[FrozeninTime]

Originally Posted by INJAXN

My question: Was CT scan necessary/ or is he just being looted?

I would say sign of the times we are living in. Doctor practices defensive medicine and patient under influence media looks at every investigation doctor prescribes with suspicion.

[HydroFuel]

Originally Posted by INJAXN

A friend ( 31 Yrs - Male) has throat infection for 2 and a half weeks now.
doctor has now given some medication and asked to wait for a week and see if coughing persists.
He has no other complains except for coughing.

Similar situation with me. Coughing mostly dry started just before Diwali. Since first time it lasted for more than 5 days I visited my family doctor. Though just BAMS doctor know all my history, first gave allergic medicine. I also get mild dust allergy of sneezing temperorily. But even then coughing persisted. So other antibiotic medicine was given. But still coughing persisted.
I also had Gas Reflux at night one year back due to night duty and inconsistent eating due to it and after treatment by ENT and GI specialist it stopped. Endoscopy was also conducted which did not reveal anything other than acidity in stomach. Now I am only on Rabeprazole i.e. Razo in the morning for last 6 months. But that possibility is also ruled out as there is no pattern of coughing and not at night after sleeping.
I am also advised chest xray and blood check CSR Cbc.
I am going to do that in couple of days.
What can be possible cause?

[gkveda]

Originally Posted by INJAXN

A friend ( 31 Yrs - Male) has throat infection for 2 and a half weeks now.
He visited a doctor, chest X-ray was done and based on that HRCT( Thorax ) was suggested.
So obviously he got freaked out and called me. Since the doctor he visited is an MD, we decided to go for CT Scan.

Following is report snippet:
Few Prominent subcarnial and right para tracheal lyphs nodes are noted, larget measuring 11x6 mm in right paratracheal region. No Obvious e/o nercrosis / classification seen within lymph nodes. - likely of reactive etiology.

doctor has now given some medication and asked to wait for a week and see if coughing persists.

My question: Was CT scan necessary/ or is he just being looted?
He has no other complains except for coughing.

My suggestion is to get his sugar level tested through physician. I was also identified with diabetes through the same symptom. Cough never stopped (Basically, infections do not cure quickly if sugar levels are high).

I got all tests done and finally, a physician did blood sugar test and started medication for sugar level control. Once it came under control, cough also vanished with normal throat infection antibiotics

[hema4saran]

Can someone please provide your opinions on my case here? I had history of 3 seizures in the past 3 years.

Seizure 1: It happened in March 2015 in Chennai at my home after dinner. I was blacked out and my parents said that I had stiff hands and legs for few mins. Consulted the neurologist immediately and was told to take Eptoin 3 tablets per day. EEG, CT and MRI all came out normal. I travelled to US immediately in the month of April and took the tablet for first 2 months and left it as such as I got busy with my work schedule .

Seizure 2: It happened here in US in July last year. Again after dinner and my wife took me to emergency. I was blacked out and again stiff hands and legs. I consulted neurologist in the next week. Again EEG, MRI and CT all came out normal. The doctor advised me to take Keppra XR 500 mg once day. I have been taking it continuosly since then for more than a year. As per the Texas rule, I was not supposed to drive for 3 months and I worked from home for the entire 3 months and continued my routine activities after that.

Seizure 3: Again happened in September this year. Same routine. After dinner, but this time I was aware that I am gonna black out and told my wife not to panic and call my friend for help. Again EEG and CT came out normal. But MRI told the below things.

1. No Acute intracranial abnormality or interval adverse change.
2. Mild paranesal sinuses.
3. Small focus of extra-axial enhancement, overlying the right frontoparietal lobe (Approximately 3.7mm). Likely a small meningioma.

But my neurologist was very sure that this meningioma is not the case for my seizure as it is very very small and negligible in images. He increased my dosage of Keppra XR to 1000mg per day. I don't have any other symptoms related to meningioma like headache, no blurriness in vision, memory loss etc.

I am again working from home for the past two months without any driving. Since my current work place is 25 miles away from my home, I am planning to switch my project which is very close to my home to avoid the commuting distance.

The doctor told me to continue my daily activities after mid of next month. My blood sugar levels, pressure levels all came out normal. I am planning to consult another neurologist when I visit Chennai next time.

I had done lot of overnight drives here in US in the last couple of years. Me and my friend even covered around 1300 miles when I moved from Charlotte to Dallas last year. But now I am trying to avoid all these and planning to keep all the driving in day times.

Is this something related to the sudden change in blood sugar levels after my dinner? I don't have any issues with my sleep. I am having a sound sleep for 6 to 7 hours in the night. I am not a smoker and only consumed a little alcohol occasionally during friends gathering. Even my work is not hectic for the past one year. So no work tension. I am kind of person who takes things very lightly and just move on with life from any type of issue.

Even now I have a strong feeling that I can easily overcome this with the help of medicine. So if any of our doctors can provide a opinion about my case it would be helpful.

[ascertain]

You have indeed presented an extremely unusual dilemma.

Ok- I'd like to ask a few things , and hope you will have the facts ready.

1) Did you have any seizures during childhood/adolescence? - ask your parents- they might remember.
2) Family history of seizure disorders?
3) Any other medications you are taking?
4) Were an ECG & Carotid doppler done at your hospital?
5) Do you consume a lot of coffee/ chocolates?
6) Do you remember what you were eating during the times you fainted?

Your CT report might have additional information - it'd be great if you could scan it for reference.

There are many possibilities - no denying that.
There are seizures which are precipitated by some types of foods.. but in most of thes cases there would be a preceding history of seizures/ headaches etc.
There is also a rare entity called ' Eating epilepsy'

Do send across the information, and I hope I can offer you some help.

[carboy]

How often must the tetanus injection be taken?

[Chetan_Rao]

Originally Posted by carboy

How often must the tetanus injection be taken?

Conventional medical wisdom says a booster shot every 10 years (US CDC recommends the same in their vaccine schedule).

Most docs would give an extra booster for a bad injury, like when I had a bad burn from a bike exhaust a couple years ago, even though my regular booster was taken only a year or so prior.

[JMaruru]

How about the hepatitis vaccine? We have taken 3 doses of it on day 1, month 1 and the final dose at the end of 6 months in 2016.

Does it need to be repeated in any intervals OR is it once in lifetime?
Please advise!

[Chetan_Rao]

Originally Posted by JMaruru

How about the hepatitis vaccine? We have taken 3 doses of it on day 1, month 1 and the final dose at the end of 6 months in 2016.

Does it need to be repeated in any intervals OR is it once in lifetime?
Please advise!

Immunity may vary by person (it's never absolute), but 3-dose immunization is meant to provide long-term immunity. The 3rd dose given usually at the 6-month mark is what theoretically provides long-term protection (upto 20 years or more according to CDC documentation).

Here's what the CDC FAQ says about taking booster shots:

Are booster doses of Hepatitis B vaccine necessary?
It depends. A “booster” dose of Hepatitis B vaccine is a dose that increases or extends the effectiveness of the vaccine. Booster doses are recommended only for hemodialysis patients and can be considered for other people with a weakened immune system. Booster doses are not recommended for persons with normal immune status who have been fully vaccinated.

[aadya]

Originally Posted by carboy

How often must the tetanus injection be taken?

Tetanus vaccine(Toxoid) should be taken as two doses at one month interval and followed by a booster after by 12 months and then one booster every 10 years.

If we have completed the childhood vaccination in proper schdule DPT X 3, DT at 5 years and TT at 12 years then one booster every ten years would suffice.

If we are not sure of the vaccine status, a minimum of two doses at one month interval is good enough. A Single dose vaccine without knowledge of previous vaccination status does not have any use.

Originally Posted by Chetan_Rao

Immunity may vary by person (it's never absolute), but 3-dose immunization is meant to provide long-term immunity. The 3rd dose given usually at the 6-month mark is what theoretically provides long-term protection (upto 20 years or more according to CDC documentation).

Here's what the CDC FAQ says about taking booster shots:

A three dose vaccine at the given interval is sufficient to give immunity for 20 years. Repeat if necessary after twenty years(can check the status by blood/serum antibody test).

[Rajeevraj]

Need help/inputs from experts regarding a shoulder issue. Been carrying a potential tear for a very very long time. Initial diagnosis was mostly inconclusive and since it did not impact my day to day activities, left it as is. A year or so back happened to visit a specialist and had another MRI taken. Based on that he said there is a clear tear and recommended surgery at a time that would be convenient for me. Since it was not urgent, I let it slide again for some time. Other than being unable to play sports like tennis, badminton, cricket (anything which requires sudden action from the shoulder) regular activities are all still fine.

In 2018 thinking I should do something about it one way or the other. Doctor indicated 3 weeks of arm in sling and then few weeks of physiotherapy. Hence thought to post here to check if any of the experts have any thoughts. I am not sure if an MRI image online can be reviewed appropriately, but putting it here anyway.

[condor]

Originally Posted by carboy

How often must the tetanus injection be taken?

I have done a 0-60-180 course. Doc said this is good for 5 years.

2nd shot 60 days after the first, and 3rd one @ 180 days after the first.

[wildsdi5530]

Originally Posted by Rajeevraj

In 2018 thinking I should do something about it one way or the other.

The MRI images are not clear. But looking at the report, my first suggestion will be to do a proper shoulder rehabilitation first. Then you reassess your deficiency and proceed to surgery if you still need it. @SwarnaraniClinic

[CornerCarver]

Hi All, I am a Consultant Pathologist. Great to see such a thread existing for Doctors/medical professionals here on TeamBHP. This gives me much more liberty to be on my favorite site.

[Mortis]

Is there any good solution for chronic Dry Itchy Eyes ? Doctor has prescribed daily intake of Omega 3, Lubricating drops, Drops for itching and regular fomentation. Its not really helped much. My tears do not contain enough sebum to retain moisture for long. Eyestrain is definitely there due to usage of PC and mobile phone which is made worse by the dryness. Also travel and work in a dusty environment so eyes are a bit itchy most days. Really looking for a good long term solution.