Doctors of VN

#526
#526
gordonr24 said:
I need answers. I’ve been running a low grade fever for a week now. It’s been hovering around 100 degrees, not much higher. I do not have other symptoms such as nasuea, rashes, swollen lymph nodes, sore throat, no pain urinating, no weight loss or weight gain, no loss of appetite, no runny or stuffy nose, or diarrhea. I only have symptoms that would be associated with fever but they are minor.

Any ideas? I’ve been searching. Maybe unknown origin?
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Sounds like Big Orange Fever.
 
#527
#527
That's very nonspecific symptoms... Most likely a viral illness, but if it doesn't resolve shortly, best to see your doc.

Quick notes: "fever" = temp greater than or equal to 100.4. High 99s/100.0 is actually in the normal range. There is absolutely no reason to treat fever with medication unless it helps with discomfort, as your body actually increases temperature purposefully to improve function of the immune system. Also, alternating acetaminophen and ibuprofen is no longer recommended.
 
#528
#528
kiddiedoc said:
That's very nonspecific symptoms... Most likely a viral illness, but if it doesn't resolve shortly, best to see your doc.

Quick notes: "fever" = temp greater than or equal to 100.4. High 99s/100.0 is actually in the normal range. There is absolutely no reason to treat fever with medication unless it helps with discomfort, as your body actually increases temperature purposefully to improve function of the immune system. Also, alternating acetaminophen and ibuprofen is no longer recommended.
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A for real question, my normal temp is usually a little lower (in the 97’s). When I get to 100 I usually am feeling pretty crummy. Is that normal in someone who typically runs a little on the lower than 98.6 side?
 
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#529
#529
GAVol said:
I've got one. Let's say somebody literally took a 2x4 to the face, got busted open, clear CT, but diagnosed with a concussion last Saturday. What's the typical amount of time for post concussion symptoms to clear (fatigue, lightheaded, headaches)?

Asking for a friend that has a headache a week later.
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The wife finally had enough of your tom foolery eh?
 
#530
#530
Something bit me on the arm a couple of years ago while raking leaves .... I had a red ring appear that night and it itched nonstop.... like no other itching I've ever experienced...the area around the bite was swollen and hard to the touch.... I kept it clean and circled the red ring to monitor its growth but it didn't get any bigger.... there wasn't an ulcer at the bite mark either....however... a couple of days after the bite appeared .... my neck was so stiff I could hardly turn my head and it also felt hard..... it freaked me out
 
#533
#533
About to give travel nursing a shot. Headed to Rochester NH for 13 weeks here in about a month.
 
#534
#534
My feet and ankles swelled up a couple of days ago. I had been off work for about a week and went back Wednesday and worked 8+ hours each day thru Saturday. We were painting inside a house and my work shoes had blown out, so I wore sliders/flip-flop like shoes with new ankle socks that were really too tight. I had to do some painting on a ladder and go up and down stairs multiple times during the days I worked. I have bad ankles because of basketball, but I have no pain like I sprained my ankle or something. I'm 47, 6'3 , 275 pounds and heavier than I've ever been in my life. My Grandfather had diabetes, but nobody else in my family has it that I know of. Tomorrow will be the 4th day of swelling and I had Sunday off but worked today/Monday. The swelling seems about the same around the ankles but seems to be increasing on my feet. The swelling also seems to be the same on both feet and ankles. Although I have some minor swelling earlier this summer it always seemed to go away the next day. There is some minor numbness but very little pain. This is a first and is freaking me out. I have to work again tomorrow but any advice would be greatly appreciated.
 
#535
#535
The Dog said:
My feet and ankles swelled up a couple of days ago. I had been off work for about a week and went back Wednesday and worked 8+ hours each day thru Saturday. We were painting inside a house and my work shoes had blown out, so I wore sliders/flip-flop like shoes with new ankle socks that were really too tight. I had to do some painting on a ladder and go up and down stairs multiple times during the days I worked. I have bad ankles because of basketball, but I have no pain like I sprained my ankle or something. I'm 47, 6'3 , 275 pounds and heavier than I've ever been in my life. My Grandfather had diabetes, but nobody else in my family has it that I know of. Tomorrow will be the 4th day of swelling and I had Sunday off but worked today/Monday. The swelling seems about the same around the ankles but seems to be increasing on my feet. The swelling also seems to be the same on both feet and ankles. Although I have some minor swelling earlier this summer it always seemed to go away the next day. There is some minor numbness but very little pain. This is a first and is freaking me out. I have to work again tomorrow but any advice would be greatly appreciated.
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Ever tried compression socks or calf sleeves? They make my feet feel a lot better running around the ER, but I hate taking them off so much that I don’t wear them very often.
 
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#536
#536
The Dog said:
My feet and ankles swelled up a couple of days ago. I had been off work for about a week and went back Wednesday and worked 8+ hours each day thru Saturday. We were painting inside a house and my work shoes had blown out, so I wore sliders/flip-flop like shoes with new ankle socks that were really too tight. I had to do some painting on a ladder and go up and down stairs multiple times during the days I worked. I have bad ankles because of basketball, but I have no pain like I sprained my ankle or something. I'm 47, 6'3 , 275 pounds and heavier than I've ever been in my life. My Grandfather had diabetes, but nobody else in my family has it that I know of. Tomorrow will be the 4th day of swelling and I had Sunday off but worked today/Monday. The swelling seems about the same around the ankles but seems to be increasing on my feet. The swelling also seems to be the same on both feet and ankles. Although I have some minor swelling earlier this summer it always seemed to go away the next day. There is some minor numbness but very little pain. This is a first and is freaking me out. I have to work again tomorrow but any advice would be greatly appreciated.
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If this is new I would encourage you to see your Doc and have it checked out. My concerns would be to rule out kidney , heart issues primarily but could be indicative of other issues as well. Get it looked at to make sure it isn't something serious.
 
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#537
#537
utchs81 said:
If this is new I would encourage you to see your Doc and have it checked out. My concerns would be to rule out kidney , heart issues primarily but could be indicative of other issues as well. Get it looked at to make sure it isn't something serious.
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Thanks, it is new and the swelling went down by the time I woke up this morning, but returned by the the time I got off work, today. I will get it checked out soon. xJx56, somebody at work recommended compression socks, too. So that's another thing I will check out. Thanks
 
#538
#538
The Dog said:
Thanks, it is new and the swelling went down by the time I woke up this morning, but returned by the the time I got off work, today. I will get it checked out soon. xJx56, somebody at work recommended compression socks, too. So that's another thing I will check out. Thanks
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I second what utchs said. TED Hose aka compression socks could help. Monitor extra salt intake, it causes water retention. When you get home from work prop those feet up on a recliner or an ottoman. A trip to the doc is a great idea. Basic lab draws, fasting cholesterol panel, and probably wouldn't hurt to check the A1C level, it's a blood test. Your grandfather having diabetes means there is a history.
 
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#540
#540
I've got a strange one if anyone wants to take a stab. The last 2+ weeks or so I've experienced fatigue even after a full 6 to 8 hours of sleep. After a while I could just about time it on a watch when it happened and it was 6 hours after waking up. Based on past experience my first thought is it's likely due to inadvertent shifting of my bed time. I've also had lower back pain that's lasted about the same amount of time, nothing a little Ibuprofin couldn't remedy. I figured I tweaked it somehow and it's just not healing because it coincides with the fatigue.
 
#541
#541
Coug said:
I've got a strange one if anyone wants to take a stab. The last 2+ weeks or so I've experienced fatigue even after a full 6 to 8 hours of sleep. After a while I could just about time it on a watch when it happened and it was 6 hours after waking up. Based on past experience my first thought is it's likely due to inadvertent shifting of my bed time. I've also had lower back pain that's lasted about the same amount of time, nothing a little Ibuprofin couldn't remedy. I figured I tweaked it somehow and it's just not healing because it coincides with the fatigue.
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Not sleeping good due to the back pain, or the mattress/sleep position causing the back pain and you not sleeping well.

In other words maybe the mattress is wore out. Or you've gained weight, sleep apnea, etc etc.

There's my stab.
 
#542
#542
So my wife gave birth to our son last Tuesday. The doctor said to give her the 2nd rhogam shot but the nurse decided she didn't need it.
Now baby is developing jaundice. Our appointment is tomorrow morning.

So, should I call the hospital and raise hell or is this typical??
 
#543
#543
shotgun83 said:
So my wife gave birth to our son last Tuesday. The doctor said to give her the 2nd rhogam shot but the nurse decided she didn't need it.
Now baby is developing jaundice. Our appointment is tomorrow morning.

So, should I call the hospital and raise hell or is this typical??
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Let me preface this by saying babies aren’t my specialty at all, but elevated bilirubin leading to jaundice is pretty common in newborns. I’d think it would be pretty hard to link a definite correlation. @kiddiedoc would probably be able to correct me if I’m wrong.


On another note, New Hampshire is cold and a lot more rural than I expected. This ER is severely lacking in the team dynamic.
 
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#544
#544
shotgun83 said:
So my wife gave birth to our son last Tuesday. The doctor said to give her the 2nd rhogam shot but the nurse decided she didn't need it.
Now baby is developing jaundice. Our appointment is tomorrow morning.

So, should I call the hospital and raise hell or is this typical??
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That's really dependent on blood types of baby and mom. Rhogam actually protects FUTURE pregnancies, keeping an Rh-negative mom from attacking an Rh-positive baby's red blood cells.

That being said, jaundice is common in newborns and can be a problem if the bilirubin gets too high. I would call your pediatrician and have the baby checked. He or she may order a bili level. If high, jaundice can usually be treated with phototherapy and good feedings.
 
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#546
#546
Coug said:
A bili-light basically a UV light treats infant jaundice. How does UV treat jaundice exactly?
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Put simply, it breaks bilirubin down into several (two possibly? I’m drank since that chapter.) more vase compounds that are more readily excreted in urine and feces and not have to be processed by the liver. I think that’s right, fact checkers let me know if I’m wrong so I can educate myself.
 
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#547
#547
xJesusx56 said:
Put simply, it breaks bilirubin down into several (two possibly? I’m drank since that chapter.) more vase compounds that are more readily excreted in urine and feces and not have to be processed by the liver. I think that’s right, fact checkers let me know if I’m wrong so I can educate myself.
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Yes, UV light converts bili to water-soluble forms (rather than its usual lipid-friendly state) so it can be more rapidly eliminated.
 
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#548
#548
Need some insight on this one. I just found out I've been taking a recalled bottle of Valsartan for the last 90 days. It's recalled for containing nitrosodimethylamine (NDMA) a possible human carcinogen. I asked CVS why they couldn't call me and tell me that I had a recalled bottle and they claimed a letter should have been sent by the corporate office. I never received such letter. They couldn't bother just picking up the phone as a courtesy and calling me to let me know? Now I need to know what to do if anything with regard to contacting my GP and what tests he might need to run because of this crap?
 
#549
#549
My wife is going to start her clinicals (psych nurse practitioner) in a couple of quarters, and we are required to get an opthalmoscope and otoscope. I've looked around and seen them anywhere from 30 to 550 bucks. I'm not familiar with using these instruments, so I really don't even know what to look for.

In other words any suggestions on a combo kit reasonable, but good?
 
#550
#550
jhamilton1208 said:
My wife is going to start her clinicals (psych nurse practitioner) in a couple of quarters, and we are required to get an opthalmoscope and otoscope. I've looked around and seen them anywhere from 30 to 550 bucks. I'm not familiar with using these instruments, so I really don't even know what to look for.

In other words any suggestions on a combo kit reasonable, but good?
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not sure why she should be required to have those instruments at all. Especially as a psych np. But if they are I would go low end for sure as she will likely not be using them in the future. They do come in a combo kit with interchangeable heads.
 
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