#diagnostic criteria for diabetes

[wellhealthhub]

Everything You Need to Know About Diabetes Tests - A Journey of Uncertainty and Surprises!

Prepare yourself for a roller-coaster ride through the perplexing world of diabetes tests! Embark on this whirlwind tour of different tests, diabetes types, interpreting results, and managing the enigmatic condition. Gain insights to take control of your health in this exhilarating adventure! Introduction to Diabetes Tests – The Enigmatic Puzzle Unveiled! Diabetes, a mysterious metabolic…

[headspace-hotel]

I forget why, but I was on the Wikipedia page for polycystic ovarian syndrome, and I started researching hirsutism in women, and I learned the following things in this order:

there's a diagnostic criteria used to evaluate how hairy a woman is

This is important because being too hairy is a diagnostic criteria of most disorders that cause hyperandrogenism

Disorders that cause hyperandrogenism can be diagnosed by...measuring how hairy you are (this is the main and most important diagnostic criterion for PCOS)

Disorders that cause hyperandrogenism are important because they are correlated with obesity, infertility, and...being too hairy?

I think to myself, wait, what is a normal range for testosterone in women? I find this article...which set reference ranges for "normal" testosterone levels in women...EXCLUDING WOMEN WITH PCOS?

Quote: "Polycystic ovary syndrome (PCOS) is another notable condition in genetic (XX) females, which is characterized by excessive ovarian production of androgens. This condition is included for comparison with DSD, as the affected females with PCOS are genetic and phenotypic females. The elevated levels of testosterone in these females can lead to hyperandrogenism, a clinical disorder characterized variably by hirsutism, acne, male-pattern balding, metabolic disturbances, impaired ovulation and infertility. PCOS is a common condition, affecting 7%-10% of premenopausal women."

So: the study claims to demonstrate a clear distinction between the normal range of hormone levels in "Healthy" men and "healthy" women...with "healthy" being defined in the study as...having hormones within the "normal" range.......................

So I researched what the clinically established "normal" range for testosterone in women is

THERE ISN'T ONE????

Quote from the above article: "Several different approaches have been used to define endocrine disorders. The statistical approach establishes the lower and the upper limits of hormone concentrations solely on the basis of the statistical distribution of hormone levels in a healthy reference population. As an illustration, hypo- and hypercalcemia have been defined on the basis of the statistical distribution of serum calcium concentrations. Using this approach, androgen deficiency could be defined as the occurrence of serum testosterone levels that are below the 97.5th percentile of testosterone levels in healthy population of young men. A second approach is to use a threshold hormone concentration below or above which there is high risk of developing adverse health outcomes. This approach has been used to define osteoporosis and hypercholesterolemia. However, we do not know with certainty the thresholds of testosterone levels which are associated with adverse health outcomes."

What the fuck?

What the fuck?

It's batshit crazy to make a diagnostic criteria for medical disorders by placing arbitrary cutoffs within 2-5% of either end of a statistical distribution. What the actual fuck?

"The results came back, you have Statistical Outlier Disease." "What treatments are available?" "Well, first, we recommend dietary change. You should probably stop eating so many spiders."

Another article which attempted to do this

Quote: "Subjects with signs of hirsutism or with a personal history of diabetes or hypertension, or a family history of polycystic ovarian syndrome (PCOS) were excluded."

"We're going to figure out the typical range of testosterone levels that occur in women! First, we're going to exclude all the women that are too hairy from the study. I am very good at science."

Anyway I got off topic but there are apparently race-specific diagnostic tools for "hirsutism." That's kinda weird on its own but when I looked more into this in relation to race I found this article that straight-up uses the term "mongoloid"

[rederiswrites]

So ME/CFS (myalgic encephalomyelitis/Chronic Fatigue Syndrome) and fibromyalgia are two syndromes (collections of symptoms often found together, with unknown causative mechanisms) with largely overlapping symptoms. They're currently classified as different diagnoses, but there are plenty of people who aren't convinced that they're actually different things. The biggest diagnostic difference seems to be whether the pain or the fatigue is the biggest problem.

I'm sure there are plenty of people who, like me, couldn't possibly say which of those is ruining my life more. I, like many, fulfill all the diagnostic criteria for both. I have the specific patterns of pain and inflammation characteristic of fibro, but I also have the postural orthostatic problems (Stand Up Feel Real Bad disorder) and extreme fatigue of ME/CFS. There's no test; diagnosis is an inherently subjective thing.

This is just gonna keep being about medical problems, so have a cut.

I also have problems that may be related or may be separate or may be part of the constellation of physical issues associated with ADHD, like loose tendons that lead to terrible core strength and janky joints. So while generally the pain spots for fibromyalgia are considered to have no actual material cause, I am pretty sure that my right hip and shoulder are in fact fucked up, and fibro is just making it experientially worse. I've also got a rib that spends more than half its time in just slightly the wrong goddamn place. I have multiple friends who have hypermobility problems that make mine look like a papercut, but combining them with fibro isn't a lot of fun.

A few months back, at my bestie's prompting and with his help, I started eating keto, which is essentially just restricting carbohydrates so harshly that they represent less than 20% (or less than 10%, this seems to be bioindividual) of your diet, at which point your body begins building energy transport molecules out of fat (ketones) instead of glucose. This has a history of treating several conditions (originally, seizures, but now also diabetes and inflammatory conditions), well before it became popular for weight loss.

It was an experiment. Believe me, I have mixed feelings about the fact that it worked. At first, it worked really, really well. I went from mostly bedbound to up and working full days outside. I've started to hit diminishing returns and having to nap more often, but it's still a radical improvement. I just forget how bad it was too fast. I hate how fast we forget how far we've come.

I haven't talking about it though, because I am so conflicted about restrictive diets as a thing. This started as an experiment, and as an experiment I could sell myself on no apples no potatoes no rice no crackers no no no no etc for a few weeks. After a few weeks I could decide whether it was worth it. And now here we are and it works.

But I've gone through So Much food restriction, starting when Phantom was two and we discovered that gluten fucks us both up. Then the Boy was sensitive to so many things as a baby that I cut out the entire Top Eight allergens (let's see, can I remember? Milk, eggs, peanuts, gluten, corn, soy, uhh....others...) for a year while he was nursing. Once you've cut wheat AND eggs AND corn out there is almost no commercial product you can eat and you have to prepare everything from scratch. With a toddler and a baby. I was literally starving. I used a calorie tracker for a while and found that I was nearly a thousand calories short per day, on average. I could barely think.

It's become a huge depression trigger for me. I tell people that my last major depressive episode was triggered by not being able to eat dairy, and I'm not kidding. I'm struggling with it now, too. Most of the time I'm good, but still, despite medication, I get very low and I just want to be able to fucking eat something tasty and comforting and EASY. I just want...cheese and crackers. A whole piece of fruit. A baked potato. Rice with my stir fry. But then I eat too much fucking watermelon and I can tell the difference in my wellbeing the next day.

Food becomes a minefield. Every meal becomes a struggle. You question every bite, every symptom. At least once a day the whole thing is just too annoying and I decide to just not eat, because fuck it. I dunno if it reaches eating disorder levels, but it's certainly maladaptive. I hate that I've gotten here because what you eat actually DOES matter. it's like the question of how you talk yourself out of anxiety when the world is objectively falling apart.

But I can do the things I love. I owe all this garden progress to not having had a glass of juice or a bowl of pasta in four months. Not to mention the abrupt cessation of all my dermatitis problems, frequent "silent" heartburn, a ton of digestive problems, migraines, most headaches, and more. "Nothing is worth risking depression" but is it though?

I'm holding on to the hope that these changes will allow me to heal. That I'll be able to make long-term progress, as many people say they have, and reintroduce restricted foods gradually. That I'll be able to cement the opportunity diet gave me with regular movement and conditioning and slowly claw my way up the spiral.

But on days when I feel like shit anyway, and I can't have some fucking chips about it....yeah. It's not great.

[pseudowho]

Hello Haitch! Hope you are doing well.

Last year during summer, I was diagnosed with PCOS (i had gotten it checked because i hadnt had my period in like 3 months) and since i was just 17, the doctor asked me to maintain a proper lifestyle and see till November and said that if it wasnt fixed by then, i had to do a checkup again. But i'd gotten my period by august so i never reached out again.

but this year (im 18 now), the last time id gotten my period was in april so it's been 6 months now. im gonna go to the doctor again later this month. but here's the thing— last year, i went to a gyno abroad because women's healthcare isnt the best in my country. but this year, its not possible for me to go abroad right now so im gonna have to work with a gyno from here.

now i have a feeling that theyll put me on pills and while i agree thats the easy way to fix this, im worried itll mess things up for the long run. the lifestyle the first gyno asked me to follow is a little difficult for me to get into since she'd asked me to exercise plenty and im a full time alevel student and it gets hard for me to maintain a proper routine like that. i also struggle with binge eating which i've heard comes with having pcos (im not sure if this is true tho).

so in one hand, i feel like it's easier to just start taking pills but then again it has so many side effects i don't know what to do right now.

Lots to unpack here.

CW/TW: PCOS, medical discussion, endocrine disorders, diabetes, hypothyroidism, weight management, medication management

Firstly, PCOS is often diagnosed based on vague criteria; lots of doctors flippantly diagnose it based on a volume of loose criteria. If you have an increasing number of these criteria, then yes, the chances are you have PCOS. However, it's often erroneously diagnosed without proper diagnostic procedures such as scans, bloods, and a full review of your longer term health history.

That being said, being on the pill doesn't 'cure' PCOS, it can simply manage the symptom of irregular periods. There's flimsy evidence on the pill's ability to manage/prevent weight gain and the development of other disorders that are associated with PCOS.

While weight loss is often harder for women with PCOS, especially if you have associated conditions such as an under active thyroid, it's not impossible.

Your lifetime chances of developing Diabetes are significantly higher with PCOS, and this chance goes up again if you struggle with increased body weight. PCOS and appetite changes like binge eating have been associated with each other, too.

So you'll only know if managing your weight and eating habits make a difference with your PCOS, when you've actually tried them to the absolute best of your ability. If you are at an increased ideal weight, losing weight can be very effective to manage and reduce the symptoms of PCOS.

Of the many, many thousands of women I've looked after, I'm sorry to say that those with PCOS who are very pro-active with managing their weight, perhaps taking medications as advised by their doctor (the pill and Metformin are the most common ones I see), and exercising regularly, are those who have the highest chance of being 'healthy' (though I do not use the term 'healthy' lightly).

Ultimately, PCOS is one of those things that just happens and isn't your fault. I also have an endocrine disorder that makes it very easy for me to gain weight and very difficult for me to lose it, so I absolutely understand the situation yours in right now.

But, what do you do with this information? Do you say, "I am X, Y and Z because of my PCOS" and leave it at that? Or do you say "I suffer with X, Y and Z because of my PCOS, so I make life choices to reduce the impact of my PCOS by 1, 2 and 3".

So my advice is this: PCOS may be the hand you've been dealt, but your lifestyle choices can massively improve the chances of you reducing its impact on your long-term health. I'm not blaming you, or acting like healthy eating, exercise and medication decisions are easy; they are not. Please recall I'm in a similar boat, and I'm not one to blame women for their complex health conditions.

I could talk all day about PCOS but this is my best attempt to summarise it for you.

It's really hard making tough life choices to manage the hand you've been dealt. I fully understand. I've gotten better at it as I've gotten older. @mrhaitch makes similar big decisions, because he has two diabetic parents and one diabetic siblings, so he takes care of his health to a brilliant degree, to try to give himself the best chance of not developing diabetes himself.

☝️ me being your hype man

Love,

-- Haitch xxx

[goodluckclove]

My Medical History: A Comedy of Errors

This is long as shit but since it's finally sort of resolved itself I figured it'd be worth documenting. Strap in, folks.

Me, age 12: I have Experiences

Doctor: You're schizoaffective you need many pills.

Me: Sure, I guess.

Me: Dad I experience these kinds of things being schizoaffective.

Dad, also schizoaffective: Huh I relate to none of that.

Me: Should we look into that discrepancy further?

Dad: Nah.

Me: Mom I forgot to take one of the seven medications I'm on for over a month and felt no effect from not taking it. Is there a chance I'm potentially on too much medication?

Mom: You need to take all the pills the doctors give you.

Me: I'm on more Seroquel than both you and Dad combined and have been since I was 13 is that bad?

Mom: No it's normal and good, actually.

Me: I have nothing to compare this too and if I disagree too hard with you I might be left to fend for myself in the wilderness like a newly-stray cat.

Different Doctor: I don't think you're schizoaffective because you were way too young to show signs when you were diagnosed.

Me, age 17: Oh? What do you think I am?

Different Doctor: No idea. Moving on!

Therapist: You aren't bipolar.

Me, age 18: What am I, then?

Therapist: Probably nothing. It really doesn't matter.

Me: I don't know what to do with that information.

An additional doctor: Yeah, I agree with that doctor you saw almost a decade ago. I don't think you're bipolar.

Me, 26, very tired: Okay.

Additional doctor: You're too traumatized for me to diagnose, though.

Me: Uh-huh. That's - fine. I guess.

Additional doctor: Here are some anti-psychotics though.

Me: These anti-psychotics make me throw up at least once a week can we switch to a different kind?

Additional doctor: Eh I don't know. They're not making you psychotic so it's probably fine.

Me: cool okay

Me: Hey I was on 900mgs of Seroquel from ages 13-21 do you think that could be a bad thing for me health-wise?

A doctor, at some point: It is a medical improbability that taking that much of that medication for that long didn't give you diabetes.

Me: Great. Love that for me.

Me: Therapist I need a diagnostic I'm losing my mind.

Therapist: I'm reading your diagnosis and you actually don't meet the basic clinical criteria for really any mental illness.

Me: ??????? cool

Therapist: You might have ADHD though.

Wife: You absolutely have ADHD.

Me: Can I get treated for ADHD please?

New psych: I can't treat you for ADHD if you're diagnosed as bipolar.

Me: I have had multiple doctors say I'm not bipolar. I have a diagnostic that says I'm not bipolar.

New psych: Someone at some point said you were bipolar.

Me: I was 12.

New psych: Either way. Also this diagnostic you took says you have BPD.

Me in my next therapy session: Hey uh Therapist when were you going to tell me I have BPD?

Therapist: You...don't? You don't have that.

Me: My psych said the diagnostic you sent her shows I do.

Therapist: She apparently doesn't know how to read the diagnostic then because that's - um. Incorrect.

Wife: You need to stop telling new psychs you were ever diagnosed bipolar it's clearly making them biased.

Me: That feels like denying medical people medical information they need for medicine.

Therapist: I agree with Wife actually.

Me: You - really? Fuck. I mean, okay.

Me, in an intake appointment: I was never diagnosed bipolar.

Current psych: Uh okay.

Me: I'm lying.

Current psych: Oh. Oh?

Me (Sobbing): I'm so sorry I'm lying I just lied.

Current psych: It's okay. You're - um -

Me (Weeping, shame spiraling): You seem so nice -

Current psych: Wow. Wow you are struggling.

Few Sessions Later

Current psych: Yeah you could have ADHD. Probably wanna be careful though because ADHD meds can cause mania in bipolar people, so even though you haven't really shown any signs of bipolar or schizophrenic symptoms we should still air on the side of caution.

Few More Sessions

Current psych: Ah yeah you're super ADHD. That makes sense and surprises nobody.

Me, 27, lying face-down on the floor: rad hooray for medicine.

[lornrocks]

My doctor’s gonna be disappointed I didn’t get the imaging yet they wanted me to get for diagnostic criteria but the last imaging was $1200 out of pocket and frankly I spent the months in between the imaging they ordered and this appointment I have soon going on trips and I wanted to spend my money on that instead.

I’ve already spent so much money and time off work to get 2 endoscopies, get a gastric emptying study done (it was like 2 hours and I was fighting nausea the entire time) and go to these doctor appointments. I’m getting bloodwork done tomorrow.

Idk man we know my stomach won’t empty but we have no idea why, everything looked good, they took cultures while in my tummy and djdnt find anything, I have no family history of diabetes or gastroparesis or celiac or IBS like my dad (literally a gastroenterologist, just not MY gastroenterologist) says it’s extremely likely my stomach is not functioning correctly after one of the GI viruses I’ve had before. But idk how you prove that.

Currently the only direction I was given was “eat 5-6 small low fat meals a day” which is super impractical unless I work from home or never go on vacation, so, thanks.

Idk man. My mom got mad at me for admitting I put the testing off but she of all people should understand when you have a chronic illness with no discernible cause sometimes you just wanna stop with all the tests and shit cause it’s useless. Again, I’d rather spent that $1200 on concert tickets (which I did, plus I’m paying that off each month in installments which I don’t think the hospital would let me do easily)

[bloodhaven]

I love having chemical labs and brain wave labs showing proof there's something genuinely wrong with me instead of just

. Idk. My feelers???? Like i always doubt my mental health diagnosis' because there's no like.... Diagnostic criteria above me Feeling And Doing Things, there's no labs, there's no cords attached to my head, but we both (my psych nd me, + my therapist) know I'm depressed and anxious and have bpd and bipolar and more, but there's no labs!!!

Sorry this rant got long its under the cut um tw for self harm and needles and suicide (od) attempts

Where's the paper proof ?? Where's the chemical proof? The brain scans? There aren't any because I haven't had any done, and I don't think I'll need them done??? (Unless my dizziness doesn't go away then.... I might)

But with my Narcolepsy there's brain tests, there's cords hooked to my scalp with this nasty glue gel shit all night monitoring me, I had to spend seconds at a time under scalding water to get the gel out and I have temperature trauma so of course i was triggered and burned and crying by the time it was all out, but there's proof!!! My doctor saw it! He said i sleep like a 3 month old, which isn't great, but he saw it and then he gave it to me so I have proof forever of my narcolepsy issues

For my diabetes there's blood tests every three months to make sure my A1C is good, they tested my blood three different times!!! I was tested for hyper cortisol (once) diabetes type 1 (twice) and then they did further testing to confirm my diabetes diagnosis (twice) by my primary care & by my Endocrinologist!! Its there! I have proof!! I have to shove a needle into my tummy once a week to keep my sugars under control, and every 10 days I put a CGM into my arm so i can WATCH my sugars change !!

But where's the Proof for my mental health? The scars on my wrists and thighs? I've had people accuse me of doing it for attention before. My 3 hospitalizations? The doctor for the third didn't believe i needed it, the first time I went i had to force it , and the second time was 1 month after the first for an overdose attempt.

I! Want! More! Proof! I want the paper trail, the blood draws, the labs, the scans ,etc for my mental health... I want rock solid undeniable proof of what is wrong with me so i dont spend my life going "well what if they were wrong" i dont i dont!!

[mediend2]

What are the 3 main symptoms of Autism

Autism is a complex neurodevelopmental disorder that affects a person’s ability to communicate and interact socially with other people. It is estimated that around 1 in 54 children in the US are diagnosed with autism, making it more common than diabetes, cancer, and AIDS combined.

When it comes to autism, there are three main symptoms that are generally seen in those who are affected. These are difficulties with social interaction, repetitive behaviors, and communication challenges. This article will provide an overview of these three main symptoms of autism, as well as detailing some of the specific issues associated with them.

Social interaction difficulties are a hallmark symptom of autism. People with autism often have difficulty recognizing or identifying facial expressions and identifying emotions from others. This difficulty in understanding the emotions of others can make it difficult for people with autism to connect with people and build relationships.

Finally, people with autism often have communication challenges. This can include difficulty understanding language, speaking in a proper manner, having difficulty understanding the meaning of words, and having difficulty making sense of conversations. People with autism may also have difficulties with pragmatic languages, such as understanding sarcasm or making jokes.

These are the three main symptoms of autism, and they can often be identified through diagnostic criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In order to diagnose autism, medical professionals use a variety of assessments to evaluate the severity of the symptoms and help develop an appropriate treatment plan.

In this article, we will take a closer look at each of these three main symptoms of autism, as well as provide some tips for recognizing them and seeking treatment for those affected.

Read more

[mcatmemoranda]

Patient is a [ ] yo male/female presenting to the clinic for a preoperative evaluation.

Procedure [ ]

Scheduled date of procedure [ ]

Surgeon performing procedure requesting consultation for preop is [ ] and can be contacted at [ ]

This patient is/is not medically optimized for the planned surgery, see below for details.

EKG collected in office, interpreted personally and under the direct supervision of attending physician as follows- sinus rate and rhythm, no evidence of ischemia or ST abnormalities, no blocks, normal QTc interval.

The following labs are to be completed prior to surgery, and will be evaluated upon completion. Procedure is to be performed as scheduled barring any extraordinary laboratory derangements of concern.

Current medication list has been thoroughly reviewed and should not interfere with surgery as written.

Patient has no prior history of adverse reactions to anesthesia, problems with airway management, difficult IV access, prolonged emergence, or postoperative nausea/vomiting.

Airway Mallampati score: This patient is a Grade based on the criteria listed below

-Grade I Tonsillar pillars, soft palate, entire uvula

-Grade II Tonsillar pillars, soft palate, part of uvula

-Grade III Soft palate, base of uvula

-Grade IV Hard palate only, no uvula visualized

Patient is a low/medium/high risk for this low/medium/high risk surgical procedure.

Will send documentation of this preoperative visit to surgeon [ ].

**** ADDITIONAL INFORMATION****

Patient Risk for Elective Surgical Procedure as Determined with the Criteria Below:

1- Very Low Risk

No known medical problems

2- Low Risk

Hypertension

Hyperlipidemia

Asthma

Other chronic, stable medical condition without significant functional impairment

3- Intermediate Risk

Age 70 or older

Non-insulin dependent diabetes

History of treated, stable CAD

Morbid obesity (BMI > 30)

Anemia (hemoglobin < 10)

Mild renal insufficiency

4- High Risk

-Chronic CHF

-Insulin-dependent diabetes mellitus

-Renal insufficiency: creatinine > 2

-Moderate COPD: FEV1 50% to 70%

-Obstructive sleep apnea

-History of stroke or TIA

-Known diagnosis of dementia

-Chronic pain syndrome

5- Very High Risk

-Unstable or severe cardiac disease

-Severe COPD: FEV1 < 50% predicted

-Use of home oxygen

-Pulmonary hypertension

-Severe liver disease

-Severe frailty; physical incapacitation

Surgical Risk Score Determined as Below:

1- Very Low Risk

Procedures that usually require only minimal or moderate sedation and have few physiologic effects

-Eye surgery

-GI endoscopy (without stents)

-Dental procedures

2- Low Risk

Procedures associated with minimal physiologic effect

-Hernia repair

-ENT procedures without planned flap or neck dissection

-Diagnostic cardiac catheterization

-Interventional radiology

-GI endoscopy with stent placement

-Cystoscopy

3- Intermediate Risk

Procedures associated with moderate changes in hemodynamics, risk of blood loss

-Intracranial and spine surgery

-Gynecologic and urologic surgery

-Intra-abdominal surgery without bowel resection

-Intra-thoracic surgery without lung resection

-Cardiac catheterization procedures including electrophysiology studies, ablations, AICD, pacemaker

4- High Risk

Procedures with possible significant effect on hemodynamics, blood loss

-Colorectal surgery with bowel resection

-Kidney transplant

-Major joint replacement (shoulder, knee, and hip)

-Open radical prostatectomy, cystectomy

-Major oncologic general surgery or gynecologic surgery

-Major oncologic head and neck surgery

5- Very High Risk

Procedures with major impact on hemodynamics, fluid shifts, possible major blood loss:

-Aortic surgery

-Cardiac surgery

-Intra-thoracic procedures with lung resection

-Major transplant surgery (heart, lung, liver)

High risk surgery: yes/no

Hx of ischemic heart disease: y/n

Hx of CHF: y/n

Hx of CVA/TIA: y/n

Pre-op tx with insulin: y/n

DM/how are blood sugars?

Pre-op Cr >2mg: y/n

OTHER EVALUATIONS BASED OFF PATIENT HISTORY SEE BELOW:

1. CARDIAC EVALUATION

A. Ischemic Cardiac Risk- Describe any history of cardiovascular disease and list the cardiologist/electrophysiologist. For CAD, report the results of the most recent stress test or cardiac cath, type of procedures or type of stents, date of MI, and recommendations for perioperative management. Include antiplatelet management. Continue baby aspirin for patients with cardiac stents - unless having neurosurgery, then coordinate with surgeon.

B. Ventricular function - include most recent echocardiogram evaluation ideally performed within the past 2 years

C. Valvular heart disease- include most recent echocardiogram, type of prosthetic valve

D. Arrhythmias - include any implanted devices and recent interrogation report, contact electrophysiology about device management during the surgery and include recommendations provided. For A-Fib, include CHA2DS2-VASc score

E. Beta blockade - All patients on chronic beta blockers should have these medications continue throughout the perioperative period unless there is a specifically documented contraindication.

F. Hypertension - Other than for cataract surgery, ACEI inhibitors and ARBs should be held for 24hours prior to surgery and diuretics should be held the morning of surgery

G. Vascular disease - include antiplatelet management and dates of strokes

2. PULMONARY EVALUATION

A. COPD/Asthma - include any recent exacerbations, intubations, chronic O2 use, amount of rescue inhaler use

B. OSA risk - STOPBANG score - address severity of sleep apnea and CPAP use

3. HEMATOLOGIC EVALUATION

A. Bleeding Risk - assess the bleeding risk and history for every patient

B. VTE Prophylaxis/Thrombotic risk - estimate risk and provide recommendations

C. Anticoagulation management - include pre-op and post-op medication instructions

D. Anemia - pre-op treatment plan

D. Oncology - history and treatments

4. ENDOCRINE EVALUATION

A. Diabetes mellitus - include type, medication use, recent A1c, pre-op and post-op management instructions

B. Adrenal insufficiency risk - assess for prolonged steroid use in the last year

5. RENAL EVALUATION

A. CKD - include stage, baseline labs

B. ESRD - include dialysis schedule, type, access, dry weight, location of dialysis. Generally, surgery should not be scheduled on a dialysis day.

C. Electrolyte abnormalities

6. GI EVALUATION

A. Liver disease - including MELD score and Child-Pugh classification

7. OTHER relevant comorbidities or anesthesia considerations

[substance abuse, chronic pain, delirium risk, PONV (post-operative nausea and vomiting) risk, psych disorders, neurologic disorders, infectious disease, etc.]

[ebbiemunson]

Verse: Synecdoche

I don't usually make actual posts for my verses but this one is a little closer to my heart so here we go.

Disabled Eddie

This verse will be based on my own PHYSICAL disabilities.

Diagnosed with:

Multiple Sclerosis

Cyclical Vomiting

Diabetes Type 2

Mixed Connective Tissue disease

Frequent Symptoms Eddie Experiences:

Chronic Extreme Fatigue (MS, MCTD, Diabetes, CV)

Memory issues (MS, MCTD)

Brain fog (MS, MCTD)

Inability to focus (MS, MCTD)

Chronic Pain (MS, MCTD, CV)

Cluster Headaches

Migraines

What is Cyclical Vomiting and how does it present in Eddie Munson:

Cyclical vomiting is a Migraine disorder, and presents in the abdomen! It is a disorder that causes frequent and intense bouts of vomiting, ranging from an hour to several days. It also can cause severe diarrhea and intense abdominal pain.

There are several things that can trigger an episode, but Eddie's episodes are triggered mostly by food.

His triggers:

Coconut

Pork/Ham

Carrots

Dark Chocolate

Colored sodas that have red or blue dye

Avocado

Turkey

Being over heated can also cause Eddie to enter a cyclical vomiting episode, as it causes a heat migraine, which makes the rest of his body fall out of whack. He takes medication for this disorder.

Eddie's Multiple Sclerosis:

Eddie's MS first presented in his right hand going numb through the index and thumb, losing sensation. Doctors thought he had carpel tunnel syndrome, and since Eddie was a guitar player, he was taking this seriously. He went to the doctor, and they found abdnormal activity in his nervous system consistent with a neurodegenerative disorder by conducting a Nerve Conduction test. With several MRIs, and a trip to a neurologist, at 17, Eddie was diagnosed with Multiple Sclerosis and failed his senior year of high school.

Shortly after his diagnosis, Eddie experienced what was known as the MS hug, in which he experienced extreme squeezing around his chest, and abdomen, making it difficult for him to breathe. He spent 3 months recovering from this MS relapse, and during his second repeat of Senior year, Eddie experienced his third major MS relapse, in which the entire side of his body on the left side went completely numb and lost sensation.

Eddie had issues with walking, holding things, talking, using the washroom, dressing himself, showering, and had major impacts on his quality of life. This relapse lasted about 4 months, and his body was able to recover from it to almost full function again. He still has sensation loss in his finger tips, but has regained full dexterity through physical therapy.

Eddie is heavily Medicated for this disorder.

Common symptoms Eddie experiences:

vertigo

heat sensitivity

sun sensitivity

memory loss

memory retention issues

concentration issues

brain fog

insomnia

chronic pain

stress incontinence

trouble with speaking at times

trouble with writing at times

Eddie's Diabetes:

Eddie is an insulin dependent type two diabetic. He has a hard time keeping on weight because he tries to stick to a lower carb diet, which is difficult to balance with his cyclical vomiting.

Eddie's Mixed Connective Tissue Disease:

While searching for answers regarding the numbness in his hand, Eddie spoke to his doctors about some of the extreme chronic pain he had been experiencing for years. With several blood tests, he came back with Lupus markers, and showed some symptoms related to Reynauds, and Elhers Danlos. Since he didn't meet any diagnostic criteria for any single connective tissue disease, Eddie was given the label of having Mixed Connective Tissue Disease. He is medicated for this.

[monkeymeghan]

I posted 5,706 times in 2022

That's 2,780 more posts than 2021!

664 posts created (12%)

5,042 posts reblogged (88%)

Blogs I reblogged the most:

@bringingclawstoagunfight

@hasanyoneseenmyspoons

@spockvarietyhour

@prisma-the-spooktacular

@counting-dollars-counting-stars

I tagged 3,635 of my posts in 2022

Only 36% of my posts had no tags

#cats - 599 posts

#wordle - 301 posts

#personal - 217 posts

#comics - 214 posts

#note to self - 198 posts

#quordle - 176 posts

#tumblr - 168 posts

#quotes - 144 posts

#purr in ink - 142 posts

#jurassic park - 140 posts

Longest Tag: 102 characters

#you have to keep medications away from moisture so don’t keep them in the bathroom ‘’medicine cabinet’

My Top Posts in 2022:

#5

To those of you with cfs/me, how did you get your doctor(s) to take you seriously? I meet all of the diagnostic criteria, but over the last seven or so years since my symptoms started, everyone has chalked it up to my depression. It’s really frustrating. Since I have a new pcp, I want to make an appointment to talk to her about this since today has been terrible and my family is getting frustrated with me. I know cfs/me doesn’t have a cure, but if I have a diagnosis maybe my family could understand a bit better. (Not that I want another diagnosis, I have enough already! 😕)

23 notes - Posted October 18, 2022

#4

I have a diagnosis!! I just got off the phone with my GI doctor. I had my educated suspicions, and I was right. He went over the gastric emptying study with me, and I do have gastroparesis. I don’t have diabetes (the most common cause), so I’m one of those random unknown cause cases. Now it’s not severe, as my stomach empties like it should by the four-hour mark, but it is emptying much slower at two hours. At two hours it’s at 73% and it should be below 60%. I have to try to eat less fat and eat less soluble fiber. The doctor also wrote me a script for Reglan, which will help with both nausea and increasing gastric motility. Fingers crossed!!

23 notes - Posted June 7, 2022

#3

See the full post

28 notes - Posted November 28, 2022

#2

Chloe is holding steady. Her temp has still been good, and her weight is between 6.4 and 6.6 pounds. She’s still tiny, but she’s gained a little, and I’ll take it. She has a good appetite, and is eating great. She’s talking more and more, like she usually does. She’s even still playing a little bit. She’s even run around the house with Oscar a few times. I hope we’re out of the woods, but I don’t want to get ahead of myself.

I still have a mountain of bills from the vets, so if you can, please share this post so that my gofundme makes the rounds again. I’d really appreciate that. Thanks again for everyone who has helped me in any capacity with this, even if it’s just been sending good vibes our way.

32 notes - Posted November 16, 2022

My #1 post of 2022

See the full post

51 notes - Posted November 1, 2022

Get your Tumblr 2022 Year in Review →

[shaftking]

>It will never not baffle me how hard society tries to insist that fatness is an abnormality.

It is abnormal. The human body was never meant to be obese. It was never meant to carry massive amounts of excess weight, much less upwards of a hundred extra pounds of it. It’s not insisting on something completely outlandish, it is a simple observation. No one was meant to be 300+ lbs. No one.

>The average western woman wears plus size clothing. One of the smallest garments on the scale is called a medium.

Just because the average person is overweight or obese does not mean that being overweight or obese is normal. The fact that people are considerably larger on average than they were only fourty years ago should tell you something. The general population has gotten more obese since the 1980s. Pointing to clothing sizes does not actually refute the argument that the growing number of obese people is a concern. Especially with the rise of vanity sizing, where clothing sizes today are equal in measure to much larger labeled sizes in past decades.

>Most people with anorexia are in the overweight bmi category, yet somehow that's known as "atypical anorexia".

Most people with anorexia are not overweight. One of the literal criteria for anorexia is a low body weight and a fear of gaining weight. Because when you are starving you lose weight. Shocking. Atypical anorexia is called atypical because while it lacks the underweight requirement, the patient still has experienced rapid weight loss as a result of severe food restriction.

This is really such an insane thing to lie about that is easily disproven by common knowledge or simple google search of the conditions diagnostic criteria.

If you really gave a fuck about people with EDs you would stop trying to coopt the struggles of people with anorexia and destigmatize getting help for people with BED, NES, and EDNOS which are far more common and far more likely to effect overweight and obese individuals than AN or BN.

>Fatness is often labeled the cause of a number of diseases, but there are literally no diseases exclusive to fat bodies.

Because it is. Being obese can cause motor issues in the joints as a direct result of the excess weight. It can cause fatty heart and fatty liver. It can causes hormonal problems because visceral fat is hormonally active. It results in an increased risk of heart disease and diabetes. It increases one’s risk of multiple types of cancers, including reproductive cancers.

This is literally like saying that people should just continue to smoke cigarettes because people who don’t smoke also get lung cancer. We know people who don’t smoke get lung cancer, but the risk is much higher and people who otherwise would not have gotten lung cancer are 15 to 30 times more likely to get it if they are smokers.

>Looking at movies and television, you'd think the world was 98% thin people. It's not.

I hate the use of obfuscated terms like thin and fat in these conversations because it’s entirely subjective. This is why fat activists hate terms like obese and morbidity obese, because they can actually be measured and defined. What is considered fat or thin in one culture, community, group, etc could easily be vastly different from another. Like someone could be considered hugely fat while they live in LA but move to Georgia and be considered very thin. The same for western vs Asian countries.

According to the WHO, adult overweight and obesity has risen from 25% in 1990 to 43% in 2022. Nearly doubled. Meaning, no, the “thin” population is not 98%, but 57%. But that’s not a diversity win, that is a huge cause for concern.

It will never not baffle me how hard society tries to insist that fatness is an abnormality. The average western woman wears plus size clothing. One of the smallest garments on the scale is called a medium. Most people with anorexia are in the overweight bmi category, yet somehow that's known as "atypical anorexia". Fatness is often labeled the cause of a number of diseases, but there are literally no diseases exclusive to fat bodies. Looking at movies and television, you'd think the world was 98% thin people. It's not.

My point isn't that if it was pretty rare to be fat, fatphobia would be okay. Of course not.

My point is that we're surrounded by all these artificial indicators that fatness is unnatural and uncommon and it's just not true?? Humans are not always thin and we've never all been thin and we're not all meant to be thin. Fat humans are a normal type of human. Fatness is a feature, not a bug.

[theartofechocardiography]

Comprehensive Heart Issue Consultation at The Art of Echocardiography: Your Trusted Medical Centre in Box Hill

When it comes to your heart health, early detection and expert care are paramount. At The Art of Echocardiography, we offer specialized heart issue consultations at our medical centre in Box Hill. With the added convenience of a bulk billing doctor clinic in Box Hill, we ensure that you can access high-quality heart care without worrying about the cost. Our focus is on providing comprehensive, non-invasive diagnostic services and heart health consultations to help you maintain a healthy heart for life.

Why Heart Health Matters

The heart is the engine of your body, and keeping it in top condition is essential for overall well-being. Unfortunately, heart disease remains one of the leading causes of illness and death worldwide. Conditions such as coronary artery disease, heart failure, arrhythmias, and valvular heart diseases can develop over time, often without noticeable symptoms. This is why regular heart check-ups and consultations with a heart specialist are crucial.

Expert Heart Issue Consultation at Our Box Hill Medical Centre

At The Art of Echocardiography, we specialize in heart issue consultations, where we focus on identifying potential heart problems before they develop into serious conditions. Our medical centre in Box Hill is equipped with state-of-the-art technology, allowing us to perform advanced diagnostic tests such as echocardiograms, stress tests, and electrocardiograms (ECGs) to assess heart function and detect abnormalities.

Our team of expert healthcare professionals will take the time to discuss your medical history, risk factors, and any concerns you may have regarding your heart. Whether you're experiencing symptoms like chest pain, shortness of breath, dizziness, or fatigue, or you're simply seeking a routine heart check-up, we are here to help.

Bulk Billing Doctor Clinic in Box Hill

We understand that access to heart care should not be a financial burden. That’s why The Art of Echocardiography is proud to offer bulk billing services at our doctor clinic in Box Hill. Bulk billing means that we will directly bill Medicare for your consultation, meaning you won’t need to pay out of pocket for heart health services if you meet Medicare eligibility criteria.

By offering bulk billing, we make heart health consultations more affordable and accessible, so you can prioritize your cardiovascular health without worrying about the costs. Our focus is on providing the best possible care for your heart, and we believe that finances should never be a barrier to your well-being.

Comprehensive Heart Care Services

Our heart issue consultation services go beyond just diagnosis. At The Art of Echocardiography, we offer a full range of heart health services, including:

Echocardiograms: A non-invasive ultrasound to evaluate heart function, valve movement, and overall heart health.

Stress Testing: To assess how your heart performs under physical stress and detect any hidden issues.

ECG: An essential test to measure the electrical activity of your heart and detect arrhythmias.

Preventive Care Plans: Our specialists will work with you to create a personalized plan to manage risk factors such as high cholesterol, blood pressure, and diabetes.

We also provide advice on lifestyle changes that promote heart health, such as diet, exercise, and stress management. Our goal is to ensure that your heart remains healthy for many years to come.

Visit Us Today for Your Heart Health Consultation

At The Art of Echocardiography, we are committed to providing expert heart care in a comfortable, patient-focused environment. Whether you're due for a routine check-up or experiencing symptoms of heart issues, our medical centre in Box Hill is here to support your cardiovascular health. Visit at artofecho.com.au/medical-consultation to book your appointment.

Let us help you take the first step towards a healthier heart, backed by expert care and bulk billing convenience. Your heart deserves the best – and so do you.

[thetfclinicusa12]

How To Select the Best Podiatry Clinic Over the Internet?

Maintaining healthy feet and ankles is crucial for daily support and preventing future podiatric conditions. However, proper care requires the expertise of top podiatrists. Choosing the right podiatry clinic near me online can ensure you receive the best care for your foot and ankle concerns. Here's a step-by-step guide to help you find a reliable clinic:

Research Credentials and Expertise

Start by verifying the clinic's credentials. Look for licensed podiatrists with specialized training and certifications. Check for affiliations with reputable medical boards, as these indicate a commitment to maintaining high standards of care.

Read Reviews and Testimonials

Patient reviews can provide valuable insights into the quality of care and customer service at a clinic. Look for feedback on the clinic’s professionalism, cleanliness, and success in treating conditions similar to yours. Beware of reputed clinics with negative or no reviews.

Evaluate Services Offered

Ensure the clinic provides treatments relevant to your needs, whether it’s sports injuries, diabetic foot care, or bunion surgery. A clinic offering advanced diagnostic tools like digital X-rays or orthotic fitting demonstrates a commitment to comprehensive care.

Compare Costs and Insurance Coverage

Review pricing and whether the clinic accepts your insurance. Transparent billing is essential to avoid surprises later. When it comes to picking the podiatry clinic near me, you have to list personal criteria, so that you can ensure their services matches yours expectations.

[innonurse]

AI enhances early detection of MASLD, addressing diagnostic gaps in liver disease

- By InnoNurse Staff -

A recent study presented at The Liver Meeting demonstrates the potential of AI to detect early-stage metabolic-associated steatotic liver disease (MASLD) using electronic health records.

Researchers found that 83% of patients meeting MASLD criteria remained undiagnosed, highlighting the challenge of identifying this asymptomatic condition, which can progress to severe liver disease without early intervention.

The AI algorithm analyzed imaging data from the University of Washington Medical System, identifying 834 patients with MASLD criteria, of whom only 137 had a formal diagnosis. Lead author Dr. Ariana Stuart emphasized that the findings showcase AI's ability to complement clinical workflows, rather than replacing traditional methods, by addressing gaps in early diagnosis.

MASLD, the most common liver disease in the U.S., affects 4.5 million adults and is often linked to conditions like obesity, Type 2 diabetes, and abnormal cholesterol. Early detection is crucial for effective treatment, and this study underscores AI's role in improving diagnostic rates and patient outcomes.

Read more at American Association for the Study of Liver Diseases (AASLD)

Header image credit: Canva (AI-generated).

[criticalbread]

sup. so i was diagnosed with chronic fatigue syndrome after having covid multiple times. at the moment something like half of all long covid sufferers also fit the diagnostic criteria for CFS. They're extremely similar, if not the same thing.

No one talks about CFS who doesn't have it or a loved one with it, and certainly the average person doesn't know what it actually looks like. What the quality of life is actually like. So let me tell you.

According to multiple studies, the quality of life of people with CFS is significantly lower than many of the well known and dreaded conditions like: MS, Parkinsons, diabetes, late stage cancer, you name it. According to these studies, people with CFS generally have a similar quality of life to someone with a late stage cancer during chemo treatment. Feelings of unwellness, sickness, fatigue, pain, sleep disturbances, neurological and cognitive deficits, etc. etc. but that's the baseline. It's been 3 years of this for me.

Another way I've seen it described in one of these studies based on self reported surveys across many chronic illnesses - people's numbers with CFS show we've got a similar quality of life to someone with untreated AIDS might expect around 4 months before death. This, based on thousands of surveys from thousands of people. These are ugly comparisons, meant to describe an ugly reality that is otherwise completely unknown by using comparison with what is known. We know AIDS entails terrible suffering. We know late stage cancer and the chemotherapy treatments for it entails terrible suffering. My mum went through her third cancer diagnosis and chemo treatment just over two years ago and in the end passed away from complications. I know and am not making light.

So, why use this horrible yardstick to measure?

I've had to teach my doctors about CFS. I've had to teach them the symptoms, send them research and current medication recogmmendations to symptoalleviatems even if we can't cure them because we don't know what CFS is. What's causing it, what's gone wrong, where to look - we don't fucking know. Most meds we've tried out haven't improved anything.

I have CFS as a diagnosis on file, but my doctor and I are working on the understanding that I only developed this after having COVID twice. By technicality, I could also have long covid on file, or have been given a long COVID diagnosis rather than CFS. Which one you get is based more on chance than anything - whichever one your doctor knows more about and thinks of first, that's usually what you get. But we don't know shit about fuck, babes. Not us, not 99% of doctors, not any of the health authorities who have been ignoring cfs as 'hysterical women' for decades whilst so many people had to live with it and the isolation and hopelessness it brings.

There are now millions of people with long covid in the USA alone. You DO NOT want this. Wash your hands, wear a mask, get boosters, avoid giant indoor or even outdoor crowds when you can.

if i got any of this information wrong - inevitable, pls link your data, me n my cog issues are laying down now ✌

(source)