Caracta:


Hi. Quick question.

How do you explain high ESR of 31...though it recently dropped to 28 after the patient was placed on medications? Please note that ESR has been high consistently for a long period of time.

excellence44:


please I want to know if appendix operation can affect a woman during delivery. she was operated upon ten years ago

Xiadnat:


Go and get your blood sugar checked. Can be due to drugs or food/drink intake. Are you on any medication? Supplements? Any pain or tingling with urination? White as in less yellow or like clear pure water? Any medication condition y'know of?

When you say turn as in you watch it change color? Or it comes out that way?

If you are dehydrated: urine will take up more yellowish color.
If you are more hydrated: it will take up clearer color.

Xiadnat:


Is she having vaginal birth or C-section? Assuming surgery was 10 years ago, and no complications; If vaginal, none. If C-section, then depends on extent of adhesion (scarring) that resulted from appendectomy.

Xiadnat:


High ESR generally implies some inflammatory response or reaction occurring generally autoimmune type reaction; what medication was this person placed on?

excellence44:

Thanks. d scarring is not that much. what I want to know is how will it affect her if she were to deliver through c section.will it affect the c section process and what are the chances of she delivering up to three to four children?

Onifari:
i have done blood test and they found nothing.

Caracta:


Mirazit.h Azithromyci.n...which I don't think did much other than reduce from 31 to 28. Could it be cancer or a skin problem?

Xiadnat:


ESR is really non specific measure of inflammatory state, which covers from infection to autoimmune condition to anemia to yes, tumors.

I would recommend that she goes for a thorough screen exam with history and physical from a healthcare professional.

Is she exhibiting any other symptoms? Why antibiotics?

Xiadnat:


It should not. If she has extensive scarring, it can be lysed down during C-section. She has already gotten pregnant, so most of the battle is over.

Caracta:


The non-specific measure is what has been dragging this issue. The antibiotics were as a result of re-occurring boils. The antibiotics treat the boils, the ESR drops. After a while, the boils come back, the ESR shoots up.

The doctor said even a thorough screen exam wouldn't pinpoint the cause. Speculations have been made and some ruled out.

Other parameters from the blood scan are normal and within limit...just the high ESR.

Xiadnat:


Then If this individual has had a thorough workup that includes screen for common autoimmune conditions, then it is likely s/he has baseline elevated ESR.

Yes, abscess, boils and skin infections alike can elevate it. I think the question now becomes, how come s/he is having repeated boils?

Chasing a lab number w/o clinical symptomology is rather a waste of time and resource. How old is this person? A she or he? Any other medical history? ESR of 30s isn't too bad. Now, if it is 100s, I'll definitely be more concerned.

I would suggest to treat underlining cause of boils and worry less of the lab number. When/if boil is treated successfully, then, can keep an eye of ESR with semi to annual check to make sure it is not going further up.

Regards

Walexz02:
Good morning doctor, my brother is very ill, he had a fracture in his leg which has refused to heal for over a year now. day before yesterday he went to one of our sister's house who happend to be a nurse to make some complains about his back and she gave him some injections( I think for pain relieve) ever since he took the injection he could not move his legs or body again. Please someone should help us he is becoming a vegetable some one should help us please

Caracta:


Thank you so so so much.

Female. Mid-twenties. Well, if 31 is not too high, then I guess no cause for alarm. The underlining cause of boils led to the full blood scan. Like I said, the boils keep coming back. And I guess, to treat it completely, the cause needs to be known.

So for now, ESR is high. Boils re-occur. Patient confined to antibiotics. This has been the case for almost 6 years now.

Xiadnat:


Is vision affected? Blurry? Double vision? Pain? Discharge? Redness? If non of the above, it's likely benign. Do follow up with eye exam. perhaps a floater, foreign substance?

Xiadnat:



Sure. Have they considered MRSA? I am sure fluid has been cultured and she is getting appropriate abx.

Maybe think about bathing with anti-staph soaps/cleansers like bactroba.n or chlorhexidin.e. Is she overweight and I assume no diabetes?

At last resort, she could get screened for IG deficiency.

Xiadnat:


You did not answer the rest of the questions, or are they negative? Again, do you take any medications, drink caffeinated beverages, under enormous emotional/psychological stress, anxiety/stress? Any other symptoms you notice? Anyone in the family has similar tremor etc?

The most common cause of resting tremor is neurological disorder; parkinsons' disease. What is your age bracket?

I recommend getting a neurological exam and doing some lab tests: thyroid function.

Xiadnat:


Get him to a hospital ASAP if not already done so. The infection has gotten complicated. What is the name of injection given? He may not be walking due to extraordinary pain, but I suspect he has osteomyelitis and potentially progressed to the point of affecting his central neurological system.

He needs urgent evaluation and treatment.

afolayan22:
No I dnt take,bt I work has a briclayer,none of my familly has it.I am 24 this year

Morrewhunmie:
plz doctor
I've noticed that my body temperature is always high.morning, afternoon and night,my body is always warm and this embarrasses me coz most persons have been complaining about it.plz wat can I do .it started sometimes last year.

Fumbaby:
Hi, what could be the cause of transparent salty liquid coming out the br.eas.t, although it very little and it was my dh that noticed it, should I be worried?

Am currently on CD 1 can I start bromergon?

ilesanmioo:
Good morning all, pls I need an emergency advise, although I av called a lot of doctors too, but just to seek more opinion. My cousin lost her first pregnancy at 24wEeks due to premature rupture of membrane. Now she's pregnant and 13weeks, she felt a big discharge so she immediately rushed to d hospital cos she recognised that's its cervical plug, so d doctors did an emergency scan, and discovered her cervix is opened by 0.5cm, and d baby is intact, d inner cervix plug is also intact. The doctor asked her to go home and be on bed rest but she insisted she will stay back in d hospital. Another gynae checked her this morning and said "he thinks she might need a cerlage", but she was treated for uti 2weeks ago. She's been crying all morning, cos her own gynae said he wants a "wait and see approach". Pls what do u guys feel¤

ilesanmioo:
Good morning all, pls I need an emergency advise, although I av called a lot of doctors too, but just to seek more opinion. My cousin lost her first pregnancy at 24wEeks due to premature rupture of membrane. Now she's pregnant and 13weeks, she felt a big discharge so she immediately rushed to d hospital cos she recognised that's its cervical plug, so d doctors did an emergency scan, and discovered her cervix is opened by 0.5cm, and d baby is intact, d inner cervix plug is also intact. The doctor asked her to go home and be on bed rest but she insisted she will stay back in d hospital. Another gynae checked her this morning and said "he thinks she might need a cerlage", but she was treated for uti 2weeks ago. She's been crying all morning, cos her own gynae said he wants a "wait and see approach". Pls what do u guys feel¤

Xiadnat:

Do you have other symptoms? Could screen for malaria and the like.
Are you of menopause age?

cheerios:
Hi doc! it all started as frequent urination,each time I visit d hospital,after test results(urine n blood test) no UTI or excess sugar wud be found..in Feb I noticed I lost my ereection completely&feel a lump-like thing inside my anus.went to d hospital was given drugs to treat hemorriods..it didn't work so I opted for traditional medicine..witin 3days got back my erection&anal pain stoppd.after I finished the drugs,the whole thing came back again..I went for another round,same thing happen after finishing the drugs..so I had no choice than to visit the hospital..I was given Azithromycin,Fluconazole & Secnidazole kit and also Anusol to insert into my anus..I used the drugs but there's still recurrence of both weak ereection& anal lump.so at this point am confused,I browsed the name of the drugs given to me&discovered its used to treat STD but I don't have 1..I am 31yrs never had unprotected sex..please what do I do? Is it that the hospital aren't performing the right test? Cos I have tried 2,they are both HMOs..