The Curbsiders is THE internal medicine podcast that uses expert interviews to bring you clinical pearls, practice-changing knowledge, and bad puns. Supercharge your practice as doctors Matthew Watto, Paul Williams, and friends serve up a little knowledge food for your brain hole. Yummy! No boring lectures here, just the stuff you wish they'd taught in medical school and residency.
Regarding the 6m mark.. is it typical for tremors to start on the right hand? Also, any thoughts on the theory proposed by Heiko Braak that suggests PD starts in the gut and that the alpha synuclein (Lewy body) spreads through the nervous system to the brain.. and that severing the Vagus Nerve (truncal vagotomy) can stop the progression of the disease? Personally, it seems likely that the non-motor-symptoms* that develop decades before tremors or bradykinesia, are a giant clue.. most notably constipation ( increased Akkermansia and decreased SCFAs-producing bacteria). The link between gingivitis and Alzheimer's disease suggest that also may be a bacterial brain infection that doesn't clear. Would love to see a way an accurate way of measuring alpha synuclein, and if if inhaling anti-bacterial essential oils (EOs) / volatile oils (VOs) can cross directly from the nose to the brain, to reduce lewy bodies. *Insomnia dysphonia / low voice volume REM (Sleep) Behavior Disorder (RBD) asymmetry arms not swinging when walking
Excellent episode! Thanks, so long and thanks for all the puns! Sorry, but...just have to say : I'm guessing Dr. Naik's heard all the "Attila the Pun" lines😁
I had gross hematuria for 4 days. Spefic gravity always high. Dr checked bladder via scope and all clear. Plus no infection per urine. Who do i need to see?
6 months carnivore diet, intermediate fasting, sun light for 30 min am pm sun, simple yoga with breathing techniques 2 times a day, grounding for 45 minutes, take care of your gut, supplement: Taurine, magnesium, vitamin D3, B12, Zinc copper. Sleep by 10 pm, anxiety is the main culprit, dont panic, dont read negative comments & stop googling, learn neuroplasticity techniques, with in a year your central nervous system will become normal & you can achieve silence. Tinnitus is not for life.
Sub doesn't help pain..... dnt even tell ppl that bs.... iv been on it since 2015.. i know many ppl on it.. they would laugh hearing it helps with pain 😂😂... but i tell ya what you can 110% mix bupe n oxy together and bupe and lortab together... but yall want tell ppl that... doctors dnt know... most dont... they only know what their classes told em.. most never got addicted but if they ever was put on opiods for a hot min.. they would understand... but they dont... they dont know what it feels like , they dont know what its like living with it.. nor do they know what withdrawal feels like truly... they been told , but experiencing it is totally different.. they wouldn't last 24hours in active withdrawal. It would cripple them n destroy them. Imagine not being able to sleep , at all. Maybe 5 mins per hr. Skin crawling in the arms legs , constantly stretching , yawning , stomach sickness n pain , feverish , eyes watering nose running body feels like its being crushed 24/7 it doesnt stop. It just dissappears after so many days weeks depending.. and when i hear these doctors say they know , or try to act like they know.. i shake my head.. suboxone is fckn evil , that sht had no place in the world of medicine. I been on opiods for a very long time more than half my life. Its trillion × easier to come off oxycodone n lortab then bupe.. its not even a competition.. bupe takes months to come off , oxycodone 2 to 3 day tops.. so why n the fck do that to ppl.?.??? Money... drs charge 100 a week others 150 a week. For it... they are legal drug dealers period.. bupe is a much worse drug then oxy ever was. Drs can taper ppl off oxy easily , you try that with subs your asking for releapse cause 1% can do it n survive that sufering. Bupe fcks the brain so bad its insane. And yet you still wanna push it on ppl... just use lortab n oxycodone to get ppl off opiods. Iv gotten off oxy multiple times. My mistake was choosing to try sub... i dropped to 1/8th a day... n i been on 1/8th sub a day for a yr now.... and here it is day 2.5 and the withdrawal is fckn ridiculous worse than oxy ever was
My dr wants to try me on buph for my severe chronic pain but has stated she isn’t going to take me off Percocet but just add the bup I’m sure she will take me down on the amount of Percocet but not take me off. I’m very nervous to make a change however I’m just not getting the relief much anymore. I’m going to go ahead and try it after I get my shoulder replacement done. I’m not wanting the patch or the film so she said I could do the pill, I hear you saying the pill is more for opioid abuse but can it be used for chronic pain also?
Can Meniere's disease, which causes hearing loss, be cured or improved? I have a 37db hearing loss, what treatment would be better to improve my hearing and resolve the fullness issue, as well as the occasional mild vertigo that lasts for 10 seconds and tinnitus that lasts for 1 minute?"
The problem we're all aware about by now tho with going up on the dose of Oxycodone in this case, is that it's inevitable that this issue will result again and again each time you increase the dose, since Opioids for the most part don't have the phenomenon of a ceiling effect/dose, so technically this could continue as a trend every so often until you've reached hundreds of milligrams per dose. A dose which you'd of course be tolerant to, but wouldn't necessarily relieve your pain, due to the opioid receptors becoming accustomed to the presence of the drug. (please correct me if I'm wrong)
I wish there was an actual cure and diagnosis for aps , I hade dvt in my leg and it took me until I was coughing up blood to go to the hospital , I had pneumonia too . They said there was no direct cause for the aps and no cure just a blood thinner for the rest of my life .
Hi everybody my name is daryl I have a question I have tinnitus vertigo dizzy spell and I have hearing loss my understanding is this sounds like manners. But I was told it's Cristals in me inner ear what your thought
I had extremely heavy utetine bleeding; i had fainted and got tskrn to the emergency room, had 6 units of blood transfusion. All tests for cancer, polyps, bleeding didorders, etc were negative. They tried birth control pills, endometrial ablation, D&C,; nothing worked. They just labeled it as idiopathic.
I had extremely heavy utetine bleeding; i had fainted and got tskrn to the emergency room, had 6 units of blood transfusion. All tests for cancer, polyps, bleeding didorders, etc were negative. They just labeled it as idiopathic.
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I was so happy to see this episode as someone who recently had surgery for PHPT. I'm not a doctor, and I actually had to all but diagnose myself and present the case to my primary. Fortunately, he connected me right away with a surgeon and the next day my surgery was scheduled. Looking back, it's pretty wild that it was missed for years. I had multiple elevated serum calciums going back years (starting borderline at 10.3 mg/dl and trending up), extremely low vitamin D, a DEXA scan showing osteopenia (at age 32, ordered for an unrelated reason), and had recently seen several specialists for my complaints (musculoskeletal pain, headaches, constipation, fatigue, polyuria, polydipsia, etc. -- admittedly vague symptoms). Thank you for tackling this. And curative surgery is a beautiful thing.
The doctor at the hospital gave me medroxyprogesterone and my bleeding got 10× worse went back and the gave me birthcontrol 3x for 3 days 2x for 2 days and 1 time until I finish the package made me throw up the first day on my second day still bleeding help
If I were given bupe for chronic pain, I would be livid beyond comprehension. RX your chronic-pain PTNs a real analgesic, please. Not everyone can even properly metabolize bupe to norbupe. Methadone would be a far, far better treatment modality. This is madness.
Problem is that we are now recognizing that PE can be asymptomatic and CTA positive does not necessarily mean that PE is causative- this issue needs to be explored more.
This situation is almost exactly like the case with the exception of opioid dosage. Often I ran out of pain medication before I was due to get a prescription refill. Withdrawal is seriously debilitating.
Patients will definitely see a giant needle when they are inserting a CGM. However the needle only goes a few millimeters under the skin so it's not as bad as it looks. However, some patients get scared off by this. Source: I am a doctor and I have type 1 diabetes and have been using CGMs for years.
