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I went to ER, strep test was negative but doctor said it must be strep?

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Question:

I am 21-year-old female. I am pretty healthy and have an average weight. I had a sore throat for two days and it is extremely hard to swallow due to swelling to the point I can barely eat solid food. It is not scratchy, and I do not have a cough or fever.

I went to the urgent care, strep was negative but the doctor said it must be strep and would not listen to any of my symptoms. He spent about 30 seconds with me and is treating me with Biaxin. Pain is killing me, and my stomach is having a hard time with these antibiotics even with food. I am attaching a photo.

Answer:

From the picture we received, you seem to be suffering from acute follicular tonsillitis. Usually, this is caused by strep, other bacteria responsible for this condition are Hemophilus and Moraxella. A course of antibiotic at this stage helps in early recovery. As you have been started on macrolide antibiotic, I believe it is the best course of action at this stage – you need to follow the whole course for it to be effective.

Antibiotics are known to cause gastric upset, which usually disappears once the course stops. If this is too difficult to endure ask your Doctor for  Zantac (Ranitidine) 150 mg and take before food twice daily and use warm salt water gargles at least three times a day. If situation continues, please follow up with your Doctor after seven days.

Regards,

I hit my head on a wall.

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Question: I hit my head on a wall. I am feeling pressing sensations in my left temple. Just recently I feel much smaller sensations in my right temple. Not painful just pressing. What is going on?

Answer: A blow such as the one you have received may have no consequences whatsoever. Using pain relief medication such as Acetaminophen (Tylenol) may help with the pain. Please avoid using ibuprofen (advil) for such an injury. You will need to consult if you have subsequent symptoms. Immediate medical attention is required if you experience symptoms such as bruising behind the ears or around the eyes (raccoon eyes). These can potentially indicate a severe or life-threatening injury. If you experience these symptoms, a CT scan will be required to further evaluate the situation. Sometimes a blow to the head may produce a concussion. These are difficult to diagnose. And the consequences vary. Most concussions or mild traumatic brain injuries (MTBI) symptoms will go away without treatment. So please continue to monitor your situation and should symptoms worsen please consult for more investigation.

Additional Information:

Head injury can be either closed or open (penetrating).

  • A closed head injury means you received a hard blow to the head from striking an object, but the object did not break the skull.
  • An open, or penetrating, head injury means you were hit with an object that broke the skull and entered the brain. This is more likely to happen when you move at high speed, such as going through the windshield during a car accident. It can also happen from a gunshot to the head.

Head injuries include:

  • Concussion, in which the brain is shaken, is the most common type of traumatic brain injury.
  • Scalp wounds.
  • Skull fractures.

Head injuries may cause bleeding:

  • In the brain tissue
  • In the layers that surround the brain

Common causes of head injury include:

  • Accidents at home, work, outdoors, or while playing sports
  • Falls
  • Physical assault
  • Traffic accidents

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.

Will a person suffering from Crohn’s disease be more pre disposed to get MND?

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Question:

Hi I have become paranoid that my boyfriend is going to develop MND at some point In his life and it’s not that rare and I think because he has crohn’s disease that it will make him more pre disposed to get MND. But if he has a disease already will it make it less likely to happen?

Answer:

There is no reason to believe that because your boyfriend has Crohn’s disease that there is necessarily a greater chance of developing MND. There is a 1 in 300 risk of getting MND across a lifetime. It can affect adults of any age, but is more likely to affect people over 50. MND often begins with weakness of the muscles in the hands, feet or voice, although it can start in different areas of the body and progress in different ways. It is in hereditary in about 10% of the cases as far as the remaining 90% due to a number of factors including auto immune response issues, exposure to viruses, toxins and ageing of motor neurons. Unless there are existing symptoms which may lead you to believe your boyfriend may suffer from MND, I would not focus on that and stop thinking about it.

Here are some additional factors for your information:

The physical effects of motor neurone disease can include:

  • muscle aches, cramps, twitching
  • clumsiness, stumbling
  • weakness or changes in hands, arms, legs and voice
  • slurred speech, swallowing or chewing difficulty
  • fatigue
  • muscle wasting, weight loss
  • emotional excess – for example, where a slight upset can cause an exaggerated response, such as crying or laughing
  • cognitive change (changes in thought processes)
  • respiratory changes.

Doctors often find it difficult to diagnose MND in the early stages as it can resemble other conditions, such as mutiple sclerosis  (MS). If a doctor suspects someone has MND, they will refer them to a neurologist, who will take a medical history, do a thorough examination, and may suggest other tests, such as:

1. Blood and urine tests: These can help a doctor rule out other conditions and detect any rise in creatinine kinase, a substance that muscles produce when they break down.

2. MRI brain scan: An MRI cannot detect an MND, but it can help rule out other conditions, such as stroke , brain tumour, or unusual brain structures.

3. Electromyography (EMG) and nerve conduction study (NCS): An EMG tests the amount of electrical activity within muscles, while a NCS tests the speed at which electricity moves through muscles.

4. Spinal tap, or lumbar puncture: A doctor will look for changes in the cerebrospinal fluid, which surrounds the brain and spinal cord. It can help rule out other conditions.

5. Muscle biopsy: This can help detect or rule out a muscle disease.

The doctor will normally monitor the individual for some time after the tests before confirming that they have MND.

Dr. Javez Ernesto

I suffer from extreme blood pressure problems, how can I get my BP down?

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I suffer from extreme blood pressure problems. I now have 198 over 72 but cannot get it down. I went to an ER and there they gave me a Nitroglycerin patch which helped reduce it to 180. Doctor prescribed Coversyl 5 – 2.5 but it doesn’t seem to work. I have had heart surgery with valve.

Male
Age: 52
Medications: Coversyl, Coumadin

I have spinal stenosis, bulging discs and was recently diagnosed with fibromyalgia?

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I have spinal stenosis, bulging discs and was recently diagnosed with fibromyalgia. I take Ibuprofen 800mg 3x a day; Gabapenting 600mg 3x a day, lidocaine patched 2-3 every 12 hours. Nothing seems to help. I don’t see my pain doctor until 9/6. Shoud I go to the ER? I am in so much pain that it took my 45 minutes to get dressed this morningl

Age: 48
Female
Medications: Ibuprofen, gabapentin, lidocaine patchs

I have had this mark on my toe for several months now?

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I have had this mark on my toe for several months now.
I haven’t had an injury etc…
. Now getting worried as it has not show any signs of healing.
Do I need to have it look at please?

Info: Leukonychia is a condition where white lines or dots appear on your finger or toenails. This is a very common issue and entirely harmless