[BoneCollector]

Originally Posted by nik0502

Hi Bone Collector,

I just have the recent X Rays with me. Old ones are lying home. Have attached the same.

Hi, your father had suffered an injury called Floating Knee wherein the femur and tibia are fractured on the same side. In such cases, there almost always a delay in union of bones. Moreover the tibia has segmental fracture so that also delays union quite a bit. However I am not happy with the fixation of both the bones. As per the x-rays, the femoral nail is bent in middle and thats not good. The tibia is also not looking good. I'll suggest you to consult somewhere else also. But one thing that I would like to mention is that treating Doctor will always have a better idea of the injury and healing than anyone commenting on the x-ray. Nevertheless, I feel you should get a second opinion. If any help is required, ask me, I'll PM my number. My location is not Delhi so can only suggest.

[GrammarNazi]

Hi,
My dad felt his vision has reduced and got his eye tested.

The doctor has asked us to immediately consult a Retinopathy specialist.

Dad is a diabetic since 18 years and ideally his blood sugar is abit high (190 fasting, 260 after food), although he's been trying to keep it under control.

Any advice would be helpful.

Rgds

[slicvic]

Originally Posted by GrammarNazi

Hi,
My dad felt his vision has reduced and got his eye tested.

The doctor has asked us to immediately consult a Retinopathy specialist.

There's not much information in the case notes given, Please get the next opinion soon, the sooner Retinal problems are treated, better is the result.

Regards

[driverace]

Frequent Sore throats.

Triggers:

Most often, I have observed when I have some sugary drink (cold coffee/iced tea/cold water), this is triggered.
It's not like I never have the above mentioned trigger items!
Though - As a norm, I try to keep away from cold drinks / cold water - I don't see a trigger every time I have the above items.

Symptoms:
Day 1 : Slight throat irritation OR Cold like symptoms OR feels chilly
Day 2 : Throat irritation worsens, mild throat pain in the evening, Manageable Cold + Cough + Phlegm
Day 3-5 : Sore throat to the point, that I can't talk without coughing, throat pain, Cold/Cough worsens as day goes by bearable after an hour of waking up in morning - okayish till noon - worsens a lot by evening to night.
Day 6 : Severe throat soreness, pain, cold.

I try to go to the doctor by Day 2 or Day 3, still I have to go through this cycle of 1~2 weeks of throat problem every 3-4 months! :(

I have tried everything (almost) right after I see the Day 1 symptoms - like
warm water,
saline water gargles,
honey, ginger etc.

Still, Once Day 1 symptoms set in - there is no turning back on this.

In fact, I feel like, body "is getting used to" saline water/ warm water / other treatments -
and throat still worsens.


Diagnosis:
Sometimes, the doctors diagnose - Laryngitis, sometimes Pharyngitis, but mostly throat infection, couple of times (recently) it has been with ear irritation too.

Dosage:
Mostly I get single Antibiotics ( 1 week course ) + Cough syrups.
Twice (in past 4 years or so) I have been given Broad spectrum antibiotics.

Extra information:
I don't smoke/drink.
Junk food - once/twice(max) a month.
Allergic to dust ( get sneezes on sudden exposure to dust )
On most days (particularly in humid climates) I have a choked nose on waking up OR by night time. It usually clears up during the day.

--


I would appreciate if someone can shed some light on why this throat_soreness_infection is surfacing so frequently since last 3-4 years.
Is there anything I can do about this?
I have tried asking local doctors - but, haven't received any proper answer to these questions.

Ace.

[GrammarNazi]

Originally Posted by slicvic

There's not much information in the case notes given, Please get the next opinion soon, the sooner Retinal problems are treated, better is the result.

Regards

Thanks for the reply, got an OCT test done.

Apparently the normally the thickness of Retina in the center is ~150 Microns, but it has swelled :

Pic :


Left Eye Retinal is grossly swollen, the thickness at the center is ~600 Microns
Right Eye Retina also has swelling, the thickness is ~400Microns

In the pic below, the yellow dots within the eyeball, is the swelling.



The Doc has prescribed 'Lucentis' injections for the eye, and that multiple injections over a period of time would be required. Ideally it is administered once a month. And dad could need them 5 to 6 times, possibly even more.

As personal Insurance doesn't cover this procedure, another low-cost "Off-Label" treatment they offered was with 'Avastin', (administered similarly as Lucentis).

I'm reading around online to research abit. Any thoughts/advice would be appreciated.

First is to bring & keep Blood Sugar at extremely controlled normal levels. He's on Insulin (Human Mixtard), and his FBS was 170mgs/dl and PPBS was 340mgs/dl (even after 20units of insulin + exercise & ragi-ball as breakfast). So, we're planning to consult a diabetologist ASAP too.

[slicvic]

Originally Posted by GrammarNazi

Thanks for the reply, got an OCT test done.

The Doc has prescribed 'Lucentis' injections for the eye, and that multiple injections over a period of time would be required. Ideally it is administered once a month. And dad could need them 5 to 6 times, possibly even more.

He does indeed require the said injections, double check with your Insurance provider, half of them do pay for it. Check your policy whether it is excluded. If it is not mentioned they cannot reject it.

Avastin is a good option too at almost one third the price of Lucentis. He might require Laser treatment to the retina once the swelling decreases.

[GrammarNazi]

Originally Posted by slicvic

He does indeed require the said injections, double check with your Insurance provider, half of them do pay for it. Check your policy whether it is excluded. If it is not mentioned they cannot reject it.

Avastin is a good option too at almost one third the price of Lucentis. He might require Laser treatment to the retina once the swelling decreases.

Thanks for the reply,

Turns out the insurance has lapsed. Anyway, we've decided to choose Lucentis atleast for the first 3/4 times, then on after the laser treatment, we'll use Avastin with every alternate injection.

We're closely monitoring the blood sugar and to keep it under control he's following a strict diet & slowly increasing exercise. Lets see.

Thanks again,
Regards

[Gannu_1]

Originally Posted by Gannu_1

I'm fixing an appointment to the nearby dentist next week.

Update!

We went to the dentist yesterday evening and he had a good look at all the 31 teeth when I had approached him with a problem of just one. He instantly advised me to undergo root canal treatment for the tooth having the cavity. I got severely depressed the moment I heard that! He went on, suggesting filling for 3-4 other teeth and cleaning for a whole lot of others. There is one molar tooth in my lower jaw which has an amalgam filling done way back in the ‘90s. He suggested that this filling is quite old and there are chances food particles get stuck in this tooth as well so he suggested drilling/grinding the amalgam out and there is a 50-50 chance that root canal be done for this tooth as well. Then he went on to explain the treatment with the help of some movie clips on his desktop PC and finally the rates of the treatment and the several types of caps available. I asked him multiple times if a filling could be done to avert RCT for the time being and he denied it. I asked him if anesthesia is administered during the treatment and he said, ”If you experience pain, we will give you anesthesia.” We left the clinic after that. There were no patients and the receptionist was whiling away time browsing Facebook in the PC.

Well, turns out he’s a newbie, graduated in 2010 and has about 4 years of experience in this field. We were sure, we did not want to get the treatment done from him and decided to take a second opinion from another dentist. There was one dentist who had his clinic located very close to my apartment so we decided to go to him.

Approached him, he inspected the tooth in question and suggested, “Not to worry much. We will get it treated.” With a lump in my throat, I asked him, ”You mean a root canal? He said, “Oh no! That’s the last step. Let’s get a permanent filling done first and if you experience pain later on, we will have to see if the pulp of the tooth is affected, and if yes, then we may have to get a root canal done. I breathed a HUGE sigh of relief!

We decided to go ahead with a permanent filling and he was interacting with me all the time explaining the different tools used, the dental engine he uses, the handpiece with the diamond tip that rotates as high as 2 lakh rpm, dental tourism scene in the country, 3M’s fillings and materials used, the tattoo on his arm and what not! He is precisely the kind of dentist I was looking for and came across as a godsent! He made me feel extremely comfortable at all times. His assistant who is also the receptionist helped with sucking all the saliva/water from the mouth and helping him with the tools. A friendly young woman always smiling. Paid Rs. 1500 to fill 3 teeth and he asked me to approach him if I experience any sensitivity issues while having ice creams or such, advised me to do a checkup once in 6 months and brushing after the dinner. Before we left the clinic, I asked him if anything has to be done for the tooth with the amalgam filling, he said that filling is one of the strongest fillings compared to the ceramic ones which usually degrade over time and nothing has to be done about it for now.

This man had 10 years of experience and there were a bunch of patients waiting outside the clinic after we left.



In the meantime, father had a checkup at the hometown for an increased count of PSA (prostrate specific antigen) which was reported during the 3-month checkup before. Previously, when the checkup was done during August the level stood at 17.2 ng/ml shocking all of us. The level is usually 4 ng/ml for adults above 50 years of age and if it exceeds this count, prostrate cancer is a possibility. Luckily, the count has now reduced to 7.6 ng/ml and had it been cancerous, this count wouldn't have come down the doctor suggests. Removal of the prostrate gland is a major surgery and the doc advised against it for the time being. Felt a lot relieved!

[Thad E Ginathom]

Gannu, that's great

Your first guy sounds like he qualified in marketing, with dentistry as a second subject

A while back, in London, I was talking to my dentist about the horrific experiences I had, as a child in the 1950s, where no anaesthesia was given for fillings (and the drills were uncooled, slow-speed things). He told me, "Actually there are still dentists that don't give local anaesthesia for fillings: I think that is inhuman!"

[slicvic]

Originally Posted by GrammarNazi

Anyway, we've decided to choose Lucentis atleast for the first 3/4 times

By the looks of the scan that should be enough he might not require more than three injections. (But that's my opinion only by seeing the scan and without seeing the patient)

Onset of such Retinopathy also means that there can be other systems affected, for example his kidneys. He needs to be seen by his physician too.

[Soumyajit9]

Originally Posted by Gannu_1

Update! ..... We decided to go ahead with a permanent filling and he was interacting with me all the time explaining the different tools used, the dental engine he uses, the handpiece with the diamond tip that rotates as high as 2 lakh rpm, dental tourism scene in the country, 3M’s fillings and materials used, the tattoo on his arm and what not!

That is the experience of handling a patient, not selling a patient.
I am happy that you got away with just fillings.

Makes me wonder and worry now, whether the extraction I got done, was actually neccessary or not. Anyways, it was a wisdom tooth, so I care less. The clinic guys call me every week saying you have an appointment with so-and-so doctor for RCT, while I have never booked any appointment with them. Makes me worried whether the RCT stuff is actually needed for me, or I can get away with just fillings.
Have to go for a 3rd opinion now.

[pyrodrive]

Originally Posted by driverace

Frequent Sore throats.

Triggers:


I would appreciate if someone can shed some light on why this throat_soreness_infection is surfacing so frequently since last 3-4 years.
Is there anything I can do about this?
I have tried asking local doctors - but, haven't received any proper answer to these questions.

Ace.

You may be having a predominantly allergic condition. Drugs like montelukast or seratodast may be tried. Talk about that to your treating physician.

[driverace]

Originally Posted by pyrodrive

You may be having a predominantly allergic condition. Drugs like montelukast or seratodast may be tried. Talk about that to your treating physician.

Thank you, pyrodrive- for your time & help!

Could you please help me understand a little more about this.
Does this condition develop suddenly. (since past 3-4 years - I am observing this)
Is there any good long term remedy I can practice, so the recurrence stops?

Thanks again.
Appreciate it.

Ace.

[DieselFan]

@Ace - Sore throat typically is a symptom of an underlying problem of immunity. Instead of taking loads of medication my suggestion is to build immunity - healthy balanced diet, good exercise (With cardio of at least 30 min) 3-5 times a week and good night's sleep (At least 8 hrs a day) will result in increased immunity. I have achieved this and my sore throat problem (Which was pretty regular till about 3 years back ) has now disappeared.

[JustStarted]

Hi

my baby is 18 month old and in day or two we will go for vaccination, earlier for dtp pentaxim was given which is no longer available (banned ?), so i am confused for what to opt for booster dose pentavac vs QUADRAVAC (with POLIOVAC) ?

Thanks,