctors not really giving me any more optionsHonestly all tips or advice is welcome.. ### Response: Asthma mimics need to be ruled out (vocal cord dysfunction, tracheobronchomalacia, ABPA, etc). If all else fails there may be some benefit from bronchial thermoplasty (but the overall benefit is somewhat unclear)..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Add Chrug strauss syndrome to the list too. ### Response: Sarcoidosis as well. Basically needs a full cardiac, pulmonary, and upper airway workup if youre failing this many treatments. I presume they had one if an allergist got Xolair approved, but you never know..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: How does diaphragmatic breathing differ from typical respiration in an individual without underlying respiratory conditions?To my understanding, the lungs expand and contract as a function of the diaphragm/transverse abdominals contracting, as well as the contracting of the inner/outer intercostal muscles. As a musician who plays brass instruments, there is this phrase, "Breathe with your diaphragm" that gets passed around quite often, but I never really felt like I fully understood what that means from an anatomical standpoint, because wouldn't that imply that it's possible to breathe without the diaphragm, or that an otherwise normal breath is done without the diaphragm?I am aware of diaphragmatic breathing as a form of physical therapy for individuals with chronic obstructive pulmonary disease, but what benefits, if any, would it offer for an individual without such medical issues?Follow-up, would such exercises expand an individual's vital capacity/is it possible? I believe a person's TLC cannot be changed. All in all, there is a lot of information about breathing in the world of music education that is shared and taught without citation or concrete scientific basis and I wanted to get to the bottom of it all. Thanks!. ### Response: I am not in the world of music but you are correct. Inhalation is done with the diaphragm and accessory muscles as needed. I would guess that breathing with your diaphragm is more of a cue to take a solid expanded chest, stomach out breath as opposed to a weak, chest only inhalation. Again, basically a cue to get maximal amount of air in your lungs.And yeah I think it would be a stretch to say that exercising can increase total lung capacity. Maybe, but I cant imagine it is in any appreciable way..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Does routine respiratory flora mean Im strep free?Age: 48Sex: femaleHeight: 5 8Weight: 150Race: whiteDuration of complaint: weekLocation: throatAny existing relevant medical issues: StrepCurrent medications: noneInclude a photo if relevantI was treated for strep but still felt a little sick so I asked for a other culture. The results came back routine respiratory flora. I cant get anyone at One Medical to respond/explain so I thought Id check here and see if that means Im ok or if something else is going on.. ### Response: It means you have the normal bacteria that grow in your mouth. As for whether or not you are improving from strep throat, the culture has no bearing on that..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: please help, ive been having weird respiratory problems for 10 days and idk whats going on.25f smoker hi, for 10 days ive been coughing up THICK GREEN phelgm and/or blowing it out of my nose, especially at night. i wake up every 2 hours unable to breath until i clear it out. my throat is also sore at night but just from the phelgm irritation. its so much phelgm i go through 2 boxes of tissues a day. the first day i was sneezing a lot and then my nose was running for a few days and now the last couple days it seems worse, as its turned into a lot more coughing/occasional wheezing even in the day time. i have a post nasal drip too. sometimes my nose feels clogged and sometimes it feels dry. the mucus production has only increased with time. during the day its not very bad but at night its hell and the mucus is much darker and thicker. im only relatively comfortable if im completely standing. weirdly enough i have no other symptoms like fever or pain. just various respiratory issues. im worried i may have a bacterial infection because it has only gotten worse. what could this be? please helpEDIT: went to urgent care, had bacterial infection, on antibiotics now. ### Response: You are having a bad cold my friend, sounds like it might have progressed to sinusitis. This will get better on its own, use decongestants at night, aspirin and lozenges for throat pain..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can anyone recommend some blood pressure medicines that dont cause respiratory issues?Im 25, Male, 6 and weigh 180lbs. Ive been taking Metoprolol since I was 13. I wasnt overweight, no heart defects or anything, just a genetic issue. My usual blood pressure without medication is 150/100. 25mg of Metoprolol ER brings it down to 120/80, and when Ive taken it in the past, 10mg of Lisinopril brings it down to 110/70.Ive always had bad allergies and congestion issues, and recently theyve been getting worse. Im seeing an ENT soon, but before then, I also have an appointment with my primary doctor. I suffer from pretty bad post-nasal drip which causes me to constantly clear my throat. Through research, Ive found that Beta blockers, as well as ACE inhibitors, are prone to cause asthma symptoms, congestion issues, and dry cough. Since my congestion and post nasal drip have become more problematic, Im looking to eliminate anything that might be contributing. Since there are so many different blood pressure medicines, I thought Id ask for some recommendations that are less prone to cause those side effects. So far Im leaning toward Losartan, and Ill be discussing these changes with my doctor this week. Thanks!. ### Response: Beta blockers can cause bronchoconstriction in people with asthma. You havent mentioned asthma, just congestion. Those are unrelated problems.ACE inhibitors like lisinopril increase bradykinin, which can produce a dry cough. Again, unrelated to post-nasal drip or congestion.Calcium channel blockers like amlodipine are often first line and dont have any respiratory effects, and ARBs like losartan dont increase bradykinin, so thats reasonable, but it doesnt sound too likely that your problems are related to medications..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I previously had an inhaler because I was waking up in the middle of the night not breathing. Did a sleep study and no apnea. I also go through episodes where I feel like theres so much mucus in my throat I cant breathe, but I always attributed that to anxiety.. ### Response: At that dose, metoprolol specifically is selective for the receptors in the heart and should not affect your lungs at all. At doses above 100mg/day is when I'd be concerned. (Other beta-blockers vary in their effect on asthma but metoprolol is a better one).As for Lisinopril I echo what the physician above said. It only causes dry cough and that would usually appear very early on when you take it. No effect on congestion.I personally had bad post nasal drip and congestion. Seeing a specialist helped so I'd suggest waiting for the ENT appointment..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can someone be more prone to respiratory infections?Almost every year without fail, I get an upper respiratory infection. Every spring it starts out seemingly as allergies, an itchy nose and throat, sneezing, etc. then it slowly makes its way down and I get a respiratory infection. I dont know why but it just always happens without fail. One year it got so bad that I started to have fluid buildup in my lungs and had to have a lot of antibiotics. This year its quickly getting bad but I just moved recently so I dont have a doctor, barely productive cough that tastes like blood/nasty and some chest heaviness along with fatigue and a hoarse voice/white spots on tonsils.No one else seems to have problems like this, so I was wondering if some people are just more prone to stuff like this? Ive gotten them constantly no matter what environment Im in, and it always quickly gets really bad. Even during my childhood I got them really bad, and I had RSV as a kid. Usually I dont get any answers, its just yeah you have an infection, heres antibiotics.Other than this Im a completely healthy 21 year old female, no existing conditions and no medications other than melatonin.. ### Response: Note: I am not a pulmonologist.Having had pneumonia in the past, you are more vulnerable to getting pneumonia recurrently. You might want to consult a pulmonologist to see if there's something else going on. Asthma, chronic bronchitis, reactive airways disease, and a few other less common causes of seasonal/recurrent respiratory illness might underlie your problem. Also, because you've had recurrent respiratory illnesses, you should get annual flushots and update other immunizations. If you smoke or vape, the best thing you could do is quit. Inhaled substances are not prudent if you are prone to respiratory illnesses..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Morphine and breastfeeding21f, in Ontario Canada, breastfeeding a 8 month old. Is there any safe amount of morphine I can take for pain while breastfeeding?. ### Response: Morphine is generally safe and has low transfer through breast milk.However, make sure youve maxed out your Tylenol first. 650 mg every six hours can go a long way towards pain relief..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Thank you for this! Is 650every six hours the max dose for Tylenol? I do not want to take narcotics but sometimes it seems like the only wait to get the pain to a point I can function.. ### Response: Max dose is 1000 mg every six hours, but I think you have diminishing returns after 650 mg. Plus, wouldnt go too much higher with breast feeding..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can I wait this out? I dont want to go to urgent care35F 140lbs. Been having what I assume is an upper respiratory type infection for like 3 days. Coughing up green mucus, from sinuses too. Its thick and sticky. Taking mucinex daily and drinking a lot of water. No fever.My husband insists I go to urgent care because of the green thick mucus situation. I have no fever, can I just wait this out and see if it gets worse in a few days? I dont want to be put on antibiotics by a doctor if its just a virus.. ### Response: If only 3 days in and not having fever or really bad facial pain, I have no reason to think that you have a sinus infection instead of just a viral upper respiratory infection. I don't think urgent care is warranted in this situation..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: No bad facial pain. Just coughing up mucus from the chest. Im assuming from dripping down my throat. ### Response: Yep, sounds like a nasty virus. Hydration is going to be key..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ongoing respiratory issuesLast week I started coming down with what felt like a cold. But my chest was aching very bad (under left breast and into back) and was having a hard time breathing. Gave it a few days to sort itself out but it got worse, ended up in the urgent care with a fever, cough , chest pains. Was coughing up brown, green and blood tinged mucus. Did X-ray.. doctor said they saw bronchial cuffing but radiologist stayed X-ray was all clear (confusing..) doc put me on a zpac and Im on day 3 of 5. Im still having chest pain, low grade fever and coughing up blood, and green mucous. I am a smoker and noticed after I smoke I feel horrible with chest pains and sweating.. going to ride it out another day if I am still unwell tomorrow should I go to er for another chest X-ray? Nervous about lung issues/as a ct scan awhile back showed partially collapsed lung and lung nodules. I dont feel that the antibiotic has been helping Much. Im a 27yo female so I feel Im sort of young for any serious issues. ### Response: Another chest x-ray this soon is probably not going to show anything different. Infections take time to clear, at this point I would recommend continuing the antibiotic and waiting. If your symptoms haven't started to improve after the last day of the antibiotic, then consider going back in for a reassessment. Also, smoking really diminishes the lungs ability to fight infections. I would recommend quitting smoking..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My neighbor (36M) dropped dead in front of me. I failed to resuscitate him. Hoping to get better understanding of his cause of death.This happened a month ago and Im sorry if this isnt the right place but it was a traumatic event for me and I think having some potential logical explanations might help me move on.My neighbor (who I didnt know at all really) was a 36 year old male, slightly overweight. He worked construction I believe. I was out front of my house when his truck drove down and he kind of pulled into his parking space a bit erratically but I didnt think much of it and was busy with my daughters. After what felt like a couple minutes (but was actually 12 mins according to my security camera), another neighbor screamed and said hes not breathing and asked me for help. I called 911 and immediately helped get him out of his truck and onto his back. He was blue. Me and another man took turns doing chest compressions until rescue arrived. They were able to get a pulse back but he ended up dying a week later.He and his wife had a brand new baby. They dont speak English and so when I asked her what had happened she told me as best she could that it was not a heart attack. That it was respiratory arrest. That he had a form of syncope.I actually have syncope myself (neurocardiogenic syncope and take beta blockers) and didnt want to ask any further questions. Just wondering how such a young guy can go from driving one second to just not breathing the next. As far as I know, my doctors have never told me I might just faint one day and stop breathing as a result. Im guessing this is a different kind of syncope. Just wondering if anyone knows of any possible reasons?Edit: I wasnt expecting so many responses and am so grateful. There are so many potential causes of death I hadnt thought of. Its really moving hearing so many doctors and paramedics share their own stories of losing patients and the emotional ramifications. Thank you. Im going to absolutely pursue counseling.Ive had a couple people message me about his widow and baby. I wanted to update that Ive been doing my best to help them. I got a fair amount of baby gear donated and my husband and I bought her enough groceries for a month as well as a $200 gift card to the grocery store. I also printed photos (which I got from her sister) of him and his baby on archival quality paper and framed them as a gift for them. They were already struggling before he died and both out of work. It seems like since his death, a lot of family has arrived to help her out too.And lastly, it wasnt covid (luckily). Its been a month and I already tested negative.. ### Response: Just chiming in to reinforce what has been said. We can't tell you exactly what happened, because we can't know without a lot more information. However, we can say a few things.Seeing someone die is always a hard thing to deal with. The first death we all saw in our careers stay with us, even when doing CPR becomes a routine thing, and if you ask the majority of us we'll be able to tell you what happened in detail, even after quite a few years. It does get easier though, once you realise that the person you were trying to resuscitate needed resuscitation in the first place; they were dying without your intervention and you did all you could to try and change the outcome from what was already going on. In your specific case, the fact that you kept pumping his blood for him well enough for paramedics to get a return to circulation means you did a good job of it.You should consider talking to a counselor about this. It is definitely a big thing to process, and it's normal to struggle with it. We usually get a debrief from our seniors after a death, and getting to talk it over with someone who can help you unpack it all is quite helpful.Also, know that there are various different kinds of syncope, and the kind you have doesn't cause an increase in your risk of sudden death..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I cant like this enough.I havent been authorized by the mods of this sub, but I want you to know that every death is a tragedy to medical professionals. Regardless if youre prepared for it or not, its hard to deal with losing someone. Even if you know your patient is terminal, it still hurts to have it end in death.You did everything you could, and MORE than most would do.Im so sorry you had this experience, but please know that you reacted stronger and better than a huge majority of people would.. ### Response: every death is a tragedy to medical professionals. Regardless if youre prepared for it or not, its hard to deal with losing someone. Even if you know your patient is terminal, it still hurts to have it end in death.Truth. As an oncologist, I have just grown numb to losing a patient. It still feels like a stab in my heart every time..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Hey man, just wanted to let you know that youre a great person for venturing into such a difficult field. Take care of yourself.. ### Response: Thank you.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: That's totally how I felt reading this. OP, you did amazing. I knocked myself out at work last year and all people could do was run around screaming. You were nervous but composed and did an amazing thing keeping him as best as you could until the paramedics arrived.OP, I am really proud of you, not only for your quick action but also for your caring. We can't save everyone but the people who try make me proud to be human.. ### Response: Know that you did everything that you could. Don't feel guilty. He might've had cardiac issues that resulted in cardiac arrest. Likewise, things such as OD cannot be ruled out either.When I was a resident, events like this often triggered me to have a meltdown. I'd feel guilty. Why couldn't I have saved that man or woman during that code blue? At the end of the day, we have to realize that death is a part of life. Of course, I learned this over time as a young doctor. Sometimes we cannot resuscitate an individual no matter how hard we try even if there is a crash cart with all the emergency supplies right next to us..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I go to therapy once a week for a different reason, but the one thing that helps with closure with traumatic instances is EMDR. Its like what op said, but instead of writing the event out, you work with a therapist and say the event until you feel safer. I always hold these things in my hand, as we go through the event little by little, hell ask me one to ten how do I feel (about what I just talked about) and tell me to just focus on that and well do a set. The thing in my hand (dont know what its called) will start vibrating in my hands (think like hand held massagers that were popular in the 90s ish. Its not big, but it buzzes and vibrates in your hand. Does that make sense?) Its so soothing, and I always feel like I am slightly floating and turning. Absolutely not in a way you would high. Then he would stop and ask what I notice now? I would explain the next part and repeat. When we had to stop for the day (or week, depending how often you went) he would ask 1-10 how I was feeling, do a set and I would gently open my eyes. We would do this until I felt comfortable enough to feel like the incident was more safe in my mind.ETA: I forgot to mention, in the beginning of the session, he would show me a list of emotions and ask which one could best describe my feelings of the event at that moment. Then ask 1-10 of my emotion. We would then do a set before he asked me what I noticed from the event.Every appointment, he would ask if I felt like processing that session. Sometimes you need a break, and thats okay. You still have someone to share anything you feel comfortable sharing who is a third party. He also started the processesing session showing me emotions, asking how I felt 1-10 and I could share starting with the beginning from last session, or where I left off. The whole point is to talk about the event on your terms and process how you need to.. ### Response: Realized I havent let myself process what happened.It will take time; don't be afraid to seek help from a therapist. Just know that you did everything right. Thank you.I just wanted to thank you for doing CPR on this guy. You did a good job, it's so important that people try to resuscitate a patient in this situation. Sometimes it wont work depending on the underlying disease. But that's not your fault. You guys did the right thing!.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: NAD, Im a 911 dispatcher. The fact that EMS was able to get a pulse back means you and your neighbor did the right things and did your absolute best to give him a fighting chance. Unfortunately, sometimes no matter what you do, its not enough and its too late. So many times, cardiac arrest calls we take end with EMS doing CPR until getting to the hospital, and the hospital calling it shortly after. Perhaps your quick action gave his family time to see him a last time and say goodbye. I hope you find peace and comfort... and even just a few sessions of therapy can provide such a huge benefit toward professing things like this.. ### Response: Echoing all that was said here.First off, thank you for trying to help. These kind acts keep society alive despite political posturing and divisiveness in social media.As hard as it is to imagine and as difficult it is to go about your routine, inaction would be far more paralyzing. You did everything that you could in his time of need. I have had similar instances in my career in the ED and this same message was relayed to me early in my career: We can only do everything we can do and nothing more. At the end of the day, you gave him a chance. If no one did anything, he would have died. You gave him a chance.I cant speak to exactly what happened, but respiratory arrest is essentially saying that he stopped breathing. That could imply severe asthma, anaphylaxis/allergic reaction or even cardiac arrest (eg, I had a 42 yo MI in a patient just today). Or pulmonary hypertension.I wouldnt rule out overdose. Narcotic addiction has almost never been higher and is one of the leading cause of death of young people. I pulled someone out of their car unresponsive, cyanotic last week for the exact same reason.I trained in one of the most severe areas of narcotics in the US, Kensington in Philly. Its everywhere and a daily occurance. An opioid addicts life has been replaced with daily struggle to obtain narcotics or suffer debilitating withdrawal that few ever want to experience in their lives ever again. Its said that alcohol withdrawal can kill you; narcotic withdrawal makes you wish you were dead.Fortunately, there is help. Suboxone and other treatments can help to replace their addiction with an extremely safe and effective alternative. Its unfortunate that this happened and likely could have been well known by the family. I have had this converation far too often in my career. Parents who performed CPR on their child as they were holding their grandchild in their lap on christmas morning, the daughter who could no longer struggle and overdosed on every pill in the house and the 15 year old who is going to gift of life after found in the rear of the bus. Family are expecting that someday that they will get a phonecall - they just dont know when.The carfentanyl that is used in place of heroin is deadly for anyone who cant fight their addiction and relapse, only to find that the ford taurus of narcotics was replaced with a tractor-trailer. And its often too late. Methadone can be used, and maybe used by some on the street or for pain control, but its hallmark is that your breathing is stopped often before pain control. And it has some of these cardiac effects that were mentioned regarding hydroxychloroquine.Narcan is a medication that is widely utilized. It reverses their apnea (lack of breathing/respiratory arrest). But its temporary. Sometimes ingestions can rebound and the effects can wear offI trust that you did everything you can.If this continues to haunt you, in addition to asking your family doctor for a referral to someone to speak to regarding your experience, ask for a prescription for narcan. Even our local libraries carry some. Keep some in your bag. Speak out, see if there are groups in your area that you can support financially or otherwise. Reach out to the family that was involved. Addiction is often a genetic process. Finally, if you have your own kids, be aware that opioid addiction can happen...especially those with addiction tendencies. It can happen with as few as 12 pills.Best of luck. And again - thank you for all that you do!.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Its said that alcohol withdrawal can kill youHow can it kill you? That's insane!It can happen with as few as 12 pills.It's seriously that addictive? I was on codeine cough syrup for three months and I had no problem putting the bottle away when my cough was gone. Maybe it helped that I genuinely hated every single thing about it except for the cough relief.. ### Response: How can it kill you? That's insane!Since you don't appear to have gotten an answer. Two main ways. Alcohol withdrawal can cause seizures, which can be deadly, and alcohol withdrawal can cause something called delirium tremens. Delirium tremens is more of a form of withdrawal characterized by quick and varying changes in someones heart rate and blood pressure in such a way that it can kill (through irregular heart rate called arrhythmias) or a person can become unable to "protect their airway" so to speak and choke.Alcohol withdrawal isn't a pretty thing. BUT the good and bad news is that it varies a lot from person to person.https://emedicine.medscape.com/article/166032-overview.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I'm not a doctor so I can't say much on what happened but I went through something similar.An elderly man that walked past my house every day to go to church collapsed in front of my house. I have no idea how long he was there. But I heard a woman screaming for help so I went outside to look. He had no pulse. I gave him chest compressions until ambulance arrived but i knew he was already gone. I could hear air going in and out of his lungs from the chest compressions. I'll never forget that sound and how sad I felt doing it to him when I knew he was gone and feeling his ribs crack. This was 5+ years ago and I still remember it like it was yesterday. I still wonder if i had looked out my window sooner if he would have survived and wonder how long he was there before the woman saw him. I also remember how the fire fighters arrived first and stood around me and told me to keep going rather than take over. It was definitely traumatic.I feel so sorry for your neighbors family. So young and so much life ahead to live.Life really sucks sometimes.I will always remember the experience and it was hard to process at the time but it did get better as time went on.. ### Response: This probably doesnt really add anything, but I just want to reiterate, THANK YOU. You did something that is incredibly hard both physically and emotionally. You kept your cool and did what needed to be done, and what each of us hope that someone would do for us or our loved ones. The causes of suddenly death make a long list, and include things like congenital or acquired arrhythmias, vascular issues including aneurysm rupture or clot in the brain or lungs, and among many many others drug overdose which is sadly probably the leading cause in this age group these days. Im sorry that we cant really give you an answer here. As others have said, please seek help if you need it to process this event. Its a trauma and not something that many people have experienced. Remember that you did everything right, there is likely little that would have changed the outcome, and that you helped give his family a week to say goodbye..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: To respiratory physicians: is length of time of holding breath an indication of lung capacity?Im a 24M, light smoker, on no meds, weighing 71kg at 175cm.For a smoker who is hypersensitive to the effects of smoking on his body, I am often testing my lungs, usually while exercising (swimming), to see how long I am able to hold my breath. Am I making a false conclusion when I see that my ability to hold a longer/shorter breath correlates to better/worse lung health?Side note: Ive heard that lung capacity can only deteriorate, and is rather stubborn in improving, or all together impossible.. so what gives?Ps: if there is a better sub to ask this question, please do suggest it!. ### Response: The other comments here are correct that breath holding time is not an accurate reflection of total lung capacity (TLC).But to unpack your question a little further, TLC is just one of many variables important in lung health. Chronic lung disease from smoking is predominantly obstructive (COPD), which is measured by a decrease in the forced expiratory volume in 1 second (FEV1), often also expressed as a ratio to the forced vital capacity (FVC), or the total amount of air you can blow out at once.If anything, smokers tend to increase their total lung capacity as their disease progresses because they are trapping air, unable to blow it out..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Respiratory sinus arrhythmia or sinus pause ?? EKG (sorta) included20M, 52, 150lbs, hypothyroidism, anxiety disorder, depression, .5mg Xanax, 25mgc levothyroxine, 12.5mg metoprolol 2x dailyHi again !! So I have one of those at home 1-lead ekgs and whenever I do one and take a deep breath I notice my heart rate slows down and it looks like it skips a beat...... can anyone tell me what this is ?? I have a lot of anxiety around my heart and bought the ekg to monitor my heart rate and I know these things arent 100% accurate but this is worrying me. Sorry if this is asking a lot but im not seeing my cardiologist for a couple weeks so could someone tell me what this looks like ? https://imgur.com/gallery/wjuAjvy. ### Response: 100% normal - this is respiratory sinus arrhythmia. Stop checking..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Update to Previous Post Regarding Cough Up Blood After Workout. Results Were SurprisingAge: 31Sex: MHeight: 6'6"Weight: 250 AthleticRace: White/CaucasianDuration: 4 1/2 MonthsLocation: Lungs/Upper Respiratory, Upper G/ICurrent Diagnosis: Stage 4 Aggressive Gastro-Intestinal CancerCurrent Meds: Pain Killers, DiureticsAs needed Meds: Lidocaine Patches, Anti-Nausea, Melatonin sleep aidOriginal: https://www.reddit.com/r/AskDocs/comments/c2ls61/chronic_cough_and_now_coughing_up_blood_after/?utm_medium=android_app&utm_source=shareSo after spending some time at an Urgent Care, getting some scans lined up and trying to be patient, I woke up one morning to pain and compression over my chest. Urgent Care Docs had advised me that any escalation of symptoms should mean I go to the Emergency Room. Once there they almost immediately checked me into the ICU for observation and began running every test you could name. For the next 4/5 days I did just an unreal number of scans, 2 biopsies, and they drew enough blood to fill a small pool. Pain escalated daily while there so finding a solution was a running theme. So after a lot of trails here's what they found:Current: Stage 4 Aggressive Metastatic Gastrointestinal Cancer ( Adenocarcinoma )Previous: Disseminated Intravascular CoagulationAfter doing a Lymph Node & Bone Marrow Biopsy they found my marrow filled to capacity with dead cancer cells. This pointed them in the right direction. My platelets were crashing daily (20,000 at admission) and I've got inflamed lymph nodes throughout my chest cavity which is one source of my (significant and at time escalating) pain. Its infiltrated my lungs and several vertebrae along my spine (causing vertebrae to show signs of Osteopenia) . Weirdly enough there's no noticeable tumor/mass/lump they can trace it back to. It's kind of just spread throughout (described as Adenocarcinoma) , though they were finally able to locate a small ulcer in my stomach that allowed them to finally be able to classify it. I've currently just completed my 3rd (now weekly) round of chemo (we started asap when other options such as clinical trials were deemed a non-option) and we've been able to stabilize a number of things (blood factors such as platelets, hemoglobin and the like) along the way. Many of my blood counts are still in the trash so clinical trails are not currently an option. In early stages of my 3 weeks hospital visit I was in a state called **DIC (**Disseminated Intravascular Coagulation) which caused me to act like something akin to a blood squirt gun if i bled. Essentialy it screws with you clotting factors and any bleeding event is an issue. Any procedure became an issue and many my numbers were artifically raised in order to attempt anything that would cause me to bleed. Fortunately after a week of treatments and what felt like several wheel barrows of infusions we kicked my body out of D.I.C and am more or less clotting normally. Fun story: early one morning after the vampires took their daily does of my blood a CNA came in to do a routine vitals check. This particular morning they took 2 unique sets of blood samples plus a rather large sample for testing against infectious disease. This was also kind of at the height of my "he's not clotting" phase. During the blood pressure check it popped open all the fresh holes in my arm, causing them to bleed and freaked/surprised the CNA. Made me laugh. (end of story). Immunotherapy is what my Oncologist are banking on right now so crossing my fingers. Chemo is causing reasonable progress (numbers are low but stable) so we're staying the course for now. My personal mid->long term goal is to find an alternative to opiates for pain management (who the hell knows why a person tolerates opiates for a buzz cause constipation sucks!!!) so looking at alternatives (THC pills potentially or preferably resolving the issue that's causing me pain) I've been discharged from the hospital after 3 weeks so now I'm working to find a routine that works. Losing weight so a short term goal is stopping that (I'm rather tall and (was) muscular so my bodies nuking whatever calories I put in and I'm not putting in a lot due to general nausea, but smoothies have been my friend. Please let me know if you have any questions or advice.. I'll answer what I can and absorb what reasonable advice I read.. ### Response: Man, that was not high on my list of possibilities after your original description. Sorry to hear. Give it hell..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Fortunately I do, and they've been a tremendous help. Would have been very difficult without their aid. However , things have mellowed out enough, now that I've been discharged, that most everyone has been able to return to their routines, which is nice. Their support was invaluable but I was eager to get everyone back to their normal lives as well for their own sakes and health.. ### Response: Thanks for the update, OP, though I wish it were better news.I will leave this up for now as OP has a specific follow up question regarding pain and symptom management. However, if this thread becomes off topic (including an excess of well wishing in relation to actual advice being given), we will lock it.We all want OP to do well. Stay on topic so we don't bury good advice that may come forward..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: My significant other's health has sharply deteriorated and after months we have no idea what it is.Hello. My (24F) boyfriend, Paul (29M), and I are fairly active. We go on road trips every year with our main stops being prime hiking spots. Paul is 5'7'' and 230 pounds. Due to his southeast asian/pacific genetics, his entire family is on the heavier side, but Paul is just as active as I am and eats well.Recently, we have gone long distance. Paul returned to live with his parents due to the pandemic while I stayed where I was. I visited him in June 2021. At this point, Paul had few symptoms, but some new minor health issues. We went hiking around Lake Tahoe and Paul was a little more out of breath than usual. He hasn't needed to use his inhaler since he was a kid, and he had to use it on this trip. We attributed this to recent wildfires in the area and poor air quality.However, Paul's health continued to sharply deteriorate. We went to Edinburgh, Scotland, in July. While hiking Arthur's Seat, Paul had to use his inhaler so many times he emptied it out. He could not get it refilled as we were out of the country. Until the end of the trip, Paul's breathing became more and more labored and he developed a persistent cough.I did not visit Paul August-November 2021. We spoke on the phone and Skyped regularly. During this time, Paul would sometimes leave the call or mute for a few minutes. He'd come back and apologize, saying he'd had to cough pretty violently and didn't want me to hear. I was concerned. I overheard one wracking, moaning coughing session and knew it was not just asthma or an irritated throat. By October 2021, the air quality in his area had greatly improved.I persuaded Paul to visit his general practitioner. His GP dismissed all of his concerns and cited Paul's being fat and asthmatic as the source of his issues, and that the issues would disappear with rest and exercise. I had to fight doctors for years to get them to take my chronic pelvic pain seriously, and was finally diagnosed with an ovarian cyst that was 8mm long and about to burst, so I have experience with self advocacy in the medical space. I helped Paul see new doctors.In mid-October 2021, Paul developed abdominal edema. Paul's feet, legs, and lower stomach were swelling up like crazy. He gained 40 pounds. He could barely move at all, even to go to the bathroom. He couldn't sleep lying down without suffocating, which only worsened his exhaustion. He went to the doctor again and was prescribed diuretics. The diuretics helped with the swelling and extra weight and within 2 weeks he was back to his regular weight, but the coughing and weakness persisted.About a month after regularly taking diuretics (November), Paul started feeling intense nausea on a weekly basis. This nausea would prompt coughing fits. Paul couldn't eat or focus while nauseated. Our calls became more and more infrequent as Paul's nausea and headaches grew. He told me sometimes the nausea would get so bad that he would vomit. There were no patterns to the vomiting--it didn't happen at a certain time of day or after meals. Sometimes it was foamy. He got a CT scan to look at his gall bladder and all results were within normal ranges. Blood tests, including labs for liver function, all came back normal. His doctor referred him to a gastroenterologist for more testing, but due to increases in COVID-19 cases, they haven't even processed his file, let alone scheduled appointments, which would be months out. A nurse anticipated he wouldn't be able to go in until February 2022, but at his rate of decline, this has me concerned for his mental wellbeing and life quality.This week, in late December 2021, I visited him and his family for Christmas. I had heard from Paul about his issues and was following closely with his medical updates, but seeing it firsthand was another thing altogether. I have never seen human suffering and sickness like this up close or cared for another human being in such an intimate way.Every single day, he has intense coughing fits and bouts of nausea where he makes vocalizations and gags, usually every few hours. At least once a day, these coughing fits are so bad that he spends 5-30 minutes vomiting in the sink. The vomiting has increased drastically. After this, the nausea alleviates, but Paul feels exhausted and has migraines. He barely eats. He barely sleeps.Today, he had three different nausea/coughing bouts that induced vomiting. One developed rapidly and he threw up in a restaurant bathroom. The last one, which just happened this evening as of writing this post, also caught him by surprise, and he vomited in the kitchen sink. The vomiting was so physically taxing that his nose bled profusely and he lost control of his bowels and peed himself. He was not strong enough to make it down the hall to the bathroom. Eventually, I assisted him into the shower. I am writing this before bed, and he is still coughing, and has a migraine. He hasn't gotten up from where he sat after taking the shower.I would appreciate any medical advice about what might be causing what Paul is going through, as well as tips for how to navigate the medical system to ensure this gets treated in the best way possible. I would like to reiterate that while neither of us are marathon running body builders, Paul (before all of this) was physically active and monitored his eating habits. He was also mentally active and had returned to school to pursue a degree in a new field. We both have families that are reasonably well off and are good support systems.Paul is one tough puppy, and reassures me that it "isn't so bad," but after seeing it firsthand, I know this is not something that can continue the way it is. I am extremely worried, and caring for him is beginning to wear on me mentally. Sometimes I feel sympathy nausea when I hear the noises he makes in the bathroom.Please help in any way possible. I appreciate any and every tip, and can provide additional information if needed. Thank you very much.UPDATE 12/26:We went to the ER at 4 AM right after Christmas. Luckily, it was almost completely empty. I was not allowed to go back with him, so for the entire five hours I was sitting in the waiting room, I was only ever accompanied by one or two other people at a time.Paul's shortness of breath, fatigue, and wracking coughs got him seen quickly. He texted me updates as things progressed. He got every test I wrote down from these comments--BNP test, pulmonary work, chest x rays, GI work. An echocardigram is scheduled for next week.They found out right away that Paul's BNP results were seven times higher than usual. They said this was indicative of heart failure. They also tested Paul for COVID 19. He tested negative, but did test indicating he had some kind of viral illness.Paul's doctor concluded that he was suffering from chronic RSV that was made worse by poor genetics, asthma, and obesity. Paul did confirm he had what felt like a respiratory illness in Scotland in June, then after going to a wedding in October, then this week when he got severely ill and we found out his mother had a cold.There is no cure for RSV, but a vaccine has reached human trials. The only things Paul can do to alleviate his own suffering and avoid a heart attack is to make significant lifestyle changes and live like an immunocompromised person. I believe in his ability to achieve the former, but the latter is more difficult because of his emotionally overattached mother who brings the entire extended family out for lunches, movie nights, shopping, etc. several times a week. I'm concerned she won't take it seriously or will be in denial to avoid feeling responsible and will therefore continue to expose Paul to colds that could kill him.Paul is currently resting. He was given medication for his nausea and a new inhaler. He is doing better but still coughing. We have already started on his new food regimen. I am hoping for the best, but the pandemic has proved that people rarely take precautions for others' goodwill. Thank you for all your support. Paul might never have gone to the ER if I hadn't visited and reached out to this community.. ### Response: He needs to go to the emergency department. It sounds like he has some sort of heart failure causing the shortness of breath and swelling. The nausea and vomiting could be anything, though Id be concerned about electrolyte abnormalities or increased intracranial pressure. Heart failure can cause it too but not this severe Id imagineDont have a great answer tying them together thoughThis was pretty much exactly my thought process as well. Hard to tie all of these symptoms together until we start a work up, which should definitely include an Echocardiogram. Go to the emergency department to get started, then will probably need to stay in the hospital until a diagnosis and care plan is made, as well as symptomatic improvement..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: What about ruling out lung cancer? You dont have to be a smoker or old to get lung cancer and unfortunately Asian/Pacific islanders are at higher risk?. ### Response: Lung cancer is almost unheard of in your 20s. Also none of the symptoms other than cough fit.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Disclaimer: Not a doctor.With Paul's history of being active outdoors(I also wonder if he has any pets?), I also wonder if the hospital should be checking for Lyme Disease? Depending on his other symptoms not sure how high up it would be on the differential?I know that coughing is pretty rare in it, but from the sounds of it whatever he's had has been going on for a prolonged period of time, and it kind of sounds similar to this patients story, but also maybe not entirely?I guess it could be something for the OP to ask the doctor about that they're talking with.. ### Response: It is something I thought about though I dont know Lyme prevalence in the UK and more importantly Lyme is more associated with heart block than with heart failure. Something worth thinking about though.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: When you look at intracranial pressure, how does that affect how someone breathes?I know it makes you work harder to breathe but not why.. ### Response: Theres the Cushing reflex which makes you breathe shallower but Im not 100% sure the nausea/vomiting and breathing troubles are relatedGood lord this is a hospital visit.As a physician these symptoms would spark a large battery of tests in my primary care office, but it sounds late for that. He needs to try a hospital. Make sure he tells them exactly what you wrote here..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I dont mean to be rude with this question but I know as someone with chronic illnesses I am generally reluctant to go to the ED when they flare up because of the whole history of being told theres nothing doctors can do for me, or its just because Im fat, anxious, whatever. If hes been dismissed by doctors before what should he say now to make sure he actually gets the care he needs?. ### Response: Its always hard to say what another doctor saw or thought when someone got care. Miscommunication between providers and patients are extremely common with chronic illness. With flares of chronic illnesses there is often not much that can be done outside of the norm, and brief emergency care is frequently not enough to solve the flare but hospital care is frequently not indicated, which can make one feel very much dismissed.In this case, OPs BF has several huge red flags that suggest he should go to the emergency room for evaluation.Severe worsening nausea and headachesLoss of bowel/bladder controlProgressive coughing and shortness of breathFluid buildup requiring diuretics (this is VERY unusual and requires a significant evaluation that I dont see written about here).


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: How can we determine which ER around us is the best/most advanced? Paul's insurance is considered good (Kaiser Permanente) but his doctors barely listen to him, infrequently order tests, and weren't overly concerned/in emergency mode over the fluid buildup.. ### Response: If he is a Kaiser insured patient he will only be able to seek care at Kaiser facilities. This is a situation of the squeaky wheel getting the grease. He needs to go to the biggest Kaiser in the area and be on his doctors ass every single day until he gets help..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: There is a Kaiser ER near us. Hopefully they listen.. ### Response: Kaiser is generally a good system, but weird things can be harder to diagnose in the system because they are much more conservative in general with testing.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ideally it should be an academic / teaching hospital. They're more used to seeing unusual cases and thinking outside of the box.. ### Response: This will not be possible with Kaiser insurance, they will simply send him to a Kaiser hospital from the academic hospital ER, and he will get a large bill for it.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Im with Kaiser and Ive gone directly to the ER for an emergency by ambulance. I just paid my co pay.. ### Response: It can happen, but you cannot be admitted to a non-Kaiser hospital unless you are too unstable for transfer or the Kaiser is on diversion for some reason..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I agree. He should go straight to the most advanced ER/hospital local to him. A lot of things are probably going on.Once the more acute and scary things are sorted out I'd look into a sleep study to find out if he has sleep apnea since it can cause a cascade of serious problems.Also I do not mean to sound insensitive (and of course doing this is a very personal decision) but if obesity is a big problem for him he may want to consider weight loss surgery after he recovers from whatever is going on now. I was obese my entire life, once my health started failing I had gastric bypass surgery and I can't tell you how much it has helped me and probably saved my life.. ### Response: I agree he needs urgent evaluation with his worsening symptoms. The differential is broad for his various symptoms and will likely need cardiac, pulmonary and GI workup..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: The most important part is that - while you may have a list and such, an ER visit isnt going to find the exact diagnosis right there and perform all those tests at your request. The goal of this visit is going to be to assess for any acute abnormalities OR to get him admitted to an internal medicine team that can take the time to work these things out.. ### Response: Posts by unflaired users that claim or strongly imply legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: As the physicians here have responded, go to ERnow. And please update! Very curious to hear his outcomes. Best of luck to you. ### Response: Does he use drugs, specifically marijuana?Food allergies? It would be a bit drastic, and may not explain the swelling, but you can develop them at any time.A bit young for cancers, but maybe he is genetically predisposed, getting at least a CT scan with contrast of his abdomen would be good.This is concerning for his heart too, as mentioned.He needs quick workup, as mentioned. Worrisome is not eating and what his electrolytes are like.Not that being obese is the sole cause of his symptoms, but he should lose weight. Almost every physician you will run into will say this as it is important for his health, just as they would tell him to stop smoking if he was smoking..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: He doesn't use drugs and has no known food allergies. He was able to eat breakfast today, and so far it hasn't come back up, though he is coughing. I feel overwhelmed by these responses but appreciative. I'm worried about going to the ER because our area is having a huge COVID surge and hospitals are at capacity. Is it safe to wait? Where is best to go?. ### Response: As tough as it is right now, you might have to take him for emergency care. If he is coughing/vomiting so much that he loses control of bodily functions and is unable to eat and generally take care of himself, he should be seen sooner rather than later.Are the headaches coming before or just after the other symptoms? Bad migraines can present with nausea and vomiting, and sometimes neurological complaints, as well.It's hard to tell more without seeing full labs and imaging, again, pointing to getting some answers quicker by going to an ER..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: They were probably wondering if cannabis hypermesis syndrome could be contributing to ten vomiting. ### Response: Yes, cannabis hyperemesis syndrome, or cyclical vomiting syndrome, as mentioned. Usually people who have been smoking daily for while, 10-15 years, but can happen with less..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: [25m 175lb 61] Post-Concussion Respiratory IssueI suffered a mild to severe concussion on Dec 10th after flipping my car. Jan 13th I began to get sick. I mention this because I know it affects the immune system.So, 1/13; It started with a sore throat & a lump by my adams apple. For the first week It progressed to wheezing, headaches, extreme fatigue and as much mucus and snot that the body can produce. By Jan 22nd I felt better, but the mucus and sinus pressure was still there. Today is Jan 28th. The past 4 days Ive had mucus that began as lime green color the first two days, and the past 2 days (including today) has been the color of an egg yolk. I also coughed up blood a little while ago today. I have never had a sickness last me this long. Not even covid. Im concerned. What should I do?. ### Response: It sounds like you have an upper respiratory tract infection.It could be that your symptoms resolved and you got a second infection.It could be that you've got a bit of congestion or post nasal drip. You can treat this with a mucolytic agent that can help the body break down and clear the mucous.It could be that you've developed a bacterial infection that is taking longer to clear and may require some antibiotics.It is likely that these symptoms have nothing to do with your car accident.Given how long your symptoms have been going for, I'd suggest seeing your GP or PCP for further treatment options..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Undiagnosed respiratory illness.32M177cm77kgEuropean whiteI've had an ongoing illness with no diagnosis for 2 years. Main symptoms are respiratory; sore chest, flu-like symptoms, no energy, coughing up blood and mucous, shortness of breath, exhaustion at the slightest of exertion. Numb nose, inflammation all in nose.I've had a CT scan abdominal and there was nothing too abnormal. One thing stated was large lung volume, but no signs of COPD, fibrosis. I also did genetic test with Ancestry which stated I have a significantly increased risk (although stated it could be a mistake) for lung diseases. I would like to know is there any clinical significance to increased lung volumes with no other symptoms? It's just something I am curious of but can't find answers online, like is it a precursor to getting COPD or something. Can someone explain if it means anything?At this stage due to the CT abdo scan coming back mostly normal, I am beginning to suspect some sort of nasal infection, but I would like someone explain to me what increased lung volume could mean, so I can move forward and narrow down my illness and eliminate all other possibilities whilst also understanding what it means.. ### Response: There's honestly no real clinical significance to just noting large lung volumes..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: For 19 days, My wife has had fever and muscle soreness to where I have to help her stand up and get out of bed. She is convinced she is dying. Please help.We have been to the clinic twice since this started but since she has no respiratory problems they did not test for covid. She had a chest x-rayMe and our 1 year old are fine. Wife did not get the flu shot this year so we think it might be related but for 19 days seems outrageous.She has been prescribed antibiotics and tamiflu which she finished two days ago.She gets fevers around 2pm and closer to bed time around 9pm. They've been around 102 on average and peaking at 102.9 a few days ago.We're scared because this hasn't let up for 19 days. Are there side effects if your body stays at fever temperature for long periods of time?Is 19 days unheard of for the flu?? Is it likely something else?31 F 5'9 188 lbs. Caucasian.Taking Tylenol regularly to fight fever and achesUpdate: Wife is in hospital. Thank you for the help.I can't be with her yet. All of our normal sitters and family are either out of town, unavailable or also sick.They would not let us bring the baby in so I'm just home waiting for info. She is at least in good hands.. ### Response: She'd almost certainly have a headache though and I see no mention of that..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Headache can sometimes manifest as neck pain if its referred pain, I just wouldnt rule out.. ### Response: Right, but I've never heard of neck pain without headache. It's referred from the meninges so it'd be very strange to present like that. It's always possible but the likelihood is maybe < 1%? Additionally, symptoms typically start improving within 7-10 days.Any answer on the mono testing? If shes never had mono it can be pretty brutal. Comes with neck pain and fevers for sure..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: How severe is the neck pain? Look up Kernigs sign. Its a maneuver you can do to test for meningitis. Meningitis is the inflammation of the lining of the spinal cord and meninges in the brain. It can be caused by both virus or bacteria. Shed be positive if she has extreme pain and cant extend past 90. If thats positive, you need to call the doctor/ED. Also, meningitis can cause a pinpoint rash. If shes darker skinned, you could see it more easily on the palms and soles of the feet. Rashes May also appear with prolonged fever. You can do the tumbler test where you take a clear glass and press it against the rash. If redness goes away when pressed, then its negative. If you can see the rash still through the glass, then its positive. Its sounding more like Mono. If possible, see if the doctor can test. Mono needs to run its course, but it can have some complications. One of them in enlarged spleen, so no sports and if she has sudden upper left abdominal pain go straight to the ER. It also can cause liver issues, so watch out for jaundice which is yellowing if the skin. I hope she starts feeling better soon OP!. ### Response: I'd be careful about posting medical advice like you are without fact checking.Kernig's is actually a pretty bad test for meningitis. It has a sensitivity of only 5% and a PPV of 27%. That's pretty awful. I also wouldn't recommend for untrained people to test it on themselves or their loved ones.Not all types of meningitis causes a rash. I believe you're referring to meningococcemia. I think this diagnosis is extremely unlikely as she has been having symptoms for 19 days. She would be dead by now. Symptoms of meningococcemia progress very rapidly. Also, the tumbler test is also a pretty bad test and all it does it to be able to differentiate petechiae from other blanchable rashes. It's not specific to meningococcemia and can also just be done with a finger."Prolonged fever" do not cause rash. I am not sure what you are referring to here. Yes, a lot of diseases that can cause fever are also associated with rashes but it's not the fever itself that leads to a rash.I don't think Mono is likely here. While some of the symptoms would match, it would be unlikely to have persistent fevers for 19 days with simple mono.OP, I believe that at this point a visit to the hospital is warranted if your wife is as impaired as you are describing it..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: THIS. NAD but same symptoms I had and it was sepsis. I was also sent home from doctor/ER twice before they realized it. Need to have blood taken for dx (in my case anyway).. ### Response: Please read our rule on claiming credentials.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: I wouldnt worry about COVID right now. As your wife is probably septic and requires urgent care to live and prevent death.Spesis KillsSorry to sound blunt please update us. ### Response: This is your final warning on claiming credentials without verification..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ok. Can you please send me the information so I can send through my information. Kind regards Rachelle. Sorry I have never done this before.. ### Response: Posts by unflaired users that claim legitimacy by virtue of professional medical experience are not allowed.If you are a medical professional who wishes to become a verified contributor to this subreddit, please message the moderators with a link to a picture of your medical ID, student ID, diploma, or other form of verification. Imgur.com is convenient, but you can host anywhere. Please block out personal information, such as your name and picture. You must include your reddit username in the photo!We do not accept digital forms of identification..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Exactly. Ive seen a couple cases like this. Id still recommend for OP to have her checked in the ED. Would rather not miss another explanation such as underlying infection and like others have mentioned possibly sepsis. Id suspect an infectious source will need to be ruled out first as it can then be treated with antibiotics and is more lethal. If nothing is identified from labs/imaging maybe further pursue labs to rule out rheumatoid arthritis.. ### Response: This sounds like it could be mono. It's possible she's septic from various sources but I'd think they would have been ruled out by the clinic you went to.Has she been getting worse or does it seem like she was bad at first and has stayed at that level?What does she doe for work? Has she had any sick contacts?.


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Can the flu be misdiagnosed as an upper respiratory infection?M14Height: 5'3"Weight: 145 lbsRace: WhiteComplaint: Very flu like symptoms; fever, aching body, being hot cold hot cold, chills, dry cough, the whole nine yards. Doctor did 15 minute flu test (nose swab) that came back negative and prescribed an inhaler and cough syrup for an upper respiratory infection.Existing medical issues: None to my knowledgeCurrent medicine and doses: Prescribed Fluticasone nasal spray; 2 sprays in each nostril and Poly-tussin liquidSmoke? No but secondhand smoke from parentsDrink? NoRecreational Drugs? NoAny help is greatly appreciated. I am happy to answer any questions.tl;dr Flu symtoms, got diagnosed with upper respiratory infection. Doesn't sound right.. ### Response: Flu technically is an upper respiratory infection (in general, though it can cause lower respiratory infections). The false negative rates of the rapid flu swab are pretty low, so while it is theoretically possible, I would just assume that it's true that you do not have the flu. The flu is just one of many, many related illnesses that all act similarly. Our rapid nasal swabs only test for that one specific virus (influenza), but there are tons of other viruses that we cannot rapidly test for and which could cause similar symptoms. You could have parainfluenza, human metapneumovirus, RSV, etc.The treatment is the same for all of them, inhaler, cough syrup, Tylenol/ibuprofen/naproxen and time..


Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Ok. Thank you for answering! I do have a question though. How long should I stay out of school? I was planning to not go tomorrow, and have a doctors excuse to go back on the 5th. Is that good or should I stay out longer. A lot of kids have influenza but go anyway and the school won't shut down to prevent infections. On a sort of related note, I had RSV as a baby and have had bad lung function ever since I can remember.. ### Response: Just stay out of school until you're feeling better. The 5th sounds reasonable to return. Ideally people would not be in school when they're sick, but the reality is if you're in school you're going to get sick in the winter. Lots of babies have RSV, I don't know that it predisposes you to having it more as a teenager..